NAME|CPTNO|CPT|MODIFIER|FULLAMT|PROFAMT|TECHAMT|ANESUNITS|BEGIN DATEDT SH 78001|S8428|S8428 - READY GRADIENT GAUNTLET||43.87|0||0|10/01/2019 SH 78001|S8427|S8427 - READY GRADIENT GLOVE||112.77|0||0|10/01/2019 SH 78001|S8426|S8426 - CUSTOM GRAD GLOVE HEAVY||180.7|0||0|10/01/2019 SH 78001|S8425|S8425 - CUSTOM GRAD GLOVE MED||195|0||0|10/01/2019 SH 78001|S8424|S8424 - READY GRADIENT SLEEVE||78|0||0|10/01/2019 SH 78001|S8423|S8423 - CUSTOM GRAD SLEEVE HEAVY||89.6|0||0|10/01/2019 SH 78001|S8422|S8422 - CUSTOM GRAD SLEEVE MED||130|0||0|10/01/2019 SH 78001|S8421|S8421 - READY GRADIENT SLEEV/GLOV||103.87|0||0|10/01/2019 SH 78001|S8420|S8420 - CUSTOM GRADIENT SLEEV/GLOV||340.92|0||0|10/01/2019 SH 78001|Q9995|Q9995 - INJ. - EMICIZUMAB-KXWH 0.5 MG||61.845|0||0|10/01/2019 SH 78001|Q9993|Q9993 - INJ. - TRIAMCINOLONE EXT REL||23.6013|0||0|10/01/2019 SH 78001|Q9992|Q9992 - INJ - BUPRENORPHINE XR OVER 100 MG||2093.5|0||0|10/01/2019 SH 78001|Q9991|Q9991 - INJ - BUPRENORPHINE XR 100 MG OR LESS||2093.5|0||0|10/01/2019 SH 78001|Q9989|Q9989 - USTEKINUMAB - IV INJECT - 1 MG||16.1|0||0|10/01/2019 SH 78001|Q9979|||2178.99|0||0|10/01/2019 SH 78001|Q9975|||2.38|0||0|10/01/2019 SH 78001|Q9967|Q9967 - LOCM 300-399MG/ML IODINE - 1ML||0.1525|0||0|10/01/2019 SH 78001|Q9966|Q9966 - LOCM 200-299MG/ML IODINE - 1ML||0.42|0||0|10/01/2019 SH 78001|Q9965|Q9965 - LOCM 100-199MG/ML IODINE - 1ML||1.1187|0||0|10/01/2019 SH 78001|Q9964|Q9964 - HOCM>= 400MG/ML IODINE - 1ML||0|0||0|10/01/2019 SH 78001|Q9963|Q9963 - HOCM 350-399MG/ML IODINE - 1ML||0.2587|0||0|10/01/2019 SH 78001|Q9962|Q9962 - HOCM 300-349MG/ML IODINE - 1ML||0|0||0|10/01/2019 SH 78001|Q9961|Q9961 - HOCM 250-299MG/ML IODINE - 1ML||0.3325|0||0|10/01/2019 SH 78001|Q9960|Q9960 - HOCM 200-249MG/ML IODINE - 1ML||0.3013|0||0|10/01/2019 SH 78001|Q9959|Q9959 - HOCM 150-199MG/ML IODINE - 1ML||0|0||0|10/01/2019 SH 78001|Q9958|Q9958 - HOCM <=149 MG/ML IODINE - 1ML||0.0988|0||0|10/01/2019 SH 78001|Q9957|Q9957 - INJ PERFLUTREN LIP MICROS - ML||61.99|0||0|10/01/2019 SH 78001|Q9956|Q9956 - INJ OCTAFLUOROPROPANE MIC - ML||41.3263|0||0|10/01/2019 SH 78001|Q9955|Q9955 - INJ PERFLEXANE LIP MICROS - ML||0|0||0|10/01/2019 SH 78001|Q9954|Q9954 - ORAL MR CONTRAST - 100 ML||0|0||0|10/01/2019 SH 78001|Q9953|Q9953 - INJ FE-BASED MR CONTRAST - 1ML||0|0||0|10/01/2019 SH 78001|Q9951|Q9951 - LOCM >= 400 MG/ML IODINE - 1ML||0|0||0|10/01/2019 SH 78001|Q9950|Q9950 - INJ SULF HEXA LIPID MICROSPH||26.0813|0||0|10/01/2019 SH 78001|Q5106|Q5106 - INJ RETACRIT NON-ESRD USE 1000 UN||14.615|0||0|10/01/2019 SH 78001|Q5105|Q5105 - INJ RETACRIT ESRD ON DIALYSI 100 UN||1.4612|0||0|10/01/2019 SH 78001|Q5104|Q5104 - INJECTION - RENFLEXIS - 10 MG||86.5275|0||0|10/01/2019 SH 78001|Q5103|Q5103 - INJECTION - INFLECTRA - 10 MG||81.2237|0||0|10/01/2019 SH 78001|Q5102|Q5102 - INJ. - INFLIXIMAB BIOSIMILAR||100.24|0||0|10/01/2019 SH 78001|Q5101|Q5101 - INJECTION - ZARXIO - 1 MCG||0.8163|0||0|10/01/2019 SH 78001|Q5010|Q5010 - HOSPICE HOME CARE IN HOSPICE||0|0||0|10/01/2019 SH 78001|Q5009|Q5009 - HOSPICE/HOME HLTH - PLACE NOS||0|0||0|10/01/2019 SH 78001|Q5008|Q5008 - HOSPICE IN INPATIENT PSYCH||0|0||0|10/01/2019 SH 78001|Q5007|Q5007 - HOSPICE IN LTCH||0|0||0|10/01/2019 SH 78001|Q5006|Q5006 - HOSPICE IN HOSPICE FACILITY||0|0||0|10/01/2019 SH 78001|Q5005|Q5005 - HOSPICE - INPATIENT HOSPITAL||0|0||0|10/01/2019 SH 78001|Q5004|Q5004 - HOSPICE IN SNF||0|0||0|10/01/2019 SH 78001|Q5003|Q5003 - HOSPICE IN LT/NON-SKILLED NF||0|0||0|10/01/2019 SH 78001|Q5002|Q5002 - HOSPICE/HOME HLTH IN ASST LV||0|0||0|10/01/2019 SH 78001|Q5001|Q5001 - HOSPICE OR HOME HLTH IN HOME||0|0||0|10/01/2019 SH 78001|Q4172|Q4172 - PURAPLY OR PURAPLY AM||109.5825|0||0|10/01/2019 SH 78001|Q4160|Q4160 - NUSHIELD 1 SQUARE CM||0|0||0|10/01/2019 SH 78001|Q4159|Q4159 - AFFINITY1 SQUARE CM||0|0||0|10/01/2019 SH 78001|Q4158|Q4158 - KERECIS OMEGA3 - PER SQ CM||0|0||0|10/01/2019 SH 78001|Q4157|Q4157 - REVITALON 1 SQUARE CM||0|0||0|10/01/2019 SH 78001|Q4156|Q4156 - NEOX 100 OR CLARIX 100||0|0||0|10/01/2019 SH 78001|Q4155|Q4155 - NEOXFLO OR CLARIXFLO 1 MG||0|0||0|10/01/2019 SH 78001|Q4154|Q4154 - BIOVANCE 1 SQUARE CM||0|0||0|10/01/2019 SH 78001|Q4153|Q4153 - DERMAVEST - PLURIVEST SQ CM||0|0||0|10/01/2019 SH 78001|Q4152|Q4152 - DERMAPURE 1 SQUARE CM||0|0||0|10/01/2019 SH 78001|Q4151|Q4151 - AMNIOBAND - GUARDIAN 1 SQ CM||0|0||0|10/01/2019 SH 78001|Q4150|Q4150 - ALLOWRAP DS OR DRY 1 SQ CM||0|0||0|10/01/2019 SH 78001|Q4149|Q4149 - EXCELLAGEN - 0.1 CC||0|0||0|10/01/2019 SH 78001|Q4148|Q4148 - NEOX NEOX RT OR CLARIX CORD||0|0||0|10/01/2019 SH 78001|Q4147|Q4147 - ARCHITECT ECM PX FX 1 SQ CM||0|0||0|10/01/2019 SH 78001|Q4146|Q4146 - TENSIX - 1 CM||0|0||0|10/01/2019 SH 78001|Q4145|Q4145 - EPIFIX - INJ - 1 MG||0|0||0|10/01/2019 SH 78001|Q4143|Q4143 - REPRIZA - 1 CM||0|0||0|10/01/2019 SH 78001|Q4142|Q4142 - XCM BIOLOGIC TISS MATRIX 1 CM||0|0||0|10/01/2019 SH 78001|Q4141|Q4141 - ALLOSKIN AC - 1 CM||0|0||0|10/01/2019 SH 78001|Q4140|Q4140 - BIODFENCE 1 CM||0|0||0|10/01/2019 SH 78001|Q4139|Q4139 - AMNIO OR BIODMATRIX - INJ 1CC||0|0||0|10/01/2019 SH 78001|Q4138|Q4138 - BIODFENCE DRYFLEX - 1 CM||0|0||0|10/01/2019 SH 78001|Q4137|Q4137 - AMNIOEXCEL BIODEXCEL 1SQ CM||0|0||0|10/01/2019 SH 78001|Q4136|Q4136 - EZDERM||0|0||0|10/01/2019 SH 78001|Q4135|Q4135 - MEDISKIN||0|0||0|10/01/2019 SH 78001|Q4134|Q4134 - HMATRIX||0|0||0|10/01/2019 SH 78001|Q4133|Q4133 - GRAFIX STRAVIX PRIME PL SQCM||165.6075|0||0|10/01/2019 SH 78001|Q4132|Q4132 - GRAFIX CORE - GRAFIXPL CORE||167.3775|0||0|10/01/2019 SH 78001|Q4131|Q4131 - EPIFIX OR EPICORD||200.78|0||0|10/01/2019 SH 78001|Q4130|Q4130 - STRATTICE TM||0|0||0|10/01/2019 SH 78001|Q4129|Q4129 - UNITE BIOMATRIX||0|0||0|10/01/2019 SH 78001|Q4128|Q4128 - FLEXHD/ALLOPATCHHD/MATRIXHD||0|0||0|10/01/2019 SH 78001|Q4127|Q4127 - TALYMED||0|0||0|10/01/2019 SH 78001|Q4126|Q4126 - MEMODERM/DERMA/TRANZ/INTEGUP||0|0||0|10/01/2019 SH 78001|Q4125|Q4125 - ARTHROFLEX||0|0||0|10/01/2019 SH 78001|Q4124|Q4124 - OASIS TRI-LAYER WOUND MATRIX||0|0||0|10/01/2019 SH 78001|Q4123|Q4123 - ALLOSKIN||39.5187|0||0|10/01/2019 SH 78001|Q4122|Q4122 - DERMACELL||0|0||0|10/01/2019 SH 78001|Q4121|Q4121 - THERASKIN||56.1425|0||0|10/01/2019 SH 78001|Q4120|Q4120 - MATRISTEM BURN MATRIX||0|0||0|10/01/2019 SH 78001|Q4119|Q4119 - MATRISTEM WOUND MATRIX||0|0||0|10/01/2019 SH 78001|Q4118|Q4118 - MATRISTEM MICROMATRIX||0|0||0|10/01/2019 SH 78001|Q4117|Q4117 - HYALOMATRIX||0|0||0|10/01/2019 SH 78001|Q4116|Q4116 - ALLODERM||40.38|0||0|10/01/2019 SH 78001|Q4115|Q4115 - ALLOSKIN||12.5925|0||0|10/01/2019 SH 78001|Q4114|Q4114 - INTEGRA FLOWABLE WOUND MATRI||1961.08|0||0|10/01/2019 SH 78001|Q4113|Q4113 - GRAFTJACKET XPRESS||1215.6875|0||0|10/01/2019 SH 78001|Q4112|Q4112 - CYMETRA INJECTABLE||1215.6875|0||0|10/01/2019 SH 78001|Q4111|Q4111 - GAMMAGRAFT||9.6975|0||0|10/01/2019 SH 78001|Q4110|Q4110 - PRIMATRIX||60.14|0||0|10/01/2019 SH 78001|Q4108|Q4108 - INTEGRA MATRIX||45.67|0||0|10/01/2019 SH 78001|Q4107|Q4107 - GRAFTJACKET||114.1025|0||0|10/01/2019 SH 78001|Q4106|Q4106 - DERMAGRAFT||41.3125|0||0|10/01/2019 SH 78001|Q4105|Q4105 - INTEGRA DRT OR OMNIGRAFT||37.28|0||0|10/01/2019 SH 78001|Q4104|Q4104 - INTEGRA BMWD||48.48|0||0|10/01/2019 SH 78001|Q4103|Q4103 - OASIS BURN MATRIX||0|0||0|10/01/2019 SH 78001|Q4102|Q4102 - OASIS WOUND MATRIX||14.04|0||0|10/01/2019 SH 78001|Q4101|Q4101 - APLIGRAF||38.5025|0||0|10/01/2019 SH 78001|Q4100|Q4100 - SKIN SUBSTITUTE - NOS||0|0||0|10/01/2019 SH 78001|Q4082|Q4082 - DRUG/BIO NOC PART B DRUG CAP||0|0||0|10/01/2019 SH 78001|Q4081|Q4081 - EPOETIN ALFA - 100 UNITS ESRD||1.6362|0||0|10/01/2019 SH 78001|Q4074|Q4074 - ILOPROST NON-COMP UNIT DOSE||177.2912|0||0|10/01/2019 SH 78001|Q4051|Q4051 - SPLINT SUPPLIES MISC||0|0||0|10/01/2019 SH 78001|Q4050|Q4050 - CAST SUPPLIES UNLISTED||0|0||0|10/01/2019 SH 78001|Q4049|Q4049 - FINGER SPLINT - STATIC||2.52|0||0|10/01/2019 SH 78001|Q4048|Q4048 - CAST SUP SHT LEG SPLNT PED F||11.12|0||0|10/01/2019 SH 78001|Q4047|Q4047 - CAST SUP SHT LEG SPLNT PED P||6.89|0||0|10/01/2019 SH 78001|Q4046|Q4046 - CAST SUP SHT LEG SPLNT FBRGL||22.22|0||0|10/01/2019 SH 78001|Q4045|Q4045 - CAST SUP SHT LEG SPLNT PLSTR||13.82|0||0|10/01/2019 SH 78001|Q4044|Q4044 - CAST SUP LNG LEG SPLNT PED F||20.33|0||0|10/01/2019 SH 78001|Q4043|Q4043 - CAST SUP LNG LEG SPLNT PED P||11.92|0||0|10/01/2019 SH 78001|Q4042|Q4042 - CAST SUP LNG LEG SPLNT FBRGL||40.64|0||0|10/01/2019 SH 78001|Q4041|Q4041 - CAST SUP LNG LEG SPLNT PLSTR||23.81|0||0|10/01/2019 SH 78001|Q4040|Q4040 - CAST SUP SHRT LEG PED FBRGLS||24.52|0||0|10/01/2019 SH 78001|Q4039|Q4039 - CAST SUP SHRT LEG PED PLSTER||9.8|0||0|10/01/2019 SH 78001|Q4038|Q4038 - CAST SUP SHRT LEG FIBERGLASS||49.04|0||0|10/01/2019 SH 78001|Q4037|Q4037 - CAST SUP SHRT LEG PLASTER||19.57|0||0|10/01/2019 SH 78001|Q4036|Q4036 - CAST SUP LNGLEG CYLNDR PED F||39.92|0||0|10/01/2019 SH 78001|Q4035|Q4035 - CAST SUP LNGLEG CYLNDR PED P||16.04|0||0|10/01/2019 SH 78001|Q4034|Q4034 - CAST SUP LNG LEG CYLINDER FB||79.82|0||0|10/01/2019 SH 78001|Q4033|Q4033 - CAST SUP LNG LEG CYLINDER PL||32.1|0||0|10/01/2019 SH 78001|Q4032|Q4032 - CAST SUP LNG LEG PED FBRGLS||45.29|0||0|10/01/2019 SH 78001|Q4031|Q4031 - CAST SUP LNG LEG PED PLASTER||17.2|0||0|10/01/2019 SH 78001|Q4030|Q4030 - CAST SUP LONG LEG FIBERGLASS||90.58|0||0|10/01/2019 SH 78001|Q4029|Q4029 - CAST SUP LONG LEG PLASTER||34.4|0||0|10/01/2019 SH 78001|Q4028|Q4028 - CAST SUP HIP SPICA PED FBRGL||70.27|0||0|10/01/2019 SH 78001|Q4027|Q4027 - CAST SUP HIP SPICA PED PLSTR||22.51|0||0|10/01/2019 SH 78001|Q4026|Q4026 - CAST SUP HIP SPICA FIBERGLAS||140.48|0||0|10/01/2019 SH 78001|Q4025|Q4025 - CAST SUP HIP SPICA PLASTER||44.99|0||0|10/01/2019 SH 78001|Q4024|Q4024 - CAST SUP SHT ARM SPLNT PED F||7.25|0||0|10/01/2019 SH 78001|Q4023|Q4023 - CAST SUP SHT ARM SPLNT PED P||4.03|0||0|10/01/2019 SH 78001|Q4022|Q4022 - CAST SUP SHT ARM SPLINT FBRG||14.48|0||0|10/01/2019 SH 78001|Q4021|Q4021 - CAST SUP SHT ARM SPLINT PLST||8.03|0||0|10/01/2019 SH 78001|Q4020|Q4020 - CAST SUP LNG ARM SPLNT PED F||8.66|0||0|10/01/2019 SH 78001|Q4019|Q4019 - CAST SUP LNG ARM SPLNT PED P||5.44|0||0|10/01/2019 SH 78001|Q4018|Q4018 - CAST SUP LNG ARM SPLINT FBRG||17.28|0||0|10/01/2019 SH 78001|Q4017|Q4017 - CAST SUP LNG ARM SPLINT PLST||10.85|0||0|10/01/2019 SH 78001|Q4016|Q4016 - CAST SUP GAUNTLET PED FBRGLS||15.8|0||0|10/01/2019 SH 78001|Q4015|Q4015 - CAST SUP GAUNTLET PED PLSTER||9.4|0||0|10/01/2019 SH 78001|Q4014|Q4014 - CAST SUP GAUNTLET FIBERGLASS||31.63|0||0|10/01/2019 SH 78001|Q4013|Q4013 - CAST SUP GAUNTLET PLASTER||18.76|0||0|10/01/2019 SH 78001|Q4012|Q4012 - CAST SUP SHT ARM PED FBRGLAS||11.6|0||0|10/01/2019 SH 78001|Q4011|Q4011 - CAST SUP SHT ARM PED PLASTER||5.14|0||0|10/01/2019 SH 78001|Q4010|Q4010 - CAST SUP SHT ARM ADULT FBRGL||23.2|0||0|10/01/2019 SH 78001|Q4009|Q4009 - CAST SUP SHT ARM ADULT PLSTR||10.31|0||0|10/01/2019 SH 78001|Q4008|Q4008 - CAST SUP LONG ARM PED FBRGLS||17.38|0||0|10/01/2019 SH 78001|Q4007|Q4007 - CAST SUP LONG ARM PED PLSTER||7.73|0||0|10/01/2019 SH 78001|Q4006|Q4006 - CAST SUP LONG ARM ADULT FBRG||34.78|0||0|10/01/2019 SH 78001|Q4005|Q4005 - CAST SUP LONG ARM ADULT PLST||15.43|0||0|10/01/2019 SH 78001|Q4004|Q4004 - CAST SUP SHOULDER CAST FBRGL||144.89|0||0|10/01/2019 SH 78001|Q4003|Q4003 - CAST SUP SHOULDER CAST PLSTR||41.86|0||0|10/01/2019 SH 78001|Q4002|Q4002 - CAST SUP BODY CAST FIBERGLAS||220.24|0||0|10/01/2019 SH 78001|Q4001|Q4001 - CAST SUP BODY CAST PLASTER||58.28|0||0|10/01/2019 SH 78001|Q3031|Q3031 - COLLAGEN SKIN TEST||0|0||0|10/01/2019 SH 78001|Q3028|Q3028 - INJ BETA INTERFERON SQ 1 MCG||0|0||0|10/01/2019 SH 78001|Q3027|Q3027 - INJ BETA INTERFERON IM 1 MCG||67.7188|0||0|10/01/2019 SH 78001|Q3014|Q3014 - TELEHEALTH FACILITY FEE||0|0||0|10/01/2019 SH 78001|Q3001|Q3001 - BRACHYTHERAPY RADIOELEMENTS||0|0||0|10/01/2019 SH 78001|Q2052|Q2052 - IVIG DEMO - SERVICES/SUPPLIES||0|0||0|10/01/2019 SH 78001|Q2050|Q2050 - DOXORUBICIN INJ 10MG||465.615|0||0|10/01/2019 SH 78001|Q2049|Q2049 - IMPORTED LIPODOX INJ||635.54|0||0|10/01/2019 SH 78001|Q2043|Q2043 - SIPULEUCEL-T AUTO CD54+||51915.7937|0||0|10/01/2019 SH 78001|Q2039|Q2039 - INFLUENZA VIRUS VACCINE - NOS||0|0||0|10/01/2019 SH 78001|Q2038|Q2038 - FLUZONE VACC - 3 YRS & > - IM||15.06|0||0|10/01/2019 SH 78001|Q2037|Q2037 - FLUVIRIN VACC - 3 YRS & > - IM||22.1062|0||0|10/01/2019 SH 78001|Q2036|Q2036 - FLULAVAL VACC - 3 YRS & > - IM||0|0||0|10/01/2019 SH 78001|Q2035|Q2035 - AFLURIA VACC - 3 YRS & > - IM||22.1062|0||0|10/01/2019 SH 78001|Q2034|Q2034 - AGRIFLU VACCINE||0|0||0|10/01/2019 SH 78001|Q2028|Q2028 - INJ - SCULPTRA - 0.5 MG||0|0||0|10/01/2019 SH 78001|Q2026|Q2026 - RADIESSE INJECTION||0|0||0|10/01/2019 SH 78001|Q2017|Q2017 - TENIPOSIDE - 50 MG||0|0||0|10/01/2019 SH 78001|Q2009|Q2009 - FOSPHENYTOIN INJ PE||0|0||0|10/01/2019 SH 78001|Q2004|Q2004 - BLADDER CALCULI IRRIG SOL||0|0||0|10/01/2019 SH 78001|Q1005|Q1005 - NTIOL CATEGORY 5||0|0||0|10/01/2019 SH 78001|Q1004|Q1004 - NTIOL CATEGORY 4||0|0||0|10/01/2019 SH 78001|Q0515|Q0515 - SERMORELIN ACETATE INJECTION||0|0||0|10/01/2019 SH 78001|Q0514|Q0514 - DISP FEE INHAL DRUGS/90 DAYS||0|0||0|10/01/2019 SH 78001|Q0513|Q0513 - DISP FEE INHAL DRUGS/30 DAYS||0|0||0|10/01/2019 SH 78001|Q0512|Q0512 - PX SUP FEE ANTI-CAN SUB PRES||0|0||0|10/01/2019 SH 78001|Q0511|Q0511 - SUP FEE ANTIEM - ANTICA - IMMUNO||0|0||0|10/01/2019 SH 78001|Q0510|Q0510 - DISPENS FEE IMMUNOSUPRESSIVE||0|0||0|10/01/2019 SH 78001|Q0509|Q0509 - MIS SUP/AC IMP VAD NOPAY MED||0|0||0|10/01/2019 SH 78001|Q0508|Q0508 - MIS SUP/ACC IMP VAD||0|0||0|10/01/2019 SH 78001|Q0507|Q0507 - MISC SUP/ACC EXT VAD||0|0||0|10/01/2019 SH 78001|Q0506|Q0506 - LITH-ION BATT ELEC/PNEUM VAD||988.27|0||0|10/01/2019 SH 78001|Q0504|Q0504 - PWR ADPT PNEUM VAD - REP VEH||793.93|0||0|10/01/2019 SH 78001|Q0503|Q0503 - BATTERY PNEUM VAD REPLACEMNT||1504.62|0||0|10/01/2019 SH 78001|Q0502|Q0502 - MOBILITY CART PNEUM VAD - REP||752.29|0||0|10/01/2019 SH 78001|Q0501|Q0501 - SHWR COV ELEC/COMBO VAD - REP||590.9|0||0|10/01/2019 SH 78001|Q0500|Q0500 - FILTERS ELEC/COMBO VAD - REP||35.34|0||0|10/01/2019 SH 78001|Q0499|Q0499 - BELT/VEST ELEC/COMBO VAD REP||193.1|0||0|10/01/2019 SH 78001|Q0498|Q0498 - HOLSTER ELEC/COMBO VAD - REP||594.32|0||0|10/01/2019 SH 78001|Q0497|Q0497 - BAT CLPS ELEC/COMB VAD - REP||541.66|0||0|10/01/2019 SH 78001|Q0496|Q0496 - BATTERY ELEC/COMBO VAD - REP||1734.71|0||0|10/01/2019 SH 78001|Q0495|Q0495 - CHARGER ELEC/COMBO VAD - REP||4833.18|0||0|10/01/2019 SH 78001|Q0494|Q0494 - EMR HD PMP ELEC/COMBO - REP||248.26|0||0|10/01/2019 SH 78001|Q0493|Q0493 - EMR PWR CBL COMBO VAD - REP||293.35|0||0|10/01/2019 SH 78001|Q0492|Q0492 - EMR PWR CBL ELEC VAD - REP||103.07|0||0|10/01/2019 SH 78001|Q0491|Q0491 - EMR PWR SOURCE COMBO VAD REP||1278.94|0||0|10/01/2019 SH 78001|Q0490|Q0490 - EMR PWR SOURCE ELEC VAD - REP||813.54|0||0|10/01/2019 SH 78001|Q0489|Q0489 - PWR PCK BASE COMBO VAD - REP||18807.84|0||0|10/01/2019 SH 78001|Q0488|Q0488 - PWR PACK BASE ELEC VAD - REP||0|0||0|10/01/2019 SH 78001|Q0487|Q0487 - LEADS ANY TYPE VAD - REP ONLY||394.98|0||0|10/01/2019 SH 78001|Q0486|Q0486 - MON CABLE ELEC/PNEUM VAD REP||338.53|0||0|10/01/2019 SH 78001|Q0485|Q0485 - MONITOR CABLE ELEC VAD - REP||406.76|0||0|10/01/2019 SH 78001|Q0484|Q0484 - MONITOR ELEC OR COMB VAD REP||4212.98|0||0|10/01/2019 SH 78001|Q0483|Q0483 - MONITOR ELEC VAD - REP||21694.38|0||0|10/01/2019 SH 78001|Q0482|Q0482 - MICROPRCSR CU COMBO VAD - REP||5266.2|0||0|10/01/2019 SH 78001|Q0481|Q0481 - MICROPRCSR CU ELEC VAD - REP||16813.19|0||0|10/01/2019 SH 78001|Q0480|Q0480 - DRIVER PNEUMATIC VAD - REP||104210.65|0||0|10/01/2019 SH 78001|Q0479|Q0479 - POWER MODULE COMBO VAD - REP||13974.72|0||0|10/01/2019 SH 78001|Q0478|Q0478 - POWER ADAPTER - COMBO VAD||212.63|0||0|10/01/2019 SH 78001|Q0181|Q0181 - UNSPECIFIED ORAL ANTI-EMETIC||0|0||0|10/01/2019 SH 78001|Q0180|Q0180 - DOLASETRON MESYLATE ORAL||119.03|0||0|10/01/2019 SH 78001|Q0177|Q0177 - HYDROXYZINE PAMOATE 25MG||0|0||0|10/01/2019 SH 78001|Q0175|Q0175 - PERPHENAZINE 4MG ORAL||0|0||0|10/01/2019 SH 78001|Q0174|Q0174 - THIETHYLPERAZINE MALEATE10MG||0|0||0|10/01/2019 SH 78001|Q0173|Q0173 - TRIMETHOBENZAMIDE HCL 250MG||0|0||0|10/01/2019 SH 78001|Q0169|Q0169 - PROMETHAZINE HCL 12.5MG ORAL||0.0262|0||0|10/01/2019 SH 78001|Q0167|Q0167 - DRONABINOL 2.5MG ORAL||4.0012|0||0|10/01/2019 SH 78001|Q0166|Q0166 - GRANISETRON HCL 1 MG ORAL||1.8413|0||0|10/01/2019 SH 78001|Q0164|Q0164 - PROCHLORPERAZINE MALEATE 5MG||0.0387|0||0|10/01/2019 SH 78001|Q0163|Q0163 - DIPHENHYDRAMINE HCL 50MG||0.34|0||0|10/01/2019 SH 78001|Q0162|Q0162 - ONDANSETRON ORAL||0.0525|0||0|10/01/2019 SH 78001|Q0161|Q0161 - CHLORPROMAZINE HCL 5 MG ORAL||0|0||0|10/01/2019 SH 78001|Q0144|Q0144 - AZITHROMYCIN DIHYDRATE - ORAL||0|0||0|10/01/2019 SH 78001|Q0139|Q0139 - FERUMOXYTOL - ESRD USE||1.2012|0||0|10/01/2019 SH 78001|Q0138|Q0138 - FERUMOXYTOL - NON-ESRD||1.2012|0||0|10/01/2019 SH 78001|Q0115|Q0115 - POST-COITAL MUCOUS EXAM||16.15|0||0|10/01/2019 SH 78001|Q0114|Q0114 - FERN TEST||11.69|0||0|10/01/2019 SH 78001|Q0113|Q0113 - PINWORM EXAMINATIONS||8.83|0||0|10/01/2019 SH 78001|Q0112|Q0112 - POTASSIUM HYDROXIDE PREPS||6.97|0||0|10/01/2019 SH 78001|Q0111|Q0111 - WET MOUNTS/ W PREPARATIONS||6.97|0||0|10/01/2019 SH 78001|Q0092|Q0092 - SET UP PORT XRAY EQUIPMENT||27.53|0||0|10/01/2019 SH 78001|Q0091|Q0091 - OBTAINING SCREEN PAP SMEAR||50.85|0||0|10/01/2019 SH 78001|Q0085|Q0085 - CHEMO BY BOTH INFUSION AND O||0|0||0|10/01/2019 SH 78001|Q0084|Q0084 - CHEMOTHERAPY BY INFUSION||0|0||0|10/01/2019 SH 78001|Q0083|Q0083 - CHEMO BY OTHER THAN INFUSION||0|0||0|10/01/2019 SH 78001|Q0081|Q0081 - INFUSION THER OTHER THAN CHE||0|0||0|10/01/2019 SH 78001|Q0035|Q0035 - CARDIOKYMOGRAPHY||23.62|10.43||0|10/01/2019 SH 78001|P9047|P9047 - ALBUMIN (HUMAN) - 25% - 50ML||66.7975|0||0|10/01/2019 SH 78001|P9046|P9046 - ALBUMIN (HUMAN) - 25% - 20 ML||28.11|0||0|10/01/2019 SH 78001|P9045|P9045 - ALBUMIN (HUMAN) - 5% - 250 ML||68.4|0||0|10/01/2019 SH 78001|P9041|P9041 - ALBUMIN (HUMAN) - 5% - 50ML||14.7487|0||0|10/01/2019 SH 78001|L8696|L8696 - EXT ANTENNA PHREN NERVE STIM||250.81|0||0|10/01/2019 SH 78001|L8695|L8695 - EXTERNAL RECHARG SYS EXTERN||19.27|0||0|10/01/2019 SH 78001|L8694|L8694 - AOI TRANSDUCER/ACTUATOR REPL||1108.03|0||0|10/01/2019 SH 78001|L8693|L8693 - AUD OSSEO DEV - ABUTMENT||1754.5|0||0|10/01/2019 SH 78001|L8691|L8691 - AOI SND PROC REPL EXCL ACTUA||3085.38|0||0|10/01/2019 SH 78001|L8690|L8690 - AUD OSSEO DEV - INT/EXT COMP||5504.35|0||0|10/01/2019 SH 78001|L8689|L8689 - EXTERNAL RECHARG SYS INTERN||1995.85|0||0|10/01/2019 SH 78001|L8684|L8684 - RADIOF TRSMTR IMPLT SCRL NEU||797.35|0||0|10/01/2019 SH 78001|L8683|L8683 - RADIOFQ TRSMTR FOR IMPLT NEU||6071.83|0||0|10/01/2019 SH 78001|L8682|L8682 - IMPLT NEUROSTIM RADIOFQ REC||6898.04|0||0|10/01/2019 SH 78001|L8681|L8681 - PT PRGRM FOR IMPLT NEUROSTIM||1306.87|0||0|10/01/2019 SH 78001|L8679|L8679 - IMP NEUROSTI PLS GN ANY TYPE||9654.64|0||0|10/01/2019 SH 78001|L8670|L8670 - VASCULAR GRAFT - SYNTHETIC||636.91|0||0|10/01/2019 SH 78001|L8659|L8659 - INTERPHALANGEAL JOINT REPL||2232.76|0||0|10/01/2019 SH 78001|L8658|L8658 - INTERPHALANGEAL JOINT SPACER||358.92|0||0|10/01/2019 SH 78001|L8642|L8642 - HALLUX IMPLANT||343.43|0||0|10/01/2019 SH 78001|L8641|L8641 - METATARSAL JOINT IMPLANT||418.38|0||0|10/01/2019 SH 78001|L8631|L8631 - MCP JOINT REPL 2 PC OR MORE||2587|0||0|10/01/2019 SH 78001|L8630|L8630 - METACARPOPHALANGEAL IMPLANT||385.48|0||0|10/01/2019 SH 78001|L8629|L8629 - CID TRANSMIT COIL AND CABLE||207.18|0||0|10/01/2019 SH 78001|L8628|L8628 - CID EXT CONTROLLER REPL||1431.4|0||0|10/01/2019 SH 78001|L8627|L8627 - CID EXT SPEECH PROCESS REPL||7965.08|0||0|10/01/2019 SH 78001|L8625|L8625 - CHARGER COCH IMPL/AOI BATTRY REP EA||221.59|0||0|10/01/2019 SH 78001|L8624|L8624 - LITH ION BATT CID - EAR LEVEL||186.55|0||0|10/01/2019 SH 78001|L8623|L8623 - LITH ION BATT CID - NON-EARLVL||74.84|0||0|10/01/2019 SH 78001|L8622|L8622 - REPL ALKALINE BATTERY||0.37|0||0|10/01/2019 SH 78001|L8621|L8621 - REPL ZINC AIR BATTERY||0.71|0||0|10/01/2019 SH 78001|L8619|L8619 - COCH IMP EXT PROC/CONTR RPLC||9396.47|0||0|10/01/2019 SH 78001|L8618|L8618 - COCH IMPLANT TRAN CABLE REPL||30.32|0||0|10/01/2019 SH 78001|L8617|L8617 - COCH IMPLANT TRANS COIL REPL||106.19|0||0|10/01/2019 SH 78001|L8616|L8616 - COCH IMPLANT MICROPHONE REPL||121.55|0||0|10/01/2019 SH 78001|L8615|L8615 - COCH IMPLANT HEADSET REPLACE||521.86|0||0|10/01/2019 SH 78001|L8614|L8614 - COCHLEAR DEVICE||21905.1|0||0|10/01/2019 SH 78001|L8613|L8613 - OSSICULAR IMPLANT||346.07|0||0|10/01/2019 SH 78001|L8612|L8612 - AQUEOUS SHUNT PROSTHESIS||772.98|0||0|10/01/2019 SH 78001|L8610|L8610 - OCULAR IMPLANT||732.89|0||0|10/01/2019 SH 78001|L8609|L8609 - ARTIFICIAL CORNEA||7538.81|0||0|10/01/2019 SH 78001|L8606|L8606 - SYNTHETIC IMPLNT URINARY 1ML||263.4|0||0|10/01/2019 SH 78001|L8605|L8605 - INJ BULKING AGENT ANAL CANAL||828.73|0||0|10/01/2019 SH 78001|L8603|L8603 - COLLAGEN IMP URINARY 2.5 ML||501.78|0||0|10/01/2019 SH 78001|L8600|L8600 - IMPLANT BREAST SILICONE/EQ||714.48|0||0|10/01/2019 SH 78001|L8515|L8515 - GEL CAP APP DEVICE FOR TRACH||73.02|0||0|10/01/2019 SH 78001|L8514|L8514 - REPL TRACH PUNCTURE DILATOR||109.12|0||0|10/01/2019 SH 78001|L8513|L8513 - TRACH PROS CLEANING DEVICE||6.02|0||0|10/01/2019 SH 78001|L8512|L8512 - GEL CAP FOR TRACH VOICE PROS||2.54|0||0|10/01/2019 SH 78001|L8511|L8511 - INDWELLING TRACH INSERT||84.16|0||0|10/01/2019 SH 78001|L8510|L8510 - VOICE AMPLIFIER||292.4|0||0|10/01/2019 SH 78001|L8509|L8509 - TRACH-ESOPH VOICE PROS MD IN||126.38|0||0|10/01/2019 SH 78001|L8507|L8507 - TRACH-ESOPH VOICE PROS PT IN||48.47|0||0|10/01/2019 SH 78001|L8501|L8501 - TRACHEOSTOMY SPEAKING VALVE||167.71|0||0|10/01/2019 SH 78001|L8500|L8500 - ARTIFICIAL LARYNX||755.11|0||0|10/01/2019 SH 78001|L8485|L8485 - PROS SOCK SINGLE PLY UPPER L||12.72|0||0|10/01/2019 SH 78001|L8480|L8480 - PROS SOCK SINGLE PLY AK||10.54|0||0|10/01/2019 SH 78001|L8470|L8470 - PROS SOCK SINGLE PLY BK||7.63|0||0|10/01/2019 SH 78001|L8465|L8465 - SHRINKER UPPER LIMB||74.41|0||0|10/01/2019 SH 78001|L8460|L8460 - SHRINKER ABOVE KNEE||83.48|0||0|10/01/2019 SH 78001|L8440|L8440 - SHRINKER BELOW KNEE||59.99|0||0|10/01/2019 SH 78001|L8435|L8435 - PROS SOCK MULTI PLY UPPER LM||28.3|0||0|10/01/2019 SH 78001|L8430|L8430 - PROSTHETIC SOCK MULTI PLY AK||31.54|0||0|10/01/2019 SH 78001|L8420|L8420 - PROSTHETIC SOCK MULTI PLY BK||28.68|0||0|10/01/2019 SH 78001|L8417|L8417 - PROS SHEATH/SOCK W GEL CUSHN||87|0||0|10/01/2019 SH 78001|L8415|L8415 - SHEATH UPPER LIMB||24.53|0||0|10/01/2019 SH 78001|L8410|L8410 - SHEATH ABOVE KNEE||24.67|0||0|10/01/2019 SH 78001|L8400|L8400 - SHEATH BELOW KNEE||21.68|0||0|10/01/2019 SH 78001|L8330|L8330 - TRUSS ADD TO STD PAD SCROTAL||74.18|0||0|10/01/2019 SH 78001|L8320|L8320 - TRUSS ADDITION TO STD PAD WA||74.84|0||0|10/01/2019 SH 78001|L8310|L8310 - TRUSS DOUBLE W/ STANDARD PAD||171.34|0||0|10/01/2019 SH 78001|L8300|L8300 - TRUSS SINGLE W/ STANDARD PAD||111.43|0||0|10/01/2019 SH 78001|L8047|L8047 - NASAL SEPTAL PROSTHESIS||1552.93|0||0|10/01/2019 SH 78001|L8046|L8046 - PARTIAL FACIAL PROSTHESIS||3030.14|0||0|10/01/2019 SH 78001|L8045|L8045 - AURICULAR PROSTHESIS||2941.21|0||0|10/01/2019 SH 78001|L8044|L8044 - HEMI-FACIAL PROSTHESIS||4696.72|0||0|10/01/2019 SH 78001|L8043|L8043 - UPPER FACIAL PROSTHESIS||4242.2|0||0|10/01/2019 SH 78001|L8042|L8042 - ORBITAL PROSTHESIS||3787.68|0||0|10/01/2019 SH 78001|L8041|L8041 - MIDFACIAL PROSTHESIS||3371.05|0||0|10/01/2019 SH 78001|L8040|L8040 - NASAL PROSTHESIS||2796.83|0||0|10/01/2019 SH 78001|L8035|L8035 - CUSTOM BREAST PROSTHESIS||4239.06|0||0|10/01/2019 SH 78001|L8032|L8032 - REUSABLE NIPPLE PROSTHESIS||45.32|0||0|10/01/2019 SH 78001|L8031|L8031 - BREAST PROSTHESIS W ADHESIVE||377.32|0||0|10/01/2019 SH 78001|L8030|L8030 - BREAST PROSTHES W/O ADHESIVE||377.32|0||0|10/01/2019 SH 78001|L8020|L8020 - MASTECTOMY FORM||260.84|0||0|10/01/2019 SH 78001|L8015|L8015 - EXT BREASTPROSTHESIS GARMENT||69.35|0||0|10/01/2019 SH 78001|L8010|L8010 - MASTECTOMY SLEEVE||54|0||0|10/01/2019 SH 78001|L8002|L8002 - BRST PRSTH BRA & BILAT FORM||190.91|0||0|10/01/2019 SH 78001|L8001|L8001 - BREAST PROSTHESIS BRA & FORM||145.13|0||0|10/01/2019 SH 78001|L8000|L8000 - MASTECTOMY BRA||50.33|0||0|10/01/2019 SH 78001|L7700|L7700 - PROS SOC INSERT GASKET/SEAL||130.94|0||0|10/01/2019 SH 78001|L7405|L7405 - ADD UE PROST S/D ACRYLIC||841.08|0||0|10/01/2019 SH 78001|L7404|L7404 - ADD UE PROST A/E ACRYLIC||643.08|0||0|10/01/2019 SH 78001|L7403|L7403 - ADD UE PROST B/E ACRYLIC||426.12|0||0|10/01/2019 SH 78001|L7402|L7402 - ADD UE PROST S/D ULTLITE MAT||428.7|0||0|10/01/2019 SH 78001|L7401|L7401 - ADD UE PROST A/E ULTLITE MAT||397.01|0||0|10/01/2019 SH 78001|L7400|L7400 - ADD UE PROST BE/WD - ULTLITE||354.64|0||0|10/01/2019 SH 78001|L7368|L7368 - LITHIUM ION BATTERY CHARGER||583.97|0||0|10/01/2019 SH 78001|L7367|L7367 - REPLACEMNT LITHIUM IONBATTER||450.46|0||0|10/01/2019 SH 78001|L7366|L7366 - BATTERY CHRGR 12 VOLT UTAH/E||614.16|0||0|10/01/2019 SH 78001|L7364|L7364 - TWELVE VOLT BATTERY UTAH/EQU||455.93|0||0|10/01/2019 SH 78001|L7362|L7362 - BATTERY CHRGR SIX VOLT OTTO||286.67|0||0|10/01/2019 SH 78001|L7360|L7360 - SIX VOLT BAT OTTO BOCK/EQ EA||273.01|0||0|10/01/2019 SH 78001|L7259|L7259 - ELECTRONIC WRIST ROTATOR ANY||3656.72|0||0|10/01/2019 SH 78001|L7191|L7191 - ELBOW CHILD MYOELECTRONIC CT||10575.79|0||0|10/01/2019 SH 78001|L7190|L7190 - ELBOW ADOLESCENT MYOELECTRON||8832.23|0||0|10/01/2019 SH 78001|L7186|L7186 - ELECTRON ELBOW CHILD SWITCH||10120.94|0||0|10/01/2019 SH 78001|L7185|L7185 - ELECTRON ELBOW ADOLESCENT SW||8408.92|0||0|10/01/2019 SH 78001|L7181|L7181 - ELECTRONIC ELBO SIMULTANEOUS||46361.38|0||0|10/01/2019 SH 78001|L7180|L7180 - ELECTRONIC ELBOW SEQUENTIAL||37377.18|0||0|10/01/2019 SH 78001|L7170|L7170 - ELECTRONIC ELBOW HOSMER SWIT||8515.25|0||0|10/01/2019 SH 78001|L7045|L7045 - PEDIATRIC ELECTRIC HOOK||1849.38|0||0|10/01/2019 SH 78001|L7040|L7040 - PREHENSILE ACTUATOR||3225.66|0||0|10/01/2019 SH 78001|L7009|L7009 - ADULT ELECTRIC HOOK||4017.2|0||0|10/01/2019 SH 78001|L7008|L7008 - PEDIATRIC ELECTRIC HAND||6196.75|0||0|10/01/2019 SH 78001|L7007|L7007 - ADULT ELECTRIC HAND||3937.21|0||0|10/01/2019 SH 78001|L6975|L6975 - INTERSCAP-THOR MYOELECTRONIC||18814.92|0||0|10/01/2019 SH 78001|L6970|L6970 - INTERSCAPULAR-THOR SWITCH CT||17203.34|0||0|10/01/2019 SH 78001|L6965|L6965 - SHLDR DISARTIC MYOELECTRONIC||16509.67|0||0|10/01/2019 SH 78001|L6960|L6960 - SHLDR DISARTIC SWITCH CONTRO||15479.71|0||0|10/01/2019 SH 78001|L6955|L6955 - ABOVE ELBOW MYOELECTRONIC CT||13665.59|0||0|10/01/2019 SH 78001|L6950|L6950 - ABOVE ELBOW SWITCH CONTROL||11410.48|0||0|10/01/2019 SH 78001|L6945|L6945 - ELBOW DISART MYOELECTRONIC C||12266.17|0||0|10/01/2019 SH 78001|L6940|L6940 - ELBOW DISARTICULATION SWITCH||10038.77|0||0|10/01/2019 SH 78001|L6935|L6935 - BELOW ELBOW MYOELECTRONIC CT||10438.87|0||0|10/01/2019 SH 78001|L6930|L6930 - BELOW ELBOW SWITCH CONTROL||7683.32|0||0|10/01/2019 SH 78001|L6925|L6925 - WRIST DISART MYOELECTRONIC C||10279.34|0||0|10/01/2019 SH 78001|L6920|L6920 - WRIST DISARTICUL SWITCH CTRL||7635.97|0||0|10/01/2019 SH 78001|L6915|L6915 - HAND RESTORATION REPLACMNT G||875.82|0||0|10/01/2019 SH 78001|L6910|L6910 - HAND RESTORATION NO FINGERS||1737.1|0||0|10/01/2019 SH 78001|L6905|L6905 - HAND RESTORATION MULTIPLE FI||2031.46|0||0|10/01/2019 SH 78001|L6900|L6900 - HAND RESTORAT THUMB/1 FINGER||2043.07|0||0|10/01/2019 SH 78001|L6895|L6895 - CUSTOM GLOVE FOR TERM DEVICE||715.93|0||0|10/01/2019 SH 78001|L6890|L6890 - PREFAB GLOVE FOR TERM DEVICE||194.6|0||0|10/01/2019 SH 78001|L6885|L6885 - REPLC SOCKT SHLDR DIS/INTERC||4030.57|0||0|10/01/2019 SH 78001|L6884|L6884 - REPLC SOCKT ABOVE ELBOW DISA||2694.85|0||0|10/01/2019 SH 78001|L6883|L6883 - REPLC SOCKT BELOW E/W DISA||1815.68|0||0|10/01/2019 SH 78001|L6882|L6882 - MICROPROCESSOR CONTROL UPLMB||3588.23|0||0|10/01/2019 SH 78001|L6881|L6881 - TERM DEV AUTO GRASP FEATURE||4730.35|0||0|10/01/2019 SH 78001|L6880|L6880 - ELEC HAND IND ART DIGITS||27645.23|0||0|10/01/2019 SH 78001|L6810|L6810 - TERM DEV PRECISION PINCH DEV||220.66|0||0|10/01/2019 SH 78001|L6805|L6805 - TERM DEV MODIFIER WRIST UNIT||389.29|0||0|10/01/2019 SH 78001|L6722|L6722 - HOOK/HAND - HVY DTY - VOL CLOS||2346.02|0||0|10/01/2019 SH 78001|L6721|L6721 - HOOK/HAND - HVY DTY - VOL OPEN||2721.4|0||0|10/01/2019 SH 78001|L6715|L6715 - TERM DEVICE - MULTI ART DIGIT||3653.04|0||0|10/01/2019 SH 78001|L6714|L6714 - PED TERM DEV - HAND - VOL CLOS||1531.12|0||0|10/01/2019 SH 78001|L6713|L6713 - PED TERM DEV - HAND - VOL OPEN||1807.67|0||0|10/01/2019 SH 78001|L6712|L6712 - PED TERM DEV - HOOK - VOL CLOS||1432.3|0||0|10/01/2019 SH 78001|L6711|L6711 - PED TERM DEV - HOOK - VOL OPEN||777.9|0||0|10/01/2019 SH 78001|L6709|L6709 - TERM DEV MECH HAND VOL CLOSE||1386.22|0||0|10/01/2019 SH 78001|L6708|L6708 - TERM DEV MECH HAND VOL OPEN||961.97|0||0|10/01/2019 SH 78001|L6707|L6707 - TERM DEV MECH HOOK VOL CLOSE||1471.5|0||0|10/01/2019 SH 78001|L6706|L6706 - TERM DEV MECH HOOK VOL OPEN||399.23|0||0|10/01/2019 SH 78001|L6704|L6704 - TERM DEV - SPORT/REC/WORK ATT||670.08|0||0|10/01/2019 SH 78001|L6703|L6703 - TERM DEV - PASSIVE HAND MITT||415.96|0||0|10/01/2019 SH 78001|L6698|L6698 - BELOW/ABOVE ELBOW LOCK MECH||657.92|0||0|10/01/2019 SH 78001|L6697|L6697 - CUS ELBO SKT IN NOT CON/ATYP||1522.01|0||0|10/01/2019 SH 78001|L6696|L6696 - CUS ELBO SKT IN FOR CON/ATYP||1522.01|0||0|10/01/2019 SH 78001|L6695|L6695 - ELBOW SOCKET INS USE W/O LCK||677.95|0||0|10/01/2019 SH 78001|L6694|L6694 - ELBOW SOCKET INS USE W/LOCK||813.58|0||0|10/01/2019 SH 78001|L6693|L6693 - LOCKINGELBOW FOREARM CNTRBAL||3284.88|0||0|10/01/2019 SH 78001|L6692|L6692 - SILICONE GEL INSERT OR EQUAL||639.86|0||0|10/01/2019 SH 78001|L6691|L6691 - REMOVABLE INSERT EACH||396.42|0||0|10/01/2019 SH 78001|L6690|L6690 - FRAME TYP SOCK INTERSCAP-THO||856.48|0||0|10/01/2019 SH 78001|L6689|L6689 - FRAME TYP SOCKET SHOULDER DI||785.96|0||0|10/01/2019 SH 78001|L6688|L6688 - FRAME TYP SOCK ABOVE ELB/DIS||656|0||0|10/01/2019 SH 78001|L6687|L6687 - FRAME TYP SOCKET BEL ELBOW/W||659.98|0||0|10/01/2019 SH 78001|L6686|L6686 - SUCTION SOCKET||900.65|0||0|10/01/2019 SH 78001|L6684|L6684 - TEST SOCKET SHLDR DISART/THO||398.83|0||0|10/01/2019 SH 78001|L6682|L6682 - TEST SOCK ELBW DISART/ABOVE||293.51|0||0|10/01/2019 SH 78001|L6680|L6680 - TEST SOCK WRIST DISART/BEL E||265.46|0||0|10/01/2019 SH 78001|L6677|L6677 - UE TRIPLE CONTROL HARNESS||343.28|0||0|10/01/2019 SH 78001|L6676|L6676 - HARNESS FIGURE OF 8 DUAL CON||158.83|0||0|10/01/2019 SH 78001|L6675|L6675 - HARNESS FIGURE OF 8 SING CON||137.41|0||0|10/01/2019 SH 78001|L6672|L6672 - HARNESS CHEST/SHLDER SADDLE||231.22|0||0|10/01/2019 SH 78001|L6670|L6670 - HOOK TO HAND CABLE ADAPTER||58.26|0||0|10/01/2019 SH 78001|L6665|L6665 - TEFLON OR EQUAL CABLE LINING||52.69|0||0|10/01/2019 SH 78001|L6660|L6660 - HEAVY DUTY CONTROL CABLE||105.02|0||0|10/01/2019 SH 78001|L6655|L6655 - STANDARD CONTROL CABLE EXTRA||93.71|0||0|10/01/2019 SH 78001|L6650|L6650 - SHOULDER UNIVERSAL JOINT||476.81|0||0|10/01/2019 SH 78001|L6648|L6648 - EXT PWRD SHLDER LOCK/UNLOCK||3763.8|0||0|10/01/2019 SH 78001|L6647|L6647 - SHOULDER LOCK ACTUATOR||600.79|0||0|10/01/2019 SH 78001|L6646|L6646 - MULTIPO LOCKING SHOULDER JNT||3649.38|0||0|10/01/2019 SH 78001|L6645|L6645 - SHOULDER FLEXION-ABDUCTION J||459.24|0||0|10/01/2019 SH 78001|L6642|L6642 - EXCURSION AMPLIFIER LEVER TY||248.8|0||0|10/01/2019 SH 78001|L6641|L6641 - EXCURSION AMPLIFIER PULLEY T||183.55|0||0|10/01/2019 SH 78001|L6640|L6640 - SHOULDER ABDUCTION JOINT PAI||381.86|0||0|10/01/2019 SH 78001|L6638|L6638 - ELEC LOCK ON MANUAL PW ELBOW||2893.51|0||0|10/01/2019 SH 78001|L6637|L6637 - NUDGE CONTROL ELBOW LOCK||429.84|0||0|10/01/2019 SH 78001|L6635|L6635 - LIFT ASSIST FOR ELBOW||201.53|0||0|10/01/2019 SH 78001|L6632|L6632 - LATEX SUSPENSION SLEEVE EACH||85.64|0||0|10/01/2019 SH 78001|L6630|L6630 - STAINLESS STEEL ANY WRIST||246.59|0||0|10/01/2019 SH 78001|L6629|L6629 - LAMINATION COLLAR W/ COUPLIN||167.4|0||0|10/01/2019 SH 78001|L6628|L6628 - QUICK DISCONN HOOK ADAPTER O||548.12|0||0|10/01/2019 SH 78001|L6625|L6625 - ROTATION WRST W/ CABLE LOCK||695.32|0||0|10/01/2019 SH 78001|L6624|L6624 - FLEX/EXT/ROTATION WRIST UNIT||4357.58|0||0|10/01/2019 SH 78001|L6623|L6623 - SPRING-ASS ROT WRST W/ LATCH||978.6|0||0|10/01/2019 SH 78001|L6621|L6621 - FLEX/EXT WRIST W/WO FRICTION||2646.52|0||0|10/01/2019 SH 78001|L6620|L6620 - FLEXION/EXTENSION WRIST UNIT||350.82|0||0|10/01/2019 SH 78001|L6616|L6616 - DISCONNECT INSERT LOCKING WR||81.25|0||0|10/01/2019 SH 78001|L6615|L6615 - DISCONNECT LOCKING WRIST UNI||219.28|0||0|10/01/2019 SH 78001|L6611|L6611 - ADDITIONAL SWITCH - EXT POWER||476.36|0||0|10/01/2019 SH 78001|L6610|L6610 - FLEXIBLE METAL HINGE PAIR||203.51|0||0|10/01/2019 SH 78001|L6605|L6605 - SINGLE PIVOT HINGE PAIR||211.92|0||0|10/01/2019 SH 78001|L6600|L6600 - POLYCENTRIC HINGE PAIR||214.62|0||0|10/01/2019 SH 78001|L6590|L6590 - SHDR FAIR LEAD CABLE DIRECT||3171.97|0||0|10/01/2019 SH 78001|L6588|L6588 - SHDR FAIR LEAD CABLE MOLDED||3339.48|0||0|10/01/2019 SH 78001|L6586|L6586 - ELBOW FAIR LEAD CABLE DIR FO||2541.5|0||0|10/01/2019 SH 78001|L6584|L6584 - ELBOW FAIR LEAD CABLE MOLDED||2715.74|0||0|10/01/2019 SH 78001|L6582|L6582 - WRIST/ELBOW BOWDEN CBL DIR F||1731.7|0||0|10/01/2019 SH 78001|L6580|L6580 - WRIST/ELBOW BOWDEN CABLE MOL||1911.92|0||0|10/01/2019 SH 78001|L6570|L6570 - SCAP THORAC PROSTH TISS SHAP||5007.95|0||0|10/01/2019 SH 78001|L6550|L6550 - SHLDR DISAR PROSTH TISS SHAP||4460.51|0||0|10/01/2019 SH 78001|L6500|L6500 - ABOVE ELBOW PROSTH TISS SHAP||3710.86|0||0|10/01/2019 SH 78001|L6450|L6450 - ELB DISART PROSTH TISS SHAP||3546.95|0||0|10/01/2019 SH 78001|L6400|L6400 - BELOW ELBOW PROSTH TISS SHAP||2654.96|0||0|10/01/2019 SH 78001|L6388|L6388 - POSTOP APPLICAT RIGID DSG ON||503|0||0|10/01/2019 SH 78001|L6386|L6386 - POSTOP EA CAST CHG & REALIGN||459.49|0||0|10/01/2019 SH 78001|L6384|L6384 - POSTOP DSG CAST CHG SHLDER/T||2908.68|0||0|10/01/2019 SH 78001|L6382|L6382 - POSTOP DSG CAST CHG ELB DIS/||2102.57|0||0|10/01/2019 SH 78001|L6380|L6380 - POSTOP DSG CAST CHG WRST/ELB||1397.57|0||0|10/01/2019 SH 78001|L6370|L6370 - THORACIC PASSIVE RESTOR CAP||2411.77|0||0|10/01/2019 SH 78001|L6360|L6360 - THORACIC PASSIVE RESTOR COMP||4030.57|0||0|10/01/2019 SH 78001|L6350|L6350 - THORACIC INTERN LOCK ELBOW||4481.69|0||0|10/01/2019 SH 78001|L6320|L6320 - SHOULDER PASSIVE RESTOR CAP||2010.7|0||0|10/01/2019 SH 78001|L6310|L6310 - SHOULDER PASSIVE RESTOR COMP||3680.74|0||0|10/01/2019 SH 78001|L6300|L6300 - SHLDER DISART INT LOCK ELBOW||4262.81|0||0|10/01/2019 SH 78001|L6250|L6250 - ELBOW INTER LOC ELBOW FORARM||3270.54|0||0|10/01/2019 SH 78001|L6205|L6205 - ELBOW MOLDED W/ EXPAND INTER||4166.62|0||0|10/01/2019 SH 78001|L6200|L6200 - ELBOW MOLD OUTSID LOCK HINGE||3121.43|0||0|10/01/2019 SH 78001|L6130|L6130 - ELBOW STUMP ACTIVATED LOCK H||2961.97|0||0|10/01/2019 SH 78001|L6120|L6120 - ELBOW MOLD DOUB SPLT SOC STE||2721.94|0||0|10/01/2019 SH 78001|L6110|L6110 - ELBOW MOLD SOCK SUSPENSION T||2335.7|0||0|10/01/2019 SH 78001|L6100|L6100 - ELB MOLD SOCK FLEX HINGE PAD||2202.11|0||0|10/01/2019 SH 78001|L6055|L6055 - WRST MOLD SOCK W/EXP INTERFA||3029.32|0||0|10/01/2019 SH 78001|L6050|L6050 - WRST MLD SCK FLX HNG TRI PAD||2173.51|0||0|10/01/2019 SH 78001|L6026|L6026 - PART HAND MYO EXCLU TERM DEV||5719.69|0||0|10/01/2019 SH 78001|L6020|L6020 - PART HAND NO FINGERS||1577.34|0||0|10/01/2019 SH 78001|L6010|L6010 - PART HAND LITTLE/RING||1691.81|0||0|10/01/2019 SH 78001|L6000|L6000 - PART HAND THUMB REM||1520.27|0||0|10/01/2019 SH 78001|L5990|L5990 - USER ADJUSTABLE HEEL HEIGHT||2099.16|0||0|10/01/2019 SH 78001|L5988|L5988 - VERTICAL SHOCK REDUCING PYLO||2311.46|0||0|10/01/2019 SH 78001|L5987|L5987 - SHANK FT W VERT LOAD PYLON||8323.64|0||0|10/01/2019 SH 78001|L5986|L5986 - MULTI-AXIAL ROTATION UNIT||725.05|0||0|10/01/2019 SH 78001|L5985|L5985 - LWR EXT DYNAMIC PROSTH PYLON||326.74|0||0|10/01/2019 SH 78001|L5984|L5984 - ENDOSKELETAL AXIAL ROTATION||651.82|0||0|10/01/2019 SH 78001|L5982|L5982 - EXOSKELETAL AXIAL ROTATION U||661.46|0||0|10/01/2019 SH 78001|L5981|L5981 - FLEX-WALK SYS LOW EXT PROSTH||3427.2|0||0|10/01/2019 SH 78001|L5980|L5980 - FLEX FOOT SYSTEM||4242.3|0||0|10/01/2019 SH 78001|L5979|L5979 - MULTI-AXIAL ANKLE/FT PROSTH||2610.76|0||0|10/01/2019 SH 78001|L5978|L5978 - FT PROSTH MULTIAXIAL ANKL/FT||333.91|0||0|10/01/2019 SH 78001|L5976|L5976 - ENERGY STORING FOOT||640.76|0||0|10/01/2019 SH 78001|L5975|L5975 - COMBO ANKLE/FOOT PROSTHESIS||536.44|0||0|10/01/2019 SH 78001|L5974|L5974 - FOOT SINGLE AXIS ANKLE/FOOT||266.63|0||0|10/01/2019 SH 78001|L5973|L5973 - ANK-FOOT SYS DORS-PLANT FLEX||19906.97|0||0|10/01/2019 SH 78001|L5972|L5972 - FLEXIBLE KEEL FOOT||434.05|0||0|10/01/2019 SH 78001|L5971|L5971 - SACH FOOT - REPLACEMENT||232.38|0||0|10/01/2019 SH 78001|L5970|L5970 - FOOT EXTERNAL KEEL SACH FOOT||232.38|0||0|10/01/2019 SH 78001|L5968|L5968 - MULTIAXIAL ANKLE W DORSIFLEX||4204.7|0||0|10/01/2019 SH 78001|L5966|L5966 - HIP FLEXIBLE COVER SYSTEM||1365.42|0||0|10/01/2019 SH 78001|L5964|L5964 - ABOVE KNEE FLEX COVER SYSTEM||1071.56|0||0|10/01/2019 SH 78001|L5962|L5962 - BELOW KNEE FLEX COVER SYSTEM||725.92|0||0|10/01/2019 SH 78001|L5961|L5961 - ENDO POLY HIP - PNEU/HYD/ROT||5259.74|0||0|10/01/2019 SH 78001|L5960|L5960 - ENDO HIP ULTRA-LIGHT MATERIA||1103.04|0||0|10/01/2019 SH 78001|L5950|L5950 - ENDO AK ULTRA-LIGHT MATERIAL||897.38|0||0|10/01/2019 SH 78001|L5940|L5940 - ENDO BK ULTRA-LIGHT MATERIAL||573.94|0||0|10/01/2019 SH 78001|L5930|L5930 - HIGH ACTIVITY KNEE FRAME||3894.55|0||0|10/01/2019 SH 78001|L5925|L5925 - ABOVE KNEE MANUAL LOCK||512.6|0||0|10/01/2019 SH 78001|L5920|L5920 - ENDO AK/HIP ALIGNABLE SYSTEM||607.09|0||0|10/01/2019 SH 78001|L5910|L5910 - ENDO BELOW KNEE ALIGNABLE SY||414.4|0||0|10/01/2019 SH 78001|L5859|L5859 - KNEE-SHIN PRO FLEX/EXT CONT||16788.25|0||0|10/01/2019 SH 78001|L5858|L5858 - STANCE PHASE ONLY||21504.32|0||0|10/01/2019 SH 78001|L5857|L5857 - ELEC KNEE-SHIN SWING ONLY||9856.07|0||0|10/01/2019 SH 78001|L5856|L5856 - ELEC KNEE-SHIN SWING/STANCE||27776.38|0||0|10/01/2019 SH 78001|L5855|L5855 - MECH HIP EXTENSION ASSIST||393.3|0||0|10/01/2019 SH 78001|L5850|L5850 - ENDO AK/HIP KNEE EXTENS ASSI||146.38|0||0|10/01/2019 SH 78001|L5848|L5848 - KNEE-SHIN SYS HYDRAUL STANCE||1244.2|0||0|10/01/2019 SH 78001|L5845|L5845 - KNEE-SHIN SYS STANCE FLEXION||2073.91|0||0|10/01/2019 SH 78001|L5840|L5840 - MULTI-AXIAL KNEE/SHIN SYSTEM||4014.43|0||0|10/01/2019 SH 78001|L5830|L5830 - ENDO KNEE-SHIN PNEUM/SWG PHA||2171.12|0||0|10/01/2019 SH 78001|L5828|L5828 - ENDO KNEE-SHIN FLUID SWG/STA||3231.1|0||0|10/01/2019 SH 78001|L5826|L5826 - MINIATURE KNEE JOINT||3613.38|0||0|10/01/2019 SH 78001|L5824|L5824 - ENDO KNEE-SHIN FLUID SWING P||1754.68|0||0|10/01/2019 SH 78001|L5822|L5822 - ENDO KNEE-SHIN PNEUM SWG FRC||1948.43|0||0|10/01/2019 SH 78001|L5818|L5818 - ENDO KNEE-SHIN FRCT SWG & ST||1098.79|0||0|10/01/2019 SH 78001|L5816|L5816 - ENDO KNEE-SHIN POLYC MCH STA||978.92|0||0|10/01/2019 SH 78001|L5814|L5814 - ENDO KNEE-SHIN HYDRAL SWG PH||4297.19|0||0|10/01/2019 SH 78001|L5812|L5812 - ENDO KNEE-SHIN FRCT SWG & ST||646.8|0||0|10/01/2019 SH 78001|L5811|L5811 - ENDO KNEE-SHIN MNL LCK ULTRA||834.47|0||0|10/01/2019 SH 78001|L5810|L5810 - ENDOSKEL KNEE-SHIN MNL LOCK||557.06|0||0|10/01/2019 SH 78001|L5795|L5795 - EXOSKEL HIP ULTRA-LIGHT MATE||1638|0||0|10/01/2019 SH 78001|L5790|L5790 - EXOSKELETAL AK ULTRA-LIGHT M||822.7|0||0|10/01/2019 SH 78001|L5785|L5785 - EXOSKELETAL BK ULTRALT MATER||736.37|0||0|10/01/2019 SH 78001|L5782|L5782 - HD LOW LIMB PROS VACUUM PUMP||4880.69|0||0|10/01/2019 SH 78001|L5781|L5781 - LOWER LIMB PROS VACUUM PUMP||4629.62|0||0|10/01/2019 SH 78001|L5780|L5780 - KNEE-SHIN PNEUM/HYDRA PNEUM||1309.99|0||0|10/01/2019 SH 78001|L5728|L5728 - KNEE-SHIN FLUID SWG & STANCE||2722.58|0||0|10/01/2019 SH 78001|L5726|L5726 - KNEE-SHIN EXT JNTS FLD SWG E||1990.38|0||0|10/01/2019 SH 78001|L5724|L5724 - KNEE-SHIN EXO FLUID SWING PH||1727.05|0||0|10/01/2019 SH 78001|L5722|L5722 - KNEE-SHIN PNEUM SWG FRCT EXO||1101.17|0||0|10/01/2019 SH 78001|L5718|L5718 - KNEE-SHIN EXO FRCT SWG & STA||1042.32|0||0|10/01/2019 SH 78001|L5716|L5716 - KNEE-SHIN EXO MECH STANCE PH||833.93|0||0|10/01/2019 SH 78001|L5714|L5714 - KNEE-SHIN EXO VARIABLE FRICT||514.72|0||0|10/01/2019 SH 78001|L5712|L5712 - KNEE-SHIN EXO FRICT SWG & ST||501.1|0||0|10/01/2019 SH 78001|L5711|L5711 - KNEE-SHIN EXO MNL LOCK ULTRA||598.04|0||0|10/01/2019 SH 78001|L5710|L5710 - KNE-SHIN EXO SNG AXI MNL LOC||427.91|0||0|10/01/2019 SH 78001|L5707|L5707 - CUSTOM SHAPE CVR HIP DISART||1416.19|0||0|10/01/2019 SH 78001|L5706|L5706 - CUSTOM SHAPE CVR KNEE DISART||1074.22|0||0|10/01/2019 SH 78001|L5705|L5705 - CUSTOM SHAPE COVER AK||1095.85|0||0|10/01/2019 SH 78001|L5704|L5704 - CUSTOM SHAPE COVER BK||613.3|0||0|10/01/2019 SH 78001|L5703|L5703 - SYMES ANKLE W/O (SACH) FOOT||2577.65|0||0|10/01/2019 SH 78001|L5702|L5702 - REPLACE SOCKET HIP||4980.88|0||0|10/01/2019 SH 78001|L5701|L5701 - REPLACE SOCKET ABOVE KNEE||3937|0||0|10/01/2019 SH 78001|L5700|L5700 - REPLACE SOCKET BELOW KNEE||3278.3|0||0|10/01/2019 SH 78001|L5699|L5699 - SHOULDER HARNESS||270.58|0||0|10/01/2019 SH 78001|L5698|L5698 - AK/KNEE DISARTIC SILESIAN BA||150.2|0||0|10/01/2019 SH 78001|L5697|L5697 - AK/KNEE DISARTIC PELVIC BAND||91.85|0||0|10/01/2019 SH 78001|L5696|L5696 - AK/KNEE DISARTIC PELVIC JOIN||211.69|0||0|10/01/2019 SH 78001|L5695|L5695 - AK SLEEVE SUSP NEOPRENE/EQUA||191.63|0||0|10/01/2019 SH 78001|L5694|L5694 - AK PELVIC CONTROL BELT PAD/L||207.58|0||0|10/01/2019 SH 78001|L5692|L5692 - AK PELVIC CONTROL BELT LIGHT||152.04|0||0|10/01/2019 SH 78001|L5690|L5690 - BK WAIST BELT PADDED AND LIN||111.96|0||0|10/01/2019 SH 78001|L5688|L5688 - BK WAIST BELT WEBBING||69.89|0||0|10/01/2019 SH 78001|L5686|L5686 - BK BACK CHECK||58.45|0||0|10/01/2019 SH 78001|L5685|L5685 - BELOW KNEE SUS/SEAL SLEEVE||148.2|0||0|10/01/2019 SH 78001|L5684|L5684 - BK FORK STRAP||55.07|0||0|10/01/2019 SH 78001|L5683|L5683 - INITIAL CUSTOM SOCKET INSERT||1522.01|0||0|10/01/2019 SH 78001|L5682|L5682 - BK THIGH LACER GLUT/ISCHIA M||715.56|0||0|10/01/2019 SH 78001|L5681|L5681 - INTL CUSTM CONG/LATYP INSERT||1522.01|0||0|10/01/2019 SH 78001|L5680|L5680 - BK THIGH LACER NON-MOLDED||379.24|0||0|10/01/2019 SH 78001|L5679|L5679 - SOCKET INSERT W/O LOCK MECH||677.95|0||0|10/01/2019 SH 78001|L5678|L5678 - BK JOINT COVERS PAIR||45.43|0||0|10/01/2019 SH 78001|L5677|L5677 - BK KNEE JOINTS POLYCENTRIC P||564.14|0||0|10/01/2019 SH 78001|L5676|L5676 - BK KNEE JOINTS SINGLE AXIS P||414.62|0||0|10/01/2019 SH 78001|L5673|L5673 - SOCKET INSERT W LOCK MECH||813.58|0||0|10/01/2019 SH 78001|L5672|L5672 - BK REMOVABLE MEDIAL BRIM SUS||341.18|0||0|10/01/2019 SH 78001|L5671|L5671 - BK/AK LOCKING MECHANISM||657.92|0||0|10/01/2019 SH 78001|L5670|L5670 - BK MOLDED SUPRACONDYLAR SUSP||310.48|0||0|10/01/2019 SH 78001|L5668|L5668 - BK MOLDED DISTAL CUSHION||129.18|0||0|10/01/2019 SH 78001|L5666|L5666 - BELOW KNEE CUFF SUSPENSION||80.09|0||0|10/01/2019 SH 78001|L5665|L5665 - MULTI-DUROMETER BELOW KNEE||585.85|0||0|10/01/2019 SH 78001|L5661|L5661 - MULTI-DUROMETER SYMES||696.29|0||0|10/01/2019 SH 78001|L5658|L5658 - SOCKET INSERT ABOVE KNEE||416.02|0||0|10/01/2019 SH 78001|L5656|L5656 - SOCKET INSERT KNEE ARTICULAT||431.38|0||0|10/01/2019 SH 78001|L5655|L5655 - SOCKET INSERT BELOW KNEE||321.56|0||0|10/01/2019 SH 78001|L5654|L5654 - SOCKET INSERT SYMES||379.46|0||0|10/01/2019 SH 78001|L5653|L5653 - KNEE DISART EXPAND WALL SOCK||665.9|0||0|10/01/2019 SH 78001|L5652|L5652 - SUCTION SUSP AK/KNEE DISART||498.84|0||0|10/01/2019 SH 78001|L5651|L5651 - AK FLEX INNER SOCKET EXT FRA||1374.07|0||0|10/01/2019 SH 78001|L5650|L5650 - TOT CONTACT AK/KNEE DISART S||558.58|0||0|10/01/2019 SH 78001|L5649|L5649 - ISCH CONTAINMT/NARROW M-L SO||2729.64|0||0|10/01/2019 SH 78001|L5648|L5648 - ABOVE KNEE CUSHION SOCKET||753.3|0||0|10/01/2019 SH 78001|L5647|L5647 - BELOW KNEE SUCTION SOCKET||910.15|0||0|10/01/2019 SH 78001|L5646|L5646 - BELOW KNEE CUSHION SOCKET||626.9|0||0|10/01/2019 SH 78001|L5645|L5645 - BK FLEX INNER SOCKET EXT FRA||912.94|0||0|10/01/2019 SH 78001|L5644|L5644 - ABOVE KNEE WOOD SOCKET||675.8|0||0|10/01/2019 SH 78001|L5643|L5643 - HIP FLEX INNER SOCKET EXT FR||1780.85|0||0|10/01/2019 SH 78001|L5642|L5642 - ABOVE KNEE LEATHER SOCKET||708.9|0||0|10/01/2019 SH 78001|L5640|L5640 - KNEE DISARTICULAT LEATHER SO||731.63|0||0|10/01/2019 SH 78001|L5639|L5639 - BELOW KNEE WOOD SOCKET||1282.84|0||0|10/01/2019 SH 78001|L5638|L5638 - BELOW KNEE LEATHER SOCKET||575.8|0||0|10/01/2019 SH 78001|L5637|L5637 - BELOW KNEE TOTAL CONTACT||330.54|0||0|10/01/2019 SH 78001|L5636|L5636 - SYMES TYPE MEDIAL OPENING SO||291.54|0||0|10/01/2019 SH 78001|L5634|L5634 - SYMES TYPE POSTER OPENING SO||348.05|0||0|10/01/2019 SH 78001|L5632|L5632 - SYMES TYPE PTB BRIM DESIGN S||280.58|0||0|10/01/2019 SH 78001|L5631|L5631 - AK/KNEE DISARTIC ACRYLIC SOC||502.73|0||0|10/01/2019 SH 78001|L5630|L5630 - SYME TYP EXPANDABL WALL SCKT||513.5|0||0|10/01/2019 SH 78001|L5629|L5629 - BELOW KNEE ACRYLIC SOCKET||363.61|0||0|10/01/2019 SH 78001|L5628|L5628 - TEST SOCKET HEMIPELVECTOMY||583.31|0||0|10/01/2019 SH 78001|L5626|L5626 - TEST SOCKET HIP DISARTICULAT||545.53|0||0|10/01/2019 SH 78001|L5624|L5624 - TEST SOCKET ABOVE KNEE||415.98|0||0|10/01/2019 SH 78001|L5622|L5622 - TEST SOCKET KNEE DISARTICULA||414.79|0||0|10/01/2019 SH 78001|L5620|L5620 - TEST SOCKET BELOW KNEE||318.11|0||0|10/01/2019 SH 78001|L5618|L5618 - TEST SOCKET SYMES||342.48|0||0|10/01/2019 SH 78001|L5617|L5617 - AK/BK SELF-ALIGNING UNIT EA||647.39|0||0|10/01/2019 SH 78001|L5616|L5616 - AK UNIV MULTIPLEX SYS FRICT||1557.53|0||0|10/01/2019 SH 78001|L5614|L5614 - 4-BAR LINK ABOVE KNEE W/SWNG||1952.51|0||0|10/01/2019 SH 78001|L5613|L5613 - AK 4 BAR LING W/HYDRAUL SWIG||2882.22|0||0|10/01/2019 SH 78001|L5611|L5611 - AK 4 BAR LINK W/FRIC SWING||1843.48|0||0|10/01/2019 SH 78001|L5610|L5610 - ABOVE KNEE HYDRACADENCE||2368.91|0||0|10/01/2019 SH 78001|L5600|L5600 - HIP DISART SACH LAMINAT MOLD||5223.42|0||0|10/01/2019 SH 78001|L5595|L5595 - HIP DISARTIC SACH THERMOPLS||4859.21|0||0|10/01/2019 SH 78001|L5590|L5590 - PREP AK ISCHIAL LAMINATED||2750.54|0||0|10/01/2019 SH 78001|L5585|L5585 - PREP AK ISCHIAL OPEN END||3321.65|0||0|10/01/2019 SH 78001|L5580|L5580 - PREP AK ISCHIAL THERMO MOLD||2699.08|0||0|10/01/2019 SH 78001|L5570|L5570 - PREP AK ISCHIAL DIRECT FORM||2311.98|0||0|10/01/2019 SH 78001|L5560|L5560 - PREP AK ISCHIAL PLAST MOLDED||2223.82|0||0|10/01/2019 SH 78001|L5540|L5540 - PREP BK PTB LAMINATED SOCKET||2070.92|0||0|10/01/2019 SH 78001|L5535|L5535 - PREP BK PTB OPEN END SOCKET||1940.32|0||0|10/01/2019 SH 78001|L5530|L5530 - PREP BK PTB THERMOPLS MOLDED||1976.28|0||0|10/01/2019 SH 78001|L5520|L5520 - PERP BK PTB THERMOPLS DIRECT||1645.39|0||0|10/01/2019 SH 78001|L5510|L5510 - PREP BK PTB PLASTER MOLDED||1665.79|0||0|10/01/2019 SH 78001|L5505|L5505 - INIT AK ISCHAL PLSTR DIRECT||2032.37|0||0|10/01/2019 SH 78001|L5500|L5500 - INIT BK PTB PLASTER DIRECT||1469.51|0||0|10/01/2019 SH 78001|L5460|L5460 - POSTOP APP NON-WGT BEAR DSG||624.07|0||0|10/01/2019 SH 78001|L5450|L5450 - POSTOP APP NON-WGT BEAR DSG||468.41|0||0|10/01/2019 SH 78001|L5430|L5430 - POSTOP DSG AK EA ADD CAST CH||575.77|0||0|10/01/2019 SH 78001|L5420|L5420 - POSTOP DSG & 1 CAST CHG AK/D||1909.51|0||0|10/01/2019 SH 78001|L5410|L5410 - POSTOP DSG BK EA ADD CAST CH||478.06|0||0|10/01/2019 SH 78001|L5400|L5400 - POSTOP DRESS & 1 CAST CHG BK||1558.19|0||0|10/01/2019 SH 78001|L5341|L5341 - HEMIPELVECTOMY CANADIAN SACH||6051.42|0||0|10/01/2019 SH 78001|L5331|L5331 - HIP DISART CANADIAN SACH FT||5813.06|0||0|10/01/2019 SH 78001|L5321|L5321 - AK OPEN END SACH||4562.12|0||0|10/01/2019 SH 78001|L5312|L5312 - KNEE DISART - SACH FT - ENDO||4505.17|0||0|10/01/2019 SH 78001|L5301|L5301 - BK MOLD SOCKET SACH FT ENDO||3147.31|0||0|10/01/2019 SH 78001|L5280|L5280 - HEMIPELVECT CANAD SING AXIS||5865.06|0||0|10/01/2019 SH 78001|L5270|L5270 - TILT TABLE LOCKING HIP SING||5910.31|0||0|10/01/2019 SH 78001|L5250|L5250 - HIP CANAD SING AXI CONS FRIC||5936.66|0||0|10/01/2019 SH 78001|L5230|L5230 - FEM FOCAL DEFIC CONSTANT FRI||4352.68|0||0|10/01/2019 SH 78001|L5220|L5220 - NO KNEE JOINT WITH ARTIC ALI||3155.95|0||0|10/01/2019 SH 78001|L5210|L5210 - NO KNEE/ANKLE JOINTS W/ FT B||2776.45|0||0|10/01/2019 SH 78001|L5200|L5200 - KNE SING AXIS FRIC SHIN SACH||4185.19|0||0|10/01/2019 SH 78001|L5160|L5160 - MOLD SOCKET BENT KNEE SHIN S||4370.32|0||0|10/01/2019 SH 78001|L5150|L5150 - MOLD SCKT EXT KNEE SHIN SACH||4018.02|0||0|10/01/2019 SH 78001|L5105|L5105 - PLAST SOCKET JTS/THGH LACER||3974.84|0||0|10/01/2019 SH 78001|L5100|L5100 - MOLDED SOCKET SHIN SACH FOOT||2753.41|0||0|10/01/2019 SH 78001|L5060|L5060 - SYMES MET FR LEATH SOCKET AR||3160.25|0||0|10/01/2019 SH 78001|L5050|L5050 - ANK SYMES MOLD SCKT SACH FT||2747.34|0||0|10/01/2019 SH 78001|L5020|L5020 - TIBIAL TUBERCLE HGT W/ TOE F||2483.63|0||0|10/01/2019 SH 78001|L5010|L5010 - MOLD SOCKET ANK HGT W/ TOE F||1462.48|0||0|10/01/2019 SH 78001|L5000|L5000 - SHO INSERT W ARCH TOE FILLER||605.52|0||0|10/01/2019 SH 78001|L4398|L4398 - FOOT DROP SPLINT PRE OTS||89.21|0||0|10/01/2019 SH 78001|L4397|L4397 - STATIC OR DYNAMI AFO PRE OTS||193.84|0||0|10/01/2019 SH 78001|L4396|L4396 - STATIC OR DYNAMI AFO PRE CST||193.84|0||0|10/01/2019 SH 78001|L4394|L4394 - REPLACE FOOT DROP SPINT||19.85|0||0|10/01/2019 SH 78001|L4392|L4392 - REPLACE AFO SOFT INTERFACE||27.19|0||0|10/01/2019 SH 78001|L4387|L4387 - NON-PNEUM WALK BOOT PRE OTS||183.1|0||0|10/01/2019 SH 78001|L4386|L4386 - NON-PNEUM WALK BOOT PRE CST||183.1|0||0|10/01/2019 SH 78001|L4370|L4370 - PNEUM FULL LEG SPLNT PRE OTS||202.75|0||0|10/01/2019 SH 78001|L4361|L4361 - PNEUMA/VAC WALK BOOT PRE OTS||315.95|0||0|10/01/2019 SH 78001|L4360|L4360 - PNEUMAT WALKING BOOT PRE CST||315.95|0||0|10/01/2019 SH 78001|L4350|L4350 - ANKLE CONTROL ORTHO PRE OTS||112.93|0||0|10/01/2019 SH 78001|L4130|L4130 - REPLACE PRETIBIAL SHELL||626.83|0||0|10/01/2019 SH 78001|L4110|L4110 - REPL LEATH CUFF KAFO-AFO CAL||91.07|0||0|10/01/2019 SH 78001|L4100|L4100 - REPL LEATH CUFF KAFO PROX TH||114.6|0||0|10/01/2019 SH 78001|L4090|L4090 - REPL MET BAND KAFO-AFO CALF/||101.62|0||0|10/01/2019 SH 78001|L4080|L4080 - REPL MET BAND KAFO-AFO PROX||114.79|0||0|10/01/2019 SH 78001|L4070|L4070 - REPLACE PROX & DIST UPRIGHT||325.63|0||0|10/01/2019 SH 78001|L4060|L4060 - REPLACE HIGH ROLL CUFF||341.3|0||0|10/01/2019 SH 78001|L4055|L4055 - REPLACE NON-MOLDED CALF LACE||287.1|0||0|10/01/2019 SH 78001|L4050|L4050 - REPLACE MOLDED CALF LACER||443.39|0||0|10/01/2019 SH 78001|L4045|L4045 - REPLACE NON-MOLDED THIGH LAC||352.3|0||0|10/01/2019 SH 78001|L4040|L4040 - REPLACE MOLDED THIGH LACER||438.4|0||0|10/01/2019 SH 78001|L4030|L4030 - REPLACE SOCKET BRIM CUST FIT||542.23|0||0|10/01/2019 SH 78001|L4020|L4020 - REPLACE QUADLAT SOCKET BRIM||984.8|0||0|10/01/2019 SH 78001|L4010|L4010 - REPLACE TRILATERAL SOCKET BR||788.42|0||0|10/01/2019 SH 78001|L4002|L4002 - REPLACE STRAP - ANY ORTHOSIS||0|0||0|10/01/2019 SH 78001|L4000|L4000 - REPL GIRDLE MILWAUKEE ORTH||1401.04|0||0|10/01/2019 SH 78001|L3995|L3995 - SOCK FRACTURE OR EQUAL EACH||35.95|0||0|10/01/2019 SH 78001|L3984|L3984 - UPPER EXT FX ORTHOSIS WRIST||428.46|0||0|10/01/2019 SH 78001|L3982|L3982 - UPPER EXT FX ORTHOSIS RAD/UL||401.4|0||0|10/01/2019 SH 78001|L3981|L3981 - UE FX ORTH SHOUL CAP FOREARM||1057.87|0||0|10/01/2019 SH 78001|L3980|L3980 - UP EXT FX ORTHOS HUMERAL NOS||324.89|0||0|10/01/2019 SH 78001|L3978|L3978 - SEWHFO AIRPLANE W/JNT(S) CF||2084.77|0||0|10/01/2019 SH 78001|L3977|L3977 - SEWHFO CAP DESGN W/JNT(S) CF||1978.91|0||0|10/01/2019 SH 78001|L3976|L3976 - SEWHFO AIRPLANE W/O JNTS CF||1765.78|0||0|10/01/2019 SH 78001|L3975|L3975 - SEWHFO CAP DESIGN W/O JNT CF||1765.78|0||0|10/01/2019 SH 78001|L3973|L3973 - SEWHO AIRPLANE W/JNT(S) CF||2084.77|0||0|10/01/2019 SH 78001|L3971|L3971 - SEWHO CAP DESIGN W/JNT(S) CF||1978.91|0||0|10/01/2019 SH 78001|L3967|L3967 - SEWHO AIRPLANE W/O JNTS CF||2084.77|0||0|10/01/2019 SH 78001|L3962|L3962 - SEWHO ERBS PALSEY DESIGN ABD||902.02|0||0|10/01/2019 SH 78001|L3961|L3961 - SEWHO CAP DESIGN W/O JNTS CF||1765.78|0||0|10/01/2019 SH 78001|L3960|L3960 - SEWHO AIRPLAN DESIG ABDU POS||866.3|0||0|10/01/2019 SH 78001|L3956|L3956 - ADD JOINT UPPER EXT ORTHOSIS||0|0||0|10/01/2019 SH 78001|L3935|L3935 - FO NONTORSION JOINT CF||232.21|0||0|10/01/2019 SH 78001|L3933|L3933 - FO W/O JOINTS CF||224.26|0||0|10/01/2019 SH 78001|L3931|L3931 - WHFO NONTORSION JOINT PREFAB||214.03|0||0|10/01/2019 SH 78001|L3930|L3930 - HFO NONTORSION JNTS PRE OTS||88.48|0||0|10/01/2019 SH 78001|L3929|L3929 - HFO NONTORSION JNTS PRE CST||88.48|0||0|10/01/2019 SH 78001|L3927|L3927 - FO PIP DIP NO JT SPR PRE OTS||36.78|0||0|10/01/2019 SH 78001|L3925|L3925 - FO PIP DIP JNT/SPRNG PRE OTS||55.52|0||0|10/01/2019 SH 78001|L3924|L3924 - HFO WITHOUT JOINTS PRE OTS||91.42|0||0|10/01/2019 SH 78001|L3923|L3923 - HFO WITHOUT JOINTS PRE CST||91.42|0||0|10/01/2019 SH 78001|L3921|L3921 - HFO W/JOINT(S) CF||337.56|0||0|10/01/2019 SH 78001|L3919|L3919 - HO W/O JOINTS CF||284.66|0||0|10/01/2019 SH 78001|L3918|L3918 - METACARP FX ORTHOSIS PRE OTS||111.02|0||0|10/01/2019 SH 78001|L3917|L3917 - METACARP FX ORTHOSIS PRE CST||111.02|0||0|10/01/2019 SH 78001|L3916|L3916 - WHO NONTORSION JNTS PRE OTS||558.67|0||0|10/01/2019 SH 78001|L3915|L3915 - WHO NONTORSION JNTS PRE CST||558.67|0||0|10/01/2019 SH 78001|L3913|L3913 - HFO W/O JOINTS CF||284.66|0||0|10/01/2019 SH 78001|L3912|L3912 - HFO FLEXION GLOVE PRE OTS||101|0||0|10/01/2019 SH 78001|L3908|L3908 - WHO COCK-UP NONMOLDE PRE OTS||62.96|0||0|10/01/2019 SH 78001|L3906|L3906 - WHO W/O JOINTS CF||443.35|0||0|10/01/2019 SH 78001|L3905|L3905 - WHO W/NONTORSION JNT(S) CF||1042.25|0||0|10/01/2019 SH 78001|L3904|L3904 - WHFO ELECTRIC CUSTOM FITTED||3747.58|0||0|10/01/2019 SH 78001|L3901|L3901 - HINGE EXT/FLEX WRIST FINGER||1840.91|0||0|10/01/2019 SH 78001|L3900|L3900 - HINGE EXTENSION/FLEX WRIST/F||1641.82|0||0|10/01/2019 SH 78001|L3809|L3809 - WHFO W/O JOINTS PRE OTS||262.81|0||0|10/01/2019 SH 78001|L3808|L3808 - WHFO - RIGID W/O JOINTS||351.04|0||0|10/01/2019 SH 78001|L3807|L3807 - WHFO W/O JOINTS PRE CST||262.81|0||0|10/01/2019 SH 78001|L3806|L3806 - WHFO W/JOINT(S) CUSTOM FAB||477.4|0||0|10/01/2019 SH 78001|L3766|L3766 - EWHFO W/JOINT(S) CF||1427.04|0||0|10/01/2019 SH 78001|L3765|L3765 - EWHFO RIGID W/O JNTS CF||1347.61|0||0|10/01/2019 SH 78001|L3764|L3764 - EWHO W/JOINT(S) CF||832.16|0||0|10/01/2019 SH 78001|L3763|L3763 - EWHO RIGID W/O JNTS CF||834.42|0||0|10/01/2019 SH 78001|L3762|L3762 - EO RIGID W/O JOINTS PRE OTS||113.02|0||0|10/01/2019 SH 78001|L3761|L3761 - EO - ADJ LOCK JOINT PREFAB OT||532.93|0||0|10/01/2019 SH 78001|L3760|L3760 - EO ADJ JT PREFAB CUSTOM FIT||525.58|0||0|10/01/2019 SH 78001|L3740|L3740 - CUFFS ADJ LOCK W/ ACTIVE CON||1124.66|0||0|10/01/2019 SH 78001|L3730|L3730 - FOREARM/ARM CUFFS EXT/FLEX A||1000.73|0||0|10/01/2019 SH 78001|L3720|L3720 - FOREARM/ARM CUFFS FREE MOTIO||760.21|0||0|10/01/2019 SH 78001|L3710|L3710 - EO ELAS W/METAL JNTS PRE OTS||152.38|0||0|10/01/2019 SH 78001|L3702|L3702 - EO W/O JOINTS CF||303.48|0||0|10/01/2019 SH 78001|L3675|L3675 - SO VEST CANVAS/WEB PRE OTS||184.44|0||0|10/01/2019 SH 78001|L3674|L3674 - SO AIRPLANE W/WO JOINT CF||1242.3|0||0|10/01/2019 SH 78001|L3671|L3671 - SO CAP DESIGN W/O JNTS CF||946.98|0||0|10/01/2019 SH 78001|L3670|L3670 - SO ACRO/CLAV CAN WEB PRE OTS||150.55|0||0|10/01/2019 SH 78001|L3660|L3660 - SO 8 AB RSTR CAN/WEB PRE OTS||108.01|0||0|10/01/2019 SH 78001|L3650|L3650 - SO 8 ABD RESTRAINT PRE OTS||62.9|0||0|10/01/2019 SH 78001|L3640|L3640 - SHOE DENNIS BROWNE SPLINT BO||49.91|0||0|10/01/2019 SH 78001|L3630|L3630 - TRANS SHOE SOLID STIRRUP NEW||116.03|0||0|10/01/2019 SH 78001|L3620|L3620 - TRANS SHOE SOLID STIRRUP EXI||88.14|0||0|10/01/2019 SH 78001|L3610|L3610 - TRANS SHOE CALIPER PLATE NEW||116.03|0||0|10/01/2019 SH 78001|L3600|L3600 - TRANS SHOE CALIP PLATE EXIST||88.14|0||0|10/01/2019 SH 78001|L3595|L3595 - ORTHO SHOE ADD MARCH BAR||48.46|0||0|10/01/2019 SH 78001|L3590|L3590 - O SHOE CONVERT TO SOF COUNTE||61.69|0||0|10/01/2019 SH 78001|L3580|L3580 - O SHOE ADD INSTEP VELCRO CLO||74.89|0||0|10/01/2019 SH 78001|L3570|L3570 - O SHOE ADD INSTEP EXTENSION||98.44|0||0|10/01/2019 SH 78001|L3560|L3560 - O SHOE ADD HORSESHOE TOE TAP||26.41|0||0|10/01/2019 SH 78001|L3550|L3550 - O SHOE ADD STANDARD TOE TAP||10.3|0||0|10/01/2019 SH 78001|L3540|L3540 - ORTHO SHOE ADD FULL SOLE||58.76|0||0|10/01/2019 SH 78001|L3530|L3530 - ORTHO SHOE ADD HALF SOLE||36.72|0||0|10/01/2019 SH 78001|L3520|L3520 - O SHOE ADD FELT W LEATH INSL||36.72|0||0|10/01/2019 SH 78001|L3510|L3510 - ORTHOPEDIC SHOE ADD RUB INSL||33.8|0||0|10/01/2019 SH 78001|L3500|L3500 - ORTHO SHOE ADD LEATHER INSOL||33.8|0||0|10/01/2019 SH 78001|L3480|L3480 - SHOE HEEL PAD & DEPRESS FOR||71.94|0||0|10/01/2019 SH 78001|L3470|L3470 - SHOE HEEL THOMAS EXTEND TO B||71.94|0||0|10/01/2019 SH 78001|L3465|L3465 - SHOE HEEL THOMAS WITH WEDGE||67.56|0||0|10/01/2019 SH 78001|L3460|L3460 - SHOE HEEL NEW RUBBER STANDAR||39.64|0||0|10/01/2019 SH 78001|L3455|L3455 - SHOE HEEL NEW LEATHER STANDA||47.02|0||0|10/01/2019 SH 78001|L3450|L3450 - SHOE HEEL SACH CUSHION TYPE||121.87|0||0|10/01/2019 SH 78001|L3440|L3440 - HEEL LEATHER REINFORCED||88.14|0||0|10/01/2019 SH 78001|L3430|L3430 - SHO HEEL COUNT PLAST REINFOR||185.05|0||0|10/01/2019 SH 78001|L3420|L3420 - FULL SOLE/HEEL WEDGE BTWEEN||63.13|0||0|10/01/2019 SH 78001|L3410|L3410 - SHOE METATARSAL BAR BETWEEN||107.24|0||0|10/01/2019 SH 78001|L3400|L3400 - SHOE METATARSAL BAR WEDGE RO||47.02|0||0|10/01/2019 SH 78001|L3390|L3390 - SHOE OUTFLARE WEDGE||57.29|0||0|10/01/2019 SH 78001|L3380|L3380 - SHOE CLUBFOOT WEDGE||57.29|0||0|10/01/2019 SH 78001|L3370|L3370 - SHOE SOLE WEDGE BETWEEN SOLE||57.29|0||0|10/01/2019 SH 78001|L3360|L3360 - SHOE SOLE WEDGE OUTSIDE SOLE||41.12|0||0|10/01/2019 SH 78001|L3350|L3350 - SHOE HEEL WEDGE||26.41|0||0|10/01/2019 SH 78001|L3340|L3340 - SHOE WEDGE SACH||98.44|0||0|10/01/2019 SH 78001|L3334|L3334 - SHOE LIFTS ELEVATION HEEL /I||44.05|0||0|10/01/2019 SH 78001|L3332|L3332 - SHOE LIFTS TAPERED TO ONE-HA||85.18|0||0|10/01/2019 SH 78001|L3330|L3330 - LIFTS ELEVATION METAL EXTENS||653.54|0||0|10/01/2019 SH 78001|L3310|L3310 - SHOE LIFT ELEV HEEL/SOLE NEO||94.01|0||0|10/01/2019 SH 78001|L3300|L3300 - SHO LIFT TAPER TO METATARSAL||60.2|0||0|10/01/2019 SH 78001|L3260|L3260 - AMBULATORY SURGICAL BOOT EAC||21.5|0||0|10/01/2019 SH 78001|L3225|L3225 - MAN'S SHOE OXFORD BRACE||72.65|0||0|10/01/2019 SH 78001|L3224|L3224 - WOMAN'S SHOE OXFORD BRACE||63.16|0||0|10/01/2019 SH 78001|L3170|L3170 - FOOT PLAS HEEL STABI PRE OTS||58.76|0||0|10/01/2019 SH 78001|L3150|L3150 - ABDUCT ROTATION BAR W/O SHOE||94.01|0||0|10/01/2019 SH 78001|L3140|L3140 - ABDUCTION ROTATION BAR SHOE||102.82|0||0|10/01/2019 SH 78001|L3100|L3100 - HALLUS-VALGUS NT DYN PRE OTS||49.91|0||0|10/01/2019 SH 78001|L3090|L3090 - ARCH SUPP ATT TO SHOE LONG/M||47.02|0||0|10/01/2019 SH 78001|L3080|L3080 - ARCH SUPP ATT TO SHOE METATA||36.72|0||0|10/01/2019 SH 78001|L3070|L3070 - ARCH SUPRT ATT TO SHO LONGIT||36.72|0||0|10/01/2019 SH 78001|L3060|L3060 - FOOT ARCH SUPP LONGITUD/META||85.18|0||0|10/01/2019 SH 78001|L3050|L3050 - FOOT ARCH SUPP PREMOLD METAT||54.35|0||0|10/01/2019 SH 78001|L3040|L3040 - FT ARCH SUPRT PREMOLD LONGIT||54.35|0||0|10/01/2019 SH 78001|L3031|L3031 - FOOT LAMIN/PREPREG COMPOSITE||141.42|0||0|10/01/2019 SH 78001|L3030|L3030 - FOOT ARCH SUPPORT REMOV PREM||88.14|0||0|10/01/2019 SH 78001|L3020|L3020 - FOOT LONGITUD/METATARSAL SUP||229.12|0||0|10/01/2019 SH 78001|L3010|L3010 - FOOT LONGITUDINAL ARCH SUPPO||201.2|0||0|10/01/2019 SH 78001|L3003|L3003 - FOOT INSERT SILICONE GEL EAC||201.2|0||0|10/01/2019 SH 78001|L3002|L3002 - FOOT INSERT PLASTAZOTE OR EQ||186.52|0||0|10/01/2019 SH 78001|L3001|L3001 - FOOT INSERT REMOV MOLDED SPE||152.72|0||0|10/01/2019 SH 78001|L3000|L3000 - FT INSERT UCB BERKELEY SHELL||362.77|0||0|10/01/2019 SH 78001|L2850|L2850 - FEMORAL LGTH SOCK FX OR EQUA||66.49|0||0|10/01/2019 SH 78001|L2840|L2840 - TIBIAL LENGTH SOCK FX OR EQU||58.54|0||0|10/01/2019 SH 78001|L2830|L2830 - SOFT INTERFACE ABOVE KNEE SE||104.88|0||0|10/01/2019 SH 78001|L2820|L2820 - SOFT INTERFACE BELOW KNEE SE||93.26|0||0|10/01/2019 SH 78001|L2810|L2810 - KNEE CONTROL CONDYLAR PAD||83.88|0||0|10/01/2019 SH 78001|L2800|L2800 - KNEE CAP MEDIAL OR LATERAL P||114.55|0||0|10/01/2019 SH 78001|L2795|L2795 - KNEE CONTROL FULL KNEECAP||91.26|0||0|10/01/2019 SH 78001|L2785|L2785 - DROP LOCK RETAINER EACH||45.38|0||0|10/01/2019 SH 78001|L2780|L2780 - NON-CORROSIVE FINISH||77.2|0||0|10/01/2019 SH 78001|L2768|L2768 - ORTHO SIDEBAR DISCONNECT||150.48|0||0|10/01/2019 SH 78001|L2760|L2760 - EXTENSION PER EXTENSION PER||65.26|0||0|10/01/2019 SH 78001|L2755|L2755 - CARBON GRAPHITE LAMINATION||150.92|0||0|10/01/2019 SH 78001|L2750|L2750 - PLATING CHROME/NICKEL PR BAR||89.77|0||0|10/01/2019 SH 78001|L2680|L2680 - THORAC CONT LAT SUPPORT UPRI||168.06|0||0|10/01/2019 SH 78001|L2670|L2670 - THORAC CONT PARASPINAL UPRIG||183.2|0||0|10/01/2019 SH 78001|L2660|L2660 - THORACIC CONTROL THORACIC BA||200.17|0||0|10/01/2019 SH 78001|L2650|L2650 - PELV & THOR CONTROL GLUTEAL||128.88|0||0|10/01/2019 SH 78001|L2640|L2640 - PELVIC CONTROL BAND & BELT B||360.91|0||0|10/01/2019 SH 78001|L2630|L2630 - PELVIC CONTROL BAND & BELT U||265.94|0||0|10/01/2019 SH 78001|L2628|L2628 - METAL FRAME RECIPRO HIP & CA||2166.86|0||0|10/01/2019 SH 78001|L2627|L2627 - PLASTIC MOLD RECIPRO HIP & C||1844.64|0||0|10/01/2019 SH 78001|L2624|L2624 - HIP ADJ FLEX EXT ABDUCT CONT||447.73|0||0|10/01/2019 SH 78001|L2622|L2622 - HIP JOINT ADJUSTABLE FLEXION||329.34|0||0|10/01/2019 SH 78001|L2620|L2620 - PELVIC CONTROL HIP HEAVY DUT||287.16|0||0|10/01/2019 SH 78001|L2610|L2610 - HIP CLEVIS/THRUST BEARING LO||260.82|0||0|10/01/2019 SH 78001|L2600|L2600 - HIP CLEVIS/THRUST BEARING FR||220.57|0||0|10/01/2019 SH 78001|L2580|L2580 - PELVIC CONTROL PELVIC SLING||646.55|0||0|10/01/2019 SH 78001|L2570|L2570 - HIP CLEVIS TYPE 2 POSIT JNT||682.06|0||0|10/01/2019 SH 78001|L2550|L2550 - THIGH/WGHT BEAR HIGH ROLL CU||308.45|0||0|10/01/2019 SH 78001|L2540|L2540 - THIGH/WGHT BEAR LACER MOLDED||454.06|0||0|10/01/2019 SH 78001|L2530|L2530 - THIGH/WGHT BEAR LACER NON-MO||252.34|0||0|10/01/2019 SH 78001|L2526|L2526 - TH/WGHT BEAR NAR M-L BRIM CU||914.92|0||0|10/01/2019 SH 78001|L2525|L2525 - TH/WGHT BEAR NAR M-L BRIM MO||1697.4|0||0|10/01/2019 SH 78001|L2520|L2520 - TH/WGHT BEAR QUAD-LAT BRIM C||494.76|0||0|10/01/2019 SH 78001|L2510|L2510 - TH/WGHT BEAR QUAD-LAT BRIM M||907.13|0||0|10/01/2019 SH 78001|L2500|L2500 - THI/GLUT/ISCHIA WGT BEARING||338.81|0||0|10/01/2019 SH 78001|L2492|L2492 - KNEE LIFT LOOP DROP LOCK RIN||109.51|0||0|10/01/2019 SH 78001|L2430|L2430 - KNEE JNT RATCHET LOCK EA JNT||165.53|0||0|10/01/2019 SH 78001|L2425|L2425 - KNEE DISC/DIAL LOCK/ADJ FLEX||165.53|0||0|10/01/2019 SH 78001|L2415|L2415 - KNEE JOINT CAM LOCK EACH JOI||140.29|0||0|10/01/2019 SH 78001|L2405|L2405 - KNEE JOINT DROP LOCK EA JNT||100.69|0||0|10/01/2019 SH 78001|L2397|L2397 - SUSPENSION SLEEVE LOWER EXT||125.87|0||0|10/01/2019 SH 78001|L2395|L2395 - OFFSET KNEE JOINT HEAVY DUTY||179.5|0||0|10/01/2019 SH 78001|L2390|L2390 - OFFSET KNEE JOINT EACH||117.56|0||0|10/01/2019 SH 78001|L2387|L2387 - ADD LE POLY KNEE CUSTOM KAFO||195.23|0||0|10/01/2019 SH 78001|L2385|L2385 - STRAIGHT KNEE JOINT HEAVY DU||143.86|0||0|10/01/2019 SH 78001|L2380|L2380 - TORSION STRAIGHT KNEE JOINT||132.22|0||0|10/01/2019 SH 78001|L2375|L2375 - TORSION ANK & HALF SOLID STI||121.34|0||0|10/01/2019 SH 78001|L2370|L2370 - PATTEN BOTTOM||275.69|0||0|10/01/2019 SH 78001|L2360|L2360 - EXTENDED STEEL SHANK||55.56|0||0|10/01/2019 SH 78001|L2350|L2350 - PROSTHETIC TYPE SOCKET MOLDE||956.96|0||0|10/01/2019 SH 78001|L2340|L2340 - PRE-TIBIAL SHELL MOLDED TO P||585.41|0||0|10/01/2019 SH 78001|L2335|L2335 - ANTERIOR SWING BAND||248.09|0||0|10/01/2019 SH 78001|L2330|L2330 - LACER MOLDED TO PATIENT MODE||421.7|0||0|10/01/2019 SH 78001|L2320|L2320 - NON-MOLDED LACER||220.97|0||0|10/01/2019 SH 78001|L2310|L2310 - ABDUCTION BAR-STRAIGHT||132.12|0||0|10/01/2019 SH 78001|L2300|L2300 - ABDUCTION BAR JOINTED ADJUST||294.29|0||0|10/01/2019 SH 78001|L2280|L2280 - MOLDED INNER BOOT||521.35|0||0|10/01/2019 SH 78001|L2275|L2275 - PLASTIC MOD LOW EXT PAD/LINE||140.34|0||0|10/01/2019 SH 78001|L2270|L2270 - VARUS/VALGUS STRAP PADDED/LI||57.68|0||0|10/01/2019 SH 78001|L2265|L2265 - LONG TONGUE STIRRUP||126.48|0||0|10/01/2019 SH 78001|L2260|L2260 - REINFORCED SOLID STIRRUP||215.29|0||0|10/01/2019 SH 78001|L2250|L2250 - FOOT PLATE MOLDED STIRRUP AT||381.61|0||0|10/01/2019 SH 78001|L2240|L2240 - ROUND CALIPER AND PLATE ATTA||89.82|0||0|10/01/2019 SH 78001|L2232|L2232 - ROCKER BOTTOM - CONTACT AFO||111.56|0||0|10/01/2019 SH 78001|L2230|L2230 - SPLIT FLAT CALIPER STIRR & P||82.4|0||0|10/01/2019 SH 78001|L2220|L2220 - DORSI & PLANTAR FLEX ASS/RES||95.14|0||0|10/01/2019 SH 78001|L2210|L2210 - DORSIFLEXION ASSIST EACH JOI||82.86|0||0|10/01/2019 SH 78001|L2200|L2200 - LIMITED ANKLE MOTION EA JNT||51.06|0||0|10/01/2019 SH 78001|L2192|L2192 - PELVIC BAND & BELT THIGH FLA||382.93|0||0|10/01/2019 SH 78001|L2190|L2190 - WAIST BELT||111.4|0||0|10/01/2019 SH 78001|L2188|L2188 - QUADRILATERAL BRIM||428.86|0||0|10/01/2019 SH 78001|L2186|L2186 - ADJ MOTION KNEE JNT LERMAN T||196.57|0||0|10/01/2019 SH 78001|L2184|L2184 - LIMITED MOTION KNEE JOINT||177.38|0||0|10/01/2019 SH 78001|L2182|L2182 - DROP LOCK KNEE||98.44|0||0|10/01/2019 SH 78001|L2180|L2180 - PLAS SHOE INSERT W ANK JOINT||125.77|0||0|10/01/2019 SH 78001|L2136|L2136 - KAFO FEMORAL FX CAST RIGID||1270.08|0||0|10/01/2019 SH 78001|L2134|L2134 - KAFO FEM FX CAST SEMI-RIGID||1038.72|0||0|10/01/2019 SH 78001|L2132|L2132 - KAFO FEMORAL FX CAST SOFT||866.35|0||0|10/01/2019 SH 78001|L2128|L2128 - KAFO FEM FX CAST MOLDED TO P||1841.57|0||0|10/01/2019 SH 78001|L2126|L2126 - KAFO FEM FX CAST THERMOPLAS||1461.31|0||0|10/01/2019 SH 78001|L2116|L2116 - AFO TIBIAL FRACTURE RIGID||821.3|0||0|10/01/2019 SH 78001|L2114|L2114 - AFO TIB FX SEMI-RIGID||623.36|0||0|10/01/2019 SH 78001|L2112|L2112 - AFO TIBIAL FRACTURE SOFT||544.85|0||0|10/01/2019 SH 78001|L2108|L2108 - AFO TIB FX CAST MOLDED TO PT||1147.49|0||0|10/01/2019 SH 78001|L2106|L2106 - AFO TIB FX CAST PLASTER MOLD||730.21|0||0|10/01/2019 SH 78001|L2090|L2090 - HKAFO UNILAT TORSION BALL BR||506.22|0||0|10/01/2019 SH 78001|L2080|L2080 - HKAFO UNILAT TORSION CABLE||410.69|0||0|10/01/2019 SH 78001|L2070|L2070 - HKAFO TORSION UNILAT ROT STR||192.58|0||0|10/01/2019 SH 78001|L2060|L2060 - HKAFO TORSION BALL BEARING J||670.38|0||0|10/01/2019 SH 78001|L2050|L2050 - HKAFO TORSION CABLE HIP PELV||522.34|0||0|10/01/2019 SH 78001|L2040|L2040 - HKAFO TORSION BIL ROT STRAPS||196.14|0||0|10/01/2019 SH 78001|L2038|L2038 - KAFO W/O JOINT MULTI-AXIS AN||1535.5|0||0|10/01/2019 SH 78001|L2037|L2037 - KAFO PLAS SING FREE KNEE MOL||1836.26|0||0|10/01/2019 SH 78001|L2036|L2036 - KAFO PLAS DOUB FREE KNEE MOL||1992.56|0||0|10/01/2019 SH 78001|L2035|L2035 - KAFO PLASTIC PEDIATRIC SIZE||200.05|0||0|10/01/2019 SH 78001|L2034|L2034 - KAFO PLA SIN UP W/WO K/A CUS||2371.19|0||0|10/01/2019 SH 78001|L2030|L2030 - KAFO DBL SOLID STIRRUP W/O J||1087.98|0||0|10/01/2019 SH 78001|L2020|L2020 - KAFO DBL SOLID STIRRUP BAND/||1254.02|0||0|10/01/2019 SH 78001|L2010|L2010 - KAFO SNG SOLID STIRRUP W/O J||993.01|0||0|10/01/2019 SH 78001|L2005|L2005 - KAFO SNG/DBL MECHANICAL ACT||4732.12|0||0|10/01/2019 SH 78001|L2000|L2000 - KAFO SING FRE STIRR THI/CALF||1089.31|0||0|10/01/2019 SH 78001|L1990|L1990 - AFO DOUB SOLID STIRRUP CALF||506.44|0||0|10/01/2019 SH 78001|L1980|L1980 - AFO SING SOLID STIRRUP CALF||394.15|0||0|10/01/2019 SH 78001|L1971|L1971 - AFO W/ANKLE JOINT - PREFAB||541.28|0||0|10/01/2019 SH 78001|L1970|L1970 - AFO PLASTIC MOLDED W/ANKLE J||880.46|0||0|10/01/2019 SH 78001|L1960|L1960 - AFO POS SOLID ANK PLASTIC MO||595.28|0||0|10/01/2019 SH 78001|L1951|L1951 - AFO SPIRAL PREFABRICATED||969.84|0||0|10/01/2019 SH 78001|L1950|L1950 - AFO SPIRAL MOLDED TO PT PLAS||799.94|0||0|10/01/2019 SH 78001|L1945|L1945 - AFO MOLDED PLAS RIG ANT TIB||1054.37|0||0|10/01/2019 SH 78001|L1940|L1940 - AFO MOLDED TO PATIENT PLASTI||574.14|0||0|10/01/2019 SH 78001|L1932|L1932 - AFO RIG ANT TIB PREFAB TCF/=||1030.5|0||0|10/01/2019 SH 78001|L1930|L1930 - AFO PLASTIC||254.06|0||0|10/01/2019 SH 78001|L1920|L1920 - AFO SING UPRIGHT W/ ADJUST S||375.47|0||0|10/01/2019 SH 78001|L1910|L1910 - AFO SING BAR CLASP ATTACH SH||287.21|0||0|10/01/2019 SH 78001|L1907|L1907 - AFO SUPRAMALLEOLAR CUSTOM||649.8|0||0|10/01/2019 SH 78001|L1906|L1906 - AFO MULTILIG ANK SUP PRE OTS||147.58|0||0|10/01/2019 SH 78001|L1904|L1904 - AFO MOLDED ANKLE GAUNTLET||505.03|0||0|10/01/2019 SH 78001|L1902|L1902 - AFO ANKLE GAUNTLET PRE OTS||88.22|0||0|10/01/2019 SH 78001|L1900|L1900 - AFO SPRNG WIR DRSFLX CALF BD||324.82|0||0|10/01/2019 SH 78001|L1860|L1860 - KO SUPRACONDYLAR SOCKET MOLD||1199.02|0||0|10/01/2019 SH 78001|L1850|L1850 - KO SWEDISH TYPE PRE OTS||309.13|0||0|10/01/2019 SH 78001|L1848|L1848 - KO DBL UPRIGHT W/AIR PRE OTS||664.22|0||0|10/01/2019 SH 78001|L1847|L1847 - KO DBL UPRIGHT W/AIR PRE CST||664.22|0||0|10/01/2019 SH 78001|L1846|L1846 - KO W ADJ FLEX/EXT ROTAT MOLD||1372.44|0||0|10/01/2019 SH 78001|L1845|L1845 - KO DOUBLE UPRIGHT PRE CST||1081.67|0||0|10/01/2019 SH 78001|L1844|L1844 - KO W/ADJ JT ROT CNTRL MOLDED||1795.43|0||0|10/01/2019 SH 78001|L1843|L1843 - KO SINGLE UPRIGHT PRE CST||1036.15|0||0|10/01/2019 SH 78001|L1840|L1840 - KO DEROT ANT CRUCIATE CUSTOM||1076.64|0||0|10/01/2019 SH 78001|L1836|L1836 - KO RIGID W/O JOINTS PRE OTS||154.07|0||0|10/01/2019 SH 78001|L1834|L1834 - KO W/0 JOINT RIGID MOLDED TO||1024.22|0||0|10/01/2019 SH 78001|L1833|L1833 - KO ADJ JNT POS R SUP PRE OTS||870.59|0||0|10/01/2019 SH 78001|L1832|L1832 - KO ADJ JNT POS R SUP PRE CST||870.59|0||0|10/01/2019 SH 78001|L1831|L1831 - KNEE ORTH POS LOCKING JOINT||339.86|0||0|10/01/2019 SH 78001|L1830|L1830 - KO IMMOB CANVAS LONG PRE OTS||116.48|0||0|10/01/2019 SH 78001|L1820|L1820 - KO ELAS W/ CONDYLE PADS & JO||139.26|0||0|10/01/2019 SH 78001|L1812|L1812 - KO ELASTIC W/JOINTS PRE OTS||139.81|0||0|10/01/2019 SH 78001|L1810|L1810 - KO ELASTIC WITH JOINTS||139.81|0||0|10/01/2019 SH 78001|L1755|L1755 - LEGG PERTHES PATTEN BOTTOM T||1771.48|0||0|10/01/2019 SH 78001|L1730|L1730 - LEGG PERTHES ORTH SCOTTISH R||1217.08|0||0|10/01/2019 SH 78001|L1720|L1720 - LEGG PERTHES ORTHOSIS TRILAT||1613.15|0||0|10/01/2019 SH 78001|L1710|L1710 - LEGG PERTHES ORTH NEWINGTON||2183.75|0||0|10/01/2019 SH 78001|L1700|L1700 - LEG PERTHES ORTH TORONTO TYP||1857.82|0||0|10/01/2019 SH 78001|L1690|L1690 - COMBINATION BILATERAL HO||2233.13|0||0|10/01/2019 SH 78001|L1686|L1686 - HO POST-OP HIP ABDUCTION||1069.66|0||0|10/01/2019 SH 78001|L1685|L1685 - POST-OP HIP ABDUCT CUSTOM FA||1594.43|0||0|10/01/2019 SH 78001|L1680|L1680 - PELVIC & HIP CONTROL THIGH C||1511.06|0||0|10/01/2019 SH 78001|L1660|L1660 - HO ABDUCTION STATIC PLASTIC||183.79|0||0|10/01/2019 SH 78001|L1652|L1652 - HO BI THIGHCUFFS W SPRDR BAR||411.67|0||0|10/01/2019 SH 78001|L1650|L1650 - HO ABDUCTION HIP ADJUSTABLE||262.81|0||0|10/01/2019 SH 78001|L1640|L1640 - PELV BAND/SPREAD BAR THIGH C||495.56|0||0|10/01/2019 SH 78001|L1630|L1630 - ABDUCT CONTROL HIP SEMI-FLEX||185.28|0||0|10/01/2019 SH 78001|L1620|L1620 - HO FLEX PAVLIK HARNS PRE CST||155.26|0||0|10/01/2019 SH 78001|L1610|L1610 - HO FREJKA COV ONLY PRE CST||47.15|0||0|10/01/2019 SH 78001|L1600|L1600 - HO FLEX FREJKA W/COV PRE CST||138.4|0||0|10/01/2019 SH 78001|L1310|L1310 - POST-OPERATIVE BODY JACKET||1846.02|0||0|10/01/2019 SH 78001|L1300|L1300 - BODY JACKET MOLD TO PATIENT||1793.99|0||0|10/01/2019 SH 78001|L1290|L1290 - LATERAL TROCHANTERIC PAD||107.32|0||0|10/01/2019 SH 78001|L1280|L1280 - RIB GUSSET (ELASTIC) EACH||94.66|0||0|10/01/2019 SH 78001|L1270|L1270 - ABDOMINAL PAD||106.19|0||0|10/01/2019 SH 78001|L1260|L1260 - ANTERIOR THORACIC DEROTATION||106.31|0||0|10/01/2019 SH 78001|L1250|L1250 - ANTERIOR ASIS PAD||103.45|0||0|10/01/2019 SH 78001|L1240|L1240 - LUMBAR DEROTATION PAD||105.06|0||0|10/01/2019 SH 78001|L1230|L1230 - MILWAUKEE TYPE SUPERSTRUCTUR||610.5|0||0|10/01/2019 SH 78001|L1220|L1220 - ANTERIOR THORACIC EXTENSION||237.92|0||0|10/01/2019 SH 78001|L1210|L1210 - LATERAL THORACIC EXTENSION||281.02|0||0|10/01/2019 SH 78001|L1200|L1200 - FURNSH INITIAL ORTHOSIS ONLY||1866.43|0||0|10/01/2019 SH 78001|L1120|L1120 - COVERS FOR UPRIGHT EACH||46.9|0||0|10/01/2019 SH 78001|L1110|L1110 - RING FLANGE PLAS/LEATHER MOL||294.34|0||0|10/01/2019 SH 78001|L1100|L1100 - RING FLANGE PLASTIC/LEATHER||173.77|0||0|10/01/2019 SH 78001|L1090|L1090 - LUMBAR SLING||98.44|0||0|10/01/2019 SH 78001|L1085|L1085 - OUTRIGGER BIL W/ VERT EXTENS||210.74|0||0|10/01/2019 SH 78001|L1080|L1080 - OUTRIGGER||75.86|0||0|10/01/2019 SH 78001|L1070|L1070 - TRAPEZIUS SLING||109.48|0||0|10/01/2019 SH 78001|L1060|L1060 - THORACIC PAD||107.09|0||0|10/01/2019 SH 78001|L1050|L1050 - STERNAL PAD||94.93|0||0|10/01/2019 SH 78001|L1040|L1040 - LUMBAR OR LUMBAR RIB PAD||109.64|0||0|10/01/2019 SH 78001|L1030|L1030 - LUMBAR BOLSTER PAD||91.09|0||0|10/01/2019 SH 78001|L1025|L1025 - KYPHOSIS PAD FLOATING||136.36|0||0|10/01/2019 SH 78001|L1020|L1020 - KYPHOSIS PAD||119.98|0||0|10/01/2019 SH 78001|L1010|L1010 - CTLSO AXILLA SLING||87.8|0||0|10/01/2019 SH 78001|L1005|L1005 - TENSION BASED SCOLIOSIS ORTH||3696.17|0||0|10/01/2019 SH 78001|L1001|L1001 - CTLSO INFANT IMMOBILIZER||0|0||0|10/01/2019 SH 78001|L1000|L1000 - CTLSO MILWAUKE INITIAL MODEL||2180.41|0||0|10/01/2019 SH 78001|L0984|L0984 - PROTECT BODY SOCK EA PRE OTS||65.21|0||0|10/01/2019 SH 78001|L0982|L0982 - STOCKING SUP GRIPS 4 PRE OTS||20.44|0||0|10/01/2019 SH 78001|L0980|L0980 - PERONEAL STRAPS PAIR PRE OTS||18.76|0||0|10/01/2019 SH 78001|L0978|L0978 - AXILLARY CRUTCH EXTENSION||206.74|0||0|10/01/2019 SH 78001|L0976|L0976 - LSO FULL CORSET||228.97|0||0|10/01/2019 SH 78001|L0974|L0974 - TLSO FULL CORSET||256.37|0||0|10/01/2019 SH 78001|L0972|L0972 - LSO CORSET FRONT||125.47|0||0|10/01/2019 SH 78001|L0970|L0970 - TLSO CORSET FRONT||122.75|0||0|10/01/2019 SH 78001|L0861|L0861 - HALO REPL LINER/INTERFACE||248.9|0||0|10/01/2019 SH 78001|L0859|L0859 - MRI COMPATIBLE SYSTEM||1308.35|0||0|10/01/2019 SH 78001|L0830|L0830 - HALO CERV INTO MILWAUKEE TYP||3367.74|0||0|10/01/2019 SH 78001|L0820|L0820 - HALO CERVICAL INTO BODY JACK||2332.4|0||0|10/01/2019 SH 78001|L0810|L0810 - HALO CERVICAL INTO JCKT VEST||2883.23|0||0|10/01/2019 SH 78001|L0710|L0710 - CTLSO A-P-L CONTROL W/ INTER||2714|0||0|10/01/2019 SH 78001|L0700|L0700 - CTLSO A-P-L CONTROL MOLDED||2486.34|0||0|10/01/2019 SH 78001|L0651|L0651 - LSO SAG-CO SHELL PNL PRE OTS||1572.12|0||0|10/01/2019 SH 78001|L0650|L0650 - LSO SC R ANT/POS PNL PRE OTS||1572.12|0||0|10/01/2019 SH 78001|L0649|L0649 - LSO SC R POS/LAT PNL PRE OTS||331.15|0||0|10/01/2019 SH 78001|L0648|L0648 - LSO SAG R AN/POS PNL PRE OTS||1185.5|0||0|10/01/2019 SH 78001|L0643|L0643 - LSO SAG CTR RIGI POS PRE OTS||187|0||0|10/01/2019 SH 78001|L0642|L0642 - LO SAG RI AN/POS PNL PRE OTS||474.71|0||0|10/01/2019 SH 78001|L0641|L0641 - LO RIG POS PNL L1-L5 PRE OTS||90.02|0||0|10/01/2019 SH 78001|L0640|L0640 - LSO S/C SHELL/PANEL CUSTOM||1208.4|0||0|10/01/2019 SH 78001|L0639|L0639 - LSO S/C SHELL/PANEL PREFAB||1572.12|0||0|10/01/2019 SH 78001|L0638|L0638 - LSO SAG-CORONAL PANEL CUSTOM||1523.1|0||0|10/01/2019 SH 78001|L0637|L0637 - LSO SC R ANT/POS PNL PRE CST||1572.12|0||0|10/01/2019 SH 78001|L0636|L0636 - LSO SAGITTAL RIGID PANEL CUS||1811.96|0||0|10/01/2019 SH 78001|L0635|L0635 - LSO SAGIT RIGID PANEL PREFAB||1227.98|0||0|10/01/2019 SH 78001|L0634|L0634 - LSO FLEXION CONTROL CUSTOM||0|0||0|10/01/2019 SH 78001|L0633|L0633 - LSO SC R POS/LAT PNL PRE CST||331.15|0||0|10/01/2019 SH 78001|L0632|L0632 - LSO SAG RIGID FRAME CUST||0|0||0|10/01/2019 SH 78001|L0631|L0631 - LSO SAG R AN/POS PNL PRE CST||1185.5|0||0|10/01/2019 SH 78001|L0630|L0630 - LSO R POST PNL SJ-T9 PRE CST||187|0||0|10/01/2019 SH 78001|L0629|L0629 - LSO FLEX W/RIGID STAYS CUST||0|0||0|10/01/2019 SH 78001|L0628|L0628 - LSO FLEX NO RI STAYS PRE OTS||96.85|0||0|10/01/2019 SH 78001|L0627|L0627 - LO SAG RI AN/POS PNL PRE CST||474.71|0||0|10/01/2019 SH 78001|L0626|L0626 - LO SAG RIG PNL STAYS PRE CST||90.02|0||0|10/01/2019 SH 78001|L0625|L0625 - LO FLEX L1-BELOW L5 PRE OTS||63.64|0||0|10/01/2019 SH 78001|L0624|L0624 - SIO PANEL CUSTOM||0|0||0|10/01/2019 SH 78001|L0623|L0623 - SIO RIG PNL PELV/SAC PRE OTS||0|0||0|10/01/2019 SH 78001|L0622|L0622 - SIO FLEX PELVISACRAL CUSTOM||279.22|0||0|10/01/2019 SH 78001|L0621|L0621 - SIO FLEX PELVIC/SACR PRE OTS||102.97|0||0|10/01/2019 SH 78001|L0492|L0492 - TLSO 3 PIECE RIGID SHELL||574.79|0||0|10/01/2019 SH 78001|L0491|L0491 - TLSO 2 PIECE RIGID SHELL||886.87|0||0|10/01/2019 SH 78001|L0490|L0490 - TLSO RIGID PLASTIC PRE ONE||326.66|0||0|10/01/2019 SH 78001|L0488|L0488 - TLSO RIGID LINED PRE ONE PIE||1159.25|0||0|10/01/2019 SH 78001|L0486|L0486 - TLSO RIGIDLINED CUST FAB TWO||2024.92|0||0|10/01/2019 SH 78001|L0484|L0484 - TLSO RIGID PLASTIC CUST FAB||2044.08|0||0|10/01/2019 SH 78001|L0482|L0482 - TLSO RIGID LINED CUSTOM FAB||1753.1|0||0|10/01/2019 SH 78001|L0480|L0480 - TLSO RIGID PLASTIC CUSTOM FA||1529.27|0||0|10/01/2019 SH 78001|L0472|L0472 - TLSO RIGID FRAME HYPEREX PRE||494.56|0||0|10/01/2019 SH 78001|L0470|L0470 - TLSO RIGID FRAME PRE SUBCLAV||787.88|0||0|10/01/2019 SH 78001|L0469|L0469 - TLSO RIG FRAM PELVIC PRE OTS||553.39|0||0|10/01/2019 SH 78001|L0468|L0468 - TLSO RIG FRAM PELVIC PRE CST||553.39|0||0|10/01/2019 SH 78001|L0467|L0467 - TLSO R FRAM SOFT PRE OTS||441.4|0||0|10/01/2019 SH 78001|L0466|L0466 - TLSO R FRAM SOFT ANT PRE CST||441.4|0||0|10/01/2019 SH 78001|L0464|L0464 - TLSO 4MOD SACRO-SCAP PRE||1716.55|0||0|10/01/2019 SH 78001|L0462|L0462 - TLSO 3MOD SACRO-SCAP PRE||1441.9|0||0|10/01/2019 SH 78001|L0460|L0460 - TLSO 2 SHL SYMPHYS-STERN CST||1159.25|0||0|10/01/2019 SH 78001|L0458|L0458 - TLSO 2MOD SYMPHIS-XIPHO PRE||1029.9|0||0|10/01/2019 SH 78001|L0457|L0457 - TLSO FLEX TRNK SJ-SS PRE OTS||1148.56|0||0|10/01/2019 SH 78001|L0456|L0456 - TLSO FLEX TRNK SJ-SS PRE CST||1148.56|0||0|10/01/2019 SH 78001|L0455|L0455 - TLSO FLEX TRNK SJ-T9 PRE OTS||400.51|0||0|10/01/2019 SH 78001|L0454|L0454 - TLSO TRNK SJ-T9 PRE CST||400.51|0||0|10/01/2019 SH 78001|L0452|L0452 - TLSO FLEX CUSTOM FAB THORACI||0|0||0|10/01/2019 SH 78001|L0450|L0450 - TLSO FLEX TRUNK/THOR PRE OTS||217.14|0||0|10/01/2019 SH 78001|L0220|L0220 - THOR RIB BELT CUSTOM FABRICA||131.53|0||0|10/01/2019 SH 78001|L0200|L0200 - CERV COL SUPP ADJ BAR & THOR||554.6|0||0|10/01/2019 SH 78001|L0190|L0190 - CERV COLLAR SUPP ADJ CERV BA||604|0||0|10/01/2019 SH 78001|L0180|L0180 - CER POST COL OCC/MAN SUP ADJ||401.23|0||0|10/01/2019 SH 78001|L0174|L0174 - CERV SR 2PC THOR EXT PRE OTS||295.03|0||0|10/01/2019 SH 78001|L0172|L0172 - CERV COL SR FOAM 2PC PRE OTS||164.23|0||0|10/01/2019 SH 78001|L0170|L0170 - CERVICAL COLLAR MOLDED TO PT||809.98|0||0|10/01/2019 SH 78001|L0160|L0160 - CERV SR WIRE OCC/MAN PRE OTS||191.41|0||0|10/01/2019 SH 78001|L0150|L0150 - CERV SEMI-RIG ADJ MOLDED CHN||134.44|0||0|10/01/2019 SH 78001|L0140|L0140 - CERVICAL SEMI-RIGID ADJUSTAB||80.62|0||0|10/01/2019 SH 78001|L0130|L0130 - FLEX THERMOPLASTIC COLLAR MO||233.63|0||0|10/01/2019 SH 78001|L0120|L0120 - CERV FLEX N/ADJ FOAM PRE OTS||32.3|0||0|10/01/2019 SH 78001|L0113|L0113 - CRANIAL CERVICAL TORTICOLLIS||329.34|0||0|10/01/2019 SH 78001|L0112|L0112 - CRANIAL CERVICAL ORTHOSIS||1616.3|0||0|10/01/2019 SH 78001|K0864|K0864 - PWC GP3 XHD MULT POW OPT S/B||0|2060.28||0|10/01/2019 SH 78001|K0863|K0863 - PWC GP3 VHD MULT POW OPT S/B||0|1731.31||0|10/01/2019 SH 78001|K0862|K0862 - PWC GP3 HD MULT POW OPT S/B||0|1211.88||0|10/01/2019 SH 78001|K0861|K0861 - PWC GP3 STD MULT POW OPT S/B||0|978.32||0|10/01/2019 SH 78001|K0860|K0860 - PWC GP3 VHD SING POW OPT S/B||0|1731.31||0|10/01/2019 SH 78001|K0859|K0859 - PWC GP3 HD SING POW OPT CAP||0|1155.76||0|10/01/2019 SH 78001|K0858|K0858 - PWC GP3 HD SING POW OPT S/B||0|1211.88||0|10/01/2019 SH 78001|K0857|K0857 - PWC GP3 STD SING POW OPT CAP||0|996.34||0|10/01/2019 SH 78001|K0856|K0856 - PWC GP3 STD SING POW OPT S/B||0|976.76||0|10/01/2019 SH 78001|K0855|K0855 - PWC GP 3 XHD CAP CHAIR||0|1567.88||0|10/01/2019 SH 78001|K0854|K0854 - PWC GP 3 XHD SEAT/BACK||0|1659.74||0|10/01/2019 SH 78001|K0853|K0853 - PWC GP 3 VHD CAP CHAIR||0|1252.85||0|10/01/2019 SH 78001|K0852|K0852 - PWC GP 3 VHD SEAT/BACK||0|1219.61||0|10/01/2019 SH 78001|K0851|K0851 - PWC GP 3 HD CAP CHAIR||0|1014.9||0|10/01/2019 SH 78001|K0850|K0850 - PWC GP 3 HD SEAT/BACK||0|1055.54||0|10/01/2019 SH 78001|K0849|K0849 - PWC GP 3 STD CAP CHAIR||0|874.9||0|10/01/2019 SH 78001|K0848|K0848 - PWC GP 3 STD SEAT/BACK||0|909.97||0|10/01/2019 SH 78001|K0843|K0843 - PWC GP2 HD MULT POW OPT S/B||0|895.38||0|10/01/2019 SH 78001|K0842|K0842 - PWC GP2 STD MULT POW OPT CAP||0|743.69||0|10/01/2019 SH 78001|K0841|K0841 - PWC GP2 STD MULT POW OPT S/B||0|743.69||0|10/01/2019 SH 78001|K0840|K0840 - PWC GP2 XHD SING POW OPT S/B||0|1635.58||0|10/01/2019 SH 78001|K0839|K0839 - PWC GP2 VHD SING POW OPT S/B||0|1079.62||0|10/01/2019 SH 78001|K0838|K0838 - PWC GP 2 HD SING POW OPT CAP||0|746||0|10/01/2019 SH 78001|K0837|K0837 - PWC GP 2 HD SING POW OPT S/B||0|833.9||0|10/01/2019 SH 78001|K0836|K0836 - PWC GP2 STD SING POW OPT CAP||0|724.57||0|10/01/2019 SH 78001|K0835|K0835 - PWC GP2 STD SING POW OPT S/B||0|698.69||0|10/01/2019 SH 78001|K0829|K0829 - PWC GP 2 XTRA HD CAP CHAIR||0|1092.41||0|10/01/2019 SH 78001|K0828|K0828 - PWC GP 2 XTRA HD SEAT/BACK||0|1189.6||0|10/01/2019 SH 78001|K0827|K0827 - PWC GP VHD CAP CHAIR||0|917.98||0|10/01/2019 SH 78001|K0826|K0826 - PWC GP 2 VHD SEAT/BACK||0|1079.62||0|10/01/2019 SH 78001|K0825|K0825 - PWC GP 2 HD CAP CHAIR||0|763.44||0|10/01/2019 SH 78001|K0824|K0824 - PWC GP 2 HD SEAT/BACK||0|833.9||0|10/01/2019 SH 78001|K0823|K0823 - PWC GP 2 STD CAP CHAIR||0|692.9||0|10/01/2019 SH 78001|K0822|K0822 - PWC GP 2 STD SEAT/BACK||0|688.38||0|10/01/2019 SH 78001|K0821|K0821 - PWC GP 2 STD PORT CAP CHAIR||0|569.58||0|10/01/2019 SH 78001|K0820|K0820 - PWC GP 2 STD PORT SEAT/BACK||0|443.71||0|10/01/2019 SH 78001|K0816|K0816 - PWC GP 1 STD CAP CHAIR||0|579.88||0|10/01/2019 SH 78001|K0815|K0815 - PWC GP 1 STD SEAT/BACK||0|605.48||0|10/01/2019 SH 78001|K0814|K0814 - PWC GP 1 STD PORT CAP CHAIR||0|531.77||0|10/01/2019 SH 78001|K0813|K0813 - PWC GP 1 STD PORT SEAT/BACK||0|415.42||0|10/01/2019 SH 78001|K0808|K0808 - POV GROUP 2 VHD 451-600 LBS||4215.01|421.5||0|10/01/2019 SH 78001|K0807|K0807 - POV GROUP 2 HD 301-450 LBS||2724.28|272.44||0|10/01/2019 SH 78001|K0806|K0806 - POV GROUP 2 STD UP TO 300LBS||1795.36|179.53||0|10/01/2019 SH 78001|K0802|K0802 - POV GROUP 1 VHD 451-600 LBS||2707.76|270.77||0|10/01/2019 SH 78001|K0801|K0801 - POV GROUP 1 HD 301-450 LBS||2392.69|239.23||0|10/01/2019 SH 78001|K0800|K0800 - POV GROUP 1 STD UP TO 300LBS||1484.1|148.43||0|10/01/2019 SH 78001|K0738|K0738 - PORTABLE GAS OXYGEN SYSTEM||0|61.96||0|10/01/2019 SH 78001|K0733|K0733 - 12-24HR SEALED LEAD ACID||34.68|3.49||0|10/01/2019 SH 78001|K0730|K0730 - CTRL DOSE INH DRUG DELIV SYS||0|229.63||0|10/01/2019 SH 78001|K0672|K0672 - REMOVABLE SOFT INTERFACE LE||97.93|0||0|10/01/2019 SH 78001|K0609|K0609 - REPL ELECTRODE FOR AED||1073.65|0||0|10/01/2019 SH 78001|K0608|K0608 - REPL GARMENT FOR AED||161.44|16.18||0|10/01/2019 SH 78001|K0607|K0607 - REPL BATT FOR AED||0|25.88||0|10/01/2019 SH 78001|K0605|K0605 - REPL BATT LITHIUM 4.5 V||19.45|0||0|10/01/2019 SH 78001|K0604|K0604 - REPL BATT LITHIUM 3.6 V||8.1|0||0|10/01/2019 SH 78001|K0603|K0603 - REPL BATT ALKALINE 1.5 V||0.76|0||0|10/01/2019 SH 78001|K0602|K0602 - REPL BATT SILVER OXIDE 3 V||8.46|0||0|10/01/2019 SH 78001|K0601|K0601 - REPL BATT SILVER OXIDE 1.5 V||1.48|0||0|10/01/2019 SH 78001|K0554|K0554 - THER CGM RECEIVER/MONITOR||298.76|29.88||0|10/01/2019 SH 78001|K0553|K0553 - THER CGM SUPPLY ALLOWANCE||301.33|0||0|10/01/2019 SH 78001|K0552|K0552 - SUP/EXT NON-INS INF PUMP SYR||3.53|0||0|10/01/2019 SH 78001|K0455|K0455 - PUMP UNINTERRUPTED INFUSION||0|342.22||0|10/01/2019 SH 78001|K0195|K0195 - ELEVATING WHLCHAIR LEG RESTS||0|24.02||0|10/01/2019 SH 78001|K0105|K0105 - IV HANGER||132.43|13.24||0|10/01/2019 SH 78001|K0098|K0098 - DRIVE BELT FOR PWC - REPL||31.24|3.13||0|10/01/2019 SH 78001|K0077|K0077 - FR CSTR ASMB SOL TIRE REP EA||78.4|7.82||0|10/01/2019 SH 78001|K0073|K0073 - CASTER PIN LOCK EACH||46.36|4.64||0|10/01/2019 SH 78001|K0072|K0072 - FR CSTR SEMI-PNE TIRE REP EA||87.6|8.76||0|10/01/2019 SH 78001|K0071|K0071 - FR CSTR COMP PNE TIRE REP EA||145.51|14.57||0|10/01/2019 SH 78001|K0070|K0070 - RR WHL COMPL PNE TIRE REP EA||243.95|24.42||0|10/01/2019 SH 78001|K0069|K0069 - RR WHL COMPL SOL TIRE REP EA||133.1|13.86||0|10/01/2019 SH 78001|K0065|K0065 - SPOKE PROTECTORS||59.21|5.93||0|10/01/2019 SH 78001|K0056|K0056 - SEAT HT <17 OR >=21 LTWT WC||126.67|12.67||0|10/01/2019 SH 78001|K0053|K0053 - ELEVATE FOOTREST ARTICULATE||117.11|11.7||0|10/01/2019 SH 78001|K0052|K0052 - SWINGAWAY DETACH FTREST REPL||106.13|10.61||0|10/01/2019 SH 78001|K0051|K0051 - CAM REL ASM FT/LEGRST REP EA||60.38|6.07||0|10/01/2019 SH 78001|K0050|K0050 - RATCHET ASSEMBLY REPLACEMENT||37.31|3.72||0|10/01/2019 SH 78001|K0047|K0047 - ELEV LEGRST UPR HANGR REP EA||87.79|8.81||0|10/01/2019 SH 78001|K0046|K0046 - ELEV LGRST LWR EXTEN REPL EA||22.4|2.23||0|10/01/2019 SH 78001|K0045|K0045 - FTRST COMPL ASSEMBLY REPL EA||65|6.7||0|10/01/2019 SH 78001|K0044|K0044 - FTRST UPR HANGER BRAC REP EA||19.1|1.92||0|10/01/2019 SH 78001|K0043|K0043 - FTRST LOWR EXTEN TUBE REP EA||22.4|2.23||0|10/01/2019 SH 78001|K0042|K0042 - STANDARD SIZE FTPLATE REP EA||41.83|4.18||0|10/01/2019 SH 78001|K0041|K0041 - LARGE SIZE FOOTPLATE EACH||60.74|6.12||0|10/01/2019 SH 78001|K0040|K0040 - ADJUSTABLE ANGLE FOOTPLATE||85.73|8.56||0|10/01/2019 SH 78001|K0039|K0039 - LEG STRAP H STYLE EACH||61.85|6.22||0|10/01/2019 SH 78001|K0038|K0038 - LEG STRAP EACH||27.86|2.78||0|10/01/2019 SH 78001|K0037|K0037 - HI MOUNT FLIP-UP FOOTREST EA||55.28|4.93||0|10/01/2019 SH 78001|K0020|K0020 - FIXED ADJUST ARMREST PAIR||53.34|5.34||0|10/01/2019 SH 78001|K0019|K0019 - ARM PAD REPL - EACH||19.51|1.96||0|10/01/2019 SH 78001|K0018|K0018 - DETACH ADJUST ARMRST UPPER||32.77|3.26||0|10/01/2019 SH 78001|K0017|K0017 - DETACH ADJUST ARMREST BASE||58.67|5.87||0|10/01/2019 SH 78001|K0015|K0015 - DETACH NON-ADJ HT ARMRST REP||208.61|20.86||0|10/01/2019 SH 78001|K0012|K0012 - LTWT PORTBL POWER WHLCHR||0|419.77||0|10/01/2019 SH 78001|K0011|K0011 - STND WT PWR WHLCHR W CONTROL||0|682.3||0|10/01/2019 SH 78001|K0010|K0010 - STND WT FRAME POWER WHLCHR||0|482.28||0|10/01/2019 SH 78001|K0009|K0009 - OTHER MANUAL WHEELCHAIR/BASE||0|99.04||0|10/01/2019 SH 78001|K0007|K0007 - EXTRA HEAVY DUTY WHEELCHAIR||0|233.78||0|10/01/2019 SH 78001|K0006|K0006 - HEAVY DUTY WHEELCHAIR||0|167.05||0|10/01/2019 SH 78001|K0005|K0005 - ULTRALIGHTWEIGHT WHEELCHAIR||2462.45|246.22||0|10/01/2019 SH 78001|K0004|K0004 - HIGH STRENGTH LTWT WHLCHR||0|151.3||0|10/01/2019 SH 78001|K0003|K0003 - LIGHTWEIGHT WHEELCHAIR||0|117.83||0|10/01/2019 SH 78001|K0002|K0002 - STND HEMI (LOW SEAT) WHLCHR||0|92.64||0|10/01/2019 SH 78001|K0001|K0001 - STANDARD WHEELCHAIR||0|62.63||0|10/01/2019 SH 78001|J9400|J9400 - INJ - ZIV-AFLIBERCEPT - 1 MG||10.1062|0||0|10/01/2019 SH 78001|J9395|J9395 - INJECTION - FULVESTRANT||121.5525|0||0|10/01/2019 SH 78001|J9390|J9390 - VINORELBINE TARTRATE INJ||21.5413|0||0|10/01/2019 SH 78001|J9371|J9371 - INJ - VINCRISTINE SUL LIP 1 MG||3508.9313|0||0|10/01/2019 SH 78001|J9370|J9370 - VINCRISTINE SULFATE 1 MG INJ||6.5187|0||0|10/01/2019 SH 78001|J9360|J9360 - VINBLASTINE SULFATE INJ||4.7613|0||0|10/01/2019 SH 78001|J9357|J9357 - VALRUBICIN INJECTION||1561.4675|0||0|10/01/2019 SH 78001|J9355|J9355 - TRASTUZUMAB INJECTION||129.66|0||0|10/01/2019 SH 78001|J9354|J9354 - INJ - ADO-TRASTUZUMAB EMT 1 MG||38.365|0||0|10/01/2019 SH 78001|J9352|J9352 - INJECTION TRABECTEDIN 0.1MG||370.5238|0||0|10/01/2019 SH 78001|J9351|J9351 - TOPOTECAN INJECTION||1.295|0||0|10/01/2019 SH 78001|J9330|J9330 - TEMSIROLIMUS INJECTION||92.2113|0||0|10/01/2019 SH 78001|J9328|J9328 - TEMOZOLOMIDE INJECTION||13.2012|0||0|10/01/2019 SH 78001|J9325|J9325 - INJ TALIMOGENE LAHERPAREPVEC||62.125|0||0|10/01/2019 SH 78001|J9320|J9320 - STREPTOZOCIN INJECTION||429.9837|0||0|10/01/2019 SH 78001|J9315|J9315 - ROMIDEPSIN INJECTION||411.3025|0||0|10/01/2019 SH 78001|J9310|J9310 - RITUXIMAB INJECTION||1144.12|0||0|10/01/2019 SH 78001|J9308|J9308 - INJECTION - RAMUCIRUMAB||72.0825|0||0|10/01/2019 SH 78001|J9307|J9307 - PRALATREXATE INJECTION||333.8462|0||0|10/01/2019 SH 78001|J9306|J9306 - INJECTION - PERTUZUMAB - 1 MG||14.7587|0||0|10/01/2019 SH 78001|J9305|J9305 - PEMETREXED INJECTION||84.3238|0||0|10/01/2019 SH 78001|J9303|J9303 - PANITUMUMAB INJECTION||142.545|0||0|10/01/2019 SH 78001|J9302|J9302 - OFATUMUMAB INJECTION||73.05|0||0|10/01/2019 SH 78001|J9301|J9301 - OBINUTUZUMAB INJ||78.5537|0||0|10/01/2019 SH 78001|J9299|J9299 - INJECTION - NIVOLUMAB||33.9438|0||0|10/01/2019 SH 78001|J9295|J9295 - INJECTION - NECITUMUMAB - 1 MG||6.8812|0||0|10/01/2019 SH 78001|J9293|J9293 - MITOXANTRONE HYDROCHL / 5 MG||37.3462|0||0|10/01/2019 SH 78001|J9285|J9285 - INJ - OLARATUMAB - 10 MG||63.795|0||0|10/01/2019 SH 78001|J9280|J9280 - MITOMYCIN INJECTION||180.095|0||0|10/01/2019 SH 78001|J9271|J9271 - INJ PEMBROLIZUMAB||60.7175|0||0|10/01/2019 SH 78001|J9268|J9268 - PENTOSTATIN INJECTION||2506.5087|0||0|10/01/2019 SH 78001|J9267|J9267 - PACLITAXEL INJECTION||0.1613|0||0|10/01/2019 SH 78001|J9266|J9266 - PEGASPARGASE INJECTION||18787.72|0||0|10/01/2019 SH 78001|J9264|J9264 - PACLITAXEL PROTEIN BOUND||14.035|0||0|10/01/2019 SH 78001|J9263|J9263 - OXALIPLATIN||0.2562|0||0|10/01/2019 SH 78001|J9261|J9261 - NELARABINE INJECTION||190.1375|0||0|10/01/2019 SH 78001|J9260|J9260 - METHOTREXATE SODIUM INJ||3.0725|0||0|10/01/2019 SH 78001|J9250|J9250 - METHOTREXATE SODIUM INJ||0.3063|0||0|10/01/2019 SH 78001|J9245|J9245 - INJ MELPHALAN HYDROCHL 50 MG||1319.895|0||0|10/01/2019 SH 78001|J9230|J9230 - MECHLORETHAMINE HCL INJ||403.3238|0||0|10/01/2019 SH 78001|J9228|J9228 - IPILIMUMAB INJECTION||185.7887|0||0|10/01/2019 SH 78001|J9226|J9226 - SUPPRELIN LA IMPLANT||38052.3725|0||0|10/01/2019 SH 78001|J9225|J9225 - VANTAS IMPLANT||4315.4125|0||0|10/01/2019 SH 78001|J9218|J9218 - LEUPROLIDE ACETATE INJECITON||41.495|0||0|10/01/2019 SH 78001|J9217|J9217 - LEUPROLIDE ACETATE SUSPNSION||272.7175|0||0|10/01/2019 SH 78001|J9214|J9214 - INTERFERON ALFA-2B INJ||42.975|0||0|10/01/2019 SH 78001|J9211|J9211 - IDARUBICIN HCL INJECTION||44.3062|0||0|10/01/2019 SH 78001|J9209|J9209 - MESNA INJECTION||3.09|0||0|10/01/2019 SH 78001|J9208|J9208 - IFOSFAMIDE INJECTION||32.8413|0||0|10/01/2019 SH 78001|J9207|J9207 - IXABEPILONE INJECTION||88.2412|0||0|10/01/2019 SH 78001|J9206|J9206 - IRINOTECAN INJECTION||3.8312|0||0|10/01/2019 SH 78001|J9205|J9205 - INJ IRINOTECAN LIPOSOME 1 MG||57.04|0||0|10/01/2019 SH 78001|J9203|J9203 - GEMTUZUMAB OZOGAMICIN 0.1 MG||241.445|0||0|10/01/2019 SH 78001|J9202|J9202 - GOSERELIN ACETATE IMPLANT||584.47|0||0|10/01/2019 SH 78001|J9201|J9201 - GEMCITABINE HCL INJECTION||8.1237|0||0|10/01/2019 SH 78001|J9200|J9200 - FLOXURIDINE INJECTION||111.5125|0||0|10/01/2019 SH 78001|J9190|J9190 - FLUOROURACIL INJECTION||2.1725|0||0|10/01/2019 SH 78001|J9185|J9185 - FLUDARABINE PHOSPHATE INJ||92.8462|0||0|10/01/2019 SH 78001|J9181|J9181 - ETOPOSIDE INJECTION||1.6887|0||0|10/01/2019 SH 78001|J9179|J9179 - ERIBULIN MESYLATE INJECTION||141.2337|0||0|10/01/2019 SH 78001|J9178|J9178 - INJ - EPIRUBICIN HCL - 2 MG||1.6113|0||0|10/01/2019 SH 78001|J9176|J9176 - INJECTION - ELOTUZUMAB - 1 MG||8.0237|0||0|10/01/2019 SH 78001|J9171|J9171 - DOCETAXEL INJECTION||2.2662|0||0|10/01/2019 SH 78001|J9155|J9155 - DEGARELIX INJECTION||4.5687|0||0|10/01/2019 SH 78001|J9150|J9150 - DAUNORUBICIN INJECTION||52.8775|0||0|10/01/2019 SH 78001|J9145|J9145 - INJECTION - DARATUMUMAB 10 MG||63.6863|0||0|10/01/2019 SH 78001|J9130|J9130 - DACARBAZINE 100 MG INJ||4.9138|0||0|10/01/2019 SH 78001|J9120|J9120 - DACTINOMYCIN INJECTION||1967.5812|0||0|10/01/2019 SH 78001|J9100|J9100 - CYTARABINE HCL 100 MG INJ||0.7462|0||0|10/01/2019 SH 78001|J9098|J9098 - CYTARABINE LIPOSOME INJ||785.46|0||0|10/01/2019 SH 78001|J9070|J9070 - CYCLOPHOSPHAMIDE 100 MG INJ||52.2837|0||0|10/01/2019 SH 78001|J9065|J9065 - INJ CLADRIBINE PER 1 MG||27.8412|0||0|10/01/2019 SH 78001|J9060|J9060 - CISPLATIN 10 MG INJECTION||2.48|0||0|10/01/2019 SH 78001|J9055|J9055 - CETUXIMAB INJECTION||75.9737|0||0|10/01/2019 SH 78001|J9050|J9050 - CARMUSTINE INJECTION||4901.8825|0||0|10/01/2019 SH 78001|J9047|J9047 - INJECTION - CARFILZOMIB - 1 MG||43.9925|0||0|10/01/2019 SH 78001|J9045|J9045 - CARBOPLATIN INJECTION||4.0525|0||0|10/01/2019 SH 78001|J9043|J9043 - CABAZITAXEL INJECTION||204.4825|0||0|10/01/2019 SH 78001|J9042|J9042 - BRENTUXIMAB VEDOTIN INJ||188.5238|0||0|10/01/2019 SH 78001|J9041|J9041 - INJ. - VELCADE 0.1 MG||58.4312|0||0|10/01/2019 SH 78001|J9040|J9040 - BLEOMYCIN SULFATE INJECTION||34.7725|0||0|10/01/2019 SH 78001|J9039|J9039 - INJECTION - BLINATUMOMAB||137.4038|0||0|10/01/2019 SH 78001|J9035|J9035 - BEVACIZUMAB INJECTION||98.5662|0||0|10/01/2019 SH 78001|J9034|J9034 - INJ. - BENDEKA 1 MG||29.3062|0||0|10/01/2019 SH 78001|J9033|J9033 - INJ. - TREANDA 1 MG||38.4338|0||0|10/01/2019 SH 78001|J9032|J9032 - INJECTION - BELINOSTAT - 10MG||46.5688|0||0|10/01/2019 SH 78001|J9031|J9031 - BCG LIVE INTRAVESICAL VAC||172.64|0||0|10/01/2019 SH 78001|J9027|J9027 - CLOFARABINE INJECTION||150.2975|0||0|10/01/2019 SH 78001|J9025|J9025 - AZACITIDINE INJECTION||1.8862|0||0|10/01/2019 SH 78001|J9023|J9023 - INJECTION - AVELUMAB - 10 MG||100.7375|0||0|10/01/2019 SH 78001|J9022|J9022 - INJ - ATEZOLIZUMAB - 10 MG||96.1188|0||0|10/01/2019 SH 78001|J9020|J9020 - ASPARAGINASE - NOS||80.7|0||0|10/01/2019 SH 78001|J9019|J9019 - ERWINAZE INJECTION||518.5312|0||0|10/01/2019 SH 78001|J9017|J9017 - ARSENIC TRIOXIDE INJECTION||96.33|0||0|10/01/2019 SH 78001|J9000|J9000 - DOXORUBICIN HCL INJECTION||3.8388|0||0|10/01/2019 SH 78001|J8705|J8705 - TOPOTECAN ORAL||129.8237|0||0|10/01/2019 SH 78001|J8700|J8700 - TEMOZOLOMIDE||1.1538|0||0|10/01/2019 SH 78001|J8670|J8670 - ROLAPITANT - ORAL - 1 MG||2.7812|0||0|10/01/2019 SH 78001|J8655|J8655 - ORAL NETUPITANT - PALONOSETRO||425.78|0||0|10/01/2019 SH 78001|J8610|J8610 - METHOTREXATE ORAL 2.5 MG||1.4238|0||0|10/01/2019 SH 78001|J8600|J8600 - MELPHALAN ORAL 2 MG||14.5962|0||0|10/01/2019 SH 78001|J8560|J8560 - ETOPOSIDE ORAL 50 MG||94.7362|0||0|10/01/2019 SH 78001|J8540|J8540 - ORAL DEXAMETHASONE||0.1062|0||0|10/01/2019 SH 78001|J8530|J8530 - CYCLOPHOSPHAMIDE ORAL 25 MG||5.0575|0||0|10/01/2019 SH 78001|J8521|J8521 - CAPECITABINE - ORAL - 500 MG||6.7|0||0|10/01/2019 SH 78001|J8520|J8520 - CAPECITABINE - ORAL - 150 MG||2.2725|0||0|10/01/2019 SH 78001|J8510|J8510 - ORAL BUSULFAN||30.16|0||0|10/01/2019 SH 78001|J8501|J8501 - ORAL APREPITANT||9.3637|0||0|10/01/2019 SH 78001|J7686|J7686 - TREPROSTINIL - NON-COMP UNIT||730.4062|0||0|10/01/2019 SH 78001|J7682|J7682 - TOBRAMYCIN NON-COMP UNIT||60.8137|0||0|10/01/2019 SH 78001|J7674|J7674 - METHACHOLINE CHLORIDE - NEB||0.6725|0||0|10/01/2019 SH 78001|J7665|J7665 - MANNITOL FOR INHALER||0.84|0||0|10/01/2019 SH 78001|J7644|J7644 - IPRATROPIUM BROMIDE NON-COMP||0.2712|0||0|10/01/2019 SH 78001|J7639|J7639 - DORNASE ALFA NON-COMP UNIT||59.6562|0||0|10/01/2019 SH 78001|J7631|J7631 - CROMOLYN SODIUM NONCOMP UNIT||9.6188|0||0|10/01/2019 SH 78001|J7626|J7626 - BUDESONIDE NON-COMP UNIT||4.4062|0||0|10/01/2019 SH 78001|J7620|J7620 - ALBUTEROL IPRATROP NON-COMP||0.1775|0||0|10/01/2019 SH 78001|J7614|J7614 - LEVALBUTEROL NON-COMP UNIT||0.075|0||0|10/01/2019 SH 78001|J7613|J7613 - ALBUTEROL NON-COMP UNIT||0.0575|0||0|10/01/2019 SH 78001|J7612|J7612 - LEVALBUTEROL NON-COMP CON||0.2512|0||0|10/01/2019 SH 78001|J7611|J7611 - ALBUTEROL NON-COMP CON||0.1988|0||0|10/01/2019 SH 78001|J7608|J7608 - ACETYLCYSTEINE NON-COMP UNIT||5.4737|0||0|10/01/2019 SH 78001|J7606|J7606 - FORMOTEROL FUMARATE - INH||13.5262|0||0|10/01/2019 SH 78001|J7605|J7605 - ARFORMOTEROL NON-COMP UNIT||12.3375|0||0|10/01/2019 SH 78001|J7527|J7527 - ORAL EVEROLIMUS||10.76|0||0|10/01/2019 SH 78001|J7525|J7525 - TACROLIMUS INJECTION||257.8975|0||0|10/01/2019 SH 78001|J7520|J7520 - SIROLIMUS - ORAL||9.1438|0||0|10/01/2019 SH 78001|J7518|J7518 - MYCOPHENOLIC ACID||3.8525|0||0|10/01/2019 SH 78001|J7517|J7517 - MYCOPHENOLATE MOFETIL ORAL||1.9112|0||0|10/01/2019 SH 78001|J7516|J7516 - CYCLOSPORIN PARENTERAL 250MG||55.2463|0||0|10/01/2019 SH 78001|J7515|J7515 - CYCLOSPORINE ORAL 25 MG||0.895|0||0|10/01/2019 SH 78001|J7512|J7512 - PREDNISONE IR OR DR ORAL 1 MG||0.0187|0||0|10/01/2019 SH 78001|J7511|J7511 - ANTITHYMOCYTE GLOBULN RABBIT||907.1137|0||0|10/01/2019 SH 78001|J7510|J7510 - PREDNISOLONE ORAL PER 5 MG||0.0813|0||0|10/01/2019 SH 78001|J7509|J7509 - METHYLPREDNISOLONE ORAL||0.3325|0||0|10/01/2019 SH 78001|J7508|J7508 - TACROL ASTAGRAF EX REL ORAL||0.5913|0||0|10/01/2019 SH 78001|J7507|J7507 - TACROLIMUS IMME REL ORAL 1MG||0.6663|0||0|10/01/2019 SH 78001|J7506|J7506 - PREDNISONE ORAL PER 5 MG||0.09|0||0|10/01/2019 SH 78001|J7504|J7504 - LYMPHOCYTE IMMUNE GLOBULIN||2633.135|0||0|10/01/2019 SH 78001|J7503|J7503 - TACROL ENVARSUS EX REL ORAL||1.5675|0||0|10/01/2019 SH 78001|J7502|J7502 - CYCLOSPORINE ORAL 100 MG||3.0288|0||0|10/01/2019 SH 78001|J7500|J7500 - AZATHIOPRINE ORAL 50MG||0.75|0||0|10/01/2019 SH 78001|J7336|J7336 - CAPSAICIN 8% PATCH||3.9375|0||0|10/01/2019 SH 78001|J7327|J7327 - MONOVISC INJ PER DOSE||995.7025|0||0|10/01/2019 SH 78001|J7326|J7326 - GEL-ONE||636.685|0||0|10/01/2019 SH 78001|J7325|J7325 - SYNVISC OR SYNVISC-ONE||14.6237|0||0|10/01/2019 SH 78001|J7324|J7324 - ORTHOVISC INJ PER DOSE||175.4263|0||0|10/01/2019 SH 78001|J7323|J7323 - EUFLEXXA INJ PER DOSE||179.6675|0||0|10/01/2019 SH 78001|J7321|J7321 - HYALGAN SUPARTZ VISCO-3 DOSE||103.9688|0||0|10/01/2019 SH 78001|J7320|J7320 - GENVISC 850 - INJ - 1 MG||7.815|0||0|10/01/2019 SH 78001|J7316|J7316 - INJ - OCRIPLASMIN - 0.125 MG||1273.3688|0||0|10/01/2019 SH 78001|J7313|J7313 - FLUOCINOL ACET INTRAVIT IMP||612.7475|0||0|10/01/2019 SH 78001|J7312|J7312 - DEXAMETHASONE INTRA IMPLANT||250.245|0||0|10/01/2019 SH 78001|J7311|J7311 - FLUOCINOLONE ACETONIDE IMPLT||25494.1175|0||0|10/01/2019 SH 78001|J7310|J7310 - GANCICLOVIR LONG ACT IMPLANT||21200|0||0|10/01/2019 SH 78001|J7308|J7308 - AMINOLEVULINIC ACID HCL TOP||505.7387|0||0|10/01/2019 SH 78001|J7307|J7307 - ETONOGESTREL IMPLANT SYSTEM||715|0||0|10/01/2019 SH 78001|J7297|J7297 - LILETTA - 52 MG||0|0||0|10/01/2019 SH 78001|J7205|J7205 - FACTOR VIII FC FUSION RECOMB||2.5112|0||0|10/01/2019 SH 78001|J7201|J7201 - FACTOR IX ALPROLIX RECOMB||3.74|0||0|10/01/2019 SH 78001|J7200|J7200 - FACTOR IX RECOMBINAN RIXUBIS||1.685|0||0|10/01/2019 SH 78001|J7198|J7198 - ANTI-INHIBITOR||2.6387|0||0|10/01/2019 SH 78001|J7197|J7197 - ANTITHROMBIN III INJECTION||4.605|0||0|10/01/2019 SH 78001|J7195|J7195 - FACTOR IX RECOMBINANT NOS||1.8887|0||0|10/01/2019 SH 78001|J7194|J7194 - FACTOR IX COMPLEX||1.7825|0||0|10/01/2019 SH 78001|J7193|J7193 - FACTOR IX NON-RECOMBINANT||1.4212|0||0|10/01/2019 SH 78001|J7192|J7192 - FACTOR VIII RECOMBINANT NOS||1.6925|0||0|10/01/2019 SH 78001|J7190|J7190 - FACTOR VIII||1.3838|0||0|10/01/2019 SH 78001|J7189|J7189 - FACTOR VIIA||2.5863|0||0|10/01/2019 SH 78001|J7187|J7187 - HUMATE-P - INJ||1.405|0||0|10/01/2019 SH 78001|J7186|J7186 - ANTIHEMOPHILIC VIII/VWF COMP||1.2425|0||0|10/01/2019 SH 78001|J7185|J7185 - XYNTHA INJ||1.5637|0||0|10/01/2019 SH 78001|J7183|J7183 - WILATE INJECTION||1.285|0||0|10/01/2019 SH 78001|J7182|J7182 - FACTOR VIII RECOMB NOVOEIGHT||1.6625|0||0|10/01/2019 SH 78001|J7180|J7180 - FACTOR XIII ANTI-HEM FACTOR||10.2688|0||0|10/01/2019 SH 78001|J7120|J7120 - RINGERS LACTATE INFUSION||3.3413|0||0|10/01/2019 SH 78001|J7070|J7070 - D5W INFUSION||5.61|0||0|10/01/2019 SH 78001|J7060|J7060 - 5% DEXTROSE/WATER||2.8487|0||0|10/01/2019 SH 78001|J7050|J7050 - NORMAL SALINE SOLUTION INFUS||0.78|0||0|10/01/2019 SH 78001|J7042|J7042 - 5% DEXTROSE/NORMAL SALINE||1.2575|0||0|10/01/2019 SH 78001|J7040|J7040 - NORMAL SALINE SOLUTION INFUS||1.57|0||0|10/01/2019 SH 78001|J7030|J7030 - NORMAL SALINE SOLUTION INFUS||3.1212|0||0|10/01/2019 SH 78001|J3489|J3489 - ZOLEDRONIC ACID 1MG||18.395|0||0|10/01/2019 SH 78001|J3486|J3486 - ZIPRASIDONE MESYLATE||22.5888|0||0|10/01/2019 SH 78001|J3485|J3485 - ZIDOVUDINE||1.8925|0||0|10/01/2019 SH 78001|J3480|J3480 - INJ POTASSIUM CHLORIDE||0.1512|0||0|10/01/2019 SH 78001|J3475|J3475 - INJ MAGNESIUM SULFATE||0.6325|0||0|10/01/2019 SH 78001|J3473|J3473 - HYALURONIDASE RECOMBINANT||0.4475|0||0|10/01/2019 SH 78001|J3471|J3471 - OVINE - UP TO 999 USP UNITS||0.5062|0||0|10/01/2019 SH 78001|J3465|J3465 - INJECTION - VORICONAZOLE||2.425|0||0|10/01/2019 SH 78001|J3430|J3430 - VITAMIN K PHYTONADIONE INJ||5.3425|0||0|10/01/2019 SH 78001|J3420|J3420 - VITAMIN B12 INJECTION||2.385|0||0|10/01/2019 SH 78001|J3415|J3415 - PYRIDOXINE HCL 100 MG||11.9038|0||0|10/01/2019 SH 78001|J3411|J3411 - THIAMINE HCL 100 MG||3.6425|0||0|10/01/2019 SH 78001|J3410|J3410 - HYDROXYZINE HCL INJECTION||9.0813|0||0|10/01/2019 SH 78001|J3396|J3396 - VERTEPORFIN INJECTION||13.57|0||0|10/01/2019 SH 78001|J3385|J3385 - VELAGLUCERASE ALFA||431.5625|0||0|10/01/2019 SH 78001|J3380|J3380 - INJECTION - VEDOLIZUMAB||24.5275|0||0|10/01/2019 SH 78001|J3370|J3370 - VANCOMYCIN HCL INJECTION||4.8913|0||0|10/01/2019 SH 78001|J3360|J3360 - DIAZEPAM INJECTION||8.6937|0||0|10/01/2019 SH 78001|J3358|J3358 - USTEKINUMAB - IV INJECT - 1 MG||15.6862|0||0|10/01/2019 SH 78001|J3357|J3357 - USTEKINUMAB SUB CU INJ - 1 MG||244.4338|0||0|10/01/2019 SH 78001|J3315|J3315 - TRIPTORELIN PAMOATE||327.62|0||0|10/01/2019 SH 78001|J3303|J3303 - TRIAMCINOLONE HEXACETONL INJ||2.27|0||0|10/01/2019 SH 78001|J3301|J3301 - TRIAMCINOLONE ACET INJ NOS||2.2075|0||0|10/01/2019 SH 78001|J3300|J3300 - TRIAMCINOLONE A INJ PRS-FREE||4.8213|0||0|10/01/2019 SH 78001|J3285|J3285 - TREPROSTINIL INJECTION||76.5463|0||0|10/01/2019 SH 78001|J3262|J3262 - TOCILIZUMAB INJECTION||5.8987|0||0|10/01/2019 SH 78001|J3260|J3260 - TOBRAMYCIN SULFATE INJECTION||3.7538|0||0|10/01/2019 SH 78001|J3250|J3250 - TRIMETHOBENZAMIDE HCL INJ||40.2963|0||0|10/01/2019 SH 78001|J3243|J3243 - TIGECYCLINE INJECTION||2.82|0||0|10/01/2019 SH 78001|J3240|J3240 - THYROTROPIN INJECTION||2010.8937|0||0|10/01/2019 SH 78001|J3230|J3230 - CHLORPROMAZINE HCL INJECTION||36.6812|0||0|10/01/2019 SH 78001|J3121|J3121 - INJ TESTOSTERO ENANTHATE 1MG||0.0475|0||0|10/01/2019 SH 78001|J3105|J3105 - TERBUTALINE SULFATE INJ||3.6187|0||0|10/01/2019 SH 78001|J3101|J3101 - TENECTEPLASE INJECTION||151.2812|0||0|10/01/2019 SH 78001|J3095|J3095 - TELAVANCIN INJECTION||6.8587|0||0|10/01/2019 SH 78001|J3090|J3090 - INJ TEDIZOLID PHOSPHATE||1.7962|0||0|10/01/2019 SH 78001|J3070|J3070 - PENTAZOCINE INJECTION||135.4812|0||0|10/01/2019 SH 78001|J3060|J3060 - INJ - TALIGLUCERASE ALFA 10 U||50.4875|0||0|10/01/2019 SH 78001|J3010|J3010 - FENTANYL CITRATE INJECTION||0.7438|0||0|10/01/2019 SH 78001|J3000|J3000 - STREPTOMYCIN INJECTION||20.5738|0||0|10/01/2019 SH 78001|J2997|J2997 - ALTEPLASE RECOMBINANT||109.525|0||0|10/01/2019 SH 78001|J2993|J2993 - RETEPLASE INJECTION||2877.39|0||0|10/01/2019 SH 78001|J2930|J2930 - METHYLPREDNISOLONE INJECTION||8.7063|0||0|10/01/2019 SH 78001|J2920|J2920 - METHYLPREDNISOLONE INJECTION||6.0062|0||0|10/01/2019 SH 78001|J2916|J2916 - NA FERRIC GLUCONATE COMPLEX||2.7237|0||0|10/01/2019 SH 78001|J2850|J2850 - INJ SECRETIN SYNTHETIC HUMAN||43.48|0||0|10/01/2019 SH 78001|J2820|J2820 - SARGRAMOSTIM INJECTION||44.52|0||0|10/01/2019 SH 78001|J2810|J2810 - INJ THEOPHYLLINE PER 40 MG||0.3837|0||0|10/01/2019 SH 78001|J2805|J2805 - SINCALIDE INJECTION||133.3113|0||0|10/01/2019 SH 78001|J2800|J2800 - METHOCARBAMOL INJECTION||30.1588|0||0|10/01/2019 SH 78001|J2796|J2796 - ROMIPLOSTIM INJECTION||88.185|0||0|10/01/2019 SH 78001|J2795|J2795 - ROPIVACAINE HCL INJECTION||0.0988|0||0|10/01/2019 SH 78001|J2794|J2794 - RISPERIDONE - LONG ACTING||11.7525|0||0|10/01/2019 SH 78001|J2792|J2792 - RHO(D) IMMUNE GLOBULIN H - SD||34.145|0||0|10/01/2019 SH 78001|J2791|J2791 - RHOPHYLAC INJECTION||6.06|0||0|10/01/2019 SH 78001|J2790|J2790 - RHO D IMMUNE GLOBULIN INJ||103.0512|0||0|10/01/2019 SH 78001|J2788|J2788 - RHO D IMMUNE GLOBULIN 50 MCG||31.7188|0||0|10/01/2019 SH 78001|J2785|J2785 - REGADENOSON INJECTION||70.6225|0||0|10/01/2019 SH 78001|J2783|J2783 - RASBURICASE||339.5562|0||0|10/01/2019 SH 78001|J2780|J2780 - RANITIDINE HYDROCHLORIDE INJ||6.8137|0||0|10/01/2019 SH 78001|J2778|J2778 - RANIBIZUMAB INJECTION||466.875|0||0|10/01/2019 SH 78001|J2770|J2770 - QUINUPRISTIN/DALFOPRISTIN||523.2387|0||0|10/01/2019 SH 78001|J2765|J2765 - METOCLOPRAMIDE HCL INJECTION||1.0662|0||0|10/01/2019 SH 78001|J2760|J2760 - PHENTOLAINE MESYLATE INJ||198.75|0||0|10/01/2019 SH 78001|J2730|J2730 - PRALIDOXIME CHLORIDE INJ||114.88|0||0|10/01/2019 SH 78001|J2724|J2724 - PROTEIN C CONCENTRATE||19.17|0||0|10/01/2019 SH 78001|J2720|J2720 - INJ PROTAMINE SULFATE/10 MG||1.4312|0||0|10/01/2019 SH 78001|J2704|J2704 - INJ - PROPOFOL - 10 MG||0.1475|0||0|10/01/2019 SH 78001|J2700|J2700 - OXACILLIN SODIUM INJECITON||2.8325|0||0|10/01/2019 SH 78001|J2690|J2690 - PROCAINAMIDE HCL INJECTION||86.5425|0||0|10/01/2019 SH 78001|J2680|J2680 - FLUPHENAZINE DECANOATE 25 MG||17.4225|0||0|10/01/2019 SH 78001|J2675|J2675 - INJ PROGESTERONE PER 50 MG||1.3775|0||0|10/01/2019 SH 78001|J2597|J2597 - INJ DESMOPRESSIN ACETATE||16.1288|0||0|10/01/2019 SH 78001|J2562|J2562 - PLERIXAFOR INJECTION||412.2663|0||0|10/01/2019 SH 78001|J2560|J2560 - PHENOBARBITAL SODIUM INJ||47.7088|0||0|10/01/2019 SH 78001|J2550|J2550 - PROMETHAZINE HCL INJECTION||2.4062|0||0|10/01/2019 SH 78001|J2545|J2545 - PENTAMIDINE NON-COMP UNIT||144.345|0||0|10/01/2019 SH 78001|J2543|J2543 - PIPERACILLIN/TAZOBACTAM||3.4075|0||0|10/01/2019 SH 78001|J2540|J2540 - PENICILLIN G POTASSIUM INJ||1.3562|0||0|10/01/2019 SH 78001|J2515|J2515 - PENTOBARBITAL SODIUM INJ||61.5012|0||0|10/01/2019 SH 78001|J2510|J2510 - PENICILLIN G PROCAINE INJ||36.6187|0||0|10/01/2019 SH 78001|J2507|J2507 - PEGLOTICASE INJECTION||2902.5788|0||0|10/01/2019 SH 78001|J2505|J2505 - INJECTION - PEGFILGRASTIM 6MG||5901.0538|0||0|10/01/2019 SH 78001|J2504|J2504 - PEGADEMASE BOVINE - 25 IU||459.9513|0||0|10/01/2019 SH 78001|J2503|J2503 - PEGAPTANIB SODIUM INJECTION||897.3312|0||0|10/01/2019 SH 78001|J2501|J2501 - PARICALCITOL||0.9313|0||0|10/01/2019 SH 78001|J2469|J2469 - PALONOSETRON HCL||28.255|0||0|10/01/2019 SH 78001|J2430|J2430 - PAMIDRONATE DISODIUM /30 MG||12.5612|0||0|10/01/2019 SH 78001|J2426|J2426 - PALIPERIDONE PALMITATE INJ||13.5962|0||0|10/01/2019 SH 78001|J2425|J2425 - PALIFERMIN INJECTION||25.4225|0||0|10/01/2019 SH 78001|J2410|J2410 - OXYMORPHONE HCL INJECTION||3.65|0||0|10/01/2019 SH 78001|J2407|J2407 - INJECTION - ORITAVANCIN||32.0213|0||0|10/01/2019 SH 78001|J2405|J2405 - ONDANSETRON HCL INJECTION||0.0988|0||0|10/01/2019 SH 78001|J2400|J2400 - CHLOROPROCAINE HCL INJECTION||23.485|0||0|10/01/2019 SH 78001|J2360|J2360 - ORPHENADRINE INJECTION||7.985|0||0|10/01/2019 SH 78001|J2358|J2358 - OLANZAPINE LONG-ACTING INJ||3.6463|0||0|10/01/2019 SH 78001|J2357|J2357 - OMALIZUMAB INJECTION||45.4175|0||0|10/01/2019 SH 78001|J2355|J2355 - OPRELVEKIN INJECTION||533.6437|0||0|10/01/2019 SH 78001|J2354|J2354 - OCTREOTIDE INJ - NON-DEPOT||1.1612|0||0|10/01/2019 SH 78001|J2353|J2353 - OCTREOTIDE INJECTION - DEPOT||248.7887|0||0|10/01/2019 SH 78001|J2350|J2350 - INJECTION - OCRELIZUMAB - 1 MG||71.4675|0||0|10/01/2019 SH 78001|J2323|J2323 - NATALIZUMAB INJECTION||24.8762|0||0|10/01/2019 SH 78001|J2315|J2315 - NALTREXONE - DEPOT FORM||4.0788|0||0|10/01/2019 SH 78001|J2310|J2310 - INJ NALOXONE HYDROCHLORIDE||29.8337|0||0|10/01/2019 SH 78001|J2300|J2300 - INJ NALBUPHINE HYDROCHLORIDE||3.6288|0||0|10/01/2019 SH 78001|J2280|J2280 - INJ - MOXIFLOXACIN 100 MG||12.1625|0||0|10/01/2019 SH 78001|J2278|J2278 - ZICONOTIDE INJECTION||9.4738|0||0|10/01/2019 SH 78001|J2274|J2274 - INJ MORPHINE PF EPID ITHC||14.2812|0||0|10/01/2019 SH 78001|J2270|J2270 - MORPHINE SULFATE INJECTION||3.0412|0||0|10/01/2019 SH 78001|J2260|J2260 - INJ MILRINONE LACTATE / 5 MG||2.0713|0||0|10/01/2019 SH 78001|J2250|J2250 - INJ MIDAZOLAM HYDROCHLORIDE||0.155|0||0|10/01/2019 SH 78001|J2248|J2248 - MICAFUNGIN SODIUM INJECTION||1.08|0||0|10/01/2019 SH 78001|J2210|J2210 - METHYLERGONOVIN MALEATE INJ||18.5075|0||0|10/01/2019 SH 78001|J2185|J2185 - MEROPENEM||1.0175|0||0|10/01/2019 SH 78001|J2175|J2175 - MEPERIDINE HYDROCHL /100 MG||4.71|0||0|10/01/2019 SH 78001|J2150|J2150 - MANNITOL INJECTION||2.9038|0||0|10/01/2019 SH 78001|J2060|J2060 - LORAZEPAM INJECTION||0.955|0||0|10/01/2019 SH 78001|J2020|J2020 - LINEZOLID INJECTION||14.8963|0||0|10/01/2019 SH 78001|J2010|J2010 - LINCOMYCIN INJECTION||16.2825|0||0|10/01/2019 SH 78001|J2001|J2001 - LIDOCAINE INJECTION||0.0275|0||0|10/01/2019 SH 78001|J1980|J1980 - HYOSCYAMINE SULFATE INJ||37.9213|0||0|10/01/2019 SH 78001|J1956|J1956 - LEVOFLOXACIN INJECTION||1.5675|0||0|10/01/2019 SH 78001|J1955|J1955 - INJ LEVOCARNITINE PER 1 GM||40.095|0||0|10/01/2019 SH 78001|J1953|J1953 - LEVETIRACETAM INJECTION||0.1487|0||0|10/01/2019 SH 78001|J1950|J1950 - LEUPROLIDE ACETATE /3.75 MG||1496.1388|0||0|10/01/2019 SH 78001|J1942|J1942 - ARIPIPRAZOLE LAUROXIL 1MG||3.0725|0||0|10/01/2019 SH 78001|J1940|J1940 - FUROSEMIDE INJECTION||1.0938|0||0|10/01/2019 SH 78001|J1931|J1931 - LARONIDASE INJECTION||38.2687|0||0|10/01/2019 SH 78001|J1930|J1930 - LANREOTIDE INJECTION||73.65|0||0|10/01/2019 SH 78001|J1885|J1885 - KETOROLAC TROMETHAMINE INJ||0.7075|0||0|10/01/2019 SH 78001|J1850|J1850 - KANAMYCIN SULFATE 75 MG INJ||1.44|0||0|10/01/2019 SH 78001|J1840|J1840 - KANAMYCIN SULFATE 500 MG INJ||9.61|0||0|10/01/2019 SH 78001|J1817|J1817 - INSULIN FOR INSULIN PUMP USE||13.9962|0||0|10/01/2019 SH 78001|J1815|J1815 - INSULIN INJECTION||1.1725|0||0|10/01/2019 SH 78001|J1800|J1800 - PROPRANOLOL INJECTION||5.6675|0||0|10/01/2019 SH 78001|J1790|J1790 - DROPERIDOL INJECTION||2.67|0||0|10/01/2019 SH 78001|J1786|J1786 - IMUGLUCERASE INJECTION||51.6662|0||0|10/01/2019 SH 78001|J1756|J1756 - IRON SUCROSE INJECTION||0.2925|0||0|10/01/2019 SH 78001|J1750|J1750 - INJ IRON DEXTRAN||17.0862|0||0|10/01/2019 SH 78001|J1745|J1745 - INFLIXIMAB NOT BIOSIMIL 10MG||104.8738|0||0|10/01/2019 SH 78001|J1743|J1743 - IDURSULFASE INJECTION||678.6463|0||0|10/01/2019 SH 78001|J1742|J1742 - IBUTILIDE FUMARATE INJECTION||373.3138|0||0|10/01/2019 SH 78001|J1740|J1740 - IBANDRONATE SODIUM INJECTION||97.6363|0||0|10/01/2019 SH 78001|J1720|J1720 - HYDROCORTISONE SODIUM SUCC I||16.4713|0||0|10/01/2019 SH 78001|J1670|J1670 - TETANUS IMMUNE GLOBULIN INJ||346.985|0||0|10/01/2019 SH 78001|J1652|J1652 - FONDAPARINUX SODIUM||2.8537|0||0|10/01/2019 SH 78001|J1650|J1650 - INJ ENOXAPARIN SODIUM||1.09|0||0|10/01/2019 SH 78001|J1645|J1645 - DALTEPARIN SODIUM||18.7275|0||0|10/01/2019 SH 78001|J1644|J1644 - INJ HEPARIN SODIUM PER 1000U||0.2487|0||0|10/01/2019 SH 78001|J1642|J1642 - INJ HEPARIN SODIUM PER 10 U||0.225|0||0|10/01/2019 SH 78001|J1640|J1640 - HEMIN - 1 MG||28.805|0||0|10/01/2019 SH 78001|J1631|J1631 - HALOPERIDOL DECANOATE INJ||22.48|0||0|10/01/2019 SH 78001|J1630|J1630 - HALOPERIDOL INJECTION||1.235|0||0|10/01/2019 SH 78001|J1627|J1627 - INJ - GRANISETRON - XR - 0.1 MG||4.8563|0||0|10/01/2019 SH 78001|J1626|J1626 - GRANISETRON HCL INJECTION||0.3987|0||0|10/01/2019 SH 78001|J1610|J1610 - GLUCAGON HYDROCHLORIDE/1 MG||246.65|0||0|10/01/2019 SH 78001|J1602|J1602 - GOLIMUMAB FOR IV USE 1MG||30.3762|0||0|10/01/2019 SH 78001|J1580|J1580 - GARAMYCIN GENTAMICIN INJ||1.6987|0||0|10/01/2019 SH 78001|J1575|J1575 - HYQVIA 100MG IMMUNEGLOBULIN||17.9288|0||0|10/01/2019 SH 78001|J1572|J1572 - FLEBOGAMMA INJECTION||43.9513|0||0|10/01/2019 SH 78001|J1571|J1571 - HEPAGAM B IM INJECTION||84.86|0||0|10/01/2019 SH 78001|J1570|J1570 - GANCICLOVIR SODIUM INJECTION||85.6612|0||0|10/01/2019 SH 78001|J1569|J1569 - GAMMAGARD LIQUID INJECTION||57.91|0||0|10/01/2019 SH 78001|J1568|J1568 - OCTAGAM INJECTION||41.4487|0||0|10/01/2019 SH 78001|J1566|J1566 - IMMUNE GLOBULIN - POWDER||50.01|0||0|10/01/2019 SH 78001|J1561|J1561 - GAMUNEX-C/GAMMAKED||50.295|0||0|10/01/2019 SH 78001|J1560|J1560 - GAMMA GLOBULIN > 10 CC INJ||481.0125|0||0|10/01/2019 SH 78001|J1559|J1559 - HIZENTRA INJECTION||12.3125|0||0|10/01/2019 SH 78001|J1557|J1557 - GAMMAPLEX INJECTION||69.715|0||0|10/01/2019 SH 78001|J1556|J1556 - INJ - IMM GLOB BIVIGAM - 500 MG||88.145|0||0|10/01/2019 SH 78001|J1555|J1555 - INJ CUVITRU - 100 MG||16.7462|0||0|10/01/2019 SH 78001|J1460|J1460 - GAMMA GLOBULIN 1 CC INJ||48.1013|0||0|10/01/2019 SH 78001|J1459|J1459 - INJ IVIG PRIVIGEN 500 MG||49.5875|0||0|10/01/2019 SH 78001|J1458|J1458 - GALSULFASE INJECTION||479.0163|0||0|10/01/2019 SH 78001|J1453|J1453 - FOSAPREPITANT INJECTION||2.5975|0||0|10/01/2019 SH 78001|J1450|J1450 - FLUCONAZOLE||5.6113|0||0|10/01/2019 SH 78001|J1447|J1447 - INJ TBO FILGRASTIM 1 MICROG||0.74|0||0|10/01/2019 SH 78001|J1446|J1446 - INJ TBO-FILGRASTIM 5 MCG||4.83|0||0|10/01/2019 SH 78001|J1442|J1442 - INJ FILGRASTIM EXCL BIOSIMIL||1.2788|0||0|10/01/2019 SH 78001|J1439|J1439 - INJ FERRIC CARBOXYMALTOS 1 MG||1.3362|0||0|10/01/2019 SH 78001|J1438|J1438 - ETANERCEPT INJECTION||514.64|0||0|10/01/2019 SH 78001|J1430|J1430 - ETHANOLAMINE OLEATE 100 MG||555.1237|0||0|10/01/2019 SH 78001|J1410|J1410 - INJ ESTROGEN CONJUGATE 25 MG||387.9912|0||0|10/01/2019 SH 78001|J1380|J1380 - ESTRADIOL VALERATE 10 MG INJ||19.68|0||0|10/01/2019 SH 78001|J1364|J1364 - ERYTHRO LACTOBIONATE /500 MG||98.5837|0||0|10/01/2019 SH 78001|J1335|J1335 - ERTAPENEM INJECTION||78.48|0||0|10/01/2019 SH 78001|J1325|J1325 - EPOPROSTENOL INJECTION||20.0975|0||0|10/01/2019 SH 78001|J1300|J1300 - ECULIZUMAB INJECTION||288.1|0||0|10/01/2019 SH 78001|J1290|J1290 - ECALLANTIDE INJECTION||596.0838|0||0|10/01/2019 SH 78001|J1270|J1270 - INJECTION - DOXERCALCIFEROL||0.5875|0||0|10/01/2019 SH 78001|J1267|J1267 - DORIPENEM INJECTION||1.1062|0||0|10/01/2019 SH 78001|J1265|J1265 - DOPAMINE INJECTION||0.7538|0||0|10/01/2019 SH 78001|J1260|J1260 - DOLASETRON MESYLATE||7.62|0||0|10/01/2019 SH 78001|J1250|J1250 - INJ DOBUTAMINE HCL/250 MG||6.32|0||0|10/01/2019 SH 78001|J1245|J1245 - DIPYRIDAMOLE INJECTION||1.0037|0||0|10/01/2019 SH 78001|J1240|J1240 - DIMENHYDRINATE INJECTION||8.8125|0||0|10/01/2019 SH 78001|J1230|J1230 - METHADONE INJECTION||22.485|0||0|10/01/2019 SH 78001|J1212|J1212 - DIMETHYL SULFOXIDE 50% 50 ML||664.4412|0||0|10/01/2019 SH 78001|J1205|J1205 - CHLOROTHIAZIDE SODIUM INJ||94.1412|0||0|10/01/2019 SH 78001|J1200|J1200 - DIPHENHYDRAMINE HCL INJECTIO||0.7338|0||0|10/01/2019 SH 78001|J1190|J1190 - DEXRAZOXANE HCL INJECTION||295.6162|0||0|10/01/2019 SH 78001|J1170|J1170 - HYDROMORPHONE INJECTION||1.7175|0||0|10/01/2019 SH 78001|J1165|J1165 - PHENYTOIN SODIUM INJECTION||0.7462|0||0|10/01/2019 SH 78001|J1162|J1162 - DIGOXIN IMMUNE FAB (OVINE)||4390.2288|0||0|10/01/2019 SH 78001|J1160|J1160 - DIGOXIN INJECTION||8.74|0||0|10/01/2019 SH 78001|J1120|J1120 - ACETAZOLAMID SODIUM INJECTIO||18.9675|0||0|10/01/2019 SH 78001|J1110|J1110 - INJ DIHYDROERGOTAMINE MESYLT||115.235|0||0|10/01/2019 SH 78001|J1100|J1100 - DEXAMETHASONE SODIUM PHOS||0.1512|0||0|10/01/2019 SH 78001|J1071|J1071 - INJ TESTOSTERONE CYPIONATE||0.0312|0||0|10/01/2019 SH 78001|J1050|J1050 - MEDROXYPROGESTERONE ACETATE||0.7037|0||0|10/01/2019 SH 78001|J1040|J1040 - METHYLPREDNISOLONE 80 MG INJ||16.8875|0||0|10/01/2019 SH 78001|J1030|J1030 - METHYLPREDNISOLONE 40 MG INJ||8.7513|0||0|10/01/2019 SH 78001|J1020|J1020 - METHYLPREDNISOLONE 20 MG INJ||5.2213|0||0|10/01/2019 SH 78001|J1000|J1000 - DEPO-ESTRADIOL CYPIONATE INJ||27.46|0||0|10/01/2019 SH 78001|J0897|J0897 - DENOSUMAB INJECTION||22.9725|0||0|10/01/2019 SH 78001|J0895|J0895 - DEFEROXAMINE MESYLATE INJ||25.2013|0||0|10/01/2019 SH 78001|J0894|J0894 - DECITABINE INJECTION||18.1187|0||0|10/01/2019 SH 78001|J0888|J0888 - EPOETIN BETA NON ESRD||2.2338|0||0|10/01/2019 SH 78001|J0887|J0887 - EPOETIN BETA ESRD USE||2.2338|0||0|10/01/2019 SH 78001|J0886|J0886 - INJ - EPOETIN ALFA - 1000 UNITS FOR ESRD ON DIALYSIS||15.78|0||0|10/01/2019 SH 78001|J0885|J0885 - EPOETIN ALFA - NON-ESRD||16.3625|0||0|10/01/2019 SH 78001|J0882|J0882 - DARBEPOETIN ALFA - ESRD USE||4.7975|0||0|10/01/2019 SH 78001|J0881|J0881 - DARBEPOETIN ALFA - NON-ESRD||4.7975|0||0|10/01/2019 SH 78001|J0878|J0878 - DAPTOMYCIN INJECTION||0.445|0||0|10/01/2019 SH 78001|J0875|J0875 - INJECTION - DALBAVANCIN||18.3225|0||0|10/01/2019 SH 78001|J0850|J0850 - CYTOMEGALOVIRUS IMM IV /VIAL||1411.4|0||0|10/01/2019 SH 78001|J0840|J0840 - CROTALIDAE POLY IMMUNE FAB||4039.9225|0||0|10/01/2019 SH 78001|J0834|J0834 - INJ. - COSYNTROPIN - 0.25 MG||41.44|0||0|10/01/2019 SH 78001|J0800|J0800 - CORTICOTROPIN INJECTION||4987.71|0||0|10/01/2019 SH 78001|J0795|J0795 - CORTICORELIN OVINE TRIFLUTAL||10.755|0||0|10/01/2019 SH 78001|J0780|J0780 - PROCHLORPERAZINE INJECTION||12.565|0||0|10/01/2019 SH 78001|J0775|J0775 - COLLAGENASE - CLOST HIST INJ||54.3775|0||0|10/01/2019 SH 78001|J0770|J0770 - COLISTIMETHATE SODIUM INJ||20.1487|0||0|10/01/2019 SH 78001|J0744|J0744 - CIPROFLOXACIN IV||4.0213|0||0|10/01/2019 SH 78001|J0743|J0743 - CILASTATIN SODIUM INJECTION||8.7|0||0|10/01/2019 SH 78001|J0740|J0740 - CIDOFOVIR INJECTION||583.26|0||0|10/01/2019 SH 78001|J0735|J0735 - CLONIDINE HYDROCHLORIDE||15.2562|0||0|10/01/2019 SH 78001|J0725|J0725 - CHORIONIC GONADOTROPIN/1000U||30.1412|0||0|10/01/2019 SH 78001|J0720|J0720 - CHLORAMPHENICOL SODIUM INJEC||49.6613|0||0|10/01/2019 SH 78001|J0717|J0717 - CERTOLIZUMAB PEGOL INJ 1MG||10.0288|0||0|10/01/2019 SH 78001|J0713|J0713 - INJ CEFTAZIDIME PER 500 MG||2.8988|0||0|10/01/2019 SH 78001|J0712|J0712 - CEFTAROLINE FOSAMIL INJ||3.6225|0||0|10/01/2019 SH 78001|J0702|J0702 - BETAMETHASONE ACET&SOD PHOSP||8.7375|0||0|10/01/2019 SH 78001|J0698|J0698 - CEFOTAXIME SODIUM INJECTION||0.67|0||0|10/01/2019 SH 78001|J0697|J0697 - STERILE CEFUROXIME INJECTION||2.4875|0||0|10/01/2019 SH 78001|J0696|J0696 - CEFTRIAXONE SODIUM INJECTION||0.7388|0||0|10/01/2019 SH 78001|J0694|J0694 - CEFOXITIN SODIUM INJECTION||4.7825|0||0|10/01/2019 SH 78001|J0692|J0692 - CEFEPIME HCL FOR INJECTION||3.1187|0||0|10/01/2019 SH 78001|J0690|J0690 - CEFAZOLIN SODIUM INJECTION||0.97|0||0|10/01/2019 SH 78001|J0670|J0670 - INJ MEPIVACAINE HCL/10 ML||3.1787|0||0|10/01/2019 SH 78001|J0641|J0641 - LEVOLEUCOVORIN INJECTION||0.2913|0||0|10/01/2019 SH 78001|J0640|J0640 - LEUCOVORIN CALCIUM INJECTION||3.9162|0||0|10/01/2019 SH 78001|J0638|J0638 - CANAKINUMAB INJECTION||138.15|0||0|10/01/2019 SH 78001|J0637|J0637 - CASPOFUNGIN ACETATE||17.0012|0||0|10/01/2019 SH 78001|J0636|J0636 - INJ CALCITRIOL PER 0.1 MCG||0.6937|0||0|10/01/2019 SH 78001|J0630|J0630 - CALCITONIN SALMON INJECTION||3257.665|0||0|10/01/2019 SH 78001|J0610|J0610 - CALCIUM GLUCONATE INJECTION||5.2012|0||0|10/01/2019 SH 78001|J0600|J0600 - EDETATE CALCIUM DISODIUM INJ||6993.0275|0||0|10/01/2019 SH 78001|J0598|J0598 - C-1 ESTERASE - CINRYZE||69.9262|0||0|10/01/2019 SH 78001|J0597|J0597 - C-1 ESTERASE - BERINERT||61.1688|0||0|10/01/2019 SH 78001|J0596|J0596 - INJECTION - RUCONEST||34.645|0||0|10/01/2019 SH 78001|J0595|J0595 - BUTORPHANOL TARTRATE 1 MG||2.9925|0||0|10/01/2019 SH 78001|J0594|J0594 - BUSULFAN INJECTION||25.3388|0||0|10/01/2019 SH 78001|J0592|J0592 - BUPRENORPHINE HYDROCHLORIDE||4.8937|0||0|10/01/2019 SH 78001|J0588|J0588 - INCOBOTULINUMTOXIN A||6.3525|0||0|10/01/2019 SH 78001|J0587|J0587 - INJ - RIMABOTULINUMTOXINB||15.0188|0||0|10/01/2019 SH 78001|J0586|J0586 - ABOBOTULINUMTOXINA||10.5312|0||0|10/01/2019 SH 78001|J0585|J0585 - INJECTION - ONABOTULINUMTOXINA||7.6975|0||0|10/01/2019 SH 78001|J0583|J0583 - BIVALIRUDIN||1.2025|0||0|10/01/2019 SH 78001|J0570|J0570 - BUPRENORPHINE IMPLANT 74.2MG||1563.655|0||0|10/01/2019 SH 78001|J0561|J0561 - PENICILLIN G BENZATHINE INJ||17.4213|0||0|10/01/2019 SH 78001|J0558|J0558 - PENG BENZATHINE/PROCAINE INJ||13.6562|0||0|10/01/2019 SH 78001|J0515|J0515 - INJ BENZTROPINE MESYLATE||20.8463|0||0|10/01/2019 SH 78001|J0500|J0500 - DICYCLOMINE INJECTION||96.4|0||0|10/01/2019 SH 78001|J0490|J0490 - BELIMUMAB INJECTION||54.5237|0||0|10/01/2019 SH 78001|J0485|J0485 - BELATACEPT INJECTION||4.7862|0||0|10/01/2019 SH 78001|J0480|J0480 - BASILIXIMAB||4570.0087|0||0|10/01/2019 SH 78001|J0476|J0476 - BACLOFEN INTRATHECAL TRIAL||74.24|0||0|10/01/2019 SH 78001|J0475|J0475 - BACLOFEN 10 MG INJECTION||216.6375|0||0|10/01/2019 SH 78001|J0470|J0470 - DIMECAPROL INJECTION||63.055|0||0|10/01/2019 SH 78001|J0461|J0461 - ATROPINE SULFATE INJECTION||0.0825|0||0|10/01/2019 SH 78001|J0456|J0456 - AZITHROMYCIN||3.8112|0||0|10/01/2019 SH 78001|J0401|J0401 - INJ ARIPIPRAZOLE EXT REL 1MG||6.5462|0||0|10/01/2019 SH 78001|J0400|J0400 - ARIPIPRAZOLE INJECTION||0.95|0||0|10/01/2019 SH 78001|J0360|J0360 - HYDRALAZINE HCL INJECTION||3.5537|0||0|10/01/2019 SH 78001|J0348|J0348 - ANIDULAFUNGIN INJECTION||0.7025|0||0|10/01/2019 SH 78001|J0295|J0295 - AMPICILLIN SULBACTAM 1.5 GM||2.9888|0||0|10/01/2019 SH 78001|J0290|J0290 - AMPICILLIN 500 MG INJ||1.395|0||0|10/01/2019 SH 78001|J0289|J0289 - AMPHOTERICIN B LIPOSOME INJ||60.0838|0||0|10/01/2019 SH 78001|J0287|J0287 - AMPHOTERICIN B LIPID COMPLEX||24.17|0||0|10/01/2019 SH 78001|J0285|J0285 - AMPHOTERICIN B||42.1|0||0|10/01/2019 SH 78001|J0280|J0280 - AMINOPHYLLIN 250 MG INJ||8.5337|0||0|10/01/2019 SH 78001|J0278|J0278 - AMIKACIN SULFATE INJECTION||1.3987|0||0|10/01/2019 SH 78001|J0257|J0257 - GLASSIA INJECTION||5.8963|0||0|10/01/2019 SH 78001|J0256|J0256 - ALPHA 1 PROTEINASE INHIBITOR||5.6387|0||0|10/01/2019 SH 78001|J0221|J0221 - LUMIZYME INJECTION||203.52|0||0|10/01/2019 SH 78001|J0220|J0220 - ALGLUCOSIDASE ALFA INJECTION||258.38|0||0|10/01/2019 SH 78001|J0210|J0210 - METHYLDOPATE HCL INJECTION||53|0||0|10/01/2019 SH 78001|J0207|J0207 - AMIFOSTINE||1220.6975|0||0|10/01/2019 SH 78001|J0202|J0202 - INJECTION - ALEMTUZUMAB||2304.095|0||0|10/01/2019 SH 78001|J0180|J0180 - AGALSIDASE BETA INJECTION||218.3375|0||0|10/01/2019 SH 78001|J0178|J0178 - AFLIBERCEPT INJECTION||1209.5912|0||0|10/01/2019 SH 78001|J0171|J0171 - ADRENALIN EPINEPHRINE INJECT||0.73|0||0|10/01/2019 SH 78001|J0153|J0153 - ADENOSINE INJ 1MG||0.9625|0||0|10/01/2019 SH 78001|J0135|J0135 - ADALIMUMAB INJECTION||1061.3|0||0|10/01/2019 SH 78001|J0133|J0133 - ACYCLOVIR INJECTION||0.065|0||0|10/01/2019 SH 78001|J0132|J0132 - ACETYLCYSTEINE INJECTION||1.535|0||0|10/01/2019 SH 78001|J0130|J0130 - ABCIXIMAB INJECTION||1607.0463|0||0|10/01/2019 SH 78001|J0129|J0129 - ABATACEPT INJECTION||64.535|0||0|10/01/2019 SH 78001|G6058|G6058 - DRUG CONFIRMATION DMBENZ BENZODIAZEPINES||21.64|0||0|10/01/2019 SH 78001|G6057|||25.43|0||0|10/01/2019 SH 78001|G6056|G6056 - OPIATES DRUG AND METABOLITES EACH PROCEDURE||31.78|0||0|10/01/2019 SH 78001|G6055|||38.68|0||0|10/01/2019 SH 78001|G6054|||24.19|0||0|10/01/2019 SH 78001|G6053|G6053 - ASSAY OF METHADONE||26.66|0||0|10/01/2019 SH 78001|G6052|G6052 - ASSAY OF MEPROBAMATE||28.78|0||0|10/01/2019 SH 78001|G6051|G6051 - ASSAY - FLURAZEPAM||32.33|0||0|10/01/2019 SH 78001|G6050|||28.22|0||0|10/01/2019 SH 78001|G6049|||35.09|0||0|10/01/2019 SH 78001|G6048|||22.62|0||0|10/01/2019 SH 78001|G6047|G6047 - DIHYDROTESTOSTERONE||42.16|0||0|10/01/2019 SH 78001|G6046|G6046 - ASSAY OF DIHYDROMORPHINONE||41.98|0||0|10/01/2019 SH 78001|G6045|G6045 - ASSAY OF DIHYDROCODEINONE||33.72|0||0|10/01/2019 SH 78001|G6044|G6044 - ASSAY OF COCAINE||15.66|0||0|10/01/2019 SH 78001|G6043|G6043 - ASSAY OF BARBITURATES||18.7|0||0|10/01/2019 SH 78001|G6042|G6042 - ASSAY OF AMPHETAMINES||25.38|0||0|10/01/2019 SH 78001|G6041|G6041 - ASSAY OF URINE ALKALOIDS||49.02|0||0|10/01/2019 SH 78001|G6040|G6040 - ALCOHOL ETHANOL ANY SPEC EXCEPT BREATH||17.64|0||0|10/01/2019 SH 78001|G6039|||33.05|0||0|10/01/2019 SH 78001|G6038|||11.59|0||0|10/01/2019 SH 78001|G6037|G6037 - ASSAY OF NORTRIPTYLINE||18.54|0||0|10/01/2019 SH 78001|G6036|G6036 - ASSAY OF IMIPRAMINE||28.1|0||0|10/01/2019 SH 78001|G6035|||23.7|0||0|10/01/2019 SH 78001|G6034|||25.31|0||0|10/01/2019 SH 78001|G6032|G6032 - ASSAY OF DESIPRAMINE||28.1|0||0|10/01/2019 SH 78001|G6031|G6031 - DRUG SCREEN BENZODIAZEPINES||30.2|0||0|10/01/2019 SH 78001|G6030|G6030 - ASSAY OF AMITRIPTYLINE||29.23|0||0|10/01/2019 SH 78001|G0477|G0477 - DRUG TEST PRESUMP OPTICAL||18.51|0||0|10/01/2019 SH 78001|G0471|G0471 - VEN BLOOD COLL SNF/HHA||6|0||0|10/01/2019 SH 78001|G0464|G0464 - COLORECTAL CANCER SCREENING||460.42|0||0|10/01/2019 SH 78001|G0463|G0463 - HOSPITAL OUTPT CLINIC VISIT||124.01|0||0|10/01/2019 SH 78001|G0447|G0447 - BEHAVIOR COUNSEL OBESITY 15M||301.15|0||0|10/01/2019 SH 78001|G0439|G0439 - PPPS - SUBSEQ VISIT||132.84|0||0|10/01/2019 SH 78001|G0435|G0435 - ORAL HIV-1/HIV-2 SCREEN||19.58|0||0|10/01/2019 SH 78001|G0434|G0434 - DRUG SCRN OTH THN CHROMATOGRAPH ANY # DRUG CLS BY||22.75|0||0|10/01/2019 SH 78001|G0433|G0433 - ELISA HIV-1/HIV-2 SCREEN||22.39|0||0|10/01/2019 SH 78001|G0432|G0432 - EIA HIV-1/HIV-2 SCREEN||22.39|0||0|10/01/2019 SH 78001|G0431|G0431 - DRUG SCRN QUAL SNGL CLASS METH EACH||113.72|0||0|10/01/2019 SH 78001|G0402|G0402 - INITIAL PREVENTIVE EXAM||192.81|0||0|10/01/2019 SH 78001|G0399|G0399 - HOME SLEEP TEST/TYPE 3 PORTA||385|250.25||0|10/01/2019 SH 78001|G0328|G0328 - FECAL BLOOD SCRN IMMUNOASSAY||25.98|0||0|10/01/2019 SH 78001|G0307|G0307 - CBC WITHOUT PLATELET||10.57|0||0|10/01/2019 SH 78001|G0306|G0306 - CBC/DIFFWBC W/O PLATELET||12.7|0||0|10/01/2019 SH 78001|G0289|G0289 - ARTHRO - LOOSE BODY + CHONDRO||104.59|0||0|10/01/2019 SH 78001|G0204|G0204 - DX MAMMO INCL CAD BI||181.85|51.68||0|10/01/2019 SH 78001|G0148|G0148 - SCR C/V CYTO - AUTOSYS - RESCR||17.26|0||0|10/01/2019 SH 78001|G0147|G0147 - SCR C/V CYTO - AUTOMATED SYS||17.26|0||0|10/01/2019 SH 78001|G0145|G0145 - SCR C/V CYTO - THINLAYER - RESCR||43.22|0||0|10/01/2019 SH 78001|G0144|G0144 - SCR C/V CYTO - THINLAYER - RESCR||34.9|0||0|10/01/2019 SH 78001|G0143|G0143 - SCR C/V CYTO - THINLAYER - RESCR||33.08|0||0|10/01/2019 SH 78001|G0123|G0123 - SCREEN CERV/VAG THIN LAYER||33.08|0||0|10/01/2019 SH 78001|G0103|G0103 - PSA SCREENING||30.04|0||0|10/01/2019 SH 78001|G0101|G0101 - CA SCREEN;PELVIC/BREAST EXAM||43.68|0||0|10/01/2019 SH 78001|G0027|G0027 - SEMEN ANALYSIS||10.62|0||0|10/01/2019 SH 78001|G0009|G0009 - ADMIN PNEUMOCOCCAL VACCINE||28.27|0||0|10/01/2019 SH 78001|G0008|G0008 - ADMIN INFLUENZA VIRUS VAC||28.27|0||0|10/01/2019 SH 78001|E2633|E2633 - MOBILE ARM SUPPORT SUPINATOR||189.86|19||0|10/01/2019 SH 78001|E2632|E2632 - OFFSET/LAT ROCKER ARM W/ELA||223.85|22.38||0|10/01/2019 SH 78001|E2631|E2631 - ELEVAT PROXIMAL ARM SUPPORT||352.04|35.21||0|10/01/2019 SH 78001|E2630|E2630 - MONOSUSPENSION ARM/HAND SUPP||880.07|88.01||0|10/01/2019 SH 78001|E2629|E2629 - FRICTION DAMPENING ARM SUPP||1258.5|125.83||0|10/01/2019 SH 78001|E2628|E2628 - MOBILE ARM SUPPORTS RECLININ||994.49|99.44||0|10/01/2019 SH 78001|E2627|E2627 - ARM SUPP ATT TO WC RANCHO TY||1320.11|132.05||0|10/01/2019 SH 78001|E2626|E2626 - SEO MOBILE ARM SUP ATT TO WC||827.3|82.7||0|10/01/2019 SH 78001|E2625|E2625 - ADJ SKIN PRO/POS WC CUS>=22||485.68|48.55||0|10/01/2019 SH 78001|E2624|E2624 - ADJ SKIN PRO/POS CUS<22IN||383.65|38.38||0|10/01/2019 SH 78001|E2623|E2623 - ADJ SKIN PRO WC CUS WD>=22IN||484.2|48.43||0|10/01/2019 SH 78001|E2622|E2622 - ADJ SKIN PRO W/C CUS WD<22IN||380.52|38.06||0|10/01/2019 SH 78001|E2621|E2621 - WC PLANAR BACK CUSH WD>=22IN||659.83|65.99||0|10/01/2019 SH 78001|E2620|E2620 - WC PLANAR BACK CUSH WD <22IN||628.75|62.88||0|10/01/2019 SH 78001|E2619|E2619 - REPLACE COVER W/C SEAT CUSH||58.91|5.89||0|10/01/2019 SH 78001|E2616|E2616 - POS BACK POST/LAT WDTH>=22IN||698.65|69.86||0|10/01/2019 SH 78001|E2615|E2615 - POS BACK POST/LAT WDTH <22IN||519.25|51.94||0|10/01/2019 SH 78001|E2614|E2614 - POSITION BACK CUSH WD>=22IN||624.44|62.45||0|10/01/2019 SH 78001|E2613|E2613 - POSITION BACK CUSH WD <22IN||451.21|45.13||0|10/01/2019 SH 78001|E2612|E2612 - GEN USE BACK CUSH WDTH>=22IN||485.08|48.5||0|10/01/2019 SH 78001|E2611|E2611 - GEN USE BACK CUSH WDTH <22IN||358.58|35.84||0|10/01/2019 SH 78001|E2608|E2608 - SKIN PRO/POS WC CUS WD>=22IN||399.6|39.95||0|10/01/2019 SH 78001|E2607|E2607 - SKIN PRO/POS WC CUS WD <22IN||332.75|33.28||0|10/01/2019 SH 78001|E2606|E2606 - POSITION WC CUSH WDTH>=22 IN||482.09|48.22||0|10/01/2019 SH 78001|E2605|E2605 - POSITION WC CUSH WDTH <22 IN||309.01|30.91||0|10/01/2019 SH 78001|E2604|E2604 - SKIN PROTECT WC CUS WD>=22IN||216.3|21.62||0|10/01/2019 SH 78001|E2603|E2603 - SKIN PROTECT WC CUS WD <22IN||174.01|17.41||0|10/01/2019 SH 78001|E2602|E2602 - GEN W/C CUSHION WDTH >=22 IN||137.06|13.72||0|10/01/2019 SH 78001|E2601|E2601 - GEN W/C CUSHION WDTH < 22 IN||70.2|7.04||0|10/01/2019 SH 78001|E2512|E2512 - SGD ACCESSORY - MOUNTING SYS||0|0||0|10/01/2019 SH 78001|E2511|E2511 - SGD SFTWRE PRGRM FOR PC/PDA||0|0||0|10/01/2019 SH 78001|E2510|E2510 - SGD W MULTI METHODS MSG/ACCS||9014.88|901.49||0|10/01/2019 SH 78001|E2508|E2508 - SGD SPELLING PHYS CONTACT||4763.81|476.38||0|10/01/2019 SH 78001|E2506|E2506 - SGD PREREC MSG > 40 MIN||3080.72|308.05||0|10/01/2019 SH 78001|E2504|E2504 - SGD PREREC MSG>20MIN <=40MIN||2101.01|210.13||0|10/01/2019 SH 78001|E2502|E2502 - SGD PREREC MSG >8MIN <=20MIN||1592.72|159.28||0|10/01/2019 SH 78001|E2500|E2500 - SGD DIGITIZED PRE-REC <=8MIN||520.85|52.09||0|10/01/2019 SH 78001|E2402|E2402 - NEG PRESS WOUND THERAPY PUMP||0|1970.51||0|10/01/2019 SH 78001|E2397|E2397 - PWC ACC - LITH-BASED BATTERY||551.6|55.16||0|10/01/2019 SH 78001|E2396|E2396 - CASTER FORK||76.34|8.1||0|10/01/2019 SH 78001|E2395|E2395 - CASTER WHEEL EXCLUDES TIRE||62.62|6.28||0|10/01/2019 SH 78001|E2394|E2394 - DRIVE WHEEL EXCLUDES TIRE||88.13|8.83||0|10/01/2019 SH 78001|E2392|E2392 - SOLID CASTER TIRE - INTEGRATE||61.85|6.22||0|10/01/2019 SH 78001|E2391|E2391 - SOLID CASTER TIRE||23.52|2.36||0|10/01/2019 SH 78001|E2390|E2390 - SOLID DRIVE WHEEL TIRE||49.12|4.91||0|10/01/2019 SH 78001|E2389|E2389 - FOAM CASTER TIRE||31.42|3.16||0|10/01/2019 SH 78001|E2388|E2388 - FOAM DRIVE WHEEL TIRE||57.83|5.8||0|10/01/2019 SH 78001|E2387|E2387 - FOAM FILLED CASTER TIRE||77.47|7.75||0|10/01/2019 SH 78001|E2386|E2386 - FOAM FILLED DRIVE WHEEL TIRE||172.78|17.28||0|10/01/2019 SH 78001|E2385|E2385 - TUBE - PNEUMATIC CASTER TIRE||56.83|5.71||0|10/01/2019 SH 78001|E2384|E2384 - PNEUMATIC CASTER TIRE||92.89|9.31||0|10/01/2019 SH 78001|E2383|E2383 - INSERT - PNEUM WHEEL DRIVE||174.36|17.44||0|10/01/2019 SH 78001|E2382|E2382 - TUBE - PNEUM WHEEL DRIVE TIRE||23.83|2.38||0|10/01/2019 SH 78001|E2381|E2381 - PNEUM DRIVE WHEEL TIRE||87.44|8.77||0|10/01/2019 SH 78001|E2378|E2378 - PW ACTUATOR REPLACEMENT||0|68.16||0|10/01/2019 SH 78001|E2377|E2377 - EXPANDABLE CONTROLLER - INITL||0|55.75||0|10/01/2019 SH 78001|E2376|E2376 - EXPANDABLE CONTROLLER - REPL||0|154.09||0|10/01/2019 SH 78001|E2375|E2375 - NON-EXPANDABLE CONTROLLER||983.33|98.32||0|10/01/2019 SH 78001|E2374|E2374 - HAND/CHIN CTRL STD JOYSTICK||0|61.32||0|10/01/2019 SH 78001|E2373|E2373 - HAND/CHIN CTRL SPEC JOYSTICK||0|93.61||0|10/01/2019 SH 78001|E2372|E2372 - GR27 NON-SEALED LEADACID||0|0||0|10/01/2019 SH 78001|E2371|E2371 - GR27 SEALED LEADACID BATTERY||173.05|17.32||0|10/01/2019 SH 78001|E2370|E2370 - PWR WC DR WH MOTOR/GEAR COMB||921.66|92.17||0|10/01/2019 SH 78001|E2369|E2369 - PWR WC DRIVEWHEEL GEAR REPL||516.53|51.67||0|10/01/2019 SH 78001|E2368|E2368 - PWR WC DRIVEWHEEL MOTOR REPL||593.03|59.3||0|10/01/2019 SH 78001|E2367|E2367 - BATTERY CHARGER - DUAL MODE||481.09|48.11||0|10/01/2019 SH 78001|E2366|E2366 - BATTERY CHARGER - SINGLE MODE||257.24|25.8||0|10/01/2019 SH 78001|E2365|E2365 - U1 SEALED LEADACID BATTERY||128.77|12.86||0|10/01/2019 SH 78001|E2364|E2364 - U1NONSEALED LEADACID BATTERY||127.2|12.78||0|10/01/2019 SH 78001|E2363|E2363 - GR24 SEALED LEADACID BATTERY||213.54|21.35||0|10/01/2019 SH 78001|E2362|E2362 - GR24 NONSEALED LEADACID||122.52|12.25||0|10/01/2019 SH 78001|E2361|E2361 - 22NF SEALED LEADACID BATTERY||160.1|16.01||0|10/01/2019 SH 78001|E2360|E2360 - 22NF NONSEALED LEADACID||127.2|12.78||0|10/01/2019 SH 78001|E2359|E2359 - GR34 SEALED LEADACID BATTERY||231.95|23.21||0|10/01/2019 SH 78001|E2351|E2351 - ELECTRONIC SGD INTERFACE||802.03|80.23||0|10/01/2019 SH 78001|E2343|E2343 - W/C DPTH 22-25 IN SEAT FRAME||954.71|95.46||0|10/01/2019 SH 78001|E2342|E2342 - W/C DPTH 20-21 IN SEAT FRAME||596.69|59.66||0|10/01/2019 SH 78001|E2341|E2341 - W/C WDTH 24-27 IN SEAT FRAME||716.03|71.59||0|10/01/2019 SH 78001|E2340|E2340 - W/C WDTH 20-23 IN SEAT FRAME||477.31|47.75||0|10/01/2019 SH 78001|E2330|E2330 - HEAD CONTROL PROXIMITY SWITC||0|392.84||0|10/01/2019 SH 78001|E2329|E2329 - HEAD CONTROL NONPROPORTIONAL||0|202.75||0|10/01/2019 SH 78001|E2328|E2328 - HEAD/EXTREMITY CONTROL INTER||0|568.86||0|10/01/2019 SH 78001|E2327|E2327 - HEAD CONTROL INTERFACE MECH||0|299.89||0|10/01/2019 SH 78001|E2326|E2326 - BREATH TUBE KIT||0|39.86||0|10/01/2019 SH 78001|E2325|E2325 - SIP AND PUFF INTERFACE||0|154.63||0|10/01/2019 SH 78001|E2324|E2324 - CHIN CUP INTERFACE||50.3|5||0|10/01/2019 SH 78001|E2323|E2323 - SPECIAL JOYSTICK HANDLE||79.4|7.93||0|10/01/2019 SH 78001|E2322|E2322 - MULT MECH SWITCHES||0|161.89||0|10/01/2019 SH 78001|E2321|E2321 - HAND INTERFACE JOYSTICK||0|182.45||0|10/01/2019 SH 78001|E2313|E2313 - PWC HARNESS - EXPAND CONTROL||0|42.68||0|10/01/2019 SH 78001|E2312|E2312 - MINI-PROP REMOTE JOYSTICK||0|268.61||0|10/01/2019 SH 78001|E2311|E2311 - ELECTRO CONNECT BTW 2 SYS||0|271.99||0|10/01/2019 SH 78001|E2310|E2310 - ELECTRO CONNECT BTW CONTROL||0|134.33||0|10/01/2019 SH 78001|E2294|E2294 - CONTOUR SEAT FOR PED SIZE WC||345.8|0||0|10/01/2019 SH 78001|E2293|E2293 - CONTOUR BACK FOR PED SIZE WC||399.36|0||0|10/01/2019 SH 78001|E2231|E2231 - SOLID SEAT SUPPORT BASE||204.68|20.47||0|10/01/2019 SH 78001|E2228|E2228 - MWC ACC - WHEELCHAIR BRAKE||1247.05|124.69||0|10/01/2019 SH 78001|E2227|E2227 - GEAR REDUCTION DRIVE WHEEL||0|249.18||0|10/01/2019 SH 78001|E2226|E2226 - CASTER FORK REPLACEMENT ONLY||50.54|5.05||0|10/01/2019 SH 78001|E2225|E2225 - CASTER WHEEL EXCLUDES TIRE||23.18|2.32||0|10/01/2019 SH 78001|E2224|E2224 - PROPULSION WHL EXCL TIRE REP||111.01|11.65||0|10/01/2019 SH 78001|E2222|E2222 - SOLID CASTER INTEG WHL - REPL||28.06|2.77||0|10/01/2019 SH 78001|E2221|E2221 - SOLID CASTER TIRE REPL - EACH||34.03|3.44||0|10/01/2019 SH 78001|E2220|E2220 - SOLID PROPULS TIRE - REPL - EA||38|3.67||0|10/01/2019 SH 78001|E2219|E2219 - FOAM CASTER TIRE ANY SIZE EA||55.74|6.3||0|10/01/2019 SH 78001|E2218|E2218 - FOAM PROPULSION TIRE EACH||0|0||0|10/01/2019 SH 78001|E2217|E2217 - FOAM FILLED CASTER TIRE EACH||0|0||0|10/01/2019 SH 78001|E2216|E2216 - FOAM FILLED PROPULSION TIRE||0|0||0|10/01/2019 SH 78001|E2215|E2215 - PNEUMATIC CASTER TIRE TUBE||12.78|1.27||0|10/01/2019 SH 78001|E2214|E2214 - PNEUMATIC CASTER TIRE EACH||40.76|4.48||0|10/01/2019 SH 78001|E2213|E2213 - PNEUMATIC PROP TIRE INSERT||40.51|4.07||0|10/01/2019 SH 78001|E2212|E2212 - PNEUMATIC PROP TIRE TUBE||7.82|0.83||0|10/01/2019 SH 78001|E2211|E2211 - PNEUMATIC PROPULSION TIRE||48.74|4.85||0|10/01/2019 SH 78001|E2210|E2210 - WHEELCHAIR BEARINGS||7.51|0.76||0|10/01/2019 SH 78001|E2209|E2209 - ARM TROUGH EACH||123.02|12.32||0|10/01/2019 SH 78001|E2208|E2208 - CYLINDER TANK CARRIER||136.37|13.63||0|10/01/2019 SH 78001|E2207|E2207 - CRUTCH AND CANE HOLDER||57.73|5.8||0|10/01/2019 SH 78001|E2206|E2206 - MAN WC WHL LOCK COMP REPL EA||54.18|5.4||0|10/01/2019 SH 78001|E2205|E2205 - MANUAL WC ACCESSORY - HANDRIM||43.51|4.33||0|10/01/2019 SH 78001|E2204|E2204 - FRAME DEPTH 22 TO 25 IN||1083.41|108.35||0|10/01/2019 SH 78001|E2203|E2203 - FRAME DEPTH LESS THAN 22 IN||638.08|63.79||0|10/01/2019 SH 78001|E2202|E2202 - SEAT WIDTH 24-27 IN||631.3|63.13||0|10/01/2019 SH 78001|E2201|E2201 - MAN W/CH ACC SEAT W>=20''<24''||496.96|49.69||0|10/01/2019 SH 78001|E2120|E2120 - PULSE GEN SYS TX ENDOLYMP FL||0|377.64||0|10/01/2019 SH 78001|E2101|E2101 - BLD GLUCOSE MONITOR W LANCE||251.15|25.1||0|10/01/2019 SH 78001|E2100|E2100 - BLD GLUCOSE MONITOR W VOICE||728.18|72.83||0|10/01/2019 SH 78001|E2000|E2000 - GASTRIC SUCTION PUMP HME MDL||0|66.94||0|10/01/2019 SH 78001|E1841|E1841 - STATIC STR SHLDR DEV ROM ADJ||0|603.35||0|10/01/2019 SH 78001|E1840|E1840 - ADJ SHOULDER EXT/FLEX DEVICE||0|492.89||0|10/01/2019 SH 78001|E1831|E1831 - STATIC STR TOE DEV EXT/FLEX||0|88.01||0|10/01/2019 SH 78001|E1830|E1830 - ADJUST TOE EXT/FLEX DEVICE||0|143.04||0|10/01/2019 SH 78001|E1825|E1825 - ADJUST FINGER EXT/FLEX DEVC||0|143.04||0|10/01/2019 SH 78001|E1821|E1821 - REPLACEMENT INTERFACE SPSD||140.18|13.99||0|10/01/2019 SH 78001|E1820|E1820 - SOFT INTERFACE MATERIAL||108.88|10.88||0|10/01/2019 SH 78001|E1818|E1818 - SPS FOREARM DEVICE||0|179.66||0|10/01/2019 SH 78001|E1816|E1816 - SPS ANKLE DEVICE||0|176||0|10/01/2019 SH 78001|E1815|E1815 - ADJUST ANKLE EXT/FLEX DEVICE||0|143.04||0|10/01/2019 SH 78001|E1812|E1812 - KNEE EXT/FLEX W ACT RES CTRL||0|114.53||0|10/01/2019 SH 78001|E1811|E1811 - SPS KNEE DEVICE||0|173.3||0|10/01/2019 SH 78001|E1810|E1810 - ADJUST KNEE EXT/FLEX DEVICE||0|141.05||0|10/01/2019 SH 78001|E1806|E1806 - SPS WRIST DEVICE||0|136.84||0|10/01/2019 SH 78001|E1805|E1805 - ADJUST WRIST EXT/FLEX DEVICE||0|143.04||0|10/01/2019 SH 78001|E1802|E1802 - ADJST FOREARM PRO/SUP DEVICE||0|435.29||0|10/01/2019 SH 78001|E1801|E1801 - SPS ELBOW DEVICE||0|166.69||0|10/01/2019 SH 78001|E1800|E1800 - ADJUST ELBOW EXT/FLEX DEVICE||0|138.68||0|10/01/2019 SH 78001|E1702|E1702 - REPL MEASR SCALES JAW MOTION||26.94|0||0|10/01/2019 SH 78001|E1701|E1701 - REPL CUSHIONS FOR JAW MOTION||13.42|0||0|10/01/2019 SH 78001|E1700|E1700 - JAW MOTION REHAB SYSTEM||0|45.94||0|10/01/2019 SH 78001|E1406|E1406 - O2/WATER VAPOR ENRICH W/O HE||0|238.55||0|10/01/2019 SH 78001|E1405|E1405 - O2/WATER VAPOR ENRICH W/HEAT||0|256.8||0|10/01/2019 SH 78001|E1392|E1392 - PORTABLE OXYGEN CONCENTRATOR||0|61.96||0|10/01/2019 SH 78001|E1391|E1391 - OXYGEN CONCENTRATOR - DUAL||0|217.1||0|10/01/2019 SH 78001|E1390|E1390 - OXYGEN CONCENTRATOR||0|217.1||0|10/01/2019 SH 78001|E1372|E1372 - OXY SUPPL HEATER FOR NEBULIZ||184.57|26.83||0|10/01/2019 SH 78001|E1355|E1355 - OXYGEN SUPPLIES STAND/RACK||28.42|0||0|10/01/2019 SH 78001|E1353|E1353 - OXYGEN SUPPLIES REGULATOR||37.73|0||0|10/01/2019 SH 78001|E1310|E1310 - WHIRLPOOL NON-PORTABLE||2860.2|244.63||0|10/01/2019 SH 78001|E1298|E1298 - WHEELCHAIR SPEC SEAT DEPTH/W||564.29|57.73||0|10/01/2019 SH 78001|E1297|E1297 - WHEELCHAIR SPECIAL SEAT DEPT||139.33|15.48||0|10/01/2019 SH 78001|E1296|E1296 - WHEELCHAIR SPECIAL SEAT HEIG||654.85|66.53||0|10/01/2019 SH 78001|E1295|E1295 - WHEELCHAIR HEAVY DUTY FIXED||0|161.78||0|10/01/2019 SH 78001|E1280|E1280 - WHCHR H-DUTY DET ARM LEG RES||0|152.28||0|10/01/2019 SH 78001|E1270|E1270 - WHEELCHAIR LIGHTWEIGHT LEG R||0|105.14||0|10/01/2019 SH 78001|E1240|E1240 - WHCHR LITWT DET ARM LEG REST||0|137.22||0|10/01/2019 SH 78001|E1238|E1238 - FLD PED WC ADJSTABL W/O SEAT||0|218.27||0|10/01/2019 SH 78001|E1237|E1237 - RGD PED WC ADJSTABL W/O SEAT||0|220.18||0|10/01/2019 SH 78001|E1236|E1236 - FOLDING PED WC ADJUSTABLE||0|218.27||0|10/01/2019 SH 78001|E1235|E1235 - RIGID PED WC ADJUSTABLE||0|247.42||0|10/01/2019 SH 78001|E1234|E1234 - FLD PED WC TLTNSPC W/O SEAT||0|256.94||0|10/01/2019 SH 78001|E1233|E1233 - RIG PED WC TLTNSPC W/O SEAT||0|295.12||0|10/01/2019 SH 78001|E1232|E1232 - FOLDING PED WC TILT-IN-SPACE||0|284.84||0|10/01/2019 SH 78001|E1231|E1231 - RIGID PED W/C TILT-IN-SPACE||0|0||0|10/01/2019 SH 78001|E1230|E1230 - POWER OPERATED VEHICLE||3012.58|296.29||0|10/01/2019 SH 78001|E1228|E1228 - WHEELCHAIR SPEC SZ SPEC HT B||0|31.73||0|10/01/2019 SH 78001|E1227|E1227 - WHEELCHAIR SPEC SZ SPEC HT A||369.61|36.97||0|10/01/2019 SH 78001|E1226|E1226 - MANUAL FULLY RECLINING BACK||726.78|74.8||0|10/01/2019 SH 78001|E1225|E1225 - MANUAL SEMI-RECLINING BACK||0|54.1||0|10/01/2019 SH 78001|E1224|E1224 - WHEELCHAIR SPEC SIZE W/ LEG||0|108.08||0|10/01/2019 SH 78001|E1223|E1223 - WHEELCHAIR SPEC SIZE W FOOT||0|98.58||0|10/01/2019 SH 78001|E1222|E1222 - WHEELCHAIR SPEC SIZE W/ LEG||0|89.51||0|10/01/2019 SH 78001|E1221|E1221 - WHEELCHAIR SPEC SIZE W FOOT||0|63.29||0|10/01/2019 SH 78001|E1200|E1200 - WHEELCHAIR AMPUTEE FIXED ARM||0|98.51||0|10/01/2019 SH 78001|E1195|E1195 - WHEELCHAIR AMPUTEE HEAVY DUT||0|142.22||0|10/01/2019 SH 78001|E1190|E1190 - WHEELCHAIR AMPUTEE W/ LEG RE||0|132.55||0|10/01/2019 SH 78001|E1180|E1180 - WHEELCHAIR AMPUTEE W/ FOOT R||0|114.73||0|10/01/2019 SH 78001|E1172|E1172 - WHEELCHAIR AMPUTEE DETACH AR||0|130.48||0|10/01/2019 SH 78001|E1171|E1171 - WHEELCHAIR AMPUTEE W/O LEG R||0|94.42||0|10/01/2019 SH 78001|E1170|E1170 - WHLCHR AMPU FXD ARM LEG REST||0|101.14||0|10/01/2019 SH 78001|E1161|E1161 - MANUAL ADULT WC W TILTINSPAC||0|315.14||0|10/01/2019 SH 78001|E1160|E1160 - WHEELCHAIR FIXED ARMS||0|70.76||0|10/01/2019 SH 78001|E1150|E1150 - WHEELCHAIR STANDARD W/ LEG R||0|99.66||0|10/01/2019 SH 78001|E1110|E1110 - WHEELCHAIR SEMI-RECL DETACH||0|115.09||0|10/01/2019 SH 78001|E1100|E1100 - WHCHR S-RECL FXD ARM LEG RES||0|117.52||0|10/01/2019 SH 78001|E1093|E1093 - WHEELCHAIR WIDE W/ FOOT REST||0|125.12||0|10/01/2019 SH 78001|E1092|E1092 - WHEELCHAIR WIDE W/ LEG RESTS||0|171.18||0|10/01/2019 SH 78001|E1088|E1088 - WHEELCHAIR LIGHTWEIGHT DET A||0|183.37||0|10/01/2019 SH 78001|E1087|E1087 - WHEELCHAIR LIGHTWT FIXED ARM||0|143.24||0|10/01/2019 SH 78001|E1084|E1084 - HEMI-WHEELCHAIR DETACHABLE A||0|130.67||0|10/01/2019 SH 78001|E1083|E1083 - HEMI-WHEELCHAIR FIXED ARMS||0|89.15||0|10/01/2019 SH 78001|E1070|E1070 - WHEELCHAIR DETACHABLE FOOT R||0|124.01||0|10/01/2019 SH 78001|E1060|E1060 - WHEELCHAIR DETACHABLE ARMS||0|142.72||0|10/01/2019 SH 78001|E1050|E1050 - WHELCHR FXD FULL LENGTH ARMS||0|115.3||0|10/01/2019 SH 78001|E1039|E1039 - TRANSPORT CHAIR PT WT >300LB||0|45.54||0|10/01/2019 SH 78001|E1038|E1038 - TRANSPORT CHAIR PT WT<=300LB||0|24.01||0|10/01/2019 SH 78001|E1037|E1037 - TRANSPORT CHAIR - PED SIZE||0|144.49||0|10/01/2019 SH 78001|E1036|E1036 - PATIENT TRANSFER SYSTEM >300||0|1145||0|10/01/2019 SH 78001|E1035|E1035 - PATIENT TRANSFER SYSTEM <300||0|816.76||0|10/01/2019 SH 78001|E1031|E1031 - ROLLABOUT CHAIR WITH CASTERS||0|57.19||0|10/01/2019 SH 78001|E1030|E1030 - W/C VENT TRAY GIMBALED||0|133.78||0|10/01/2019 SH 78001|E1029|E1029 - W/C VENT TRAY FIXED||0|42.41||0|10/01/2019 SH 78001|E1028|E1028 - W/C MANUAL SWINGAWAY||237.11|23.7||0|10/01/2019 SH 78001|E1020|E1020 - RESIDUAL LIMB SUPPORT SYSTEM||279.43|27.92||0|10/01/2019 SH 78001|E1018|E1018 - HD SHCK ABSRBER FOR HD POWWC||0|0||0|10/01/2019 SH 78001|E1017|E1017 - HD SHCK ABSRBR FOR HD MAN WC||0|0||0|10/01/2019 SH 78001|E1016|E1016 - SHOCK ABSORBER FOR POWER W/C||150.76|15.1||0|10/01/2019 SH 78001|E1015|E1015 - SHOCK ABSORBER FOR MAN W/C||152.78|15.26||0|10/01/2019 SH 78001|E1014|E1014 - RECLINING BACK ADD PED W/C||0|48.65||0|10/01/2019 SH 78001|E1011|E1011 - PED WC MODIFY WIDTH ADJUSTM||0|0||0|10/01/2019 SH 78001|E1010|E1010 - ADD PWR LEG ELEVATION||0|131.32||0|10/01/2019 SH 78001|E1009|E1009 - ADD MECH LEG ELEVATION||0|0||0|10/01/2019 SH 78001|E1008|E1008 - PWR SEAT COMBO PWR SHEAR||0|1003.58||0|10/01/2019 SH 78001|E1007|E1007 - PWR SEAT COMBO W/SHEAR||0|1003.51||0|10/01/2019 SH 78001|E1006|E1006 - PWR SEAT COMBO W/O SHEAR||0|741.1||0|10/01/2019 SH 78001|E1005|E1005 - PWR SEAT RECLINE PWR||0|605.03||0|10/01/2019 SH 78001|E1004|E1004 - PWR SEAT RECLINE MECH||0|558.95||0|10/01/2019 SH 78001|E1003|E1003 - PWR SEAT RECLINE||0|504.13||0|10/01/2019 SH 78001|E1002|E1002 - PWR SEAT TILT||0|465.29||0|10/01/2019 SH 78001|E0995|E0995 - WC CALF REST - PAD REPLACEMNT||34.9|3.5||0|10/01/2019 SH 78001|E0994|E0994 - WHEELCHAIR ARM REST||19.96|2.02||0|10/01/2019 SH 78001|E0992|E0992 - WHEELCHAIR SOLID SEAT INSERT||107.74|10.67||0|10/01/2019 SH 78001|E0990|E0990 - WHEELCHAIR ELEVATING LEG RES||134.81|13.49||0|10/01/2019 SH 78001|E0988|E0988 - LEVER-ACTIVATED WHEEL DRIVE||0|398.71||0|10/01/2019 SH 78001|E0986|E0986 - MAN W/C PUSH-RIM POWR SYSTEM||0|647.9||0|10/01/2019 SH 78001|E0985|E0985 - W/C SEAT LIFT MECHANISM||270.19|27.04||0|10/01/2019 SH 78001|E0984|E0984 - ADD PWR TILLER||0|254.46||0|10/01/2019 SH 78001|E0983|E0983 - ADD PWR JOYSTICK||0|323.54||0|10/01/2019 SH 78001|E0982|E0982 - BACK UPHOLSTERY - REPLACEMENT||59.15|5.92||0|10/01/2019 SH 78001|E0981|E0981 - SEAT UPHOLSTERY - REPLACEMENT||52.34|5.23||0|10/01/2019 SH 78001|E0980|E0980 - WHEELCHAIR SAFETY VEST||37.43|3.74||0|10/01/2019 SH 78001|E0978|E0978 - W/C ACC - SAF BELT PELV STRAP||49.02|4.91||0|10/01/2019 SH 78001|E0974|E0974 - W/CH ACCESS ANTI-ROLLBACK||104.44|11.08||0|10/01/2019 SH 78001|E0973|E0973 - W/CH ACCESS DET ADJ ARMREST||131.99|12.56||0|10/01/2019 SH 78001|E0971|E0971 - WHEELCHAIR ANTI-TIPPING DEVI||57.78|5.8||0|10/01/2019 SH 78001|E0969|E0969 - WHEELCHAIR NARROWING DEVICE||208.63|20.65||0|10/01/2019 SH 78001|E0968|E0968 - WHEELCHAIR COMMODE SEAT||0|22.96||0|10/01/2019 SH 78001|E0967|E0967 - MAN WC RIM/PROJECTION REP EA||87.48|8.76||0|10/01/2019 SH 78001|E0966|E0966 - WHEELCHAIR HEAD REST EXTENSI||87.32|8.72||0|10/01/2019 SH 78001|E0961|E0961 - WHEELCHAIR BRAKE EXTENSION||33.68|3.52||0|10/01/2019 SH 78001|E0960|E0960 - W/C SHOULDER HARNESS/STRAPS||104.45|10.46||0|10/01/2019 SH 78001|E0959|E0959 - AMPUTEE ADAPTER||51.29|5.11||0|10/01/2019 SH 78001|E0958|E0958 - WHLCHR ATT- CONV 1 ARM DRIVE||0|57.11||0|10/01/2019 SH 78001|E0957|E0957 - W/C MEDIAL THIGH SUPPORT||158.35|15.84||0|10/01/2019 SH 78001|E0956|E0956 - W/C LATERAL TRUNK/HIP SUPPOR||113.16|11.32||0|10/01/2019 SH 78001|E0955|E0955 - CUSHIONED HEADREST||232.12|23.23||0|10/01/2019 SH 78001|E0954|E0954 - FOOT BOX - ANY TYPE EACH FOOT||60.82|6.11||0|10/01/2019 SH 78001|E0953|E0953 - W/C LATERAL THIGH/KNEE SUP EACH||87.48|8.75||0|10/01/2019 SH 78001|E0952|E0952 - TOE LOOP/HOLDER - EACH||18.38|1.91||0|10/01/2019 SH 78001|E0951|E0951 - LOOP HEEL||21.79|2.24||0|10/01/2019 SH 78001|E0950|E0950 - TRAY||101.44|10.16||0|10/01/2019 SH 78001|E0948|E0948 - FRACTURE FRAME ATTACHMNTS CE||715.6|71.57||0|10/01/2019 SH 78001|E0947|E0947 - FRACTURE FRAME ATTACHMNTS PE||715.6|72.44||0|10/01/2019 SH 78001|E0946|E0946 - FRACTURE FRAME DUAL W CROSS||0|66.98||0|10/01/2019 SH 78001|E0945|E0945 - BELT/HARNESS EXTREMITY||50.18|5.03||0|10/01/2019 SH 78001|E0944|E0944 - PELVIC BELT/HARNESS/BOOT||59.7|5.98||0|10/01/2019 SH 78001|E0942|E0942 - CERVICAL HEAD HARNESS/HALTER||22.91|2.66||0|10/01/2019 SH 78001|E0941|E0941 - GRAVITY ASSISTED TRACTION DE||0|57.8||0|10/01/2019 SH 78001|E0940|E0940 - TRAPEZE BAR FREE STANDING||0|33.92||0|10/01/2019 SH 78001|E0935|E0935 - CONT PAS MOTION EXERCISE DEV||0|25.74||0|10/01/2019 SH 78001|E0930|E0930 - FRACTURE FRAME FREE STANDING||0|51.72||0|10/01/2019 SH 78001|E0920|E0920 - FRACTURE FRAME ATTACHED TO B||0|54.61||0|10/01/2019 SH 78001|E0912|E0912 - HD TRAPEZE BAR FREE STANDING||0|131.42||0|10/01/2019 SH 78001|E0911|E0911 - HD TRAPEZE BAR ATTACH TO BED||0|57.22||0|10/01/2019 SH 78001|E0910|E0910 - TRAPEZE BAR ATTACHED TO BED||0|21.59||0|10/01/2019 SH 78001|E0900|E0900 - TRAC STAND FREE STAND PELVIC||145.07|31.27||0|10/01/2019 SH 78001|E0890|E0890 - TRACTION FRAME ATTACH PELVIC||136.31|43.49||0|10/01/2019 SH 78001|E0880|E0880 - TRAC STAND FREE STAND EXTREM||142.14|22.32||0|10/01/2019 SH 78001|E0870|E0870 - TRACT FRAME ATTACH FOOTBOARD||131.69|15.19||0|10/01/2019 SH 78001|E0860|E0860 - TRACT EQUIP CERVICAL TRACT||48.19|7.38||0|10/01/2019 SH 78001|E0856|E0856 - CERVIC COLLAR W AIR BLADDERS||0|20.5||0|10/01/2019 SH 78001|E0855|E0855 - CERVICAL TRACTION EQUIPMENT||0|66.94||0|10/01/2019 SH 78001|E0850|E0850 - TRACTION STAND FREE STANDING||118.93|16.33||0|10/01/2019 SH 78001|E0849|E0849 - CERVICAL PNEUM TRAC EQUIP||0|68.65||0|10/01/2019 SH 78001|E0840|E0840 - TRACT FRAME ATTACH HEADBOARD||94.64|21.74||0|10/01/2019 SH 78001|E0791|E0791 - PARENTERAL INFUSION PUMP STA||0|357.98||0|10/01/2019 SH 78001|E0784|E0784 - EXT AMB INFUSN PUMP INSULIN||0|556.18||0|10/01/2019 SH 78001|E0781|E0781 - EXTERNAL AMBULATORY INFUS PU||0|342.22||0|10/01/2019 SH 78001|E0780|E0780 - MECH AMB INFUSION PUMP <8HRS||13.81|0||0|10/01/2019 SH 78001|E0779|E0779 - AMB INFUSION PUMP MECHANICAL||0|21.74||0|10/01/2019 SH 78001|E0776|E0776 - IV POLE||162.08|21.12||0|10/01/2019 SH 78001|E0765|E0765 - NERVE STIMULATOR FOR TX N&V||112.06|11.22||0|10/01/2019 SH 78001|E0762|E0762 - TRANS ELEC JT STIM DEV SYS||0|146.45||0|10/01/2019 SH 78001|E0745|E0745 - NEUROMUSCULAR STIM FOR SHOCK||0|119.23||0|10/01/2019 SH 78001|E0744|E0744 - NEUROMUSCULAR STIM FOR SCOLI||0|121.97||0|10/01/2019 SH 78001|E0740|E0740 - NON-IMPLANT PELV FLR E-STIM||0|69.66||0|10/01/2019 SH 78001|E0731|E0731 - CONDUCTIVE GARMENT FOR TENS/||475.09|0||0|10/01/2019 SH 78001|E0730|E0730 - TENS FOUR LEAD||493.56|0||0|10/01/2019 SH 78001|E0720|E0720 - TENS TWO LEAD||489.59|0||0|10/01/2019 SH 78001|E0705|E0705 - TRANSFER DEVICE||73.42|7.46||0|10/01/2019 SH 78001|E0694|E0694 - UVL MD CABINET SYS 6 FT||5896.94|589.69||0|10/01/2019 SH 78001|E0693|E0693 - UVL SYS PANEL 6 FT||1852.7|185.28||0|10/01/2019 SH 78001|E0692|E0692 - UVL SYS PANEL 4 FT||1502.94|150.28||0|10/01/2019 SH 78001|E0691|E0691 - UVL PNL 2 SQ FT OR LESS||1196.87|119.68||0|10/01/2019 SH 78001|E0675|E0675 - PNEUMATIC COMPRESSION DEVICE||0|512.2||0|10/01/2019 SH 78001|E0673|E0673 - PRESSURE PNEUM APPL HALF LEG||357.18|35.72||0|10/01/2019 SH 78001|E0672|E0672 - PRESSURE PNEUM APPL FULL ARM||429.84|43||0|10/01/2019 SH 78001|E0671|E0671 - PRESSURE PNEUM APPL FULL LEG||553.22|55.34||0|10/01/2019 SH 78001|E0670|E0670 - SEG PNEUM INT LEGS/TRUNK||1674.31|179.24||0|10/01/2019 SH 78001|E0669|E0669 - SEG PNEUMATIC APPLI HALF LEG||241.12|24.13||0|10/01/2019 SH 78001|E0668|E0668 - SEG PNEUMATIC APPL FULL ARM||588.55|58.08||0|10/01/2019 SH 78001|E0667|E0667 - SEG PNEUMATIC APPL FULL LEG||431.24|48.7||0|10/01/2019 SH 78001|E0666|E0666 - PNEUMATIC APPLIANCE HALF LEG||183.94|18.95||0|10/01/2019 SH 78001|E0665|E0665 - PNEUMATIC APPLIANCE FULL ARM||178.54|17.87||0|10/01/2019 SH 78001|E0660|E0660 - PNEUMATIC APPLIANCE FULL LEG||212.77|21.7||0|10/01/2019 SH 78001|E0657|E0657 - SEGMENTAL PNEUMATIC CHEST||0|72.3||0|10/01/2019 SH 78001|E0656|E0656 - SEGMENTAL PNEUMATIC TRUNK||0|76.97||0|10/01/2019 SH 78001|E0655|E0655 - PNEUMATIC APPLIANCE HALF ARM||125.74|14.36||0|10/01/2019 SH 78001|E0652|E0652 - PNEUM COMPRES W/CAL PRESSURE||7061.2|697.86||0|10/01/2019 SH 78001|E0651|E0651 - PNEUM COMPRESSOR SEGMENTAL||1223.27|124.97||0|10/01/2019 SH 78001|E0650|E0650 - PNEUMA COMPRESOR NON-SEGMENT||815.39|106.36||0|10/01/2019 SH 78001|E0640|E0640 - FIXED PATIENT LIFT SYSTEM||0|146.32||0|10/01/2019 SH 78001|E0639|E0639 - MOVEABLE PATIENT LIFT SYSTEM||0|146.32||0|10/01/2019 SH 78001|E0636|E0636 - PT SUPPORT & POSITIONING SYS||0|1404.61||0|10/01/2019 SH 78001|E0635|E0635 - PATIENT LIFT ELECTRIC||0|162.97||0|10/01/2019 SH 78001|E0630|E0630 - PATIENT LIFT HYDRAULIC||0|122.3||0|10/01/2019 SH 78001|E0629|E0629 - SEAT LIFT MECH - NON-ELECTRIC||440.48|44.05||0|10/01/2019 SH 78001|E0628|E0628 - SEAT LIFT FOR PT FURN-ELECTR||449.29|44.94||0|10/01/2019 SH 78001|E0627|E0627 - SEAT LIFT MECH - ELECTRIC ANY||449.29|44.94||0|10/01/2019 SH 78001|E0621|E0621 - PATIENT LIFT SLING OR SEAT||108.67|10.46||0|10/01/2019 SH 78001|E0620|E0620 - CAP BLD SKIN PIERCING LASER||0|116.45||0|10/01/2019 SH 78001|E0619|E0619 - APNEA MONITOR W RECORDER||0|0||0|10/01/2019 SH 78001|E0618|E0618 - APNEA MONITOR||0|373.43||0|10/01/2019 SH 78001|E0617|E0617 - AUTOMATIC EXT DEFIBRILLATOR||0|404.96||0|10/01/2019 SH 78001|E0615|E0615 - PACEMAKER MONITR DIGITAL/VIS||637.74|77.92||0|10/01/2019 SH 78001|E0610|E0610 - PACEMAKER MONITR AUDIBLE/VIS||280.25|28.39||0|10/01/2019 SH 78001|E0607|E0607 - BLOOD GLUCOSE MONITOR HOME||88.99|8.89||0|10/01/2019 SH 78001|E0606|E0606 - DRAINAGE BOARD POSTURAL||0|30.58||0|10/01/2019 SH 78001|E0605|E0605 - VAPORIZER ROOM TYPE||29.93|3.48||0|10/01/2019 SH 78001|E0603|E0603 - ELECTRIC BREAST PUMP||153|15.3||0|10/01/2019 SH 78001|E0602|E0602 - MANUAL BREAST PUMP||39.31|3.95||0|10/01/2019 SH 78001|E0601|E0601 - CONT AIRWAY PRESSURE DEVICE||973.96|128.24||0|10/01/2019 SH 78001|E0600|E0600 - SUCTION PUMP PORTAB HOM MODL||0|54.24||0|10/01/2019 SH 78001|E0585|E0585 - NEBULIZER W/ COMPRESSOR & HE||0|39.7||0|10/01/2019 SH 78001|E0580|E0580 - NEBULIZER FOR USE W/ REGULAT||153.89|15.4||0|10/01/2019 SH 78001|E0575|E0575 - NEBULIZER ULTRASONIC||0|134.23||0|10/01/2019 SH 78001|E0574|E0574 - ULTRASONIC GENERATOR W SVNEB||0|52.32||0|10/01/2019 SH 78001|E0572|E0572 - AEROSOL COMPRESSOR ADJUST PR||0|49.49||0|10/01/2019 SH 78001|E0570|E0570 - NEBULIZER WITH COMPRESSION||126.16|21.44||0|10/01/2019 SH 78001|E0565|E0565 - COMPRESSOR AIR POWER SOURCE||0|81.26||0|10/01/2019 SH 78001|E0562|E0562 - HUMIDIFIER HEATED USED W PAP||345.8|34.56||0|10/01/2019 SH 78001|E0561|E0561 - HUMIDIFIER NONHEATED W PAP||122.83|12.26||0|10/01/2019 SH 78001|E0560|E0560 - HUMIDIFIER SUPPLEMENTAL W/ I||167.36|21.13||0|10/01/2019 SH 78001|E0550|E0550 - HUMIDIF EXTENS SUPPLE W IPPB||0|66.77||0|10/01/2019 SH 78001|E0500|E0500 - IPPB ALL TYPES||0|124.27||0|10/01/2019 SH 78001|E0486|E0486 - ORAL DEVICE/APPLIANCE CUSFAB||0|0||0|10/01/2019 SH 78001|E0485|E0485 - ORAL DEVICE/APPLIANCE PREFAB||0|0||0|10/01/2019 SH 78001|E0484|E0484 - NON-ELEC OSCILLATORY PEP DVC||49.19|4.91||0|10/01/2019 SH 78001|E0483|E0483 - HI FREQ CHEST WALL OSCIL SYS||0|1416.02||0|10/01/2019 SH 78001|E0482|E0482 - COUGH STIMULATING DEVICE||0|555.56||0|10/01/2019 SH 78001|E0480|E0480 - PERCUSSOR ELECT/PNEUM HOME M||0|57.54||0|10/01/2019 SH 78001|E0472|E0472 - RAD W BACKUP INVASIVE INTRFC||0|737.21||0|10/01/2019 SH 78001|E0471|E0471 - RAD W/BACKUP NON INV INTRFC||0|737.21||0|10/01/2019 SH 78001|E0470|E0470 - RAD W/O BACKUP NON-INV INTFC||1980.22|294.58||0|10/01/2019 SH 78001|E0464|E0464 - PRESR SUPP VENT W VOL CONTR MODE USED W NONINVA IN||0|1873.22||0|10/01/2019 SH 78001|E0463|E0463 - PRESSURE SUPPORT VENT INVASIVE INT||0|1873.22||0|10/01/2019 SH 78001|E0462|E0462 - ROCKING BED W/ OR W/O SIDE R||0|388.13||0|10/01/2019 SH 78001|E0461|E0461 - VOL VENT BACKUP RATE FEATUR NON-INVASV INTERFCE||0|1271.36||0|10/01/2019 SH 78001|E0460|E0460 - NEG PRESSURE VENTILATOR; PORTABLE/STATIONARY AR||0|977.06||0|10/01/2019 SH 78001|E0450|E0450 - VOL VENT STATION/PRTBLE W/BACKUP RATE FEATUR||0|1271.36||0|10/01/2019 SH 78001|E0444|E0444 - PORTABLE 02 CONTENTS - LIQUID||92.94|0||0|10/01/2019 SH 78001|E0443|E0443 - PORTABLE 02 CONTENTS - GAS||92.94|0||0|10/01/2019 SH 78001|E0442|E0442 - STATIONARY O2 CONTENTS - LIQ||92.94|0||0|10/01/2019 SH 78001|E0441|E0441 - STATIONARY O2 CONTENTS - GAS||92.94|0||0|10/01/2019 SH 78001|E0439|E0439 - STATIONARY LIQUID 02||0|217.1||0|10/01/2019 SH 78001|E0434|E0434 - PORTABLE LIQUID 02||0|36.5||0|10/01/2019 SH 78001|E0433|E0433 - PORTABLE LIQUID OXYGEN SYS||0|61.96||0|10/01/2019 SH 78001|E0431|E0431 - PORTABLE GASEOUS 02||0|36.5||0|10/01/2019 SH 78001|E0424|E0424 - STATIONARY COMPRESSED GAS 02||0|217.1||0|10/01/2019 SH 78001|E0373|E0373 - NONPOWERED PRESSURE MATTRESS||0|687.92||0|10/01/2019 SH 78001|E0372|E0372 - POWERED AIR MATTRESS OVERLAY||0|600.55||0|10/01/2019 SH 78001|E0371|E0371 - NONPOWER MATTRESS OVERLAY||0|494.93||0|10/01/2019 SH 78001|E0326|E0326 - URINAL FEMALE JUG-TYPE||12.28|1.34||0|10/01/2019 SH 78001|E0325|E0325 - URINAL MALE JUG-TYPE||11.46|1.72||0|10/01/2019 SH 78001|E0316|E0316 - BED SAFETY ENCLOSURE||0|242.54||0|10/01/2019 SH 78001|E0310|E0310 - RAILS BED SIDE FULL LENGTH||222.86|24.95||0|10/01/2019 SH 78001|E0305|E0305 - RAILS BED SIDE HALF LENGTH||0|17.36||0|10/01/2019 SH 78001|E0304|E0304 - HOSP BED XTRA HVY DTY X WIDE||0|884.74||0|10/01/2019 SH 78001|E0303|E0303 - HOSP BED HVY DTY XTRA WIDE||0|339.17||0|10/01/2019 SH 78001|E0302|E0302 - EX HD HOSP BED > 600 LBS||0|821.32||0|10/01/2019 SH 78001|E0301|E0301 - HD HOSP BED - 350-600 LBS||0|301.01||0|10/01/2019 SH 78001|E0300|E0300 - ENCLOSED PED CRIB HOSP GRADE||0|325.86||0|10/01/2019 SH 78001|E0297|E0297 - HOSP BED TOTAL ELECT W/O MAT||0|137.26||0|10/01/2019 SH 78001|E0296|E0296 - HOSP BED TOTAL ELECT W/ MATT||0|160.22||0|10/01/2019 SH 78001|E0295|E0295 - HOSP BED SEMI-ELECT W/O MATT||0|124.26||0|10/01/2019 SH 78001|E0294|E0294 - HOSP BED SEMI-ELECT W/ MATTR||0|127.49||0|10/01/2019 SH 78001|E0293|E0293 - HOSP BED VAR HT NO SR NO MAT||0|69.79||0|10/01/2019 SH 78001|E0292|E0292 - HOSP BED VAR HT NO SR W/MATT||0|82||0|10/01/2019 SH 78001|E0291|E0291 - HOSP BED FX HT W/O RAIL W/O||0|52.99||0|10/01/2019 SH 78001|E0290|E0290 - HOSP BED FX HT W/O RAILS W/M||0|72.94||0|10/01/2019 SH 78001|E0280|E0280 - BED CRADLE||43.86|4.73||0|10/01/2019 SH 78001|E0277|E0277 - POWERED PRES-REDU AIR MATTRS||0|807.59||0|10/01/2019 SH 78001|E0276|E0276 - BED PAN FRACTURE||17.72|2.1||0|10/01/2019 SH 78001|E0275|E0275 - BED PAN STANDARD||20.4|2.14||0|10/01/2019 SH 78001|E0272|E0272 - MATTRESS FOAM RUBBER||232.32|24.26||0|10/01/2019 SH 78001|E0271|E0271 - MATTRESS INNERSPRING||233.09|23.33||0|10/01/2019 SH 78001|E0266|E0266 - HOSP BED TOTAL ELEC W/O MATT||0|173.3||0|10/01/2019 SH 78001|E0265|E0265 - HOSP BED TOTAL ELECTR W/ MAT||0|195.06||0|10/01/2019 SH 78001|E0261|E0261 - HOSP BED SEMI-ELECTR W/O MAT||0|133.63||0|10/01/2019 SH 78001|E0260|E0260 - HOSP BED SEMI-ELECTR W/ MATT||0|161.26||0|10/01/2019 SH 78001|E0256|E0256 - HOSPITAL BED VAR HT W/O MATT||0|81.34||0|10/01/2019 SH 78001|E0255|E0255 - HOSPITAL BED VAR HT W/ MATTR||0|115.6||0|10/01/2019 SH 78001|E0251|E0251 - HOSP BED FIXD HT W/O MATTRES||0|73.24||0|10/01/2019 SH 78001|E0250|E0250 - HOSP BED FIXED HT W/ MATTRES||0|97.69||0|10/01/2019 SH 78001|E0249|E0249 - PAD WATER CIRCULATING HEAT U||132.67|14.59||0|10/01/2019 SH 78001|E0239|E0239 - HYDROCOLLATOR UNIT PORTABLE||599.15|59.93||0|10/01/2019 SH 78001|E0236|E0236 - PUMP FOR WATER CIRCULATING P||0|52.48||0|10/01/2019 SH 78001|E0235|E0235 - PARAFFIN BATH UNIT PORTABLE||0|22.98||0|10/01/2019 SH 78001|E0225|E0225 - HYDROCOLLATOR UNIT||517.66|51.02||0|10/01/2019 SH 78001|E0217|E0217 - WATER CIRC HEAT PAD W PUMP||657.66|65.74||0|10/01/2019 SH 78001|E0215|E0215 - ELECTRIC HEAT PAD MOIST||80.21|8.39||0|10/01/2019 SH 78001|E0210|E0210 - ELECTRIC HEAT PAD STANDARD||38.81|3.86||0|10/01/2019 SH 78001|E0205|E0205 - HEAT LAMP WITH STAND||258.48|28.43||0|10/01/2019 SH 78001|E0202|E0202 - PHOTOTHERAPY LIGHT W/ PHOTOM||0|70.9||0|10/01/2019 SH 78001|E0200|E0200 - HEAT LAMP WITHOUT STAND||105.6|14.34||0|10/01/2019 SH 78001|E0199|E0199 - DRY PRESSURE PAD FOR MATTRES||42.71|4.25||0|10/01/2019 SH 78001|E0198|E0198 - WATER PRESSURE PAD FOR MATTR||0|25.09||0|10/01/2019 SH 78001|E0197|E0197 - AIR PRESSURE PAD FOR MATTRES||250.86|34.61||0|10/01/2019 SH 78001|E0196|E0196 - GEL PRESSURE MATTRESS||0|36.78||0|10/01/2019 SH 78001|E0194|E0194 - AIR FLUIDIZED BED||0|3684.4||0|10/01/2019 SH 78001|E0193|E0193 - POWERED AIR FLOTATION BED||0|978.71||0|10/01/2019 SH 78001|E0191|E0191 - PROTECTOR HEEL OR ELBOW||11.32|1.16||0|10/01/2019 SH 78001|E0189|E0189 - LAMBSWOOL SHEEPSKIN PAD||69.22|7.49||0|10/01/2019 SH 78001|E0188|E0188 - SYNTHETIC SHEEPSKIN PAD||35.21|4.14||0|10/01/2019 SH 78001|E0187|E0187 - WATER PRESSURE MATTRESS||0|26.28||0|10/01/2019 SH 78001|E0186|E0186 - AIR PRESSURE MATTRESS||0|22.98||0|10/01/2019 SH 78001|E0185|E0185 - GEL PRESSURE MATTRESS PAD||386.64|50.89||0|10/01/2019 SH 78001|E0184|E0184 - DRY PRESSURE MATTRESS||259.33|30.1||0|10/01/2019 SH 78001|E0182|E0182 - REPLACE PUMP - ALT PRESS PAD||0|29.63||0|10/01/2019 SH 78001|E0181|E0181 - PRESS PAD ALTERNATING W/ PUM||0|34.7||0|10/01/2019 SH 78001|E0175|E0175 - COMMODE CHAIR FOOT REST||88.22|8.82||0|10/01/2019 SH 78001|E0171|E0171 - COMMODE CHAIR NON-ELECTRIC||0|38.52||0|10/01/2019 SH 78001|E0170|E0170 - COMMODE CHAIR ELECTRIC||0|214.08||0|10/01/2019 SH 78001|E0168|E0168 - HEAVYDUTY/WIDE COMMODE CHAIR||201.02|20.2||0|10/01/2019 SH 78001|E0167|E0167 - COMMODE CHAIR PAIL OR PAN||13.58|1.42||0|10/01/2019 SH 78001|E0165|E0165 - COMMODE CHAIR WITH DETACHARM||0|24.74||0|10/01/2019 SH 78001|E0163|E0163 - COMMODE CHAIR WITH FIXED ARM||146.89|30.97||0|10/01/2019 SH 78001|E0162|E0162 - SITZ BATH CHAIR||164.96|17.3||0|10/01/2019 SH 78001|E0161|E0161 - SITZ BATH/EQUIPMENT W/FAUCET||34.93|4.04||0|10/01/2019 SH 78001|E0160|E0160 - SITZ TYPE BATH OR EQUIPMENT||37.43|4.92||0|10/01/2019 SH 78001|E0159|E0159 - BRAKE FOR WHEELED WALKER||20.51|2.12||0|10/01/2019 SH 78001|E0158|E0158 - WALKER LEG EXTENDERS SET OF4||36.94|4.08||0|10/01/2019 SH 78001|E0157|E0157 - WALKER CRUTCH ATTACHMENT||83.08|8.78||0|10/01/2019 SH 78001|E0156|E0156 - WALKER SEAT ATTACHMENT||30.35|3.89||0|10/01/2019 SH 78001|E0155|E0155 - WALKER WHEEL ATTACHMENT - PAIR||35.14|3.76||0|10/01/2019 SH 78001|E0154|E0154 - WALKER PLATFORM ATTACHMENT||80.95|8.35||0|10/01/2019 SH 78001|E0153|E0153 - FOREARM CRUTCH PLATFORM ATTA||80.41|8.88||0|10/01/2019 SH 78001|E0149|E0149 - HEAVY DUTY WHEELED WALKER||256.24|25.63||0|10/01/2019 SH 78001|E0148|E0148 - HEAVYDUTY WALKER NO WHEELS||145.87|14.6||0|10/01/2019 SH 78001|E0147|E0147 - WALKER VARIABLE WHEEL RESIST||659.88|66||0|10/01/2019 SH 78001|E0144|E0144 - ENCLOSED WALKER W REAR SEAT||0|36.58||0|10/01/2019 SH 78001|E0143|E0143 - WALKER FOLDING WHEELED W/O S||127.92|21.07||0|10/01/2019 SH 78001|E0141|E0141 - RIGID WHEELED WALKER ADJ/FIX||127.92|21.84||0|10/01/2019 SH 78001|E0140|E0140 - WALKER W TRUNK SUPPORT||414.1|41.42||0|10/01/2019 SH 78001|E0135|E0135 - WALKER FOLDING ADJUST/FIXED||86.76|19.8||0|10/01/2019 SH 78001|E0130|E0130 - WALKER RIGID ADJUST/FIXED HT||80.63|19.3||0|10/01/2019 SH 78001|E0117|E0117 - UNDERARM SPRINGASSIST CRUTCH||0|25.66||0|10/01/2019 SH 78001|E0116|E0116 - CRUTCH UNDERARM EACH NO WOOD||31.42|6.12||0|10/01/2019 SH 78001|E0114|E0114 - CRUTCH UNDERARM PAIR NO WOOD||53.42|9.7||0|10/01/2019 SH 78001|E0113|E0113 - CRUTCH UNDERARM EACH WOOD||23.93|5.82||0|10/01/2019 SH 78001|E0112|E0112 - CRUTCH UNDERARM PAIR WOOD||41.89|11.26||0|10/01/2019 SH 78001|E0111|E0111 - CRUTCH FOREARM EACH||65.52|9.54||0|10/01/2019 SH 78001|E0110|E0110 - CRUTCH FOREARM PAIR||87.84|18.1||0|10/01/2019 SH 78001|E0105|E0105 - CANE ADJUST/FIXED QUAD/3 PRO||65.42|10.03||0|10/01/2019 SH 78001|E0100|E0100 - CANE ADJUST/FIXED WITH TIP||28.07|6.72||0|10/01/2019 SH 78001|CMMT|||0|0||0|10/01/2019 SH 78001|ANEST|||48.4|0||0|10/01/2019 SH 78001|A9606|A9606 - RADIUM RA223 DICHLORIDE THER||0|0||0|10/01/2019 SH 78001|A9585|A9585 - GADOBUTROL INJECTION||0.49|0||0|10/01/2019 SH 78001|A9583|A9583 - GADOFOSVESET TRISODIUM INJ||22.25|0||0|10/01/2019 SH 78001|A9581|A9581 - GADOXETATE DISODIUM INJ||18.4975|0||0|10/01/2019 SH 78001|A9579|A9579 - GAD-BASE MR CONTRAST NOS - 1ML||2.2225|0||0|10/01/2019 SH 78001|A9578|A9578 - INJ MULTIHANCE MULTIPACK||2.44|0||0|10/01/2019 SH 78001|A9577|A9577 - INJ MULTIHANCE||2.535|0||0|10/01/2019 SH 78001|A9576|A9576 - INJ PROHANCE MULTIPACK||2.0187|0||0|10/01/2019 SH 78001|A9575|A9575 - INJ GADOTERATE MEGLUMI 0.1ML||0.2487|0||0|10/01/2019 SH 78001|A9282|A9282 - WIG ANY TYPE||260|0||0|10/01/2019 SH 78001|A8004|A8004 - REPL SOFT INTERFACE - HELMET||0|0||0|10/01/2019 SH 78001|A8003|A8003 - HARD PROTECT HELMET CUSTOM||0|0||0|10/01/2019 SH 78001|A8002|A8002 - SOFT PROTECT HELMET CUSTOM||0|0||0|10/01/2019 SH 78001|A8001|A8001 - HARD PROTECT HELMET PREFAB||204.26|20.42||0|10/01/2019 SH 78001|A8000|A8000 - SOFT PROTECT HELMET PREFAB||204.26|20.42||0|10/01/2019 SH 78001|A7527|A7527 - TRACH/LARYN TUBE PLUG/STOP||4.78|0||0|10/01/2019 SH 78001|A7526|A7526 - TRACHEOSTOMY TUBE COLLAR||4.5|0||0|10/01/2019 SH 78001|A7525|A7525 - TRACHEOSTOMY MASK||2.75|0||0|10/01/2019 SH 78001|A7524|A7524 - TRACHEOSTOMA STENT/STUD/BTTN||103.1|0||0|10/01/2019 SH 78001|A7522|A7522 - TRACH/LARYN TUBE STAINLESS||60.16|0||0|10/01/2019 SH 78001|A7521|A7521 - TRACH/LARYN TUBE CUFFED||62.65|0||0|10/01/2019 SH 78001|A7520|A7520 - TRACH/LARYN TUBE NON-CUFFED||63.24|0||0|10/01/2019 SH 78001|A7509|A7509 - HEAT & MOISTURE EXCHANGE SYS||1.88|0||0|10/01/2019 SH 78001|A7508|A7508 - HOUSING & INTEGRATED ADHESIV||3.82|0||0|10/01/2019 SH 78001|A7507|A7507 - INTEGRATED FILTER & HOLDER||3.31|0||0|10/01/2019 SH 78001|A7506|A7506 - HMES/TRACHVALVE ADHESIVEDISK||0.44|0||0|10/01/2019 SH 78001|A7505|A7505 - HMES OR TRACH VALVE HOUSING||6.24|0||0|10/01/2019 SH 78001|A7504|A7504 - TRACHEOSTOMA HMES FILTER||0.9|0||0|10/01/2019 SH 78001|A7503|A7503 - HMES FILTER HOLDER OR CAP||15.11|0||0|10/01/2019 SH 78001|A7502|A7502 - REPLACEMENT DIAPHRAGM/FPLATE||66.49|0||0|10/01/2019 SH 78001|A7501|A7501 - TRACHEOSTOMA VALVE W DIAPHRA||139.88|0||0|10/01/2019 SH 78001|A7048|A7048 - VACUUM DRAIN BOTTLE/TUBE KIT||56.66|0||0|10/01/2019 SH 78001|A7047|A7047 - RESP SUCTION ORAL INTERFACE||161.04|0||0|10/01/2019 SH 78001|A7046|A7046 - REPL WATER CHAMBER - PAP DEV||22.39|0||0|10/01/2019 SH 78001|A7045|A7045 - REPL EXHALATION PORT FOR PAP||22.34|2.23||0|10/01/2019 SH 78001|A7044|A7044 - PAP ORAL INTERFACE||138.8|0||0|10/01/2019 SH 78001|A7041|A7041 - WATER SEAL DRAIN CONTAINER||101.8|0||0|10/01/2019 SH 78001|A7040|A7040 - ONE WAY CHEST DRAIN VALVE||54.18|0||0|10/01/2019 SH 78001|A7039|A7039 - FILTER - NON DISPOSABLE W PAP||14.95|0||0|10/01/2019 SH 78001|A7038|A7038 - POS AIRWAY PRESSURE FILTER||6.14|0||0|10/01/2019 SH 78001|A7037|A7037 - POS AIRWAY PRESSURE TUBING||45.78|0||0|10/01/2019 SH 78001|A7036|A7036 - POS AIRWAY PRESS CHINSTRAP||17.75|0||0|10/01/2019 SH 78001|A7035|A7035 - POS AIRWAY PRESS HEADGEAR||41.44|0||0|10/01/2019 SH 78001|A7034|A7034 - NASAL APPLICATION DEVICE||135.04|0||0|10/01/2019 SH 78001|A7033|A7033 - REPLACEMENT NASAL PILLOWS||32.62|0||0|10/01/2019 SH 78001|A7032|A7032 - REPLACEMENT NASAL CUSHION||46.52|0||0|10/01/2019 SH 78001|A7031|A7031 - REPLACEMENT FACEMASK INTERFA||80.1|0||0|10/01/2019 SH 78001|A7030|A7030 - CPAP FULL FACE MASK||216.56|0||0|10/01/2019 SH 78001|A7029|A7029 - REPL NASAL PILLOW COMB MASK||26.95|0||0|10/01/2019 SH 78001|A7028|A7028 - REPL ORAL CUSHION COMBO MASK||66|0||0|10/01/2019 SH 78001|A7027|A7027 - COMBINATION ORAL/NASAL MASK||248.44|0||0|10/01/2019 SH 78001|A7026|A7026 - REPLACE CHST CMPRSS SYS HOSE||38.29|0||0|10/01/2019 SH 78001|A7025|A7025 - REPLACE CHEST COMPRESS VEST||0|57.94||0|10/01/2019 SH 78001|A7020|A7020 - INTERFACE - COUGH STIM DEVICE||19.28|0||0|10/01/2019 SH 78001|A7018|A7018 - WATER DISTILLED W/NEBULIZER||0.43|0||0|10/01/2019 SH 78001|A7017|A7017 - NEBULIZER NOT USED W OXYGEN||178.52|17.87||0|10/01/2019 SH 78001|A7016|A7016 - NEBULIZER DOME & MOUTHPIECE||9|0||0|10/01/2019 SH 78001|A7015|A7015 - AEROSOL MASK USED W NEBULIZE||2.51|0||0|10/01/2019 SH 78001|A7014|A7014 - COMPRESSOR NONDISPOS FILTER||5.98|0||0|10/01/2019 SH 78001|A7013|A7013 - DISPOSABLE COMPRESSOR FILTER||0.94|0||0|10/01/2019 SH 78001|A7012|A7012 - NEBULIZER WATER COLLEC DEVIC||4.99|0||0|10/01/2019 SH 78001|A7010|A7010 - DISPOSABLE CORRUGATED TUBING||26.71|0||0|10/01/2019 SH 78001|A7009|A7009 - NEBULIZER RESERVOIR BOTTLE||54.1|0||0|10/01/2019 SH 78001|A7008|A7008 - DISPOSABLE NEBULIZER PREFILL||12.46|0||0|10/01/2019 SH 78001|A7007|A7007 - LG VOL NEBULIZER DISPOSABLE||5.76|0||0|10/01/2019 SH 78001|A7006|A7006 - FILTERED NEBULIZER ADMIN SET||12.71|0||0|10/01/2019 SH 78001|A7005|A7005 - NONDISPOSABLE NEBULIZER SET||34.91|0||0|10/01/2019 SH 78001|A7004|A7004 - DISPOSABLE NEBULIZER SML VOL||2.05|0||0|10/01/2019 SH 78001|A7003|A7003 - NEBULIZER ADMINISTRATION SET||3.6|0||0|10/01/2019 SH 78001|A7002|A7002 - TUBING USED W SUCTION PUMP||4.33|0||0|10/01/2019 SH 78001|A7001|A7001 - NONDISPOSABLE PUMP CANISTER||38.53|0||0|10/01/2019 SH 78001|A7000|A7000 - DISPOSABLE CANISTER FOR PUMP||10.86|0||0|10/01/2019 SH 78001|A6550|A6550 - NEG PRES WOUND THER DRSG SET||31.5|0||0|10/01/2019 SH 78001|A6545|A6545 - GRAD COMP NON-ELASTIC BK||84.5|0||0|10/01/2019 SH 78001|A6541|A6541 - GC STOCKING WAISTLNGTH 40-50||2.4|0||0|10/01/2019 SH 78001|A6540|A6540 - GC STOCKING WAISTLNGTH 30-40||82.2|0||0|10/01/2019 SH 78001|A6539|A6539 - GC STOCKING WAISTLNGTH 18-30||83.04|0||0|10/01/2019 SH 78001|A6538|A6538 - GC STOCKING FULL LNGTH 40-50||40|0||0|10/01/2019 SH 78001|A6537|A6537 - GC STOCKING FULL LNGTH 30-40||52.5|0||0|10/01/2019 SH 78001|A6536|A6536 - GC STOCKING FULL LNGTH 18-30||51|0||0|10/01/2019 SH 78001|A6535|A6535 - GC STOCKING THIGHLNGTH 40-50||41.4|0||0|10/01/2019 SH 78001|A6534|A6534 - GC STOCKING THIGHLNGTH 30-40||48|0||0|10/01/2019 SH 78001|A6533|A6533 - GC STOCKING THIGHLNGTH 18-30||73.8|0||0|10/01/2019 SH 78001|A6532|A6532 - COMPRESSION STOCKING BK40-50||65|0||0|10/01/2019 SH 78001|A6531|A6531 - COMPRESSION STOCKING BK30-40||31.86|0||0|10/01/2019 SH 78001|A6530|A6530 - COMPRESSION STOCKING BK18-30||48|0||0|10/01/2019 SH 78001|A6513|A6513 - COMPRESS BURN MASK FACE/NECK||0|0||0|10/01/2019 SH 78001|A6511|A6511 - COMPRES BURN GARMENT PANTY||0|0||0|10/01/2019 SH 78001|A6510|A6510 - COMPRES BURN GARMENT LEOTARD||0|0||0|10/01/2019 SH 78001|A6509|A6509 - COMPRES BURN GARMENT JACKET||0|0||0|10/01/2019 SH 78001|A6508|A6508 - CMPRS BURNGARMENT FOOT-THIGH||0|0||0|10/01/2019 SH 78001|A6507|A6507 - CMPRS BURNGARMENT FOOT-KNEE||0|0||0|10/01/2019 SH 78001|A6506|A6506 - CMPRSBURNGRMNT GLOVE-AXILLA||0|0||0|10/01/2019 SH 78001|A6505|A6505 - CMPRSBURNGARMENT GLOVE-ELBOW||0|0||0|10/01/2019 SH 78001|A6504|A6504 - CMPRSBURNGARMENT GLOVE-WRIST||0|0||0|10/01/2019 SH 78001|A6503|A6503 - COMPRES BURNGARMENT FACEHOOD||0|0||0|10/01/2019 SH 78001|A6502|A6502 - COMPRES BURNGARMENT CHINSTRP||0|0||0|10/01/2019 SH 78001|A6501|A6501 - COMPRES BURNGARMENT BODYSUIT||0|0||0|10/01/2019 SH 78001|A6457|A6457 - TUBULAR DRESSING||1.52|0||0|10/01/2019 SH 78001|A6456|A6456 - ZINC PASTE BAND W >=3''<5''/YD||1.69|0||0|10/01/2019 SH 78001|A6455|A6455 - SELF-ADHER BAND >=5''/YD||1.86|0||0|10/01/2019 SH 78001|A6454|A6454 - SELF-ADHER BAND W>=3'' <5''/YD||1.03|0||0|10/01/2019 SH 78001|A6453|A6453 - SELF-ADHER BAND W <3''/YD||0.83|0||0|10/01/2019 SH 78001|A6452|A6452 - HIGH COMPRES BAND W>=3''<5''YD||7.87|0||0|10/01/2019 SH 78001|A6451|A6451 - MOD COMPRES BAND W>=3''<5''/YD||0|0||0|10/01/2019 SH 78001|A6450|A6450 - LT COMPRES BAND >=5''/YD||0|0||0|10/01/2019 SH 78001|A6449|A6449 - LT COMPRES BAND >=3'' <5''/YD||2.34|0||0|10/01/2019 SH 78001|A6448|A6448 - LT COMPRES BAND <3''/YD||1.55|0||0|10/01/2019 SH 78001|A6447|A6447 - CONFORM BAND S W >=5''/YD||0.9|0||0|10/01/2019 SH 78001|A6446|A6446 - CONFORM BAND S W>=3'' <5''/YD||0.54|0||0|10/01/2019 SH 78001|A6445|A6445 - CONFORM BAND S W <3''/YD||0.43|0||0|10/01/2019 SH 78001|A6444|A6444 - CONFORM BAND N/S W>=5''/YD||0.74|0||0|10/01/2019 SH 78001|A6443|A6443 - CONFORM BAND N/S W>=3''<5''/YD||0.37|0||0|10/01/2019 SH 78001|A6442|A6442 - CONFORM BAND N/S W<3''/YD||0.22|0||0|10/01/2019 SH 78001|A6441|A6441 - PAD BAND W>=3'' <5''/YD||0.9|0||0|10/01/2019 SH 78001|A6411|A6411 - NON-STERILE EYE PAD||0|0||0|10/01/2019 SH 78001|A6410|A6410 - STERILE EYE PAD||0.52|0||0|10/01/2019 SH 78001|A6407|A6407 - PACKING STRIPS - NON-IMPREG||2.51|0||0|10/01/2019 SH 78001|A6403|A6403 - STERILE GAUZE>16 <= 48 SQ IN||0.56|0||0|10/01/2019 SH 78001|A6402|A6402 - STERILE GAUZE <= 16 SQ IN||0.16|0||0|10/01/2019 SH 78001|A6266|A6266 - IMPREG GAUZE NO H20/SAL/YARD||2.57|0||0|10/01/2019 SH 78001|A6259|A6259 - TRANSPARENT FILM > 48 SQ IN||14.58|0||0|10/01/2019 SH 78001|A6258|A6258 - TRANSPARENT FILM >16<=48 IN||5.75|0||0|10/01/2019 SH 78001|A6257|A6257 - TRANSPARENT FILM <= 16 SQ IN||2.05|0||0|10/01/2019 SH 78001|A6255|A6255 - ABSORPT DRG >16<=48 IN W/BDR||4.04|0||0|10/01/2019 SH 78001|A6254|A6254 - ABSORPT DRG <=16 SQ IN W/BDR||1.61|0||0|10/01/2019 SH 78001|A6253|A6253 - ABSORPT DRG > 48 SQ IN W/O B||8.44|0||0|10/01/2019 SH 78001|A6252|A6252 - ABSORPT DRG >16 <=48 W/O BDR||4.33|0||0|10/01/2019 SH 78001|A6251|A6251 - ABSORPT DRG <=16 SQ IN W/O B||2.65|0||0|10/01/2019 SH 78001|A6248|A6248 - HYDROGEL DRSG GEL FILLER||21.64|0||0|10/01/2019 SH 78001|A6247|A6247 - HYDROGEL DRG > 48 SQ IN W/B||31.68|0||0|10/01/2019 SH 78001|A6246|A6246 - HYDROGEL DRG >16<=48 IN W/B||13.22|0||0|10/01/2019 SH 78001|A6245|A6245 - HYDROGEL DRG <= 16 IN W/BDR||9.67|0||0|10/01/2019 SH 78001|A6244|A6244 - HYDROGEL DRG >48 IN W/O BDR||52.32|0||0|10/01/2019 SH 78001|A6243|A6243 - HYDROGEL DRG >16<=48 W/O BDR||16.4|0||0|10/01/2019 SH 78001|A6242|A6242 - HYDROGEL DRG <=16 IN W/O BDR||8.08|0||0|10/01/2019 SH 78001|A6241|A6241 - HYDROCOLLOID DRG FILLER DRY||3.42|0||0|10/01/2019 SH 78001|A6240|A6240 - HYDROCOLLD DRG FILLER PASTE||16.31|0||0|10/01/2019 SH 78001|A6238|A6238 - HYDROCOLLD DRG >16<=48 W/BDR||30.36|0||0|10/01/2019 SH 78001|A6237|A6237 - HYDROCOLLD DRG <=16 IN W/BDR||10.55|0||0|10/01/2019 SH 78001|A6236|A6236 - HYDROCOLLD DRG > 48 IN W/O B||36.3|0||0|10/01/2019 SH 78001|A6235|A6235 - HYDROCOLLD DRG >16<=48 W/O B||22.39|0||0|10/01/2019 SH 78001|A6234|A6234 - HYDROCOLLD DRG <=16 W/O BDR||8.71|0||0|10/01/2019 SH 78001|A6233|A6233 - HYDROGEL DRESSING >48 SQ IN||25.55|0||0|10/01/2019 SH 78001|A6232|A6232 - HYDROGEL DSG>16<=48 SQ IN||9.14|0||0|10/01/2019 SH 78001|A6231|A6231 - HYDROGEL DSG<=16 SQ IN||6.24|0||0|10/01/2019 SH 78001|A6229|A6229 - GAUZE >16<=48 SQ IN WATR/SAL||4.81|0||0|10/01/2019 SH 78001|A6224|A6224 - GAUZE > 48 IN NO W/SAL W/O B||4.81|0||0|10/01/2019 SH 78001|A6223|A6223 - GAUZE >16<=48 NO W/SAL W/O B||3.23|0||0|10/01/2019 SH 78001|A6222|A6222 - GAUZE <=16 IN NO W/SAL W/O B||2.83|0||0|10/01/2019 SH 78001|A6220|A6220 - GAUZE >16 <=48 SQ IN W/BORDR||3.44|0||0|10/01/2019 SH 78001|A6219|A6219 - GAUZE <= 16 SQ IN W/BORDER||1.27|0||0|10/01/2019 SH 78001|A6217|A6217 - NON-STERILE GAUZE>16<=48 SQ||0|0||0|10/01/2019 SH 78001|A6216|A6216 - NON-STERILE GAUZE<=16 SQ IN||0.06|0||0|10/01/2019 SH 78001|A6214|A6214 - FOAM DRG > 48 SQ IN W/BORDER||13.7|0||0|10/01/2019 SH 78001|A6212|A6212 - FOAM DRG <=16 SQ IN W/BORDER||12.92|0||0|10/01/2019 SH 78001|A6211|A6211 - FOAM DRG > 48 SQ IN W/O BRDR||39.12|0||0|10/01/2019 SH 78001|A6210|A6210 - FOAM DRG >16<=48 SQ IN W/O B||26.54|0||0|10/01/2019 SH 78001|A6209|A6209 - FOAM DRSG <=16 SQ IN W/O BDR||9.95|0||0|10/01/2019 SH 78001|A6207|A6207 - CONTACT LAYER >16<= 48 SQ IN||9.77|0||0|10/01/2019 SH 78001|A6204|A6204 - COMPOSITE DRSG >16<=48 SQ IN||8.29|0||0|10/01/2019 SH 78001|A6203|A6203 - COMPOSITE DRSG <= 16 SQ IN||4.48|0||0|10/01/2019 SH 78001|A6199|A6199 - ALGINATE DRSG WOUND FILLER||7.04|0||0|10/01/2019 SH 78001|A6197|A6197 - ALGINATE DRSG >16 <=48 SQ IN||21.89|0||0|10/01/2019 SH 78001|A6196|A6196 - ALGINATE DRESSING <=16 SQ IN||9.79|0||0|10/01/2019 SH 78001|A6154|A6154 - WOUND POUCH EACH||19.15|0||0|10/01/2019 SH 78001|A6024|A6024 - COLLAGEN DSG WOUND FILLER||8.24|0||0|10/01/2019 SH 78001|A6023|A6023 - COLLAGEN DRESSING >48 SQ IN||253.48|0||0|10/01/2019 SH 78001|A6022|A6022 - COLLAGEN DRSG>16<=48 SQ IN||28|0||0|10/01/2019 SH 78001|A6021|A6021 - COLLAGEN DRESSING <=16 SQ IN||28|0||0|10/01/2019 SH 78001|A6011|A6011 - COLLAGEN GEL/PASTE WOUND FIL||3.04|0||0|10/01/2019 SH 78001|A6010|A6010 - COLLAGEN BASED WOUND FILLER||41.26|0||0|10/01/2019 SH 78001|A5513|A5513 - MULTI DEN INSERT CUSTOM MOLD||51.55|0||0|10/01/2019 SH 78001|A5512|A5512 - MULTI DEN INSERT DIRECT FORM||34.55|0||0|10/01/2019 SH 78001|A5507|A5507 - MODIFICATION DIABETIC SHOE||41.48|0||0|10/01/2019 SH 78001|A5506|A5506 - DIABETIC SHOE W/OFF SET HEEL||41.48|0||0|10/01/2019 SH 78001|A5505|A5505 - DIAB SHOE W/METATARSAL BAR||41.48|0||0|10/01/2019 SH 78001|A5504|A5504 - DIABETIC SHOE WITH WEDGE||41.48|0||0|10/01/2019 SH 78001|A5503|A5503 - DIABETIC SHOE W/ROLLER/ROCKR||41.48|0||0|10/01/2019 SH 78001|A5501|A5501 - DIABETIC CUSTOM MOLDED SHOE||254.02|0||0|10/01/2019 SH 78001|A5500|A5500 - DIAB SHOE FOR DENSITY INSERT||84.68|0||0|10/01/2019 SH 78001|A5200|A5200 - PERCUTANEOUS CATHETER ANCHOR||15.06|0||0|10/01/2019 SH 78001|A5131|A5131 - APPLIANCE CLEANER||21.12|0||0|10/01/2019 SH 78001|A5126|A5126 - DISK/FOAM PAD +OR- ADHESIVE||1.75|0||0|10/01/2019 SH 78001|A5122|A5122 - SOLID SKIN BARRIER 8X8||17.11|0||0|10/01/2019 SH 78001|A5121|A5121 - SOLID SKIN BARRIER 6X6||8.44|0||0|10/01/2019 SH 78001|A5114|A5114 - FOAM/FABRIC LEG STRAP||10.14|0||0|10/01/2019 SH 78001|A5113|A5113 - LATEX LEG STRAP||6.28|0||0|10/01/2019 SH 78001|A5112|A5112 - URINARY LEG BAG||46.1|0||0|10/01/2019 SH 78001|A5105|A5105 - URINARY SUSPENSORY||54.3|0||0|10/01/2019 SH 78001|A5102|A5102 - BEDSIDE DRAIN BTL W/WO TUBE||30.07|0||0|10/01/2019 SH 78001|A5093|A5093 - OSTOMY ACCESSORY CONVEX INSE||2.6|0||0|10/01/2019 SH 78001|A5083|A5083 - STOMA ABSORPTIVE COVER||0.85|0||0|10/01/2019 SH 78001|A5082|A5082 - CONTINENT STOMA CATHETER||15.84|0||0|10/01/2019 SH 78001|A5081|A5081 - STOMA PLUG OR SEAL - ANY TYPE||3.74|0||0|10/01/2019 SH 78001|A5073|A5073 - URINARY POUCH ON BARR W/FLNG||4.24|0||0|10/01/2019 SH 78001|A5072|A5072 - URINARY POUCH W/O BARRIER||4.7|0||0|10/01/2019 SH 78001|A5071|A5071 - URINARY POUCH W/BARRIER||8|0||0|10/01/2019 SH 78001|A5063|A5063 - DRAIN OSTOMY POUCH W/FLANGE||3.6|0||0|10/01/2019 SH 78001|A5062|A5062 - DRNBLE OSTOMY POUCH W/O BARR||2.96|0||0|10/01/2019 SH 78001|A5061|A5061 - POUCH DRAINABLE W BARRIER AT||4.7|0||0|10/01/2019 SH 78001|A5057|A5057 - 1 PC OST POU W BUILT-IN CONV||12.79|0||0|10/01/2019 SH 78001|A5056|A5056 - 1 PC OST POUCH W FILTER||6.22|0||0|10/01/2019 SH 78001|A5055|A5055 - STOMA CAP||1.92|0||0|10/01/2019 SH 78001|A5054|A5054 - CLSD OSTOMY POUCH W/FLANGE||2.4|0||0|10/01/2019 SH 78001|A5053|A5053 - CLSD OSTOMY POUCH FACEPLATE||1.98|0||0|10/01/2019 SH 78001|A5052|A5052 - CLSD OSTOMY POUCH W/O BARR||1.98|0||0|10/01/2019 SH 78001|A5051|A5051 - POUCH CLSD W BARR ATTACHED||2.75|0||0|10/01/2019 SH 78001|A4640|A4640 - ALTERNATING PRESSURE PAD||84.34|8.59||0|10/01/2019 SH 78001|A4639|A4639 - INFRARED HT SYS REPLCMNT PAD||0|38.27||0|10/01/2019 SH 78001|A4638|A4638 - REPL BATT PULSE GEN SYS||0|0||0|10/01/2019 SH 78001|A4637|A4637 - REPL TIP CANE/CRUTCH/WALKER||2.09|0.29||0|10/01/2019 SH 78001|A4636|A4636 - HANDGRIP FOR CANE ETC||4.12|0.42||0|10/01/2019 SH 78001|A4635|A4635 - UNDERARM CRUTCH PAD||5.8|0.78||0|10/01/2019 SH 78001|A4633|A4633 - UVL REPLACEMENT BULB||54.65|0||0|10/01/2019 SH 78001|A4630|A4630 - REPL BAT T.E.N.S. OWN BY PT||7.07|0||0|10/01/2019 SH 78001|A4629|A4629 - TRACHEOSTOMY CARE KIT||6.18|0||0|10/01/2019 SH 78001|A4628|A4628 - OROPHARYNGEAL SUCTION CATH||4.98|0||0|10/01/2019 SH 78001|A4626|A4626 - TRACHEOSTOMY CLEANING BRUSH||4.25|0||0|10/01/2019 SH 78001|A4625|A4625 - TRACH CARE KIT FOR NEW TRACH||9.23|0||0|10/01/2019 SH 78001|A4624|A4624 - TRACHEAL SUCTION TUBE||3.5|0||0|10/01/2019 SH 78001|A4623|A4623 - TRACHEOSTOMY INNER CANNULA||8.34|0||0|10/01/2019 SH 78001|A4620|A4620 - VARIABLE CONCENTRATION MASK||0.84|0||0|10/01/2019 SH 78001|A4619|A4619 - FACE TENT||2.47|0||0|10/01/2019 SH 78001|A4618|A4618 - BREATHING CIRCUITS||10.9|1.16||0|10/01/2019 SH 78001|A4617|A4617 - MOUTH PIECE||4.13|0||0|10/01/2019 SH 78001|A4616|A4616 - TUBING (OXYGEN) PER FOOT||0.08|0||0|10/01/2019 SH 78001|A4615|A4615 - CANNULA NASAL||0.96|0||0|10/01/2019 SH 78001|A4614|A4614 - HAND-HELD PEFR METER||31.68|0||0|10/01/2019 SH 78001|A4608|A4608 - TRANSTRACHEAL OXYGEN CATH||66.76|0||0|10/01/2019 SH 78001|A4605|A4605 - TRACH SUCTION CATH CLOSE SYS||21.84|0||0|10/01/2019 SH 78001|A4604|A4604 - TUBING WITH HEATING ELEMENT||76.68|0||0|10/01/2019 SH 78001|A4602|A4602 - REPLACE LITHIUM BATTERY 1.5V||4.96|0||0|10/01/2019 SH 78001|A4595|A4595 - TENS SUPPL 2 LEAD PER MONTH||38.38|0||0|10/01/2019 SH 78001|A4590|A4590 - SPECIAL CASTING MATERIAL||36.4|0||0|10/01/2019 SH 78001|A4565|A4565 - SLINGS||10.25|0||0|10/01/2019 SH 78001|A4562|A4562 - PESSARY - NON RUBBER - ANY TYPE||68.17|0||0|10/01/2019 SH 78001|A4561|A4561 - PESSARY RUBBER - ANY TYPE||27.43|0||0|10/01/2019 SH 78001|A4559|A4559 - COUPLING GEL OR PASTE||0.13|0||0|10/01/2019 SH 78001|A4558|A4558 - CONDUCTIVE GEL OR PASTE||7.26|0||0|10/01/2019 SH 78001|A4557|A4557 - LEAD WIRES - PAIR||28.12|0||0|10/01/2019 SH 78001|A4556|A4556 - ELECTRODES - PAIR||16.18|0||0|10/01/2019 SH 78001|A4483|A4483 - MOISTURE EXCHANGER||0|0||0|10/01/2019 SH 78001|A4481|A4481 - TRACHEOSTOMA FILTER||0.5|0||0|10/01/2019 SH 78001|A4463|A4463 - SURGICAL DRESS HOLDER REUSE||17.74|0||0|10/01/2019 SH 78001|A4461|A4461 - SURGICL DRESS HOLD NON-REUSE||4.38|0||0|10/01/2019 SH 78001|A4456|A4456 - ADHESIVE REMOVER - WIPES||0.32|0||0|10/01/2019 SH 78001|A4455|A4455 - ADHESIVE REMOVER PER OUNCE||1.91|0||0|10/01/2019 SH 78001|A4435|A4435 - 1PC OST PCH DRAIN HGH OUTPUT||7.69|0||0|10/01/2019 SH 78001|A4434|A4434 - OST PCH URINE W LOCK FLNG/FT||5|0||0|10/01/2019 SH 78001|A4433|A4433 - URINE OST PCH BAR W LOCK FLN||4.45|0||0|10/01/2019 SH 78001|A4432|A4432 - OS PCH URINE W BAR/FANGE/TAP||4.79|0||0|10/01/2019 SH 78001|A4431|A4431 - OST PCH URINE W BARRIER/TAPV||8.28|0||0|10/01/2019 SH 78001|A4430|A4430 - OST URINE PCH W B/BLTIN CONV||11.34|0||0|10/01/2019 SH 78001|A4429|A4429 - URINE OST POUCH W BLTINCONV||10.99|0||0|10/01/2019 SH 78001|A4428|A4428 - URINE OST POUCH W FAUCET/TAP||8.68|0||0|10/01/2019 SH 78001|A4427|A4427 - OST PCH DRAIN/BARR LK FLNG/F||3.71|0||0|10/01/2019 SH 78001|A4426|A4426 - OST PCH DRAIN 2 PIECE SYSTEM||3.64|0||0|10/01/2019 SH 78001|A4425|A4425 - OST PCH DRAIN FOR BARRIER FL||4.78|0||0|10/01/2019 SH 78001|A4424|A4424 - OST PCH DRAIN W BAR & FILTER||6.34|0||0|10/01/2019 SH 78001|A4423|A4423 - OST PCH FOR BAR W LK FL/FLTR||2.48|0||0|10/01/2019 SH 78001|A4422|A4422 - OST POUCH ABSORBENT MATERIAL||0.16|0||0|10/01/2019 SH 78001|A4420|A4420 - OST PCH CLSD FOR BAR W LK FL||0|0||0|10/01/2019 SH 78001|A4419|A4419 - OST PCH FOR BAR W FLANGE/FLT||2.32|0||0|10/01/2019 SH 78001|A4418|A4418 - OST PCH CLSD W/O BAR W FILTR||2.42|0||0|10/01/2019 SH 78001|A4417|A4417 - OST PCH W BAR/BLTINCONV/FLTR||4.96|0||0|10/01/2019 SH 78001|A4416|A4416 - OST PCH CLSD W BARRIER/FILTR||3.67|0||0|10/01/2019 SH 78001|A4415|A4415 - OST SKN BARR W/O CONV >4 SQI||7.98|0||0|10/01/2019 SH 78001|A4414|A4414 - OST SKNBAR W/O CONV<=4 SQ IN||6.55|0||0|10/01/2019 SH 78001|A4413|A4413 - 2 PC DRAINABLE OST POUCH||7.33|0||0|10/01/2019 SH 78001|A4412|A4412 - OST POUCH DRAIN HIGH OUTPUT||3.6|0||0|10/01/2019 SH 78001|A4411|A4411 - OST SKN BARR EXTND =4SQ||6.79|0||0|10/01/2019 SH 78001|A4410|A4410 - OST SKN BARR EXTND >4 SQ||12.05|0||0|10/01/2019 SH 78001|A4409|A4409 - OST SKN BARR CONVEX <=4 SQ I||8.28|0||0|10/01/2019 SH 78001|A4408|A4408 - EXT WEAR OST SKN BARR >4SQ''||13.14|0||0|10/01/2019 SH 78001|A4407|A4407 - EXT WEAR OST SKN BARR <=4SQ''||11.66|0||0|10/01/2019 SH 78001|A4406|A4406 - PECTIN BASED OSTOMY PASTE||7.63|0||0|10/01/2019 SH 78001|A4405|A4405 - NONPECTIN BASED OSTOMY PASTE||4.55|0||0|10/01/2019 SH 78001|A4404|A4404 - OSTOMY RING EACH||2.24|0||0|10/01/2019 SH 78001|A4402|A4402 - LUBRICANT PER OUNCE||1.81|0||0|10/01/2019 SH 78001|A4400|A4400 - OSTOMY IRRIGATION SET||55.32|0||0|10/01/2019 SH 78001|A4399|A4399 - OSTOMY IRRIG CONE/CATH W BRS||14.18|0||0|10/01/2019 SH 78001|A4398|A4398 - OSTOMY IRRIGATION BAG||16.87|0||0|10/01/2019 SH 78001|A4397|A4397 - IRRIGATION SUPPLY SLEEVE||5.88|0||0|10/01/2019 SH 78001|A4396|A4396 - PERISTOMAL HERNIA SUPPRT BLT||53.92|0||0|10/01/2019 SH 78001|A4395|A4395 - OSTOMY POUCH SOLID DEODORANT||0.06|0||0|10/01/2019 SH 78001|A4394|A4394 - OSTOMY POUCH LIQ DEODORANT||3.44|0||0|10/01/2019 SH 78001|A4393|A4393 - URINE PCH W EX WEAR BAR CONV||12.05|0||0|10/01/2019 SH 78001|A4392|A4392 - URINARY POUCH W ST WEAR BARR||10.9|0||0|10/01/2019 SH 78001|A4391|A4391 - URINARY POUCH W EX WEAR BARR||9.42|0||0|10/01/2019 SH 78001|A4390|A4390 - DRAINABLE PCH EX WEAR CONVEX||12.79|0||0|10/01/2019 SH 78001|A4389|A4389 - DRAINABLE PCH W ST WEAR BARR||8.28|0||0|10/01/2019 SH 78001|A4388|A4388 - DRAINABLE PCH W EX WEAR BARR||5.82|0||0|10/01/2019 SH 78001|A4387|A4387 - OST CLSD POUCH W ATT ST BARR||2.99|0||0|10/01/2019 SH 78001|A4385|A4385 - OST SKN BARRIER SLD EXT WEAR||6.79|0||0|10/01/2019 SH 78001|A4384|A4384 - OSTOMY FACEPLT/SILICONE RING||12.8|0||0|10/01/2019 SH 78001|A4383|A4383 - URINARY RUBBER POUCH W/O FP||37.55|0||0|10/01/2019 SH 78001|A4382|A4382 - URINARY HVY PLSTC PCH W/O FP||32.78|0||0|10/01/2019 SH 78001|A4381|A4381 - URINARY PLASTIC POUCH W/O FP||6.16|0||0|10/01/2019 SH 78001|A4380|A4380 - URINARY RUBBER POUCH W FCPLT||49.72|0||0|10/01/2019 SH 78001|A4379|A4379 - URINARY PLASTIC POUCH W FCPL||20|0||0|10/01/2019 SH 78001|A4378|A4378 - DRAINABLE RUBBER PCH W/O FP||40.94|0||0|10/01/2019 SH 78001|A4377|A4377 - DRAINABLE PLSTIC PCH W/O FP||5.72|0||0|10/01/2019 SH 78001|A4376|A4376 - DRAINABLE RUBBER PCH W FCPLT||63.38|0||0|10/01/2019 SH 78001|A4375|A4375 - DRAINABLE PLASTIC PCH W FCPL||22.88|0||0|10/01/2019 SH 78001|A4373|A4373 - SKIN BARRIER WITH FLANGE||8.35|0||0|10/01/2019 SH 78001|A4372|A4372 - SKIN BARRIER SOLID 4X4 EQUIV||5.59|0||0|10/01/2019 SH 78001|A4371|A4371 - SKIN BARRIER POWDER PER OZ||4.86|0||0|10/01/2019 SH 78001|A4369|A4369 - SKIN BARRIER LIQUID PER OZ||3.23|0||0|10/01/2019 SH 78001|A4368|A4368 - OSTOMY FILTER||0.34|0||0|10/01/2019 SH 78001|A4367|A4367 - OSTOMY BELT||8.98|0||0|10/01/2019 SH 78001|A4366|A4366 - OSTOMY VENT||1.73|0||0|10/01/2019 SH 78001|A4364|A4364 - ADHESIVE - LIQUID OR EQUAL||3.32|0||0|10/01/2019 SH 78001|A4363|A4363 - OSTOMY CLAMP - REPLACEMENT||2.69|0||0|10/01/2019 SH 78001|A4362|A4362 - SOLID SKIN BARRIER||3.92|0||0|10/01/2019 SH 78001|A4361|A4361 - OSTOMY FACE PLATE||21.48|0||0|10/01/2019 SH 78001|A4360|A4360 - DISPOSABLE EXT URETHRAL DEV||0.65|0||0|10/01/2019 SH 78001|A4358|A4358 - URINARY LEG OR ABDOMEN BAG||8.64|0||0|10/01/2019 SH 78001|A4357|A4357 - BEDSIDE DRAINAGE BAG||10.98|0||0|10/01/2019 SH 78001|A4356|A4356 - EXT URETH CLMP OR COMPR DVC||60.77|0||0|10/01/2019 SH 78001|A4355|A4355 - BLADDER IRRIGATION TUBING||10.82|0||0|10/01/2019 SH 78001|A4354|A4354 - CATH INSERTION TRAY W/BAG||13.37|0||0|10/01/2019 SH 78001|A4353|A4353 - INTERMITTENT URINARY CATH||9.32|0||0|10/01/2019 SH 78001|A4352|A4352 - COUDE TIP URINARY CATHETER||8.4|0||0|10/01/2019 SH 78001|A4351|A4351 - STRAIGHT TIP URINE CATHETER||2.41|0||0|10/01/2019 SH 78001|A4349|A4349 - DISPOSABLE MALE EXTERNAL CAT||2.69|0||0|10/01/2019 SH 78001|A4346|A4346 - CATH INDW FOLEY 3 WAY||22.18|0||0|10/01/2019 SH 78001|A4344|A4344 - CATH INDW FOLEY 2 WAY SILICN||18.12|0||0|10/01/2019 SH 78001|A4340|A4340 - INDWELLING CATHETER SPECIAL||36.11|0||0|10/01/2019 SH 78001|A4338|A4338 - INDWELLING CATHETER LATEX||13.88|0||0|10/01/2019 SH 78001|A4336|A4336 - URETHRAL INSERT||1.92|0||0|10/01/2019 SH 78001|A4334|A4334 - URINARY CATH LEG STRAP||6.55|0||0|10/01/2019 SH 78001|A4333|A4333 - URINARY CATH ANCHOR DEVICE||2.94|0||0|10/01/2019 SH 78001|A4332|A4332 - LUBE STERILE PACKET||0.16|0||0|10/01/2019 SH 78001|A4331|A4331 - EXTENSION DRAINAGE TUBING||4.24|0||0|10/01/2019 SH 78001|A4330|A4330 - STOOL COLLECTION POUCH||9.53|0||0|10/01/2019 SH 78001|A4328|A4328 - FEM URINARY COLLECT POUCH||13.63|0||0|10/01/2019 SH 78001|A4327|A4327 - FEM URINARY COLLECT DEV CUP||59.41|0||0|10/01/2019 SH 78001|A4326|A4326 - MALE EXTERNAL CATHETER||14.38|0||0|10/01/2019 SH 78001|A4322|A4322 - IRRIGATION SYRINGE||3.95|0||0|10/01/2019 SH 78001|A4321|A4321 - CATH THERAPEUTIC IRRIG AGENT||0|0||0|10/01/2019 SH 78001|A4320|A4320 - IRRIGATION TRAY||6.29|0||0|10/01/2019 SH 78001|A4316|A4316 - CATH W/DRAINAGE 3-WAY||37.82|0||0|10/01/2019 SH 78001|A4315|A4315 - CATH W/DRAINAGE 2-WAY SILCNE||29.88|0||0|10/01/2019 SH 78001|A4314|A4314 - CATH W/DRAINAGE 2-WAY LATEX||31.08|0||0|10/01/2019 SH 78001|A4313|A4313 - CATHETER W/BAG 3-WAY||20.98|0||0|10/01/2019 SH 78001|A4312|A4312 - CATH W/O BAG 2-WAY SILICONE||20.42|0||0|10/01/2019 SH 78001|A4311|A4311 - CATHETER W/O BAG 2-WAY LATEX||19.75|0||0|10/01/2019 SH 78001|A4310|A4310 - INSERT TRAY W/O BAG/CATH||9.24|0||0|10/01/2019 SH 78001|A4280|A4280 - BRST PRSTHS ADHSV ATTCHMNT||7.1|0||0|10/01/2019 SH 78001|A4265|A4265 - PARAFFIN||4.54|0||0|10/01/2019 SH 78001|A4259|A4259 - LANCETS PER BOX||13.84|0||0|10/01/2019 SH 78001|A4258|A4258 - LANCET DEVICE EACH||20.72|0||0|10/01/2019 SH 78001|A4257|A4257 - REPLACE LENSSHIELD CARTRIDGE||16.99|0||0|10/01/2019 SH 78001|A4256|A4256 - CALIBRATOR SOLUTION/CHIPS||11.16|0||0|10/01/2019 SH 78001|A4255|A4255 - GLUCOSE MONITOR PLATFORMS||5.39|0||0|10/01/2019 SH 78001|A4253|A4253 - BLOOD GLUCOSE/REAGENT STRIPS||40.75|0||0|10/01/2019 SH 78001|A4236|A4236 - SILVR OXIDE BATT GLUCOSE MON||1.93|0||0|10/01/2019 SH 78001|A4235|A4235 - LITHIUM BATT FOR GLUCOSE MON||2.69|0||0|10/01/2019 SH 78001|A4234|A4234 - J-CELL BATT FOR GLUCOSE MON||4.18|0||0|10/01/2019 SH 78001|A4233|A4233 - ALKALIN BATT FOR GLUCOSE MON||0.92|0||0|10/01/2019 SH 78001|A4222|A4222 - INFUSION SUPPLIES WITH PUMP||62.26|0||0|10/01/2019 SH 78001|A4221|A4221 - SUPP NON-INSULIN INF CATH/WK||30.16|0||0|10/01/2019 SH 78001|A4217|A4217 - STERILE WATER/SALINE - 500 ML||4.18|0||0|10/01/2019 SH 78001|A4216|A4216 - STERILE WATER/SALINE - 10 ML||0.59|0||0|10/01/2019 SH 78001|99607|99607 - MEDICATION THERAPY EACH ADDITIONAL 15 MIN(11/19)||0|0||0|10/01/2019 SH 78001|99606|99606 - MEDICATION THERAPY INITIAL 15 MIN ESTABLISHED PT||0|0||0|10/01/2019 SH 78001|99605|99605 - MEDICATION THERAPY INITIAL 15 MIN NEW PATIENT||0|0||0|10/01/2019 SH 78001|99602|99602 - HOME NFS/SPECTY DRUG ADMN PR VST MIN||0|0||0|10/01/2019 SH 78001|99448|99448 - NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN||0|0||0|10/01/2019 SH 78001|99447|99447 - NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN||0|0||0|10/01/2019 SH 78001|99446|99446 - NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN||0|0||0|10/01/2019 SH 78001|99444|99444 - PHYS/QHP ONLINE EVALUATION & MANAGEMENT SERVICE||0|0||0|10/01/2019 SH 78001|99443|99443 - PHYS/QHP TELEPHONE EVALUATION 21-30 MIN||47.08|0||0|10/01/2019 SH 78001|99442|99442 - PHYS/QHP TELEPHONE EVALUATION 11-20 MIN||31.65|0||0|10/01/2019 SH 78001|99441|99441 - PHYS/QHP TELEPHONE EVALUATION 5-10 MIN||16.6|0||0|10/01/2019 SH 78001|99429|99429 - UNLISTED PREVENTIVE MEDICINE SERVICE||0|0||0|10/01/2019 SH 78001|99416|99416 - PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN||5.41|0||0|10/01/2019 SH 78001|99415|99415 - PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR||9.66|0||0|10/01/2019 SH 78001|99412|99412 - PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M||24.74|0||0|10/01/2019 SH 78001|99411|99411 - PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M||18.49|0||0|10/01/2019 SH 78001|99409|99409 - ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN||80.89|0||0|10/01/2019 SH 78001|99408|99408 - ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN||41.22|0||0|10/01/2019 SH 78001|99407|99407 - TOBACCO USE CESSATION INTENSIVE >10 MINUTES||32.03|0||0|10/01/2019 SH 78001|99406|99406 - TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES||16.56|0||0|10/01/2019 SH 78001|99404|99404 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN||131.02|0||0|10/01/2019 SH 78001|99403|99403 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN||100.97|0||0|10/01/2019 SH 78001|99402|99402 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN||71.73|0||0|10/01/2019 SH 78001|99401|99401 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN||41.64|0||0|10/01/2019 SH 78001|99397|99397 - PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER||157.99|0||0|10/01/2019 SH 78001|99396|99396 - PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS||147.08|0||0|10/01/2019 SH 78001|99395|99395 - PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS||137.51|0||0|10/01/2019 SH 78001|99394|99394 - PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS||134.19|0||0|10/01/2019 SH 78001|99393|99393 - PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS||122.07|0||0|10/01/2019 SH 78001|99392|99392 - PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS||122.46|0||0|10/01/2019 SH 78001|99391|99391 - PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y||114.53|0||0|10/01/2019 SH 78001|99387|99387 - INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>||191.96|0||0|10/01/2019 SH 78001|99386|99386 - INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS||177.26|0||0|10/01/2019 SH 78001|99385|99385 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS||152.99|0||0|10/01/2019 SH 78001|99384|99384 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR||157.6|0||0|10/01/2019 SH 78001|99383|99383 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS||138.84|0||0|10/01/2019 SH 78001|99382|99382 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS||133.37|0||0|10/01/2019 SH 78001|99381|99381 - INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR||127.5|0||0|10/01/2019 SH 78001|99380|99380 - SUPERVISION NURS FACILITY PATIENT MONTH 30 MIN/>||122.69|0||0|10/01/2019 SH 78001|99379|99379 - SUPERVISION NURS FACILITY PATIENT MO 15-29 MIN||81.17|0||0|10/01/2019 SH 78001|99378|99378 - SUPERVISION HOSPICE PATIENT/MONTH 30 MINUTES/>||122.69|0||0|10/01/2019 SH 78001|99377|99377 - SUPERVISION HOSPICE PATIENT/MONTH 15-29 MIN||81.17|0||0|10/01/2019 SH 78001|99375|99375 - SUPERVISION PT HOME HEALTH AGENCY MONTH 30 MIN/>||122.69|0||0|10/01/2019 SH 78001|99374|99374 - SUPVJ PT HOME HEALTH AGENCY MO 15-29 MINUTES||81.17|0||0|10/01/2019 SH 78001|99368|99368 - TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN||43.46|0||0|10/01/2019 SH 78001|99367|99367 - TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN||66.44|0||0|10/01/2019 SH 78001|99366|99366 - TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN||50.49|0||0|10/01/2019 SH 78001|99364|99364 - ANTICOAGULANT MGMT OUTPATIENT EA SBSQ 90 DAYS||50.05|0||0|10/01/2019 SH 78001|99363|99363 - ANTICOAGULANT MGMT OUTPATIENT INIT 90 DAYS||146.76|0||0|10/01/2019 SH 78001|99360|99360 - PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES||0|0||0|10/01/2019 SH 78001|99359|99359 - PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MINUTES||61.74|0||0|10/01/2019 SH 78001|99358|99358 - PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR||128.96|0||0|10/01/2019 SH 78001|99357|99357 - PROLONGED SVC I/P REQ UNIT/FLOOR TIME EA 30 MIN||106.71|0||0|10/01/2019 SH 78001|99356|99356 - PROLONGED SERVICE I/P REQ UNIT/FLOOR TIME 1ST HR||107.87|0||0|10/01/2019 SH 78001|99355|99355 - PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON ADDL 30||113.56|0||0|10/01/2019 SH 78001|99354|99354 - PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON 1ST HR||116.66|0||0|10/01/2019 SH 78001|99350|99350 - HOME VST EST PT UNSTABLE/SIGNIF NEW PROB 60 MINS||207.38|0||0|10/01/2019 SH 78001|99349|99349 - HOME VISIT EST PT MOD-HI SEVERITY 40 MINUTES||149.73|0||0|10/01/2019 SH 78001|99348|99348 - HOME VISIT EST PT LOW-MOD SEVERITY 25 MINUTES||98.3|0||0|10/01/2019 SH 78001|99347|99347 - HOME VISIT EST PT SELF LIMITED/MINOR 15 MINUTES||64.84|0||0|10/01/2019 SH 78001|99345|99345 - HOME VISIT NEW PT UNSTABL/SIGNIF NEW PROB 75 MIN||258.21|0||0|10/01/2019 SH 78001|99344|99344 - HOME VISIT NEW PATIENT HI SEVERITY 60 MINUTES||213.24|0||0|10/01/2019 SH 78001|99343|99343 - HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES||152.55|0||0|10/01/2019 SH 78001|99342|99342 - HOME VISIT NEW PATIENT MOD SEVERITY 30 MINUTES||93.48|0||0|10/01/2019 SH 78001|99341|99341 - HOME VISIT NEW PATIENT LOW SEVERITY 20 MINUTES||64.11|0||0|10/01/2019 SH 78001|99340|99340 - INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>||126.87|0||0|10/01/2019 SH 78001|99339|99339 - INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 15-29 MIN||90.75|0||0|10/01/2019 SH 78001|99337|99337 - DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES||225.36|0||0|10/01/2019 SH 78001|99336|99336 - DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES||157.28|0||0|10/01/2019 SH 78001|99335|99335 - DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES||111.02|0||0|10/01/2019 SH 78001|99334|99334 - DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES||70.19|0||0|10/01/2019 SH 78001|99328|99328 - DOM/R-HOME E/M NEW PT SIGNIF NEW PROB 75 MINUTES||254.72|0||0|10/01/2019 SH 78001|99327|99327 - DOMICIL/REST HOME NEW PT VISIT HI SEVER 60 MIN||217.47|0||0|10/01/2019 SH 78001|99326|99326 - DOMICIL/REST HOME NEW PT HI-MOD SEVER 45 MINUTES||163.06|0||0|10/01/2019 SH 78001|99325|99325 - DOMICIL/REST HOME NEW PT VISIT MOD SEVER 30 MIN||94.25|0||0|10/01/2019 SH 78001|99324|99324 - DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN||64.5|0||0|10/01/2019 SH 78001|99318|99318 - E/M ANNUAL NURSING FACILITY ASSESS STABLE 30 MIN||112.13|0||0|10/01/2019 SH 78001|99316|99316 - NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES||123.04|0||0|10/01/2019 SH 78001|99315|99315 - NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES||85.06|0||0|10/01/2019 SH 78001|99310|99310 - SBSQ NURS FACIL CARE/DAY UNSTABL/NEW PROB 35 MIN||157.96|0||0|10/01/2019 SH 78001|99309|99309 - SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN||106.01|0||0|10/01/2019 SH 78001|99308|99308 - SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN||79.88|0||0|10/01/2019 SH 78001|99307|99307 - SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN||51.77|0||0|10/01/2019 SH 78001|99306|99306 - INITIAL NURSING FACILITY CARE/DAY 45 MINUTES||195.18|0||0|10/01/2019 SH 78001|99305|99305 - INITIAL NURSING FACILITY CARE/DAY 35 MINUTES||152.92|0||0|10/01/2019 SH 78001|99304|99304 - INITIAL NURSING FACILITY CARE/DAY 25 MINUTES||107.18|0||0|10/01/2019 SH 78001|99292|99292 - CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN||143.97|0||0|10/01/2019 SH 78001|99291|99291 - CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN||320.89|0||0|10/01/2019 SH 78001|99288|99288 - PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS||0|0||0|10/01/2019 SH 78001|99285|99285 - EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ||207.74|0||0|10/01/2019 SH 78001|99284|99284 - EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY||140.29|0||0|10/01/2019 SH 78001|99283|99283 - EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY||73.7|0||0|10/01/2019 SH 78001|99282|99282 - EMERGENCY DEPARTMENT VISIT LOW/MODER SEVERITY||48.82|0||0|10/01/2019 SH 78001|99281|99281 - EMERGENCY DEPARTMENT VISIT LIMITED/MINOR PROB||24.84|0||0|10/01/2019 SH 78001|99255|99255 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN||237.27|0||0|10/01/2019 SH 78001|99254|99254 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 80 MIN||196.17|0||0|10/01/2019 SH 78001|99253|99253 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 55 MIN||135.9|0||0|10/01/2019 SH 78001|99252|99252 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 40 MIN||89.13|0||0|10/01/2019 SH 78001|99251|99251 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 20 MIN||58.25|0||0|10/01/2019 SH 78001|99245|99245 - OFFICE CONSULTATION NEW/ESTAB PATIENT 80 MIN||262.64|0||0|10/01/2019 SH 78001|99244|99244 - OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN||214.39|0||0|10/01/2019 SH 78001|99243|99243 - OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN||144.29|0||0|10/01/2019 SH 78001|99242|99242 - OFFICE CONSULTATION NEW/ESTAB PATIENT 30 MIN||105.49|0||0|10/01/2019 SH 78001|99241|99241 - OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN||55.91|0||0|10/01/2019 SH 78001|99239|99239 - HOSPITAL DISCHARGE DAY MANAGEMENT > 30 MIN||125.76|0||0|10/01/2019 SH 78001|99238|99238 - HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<||85.45|0||0|10/01/2019 SH 78001|99236|99236 - OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES||256.76|0||0|10/01/2019 SH 78001|99235|99235 - OBSERVATION/INPATIENT HOSPITAL CARE 50 MINUTES||199.07|0||0|10/01/2019 SH 78001|99234|99234 - OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES||157.73|0||0|10/01/2019 SH 78001|99233|99233 - SBSQ HOSPITAL CARE/DAY 35 MINUTES||122.71|0||0|10/01/2019 SH 78001|99232|99232 - SBSQ HOSPITAL CARE/DAY 25 MINUTES||85.15|0||0|10/01/2019 SH 78001|99231|99231 - SBSQ HOSPITAL CARE/DAY 15 MINUTES||45.96|0||0|10/01/2019 SH 78001|99226|99226 - SBSQ OBSERVATION CARE/DAY 35 MINUTES||123.87|0||0|10/01/2019 SH 78001|99225|99225 - SBSQ OBSERVATION CARE/DAY 25 MINUTES||85.54|0||0|10/01/2019 SH 78001|99224|99224 - SBSQ OBSERVATION CARE/DAY 15 MINUTES||46.35|0||0|10/01/2019 SH 78001|99223|99223 - INITIAL HOSPITAL CARE/DAY 70 MINUTES||239|0||0|10/01/2019 SH 78001|99222|99222 - INITIAL HOSPITAL CARE/DAY 50 MINUTES||161.43|0||0|10/01/2019 SH 78001|99221|99221 - INITIAL HOSPITAL CARE/DAY 30 MINUTES||119.66|0||0|10/01/2019 SH 78001|99220|99220 - INITIAL OBSERVATION CARE/DAY 70 MINUTES||219.08|0||0|10/01/2019 SH 78001|99219|99219 - INITIAL OBSERVATION CARE/DAY 50 MINUTES||159.83|0||0|10/01/2019 SH 78001|99218|99218 - INITIAL OBSERVATION CARE/DAY 30 MINUTES||118.1|0||0|10/01/2019 SH 78001|99217|99217 - OBSERVATION CARE DISCHARGE MANAGEMENT||85.06|0||0|10/01/2019 SH 78001|99215|99215 - OFFICE OUTPATIENT VISIT 40 MINUTES||167.77|0||0|10/01/2019 SH 78001|99214|99214 - OFFICE OUTPATIENT VISIT 25 MINUTES||124.01|0||0|10/01/2019 SH 78001|99213|99213 - OFFICE OUTPATIENT VISIT 15 MINUTES||83.32|0||0|10/01/2019 SH 78001|99212|99212 - OFFICE OUTPATIENT VISIT 10 MINUTES||49.78|0||0|10/01/2019 SH 78001|99211|99211 - OFFICE OUTPATIENT VISIT 5 MINUTES||22.49|0||0|10/01/2019 SH 78001|99205|99205 - OFFICE OUTPATIENT NEW 60 MINUTES||239.87|0||0|10/01/2019 SH 78001|99204|99204 - OFFICE OUTPATIENT NEW 45 MINUTES||190.5|0||0|10/01/2019 SH 78001|99203|99203 - OFFICE OUTPATIENT NEW 30 MINUTES||124.45|0||0|10/01/2019 SH 78001|99202|99202 - OFFICE OUTPATIENT NEW 20 MINUTES||85.47|0||0|10/01/2019 SH 78001|99201|99201 - OFFICE OUTPATIENT NEW 10 MINUTES||49.78|0||0|10/01/2019 SH 78001|99199|99199 - UNLISTED SPECIAL SERVICE PROCEDURE/REPORT||0|0||0|10/01/2019 SH 78001|99195|99195 - PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE||109.72|0||0|10/01/2019 SH 78001|99192|99192 - ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH 30 MI||0|0||0|10/01/2019 SH 78001|99191|99191 - ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH 45 MI||0|0||0|10/01/2019 SH 78001|99190|99190 - ASSEMBLY&OPERJ PUMP OXYGENATOR/HEAT EXCH EA HR||0|0||0|10/01/2019 SH 78001|99188|99188 - APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP||0|0||0|10/01/2019 SH 78001|99184|99184 - INITIAT SELECTIVE HEAD/BODY HYPOTHERMIA NEONATE||276.31|0||0|10/01/2019 SH 78001|99183|99183 - PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION||131.36|0||0|10/01/2019 SH 78001|99177|99177 - INSTRUMENT BASED OCULAR SCR BI W/ONSITE ANALYSIS||0|0||0|10/01/2019 SH 78001|99175|99175 - IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED||18.61|0||0|10/01/2019 SH 78001|99174|99174 - INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT||0|0||0|10/01/2019 SH 78001|99173|99173 - SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT||3.49|0||0|10/01/2019 SH 78001|99172|99172 - VISUAL FUNCT SCRNG AUTO SEMI-AUTO BI QUAN DETERM||0|0||0|10/01/2019 SH 78001|99170|99170 - ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG||182.47|0||0|10/01/2019 SH 78001|99157|99157 - MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS||70.2|0||0|10/01/2019 SH 78001|99156|99156 - MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS||92.59|0||0|10/01/2019 SH 78001|99155|99155 - MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS||113.26|0||0|10/01/2019 SH 78001|99153|99153 - MOD SED SAME PHYS/QHP EACH ADDL 15 MINS||13.35|0||0|10/01/2019 SH 78001|99152|99152 - MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS||62.45|0||0|10/01/2019 SH 78001|99151|99151 - MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS||93.88|0||0|10/01/2019 SH 78001|99140|99140 - ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY||0|0||0|10/01/2019 SH 78001|99135|99135 - ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION||0|0||0|10/01/2019 SH 78001|99116|99116 - ANES COMPLICJ UTILIZATION TOTAL BODY HYPOTHERMIA||0|0||0|10/01/2019 SH 78001|99100|99100 - ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<||0|0||0|10/01/2019 SH 78001|99091|99091 - COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D||66.44|0||0|10/01/2019 SH 78001|99090|99090 - ANALYSIS CLINICAL DATA STORED IN COMPUTERS||0|0||0|10/01/2019 SH 78001|99082|99082 - UNUSUAL TRAVEL||0|0||0|10/01/2019 SH 78001|99080|99080 - SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG||0|0||0|10/01/2019 SH 78001|99078|99078 - PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING||0|0||0|10/01/2019 SH 78001|99075|99075 - MEDICAL TESTIMONY||0|0||0|10/01/2019 SH 78001|99071|99071 - EDUCATIONAL SUPPLIES PRV BY THE PHYS AT COST||0|0||0|10/01/2019 SH 78001|99070|99070 - SUPPLIES&MATERIALS ABOVE/BEYOND PROV BY PHYS/QHP||0|0||0|10/01/2019 SH 78001|99060|99060 - SVC PRV EMER OUT OFFICE DISRUPTS OFFICE SVC||0|0||0|10/01/2019 SH 78001|99058|99058 - SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS||0|0||0|10/01/2019 SH 78001|99056|99056 - SVC TYPICAL PRV OFFICE PRV OUT OFFICE REQUEST PT||0|0||0|10/01/2019 SH 78001|99053|99053 - SERVICES PROVIDED BTW 10 PM&8 AM AT 24-HR FACI||0|0||0|10/01/2019 SH 78001|99051|99051 - SVC PRV OFFICE REG SCHEDD EVN WKEND/HOLIDAY HRS||0|0||0|10/01/2019 SH 78001|99050|99050 - SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS||0|0||0|10/01/2019 SH 78001|99027|99027 - HOSPITAL MANDATED CALL SVC OUT-OF-HOSPITAL EA HR||0|0||0|10/01/2019 SH 78001|99026|99026 - HOSPITAL MANDATED CALL SERVICE IN-HOSPITAL EA HR||0|0||0|10/01/2019 SH 78001|99024|99024 - POSTOP FOLLOW UP VISIT RELATED TO ORIGINAL PX||0|0||0|10/01/2019 SH 78001|99002|99002 - HANDLE/CONVEY/ANY OTH SVC DEVICE FIT PHYS/QHP||0|0||0|10/01/2019 SH 78001|99001|99001 - HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB||0|0||0|10/01/2019 SH 78001|99000|99000 - HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB||0|0||0|10/01/2019 SH 78001|98969|98969 - NONPHYSICIAN ONLINE ASSESSMENT AND MANAGEMENT||0|0||0|10/01/2019 SH 78001|98968|98968 - NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN||47.08|0||0|10/01/2019 SH 78001|98967|98967 - NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN||31.65|0||0|10/01/2019 SH 78001|98966|98966 - NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN||16.6|0||0|10/01/2019 SH 78001|98962|98962 - EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS||10.86|0||0|10/01/2019 SH 78001|98961|98961 - EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS||14.73|0||0|10/01/2019 SH 78001|98960|98960 - EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT||30.63|0||0|10/01/2019 SH 78001|98943|98943 - CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION||31.86|0||0|10/01/2019 SH 78001|98942|98942 - CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS||62.33|0||0|10/01/2019 SH 78001|98941|98941 - CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS||47.68|0||0|10/01/2019 SH 78001|98940|98940 - CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS||32.63|0||0|10/01/2019 SH 78001|98929|98929 - OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS||101.35|0||0|10/01/2019 SH 78001|98928|98928 - OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS||84.75|0||0|10/01/2019 SH 78001|98927|98927 - OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS||68.93|0||0|10/01/2019 SH 78001|98926|98926 - OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS||52.72|0||0|10/01/2019 SH 78001|98925|98925 - OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS||36.12|0||0|10/01/2019 SH 78001|97814|97814 - ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ||36.13|0||0|10/01/2019 SH 78001|97813|97813 - ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN||45.48|0||0|10/01/2019 SH 78001|97811|97811 - ACUPUNCTURE 1/> NDLS W/O ELEC STIMJ EA 15 MIN||32.03|0||0|10/01/2019 SH 78001|97810|97810 - ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN||42.55|0||0|10/01/2019 SH 78001|97804|97804 - MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI||18.54|0||0|10/01/2019 SH 78001|97803|97803 - MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M||34.52|0||0|10/01/2019 SH 78001|97802|97802 - MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI||40.3|0||0|10/01/2019 SH 78001|97799|97799 - UNLISTED PHYSICAL MEDICINE/REHAB SERVICE/PROC||0|0||0|10/01/2019 SH 78001|97763|97763 - ORTHOTICS/PROSTH MGMT &/TRAING SBSQ ENCTR 15 MIN||55.45|0||0|10/01/2019 SH 78001|97762|97762 - CHECKOUT ORTHOTIC/PROSTHETIC ESTAB PT EA 15 MIN||53.42|0||0|10/01/2019 SH 78001|97761|97761 - PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS||38.02|0||0|10/01/2019 SH 78001|97760|97760 - ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS||43.44|0||0|10/01/2019 SH 78001|97755|97755 - ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN||41.86|0||0|10/01/2019 SH 78001|97750|97750 - PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN||38.02|0||0|10/01/2019 SH 78001|97610|97610 - LOW FREQUENCY NON-THERMAL ULTRASOUND PER DAY||134.5|0||0|10/01/2019 SH 78001|97608|97608 - NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM||0|0||0|10/01/2019 SH 78001|97607|97607 - NEG PRESSURE WOUND THERAPY NON DME 50 SQ CM||59.23|0||0|10/01/2019 SH 78001|97605|97605 - NEGATIVE PRESSURE WOUND THERAPY DME INDIVIDUALS||20.26|0||0|10/01/2019 SH 78001|97140|97140 - MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES||34.44|0||0|10/01/2019 SH 78001|97139|97139 - UNLISTED THERAPEUTIC PROCEDURE SPECIFY||0|0||0|10/01/2019 SH 78001|97124|97124 - THER PX 1/> AREAS EACH 15 MINUTES MASSAGE||30.6|0||0|10/01/2019 SH 78001|97116|97116 - THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR||32.76|0||0|10/01/2019 SH 78001|97113|97113 - THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS||48.82|0||0|10/01/2019 SH 78001|97112|97112 - THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA||38.4|0||0|10/01/2019 SH 78001|97110|97110 - THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES||37.24|0||0|10/01/2019 SH 78001|97039|97039 - UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND||0|0||0|10/01/2019 SH 78001|97036|97036 - APPL MODALITY 1/> AREAS HUBBARD TANK EA 15 MIN||37.66|0||0|10/01/2019 SH 78001|97035|97035 - APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN||14.87|0||0|10/01/2019 SH 78001|97034|97034 - APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN||20.69|0||0|10/01/2019 SH 78001|97033|97033 - APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN||36.8|0||0|10/01/2019 SH 78001|97032|97032 - APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN||22.02|0||0|10/01/2019 SH 78001|97028|97028 - APPL MODALITY 1/> AREAS ULTRAVIOLET||8.49|0||0|10/01/2019 SH 78001|97026|97026 - APPLICATION MODALITY 1/> AREAS INFRARED||6.85|0||0|10/01/2019 SH 78001|97024|97024 - APPLICATION MODALITY 1/> AREAS DIATHERMY||7.24|0||0|10/01/2019 SH 78001|97022|97022 - APPLICATION MODALITY 1/> AREAS WHIRLPOOL||26.33|0||0|10/01/2019 SH 78001|97018|97018 - APPL MODALITY 1/> AREAS PARAFFIN BATH||12.28|0||0|10/01/2019 SH 78001|97016|97016 - APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES||21.72|0||0|10/01/2019 SH 78001|97014|97014 - APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED||18.23|0||0|10/01/2019 SH 78001|97012|97012 - APPL MODALITY 1/> AREAS TRACTION MECHANICAL||18.54|0||0|10/01/2019 SH 78001|97010|97010 - APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS||6.85|0||0|10/01/2019 SH 78001|96999|96999 - UNLISTED SPECIAL DERMATOLOGICAL SERVICE/PROCED||0|0||0|10/01/2019 SH 78001|96936|96936 - RCM CELULR & SUBCELULR SKN IMGNG I&R EA ADDL||0|0||0|10/01/2019 SH 78001|96935|96935 - RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ EA ADDL||0|0||0|10/01/2019 SH 78001|96934|96934 - RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ I&R ADD||0|0||0|10/01/2019 SH 78001|96933|96933 - RCM CELULR & SUBCELULR SKN IMGNG I&R 1ST LES||0|0||0|10/01/2019 SH 78001|96932|96932 - RCM CELULR & SUBCELULR SKN IMGNG IMG ACQUISITION||0|0||0|10/01/2019 SH 78001|96931|96931 - RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ I&R 1ST||0|0||0|10/01/2019 SH 78001|96922|96922 - LASER SKIN DISEASE PSORIASIS >500 SQ CM||268.12|0||0|10/01/2019 SH 78001|96921|96921 - LASER SKIN DISEASE PSORIASIS 250-500 SQ CM||192.91|0||0|10/01/2019 SH 78001|96920|96920 - LASER SKIN DISEASE PSORIASIS TOT AREA <250 SQ CM||174.42|0||0|10/01/2019 SH 78001|96913|96913 - PHOTOCHEMOTHERAPY DERMATOSES 4-8 HRS SUPERVISION||140.72|0||0|10/01/2019 SH 78001|96912|96912 - PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA||100.02|0||0|10/01/2019 SH 78001|96910|96910 - PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB||77.92|0||0|10/01/2019 SH 78001|96904|96904 - WHOLE BODY INTEGUMENTARY PHOTOGRAPHY||68.62|0||0|10/01/2019 SH 78001|96902|96902 - MCRSCP XM HAIR PLUCK/CLIP FOR CNTS/STRUCT ABNORM||25.44|0||0|10/01/2019 SH 78001|96900|96900 - ACTINOTHERAPY ULTRAVIOLET LIGHT||22.49|0||0|10/01/2019 SH 78001|96574|96574 - DEBRIDEMENT PRMLG HYPERKERATOTIC LES W/PDT||273.53|0||0|10/01/2019 SH 78001|96573|96573 - PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP||210.87|0||0|10/01/2019 SH 78001|96571|96571 - PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN||31.48|0||0|10/01/2019 SH 78001|96570|96570 - PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN||68.02|0||0|10/01/2019 SH 78001|96567|96567 - PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY||146.92|0||0|10/01/2019 SH 78001|96549|96549 - UNLISTED CHEMOTHERAPY PROCEDURE||0|0||0|10/01/2019 SH 78001|96542|96542 - CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT||133.92|0||0|10/01/2019 SH 78001|96523|96523 - IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST||27.31|0||0|10/01/2019 SH 78001|96522|96522 - REFILL&MAINTENANCE PUMP DRUG DLVR SYSTEMIC||124.98|0||0|10/01/2019 SH 78001|96521|96521 - REFILLING & MAINTENANCE PORTABLE PUMP||151.34|0||0|10/01/2019 SH 78001|96450|96450 - CHEMOTX ADMN CNS REQ SPINAL PUNCTURE||205.55|0||0|10/01/2019 SH 78001|96446|96446 - CHEMOTX ADMN PRTL CAVITY PORT/CATH||221.08|0||0|10/01/2019 SH 78001|96440|96440 - CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS||949.33|0||0|10/01/2019 SH 78001|96425|96425 - CHEMOTX ADMN IA NFS >8 HR PRTBLE IMPLTBL PMP||197.31|0||0|10/01/2019 SH 78001|96423|96423 - CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR||86.81|0||0|10/01/2019 SH 78001|96422|96422 - CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS 7||132.97|0||0|10/01/2019 SH 78001|96405|96405 - CHEMOTHERAPY ADMINISTRATION INTRALESIONAL PTS||5.48|0||0|10/01/2019 SH 78001|96152|96152 - HLTH&BEHAVIOR IVNTJ EA 15 MIN INDIV||23.33|0||0|10/01/2019 SH 78001|96151|96151 - HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT RE-ASSMT||24.58|0||0|10/01/2019 SH 78001|96150|96150 - HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT 1ST ASSMT||25.83|0||0|10/01/2019 SH 78001|96127|96127 - BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT||5.82|0||0|10/01/2019 SH 78001|96125|96125 - STANDARDIZED COGNITIVE PERFORMANCE TESTING||135.35|0||0|10/01/2019 SH 78001|96120|96120 - NEUROPSYCHOLOG TESTING COMPUTER W/PROF I&R||54.56|0||0|10/01/2019 SH 78001|96119|96119 - NEUROPSYC TSTG W/PROF I&R ADMN BY TECH PR HR||90.78|0||0|10/01/2019 SH 78001|96118|96118 - NUROPSYC TESTING PR HR W/PT & INTERPJ TIME||114.33|0||0|10/01/2019 SH 78001|96116|96116 - NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR||109.69|0||0|10/01/2019 SH 78001|96111|96111 - DEVELOPMENTAL TESTING W/INTERP & REPORT||151.29|0||0|10/01/2019 SH 78001|96110|96110 - DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM||10.47|0||0|10/01/2019 SH 78001|96105|96105 - ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR||121.22|0||0|10/01/2019 SH 78001|96103|96103 - PSYCHOLOGICAL TESTING COMPUTER W/PROF I&R||32.08|0||0|10/01/2019 SH 78001|96102|96102 - PSYCHOLOGICAL TESTING ADMN BY TECH PR HR||71.57|0||0|10/01/2019 SH 78001|96101|96101 - PSYCHOLOGICAL TESTING PR HR WITH PATIENT||94.95|0||0|10/01/2019 SH 78001|96040|96040 - MEDICAL GENETICS COUNSELING EACH 30 MINUTES||51.56|0||0|10/01/2019 SH 78001|96020|96020 - TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP||0|200.3||0|10/01/2019 SH 78001|96004|96004 - PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR||138.44|0||0|10/01/2019 SH 78001|96003|96003 - DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC||22.55|0||0|10/01/2019 SH 78001|96002|96002 - DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC||25.83|0||0|10/01/2019 SH 78001|96001|96001 - COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG||120.65|0||0|10/01/2019 SH 78001|96000|96000 - COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS||112.53|0||0|10/01/2019 SH 78001|95999|95999 - UNLIS NEUROLOGICAL/NEUROMUSCULAR DX PX||0|0||0|10/01/2019 SH 78001|95992|95992 - CANALITH REPOSITIONING PROCEDURE||49.79|0||0|10/01/2019 SH 78001|95991|95991 - RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP||135.55|0||0|10/01/2019 SH 78001|95990|95990 - REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN||98.47|0||0|10/01/2019 SH 78001|95982|95982 - ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG||61|0||0|10/01/2019 SH 78001|95981|95981 - ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG||36.2|0||0|10/01/2019 SH 78001|95980|95980 - ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG||54.3|0||0|10/01/2019 SH 78001|95979|95979 - ELEC ALYS NSTIM PLS GEN CPLX DP BRN EA 30 MIN||126.18|0||0|10/01/2019 SH 78001|95978|95978 - ELEC ALYS NSTIM PLS GEN CPLX DP BRN 1ST HR||288.61|0||0|10/01/2019 SH 78001|95975|95975 - ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV EA 30 MIN||129.93|0||0|10/01/2019 SH 78001|95974|95974 - ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR||241.46|0||0|10/01/2019 SH 78001|95973|95973 - ANALYZE NEUROSTIM COMPLEX||46.33|0||0|10/01/2019 SH 78001|95972|95972 - ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG||63.97|0||0|10/01/2019 SH 78001|95971|95971 - ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG||66.21|0||0|10/01/2019 SH 78001|95970|95970 - ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING||75.23|0||0|10/01/2019 SH 78001|95967|95967 - MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL||0|224.98||0|10/01/2019 SH 78001|95966|95966 - MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY||0|257.02||0|10/01/2019 SH 78001|95965|95965 - MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY||0|510.6||0|10/01/2019 SH 78001|95962|95962 - FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR||294.27|198.91||0|10/01/2019 SH 78001|95961|95961 - FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR||330.07|186.25||0|10/01/2019 SH 78001|95958|95958 - WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG||653.89|265.06||0|10/01/2019 SH 78001|95957|95957 - DIGITAL ANALYSIS ELECTROENCEPHALOGRAM||354.44|124.55||0|10/01/2019 SH 78001|95956|95956 - MNTR SEIZURE CMPTR 16CHAN EEG ATND EA 24 HR||1838.53|226.26||0|10/01/2019 SH 78001|95955|95955 - EEG NONINTRACRANIAL SURGERY||237.78|63.33||0|10/01/2019 SH 78001|95954|95954 - RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE||512.32|147.92||0|10/01/2019 SH 78001|95953|95953 - LOCALIZE CEREBRAL SEIZURE CPTR PORTABLE EEG||470.88|193.71||0|10/01/2019 SH 78001|95951|95951 - LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EEG/VIDEO||0|385.55||0|10/01/2019 SH 78001|95950|95950 - MONITOR ID& LATERALIZATION SEIZURE FOCUS EEG||365.56|94.2||0|10/01/2019 SH 78001|95943|95943 - PARASYMP & SYMP NRV FUNCJ HRT RATE VARIABILITY||0|0||0|10/01/2019 SH 78001|95941|95941 - IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR||0|0||0|10/01/2019 SH 78001|95940|95940 - IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES||38.68|0||0|10/01/2019 SH 78001|95939|95939 - CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI||559.14|143.19||0|10/01/2019 SH 78001|95938|95938 - SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB||376.68|53.76||0|10/01/2019 SH 78001|95937|95937 - NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH||93.55|40.83||0|10/01/2019 SH 78001|95933|95933 - ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST||94.45|37.08||0|10/01/2019 SH 78001|95930|95930 - VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R||141.86|21.68||0|10/01/2019 SH 78001|95929|95929 - CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS||289.14|92.6||0|10/01/2019 SH 78001|95928|95928 - CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS||289.54|94.54||0|10/01/2019 SH 78001|95927|95927 - SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD||169.05|32.59||0|10/01/2019 SH 78001|95926|95926 - SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS||159.75|32.21||0|10/01/2019 SH 78001|95925|95925 - SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS||174.09|33.37||0|10/01/2019 SH 78001|95924|95924 - TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT||175.01|104.85||0|10/01/2019 SH 78001|95923|95923 - TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION||213.26|54.32||0|10/01/2019 SH 78001|95922|95922 - TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ||113.89|57.3||0|10/01/2019 SH 78001|95921|95921 - TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP||99.68|53.93||0|10/01/2019 SH 78001|95913|95913 - NERVE CONDUCTION STUDIES 13/> STUDIES||338.45|221.77||0|10/01/2019 SH 78001|95912|95912 - NERVE CONDUCTION STUDIES 11-12 STUDIES||298.02|187.93||0|10/01/2019 SH 78001|95911|95911 - NERVE CONDUCTION STUDIES 9-10 STUDIES||266.38|158.22||0|10/01/2019 SH 78001|95910|95910 - NERVE CONDUCTION STUDIES 7-8 STUDIES||223.49|126.96||0|10/01/2019 SH 78001|95909|95909 - NERVE CONDUCTION STUDIES 5-6 STUDIES||168.2|94.93||0|10/01/2019 SH 78001|95908|95908 - NERVE CONDUCTION STUDIES 3-4 STUDIES||141.91|79.5||0|10/01/2019 SH 78001|95907|95907 - NERVE CONDUCTION STUDIES 1-2 STUDIES||110.58|62.9||0|10/01/2019 SH 78001|95905|95905 - MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB||78.53|3.32||0|10/01/2019 SH 78001|95887|95887 - NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION||92.26|44.96||0|10/01/2019 SH 78001|95886|95886 - NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE||103.38|54.15||0|10/01/2019 SH 78001|95885|95885 - NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED||65.49|22.07||0|10/01/2019 SH 78001|95875|95875 - ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB||136.99|68.76||0|10/01/2019 SH 78001|95874|95874 - NEEDLE EMG GUID W/CHEMODENERVATION||80.31|23.32||0|10/01/2019 SH 78001|95873|95873 - ELECTRICAL STIMULATION GUID W/CHEMODENERVATION||83.41|24.1||0|10/01/2019 SH 78001|95872|95872 - NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER||229.27|181.98||0|10/01/2019 SH 78001|95870|95870 - NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI||98.14|22.93||0|10/01/2019 SH 78001|95869|95869 - NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12||90.78|23.32||0|10/01/2019 SH 78001|95868|95868 - NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI||149.75|74.54||0|10/01/2019 SH 78001|95867|95867 - NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI||105.4|49.19||0|10/01/2019 SH 78001|95866|95866 - NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM||151.21|79.88||0|10/01/2019 SH 78001|95865|95865 - NEEDLE ELECTROMYOGRAPHY LARYNX||164.63|99.12||0|10/01/2019 SH 78001|95864|95864 - NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS||273.84|126.53||0|10/01/2019 SH 78001|95863|95863 - NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS||241.53|119.03||0|10/01/2019 SH 78001|95861|95861 - NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS||195.51|97.04||0|10/01/2019 SH 78001|95860|95860 - NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS||138.71|61.17||0|10/01/2019 SH 78001|95857|95857 - CHOLINESTERASE INHIBITOR CHALLENGE TEST||61.24|0||0|10/01/2019 SH 78001|95852|95852 - ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID||18.31|0||0|10/01/2019 SH 78001|95851|95851 - ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI||20.86|0||0|10/01/2019 SH 78001|95834|95834 - MUSC TSTG MNL W/REPRT TOTAL EVAL BODY W/HANDS||58.06|0||0|10/01/2019 SH 78001|95833|95833 - MUSC TSTG MNL W/REPRT TOTAL EVAL BODY EX HANDS||43.14|0||0|10/01/2019 SH 78001|95832|95832 - MUSC TSTG MNL W/REPRT HAND W/WO CMPRSN NRML SIDE||34.61|0||0|10/01/2019 SH 78001|95831|95831 - MUSC TSTG MNL W/REPRT XTR EX HAND/TRNK||34.95|0||0|10/01/2019 SH 78001|95830|95830 - INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP||276.47|0||0|10/01/2019 SH 78001|95829|95829 - ELECTROCORTICOGRAM SURGERY SPX||2085.9|391.08||0|10/01/2019 SH 78001|95827|95827 - ELECTROENCEPHALOGRAM ALL NIGHT RECORDING||861.44|67.51||0|10/01/2019 SH 78001|95824|95824 - ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY||0|47.43||0|10/01/2019 SH 78001|95822|95822 - ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY||409.04|67.9||0|10/01/2019 SH 78001|95819|95819 - ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP||451.68|67.9||0|10/01/2019 SH 78001|95816|95816 - ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY||396.63|67.9||0|10/01/2019 SH 78001|95813|95813 - EEG EXTENDED MONITORING 61-119 MINUTES||554.54|109.12||0|10/01/2019 SH 78001|95812|95812 - ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN||461.76|67.9||0|10/01/2019 SH 78001|95811|95811 - POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND||723.87|149.73||0|10/01/2019 SH 78001|95810|95810 - POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND||689.32|144.26||0|10/01/2019 SH 78001|95808|95808 - POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND||665.44|102.56||0|10/01/2019 SH 78001|95807|95807 - SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN||517.29|73.42||0|10/01/2019 SH 78001|95806|95806 - SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT||189.2|72.13||0|10/01/2019 SH 78001|95805|95805 - MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG||463.45|69.97||0|10/01/2019 SH 78001|95803|95803 - ACTIGRAPHY TESTING RECORDING ANALYSIS I&R||158.6|51.22||0|10/01/2019 SH 78001|95801|95801 - SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL||104.77|58.63||0|10/01/2019 SH 78001|95800|95800 - SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME||201.12|61.57||0|10/01/2019 SH 78001|95783|95783 - POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM||1373.05|174.78||0|10/01/2019 SH 78001|95782|95782 - POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND||1008.81|145.48||0|10/01/2019 SH 78001|95251|95251 - CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R||51|0||0|10/01/2019 SH 78001|95250|95250 - CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT||172.12|0||0|10/01/2019 SH 78001|95249|95249 - CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT||60.81|0||0|10/01/2019 SH 78001|95199|95199 - UNLISTED ALLERGY/CLINICAL IMMUNOLOGIC SRVC/PX||0|0||0|10/01/2019 SH 78001|95180|95180 - RAPID DESENSITIZATION PROCEDURE EACH HOUR||154.91|0||0|10/01/2019 SH 78001|95170|95170 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE||10.73|0||0|10/01/2019 SH 78001|95165|95165 - PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN||14.22|0||0|10/01/2019 SH 78001|95149|95149 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT||77.02|0||0|10/01/2019 SH 78001|95148|95148 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT||57.64|0||0|10/01/2019 SH 78001|95147|95147 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT||38.64|0||0|10/01/2019 SH 78001|95146|95146 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT||42.91|0||0|10/01/2019 SH 78001|95145|95145 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT||24.3|0||0|10/01/2019 SH 78001|95144|95144 - PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO||13.83|0||0|10/01/2019 SH 78001|95134|95134 - PROF SVCS ALLG IMMNTX W/PRV XTRC 5 STING INSECT||0|0||0|10/01/2019 SH 78001|95133|95133 - PROF SVCS ALLG IMMNTX W/PRV XTRC 4 STING INSECT||0|0||0|10/01/2019 SH 78001|95132|95132 - PROF SVCS ALLG IMMNTX W/PRV XTRC 3 STING INSECT||0|0||0|10/01/2019 SH 78001|95131|95131 - PROF SVCS ALLG IMMNTX W/PRV XTRC 2 STING INSECT||0|0||0|10/01/2019 SH 78001|95130|95130 - PROF SVCS ALLG IMMNTX W/PRV XTRC 1 STING INSECT||0|0||0|10/01/2019 SH 78001|95125|95125 - PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 2/> NJX||0|0||0|10/01/2019 SH 78001|95120|95120 - PROF SVCS ALLG IMMNTX W/PRV ALLGIC XTRC 1 NJX||0|0||0|10/01/2019 SH 78001|95117|95117 - PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS||11.24|0||0|10/01/2019 SH 78001|95115|95115 - PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX||9.69|0||0|10/01/2019 SH 78001|95079|95079 - INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES||96.34|0||0|10/01/2019 SH 78001|95076|95076 - INGESTION CHALLENGE TEST INITIAL 120 MINUTES||133.31|0||0|10/01/2019 SH 78001|95071|95071 - INHLJ BRNCL CHALLENGE TSTG W/AGS/GASES||37.99|0||0|10/01/2019 SH 78001|95070|95070 - INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL||32.95|0||0|10/01/2019 SH 78001|95065|95065 - DIRECT NASAL MUCOUS MEMBRANE TEST||27.53|0||0|10/01/2019 SH 78001|95060|95060 - OPHTHALMIC MUCOUS MEMBRANE TESTS||38.38|0||0|10/01/2019 SH 78001|95056|95056 - PHOTO TESTS||48.46|0||0|10/01/2019 SH 78001|95052|95052 - PHOTO PATCH TEST SPECIFY NUMBER TSTS||7.37|0||0|10/01/2019 SH 78001|95044|95044 - PATCH/APPLICATION TEST SPECIFY NUMBER TESTS||6.2|0||0|10/01/2019 SH 78001|95028|95028 - IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING||14.73|0||0|10/01/2019 SH 78001|95027|95027 - INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE||5.09|0||0|10/01/2019 SH 78001|95024|95024 - INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS||8.57|0||0|10/01/2019 SH 78001|95018|95018 - ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R||21.16|0||0|10/01/2019 SH 78001|95017|95017 - ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R||8.84|0||0|10/01/2019 SH 78001|95012|95012 - NITRIC OXIDE EXPIRED GAS DETERMINATION||21.32|0||0|10/01/2019 SH 78001|95004|95004 - PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS||7.02|0||0|10/01/2019 SH 78001|94799|94799 - UNLISTED PULMONARY SERVICE/PROCEDURE||0|0||0|10/01/2019 SH 78001|94781|94781 - CAR SEAT/BED TEST INFT THRU 12 MO EA ADDL 30 MIN||25.94|0||0|10/01/2019 SH 78001|94780|94780 - CAR SEAT/BED TEST INFT THRU 12 MO 60 MIN||70.71|0||0|10/01/2019 SH 78001|94777|94777 - PEDIATRIC APNEA MONITOR PHYS/QHP REVIEW||0|0||0|10/01/2019 SH 78001|94776|94776 - PEDIATRIC APNEA MONITOR ANALYSES COMPUTER||0|0||0|10/01/2019 SH 78001|94775|94775 - PEDIATRIC APNEA MONITOR ATTACHMENT||0|0||0|10/01/2019 SH 78001|94774|94774 - PEDIATRIC APNEA MONITOR ATTACHMENT PHYS I&R||0|0||0|10/01/2019 SH 78001|94772|94772 - CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT||0|0||0|10/01/2019 SH 78001|94770|94770 - CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER||8.8|0||0|10/01/2019 SH 78001|94762|94762 - NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR||26.75|0||0|10/01/2019 SH 78001|94761|94761 - NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER||5.43|0||0|10/01/2019 SH 78001|94760|94760 - NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER||3.49|0||0|10/01/2019 SH 78001|94750|94750 - PULMONARY COMPLIANCE STUDY||89.78|13.41||0|10/01/2019 SH 78001|94729|94729 - CO DIFFUSING CAPACITY||60.53|10.91||0|10/01/2019 SH 78001|94728|94728 - AIRWAY RESISTANCE BY OSCILLOMETRY||44.17|14.7||0|10/01/2019 SH 78001|94727|94727 - GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V||47.27|14.7||0|10/01/2019 SH 78001|94726|94726 - PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST||58.9|14.7||0|10/01/2019 SH 78001|94690|94690 - O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX||54.58|4.57||0|10/01/2019 SH 78001|94681|94681 - O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC||59.41|11.73||0|10/01/2019 SH 78001|94680|94680 - O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP||63.94|15.09||0|10/01/2019 SH 78001|94669|94669 - MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION||38.77|0||0|10/01/2019 SH 78001|94668|94668 - MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ||31.4|0||0|10/01/2019 SH 78001|94667|94667 - MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL||28.69|0||0|10/01/2019 SH 78001|94664|94664 - DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP||19|0||0|10/01/2019 SH 78001|94662|94662 - CONTINUOUS NEGATIVE PRESSURE VENTJ INITIAT&MGM||40.93|0||0|10/01/2019 SH 78001|94660|94660 - CPAP VENTILATION CPAP INITIATION&MGMT||71.93|0||0|10/01/2019 SH 78001|94645|94645 - CONTINUOUS INHALATION TREATMENT EA ADDL HR||15.12|0||0|10/01/2019 SH 78001|94644|94644 - CONTINUOUS INHALATION TREATMENT 1ST HR||47.68|0||0|10/01/2019 SH 78001|94642|94642 - PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH||0|0||0|10/01/2019 SH 78001|94640|94640 - PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT||20.16|0||0|10/01/2019 SH 78001|94621|94621 - CARDIOPULMONARY EXERCISE TESTING||185.68|81.79||0|10/01/2019 SH 78001|94620|94620 - PULMONARY STRESS TESTING SIMPLE||64.04|36.13||0|10/01/2019 SH 78001|94618|94618 - PULMONARY STRESS TESTING||39.99|27.49||0|10/01/2019 SH 78001|94617|94617 - EXERCISE TEST FOR BRONCHOSPASM||108.29|40.17||0|10/01/2019 SH 78001|94610|94610 - INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP||67.1|0||0|10/01/2019 SH 78001|94453|94453 - HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION||89.36|22.68||0|10/01/2019 SH 78001|94452|94452 - HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT||64.54|17.25||0|10/01/2019 SH 78001|94450|94450 - BREATHING RESPONSE TO HYPOXIA||74.62|23.06||0|10/01/2019 SH 78001|94400|94400 - BREATHING RESPONSE TO CO2||63.77|23.06||0|10/01/2019 SH 78001|94375|94375 - RESPIRATORY FLOW VOLUME LOOP||44.38|17.63||0|10/01/2019 SH 78001|94250|94250 - EXPIRED GAS COLLECTION QUANT 1 PROCEDURE SPX||29.17|6.3||0|10/01/2019 SH 78001|94200|94200 - MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ||28.39|6.68||0|10/01/2019 SH 78001|94150|94150 - VITAL CAPACITY TOTAL SEPARATE PROCEDURE||28.22|4.57||0|10/01/2019 SH 78001|94070|94070 - BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT||67.74|34.02||0|10/01/2019 SH 78001|94060|94060 - BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN||67.86|15.52||0|10/01/2019 SH 78001|94016|94016 - PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY||30.18|0||0|10/01/2019 SH 78001|94015|94015 - PATIENT-INITIATED SPIROMETRIC RECORDING||33.34|0||0|10/01/2019 SH 78001|94014|94014 - PT-INITIATE SPIROMETRIC RECORDING PHYS/QHP R&I||63.52|0||0|10/01/2019 SH 78001|94013|94013 - MEASUREMENT LUNG VOLUMES INFANT/CHILD/2 YRS||37|0||0|10/01/2019 SH 78001|94012|94012 - MEAS SPIRO FRCD EXP FLO PRE&POST BRONCH INF/2YRS||195.36|0||0|10/01/2019 SH 78001|94011|94011 - MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT&/2 Y||118.83|0||0|10/01/2019 SH 78001|94010|94010 - SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ||40.29|10.05||0|10/01/2019 SH 78001|94005|94005 - HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>||108.51|0||0|10/01/2019 SH 78001|94004|94004 - VENTILATION ASSIST & MGMT NURSING FAC PR DAY||57.86|0||0|10/01/2019 SH 78001|94003|94003 - VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA||79.64|0||0|10/01/2019 SH 78001|94002|94002 - VENTILATION ASSIST & MGMT INPATIENT 1ST DAY||110.65|0||0|10/01/2019 SH 78001|93998|93998 - UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY||0|0||0|10/01/2019 SH 78001|93990|93990 - DUPLEX SCAN HEMODIALYSIS ACCESS||175.48|30.11||0|10/01/2019 SH 78001|93982|93982 - IMPLANT WIRELESS PRESS SENSOR STUDY ANEURYSM SAC||49|0||0|10/01/2019 SH 78001|93981|93981 - DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD||80.62|25.18||0|10/01/2019 SH 78001|93980|93980 - DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL||136.48|72.13||0|10/01/2019 SH 78001|93979|93979 - DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD||134.38|29.32||0|10/01/2019 SH 78001|93978|93978 - DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE||212.83|46.53||0|10/01/2019 SH 78001|93976|93976 - DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT||182.59|47.69||0|10/01/2019 SH 78001|93975|93975 - DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM||272.56|67.87||0|10/01/2019 SH 78001|93971|93971 - DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY||134.93|26.78||0|10/01/2019 SH 78001|93970|93970 - DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY||219.37|41.44||0|10/01/2019 SH 78001|93931|93931 - DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY||144.85|29.71||0|10/01/2019 SH 78001|93930|93930 - DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY||232.99|46.91||0|10/01/2019 SH 78001|93926|93926 - DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY||170.44|29.72||0|10/01/2019 SH 78001|93925|93925 - DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY||251.59|46.91||0|10/01/2019 SH 78001|93924|93924 - N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI||191.75|29.32||0|10/01/2019 SH 78001|93923|93923 - NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS||153.93|26.39||0|10/01/2019 SH 78001|93922|93922 - NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL||99.17|14.66||0|10/01/2019 SH 78001|93895|93895 - CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI||0|0||0|10/01/2019 SH 78001|93893|93893 - TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ||215.12|69.76||0|10/01/2019 SH 78001|93892|93892 - TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT||215.12|69.76||0|10/01/2019 SH 78001|93890|93890 - TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY||205.56|60.19||0|10/01/2019 SH 78001|93888|93888 - TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD||165.77|30.09||0|10/01/2019 SH 78001|93886|93886 - TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL||259.82|55.14||0|10/01/2019 SH 78001|93882|93882 - DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY||143.3|29.32||0|10/01/2019 SH 78001|93880|93880 - DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY||224.85|46.91||0|10/01/2019 SH 78001|93799|93799 - UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE||0|0||0|10/01/2019 SH 78001|93798|93798 - OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING||28.75|0||0|10/01/2019 SH 78001|93797|93797 - OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR||18.62|0||0|10/01/2019 SH 78001|93793|93793 - ANTICOAGULANT MGMT FOR PT TAKING WARFARIN||14.06|0||0|10/01/2019 SH 78001|93792|93792 - PT/CAREGIVER TRAING FOR INITIATION HOME INR MNTR||59.57|0||0|10/01/2019 SH 78001|93790|93790 - AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R||22.2|0||0|10/01/2019 SH 78001|93788|93788 - AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R||5.82|0||0|10/01/2019 SH 78001|93786|93786 - AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY||32.56|0||0|10/01/2019 SH 78001|93784|93784 - AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R||60.58|0||0|10/01/2019 SH 78001|93770|93770 - DERMINATION OF VENOUS PRESSUE||9.61|0||0|10/01/2019 SH 78001|93750|93750 - INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS||65.28|0||0|10/01/2019 SH 78001|93745|93745 - 1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB||0|0||0|10/01/2019 SH 78001|93740|93740 - TEMPRATURE GRADIENT STUDY||9.61|0||0|10/01/2019 SH 78001|93724|93724 - ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM||321.34|290.33||0|10/01/2019 SH 78001|93702|93702 - BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT||124.05|0||0|10/01/2019 SH 78001|93701|93701 - BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS||26.75|0||0|10/01/2019 SH 78001|93668|93668 - PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION||20.94|0||0|10/01/2019 SH 78001|93662|93662 - INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I||0|172.72||0|10/01/2019 SH 78001|93660|93660 - CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR||181.14|111.75||0|10/01/2019 SH 78001|93657|93657 - ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN||508.68|0||0|10/01/2019 SH 78001|93656|93656 - EPHYS EVL TRNSPTL TX ATRIAL FIB ISOLAT PULM VEIN||1361.22|0||0|10/01/2019 SH 78001|93655|93655 - ICAR CATHETER ABLATION ARRHYTHMIA ADD ON||509.07|0||0|10/01/2019 SH 78001|93654|93654 - EPHYS EVAL W/ABLATION VENTRICULAR TACHYCARDIA||1355.71|0||0|10/01/2019 SH 78001|93653|93653 - EPHYS EVAL W/ABLATION SUPRAVENT ARRHYTHMIA||1018.91|0||0|10/01/2019 SH 78001|93650|93650 - ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION||723.43|0||0|10/01/2019 SH 78001|93644|93644 - EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR||343.21|227.3||0|10/01/2019 SH 78001|93642|93642 - EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS||491.69|325.38||0|10/01/2019 SH 78001|93641|93641 - EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN||0|398.99||0|10/01/2019 SH 78001|93640|93640 - EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE||0|234.87||0|10/01/2019 SH 78001|93631|93631 - INTRAOP EPICAR& ENDOCAR PACG& MAPG||0|488.54||0|10/01/2019 SH 78001|93624|93624 - ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT||0|313.82||0|10/01/2019 SH 78001|93623|93623 - PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS||0|194.36||0|10/01/2019 SH 78001|93622|93622 - COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC||0|208.25||0|10/01/2019 SH 78001|93621|93621 - COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC||0|142.6||0|10/01/2019 SH 78001|93620|93620 - COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION||0|783.23||0|10/01/2019 SH 78001|93619|93619 - COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION||0|492.72||0|10/01/2019 SH 78001|93618|93618 - INDUCTION ARRHYTHMIA ELECTRICAL PACING||0|286.97||0|10/01/2019 SH 78001|93616|93616 - ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG||0|78.23||0|10/01/2019 SH 78001|93615|93615 - ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS||0|61.7||0|10/01/2019 SH 78001|93613|93613 - INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING||476.2|0||0|10/01/2019 SH 78001|93612|93612 - INTRAVENTRICULAR PACING||0|199.37||0|10/01/2019 SH 78001|93610|93610 - INTRA-ATRIAL PACING||0|200.54||0|10/01/2019 SH 78001|93609|93609 - INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA||0|338.3||0|10/01/2019 SH 78001|93603|93603 - RIGHT VENTRICULAR RECORDING||0|141.53||0|10/01/2019 SH 78001|93602|93602 - INTRA-ATRIAL RECORDING||0|141.53||0|10/01/2019 SH 78001|93600|93600 - BUNDLE OF HIS RECORDING||0|144.24||0|10/01/2019 SH 78001|93592|93592 - PERQ TRANSCATH CLS PARAVALVR LEAK EACH OCCLS DEV||546.51|0||0|10/01/2019 SH 78001|93591|93591 - PERQ TRANSCATH CLS PARAVALVR LEAK 1 AORTIC VALVE||1240.31|0||0|10/01/2019 SH 78001|93590|93590 - PERQ TRANSCATH CLS PARAVALVR LEAK 1 MITRAL VALVE||1494.41|0||0|10/01/2019 SH 78001|93583|93583 - PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER||904.76|0||0|10/01/2019 SH 78001|93582|93582 - PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS||811.59|0||0|10/01/2019 SH 78001|93581|93581 - PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT||1606.88|0||0|10/01/2019 SH 78001|93580|93580 - PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT||1176.15|0||0|10/01/2019 SH 78001|93572|93572 - IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL||0|93.95||0|10/01/2019 SH 78001|93571|93571 - IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL||0|117.63||0|10/01/2019 SH 78001|93568|93568 - NJX PULMONARY ANGIO HRT CATH W/S&I||172.89|0||0|10/01/2019 SH 78001|93567|93567 - NJX SUPRAVALV AORTOG HRT CATH W/S&I||160.11|0||0|10/01/2019 SH 78001|93566|93566 - NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I||191.8|0||0|10/01/2019 SH 78001|93565|93565 - NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I||55.73|0||0|10/01/2019 SH 78001|93564|93564 - NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I||74.37|0||0|10/01/2019 SH 78001|93563|93563 - NJX SEL HRT ART CONGENITAL HRT CATH W/S&I||71.17|0||0|10/01/2019 SH 78001|93562|93562 - INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEA||0|9.61||0|10/01/2019 SH 78001|93561|93561 - INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS||0|29.32||0|10/01/2019 SH 78001|93533|93533 - CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN||0|437.67||0|10/01/2019 SH 78001|93532|93532 - CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN||0|653.01||0|10/01/2019 SH 78001|93531|93531 - CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMA||0|528.58||0|10/01/2019 SH 78001|93530|93530 - R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY||0|270.53||0|10/01/2019 SH 78001|93505|93505 - ENDOMYOCARDIAL BIOPSY||860.04|280.89||0|10/01/2019 SH 78001|93503|93503 - INSERTION FLOW DIRECTED CATHETER FOR MONITORING||156.16|0||0|10/01/2019 SH 78001|93464|93464 - PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU||308.67|103.99||0|10/01/2019 SH 78001|93463|93463 - MEDICATION ADMIN & HEMODYNAMIC MEASURMENT||118.06|0||0|10/01/2019 SH 78001|93462|93462 - LEFT HEART CATH BY TRANSEPTAL PUNCTURE||250.18|0||0|10/01/2019 SH 78001|93461|93461 - R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I||1636.64|520.97||0|10/01/2019 SH 78001|93460|93460 - R & L HRT CATH WINJX HRT ART& L VENTR IMG||1432.53|471.92||0|10/01/2019 SH 78001|93459|93459 - CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I||1333.09|422.88||0|10/01/2019 SH 78001|93458|93458 - CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I||1206.13|375||0|10/01/2019 SH 78001|93457|93457 - CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I||1422.37|442.77||0|10/01/2019 SH 78001|93456|93456 - CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I||1260.18|396.1||0|10/01/2019 SH 78001|93455|93455 - CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I||1171.44|356.59||0|10/01/2019 SH 78001|93454|93454 - CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I||1006.1|307.93||0|10/01/2019 SH 78001|93453|93453 - R & L HRT CATH W/NJX L VENTRICULOG IMG S&I||1280.74|402.31||0|10/01/2019 SH 78001|93452|93452 - L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I||994.29|305.81||0|10/01/2019 SH 78001|93451|93451 - RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT||872.94|174||0|10/01/2019 SH 78001|93355|93355 - ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN||269.62|0||0|10/01/2019 SH 78001|93352|93352 - USE OF ECHO CONTRAST AGENT DURING STRESS ECHO||38.05|0||0|10/01/2019 SH 78001|93351|93351 - ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG||303.03|101.45||0|10/01/2019 SH 78001|93350|93350 - ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST||269.2|84.67||0|10/01/2019 SH 78001|93325|93325 - DOP ECHOCARD COLOR FLOW VELOCITY MAPPING||29|4.18||0|10/01/2019 SH 78001|93321|93321 - DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD||30.89|8.8||0|10/01/2019 SH 78001|93320|93320 - DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY||61.36|21.81||0|10/01/2019 SH 78001|93318|93318 - ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ||0|142.7||0|10/01/2019 SH 78001|93317|93317 - ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT||0|128.94||0|10/01/2019 SH 78001|93316|93316 - ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY||45.58|0||0|10/01/2019 SH 78001|93315|93315 - ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R||0|172.95||0|10/01/2019 SH 78001|93314|93314 - ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY||330.13|117.69||0|10/01/2019 SH 78001|93313|93313 - ECHO R-T 2D W/PROBE PLACEMENT ONLY||27.04|0||0|10/01/2019 SH 78001|93312|93312 - ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R||345.29|144.48||0|10/01/2019 SH 78001|93308|93308 - ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD||138.38|30.61||0|10/01/2019 SH 78001|93307|93307 - ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP||146.28|53.63||0|10/01/2019 SH 78001|93306|93306 - ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D||253.77|75.06||0|10/01/2019 SH 78001|93304|93304 - F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY||172.29|43.2||0|10/01/2019 SH 78001|93303|93303 - COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY||265.01|75.45||0|10/01/2019 SH 78001|93299|93299 - REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW||0|0||0|10/01/2019 SH 78001|93298|93298 - REM INTERROG SCRMS <30 D PHYS/QHP||31.34|0||0|10/01/2019 SH 78001|93297|93297 - REM INTERROG ICPMS <30 D PHYS/QHP||31.34|0||0|10/01/2019 SH 78001|93296|93296 - REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW||28.3|0||0|10/01/2019 SH 78001|93295|93295 - INTERROGATION EVAL REMOTE SBSQ REPRGRMG||102.37|0||0|10/01/2019 SH 78001|92603|92603 - ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG||173.02|0||0|10/01/2019 SH 78001|92602|92602 - ANALYSIS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG||103.36|0||0|10/01/2019 SH 78001|92601|92601 - ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG||160.46|0||0|10/01/2019 SH 78001|92597|92597 - EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC||84.19|0||0|10/01/2019 SH 78001|92596|92596 - EAR PROTECTOR ATTENUATION MEASUREMENTS||45.74|0||0|10/01/2019 SH 78001|92595|92595 - ELECTROACOUS EVAL HEARING AID BINAURAL||0|0||0|10/01/2019 SH 78001|92594|92594 - ELECTROACOUS EVAL HEARING AID MONAURAL||0|0||0|10/01/2019 SH 78001|92593|92593 - HEARING AID CHECK BINAURAL||0|0||0|10/01/2019 SH 78001|92592|92592 - HEARING AID CHECK MONAURAL||0|0||0|10/01/2019 SH 78001|92591|92591 - HEARING AID EXAMINATION & SELECTION BINAURAL||0|0||0|10/01/2019 SH 78001|92590|92590 - HEARING AID EXAMINATION & SELECTION MONAURAL||0|0||0|10/01/2019 SH 78001|92588|92588 - DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL||38.45|34.18||0|10/01/2019 SH 78001|92587|92587 - DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD||25.18|21.68||0|10/01/2019 SH 78001|92586|92586 - AUDITORY EVOKED POTENTIALS LIMITED||91.1|0||0|10/01/2019 SH 78001|92585|92585 - AUDITORY EVOKED POTENTIALS COMPREHENSIVE||149.88|31.25||0|10/01/2019 SH 78001|92584|92584 - ELECTROCOCHLEOGRAPHY||80.63|0||0|10/01/2019 SH 78001|92583|92583 - SELECT PICTURE AUDIOMETRY||55.44|0||0|10/01/2019 SH 78001|92582|92582 - CONDITIONING PLAY AUDIOMETRY||77.92|0||0|10/01/2019 SH 78001|92579|92579 - VISUAL REINFORCEMENT AUDIOMETRY||52.28|0||0|10/01/2019 SH 78001|92577|92577 - STENGER TEST SPEECH||17.45|0||0|10/01/2019 SH 78001|92576|92576 - SYNTHETIC SENTENCE IDENTIFICATION TEST||38.38|0||0|10/01/2019 SH 78001|92575|92575 - SENSORINEURAL ACUITY LEVEL||77.53|0||0|10/01/2019 SH 78001|92572|92572 - STAGGERED SPONDAIC WORD||34.12|0||0|10/01/2019 SH 78001|92571|92571 - FILTERED SPEECH TEST||29.85|0||0|10/01/2019 SH 78001|92570|92570 - ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY||37.29|0||0|10/01/2019 SH 78001|92568|92568 - ACOUSTIC REFLEX THRESHOLD||18.32|0||0|10/01/2019 SH 78001|92567|92567 - TYMPANOMETRY||16.77|0||0|10/01/2019 SH 78001|92565|92565 - STENGER TEST PURE TONE||17.06|0||0|10/01/2019 SH 78001|92564|92564 - SHORT INCREMENT SENSITIVITY INDEX||31.01|0||0|10/01/2019 SH 78001|92563|92563 - TONE DECAY TEST||33.73|0||0|10/01/2019 SH 78001|92562|92562 - LOUDNESS BALANCE BINAURAL/MONAURAL||50.4|0||0|10/01/2019 SH 78001|92561|92561 - BEKESY AUDIOMETRY DIAGNOSTIC||41.09|0||0|10/01/2019 SH 78001|92560|92560 - BEKESY AUDIOMETRY SCREENING||0|0||0|10/01/2019 SH 78001|92559|92559 - AUDIOMETRIC TESTING GROUPS||0|0||0|10/01/2019 SH 78001|92558|92558 - EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS||0|0||0|10/01/2019 SH 78001|92557|92557 - COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ||43.32|0||0|10/01/2019 SH 78001|92556|92556 - SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ||40.71|0||0|10/01/2019 SH 78001|92555|92555 - SPEECH AUDIOMETRY THRESHOLD||25.2|0||0|10/01/2019 SH 78001|92553|92553 - PURE TONE AUDIOMETRY AIR & BONE||40.32|0||0|10/01/2019 SH 78001|92552|92552 - PURE TONE AUDIOMETRY AIR ONLY||34.12|0||0|10/01/2019 SH 78001|92551|92551 - SCREENING TEST PURE TONE AIR ONLY||13.18|0||0|10/01/2019 SH 78001|92550|92550 - TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS||24.4|0||0|10/01/2019 SH 78001|92548|92548 - CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT||114.99|30.87||0|10/01/2019 SH 78001|92547|92547 - USE VERTICAL ELECTRODES||6.98|0||0|10/01/2019 SH 78001|92546|92546 - SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING||113.69|17.55||0|10/01/2019 SH 78001|92545|92545 - OSCILLATING TRACKING TEST W/RECORDING||16.99|15.43||0|10/01/2019 SH 78001|92544|92544 - OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC||18.24|16.68||0|10/01/2019 SH 78001|92543|92543 - CALORIC VESTIBULAR TEST||17.88|6.64||0|10/01/2019 SH 78001|92542|92542 - POSITIONAL NYSTAGMUS TEST||30.78|29.23||0|10/01/2019 SH 78001|92541|92541 - SPONTANEOUS NYSTAGMUS TEST||26.17|24.62||0|10/01/2019 SH 78001|92540|92540 - VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK||117.8|93.38||0|10/01/2019 SH 78001|92538|92538 - CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL||23.71|18.69||0|10/01/2019 SH 78001|92537|92537 - CALORIC VESTIBULAR TEST W/REC BI BITHERMAL||46.64|37.37||0|10/01/2019 SH 78001|92534|92534 - OPTOKINETIC NYSTAGMUS TEST||0|0||0|10/01/2019 SH 78001|92533|92533 - CALORIC VESTIBULAR TEST EACH IRRIGATION||0|0||0|10/01/2019 SH 78001|92532|92532 - POSITIONAL NYSTAGMUS TEST||0|0||0|10/01/2019 SH 78001|92531|92531 - SPONTANEOUS NYSTAGMUS W/GAZE||0|0||0|10/01/2019 SH 78001|92526|92526 - TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING||99.66|0||0|10/01/2019 SH 78001|92524|92524 - BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE||105.02|0||0|10/01/2019 SH 78001|92523|92523 - EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION||218.55|0||0|10/01/2019 SH 78001|92522|92522 - EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE||107.33|0||0|10/01/2019 SH 78001|92521|92521 - EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER)||125.48|0||0|10/01/2019 SH 78001|92520|92520 - LARYNGEAL FUNCTION STUDIES||85.46|0||0|10/01/2019 SH 78001|92516|92516 - FACIAL NERVE FUNCTION STUDIES||79.02|0||0|10/01/2019 SH 78001|92512|92512 - NASAL FUNCTION STUDIES||69.47|0||0|10/01/2019 SH 78001|92511|92511 - NASOPHARYNGOSCOPY W/ENDOSCOPE SPX||151.91|0||0|10/01/2019 SH 78001|92508|92508 - TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV||27.02|0||0|10/01/2019 SH 78001|92507|92507 - TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND||92.12|0||0|10/01/2019 SH 78001|92504|92504 - BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE||33.74|0||0|10/01/2019 SH 78001|92502|92502 - OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA||113.2|0||0|10/01/2019 SH 78001|92499|92499 - UNLISTED OPHTHALMOLOGICAL SERVICE/PROCEDURE||0|0||0|10/01/2019 SH 78001|92371|92371 - RPR&REFITG SPECTACLE PROSTHESIS APHAKIA||12.79|0||0|10/01/2019 SH 78001|92370|92370 - RPR&REFITG SPECTACLES EXCEPT APHAKIA||35.12|0||0|10/01/2019 SH 78001|92358|92358 - PROSTHESIS SERVICE APHAKIA TEMPORARY||12.41|0||0|10/01/2019 SH 78001|92355|92355 - FITTING SPECTACLE MOUNTED LW VIS AID TLSCP||22.87|0||0|10/01/2019 SH 78001|92354|92354 - FITTING SPECTACLE MOUNTED LW VIS AID 1 ELMNT||14.73|0||0|10/01/2019 SH 78001|92353|92353 - FITTING SPECTACLE PROSTH APHAKIA MULTIFOCAL||53.74|0||0|10/01/2019 SH 78001|92352|92352 - FITTING SPECTACLE PROSTH APHAKIA MONOFOCAL||45.81|0||0|10/01/2019 SH 78001|92342|92342 - FITTING SPECTACLES XCPT APHAKIA MULTIFOCAL||50|0||0|10/01/2019 SH 78001|92341|92341 - FITTING SPECTACLES XCPT APHAKIA BIFOCAL||46.25|0||0|10/01/2019 SH 78001|92340|92340 - FITTING SPECTACLES XCPT APHAKIA MONOFOCAL||40.38|0||0|10/01/2019 SH 78001|92326|92326 - REPLACEMENT CONTACT LENS||38.38|0||0|10/01/2019 SH 78001|92325|92325 - MODIFICAJ CONTACT LENX SPX SUPVJ ADAPTATION||46.13|0||0|10/01/2019 SH 78001|92317|92317 - RX CONTACT CORNEOSCLERAL LENS||84.92|0||0|10/01/2019 SH 78001|92316|92316 - RX CONTACT CORNEAL LENS APHAKIA BOTH EYES||102.98|0||0|10/01/2019 SH 78001|92315|92315 - RX CONTACT CORNEAL LENS APHAKIA 1 EYE||81.43|0||0|10/01/2019 SH 78001|92314|92314 - RX&FTG CONTACT CORNEAL LENS EYES XCPT APHAKIA||90.24|0||0|10/01/2019 SH 78001|92313|92313 - RX&FITG CORNEOSCLERAL LENS||110.23|0||0|10/01/2019 SH 78001|92312|92312 - RX&FITG CONTACT CORNEAL LENS APHAKIA BOTH EYES||133.81|0||0|10/01/2019 SH 78001|92311|92311 - RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE||114.8|0||0|10/01/2019 SH 78001|92310|92310 - RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK||109.78|0||0|10/01/2019 SH 78001|92287|92287 - ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R||153.94|54.7||0|10/01/2019 SH 78001|92286|92286 - ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY||43.61|26.17||0|10/01/2019 SH 78001|92285|92285 - XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE||22.71|3.71||0|10/01/2019 SH 78001|92284|92284 - DARK ADAPTATION XM W/INTERPRETATION & REPORT||69.28|15||0|10/01/2019 SH 78001|92283|92283 - COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV||61.99|11.21||0|10/01/2019 SH 78001|92275|92275 - ELECTRORETINOGRAPY W/INTERPRETATION & REPORT||164.5|62.94||0|10/01/2019 SH 78001|92270|92270 - ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT||103.94|48.89||0|10/01/2019 SH 78001|92265|92265 - NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R||97.34|54.7||0|10/01/2019 SH 78001|92260|92260 - OPHTHALMODYNAMOMETRY||21.03|0||0|10/01/2019 SH 78001|92250|92250 - FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT||87.98|28.28||0|10/01/2019 SH 78001|92242|92242 - FLUORESCEIN ICG ANGRPH W/MULTIFRAME I&R UNI/BI||275.63|208.01||0|10/01/2019 SH 78001|92240|92240 - INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI||282.74|74.57||0|10/01/2019 SH 78001|92235|92235 - FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI||123.32|55.09||0|10/01/2019 SH 78001|92230|92230 - FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT||65.81|0||0|10/01/2019 SH 78001|92228|92228 - REMOTE IMAGING MGT RETINAL DISEASE W/I&R UNI/B||40.38|25.26||0|10/01/2019 SH 78001|92227|92227 - REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/B||15.9|0||0|10/01/2019 SH 78001|92226|92226 - OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R SBS||28.57|0||0|10/01/2019 SH 78001|92225|92225 - OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R 1ST||31.12|0||0|10/01/2019 SH 78001|92145|92145 - CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI||17.8|10.43||0|10/01/2019 SH 78001|92136|92136 - OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL||100.82|36.47||0|10/01/2019 SH 78001|92134|92134 - COMPUTERIZED OPHTHALMIC IMAGING RETINA||51.41|33.58||0|10/01/2019 SH 78001|92133|92133 - COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE||50.25|32.8||0|10/01/2019 SH 78001|92132|92132 - CMPTR OPHTHALMIC DX IMG ANT SEGMT W/I&R UNI/BI||39.52|22.46||0|10/01/2019 SH 78001|92100|92100 - SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES||90.27|0||0|10/01/2019 SH 78001|92083|92083 - VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM||72.35|32.8||0|10/01/2019 SH 78001|92082|92082 - VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM||54.08|25.39||0|10/01/2019 SH 78001|92081|92081 - VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM||38.53|19.14||0|10/01/2019 SH 78001|92072|92072 - FITTING CONTACT LENS FOR MNGT OF KERATOCONUS||155.51|0||0|10/01/2019 SH 78001|92071|92071 - FIT CONTACT LENS TX OCULAR SURFACE DISEASE||44.14|0||0|10/01/2019 SH 78001|92065|92065 - ORTHOPTIC &/PLEOPTIC TRAINING W/MEDICAL DIRECTJ||60.15|21.38||0|10/01/2019 SH 78001|92060|92060 - SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX||73.95|44.87||0|10/01/2019 SH 78001|92025|92025 - COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI||43.01|23.62||0|10/01/2019 SH 78001|92020|92020 - GONIOSCOPY SEPARATE PROCEDURE||30.69|0||0|10/01/2019 SH 78001|92019|92019 - OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD||84.41|0||0|10/01/2019 SH 78001|92018|92018 - OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL||169.85|0||0|10/01/2019 SH 78001|92015|92015 - DETERMINATION REFRACTIVE STATE||23.37|0||0|10/01/2019 SH 78001|92014|92014 - OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>||140.71|0||0|10/01/2019 SH 78001|92012|92012 - OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT||97.05|0||0|10/01/2019 SH 78001|92004|92004 - OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST||169.59|0||0|10/01/2019 SH 78001|92002|92002 - OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT||92.22|0||0|10/01/2019 SH 78001|91299|91299 - UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE||0|0||0|10/01/2019 SH 78001|91200|91200 - LIVER ELASTOGRAPHY W/O IMAG W/I&R||40.46|17.2||0|10/01/2019 SH 78001|91133|91133 - ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG||192.44|40.87||0|10/01/2019 SH 78001|91132|91132 - ELECTROGASTROGRAPHY DX TRANSCUTANEOUS||165.86|32.51||0|10/01/2019 SH 78001|91122|91122 - ANORECTAL MANOMETRY||255.06|106.58||0|10/01/2019 SH 78001|91120|91120 - RECTAL SESATION TONE & COMPLIANCE TEST||477.18|60.84||0|10/01/2019 SH 78001|91117|91117 - COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R||166.54|0||0|10/01/2019 SH 78001|91112|91112 - GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP||1202.75|131.28||0|10/01/2019 SH 78001|91111|91111 - GASTROINTESTINAL TRACT IMAGING ESOPHAGUS W/I&R||809.13|62.12||0|10/01/2019 SH 78001|91110|91110 - GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R||997.03|227.54||0|10/01/2019 SH 78001|91065|91065 - BREATH HYDROGEN/METHANE TEST||90.03|12.5||0|10/01/2019 SH 78001|91040|91040 - ESOPHGL BALO DISTENSION DX STD W/PROVOCATION||486.86|60.05||0|10/01/2019 SH 78001|91038|91038 - ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG||504.49|69.94||0|10/01/2019 SH 78001|91037|91037 - GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD||181.78|60.83||0|10/01/2019 SH 78001|91035|91035 - GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD||538.03|99.2||0|10/01/2019 SH 78001|91034|91034 - GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT||210.47|59.67||0|10/01/2019 SH 78001|91030|91030 - ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS||154.77|56.3||0|10/01/2019 SH 78001|91022|91022 - DUODENAL MOTILITY MANOMETRIC STUDY||193.13|89.63||0|10/01/2019 SH 78001|91020|91020 - GASTRIC MOTILITY MANOMETRIC STUDIES||263.3|89.24||0|10/01/2019 SH 78001|91013|91013 - ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION||27.15|11.25||0|10/01/2019 SH 78001|91010|91010 - ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT||200.58|80.8||0|10/01/2019 SH 78001|90999|90999 - UNLISTED DIALYSIS PROCEDURE INPATIENT/OUTPATIENT||0|0||0|10/01/2019 SH 78001|90997|90997 - HEMOPERFUSION||111.54|0||0|10/01/2019 SH 78001|90993|90993 - DIALYSIS TRAINING PATIENT PER TRAINING SESSION||0|0||0|10/01/2019 SH 78001|90989|90989 - DIALYSIS TRAINING PATIENT COMPLETED COURSE||0|0||0|10/01/2019 SH 78001|90970|90970 - ESRD RELATED SVC YR OLD||9.14|0||0|10/01/2019 SH 78001|90969|90969 - ESRD RELATED SVC YR OLD 1 VISIT||214.95|0||0|10/01/2019 SH 78001|90961|90961 - ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS||279.89|0||0|10/01/2019 SH 78001|90960|90960 - ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS||333.13|0||0|10/01/2019 SH 78001|90959|90959 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT||347.71|0||0|10/01/2019 SH 78001|90958|90958 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS||512.46|0||0|10/01/2019 SH 78001|90957|90957 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS||760.21|0||0|10/01/2019 SH 78001|90956|90956 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT||376.42|0||0|10/01/2019 SH 78001|90955|90955 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS||539.24|0||0|10/01/2019 SH 78001|90954|90954 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS||964.89|0||0|10/01/2019 SH 78001|90953|90953 - ESRD RELATED SVC MONTHLY <2 YR OLD 1 VISIT||0|0||0|10/01/2019 SH 78001|90952|90952 - ESRD RELATED SVC MONTHLY <2 YR OLD 2/3 VISITS||0|0||0|10/01/2019 SH 78001|90951|90951 - ESRD RELATED SVC MONTHLY & <2 YR OLD 4/> VISITS||1108.68|0||0|10/01/2019 SH 78001|90947|90947 - DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS||146.69|0||0|10/01/2019 SH 78001|90945|90945 - DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL||100.62|0||0|10/01/2019 SH 78001|90940|90940 - HEMODIALYSIS ACCESS FLOW STUDY||0|0||0|10/01/2019 SH 78001|90937|90937 - HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX||123.18|0||0|10/01/2019 SH 78001|90935|90935 - HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION||85.93|0||0|10/01/2019 SH 78001|90911|90911 - BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG||96.15|0||0|10/01/2019 SH 78001|90901|90901 - BIOFEEDBACK TRAINING ANY MODALITY||43.27|0||0|10/01/2019 SH 78001|90899|90899 - UNLISTED PSYCHIATRIC SERVICE/PROCEDURE||0|0||0|10/01/2019 SH 78001|90889|90889 - PREP REPORT PT PSYCH STATUS AGENCY/PAYER||0|0||0|10/01/2019 SH 78001|90887|90887 - INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY||103.38|0||0|10/01/2019 SH 78001|90885|90885 - PSYCHIATRIC EVAL HOSPITAL RECORDS DX PURPOSES||58.51|0||0|10/01/2019 SH 78001|90882|90882 - ENVIRONMENTAL IVNTJ MGMT PURPOSES PSYC PT||0|0||0|10/01/2019 SH 78001|90880|90880 - HYPNOTHERAPY||119.65|0||0|10/01/2019 SH 78001|90876|90876 - INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN||127.31|0||0|10/01/2019 SH 78001|90875|90875 - INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN||72.3|0||0|10/01/2019 SH 78001|90870|90870 - ELECTROCONVULSIVE THERAPY||204.34|0||0|10/01/2019 SH 78001|90869|90869 - REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN||0|0||0|10/01/2019 SH 78001|90868|90868 - THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG||0|0||0|10/01/2019 SH 78001|90867|90867 - REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M||0|0||0|10/01/2019 SH 78001|90865|90865 - NARCOSYNTHESIS PSYC DX&THER PURPOSES||195.75|0||0|10/01/2019 SH 78001|90863|90863 - PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY||0|0||0|10/01/2019 SH 78001|90853|90853 - GROUP PSYCHOTHERAPY||30.48|0||0|10/01/2019 SH 78001|90849|90849 - MULTIPLE FAMILY GROUP PSYCHOTHERAPY||40.95|0||0|10/01/2019 SH 78001|90847|90847 - FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS||126.81|0||0|10/01/2019 SH 78001|90846|90846 - FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS||121.72|0||0|10/01/2019 SH 78001|90845|90845 - PSYCHOANALYSIS||108.01|0||0|10/01/2019 SH 78001|90840|90840 - PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES||75.55|0||0|10/01/2019 SH 78001|90839|90839 - PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES||157.86|0||0|10/01/2019 SH 78001|90838|90838 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN||130.31|0||0|10/01/2019 SH 78001|90837|90837 - PSYCHOTHERAPY W/PATIENT 60 MINUTES||151.09|0||0|10/01/2019 SH 78001|90836|90836 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN||98.61|0||0|10/01/2019 SH 78001|90834|90834 - PSYCHOTHERAPY W/PATIENT 45 MINUTES||100.6|0||0|10/01/2019 SH 78001|90833|90833 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN||77.87|0||0|10/01/2019 SH 78001|90832|90832 - PSYCHOTHERAPY W/PATIENT 30 MINUTES||75.93|0||0|10/01/2019 SH 78001|90792|90792 - PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES||173.9|0||0|10/01/2019 SH 78001|90791|90791 - PSYCHIATRIC DIAGNOSTIC EVALUATION||155.35|0||0|10/01/2019 SH 78001|90785|90785 - PSYCHOTHERAPY COMPLEX INTERACTIVE||16.95|0||0|10/01/2019 SH 78001|90756|90756 - CCIIV4 VACCINE ANTIBIOTIC FREE 0.5 ML DOS IM USE||28.4913|0||0|10/01/2019 SH 78001|90749|90749 - UNLISTED VACCINE/TOXOID||0|0||0|10/01/2019 SH 78001|90748|90748 - HIB-HEPB VACCINE FOR INTRAMUSCULAR USE||0|0||0|10/01/2019 SH 78001|90747|90747 - HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM||162.8063|0||0|10/01/2019 SH 78001|90746|90746 - HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE||81.4038|0||0|10/01/2019 SH 78001|90744|90744 - HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM||32.6688|0||0|10/01/2019 SH 78001|90743|90743 - HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM||32.6688|0||0|10/01/2019 SH 78001|90740|90740 - HEPB VACCINE DIALYSIS/IMMUNSUP PAT 3 DOSE IM||162.8063|0||0|10/01/2019 SH 78001|90739|90739 - HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE||163.875|0||0|10/01/2019 SH 78001|90738|90738 - JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM||0|0||0|10/01/2019 SH 78001|90736|90736 - ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE||244.85|0||0|10/01/2019 SH 78001|90735|90735 - ENCEPHALITIS VACCINE SC||0|0||0|10/01/2019 SH 78001|90734|90734 - MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE||112.44|0||0|10/01/2019 SH 78001|90733|90733 - MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE||0|0||0|10/01/2019 SH 78001|90732|90732 - PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE||134.6825|0||0|10/01/2019 SH 78001|90727|90727 - PLAGUE VACCINE IM||0|0||0|10/01/2019 SH 78001|90725|90725 - CHOLERA VACCINE INJECTABLE||0|0||0|10/01/2019 SH 78001|90723|90723 - DTAP-HEPB-IPV VACCINE INTRAMUSCULAR||64.78|0||0|10/01/2019 SH 78001|90721|90721 - DTAP/HIB VACCINE IM||0|0||0|10/01/2019 SH 78001|90720|90720 - DTWP-HIB VACCINE IM||0|0||0|10/01/2019 SH 78001|90719|90719 - DIPHTHERIA VACCINE IM||0|0||0|10/01/2019 SH 78001|90717|90717 - YELLOW FEVER VACCINE LIVE SUBQ||0|0||0|10/01/2019 SH 78001|90716|90716 - VAR VACCINE LIVE FOR SUBCUTANEOUS USE||64.78|0||0|10/01/2019 SH 78001|90715|90715 - TDAP VACCINE 7 YRS/> IM||38.6925|0||0|10/01/2019 SH 78001|90714|90714 - TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE||29.6475|0||0|10/01/2019 SH 78001|90713|90713 - POLIOVIRUS VACCINE INACTIVATED SUBQ/IM||0|0||0|10/01/2019 SH 78001|90712|90712 - ORAL POLIOVIRUS VACCINE||0|0||0|10/01/2019 SH 78001|90710|90710 - MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ||117.9|0||0|10/01/2019 SH 78001|90708|90708 - MEASLES-RUBELLA VACCINE SC||0|0||0|10/01/2019 SH 78001|90706|90706 - RUBELLA VACCINE SC||0|0||0|10/01/2019 SH 78001|90705|90705 - MEASLES VACCINE SC||0|0||0|10/01/2019 SH 78001|90704|90704 - MUMPS VACCINE SC||0|0||0|10/01/2019 SH 78001|90703|90703 - TETANUS VACCINE IM||0|0||0|10/01/2019 SH 78001|90702|90702 - DT VACCINE YOUNGER THAN 7 YRS FOR IM USE||0|0||0|10/01/2019 SH 78001|90700|90700 - DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM||22.02|0||0|10/01/2019 SH 78001|90698|90698 - DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE||66.08|0||0|10/01/2019 SH 78001|90697|90697 - DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR||0|0||0|10/01/2019 SH 78001|90696|90696 - DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE||0|0||0|10/01/2019 SH 78001|90693|90693 - TYPHOID VACCINE AKD SC||0|0||0|10/01/2019 SH 78001|90692|90692 - TYPHOID VACCINE H-P SC/ID||0|0||0|10/01/2019 SH 78001|90691|90691 - TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM||139.4038|0||0|10/01/2019 SH 78001|90690|90690 - TYPHOID VACCINE LIVE ORAL||0|0||0|10/01/2019 SH 78001|90688|90688 - IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE||22.2937|0||0|10/01/2019 SH 78001|90687|90687 - IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE||11.7538|0||0|10/01/2019 SH 78001|90686|90686 - IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE||23.79|0||0|10/01/2019 SH 78001|90685|90685 - IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE||26.4975|0||0|10/01/2019 SH 78001|90682|90682 - RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM||57.8912|0||0|10/01/2019 SH 78001|90681|90681 - RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE||66.08|0||0|10/01/2019 SH 78001|90680|90680 - RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE||66.08|0||0|10/01/2019 SH 78001|90676|90676 - RABIES VACCINE INTRADERMAL||0|0||0|10/01/2019 SH 78001|90675|90675 - RABIES VACCINE INTRAMUSCULAR||361.1963|0||0|10/01/2019 SH 78001|90674|90674 - CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE||30.0587|0||0|10/01/2019 SH 78001|90673|90673 - RIV3 VACCINE PRESERVATIVE FREE FOR IM USE||50.7662|0||0|10/01/2019 SH 78001|90672|90672 - LAIV4 VACCINE FOR INTRANASAL USE||33.59|0||0|10/01/2019 SH 78001|90670|90670 - PCV13 VACCINE FOR INTRAMUSCULAR USE||256.3913|0||0|10/01/2019 SH 78001|90669|90669 - PCV7 VACCINE IM||0|0||0|10/01/2019 SH 78001|90668|90668 - IIV VACCINE PANDEMIC FOR INTRAMUSCULAR USE||0|0||0|10/01/2019 SH 78001|90667|90667 - IIV VACCINE PANDEMIC ADJUVANT FOR IM USE||0|0||0|10/01/2019 SH 78001|90666|90666 - INFLUENZA VACCINE PANDEMIC SPLT PRSRV FREE IM||0|0||0|10/01/2019 SH 78001|90664|90664 - LAIV VACCINE PANDEMIC FORMULA FOR INTRANASAL USE||0|0||0|10/01/2019 SH 78001|90662|90662 - IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM||61.2812|0||0|10/01/2019 SH 78001|90661|90661 - CCIIV3 VACCINE PRESERVATIVE FREE 0.5 ML IM USE||27.86|0||0|10/01/2019 SH 78001|90660|90660 - LAIV3 VACCINE LIVE FOR INTRANASAL USE||0|0||0|10/01/2019 SH 78001|90658|90658 - IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE||13.82|0||0|10/01/2019 SH 78001|90657|90657 - IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE||7.53|0||0|10/01/2019 SH 78001|90656|90656 - IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE||24.0587|0||0|10/01/2019 SH 78001|90655|90655 - IIV3 VACC PRESRV FREE 0.25 ML DOSAGE IM USE||0|0||0|10/01/2019 SH 78001|90654|90654 - INFLUENZA VACC IIV3 SPLIT VIRUS PRSRV FREE ID||0|0||0|10/01/2019 SH 78001|90653|90653 - IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE||62.7713|0||0|10/01/2019 SH 78001|90651|90651 - 9VHPV VACC 2/3 DOSE SCHED IM USE||0|0||0|10/01/2019 SH 78001|90650|90650 - 2VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE||0|0||0|10/01/2019 SH 78001|90649|90649 - 4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE||0|0||0|10/01/2019 SH 78001|90648|90648 - HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE||23.75|0||0|10/01/2019 SH 78001|90647|90647 - HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE||0|0||0|10/01/2019 SH 78001|90646|90646 - HIB VACCINE PRP-D IM||0|0||0|10/01/2019 SH 78001|90645|90645 - HIB VACCINE HBOC IM||0|0||0|10/01/2019 SH 78001|90644|90644 - HIB-MENCY VACC 4 DOSE SCHED 6 WKS-18 MONTHS IM||30.93|0||0|10/01/2019 SH 78001|90636|90636 - HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM||0|0||0|10/01/2019 SH 78001|90634|90634 - HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE||0|0||0|10/01/2019 SH 78001|90633|90633 - HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE||0|0||0|10/01/2019 SH 78001|90632|90632 - HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE||70.8675|0||0|10/01/2019 SH 78001|90630|90630 - INFLUENZA VACC IIV4 SPLIT VIRUS PRSRV FREE ID||25.4288|0||0|10/01/2019 SH 78001|90625|90625 - CHOLERA VACCINE ADULT 1 DOSE LIVE FOR ORAL USE||0|0||0|10/01/2019 SH 78001|90621|90621 - MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM||0|0||0|10/01/2019 SH 78001|90620|90620 - MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM||0|0||0|10/01/2019 SH 78001|90586|90586 - BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL||172.64|0||0|10/01/2019 SH 78001|90585|90585 - BACILLUS CALMETTE-GUERIN VACC FOR TB LIVE PERQ||172.64|0||0|10/01/2019 SH 78001|90581|90581 - ANTHRAX VACCINE SUBCUTANEOUS/IM USE||0|0||0|10/01/2019 SH 78001|90477|90477 - ADENOVIRUS VACCINE TYPE 7 LIVE FOR ORAL||0|0||0|10/01/2019 SH 78001|90476|90476 - ADENOVIRUS VACCINE TYPE 4 LIVE ORAL||0|0||0|10/01/2019 SH 78001|90474|90474 - IM ADM INTRANSL/ORAL EA VACCINE||14.61|0||0|10/01/2019 SH 78001|90473|90473 - IM ADM INTRANSL/ORAL 1 VACCINE||28.27|0||0|10/01/2019 SH 78001|90472|90472 - IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE||14.61|0||0|10/01/2019 SH 78001|90471|90471 - IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE||28.27|0||0|10/01/2019 SH 78001|90461|90461 - IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT||14.61|0||0|10/01/2019 SH 78001|90460|90460 - IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX||28.27|0||0|10/01/2019 SH 78001|90399|90399 - UNLISTED IMMUNE GLOBULIN||0|0||0|10/01/2019 SH 78001|90396|90396 - VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM||0|0||0|10/01/2019 SH 78001|90393|90393 - VACCINIA IMMUNE GLOBULIN HUMAN IM||0|0||0|10/01/2019 SH 78001|90389|90389 - TETANUS IMMUNE GLOBULIN TIG HUMAN IM||0|0||0|10/01/2019 SH 78001|90386|90386 - RHO(D) IMMUNE GLOBULIN HUMAN IV||0|0||0|10/01/2019 SH 78001|90385|90385 - RHO(D) IMMUNE GLOBULIN HUMAN MINI-DOSE IM||0|0||0|10/01/2019 SH 78001|90384|90384 - RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM||0|0||0|10/01/2019 SH 78001|90378|90378 - RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E||0|0||0|10/01/2019 SH 78001|90376|90376 - RABIES IG HEAT-TREATED HUMAN IM/SUBQ||381.8012|0||0|10/01/2019 SH 78001|90375|90375 - RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ||369.7775|0||0|10/01/2019 SH 78001|90371|90371 - HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM||146.395|0||0|10/01/2019 SH 78001|90296|90296 - DIPHTHERIA ANTITOXIN EQUINE ANY ROUTE||0|0||0|10/01/2019 SH 78001|90291|90291 - CYTOMEGALOVIRUS IMMUNE GLOBULIN HUMAN IV||0|0||0|10/01/2019 SH 78001|90288|90288 - BOTULISM IMMUNE GLOBULIN HUMAN INTRAVENOUS USE||0|0||0|10/01/2019 SH 78001|90287|90287 - BOTULINUM ANTITOXIN EQUINE ANY ROUTE||0|0||0|10/01/2019 SH 78001|90284|90284 - IMMUNE GLOBULIN HUMAN SUBQ INFUSION 100 MG EA||0|0||0|10/01/2019 SH 78001|90283|90283 - IMMUNE GLOBULIN IGIV HUMAN IV USE||0|0||0|10/01/2019 SH 78001|90281|90281 - IMMUNE GLOBULIN IG HUMAN IM USE||0|0||0|10/01/2019 SH 78001|89331|89331 - SPERM EVALUATION RETROGRADE EJACULATION URINE||25.54|0||0|10/01/2019 SH 78001|89330|89330 - SPERM EVALUATION CERVICAL MUCOUS PENETRATION||16.15|0||0|10/01/2019 SH 78001|89329|89329 - SPERM EVALUATION HAMSTER PENETRATION TEST||34.24|0||0|10/01/2019 SH 78001|89325|89325 - SPERM ANTIBODIES||17.44|0||0|10/01/2019 SH 78001|89322|89322 - SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA||18.85|0||0|10/01/2019 SH 78001|89321|89321 - SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM||9.42|0||0|10/01/2019 SH 78001|89320|89320 - SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT||9.42|0||0|10/01/2019 SH 78001|89310|89310 - SEMEN ALYS MOTILITY&CNT X W/HUHNER TST||14.05|0||0|10/01/2019 SH 78001|89300|89300 - SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER||14.57|0||0|10/01/2019 SH 78001|89230|89230 - SWEAT COLLECTION IONTOPHORESIS||2.72|0||0|10/01/2019 SH 78001|89220|89220 - SPUTUM OBTAINING SPEC AEROSOL INDUCED TX SPX||17.06|0||0|10/01/2019 SH 78001|89190|89190 - NASAL SMEAR EOSINOPHILS||7.75|0||0|10/01/2019 SH 78001|89160|89160 - MEAT FIBERS FECES||6.02|0||0|10/01/2019 SH 78001|89125|89125 - FAT STAIN FECES URINE/RESPIR SECRETIONS||7.06|0||0|10/01/2019 SH 78001|89060|89060 - CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID||11.69|22.16||0|10/01/2019 SH 78001|89055|89055 - LEUKOCYTE ASSMT FECAL QUAL/SEMIQUANTITATIVE||3.83|0||0|10/01/2019 SH 78001|89051|89051 - CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT||2.88|0||0|10/01/2019 SH 78001|89050|89050 - CELL COUNT MISCELLANEOUS BODY FLUIDS||7.72|0||0|10/01/2019 SH 78001|89049|89049 - CAFFEINE HALOTHANE CONTRACTURE TEST||74.35|0||0|10/01/2019 SH 78001|88741|88741 - HEMOGLOBIN QUANTITATIVE TC PER DAY METHEMOGLOBIN||8.2|0||0|10/01/2019 SH 78001|88740|88740 - HEMOGLOBIN QUAN TC PER DAY CARBOXYHEMOGLOBIN||8.2|0||0|10/01/2019 SH 78001|88738|88738 - HGB QUANTITATIVE TRANSCUTANEOUS||8.2|0||0|10/01/2019 SH 78001|88720|88720 - BILIRUBIN TOTAL TRANSCUTANEOUS||8.2|0||0|10/01/2019 SH 78001|88388|88388 - MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SE||39.18|28.71||0|10/01/2019 SH 78001|88387|88387 - MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA||49.22|38.37||0|10/01/2019 SH 78001|88381|88381 - MICRODISSECTION PREP IDENTIFIED TARGET MANUAL||137.22|30.61||0|10/01/2019 SH 78001|88380|88380 - MICRODISSECTION PREP IDENTIFIED TARGET LASER||148.79|66.22||0|10/01/2019 SH 78001|88377|88377 - M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB||237.92|77.04||0|10/01/2019 SH 78001|88375|88375 - OPTICAL ENDOMICROSCOPIC IMAGE INTERP & REPORT||55.92|0||0|10/01/2019 SH 78001|88374|88374 - M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB||225.79|52.9||0|10/01/2019 SH 78001|88373|88373 - M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH||67.39|24.75||0|10/01/2019 SH 78001|88372|88372 - PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA||37.14|22.16||0|10/01/2019 SH 78001|88371|88371 - PROTEIN ANAL TISSUE WESTERN BLOT W/INTERP&REPO||36.29|22.16||0|10/01/2019 SH 78001|88369|88369 - M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH||82.17|29.45||0|10/01/2019 SH 78001|88368|88368 - M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL||121.68|48.41||0|10/01/2019 SH 78001|88367|88367 - M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN||119.48|41.56||0|10/01/2019 SH 78001|88366|88366 - IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN||258.54|73.63||0|10/01/2019 SH 78001|88365|88365 - IN SITU HYBRIDIZATION 1ST PROBE STAIN||173.63|52.29||0|10/01/2019 SH 78001|88364|88364 - IN SITU HYBRIDIZATION EA ADDL PROBE STAIN||107.75|31.77||0|10/01/2019 SH 78001|88363|88363 - EXAM & SELECT ARCHIVE TISSUE MOLECULAR ANALYSI||22.94|0||0|10/01/2019 SH 78001|88362|88362 - NERVE TEASING PREPARATIONS||330.46|131.58||0|10/01/2019 SH 78001|88361|88361 - M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST||188.89|70.27||0|10/01/2019 SH 78001|88360|88360 - M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL||152.1|64.88||0|10/01/2019 SH 78001|88358|88358 - MORPHOMETRIC ANALYSIS TUMOR||95.63|53.37||0|10/01/2019 SH 78001|88356|88356 - MORPHOMETRIC ANALYSIS NERVE||235.1|144.77||0|10/01/2019 SH 78001|88355|88355 - MORPHOMETRIC ANALYSIS SKELETAL MUSCLE||197.62|98.38||0|10/01/2019 SH 78001|88350|88350 - IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN||80.46|33.33||0|10/01/2019 SH 78001|88348|88348 - ELECTRON MICROSCOPY DIAGNOSTIC||382.61|91.09||0|10/01/2019 SH 78001|88347|88347 - IMMUNOFLUORESCENT STUDY||104.54|50.27||0|10/01/2019 SH 78001|88346|88346 - IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN||123.53|51.04||0|10/01/2019 SH 78001|88344|88344 - IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE||130.12|46.77||0|10/01/2019 SH 78001|88342|88342 - IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE||101.13|42.59||0|10/01/2019 SH 78001|88341|88341 - IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE||75.1|25.48||0|10/01/2019 SH 78001|88334|88334 - PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE||75.68|46.21||0|10/01/2019 SH 78001|88333|88333 - PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE||123.47|75.4||0|10/01/2019 SH 78001|88332|88332 - PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION||51.81|37.07||0|10/01/2019 SH 78001|88331|88331 - PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC||117.22|74.96||0|10/01/2019 SH 78001|88329|88329 - PATHOLOGY CONSULTATION DURING SURGERY||42.85|0||0|10/01/2019 SH 78001|88325|88325 - CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL||159|0||0|10/01/2019 SH 78001|88323|88323 - CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES||173.12|104.89||0|10/01/2019 SH 78001|88321|88321 - CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE||100.93|0||0|10/01/2019 SH 78001|88319|88319 - SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS||98.45|32.94||0|10/01/2019 SH 78001|88314|88314 - SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU||82.98|26.77||0|10/01/2019 SH 78001|88313|88313 - SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT||74.7|14.62||0|10/01/2019 SH 78001|88312|88312 - SPECIAL STAIN GROUP 1 MICROORGANISMS I&R||108.18|32.59||0|10/01/2019 SH 78001|88311|88311 - DECALCIFICATION PROCEDURE||23.92|15||0|10/01/2019 SH 78001|88309|88309 - LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||515.77|176.57||0|10/01/2019 SH 78001|88307|88307 - LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||338.76|99.97||0|10/01/2019 SH 78001|88305|88305 - LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||82.35|45.52||0|10/01/2019 SH 78001|88304|88304 - LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||50.58|13.75||0|10/01/2019 SH 78001|88302|88302 - LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||35.46|8.32||0|10/01/2019 SH 78001|88300|88300 - LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY||17.02|5.39||0|10/01/2019 SH 78001|88291|88291 - CYTOGENETICS&MOLEC CYTOGENETICS INTERP&REP||36.77|0||0|10/01/2019 SH 78001|88289|88289 - CHRMSM ANALYSIS ADDL HIGH RESOLUTION STUDY||56.23|0||0|10/01/2019 SH 78001|88285|88285 - CHRMSM ANALYSIS ADDL CELLS COUNTED EACH STUDY||31.03|0||0|10/01/2019 SH 78001|88283|88283 - CHRMSM ANALYSIS ADDL SPECIALIZED BANDING||58.24|0||0|10/01/2019 SH 78001|88280|88280 - CHRMSM ANALYSIS ADDL KARYOTYP EACH STUDY||40.98|0||0|10/01/2019 SH 78001|88275|88275 - MOLEC CYTG INTERPHASE ISH ANALYZE 100-300 CLL||65.58|0||0|10/01/2019 SH 78001|88274|88274 - MOLECULAR CYTOGENETICS INTERPHASE ISH 25-99 CLL||56.84|0||0|10/01/2019 SH 78001|88273|88273 - MOLECULAR CYTOGENETICS CHRMOML ISH 10-30 CLL||52.48|0||0|10/01/2019 SH 78001|88272|88272 - MOLECULAR CYTOGENETICS CHRMOML ISH 3-5 CELLS||43.73|0||0|10/01/2019 SH 78001|88271|88271 - MOLECULAR CYTOGENETICS DNA PROBE EACH||34.97|0||0|10/01/2019 SH 78001|88269|88269 - CHRMSM SITU AMNIOTIC CLL 6-12 COLONIES 1KARYOTYP||271.61|0||0|10/01/2019 SH 78001|88267|88267 - CHRMSM ALYS AMNIOTIC/VILLUS 15 CELL 1KARYOTYPE||293.57|0||0|10/01/2019 SH 78001|88264|88264 - CHRMSM ANALYZE 20-25 CELLS||203.54|0||0|10/01/2019 SH 78001|88263|88263 - CHRMSM COUNT 45 CELL MOSAICISM 2KARYOTYPE||245.42|0||0|10/01/2019 SH 78001|88262|88262 - CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING||203.54|0||0|10/01/2019 SH 78001|88261|88261 - CHRMSM COUNT 5 CELL 1KARYOTYPE BANDING||288.61|0||0|10/01/2019 SH 78001|88249|88249 - CHRMSM BREAKAGE SYNDS SCORE 100 CLL||282.8|0||0|10/01/2019 SH 78001|88248|88248 - CHRMSM BREAKAGE BASELINE BREAKAGE 50-100 CLL||282.8|0||0|10/01/2019 SH 78001|88245|88245 - CHRMSM BREAKAGE BASELINE SISTER 20-25 CLL||243.1|0||0|10/01/2019 SH 78001|88241|88241 - THAWING&EXPANSION FROZEN CELLS EACH ALIQUOT||13.3|0||0|10/01/2019 SH 78001|88240|88240 - CRYOPRSRV FRZING&STORAGE CELLS EA CELL LINE||13.3|0||0|10/01/2019 SH 78001|88239|88239 - TISS CUL NEO DISORDERS SOLID TUMOR||240.9|0||0|10/01/2019 SH 78001|88237|88237 - TISS CUL NEO DISORDERS BONE MARROW BLOOD CELLS||144.18|0||0|10/01/2019 SH 78001|88235|88235 - TISS CUL NON-NEO DISORDERS AMNIOTIC/CHORNC CELLS||240.48|0||0|10/01/2019 SH 78001|88233|88233 - TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX||229.81|0||0|10/01/2019 SH 78001|88230|88230 - TISS CUL NON-NEO DISORDERS LYMPHOCYTE||190.25|0||0|10/01/2019 SH 78001|88189|88189 - FLOW CYTOMETRY INTERPRETATION 16/> MARKERS||132.62|0||0|10/01/2019 SH 78001|88188|88188 - FLOW CYTOMETRY INTERPJ 9-15 MARKERS||107.01|0||0|10/01/2019 SH 78001|88187|88187 - FLOW CYTOMETRY INTERPJ 2-8 MARKERS||84.24|0||0|10/01/2019 SH 78001|88185|88185 - FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY EA||62.03|0||0|10/01/2019 SH 78001|88184|88184 - FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST||101.95|0||0|10/01/2019 SH 78001|88182|88182 - FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS||121.21|42.51||0|10/01/2019 SH 78001|88177|88177 - CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL||35.17|26.64||0|10/01/2019 SH 78001|88175|88175 - CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS||43.22|0||0|10/01/2019 SH 78001|88174|88174 - CYTP C/V AUTO THIN LYR PREPJ SCR SYS PHYS||34.9|0||0|10/01/2019 SH 78001|88173|88173 - CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT||170.42|84.36||0|10/01/2019 SH 78001|88172|88172 - CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST||64.65|43.32||0|10/01/2019 SH 78001|88167|88167 - CYTP SLIDES C/V MNL SCR&CPTR RESCR CELL S&I||17.26|0||0|10/01/2019 SH 78001|88166|88166 - CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS SUPV||17.26|0||0|10/01/2019 SH 78001|88165|88165 - CYTP SLIDES C/V MNL SCR&RESCR PHYS SUPV||17.26|0||0|10/01/2019 SH 78001|88164|88164 - CYTP SLIDES CERV/VAG MNL SCRN PHYSICIAN SUPV||17.26|0||0|10/01/2019 SH 78001|88162|88162 - CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES||111.86|47.89||0|10/01/2019 SH 78001|88161|88161 - CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ||68.08|30.09||0|10/01/2019 SH 78001|88160|88160 - CYTP SMRS ANY OTH SRC SCR&INTERPJ||75.06|31.25||0|10/01/2019 SH 78001|88155|88155 - CYTP SLIDES C/V DEFINITIVE HORMONAL EVAL||9.78|0||0|10/01/2019 SH 78001|88154|88154 - CYTP SLIDES C/V MNL SCR&CPTR-RESCR CELL S&I||17.26|0||0|10/01/2019 SH 78001|88153|88153 - CYTP SLIDES C/V MNL SCR&RESCR PHYS||17.26|0||0|10/01/2019 SH 78001|88152|88152 - CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS||17.26|0||0|10/01/2019 SH 78001|88150|88150 - CYTP SLIDES C/V MNL SCR UNDER PHYS||17.26|0||0|10/01/2019 SH 78001|88148|88148 - CYTP SMRS C/V SCR AUTO SYS MNL RESCR PHYS||17.26|0||0|10/01/2019 SH 78001|88147|88147 - CYTP SMRS C/V SCR AUTOMATED SYSTEM PHYS SUPV||17.26|0||0|10/01/2019 SH 78001|88143|88143 - CYTP C/V FLU AUTO THIN MNL SCR&RESCR PHYS||33.08|0||0|10/01/2019 SH 78001|88142|88142 - CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN||33.08|0||0|10/01/2019 SH 78001|88141|88141 - CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN||37.11|0||0|10/01/2019 SH 78001|88140|88140 - SEX CHROMATIN IDENTJ PERIPHERAL BLOOD SMEAR||13.06|0||0|10/01/2019 SH 78001|88130|88130 - SEX CHROMATIN IDENTIFICATION BARR BODIES||24.58|0||0|10/01/2019 SH 78001|88125|88125 - CYTOPATHOLOGY FORENSIC||29.82|17.03||0|10/01/2019 SH 78001|88121|88121 - CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA||605.22|60.18||0|10/01/2019 SH 78001|88120|88120 - CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL||680.91|69.19||0|10/01/2019 SH 78001|88112|88112 - CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V||72.61|33.45||0|10/01/2019 SH 78001|88108|88108 - CYTP CONCENTRATION SMEARS & INTERPRETATION||93.79|27.5||0|10/01/2019 SH 78001|88106|88106 - CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ||96.98|23.32||0|10/01/2019 SH 78001|88104|88104 - CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ||83.85|34.62||0|10/01/2019 SH 78001|87912|87912 - NFCT AGENT GENOTYPE HEPATITIS B VIRUS||142.42|0||0|10/01/2019 SH 78001|87910|87910 - NFCT AGT GENOTYPE NUCLEIC ACID CYTOMEGALOVIRUS||142.42|0||0|10/01/2019 SH 78001|87906|87906 - NFCT GEXYP DNA/RNA HIV 1 OTHER REGION||71.21|0||0|10/01/2019 SH 78001|87905|87905 - INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS||19.96|0||0|10/01/2019 SH 78001|87904|87904 - NFCT PHEXYP RESIST TISS CUL HIV EA ADDL DRUG||36.11|0||0|10/01/2019 SH 78001|87903|87903 - NFCT PHEXYP RESIST TISS CUL HIV FIRST 1-10 DRUGS||552.35|0||0|10/01/2019 SH 78001|87902|87902 - NFCT AGNT GENOTYP NUCLEIC ACID HEPATITIS C VIRUS||142.42|0||0|10/01/2019 SH 78001|87901|87901 - NFCT GEXYP NUCLEIC ACID HIV REV TRNSCR&PROTEAS||142.42|0||0|10/01/2019 SH 78001|87900|87900 - NFCT AGT DRUG SUSCEPT PHENOTYPE PREDICTION||180.52|0||0|10/01/2019 SH 78001|87899|87899 - IAADIADOO NOT OTHERWISE SPECIFIED||19.58|0||0|10/01/2019 SH 78001|87880|87880 - IAADIADOO STREPTOCOCCUS GROUP A||19.58|0||0|10/01/2019 SH 78001|87850|87850 - IAADIADOO NEISSERIA GONORRHOEAE||19.58|0||0|10/01/2019 SH 78001|87810|87810 - CHLAMYDIA TRACHOMATIS||19.58|0||0|10/01/2019 SH 78001|87809|87809 - INFECTIOUS AGENT IMMUNOASSAY OPTICAL ADENOVIRUS||19.58|0||0|10/01/2019 SH 78001|87808|87808 - IAADIADOO TRICHOMONAS VAGINALIS||19.58|0||0|10/01/2019 SH 78001|87807|87807 - IAADIADOO RESPIRATORY SYNCTIAL VIRUS||19.58|0||0|10/01/2019 SH 78001|87806|87806 - IAADIADOO HIV1 ANTIGEN W/HIV1 & HIV2 ANTIBODIES||39.32|0||0|10/01/2019 SH 78001|87804|87804 - IAADIADOO INFLUENZA||19.58|0||0|10/01/2019 SH 78001|87803|87803 - IAADIADOO CLOSTRIDIUM DIFFICILE TOXIN||19.58|0||0|10/01/2019 SH 78001|87802|87802 - IAADIADOO STREPTOCOCCUS GROUP B||19.58|0||0|10/01/2019 SH 78001|87801|87801 - IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ||64.09|0||0|10/01/2019 SH 78001|87800|87800 - IADNA MULTIPLE ORGANISMS DIRECT PROBE TQ||64.4|0||0|10/01/2019 SH 78001|87799|87799 - IADNA NOS QUANTIFICATION EACH ORGANISM||69.95|0||0|10/01/2019 SH 78001|87798|87798 - IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM||32.04|0||0|10/01/2019 SH 78001|87797|87797 - IADNA NOS DIRECT PROBE TQ EACH ORGANISM||32.21|0||0|10/01/2019 SH 78001|87662|87662 - IADNA DNA/RNA ZIKA VIRUS AMPLIFIED PROBE TQ||76.02|0||0|10/01/2019 SH 78001|87661|87661 - IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH||32.04|0||0|10/01/2019 SH 78001|87660|87660 - IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87653|87653 - IADNA STREPTOCOCCUS GROUP B AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87652|87652 - IADNA STREPTOCOCCUS GROUP A QUANTIFICATION||68.18|0||0|10/01/2019 SH 78001|87651|87651 - IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87650|87650 - IADNA STREPTOCOCCUS GROUP A DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87641|87641 - IADNA S AUREUS METHICILLIN RESIST AMP PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87640|87640 - IADNA S AUREUS AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87634|87634 - IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE||103.99|0||0|10/01/2019 SH 78001|87633|87633 - IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET||287.95|0||0|10/01/2019 SH 78001|87632|87632 - IADNA RESPIRATRY PROBE & REV TRNSCR 6-11 TARGETS||160.94|0||0|10/01/2019 SH 78001|87631|87631 - IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS||110.15|0||0|10/01/2019 SH 78001|87625|87625 - IADNA HUMAN PAPILLOMAVIRUS TYPES 16 & 18 ONLY||32.04|0||0|10/01/2019 SH 78001|87624|87624 - IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES||32.04|0||0|10/01/2019 SH 78001|87623|87623 - IADNA HUMAN PAPILLOMAVIRUS LOW-RISK TYPES||32.04|0||0|10/01/2019 SH 78001|87592|87592 - IADNA NEISSERIA GONORRHOEAE QUANTIFICATION||69.95|0||0|10/01/2019 SH 78001|87591|87591 - IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87590|87590 - IADNA NEISSERIA GONORRHOEAE DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87582|87582 - IADNA MYCOPLSM PNEUMONIAE QUANTIFICATION||68.18|0||0|10/01/2019 SH 78001|87581|87581 - IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87580|87580 - IADNA MYCOPLSM PNEUMONIAE DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87562|87562 - IADNA MYCOBACTERIA AVIUM-INTRACELLULARE QUANT||69.95|0||0|10/01/2019 SH 78001|87561|87561 - IADNA MYCOBACTERIA AVIUM-INTRACLRE AMP PRB||32.04|0||0|10/01/2019 SH 78001|87560|87560 - IADNA MYCOBACTERIA AVIUM-INTRACLRE DIR PRB||32.21|0||0|10/01/2019 SH 78001|87557|87557 - IADNA MYCOBACTERIA TUBERCULOSIS QUANTIFICATION||69.95|0||0|10/01/2019 SH 78001|87556|87556 - IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB||32.04|0||0|10/01/2019 SH 78001|87555|87555 - IADNA MYCOBACTERIA TUBERCULOSIS DIR PRB||32.21|0||0|10/01/2019 SH 78001|87552|87552 - IADNA MYCOBACTERIA SPECIES QUANTIFICATION||69.95|0||0|10/01/2019 SH 78001|87551|87551 - IADNA MYCOBACTERIA SPECIES AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87550|87550 - IADNA MYCOBACTERIA SPECIES DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87542|87542 - IADNA LEGIONELLA PNEUMOPHILA QUANTIFICATION||68.18|0||0|10/01/2019 SH 78001|87541|87541 - IADNA LEGIONELLA PNEUMOPHILA AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87540|87540 - IADNA LEGIONELLA PNEUMOPHILA DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87539|87539 - IADNA HIV-2 QUANT & REVERSE TRANSCRIPTION||69.95|0||0|10/01/2019 SH 78001|87538|87538 - IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIPJ||32.04|0||0|10/01/2019 SH 78001|87537|87537 - IADNA HIV-2 DIRECT PROBE TECHNIQUE||32.21|0||0|10/01/2019 SH 78001|87536|87536 - IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION||84.74|0||0|10/01/2019 SH 78001|87535|87535 - IADNA HIV-1 AMPLIFIED PROBE & REVERSE TRANSCRPJ||32.04|0||0|10/01/2019 SH 78001|87534|87534 - IADNA HIV-1 DIRECT PROBE TECHNIQUE||32.21|0||0|10/01/2019 SH 78001|87533|87533 - IADNA HERPES VIRUS-6 QUANTIFICATION||68.18|0||0|10/01/2019 SH 78001|87532|87532 - IADNA HERPES VIRUS-6 AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87531|87531 - IADNA HERPES VIRUS-6 DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87530|87530 - IADNA HERPES SOMPLX VIRUS QUANTIFICATION||69.95|0||0|10/01/2019 SH 78001|87529|87529 - IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87528|87528 - IADNA HERPES SIMPLX VIRUS DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87527|87527 - IADNA HEPATITIS G QUANTIFICATION||68.18|0||0|10/01/2019 SH 78001|87526|87526 - IADNA HEPATITIS G AMPLIFIED PROBE TECHNIQUE||32.04|0||0|10/01/2019 SH 78001|87525|87525 - IADNA HEPATITIS G DIRECT PROBE TECHNIQUE||32.21|0||0|10/01/2019 SH 78001|87522|87522 - IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION||69.95|0||0|10/01/2019 SH 78001|87521|87521 - IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR||32.04|0||0|10/01/2019 SH 78001|87520|87520 - IADNA HEPATITIS C DIRECT PROBE TECHNIQUE||32.21|0||0|10/01/2019 SH 78001|87517|87517 - IADNA HEPATITIS B VIRUS QUANTIFICATION||69.95|0||0|10/01/2019 SH 78001|87516|87516 - IADNA HEPATITIS B VIRUS AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87515|87515 - IADNA HEPATITIS B VIRUS DIRECT PROBE TECHNIQUE||32.21|0||0|10/01/2019 SH 78001|87512|87512 - IADNA GARDNERELLA VAGINALIS QUANTIFICATION||68.18|0||0|10/01/2019 SH 78001|87511|87511 - IADNA GARDNERELLA VAGINALIS AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87510|87510 - IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87507|87507 - IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-25||287.95|0||0|10/01/2019 SH 78001|87506|87506 - IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 6-11||160.94|0||0|10/01/2019 SH 78001|87505|87505 - NFCT AGENT DNA/RNA GASTROINTESTINAL PATHOGEN||110.15|0||0|10/01/2019 SH 78001|87503|87503 - NFCT AGENT DNA/RNA INFLUENZA >2 TYPES EA ADDL||12.7|0||0|10/01/2019 SH 78001|87502|87502 - INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES||84.74|0||0|10/01/2019 SH 78001|87501|87501 - INFECTIOUS AGENT DNA/RNA INFLUENZA EA TYPE||52.73|0||0|10/01/2019 SH 78001|87500|87500 - INFECTIOUS AGENT DNA/RNA VANCOMYCIN RESISTANCE||32.04|0||0|10/01/2019 SH 78001|87498|87498 - IADNA ENTEROVIRUS AMPLIF PROBE & REVRSE TRNSCRIP||32.04|0||0|10/01/2019 SH 78001|87497|87497 - IADNA CYTOMEGALOVIRUS QUANTIFICATION||69.95|0||0|10/01/2019 SH 78001|87496|87496 - IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87495|87495 - IADNA CYTOMEGALOVIRUS DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87493|87493 - INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE||32.04|0||0|10/01/2019 SH 78001|87492|87492 - IADNA CHLAMYDIA TRACHOMATIS QUANTIFICATION||57.08|0||0|10/01/2019 SH 78001|87491|87491 - IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87490|87490 - IADNA CHLAMYDIA TRACHOMATIS DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87487|87487 - IADNA CHLAMYDIA PNEUMONIAE QUANTIFICATION||69.95|0||0|10/01/2019 SH 78001|87486|87486 - IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87485|87485 - IADNA CHLAMYDIA PNEUMONIAE DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87483|87483 - CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25||290.26|0||0|10/01/2019 SH 78001|87482|87482 - IADNA CANDIDA SPECIES QUANTIFICATION||68.18|0||0|10/01/2019 SH 78001|87481|87481 - IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87480|87480 - IADNA CANDIDA SPECIES DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87477|87477 - IADNA BORRELIA BURGDORFERI QUANTIFICATION||69.95|0||0|10/01/2019 SH 78001|87476|87476 - IADNA BORRELIA BURGDORFERI AMPLIFIED PROBE TQ||32.04|0||0|10/01/2019 SH 78001|87475|87475 - IADNA BORRELIA BURGDORFERI DIRECT PROBE TQ||32.21|0||0|10/01/2019 SH 78001|87472|87472 - IADNA BARTONELLA HENSELAE&QUINTANA QUANTJ||69.95|0||0|10/01/2019 SH 78001|87471|87471 - IADNA BARTONELLA AMPLIFIED PROBE TECHNIQUE||32.04|0||0|10/01/2019 SH 78001|87470|87470 - IADNA BARTONELLA DIRECT PROBE TECHNIQUE||32.21|0||0|10/01/2019 SH 78001|87451|87451 - IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM||15.66|0||0|10/01/2019 SH 78001|87450|87450 - IAAD IA SINGLE STEP METHOD NOS EA ORGANISM||15.66|0||0|10/01/2019 SH 78001|87449|87449 - IAAD IA MULT STEP METHOD NOS EACH ORGANISM||19.58|0||0|10/01/2019 SH 78001|87430|87430 - IAAD IA STREPTOCOCCUS GROUP A||19.58|0||0|10/01/2019 SH 78001|87427|87427 - IAAD IA SHIGA-LIKE TOXIN||19.58|0||0|10/01/2019 SH 78001|87425|87425 - IAAD IA ROTAVIRUS||19.58|0||0|10/01/2019 SH 78001|87420|87420 - IAAD IA RESPIRATORY SYNCTIAL VIRUS||19.58|0||0|10/01/2019 SH 78001|87400|87400 - IAAD IA INFLUENZA A/B EACH||19.58|0||0|10/01/2019 SH 78001|87391|87391 - IAAD IA HIV-2||28.81|0||0|10/01/2019 SH 78001|87390|87390 - IAAD IA HIV-1||28.81|0||0|10/01/2019 SH 78001|87389|87389 - IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE||39.32|0||0|10/01/2019 SH 78001|87385|87385 - IAAD IA HISTOPLASM CAPSULATUM||19.58|0||0|10/01/2019 SH 78001|87380|87380 - IAAD IA HEPATITIS DELTA ANTIGEN||26.8|0||0|10/01/2019 SH 78001|87350|87350 - IAAD IA HEPATITIS BE ANTIGEN||18.83|0||0|10/01/2019 SH 78001|87341|87341 - IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION||16.87|0||0|10/01/2019 SH 78001|87340|87340 - IAAD IA HEPATITIS B SURFACE ANTIGEN||16.87|0||0|10/01/2019 SH 78001|87339|87339 - IAAD IA HPYLORI||19.58|0||0|10/01/2019 SH 78001|87338|87338 - IAAD IA HPYLORI STOOL||23.48|0||0|10/01/2019 SH 78001|87337|87337 - IAAD IA ENTAMOEBA HISTOLYTICA GRP||19.58|0||0|10/01/2019 SH 78001|87336|87336 - IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP||19.58|0||0|10/01/2019 SH 78001|87335|87335 - IAAD IA ESCHERICHIA COLI 0157||19.58|0||0|10/01/2019 SH 78001|87332|87332 - IAAD IA CYTOMEGALOVIRUS||19.58|0||0|10/01/2019 SH 78001|87329|87329 - IAAD IA GIARDIA||19.58|0||0|10/01/2019 SH 78001|87328|87328 - IAAD IA CRYPTOSPORIDIUM||19.58|0||0|10/01/2019 SH 78001|87327|87327 - IAAD IA CRYPTOCOCCUS NEOFORMANS||19.58|0||0|10/01/2019 SH 78001|87324|87324 - IAAD IA CLOSTRIDIUM DIFFICILE TOXIN||19.58|0||0|10/01/2019 SH 78001|87320|87320 - IAAD IA CHLAMYDIA TRACHOMATIS||19.58|0||0|10/01/2019 SH 78001|87305|87305 - IAAD IA QUAL/SEMIQUAN MULTIPLE STEP ASPERGILLUS||19.58|0||0|10/01/2019 SH 78001|87301|87301 - IAAD IA ADENOVIRUS ENTERIC TYP 40/41||19.58|0||0|10/01/2019 SH 78001|87300|87300 - IAADI POLYV MLT ORGANISMS EA POLYV ANTISERUM||19.58|0||0|10/01/2019 SH 78001|87299|87299 - IAADI NOT OTHERWISE SPECIFIED EACH ORGANISM||19.58|0||0|10/01/2019 SH 78001|87290|87290 - IAADI VARICELLA ZOSTER VIRUS||19.58|0||0|10/01/2019 SH 78001|87285|87285 - IAADI TREPONEMA PALLIDUM||19.58|0||0|10/01/2019 SH 78001|87283|87283 - IAADI RUBEOLA||19.58|0||0|10/01/2019 SH 78001|87281|87281 - IAADI PNEUMOCUSTIS CARINII||19.58|0||0|10/01/2019 SH 78001|87280|87280 - IAADI RESPIRATORY SYNCTIAL VIRUS||19.58|0||0|10/01/2019 SH 78001|87279|87279 - IAADI PARAINFLUENZA VIRUS EACH TYPE||19.58|0||0|10/01/2019 SH 78001|87278|87278 - IAADI LEGIONELLA PNEUMOPHILA||19.58|0||0|10/01/2019 SH 78001|87277|87277 - IAADI LEGIONELLA MICDADEI||19.58|0||0|10/01/2019 SH 78001|87276|87276 - IAADI INFFLUENZA A VIRUS||19.58|0||0|10/01/2019 SH 78001|87275|87275 - IAADI INFLUENZA B VIRUS||19.58|0||0|10/01/2019 SH 78001|87274|87274 - IAADI HERPES SMPLX VIRUS TYPE 1||19.58|0||0|10/01/2019 SH 78001|87273|87273 - IAADI HERPES SMPLX VIRUS TYPE 2||19.58|0||0|10/01/2019 SH 78001|87272|87272 - IAADI CRYPTOSPORIDIUM||19.58|0||0|10/01/2019 SH 78001|87271|87271 - IAADI CYTOMEGALOVIRUS DIR FLUORESCENT ANTIBODY||19.58|0||0|10/01/2019 SH 78001|87270|87270 - IAADI CHLAMYDIA TRACHOMATIS||19.58|0||0|10/01/2019 SH 78001|87269|87269 - IAADI GIARDIA||19.58|0||0|10/01/2019 SH 78001|87267|87267 - IAADI ENTEROVIRUS DIRECT FLUORESCENT ANTIBODY||19.58|0||0|10/01/2019 SH 78001|87265|87265 - IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS||19.58|0||0|10/01/2019 SH 78001|87260|87260 - IAADI ADENOVIRUS||19.58|0||0|10/01/2019 SH 78001|87255|87255 - VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC||49.42|0||0|10/01/2019 SH 78001|87254|87254 - VIRUS CENTRIFUGE ENHNCD ID IMFLUOR STAIN EA||31.94|0||0|10/01/2019 SH 78001|87253|87253 - VIRUS TISSUE CULTURE ADDL STDY/ID EACH ISOLATE||26.59|0||0|10/01/2019 SH 78001|87252|87252 - VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT||36.11|0||0|10/01/2019 SH 78001|87250|87250 - VIRUS INOCULATION EGGS/SM ANIMAL OBS&DSJ||31.94|0||0|10/01/2019 SH 78001|87230|87230 - TOXIN/ANTITOXIN ASSAY TISSUE CULTURE||32.24|0||0|10/01/2019 SH 78001|87220|87220 - TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT||6.97|0||0|10/01/2019 SH 78001|87210|87210 - SMR PRIM SRC WET MOUNT NFCT AGT||6.97|0||0|10/01/2019 SH 78001|87209|87209 - SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS||29.35|0||0|10/01/2019 SH 78001|87207|87207 - SMR PRIM SRC SPEC STAIN BODIES/PARASITS||9.78|22.16||0|10/01/2019 SH 78001|87206|87206 - SMR PRIM SRC FLUORESCENT&/AFS BCT FNGI PARASIT||8.8|0||0|10/01/2019 SH 78001|87205|87205 - SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL||3.83|0||0|10/01/2019 SH 78001|87197|87197 - SERUM BACTERICIDAL TITER||24.54|0||0|10/01/2019 SH 78001|87190|87190 - SUSCEPTIBLTY STDY ANTMCRB MYCOBACT PROPORJ MTHD||9.23|0||0|10/01/2019 SH 78001|87188|87188 - SC STD ANTMCRB AGT MACROBROTH DIL METH EA AGT||10.85|0||0|10/01/2019 SH 78001|87187|87187 - SUSCEPTIBLTY STDY ANTMCRB MICRO/AGAR DILUTJ EA||16.92|0||0|10/01/2019 SH 78001|87186|87186 - SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ||14.12|0||0|10/01/2019 SH 78001|87185|87185 - SUSCEPTIBILITY STUDY ANTIMICROBIAL ENZYME DETCJ||7.75|0||0|10/01/2019 SH 78001|87184|87184 - SUSCEPTIBILITY STUDY ANTIMICROBIAL DISK METHOD||11.27|0||0|10/01/2019 SH 78001|87181|87181 - SUSCEPTBILTY STDY ANTIMICRBIAL AGNT AGAR DILUTJ||7.75|0||0|10/01/2019 SH 78001|87177|87177 - OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID||14.53|0||0|10/01/2019 SH 78001|87176|87176 - HOMOGENIZATION TISSUE CULTURE||9.61|0||0|10/01/2019 SH 78001|87172|87172 - PINWORM EXAMINATION||6.97|0||0|10/01/2019 SH 78001|87169|87169 - MACROSCOPIC EXAMINATION PARASITE||6.97|0||0|10/01/2019 SH 78001|87168|87168 - MACROSCOPIC EXAMINATION ARTHROPOD||6.97|0||0|10/01/2019 SH 78001|87166|87166 - DARK FIELD EXAM ANY SOURCE W/O SPECIMEN COLLECT||18.44|0||0|10/01/2019 SH 78001|87164|87164 - DARK FIELD EXAM ANY SOURCE W/SPECIMEN COLLECTION||14.28|22.16||0|10/01/2019 SH 78001|87158|87158 - CULTURE TYPING OTHER METHODS||8.54|0||0|10/01/2019 SH 78001|87153|87153 - CULTYP NUCLEIC ACID SEQUENCING METH EA ISOLATE||115.69|0||0|10/01/2019 SH 78001|87152|87152 - CULTURE TYPING IDENTIFJ PULSE FIELD GEL TYPING||8.54|0||0|10/01/2019 SH 78001|87150|87150 - CULTYP NUC ACID AMP PRB CULT/ISOLATE EA ORGNISM||32.04|0||0|10/01/2019 SH 78001|87149|87149 - CULTURE TYPING NUCLEIC ACID PROBE DIR EA ORGANSM||32.21|0||0|10/01/2019 SH 78001|87147|87147 - CULTURE TYPING IMMUNOLOGIC OTH/THN IMMUNOFLUORES||7.27|0||0|10/01/2019 SH 78001|87143|87143 - CULTURE TYPING GAS/HIGH PRES LIQ CHROMATOGRAPHY||20.46|0||0|10/01/2019 SH 78001|87140|87140 - CULTURE TYPING IMMUNOFLUORESCENT EACH ANTISERUM||9.11|0||0|10/01/2019 SH 78001|87118|87118 - CULTURE MYCOBACTERIAL DEFINITIVE ID EA ISOL||17.88|0||0|10/01/2019 SH 78001|87116|87116 - CULTURE TUBERCLE/OTH ACID-FAST BACILLI ANY ISOL||11.88|0||0|10/01/2019 SH 78001|87110|87110 - CULTURE CHLAMYDIA ANY SOURCE||31.99|0||0|10/01/2019 SH 78001|87109|87109 - CULTURE MYCOPLASMA ANY SOURCE||25.13|0||0|10/01/2019 SH 78001|87107|87107 - CULTURE FUNGI DEFINITIVE ID EACH ORGANISM MOLD||16.86|0||0|10/01/2019 SH 78001|87106|87106 - CULTURE FUNGI DEFINITIVE ID EACH ORGANISM YEAST||16.86|0||0|10/01/2019 SH 78001|87103|87103 - CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD||14.72|0||0|10/01/2019 SH 78001|87102|87102 - CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD||13.72|0||0|10/01/2019 SH 78001|87101|87101 - CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL||12.59|0||0|10/01/2019 SH 78001|87088|87088 - CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE||13.22|0||0|10/01/2019 SH 78001|87086|87086 - CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE||13.19|0||0|10/01/2019 SH 78001|87084|87084 - CUL PRSMPTV PTHGNC ORGANISMS SCR DNS CHART||14.06|0||0|10/01/2019 SH 78001|87081|87081 - CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ||10.82|0||0|10/01/2019 SH 78001|87077|87077 - CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL||13.2|0||0|10/01/2019 SH 78001|87076|87076 - CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL||13.2|0||0|10/01/2019 SH 78001|87075|87075 - CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID||15.46|0||0|10/01/2019 SH 78001|87073|87073 - CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL||15.42|0||0|10/01/2019 SH 78001|87071|87071 - CUL BACT QUAN AEROBIC ISOL XCPT UR BLOOD/STOOL||15.42|0||0|10/01/2019 SH 78001|87070|87070 - CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL||14.06|0||0|10/01/2019 SH 78001|87046|87046 - CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA||15.42|0||0|10/01/2019 SH 78001|87045|87045 - CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL||15.42|0||0|10/01/2019 SH 78001|87040|87040 - CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES||16.86|0||0|10/01/2019 SH 78001|87015|87015 - CONCENTRATION INFECTIOUS AGENTS||10.91|0||0|10/01/2019 SH 78001|87003|87003 - ANIMAL INOCULATION SMALL ANIMAL W/OBS&DSJ||27.49|0||0|10/01/2019 SH 78001|86941|86941 - HEMOLYSINS&AGGLUTININS INCUBATED||19.78|0||0|10/01/2019 SH 78001|86940|86940 - HEMOLYSINS&AGGLUTININS AUTO SCREEN EACH||13.39|0||0|10/01/2019 SH 78001|86906|86906 - BLOOD TYPING SEROLOGIC RH PHENOTYPING COMPLETE||12.66|0||0|10/01/2019 SH 78001|86905|86905 - BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH||6.24|0||0|10/01/2019 SH 78001|86904|86904 - BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT||15.53|0||0|10/01/2019 SH 78001|86902|86902 - BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH||6.24|0||0|10/01/2019 SH 78001|86901|86901 - BLOOD TYPING SEROLOGIC RH (D)||4.87|0||0|10/01/2019 SH 78001|86900|86900 - BLOOD TYPING SEROLOGIC ABO||4.87|0||0|10/01/2019 SH 78001|86886|86886 - ANTIHUMAN GLOBULIN INDIRECT EACH ANTIBODY TITER||7.58|0||0|10/01/2019 SH 78001|86885|86885 - ANTIHUMAN GLOBULIN INDIR QUAL EA REAGENT CELL||9.35|0||0|10/01/2019 SH 78001|86880|86880 - ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM||8.8|0||0|10/01/2019 SH 78001|86835|86835 - ANTIBODY HLA CLASS II SEMIQUANTITATIVE PANEL||488.66|0||0|10/01/2019 SH 78001|86834|86834 - ANTIBODY HLA CLASS I SEMIQUANTITATIVE PANEL||541.01|0||0|10/01/2019 SH 78001|86833|86833 - ANTIBODY HLA CLASS II HIGH DEFINITION PANEL QUAL||174.53|0||0|10/01/2019 SH 78001|86832|86832 - ANTIBODY HLA CLASS I HIGH DEFINITION PANEL QUAL||191.98|0||0|10/01/2019 SH 78001|86831|86831 - ANTIBODY HLA CLASS II PHENOTYPE PANEL QUAL||104.71|0||0|10/01/2019 SH 78001|86830|86830 - ANTIBODY HLA CLASS I PHENOTYPE PANEL QUALITATIVE||122.16|0||0|10/01/2019 SH 78001|86829|86829 - ANTIBODY HLA CLASS I OR CLASS II ANTIGENS QUAL||48.47|0||0|10/01/2019 SH 78001|86828|86828 - ANTIBODY HLA CLASS I & CLASS II ANTIGENS QUAL||64.63|0||0|10/01/2019 SH 78001|86826|86826 - HLA CROSSMATCH NONCYTOTOXIC ADDL SERUM/DILUTION||42.64|0||0|10/01/2019 SH 78001|86825|86825 - HLA CROSSMATCH NONCYTOTOXIC 1ST SERUM/DILUTION||127.9|0||0|10/01/2019 SH 78001|86822|86822 - HLA TYPING LYMPHOCYTE CULTURE PRIMED||59.7|0||0|10/01/2019 SH 78001|86821|86821 - HLA TYPING LYMPHOCYTE CULTURE MIXED||92.2|0||0|10/01/2019 SH 78001|86817|86817 - HLA TYPING DR/DQ MULTIPLE ANTIGENS||105.14|0||0|10/01/2019 SH 78001|86816|86816 - HLA TYPING DR/DQ SINGLE ANTIGEN||45.49|0||0|10/01/2019 SH 78001|86813|86813 - HLA TYPING A/B/C MULTIPLE ANTIGENS||94.7|0||0|10/01/2019 SH 78001|86812|86812 - HLA TYPING A/B/C SINGLE ANTIGEN||42.14|0||0|10/01/2019 SH 78001|86808|86808 - SERUM SCREENING % REACTIVE ANTIBODY QUICK METH||48.47|0||0|10/01/2019 SH 78001|86807|86807 - SERUM SCREENING % REACTIVE ANTIBODY STANDRD METH||64.63|0||0|10/01/2019 SH 78001|86806|86806 - LMPHOCYTOTOXICITY ASSAY VIS CROSSMTCH W/O TITRAT||77.71|0||0|10/01/2019 SH 78001|86805|86805 - LYMPHOCYTOTOXICITY ASSAY VIS CROSSMATCH TITRATJ||85.39|0||0|10/01/2019 SH 78001|86804|86804 - HEPATITIS C ANTIBODY CONFIRMATORY TEST||25.3|0||0|10/01/2019 SH 78001|86803|86803 - HEPATITIS C ANTIBODY||23.3|0||0|10/01/2019 SH 78001|86800|86800 - THYROGLOBULIN ANTIBODY||25.98|0||0|10/01/2019 SH 78001|86794|86794 - ZIKA VIRUS IGM ANTIBODY||24.96|0||0|10/01/2019 SH 78001|86793|86793 - ANTIBODY YERSINIA||21.54|0||0|10/01/2019 SH 78001|86790|86790 - ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED||21.04|0||0|10/01/2019 SH 78001|86789|86789 - ANTIBODY WEST NILE VIRUS||19.01|0||0|10/01/2019 SH 78001|86788|86788 - ANTIBODY WEST NILE VIRUS IGM||27.52|0||0|10/01/2019 SH 78001|86787|86787 - ANTIBODY VARICELLA-ZOSTER||21.04|0||0|10/01/2019 SH 78001|86784|86784 - ANTIBODY TRICHINELLA||20.51|0||0|10/01/2019 SH 78001|86780|86780 - ANTIBODY TREPONEMA PALLIDUM||21.62|0||0|10/01/2019 SH 78001|86778|86778 - ANTIBODY TOXOPLASMA IGM||23.52|0||0|10/01/2019 SH 78001|86777|86777 - ANTIBODY TOXOPLASMA||19.01|0||0|10/01/2019 SH 78001|86774|86774 - ANTIBODY TETANUS||24.17|0||0|10/01/2019 SH 78001|86771|86771 - ANTIBODY SHIGELLA||21.54|0||0|10/01/2019 SH 78001|86768|86768 - ANTIBODY SALMONELLA||21.54|0||0|10/01/2019 SH 78001|86765|86765 - ANTIBODY RUBEOLA||21.04|0||0|10/01/2019 SH 78001|86762|86762 - ANTIBODY RUBELLA||19.01|0||0|10/01/2019 SH 78001|86759|86759 - ANTIBODY ROTAVIRUS||21.54|0||0|10/01/2019 SH 78001|86757|86757 - ANTIBODY RICKETTSIA||31.61|0||0|10/01/2019 SH 78001|86756|86756 - ANTIBODY RESPIRATORY SYNCTIAL VIRUS||21.05|0||0|10/01/2019 SH 78001|86753|86753 - ANTIBODY PROTOZOA NES||20.23|0||0|10/01/2019 SH 78001|86750|86750 - ANTIBODY PLASMODIUM MALARIA||21.54|0||0|10/01/2019 SH 78001|86747|86747 - ANTIBODY PARVOVIRUS||24.55|0||0|10/01/2019 SH 78001|86744|86744 - ANTIBODY NOCARDIA||21.54|0||0|10/01/2019 SH 78001|86741|86741 - ANTIBODY NEISSERIA MENINGITIDIS||21.54|0||0|10/01/2019 SH 78001|86738|86738 - ANTIBODY MYCOPLSM||21.62|0||0|10/01/2019 SH 78001|86735|86735 - ANTIBODY MUMPS||21.31|0||0|10/01/2019 SH 78001|86732|86732 - ANTIBODY MUCORMYCOSIS||21.54|0||0|10/01/2019 SH 78001|86729|86729 - ANTIBODY LYMPHOGRANULOMA VENEREUM||19.51|0||0|10/01/2019 SH 78001|86727|86727 - ANTIBODY LYMPHOCYTIC CHORIOMENINGITIS||21.01|0||0|10/01/2019 SH 78001|86723|86723 - ANTIBODY LISTERIA MONOCYTOGENES||21.54|0||0|10/01/2019 SH 78001|86720|86720 - ANTIBODY LEPTOSPIRA||21.54|0||0|10/01/2019 SH 78001|86717|86717 - ANTIBODY LEISHMANIA||20|0||0|10/01/2019 SH 78001|86713|86713 - ANTIBODY LEGIONELLA||24.98|0||0|10/01/2019 SH 78001|86711|86711 - ANTIBODY JOHN CUNNINGHAM VIRUS||19.01|0||0|10/01/2019 SH 78001|86710|86710 - ANTIBODY INFLUENZA VIRUS||22.13|0||0|10/01/2019 SH 78001|86709|86709 - HEPATITIS ANTIBODY HAAB IGM ANTIBODY||18.38|0||0|10/01/2019 SH 78001|86708|86708 - HEPATITIS A ANTIBODY HAAB||20.23|0||0|10/01/2019 SH 78001|86707|86707 - HEPATITIS BE ANTIBODY HBEAB||18.9|0||0|10/01/2019 SH 78001|86706|86706 - HEPATITIS B SURF ANTIBODY HBSAB||17.54|0||0|10/01/2019 SH 78001|86705|86705 - HEPATITIS B CORE ANTIBODY HBCAB IGM ANTIBODY||19.24|0||0|10/01/2019 SH 78001|86704|86704 - HEPATITIS B CORE ANTIBODY HBCAB TOTAL||19.68|0||0|10/01/2019 SH 78001|86703|86703 - ANTIBODY HIV-1&HIV-2 SINGLE RESULT||22.39|0||0|10/01/2019 SH 78001|86702|86702 - ANTIBODY HIV-2||22.07|0||0|10/01/2019 SH 78001|86701|86701 - ANTIBODY HIV-1||14.51|0||0|10/01/2019 SH 78001|86698|86698 - ANTIBODY HISTOPLASMA||20.41|0||0|10/01/2019 SH 78001|86696|86696 - ANTIBODY HERPES SMPLX TYPE 2||31.61|0||0|10/01/2019 SH 78001|86695|86695 - ANTIBODY HERPES SMPLX TYPE 1||21.54|0||0|10/01/2019 SH 78001|86694|86694 - ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST||19.01|0||0|10/01/2019 SH 78001|86692|86692 - ANTIBODY HEP DELTA AGENT||28.02|0||0|10/01/2019 SH 78001|86689|86689 - ANTIBODY HTLV/HIV ANTIBODY CONFIRMATORY TEST||31.61|0||0|10/01/2019 SH 78001|86688|86688 - ANTIBODY HTLV-II||22.87|0||0|10/01/2019 SH 78001|86687|86687 - ANTIBODY HTLV-I||13.7|0||0|10/01/2019 SH 78001|86684|86684 - ANTIBODY HAEMOPHILUS INFLUENZA||25.87|0||0|10/01/2019 SH 78001|86682|86682 - ANTIBODY HELMINTH NOT ELSEWHERE SPECIFIED||21.24|0||0|10/01/2019 SH 78001|86677|86677 - ANTIBODY HELICOBACTER PYLORI||23.69|0||0|10/01/2019 SH 78001|86674|86674 - ANTIBODY GIARDIA LAMBLIA||24.04|0||0|10/01/2019 SH 78001|86671|86671 - ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED||20.02|0||0|10/01/2019 SH 78001|86668|86668 - ANTIBODY FRANCISELLA TULARENSIS||16.99|0||0|10/01/2019 SH 78001|86666|86666 - ANTIBODY EHRLICHIA||16.62|0||0|10/01/2019 SH 78001|86665|86665 - ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA||29.63|0||0|10/01/2019 SH 78001|86664|86664 - ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA||24.98|0||0|10/01/2019 SH 78001|86663|86663 - ANTIBODY EPSTEIN-BARR EB VIRUS EARLY ANTIGEN EA||21.43|0||0|10/01/2019 SH 78001|86658|86658 - ANTIBODY ENTEROVIRUS||21.28|0||0|10/01/2019 SH 78001|86654|86654 - ANTIBODY ENCEPHALITIS WESTRN EQUINE||21.54|0||0|10/01/2019 SH 78001|86653|86653 - ANTIBODY ENCEPHALITIS ST. LOUIS||21.54|0||0|10/01/2019 SH 78001|86652|86652 - ANTIBODY ENCEPHALITIS EASTERN EQUINE||21.54|0||0|10/01/2019 SH 78001|86651|86651 - ANTIBODY ENCEPHALITIS CALIFORNIA LA CROSSE||21.54|0||0|10/01/2019 SH 78001|86648|86648 - ANTIBODY DIPHTHERIA||24.83|0||0|10/01/2019 SH 78001|86645|86645 - ANTIBODY CYTOMEGALOVIRUS CMV IGM||27.52|0||0|10/01/2019 SH 78001|86644|86644 - ANTIBODY CYTOMEGALOVIRUS CMV||19.01|0||0|10/01/2019 SH 78001|86641|86641 - ANTIBODY CRYPTOCOCCUS||23.53|0||0|10/01/2019 SH 78001|86638|86638 - ANTIBODY COXIELLA BURNETII Q FEVER||19.8|0||0|10/01/2019 SH 78001|86635|86635 - ANTIBODY COCCIDIOIDES||18.73|0||0|10/01/2019 SH 78001|86632|86632 - ANTIBODY CHLAMYDIA IGM||20.72|0||0|10/01/2019 SH 78001|86631|86631 - ANTIBODY CHLAMYDIA||19.31|0||0|10/01/2019 SH 78001|86628|86628 - ANTIBODY CANDIDA||19.61|0||0|10/01/2019 SH 78001|86625|86625 - ANTIBODY CAMPYLOBACTER||21.43|0||0|10/01/2019 SH 78001|86622|86622 - ANTIBODY BRUCELLA||14.59|0||0|10/01/2019 SH 78001|86619|86619 - ANTIBODY BORRELIA RELAPSING FEVER||21.85|0||0|10/01/2019 SH 78001|86618|86618 - ANTIBODY BORRELIA BURGDORFERI LYME DISEASE||27.82|0||0|10/01/2019 SH 78001|86617|86617 - ANTIBODY BORRELIA BURGDORFERI CONFIRMATORY TST||25.3|0||0|10/01/2019 SH 78001|86615|86615 - ANTIBODY BORDETELLA||21.54|0||0|10/01/2019 SH 78001|86612|86612 - ANTIBODY BLASTOMYCES||21.07|0||0|10/01/2019 SH 78001|86611|86611 - ANTIBODY BARTONELLA||16.62|0||0|10/01/2019 SH 78001|86609|86609 - ANTIBODY BACTERIUM NOT ELSEWHERE SPECIFIED||21.04|0||0|10/01/2019 SH 78001|86606|86606 - ANTIBODY ASPERGILLUS||24.59|0||0|10/01/2019 SH 78001|86603|86603 - ANTIBODY ADENOVIRUS||21.01|0||0|10/01/2019 SH 78001|86602|86602 - ANTIBODY ACTINOMYCES||16.62|0||0|10/01/2019 SH 78001|86593|86593 - SYPHILIS TEST QUANTITATIVE||7.19|0||0|10/01/2019 SH 78001|86592|86592 - SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL||6.97|0||0|10/01/2019 SH 78001|86590|86590 - STREPTOKINASE ANTIBODY||18.04|0||0|10/01/2019 SH 78001|86580|86580 - SKIN TEST TUBERCULOSIS INTRADERMAL||8.53|0||0|10/01/2019 SH 78001|86510|86510 - SKIN TEST HISTOPLASMOSIS||6.59|0||0|10/01/2019 SH 78001|86490|86490 - SKIN TEST COCCIDIOIDOMYCOSIS||7.37|0||0|10/01/2019 SH 78001|86486|86486 - SKIN TEST UNLISTED ANTIGEN EACH||5.43|0||0|10/01/2019 SH 78001|86481|86481 - TB ANTIGEN RESPONSE GAMMA INTERFERON T-CELL SUSP||122.35|0||0|10/01/2019 SH 78001|86480|86480 - TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON||101.22|0||0|10/01/2019 SH 78001|86431|86431 - RHEUMATOID FACTOR QUANTITATIVE||9.26|0||0|10/01/2019 SH 78001|86430|86430 - RHEUMATOID FACTOR QUALITATIVE||9.26|0||0|10/01/2019 SH 78001|86406|86406 - PARTICLE AGGLUTINATION TITER EACH ANTIBODY||17.36|0||0|10/01/2019 SH 78001|86403|86403 - PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY||16.64|0||0|10/01/2019 SH 78001|86386|86386 - NUCLEAR MATRIX PROTEIN 22 NMP22 QUALITATIVE||26.08|0||0|10/01/2019 SH 78001|86384|86384 - NITROBLUE TETRAZOLIUM DYE TEST NTD||18.6|0||0|10/01/2019 SH 78001|86382|86382 - NEUTRALIZATION TEST VIRAL||27.61|0||0|10/01/2019 SH 78001|86378|86378 - MIGRATION INHIBITORY FACTOR TEST MIF||32.16|0||0|10/01/2019 SH 78001|86376|86376 - MICROSOMAL ANTIBODIES EACH||23.76|0||0|10/01/2019 SH 78001|86367|86367 - STEM CELLS TOTAL COUNT||38.48|0||0|10/01/2019 SH 78001|86361|86361 - T CELLS ABSOLUTE CD4 COUNT||42.64|0||0|10/01/2019 SH 78001|86360|86360 - T CELLS ABSOLUTE CD4&CD8 COUNT RATIO||76.73|0||0|10/01/2019 SH 78001|86359|86359 - T CELLS TOTAL COUNT||38.48|0||0|10/01/2019 SH 78001|86357|86357 - NATURAL KILLER CELLS TOTAL COUNT||38.48|0||0|10/01/2019 SH 78001|86356|86356 - MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA||42.64|0||0|10/01/2019 SH 78001|86355|86355 - B CELLS TOTAL COUNT||38.48|0||0|10/01/2019 SH 78001|86353|86353 - LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS||80.06|0||0|10/01/2019 SH 78001|86352|86352 - CELLULAR FUNCTION ASSAY STIMUL&DETECT BIOMARKE||221.87|0||0|10/01/2019 SH 78001|86344|86344 - LEUKOCYTE PHAGOCYTOSIS||13.04|0||0|10/01/2019 SH 78001|86343|86343 - LEUKOCYTE HISTAMINE RELEASE TEST LHR||20.35|0||0|10/01/2019 SH 78001|86341|86341 - ISLET CELL ANTIBODY||32.3|0||0|10/01/2019 SH 78001|86340|86340 - INTRINSIC FACTOR ANTIBODIES||24.61|0||0|10/01/2019 SH 78001|86337|86337 - INSULIN ANTIBODIES||34.96|0||0|10/01/2019 SH 78001|86336|86336 - INHIBIN A||21.16|0||0|10/01/2019 SH 78001|86335|86335 - IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS||47.93|22.16||0|10/01/2019 SH 78001|86334|86334 - IMMUNOFIXJ ELECTROPHORESIS SERUM||36.49|22.16||0|10/01/2019 SH 78001|86332|86332 - IMMUNE COMPLEX ASSAY||39.8|0||0|10/01/2019 SH 78001|86331|86331 - IMMUNODIFFUSION GEL DIFFUSION QUAL EA AG/ANTBDY||19.56|0||0|10/01/2019 SH 78001|86329|86329 - IMMUNODIFFUSION NOT ELSEWHERE SPECIFIED||22.93|0||0|10/01/2019 SH 78001|86327|86327 - IMMUNOELECTROPHORESIS CROSSED||37.06|25.48||0|10/01/2019 SH 78001|86325|86325 - IMMUNOELECTROPHORESIS OTHER FLUIDS CONCENTRATION||36.53|22.16||0|10/01/2019 SH 78001|86320|86320 - IMMUNOELECTROPHORESIS SERUM||36.6|22.16||0|10/01/2019 SH 78001|86318|86318 - IMMUNOASSAY NFCT AGT ANTB QUAL/SEMIQUAN 1 STEP||21.14|0||0|10/01/2019 SH 78001|86317|86317 - IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUAN NOS||19.61|0||0|10/01/2019 SH 78001|86316|86316 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE||33.98|0||0|10/01/2019 SH 78001|86310|86310 - HETEROPHILE ANTIBODIES TITER AFTER ABSORPTION||12.01|0||0|10/01/2019 SH 78001|86309|86309 - HETEROPHILE ANTIBODIES TITER||10.57|0||0|10/01/2019 SH 78001|86308|86308 - HETEROPHILE ANTIBODIES SCREEN||8.45|0||0|10/01/2019 SH 78001|86305|86305 - HUMAN EPIDIDYMIS PROTEIN 4 (HE4)||33.98|0||0|10/01/2019 SH 78001|86304|86304 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125||33.98|0||0|10/01/2019 SH 78001|86301|86301 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9||33.98|0||0|10/01/2019 SH 78001|86300|86300 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3||33.98|0||0|10/01/2019 SH 78001|86294|86294 - IMMUNOASSAY TUMOR ANTIGEN QUAL/SEMIQUANTITATIVE||18.92|0||0|10/01/2019 SH 78001|86280|86280 - HEMAGGLUTINATION INHIBITION TEST HAI||13.37|0||0|10/01/2019 SH 78001|86277|86277 - GROWTH HORMONE HUMAN ANTIBODY||25.7|0||0|10/01/2019 SH 78001|86256|86256 - FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY||19.68|22.16||0|10/01/2019 SH 78001|86255|86255 - FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY||19.68|22.16||0|10/01/2019 SH 78001|86243|86243 - FC RECEPTOR||33.5|0||0|10/01/2019 SH 78001|86235|86235 - EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD||29.29|0||0|10/01/2019 SH 78001|86226|86226 - DNA ANTIBODY SINGLE STRANDED||19.78|0||0|10/01/2019 SH 78001|86225|86225 - DNA ANTIBODY NATIVE/DOUBLE STRANDED||22.43|0||0|10/01/2019 SH 78001|86215|86215 - DEOXYRIBONUCLEASE ANTIBODY||21.64|0||0|10/01/2019 SH 78001|86200|86200 - CYCLIC CITRULLINATED PEPTIDE ANTIBODY||21.14|0||0|10/01/2019 SH 78001|86185|86185 - CNTERIMMUNOELECTROPHORESIS EACH ANTIGEN||14.6|0||0|10/01/2019 SH 78001|86171|86171 - COMPLEMENT FIXATION TESTS EACH ANTIGEN||11.42|0||0|10/01/2019 SH 78001|86162|86162 - COMPLEMENT TOTAL HEMOLYTIC||33.18|0||0|10/01/2019 SH 78001|86161|86161 - COMPLEMENT FUNCTIONAL ACTIVITY EACH COMPONENT||19.6|0||0|10/01/2019 SH 78001|86160|86160 - COMPLEMENT ANTIGEN EACH COMPONENT||19.6|0||0|10/01/2019 SH 78001|86157|86157 - COLD AGGLUTININ TITER||13.16|0||0|10/01/2019 SH 78001|86156|86156 - COLD AGGLUTININ SCREEN||10.94|0||0|10/01/2019 SH 78001|86155|86155 - CHEMOTAXIS ASSAY SPECIFY METHOD||26.11|0||0|10/01/2019 SH 78001|86153|86153 - CELL ENUMERATION IMMUNE SELECTJ & ID PHYS INTERP||0|41.39||0|10/01/2019 SH 78001|86152|86152 - CELL ENUMERATION IMMUNE SELECTJ & ID FLUID SPEC||401.24|0||0|10/01/2019 SH 78001|86148|86148 - ANTI-PHOSPHATIDYLSERINE ANTIBODY||26.24|0||0|10/01/2019 SH 78001|86147|86147 - CARDIOLIPIN ANTIBODY EACH IG CLASS||41.54|0||0|10/01/2019 SH 78001|86146|86146 - BETA 2 GLYCOPROTEIN I ANTIBODY EACH||41.54|0||0|10/01/2019 SH 78001|86141|86141 - C-REACTIVE PROTEIN HIGH SENSITIVITY||21.14|0||0|10/01/2019 SH 78001|86140|86140 - C-REACTIVE PROTEIN||8.45|0||0|10/01/2019 SH 78001|86079|86079 - BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT||59.93|0||0|10/01/2019 SH 78001|86078|86078 - BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT||60.7|0||0|10/01/2019 SH 78001|86077|86077 - BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP||61.09|0||0|10/01/2019 SH 78001|86063|86063 - ANTISTREPTOLYSIN O SCREEN||9.42|0||0|10/01/2019 SH 78001|86060|86060 - ANTISTREPTOLYSIN O TITER||11.42|0||0|10/01/2019 SH 78001|86039|86039 - ANTINUCLEAR ANTIBODIES ANA TITER||18.23|0||0|10/01/2019 SH 78001|86038|86038 - ANTINUCLEAR ANTIBODIES ANA||19.74|0||0|10/01/2019 SH 78001|86023|86023 - ANTIBODY IDENTIFICATION PLATELET IMMUNOGL ASSAY||20.34|0||0|10/01/2019 SH 78001|86022|86022 - ANTIBODY IDENTIFICATION PLATELET ANTIBODIES||30|0||0|10/01/2019 SH 78001|86021|86021 - ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES||24.59|0||0|10/01/2019 SH 78001|86008|86008 - ALLERGEN SPEC IGE RECOMBINANT/PURIFIED COMPNT EA||26.57|0||0|10/01/2019 SH 78001|86005|86005 - ALLERGEN SPEC IGE QUAL MULTIALLERGEN SCREEN||8.99|0||0|10/01/2019 SH 78001|86003|86003 - ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH||8.52|0||0|10/01/2019 SH 78001|86001|86001 - ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA ALLERGEN||8.52|0||0|10/01/2019 SH 78001|86000|86000 - AGGLUTININS FEBRILE EACH ANTIGEN||11.4|0||0|10/01/2019 SH 78001|85810|85810 - VISCOSITY||19.07|0||0|10/01/2019 SH 78001|85732|85732 - THROMBOPLASTIN TIME PRTL SUBSTIT PLASMA FRCTJ EA||10.57|0||0|10/01/2019 SH 78001|85730|85730 - THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD||9.8|0||0|10/01/2019 SH 78001|85705|85705 - THROMBOPLASTIN INHIBITION TISSUE||15.72|0||0|10/01/2019 SH 78001|85675|85675 - THROMBIN TIME TITER||9.88|0||0|10/01/2019 SH 78001|85670|85670 - THROMBIN TIME PLASMA||9.42|0||0|10/01/2019 SH 78001|85660|85660 - SICKLING RBC REDUCTION||9|0||0|10/01/2019 SH 78001|85652|85652 - SEDIMENTATION RATE RBC AUTOMATED||4.42|0||0|10/01/2019 SH 78001|85651|85651 - SEDIMENTATION RATE RBC NON-AUTOMATED||5.78|0||0|10/01/2019 SH 78001|85635|85635 - REPTILASE TEST||16.07|0||0|10/01/2019 SH 78001|85613|85613 - RUSSELL VIPER VENOM TIME DILUTED||15.64|0||0|10/01/2019 SH 78001|85612|85612 - RUSSELL VIPER VENON TIME UNDILUTED||15.64|0||0|10/01/2019 SH 78001|85611|85611 - PROTHROMBIN TIME SUBSTITUTION PLASMA FRCTJ EACH||6.43|0||0|10/01/2019 SH 78001|85610|85610 - PROTHROMBIN TIME||6.42|0||0|10/01/2019 SH 78001|85598|85598 - PHOSPHOLIPID NEUTRALIZATION HEXAGONAL||29.35|0||0|10/01/2019 SH 78001|85597|85597 - PHOSPHOLIPID NEUTRALIZATION PLATELET||29.35|0||0|10/01/2019 SH 78001|85576|85576 - PLATELET AGGREGATION IN VITRO EACH AGENT||35.09|22.16||0|10/01/2019 SH 78001|85557|85557 - OSMOTIC FRAGILITY RBC INCUBATED||21.82|0||0|10/01/2019 SH 78001|85555|85555 - OSMOTIC FRAGILITY RBC UNINCUBATED||10.91|0||0|10/01/2019 SH 78001|85549|85549 - MURAMIDASE||30.62|0||0|10/01/2019 SH 78001|85547|85547 - MECHANICAL FRAGILITY RBC||9.88|0||0|10/01/2019 SH 78001|85540|85540 - WBC ALKALINE PHOSPHATASE COUNT||9.88|0||0|10/01/2019 SH 78001|85536|85536 - IRON STAIN PERIPHERAL BLOOD||10.57|0||0|10/01/2019 SH 78001|85530|85530 - HEPARIN-PROTAMINE TOLERANCE TST||23.15|0||0|10/01/2019 SH 78001|85525|85525 - HEPARIN NEUTRALIZATION||19.34|0||0|10/01/2019 SH 78001|85520|85520 - HEPARIN ASSAY||21.38|0||0|10/01/2019 SH 78001|85475|85475 - HEMOLYSIN ACID||8.52|0||0|10/01/2019 SH 78001|85461|85461 - HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE||10.84|0||0|10/01/2019 SH 78001|85460|85460 - HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS||3.95|0||0|10/01/2019 SH 78001|85445|85445 - HEINZ BODIES INDUCED ACETYL PHENYLHYDRAZINE||11.14|0||0|10/01/2019 SH 78001|85441|85441 - HEINZ BODIES DIRECT||6.86|0||0|10/01/2019 SH 78001|85421|85421 - FBRNLYC FACTORS&INHIBITORS PLSMNG AGIC ASSAY||16.63|0||0|10/01/2019 SH 78001|85420|85420 - FBRNLYC FACTORS&INHIBITRS PLSMNG XCPT AGIC ASS||10.67|0||0|10/01/2019 SH 78001|85415|85415 - FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR||28.08|0||0|10/01/2019 SH 78001|85410|85410 - FBRNLYC FACTORS&INHIBITORS ALPHA-2 ANTIPLASMIN||12.59|0||0|10/01/2019 SH 78001|85400|85400 - FIBRINOLYTIC FACTORS & INHIBITORS PLASMIN||14.45|0||0|10/01/2019 SH 78001|85397|85397 - COAGJ&FIBRINOLYSIS FUNCTIONAL ACTV NOS EA ANAL||37.46|0||0|10/01/2019 SH 78001|85396|85396 - COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY||24.1|0||0|10/01/2019 SH 78001|85390|85390 - FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR||8.45|22.16||0|10/01/2019 SH 78001|85385|85385 - FIBRINOGEN ANTIGEN||13.87|0||0|10/01/2019 SH 78001|85384|85384 - FIBRINOGEN ACTIVITY||13.87|0||0|10/01/2019 SH 78001|85380|85380 - FIBRIN DGRADJ PRODUCTS D-DIMER ULTRASENSITIVE||16.62|0||0|10/01/2019 SH 78001|85379|85379 - FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE||16.62|0||0|10/01/2019 SH 78001|85378|85378 - FIBRIN DGRADJ PRODUCTS D-DIMER QUAL/SEMIQUAN||11.65|0||0|10/01/2019 SH 78001|85370|85370 - FIBRIN DGRADJ SPLT PRODUCTS QUANTITATIVE||18.54|0||0|10/01/2019 SH 78001|85366|85366 - FIBRIN DGRADJ SPLT PRODUXS PARACOAGJ||14.06|0||0|10/01/2019 SH 78001|85362|85362 - FIBRIN DGRADJ SPLT PRODUXS AGGLUJ SLIDE SEMIQUAN||11.26|0||0|10/01/2019 SH 78001|85360|85360 - EUGLOBULIN LYSIS||13.72|0||0|10/01/2019 SH 78001|85348|85348 - COAGULATION TIME OTHER METHODS||5.64|0||0|10/01/2019 SH 78001|85347|85347 - COAGULATION TIME ACTIVATED||6.95|0||0|10/01/2019 SH 78001|85345|85345 - COAGULATION TIME LEE AND WHITE||5.64|0||0|10/01/2019 SH 78001|85337|85337 - THROMBOMODULIN||17.03|0||0|10/01/2019 SH 78001|85335|85335 - FACTOR INHIBITOR TEST||21.02|0||0|10/01/2019 SH 78001|85307|85307 - ACTIVATED PROTEIN C APC RESISTANCE ASSAY||25.02|0||0|10/01/2019 SH 78001|85306|85306 - CLOTTING INHIBITORS PROTEIN S FREE||25.02|0||0|10/01/2019 SH 78001|85305|85305 - CLOTTING INHIBITORS PROTEIN S TOTAL||18.95|0||0|10/01/2019 SH 78001|85303|85303 - CLOTTING INHIBITORS PROTEIN C ACTIVITY||22.58|0||0|10/01/2019 SH 78001|85302|85302 - CLOTTING INHIBITORS PROTEIN C ANTIGEN||19.62|0||0|10/01/2019 SH 78001|85301|85301 - CLOTTING INHIBITRS ANTITHROMBN III ANTIGEN ASSAY||17.65|0||0|10/01/2019 SH 78001|85300|85300 - CLOTTING INHIBITORS ANTITHROMBIN III ACTIVITY||19.36|0||0|10/01/2019 SH 78001|85293|85293 - CLOTTING HI MOLEC WEIGHT KININOGEN ASSAY||30.92|0||0|10/01/2019 SH 78001|85292|85292 - CLOTTING PREKALLIKREIN ASSAY FLETCHER FACT ASSAY||30.92|0||0|10/01/2019 SH 78001|85291|85291 - CLOTTING FACTOR XIII FIBRN STABILIZ SCREEN SOLUB||14.53|0||0|10/01/2019 SH 78001|85290|85290 - CLOTTING FACTOR XIII FIBRIN STABILIZING||26.69|0||0|10/01/2019 SH 78001|85280|85280 - CLOTTING FACTOR XII HAGEMAN||31.6|0||0|10/01/2019 SH 78001|85270|85270 - CLOTTING FACTOR XI PTA||29.24|0||0|10/01/2019 SH 78001|85260|85260 - CLOTTING FACTOR X STUART-PROWER||29.24|0||0|10/01/2019 SH 78001|85250|85250 - CLOTTING FACTOR IX PTC/CHRISTMAS||31.09|0||0|10/01/2019 SH 78001|85247|85247 - CLOTTING FACTOR VIII MULTIMETRIC ANALYSIS||37.46|0||0|10/01/2019 SH 78001|85246|85246 - CLOTTING FACTOR VIII VW FACTOR ANTIGEN||37.46|0||0|10/01/2019 SH 78001|85245|85245 - CLOTTING FACTOR VIII VW FACTOR RISTOCETIN COFACT||37.46|0||0|10/01/2019 SH 78001|85244|85244 - CLOTTING FACTOR VIII RELATED ANTIGEN||33.35|0||0|10/01/2019 SH 78001|85240|85240 - CLOTTING FACTOR VIII AHG 1 STAGE||29.24|0||0|10/01/2019 SH 78001|85230|85230 - CLOTTING FACTOR VII PROCONVERTIN STABLE FACTOR||29.24|0||0|10/01/2019 SH 78001|85220|85220 - CLOTTING FACTOR V ACG/PROACCELERIN LABILE FACTOR||28.81|0||0|10/01/2019 SH 78001|85210|85210 - CLOTTING FACTOR II PROTHROMBIN SPECIFIC||21.2|0||0|10/01/2019 SH 78001|85175|85175 - CLOT LYSIS TIME WHOLE BLOOD DILUTION||7.43|0||0|10/01/2019 SH 78001|85170|85170 - BLOOD CLOT RETRACTION||5.9|0||0|10/01/2019 SH 78001|85130|85130 - CHROMOGENIC SUBSTRATE ASSAY||19.42|0||0|10/01/2019 SH 78001|85097|85097 - BONE MARROW SMEAR INTERPRETATION||57.99|0||0|10/01/2019 SH 78001|85060|85060 - BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT||29.1|0||0|10/01/2019 SH 78001|85055|85055 - RETICULATED PLATELET ASSAY||42.64|0||0|10/01/2019 SH 78001|85049|85049 - BLOOD COUNT PLATELET AUTOMATED||7.31|0||0|10/01/2019 SH 78001|85048|85048 - BLOOD COUNT LEUKOCYTE WBC AUTOMATED||4.15|0||0|10/01/2019 SH 78001|85046|85046 - BLOOD COUNT RETICULOCYTES AUTO 1/> CELL MEAS||9.11|0||0|10/01/2019 SH 78001|85045|85045 - BLOOD COUNT RETICULOCYTE AUTOMATED||6.53|0||0|10/01/2019 SH 78001|85044|85044 - BLOOD COUNT RETICULOCYTE AUTOMATED||7.02|0||0|10/01/2019 SH 78001|85041|85041 - BLOOD COUNT RED BLOOD CELL AUTOMATED||4.93|0||0|10/01/2019 SH 78001|85032|85032 - BLOOD COUNT MANUAL CELL COUNT EACH||7.02|0||0|10/01/2019 SH 78001|85027|85027 - BLOOD COUNT COMPLETE AUTOMATED||10.57|0||0|10/01/2019 SH 78001|85025|85025 - BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC||12.7|0||0|10/01/2019 SH 78001|85018|85018 - BLOOD COUNT HEMOGLOBIN||3.88|0||0|10/01/2019 SH 78001|85014|85014 - BLOOD COUNT HEMATOCRIT||3.88|0||0|10/01/2019 SH 78001|85013|85013 - BLOOD COUNT SPUN MICROHEMATOCRIT||3.88|0||0|10/01/2019 SH 78001|85009|85009 - BLOOD COUNT MANUAL DIFRNTL WBC COUNT BUFFY COAT||6.07|0||0|10/01/2019 SH 78001|85008|85008 - BLD COUNT SMEAR MCRSCP W/O MNL DIFRNTL WBC COUNT||5.62|0||0|10/01/2019 SH 78001|85007|85007 - BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT||5.62|0||0|10/01/2019 SH 78001|85004|85004 - BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT||10.57|0||0|10/01/2019 SH 78001|85002|85002 - BLEEDING TIME TEST||7.36|0||0|10/01/2019 SH 78001|84830|84830 - OVULATION TEST VISUAL COLOR COMPARISON HLH||16.38|0||0|10/01/2019 SH 78001|84704|84704 - GONADOTROPIN CHORIONIC HCG FREE BETA CHAIN||10.48|0||0|10/01/2019 SH 78001|84703|84703 - GONADOTROPIN CHORIONIC QUALITATIVE||10.48|0||0|10/01/2019 SH 78001|84702|84702 - GONADOTROPIN CHORIONIC QUANTITATIVE||10.48|0||0|10/01/2019 SH 78001|84681|84681 - ASSAY OF C-PEPTIDE||25.97|0||0|10/01/2019 SH 78001|84630|84630 - ASSAY OF ZINC||18.6|0||0|10/01/2019 SH 78001|84620|84620 - XYLOSE ABSORPTION TEST BLOOD &/URINE||19.34|0||0|10/01/2019 SH 78001|84600|84600 - ASSAY OF VOLATILES||26.26|0||0|10/01/2019 SH 78001|84597|84597 - ASSAY OF VITAMIN K||22.39|0||0|10/01/2019 SH 78001|84591|84591 - ASSAY OF VITAMIN NOT OTHERWISE SPECIFIED||18.95|0||0|10/01/2019 SH 78001|84590|84590 - ASSAY OF VITAMIN A||18.95|0||0|10/01/2019 SH 78001|84588|84588 - ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE||55.43|0||0|10/01/2019 SH 78001|84586|84586 - ASSAY OF VASOACTIVE INTESTINAL PEPTIDE||57.71|0||0|10/01/2019 SH 78001|84585|84585 - ASSAY OF VANILLYLMANDELIC ACID URINE||25.31|0||0|10/01/2019 SH 78001|84583|84583 - ASSAY OF UROBILINOGEN URINE SEMIQUANTITATIVE||8.22|0||0|10/01/2019 SH 78001|84580|84580 - UROBILINOGEN URINE QUANTITATIVE TIMED SPECIMEN||11.59|0||0|10/01/2019 SH 78001|84578|84578 - ASSAY OF UROBILINOGEN URINE QUALITATIVE||5.32|0||0|10/01/2019 SH 78001|84577|84577 - ASSAY OF UROBILINOGEN FECES QUANTITATIVE||11.42|0||0|10/01/2019 SH 78001|84560|84560 - ASSAY OF URIC ACID OTHER SOURCE||7.75|0||0|10/01/2019 SH 78001|84550|84550 - ASSAY OF BLOOD/URIC ACID||7.38|0||0|10/01/2019 SH 78001|84545|84545 - UREA NITROGEN CLEARANCE||10.79|0||0|10/01/2019 SH 78001|84540|84540 - ASSAY OF UREA NITROGEN URINE||7.75|0||0|10/01/2019 SH 78001|84525|84525 - ASSAY OF UREA NITROGEN SEMIQUANTITATIVE||3.95|0||0|10/01/2019 SH 78001|84520|84520 - ASSAY OF UREA NITROGEN QUANTITATIVE||6.44|0||0|10/01/2019 SH 78001|84512|84512 - ASSAY OF TROPONIN QUALITATIVE||12.05|0||0|10/01/2019 SH 78001|84510|84510 - ASSAY OF TYROSINE||16.99|0||0|10/01/2019 SH 78001|84490|84490 - TRYPSIN FECES QUANTITATIVE 24-HR COLLECTION||12.42|0||0|10/01/2019 SH 78001|84488|84488 - ASSAY OF TRYPSIN FECES QUALITATIVE||11.93|0||0|10/01/2019 SH 78001|84485|84485 - ASSAY OF TRYPSIN DUODENAL FLUID||12.28|0||0|10/01/2019 SH 78001|84484|84484 - ASSAY OF TROPONIN QUANTITATIVE||16.07|0||0|10/01/2019 SH 78001|84482|84482 - TRIIODOTHYRONINE T3 REVERSE||25.74|0||0|10/01/2019 SH 78001|84481|84481 - ASSAY OF TRIIODOTHYRONINE T3 FREE||27.66|0||0|10/01/2019 SH 78001|84480|84480 - ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3||20.83|0||0|10/01/2019 SH 78001|84479|84479 - THYROID HORM UPTK/THYROID HORMONE BINDING RATIO||10.57|0||0|10/01/2019 SH 78001|84478|84478 - ASSAY OF TRIGLYCERIDES||9.38|0||0|10/01/2019 SH 78001|84466|84466 - ASSAY OF L7383TRANSFERRIN||20.86|0||0|10/01/2019 SH 78001|84460|84460 - TRANSFERASE ALANINE AMINO ALT SGPT||8.65|0||0|10/01/2019 SH 78001|84450|84450 - TRANSFERASE ASPARTATE AMINO AST SGOT||8.45|0||0|10/01/2019 SH 78001|84449|84449 - ASSAY OF TRANSCORTIN CORTISOL BINDING GLOBULIN||29.39|0||0|10/01/2019 SH 78001|84446|84446 - ASSAY OF TOCOPHEROL ALPHA VITAMIN E||23.15|0||0|10/01/2019 SH 78001|84445|84445 - THYROID STIMULATING IMMUNE GLOBULINS TSI||13.84|0||0|10/01/2019 SH 78001|84443|84443 - ASSAY OF THYROID STIMULATING HORMONE TSH||27.44|0||0|10/01/2019 SH 78001|84442|84442 - ASSAY OF THYROXINE BINDING GLOBULIN||19.01|0||0|10/01/2019 SH 78001|84439|84439 - ASSAY OF FREE THYROXINE||14.72|0||0|10/01/2019 SH 78001|84437|84437 - ASSAY OF THYROXINE REQUIRING ELUTION||10.57|0||0|10/01/2019 SH 78001|84436|84436 - ASSAY OF THYROXINE TOTAL||11.22|0||0|10/01/2019 SH 78001|84432|84432 - ASSAY OF THYROGLOBULIN||26.23|0||0|10/01/2019 SH 78001|84431|84431 - THROMBOXANE METABOLITE W/WO THROMBOXANE URINE||27.44|0||0|10/01/2019 SH 78001|84430|84430 - ASSAY OF THIOCYANATE||9.42|0||0|10/01/2019 SH 78001|84425|84425 - ASSAY OF THIAMINE-VITAMIN B-1||34.67|0||0|10/01/2019 SH 78001|84410|84410 - ASSAY BIOVLBL TESTOSTERONE DIRECT MEASUREMENT||87.06|0||0|10/01/2019 SH 78001|84403|84403 - ASSAY OF TESTOSTERONE TOTAL||42.16|0||0|10/01/2019 SH 78001|84402|84402 - ASSAY OF TESTOSTERONE FREE||41.58|0||0|10/01/2019 SH 78001|84392|84392 - ASSAY OF SULFATE URINE||7.75|0||0|10/01/2019 SH 78001|84379|84379 - SUGARS MONO DI&OLIGOS MLT QUANTITATIVE EA SPEC||18.83|0||0|10/01/2019 SH 78001|84378|84378 - SUGARS MONO DI&OLIGOS 1 QUANTITATIVE EACH SPEC||18.83|0||0|10/01/2019 SH 78001|84377|84377 - SUGARS MONO DI&OLIGOS MLT QUALITATIVE EACH SPE||8.98|0||0|10/01/2019 SH 78001|84376|84376 - SUGARS MONO DI&OLIGOS 1 QUALITATAIVE EACH SPEC||8.98|0||0|10/01/2019 SH 78001|84375|84375 - SUGARS CHROMATOGRAPHIC TLC/PAPER CHROMATOGRAPHY||32.02|0||0|10/01/2019 SH 78001|84315|84315 - SPECIFIC GRAVITY EXCEPT URINE||4.1|0||0|10/01/2019 SH 78001|84311|84311 - SPECTROPHOTOMETRY ANALYT NOT ELSEWHERE SPECIFIED||11.42|0||0|10/01/2019 SH 78001|84307|84307 - ASSAY OF SOMATOSTATIN||29.86|0||0|10/01/2019 SH 78001|84305|84305 - ASSAY OF SOMATOMEDIN||34.72|0||0|10/01/2019 SH 78001|84302|84302 - ASSAY OF SODIUM OTHER SOURCE||5.64|0||0|10/01/2019 SH 78001|84300|84300 - ASSAY OF URINE SODIUM||5.64|0||0|10/01/2019 SH 78001|84295|84295 - SODIUM SERUM PLASMA OR WHOLE BLOOD||7.86|0||0|10/01/2019 SH 78001|84285|84285 - ASSAY OF SILICA||38.45|0||0|10/01/2019 SH 78001|84275|84275 - ASSAY OF SIALIC ACID||21.95|0||0|10/01/2019 SH 78001|84270|84270 - ASSAY OF SEX HORMONE BINDING GLOBULIN||35.5|0||0|10/01/2019 SH 78001|84260|84260 - ASSAY OF SEROTONIN||50.59|0||0|10/01/2019 SH 78001|84255|84255 - ASSAY OF SELENIUM||41.69|0||0|10/01/2019 SH 78001|84252|84252 - ASSAY OF RIBOFLAVIN-VITAMIN B-2||33.05|0||0|10/01/2019 SH 78001|84244|84244 - ASSAY OF RENIN||35.92|0||0|10/01/2019 SH 78001|84238|84238 - RECEPTOR ASSAY NON-ENDOCRINE SPECIFY RECEPTOR||59.72|0||0|10/01/2019 SH 78001|84235|84235 - RECEPTOR ASSAY ENDOCRINE OTH/THN ESTRGN/PROGST||85.48|0||0|10/01/2019 SH 78001|84234|84234 - ASSAY OF RECEPTOR ASSAY PROGESTERONE||105.95|0||0|10/01/2019 SH 78001|84233|84233 - ASSAY OF RECEPTOR ASSAY ESTROGEN||105.18|0||0|10/01/2019 SH 78001|84228|84228 - ASSAY OF QUININE||19.01|0||0|10/01/2019 SH 78001|84220|84220 - ASSAY OF PYRUVATE KINASE||15.42|0||0|10/01/2019 SH 78001|84210|84210 - ASSAY OF PYRUVATE||17.72|0||0|10/01/2019 SH 78001|84207|84207 - ASSAY OF PYRIDOXAL PHOSPHATE||45.89|0||0|10/01/2019 SH 78001|84206|84206 - ASSAY OF PROINSULIN||29.09|0||0|10/01/2019 SH 78001|84203|84203 - PROTOPORPHYRIN RBC SCREEN||14.05|0||0|10/01/2019 SH 78001|84202|84202 - PROTOPORPHYRIN RBC QUANTITATIVE||23.42|0||0|10/01/2019 SH 78001|84182|84182 - PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL||29.39|22.16||0|10/01/2019 SH 78001|84181|84181 - PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID||27.82|22.16||0|10/01/2019 SH 78001|84166|84166 - PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI||29.12|22.16||0|10/01/2019 SH 78001|84165|84165 - PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM||17.53|22.16||0|10/01/2019 SH 78001|84163|84163 - PREGNANCY-ASSOCIATED PLASMA PROTEIN-A||10.48|0||0|10/01/2019 SH 78001|84160|84160 - PROTEIN TOTAL REFRACTOMETRY ANY SRC||8.45|0||0|10/01/2019 SH 78001|84157|84157 - PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC||5.99|0||0|10/01/2019 SH 78001|84156|84156 - PROTEIN TOTAL XCPT REFRACTOMETRY URINE||5.99|0||0|10/01/2019 SH 78001|84155|84155 - PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD||5.99|0||0|10/01/2019 SH 78001|84154|84154 - ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE||30.04|0||0|10/01/2019 SH 78001|84153|84153 - ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL||30.04|0||0|10/01/2019 SH 78001|84152|84152 - ASSAY OF PROSTATE SPECIFIC ANTIGEN COMPLEXED||30.04|0||0|10/01/2019 SH 78001|84150|84150 - ASSAY OF PROSTAGLNDIN EACH||40.75|0||0|10/01/2019 SH 78001|84146|84146 - ASSAY OF PROLACTIN||31.64|0||0|10/01/2019 SH 78001|84145|84145 - PROCALCITONIN (PCT)||43.74|0||0|10/01/2019 SH 78001|84144|84144 - ASSAY OF PROGESTERONE||33.26|0||0|10/01/2019 SH 78001|84143|84143 - 17-HYDROXYPREGNENOLONE||37.26|0||0|10/01/2019 SH 78001|84140|84140 - PREGNENOLONE||33.76|0||0|10/01/2019 SH 78001|84138|84138 - PREGNANETRIOL||30.92|0||0|10/01/2019 SH 78001|84135|84135 - PREGNANEDIOL||31.24|0||0|10/01/2019 SH 78001|84134|84134 - PREALBUMIN||23.81|0||0|10/01/2019 SH 78001|84133|84133 - POTASSIUM URINE||7.02|0||0|10/01/2019 SH 78001|84132|84132 - POTASSIUM SERUM PLASMA/WHOLE BLOOD||7.51|0||0|10/01/2019 SH 78001|84126|84126 - PORPHYRINS FECES QUANTITATIVE||41.59|0||0|10/01/2019 SH 78001|84120|84120 - PORPHYRINS URINE QUANTITATION & FRACTIONATION||24.02|0||0|10/01/2019 SH 78001|84119|84119 - PORPHYRINS URINE QUALITATAIVE||14.06|0||0|10/01/2019 SH 78001|84112|84112 - EVAL C/V AMNIOTIC FLUID PROTEIN QUAL EA SPECIMEN||105.18|0||0|10/01/2019 SH 78001|84110|84110 - ASSAY OF PORPHOBILINOGEN URINE QUANTITATIVE||13.78|0||0|10/01/2019 SH 78001|84106|84106 - PORPHOBILINOGEN URINE QUALITATIVE||6.98|0||0|10/01/2019 SH 78001|84105|84105 - ASSAY OF PHOSPHORUS INORGANIC URINE||8.45|0||0|10/01/2019 SH 78001|84100|84100 - ASSAY OF PHOSPHORUS INORGANIC||7.74|0||0|10/01/2019 SH 78001|84087|84087 - ASSAY OF PHOSPHOHEXOSE ISOMERASE||16.86|0||0|10/01/2019 SH 78001|84085|84085 - PHOSPHOGLUCONATE 6-DEHYD RBC||11.02|0||0|10/01/2019 SH 78001|84081|84081 - PHOSPHATIDYLGLYCEROL||26.98|0||0|10/01/2019 SH 78001|84080|84080 - ASSAY OF PHOSPHATASE ALKALINE ISOENZYMES||24.14|0||0|10/01/2019 SH 78001|84078|84078 - ASSAY OF PHOSPHATASE ALKALINE HEAT STABLE||11.93|0||0|10/01/2019 SH 78001|84075|84075 - ASSAY OF PHOSPHATASE ALKALINE||8.45|0||0|10/01/2019 SH 78001|84066|84066 - ASSAY OF PHOSPHATASE ACID PROSTATIC||15.78|0||0|10/01/2019 SH 78001|84061|84061 - PHOSPHATASE ACID FORENSIC EXAMINATION||12.91|0||0|10/01/2019 SH 78001|84060|84060 - ASSAY OF PHOSPHATASE ACID TOTAL||12.06|0||0|10/01/2019 SH 78001|84035|84035 - ASSAY OF PHENYLKETONES QUALITATIVE||5.98|0||0|10/01/2019 SH 78001|84030|84030 - ASSAY OF PHENYLALANINE BLOOD||8.98|0||0|10/01/2019 SH 78001|83993|83993 - ASSAY OF CALPROTECTIN FECAL||32.05|0||0|10/01/2019 SH 78001|83992|83992 - ASSAY OF PHENCYCLIDINE||24|0||0|10/01/2019 SH 78001|83987|83987 - PH EXHALED BREATH CONDENSATE||25.93|0||0|10/01/2019 SH 78001|83986|83986 - PH BODY FLUID NOT ELSEWHERE SPECIFIED||5.84|0||0|10/01/2019 SH 78001|83970|83970 - ASSAY OF PARATHORMONE||67.4|0||0|10/01/2019 SH 78001|83951|83951 - ONCOPROTEIN DES-GAMMA-CARBOXY-PROTHROMBIN DCP||105.18|0||0|10/01/2019 SH 78001|83950|83950 - ONCOPROTEIN HER-2/NEU||105.18|0||0|10/01/2019 SH 78001|83945|83945 - ASSAY OF OXALATE||21.02|0||0|10/01/2019 SH 78001|83937|83937 - ASSAY OF OSTEOCALCIN||48.74|0||0|10/01/2019 SH 78001|83935|83935 - ASSAY OF OSMOLALITY URINE||11.14|0||0|10/01/2019 SH 78001|83930|83930 - ASSAY OF OSMOLALITY BLOOD||10.8|0||0|10/01/2019 SH 78001|83921|83921 - ORGANIC ACID 1 QUANTITATIVE||26.87|0||0|10/01/2019 SH 78001|83919|83919 - ORGANIC ACIDS QUALITATIVE EACH SPECIMEN||26.87|0||0|10/01/2019 SH 78001|83918|83918 - ORGANIC ACIDS TOTAL QUANTITATIVE EACH SPECIMEN||26.87|0||0|10/01/2019 SH 78001|83916|83916 - OLIGOCLONAL IMMUNE||32.84|0||0|10/01/2019 SH 78001|83915|83915 - ASSAY OF NUCLEOTIDASE 5'-||18.22|0||0|10/01/2019 SH 78001|83885|83885 - ASSAY OF NICKEL||40.01|0||0|10/01/2019 SH 78001|83883|83883 - ASSAY OF NEPHELOMETRY EACH ANALYTE NES||22.2|0||0|10/01/2019 SH 78001|83880|83880 - NATRIURETIC PEPTIDE||55.43|0||0|10/01/2019 SH 78001|83876|83876 - MYELOPEROXIDASE MPO||55.43|0||0|10/01/2019 SH 78001|83874|83874 - MYOGLOBIN||21.1|0||0|10/01/2019 SH 78001|83873|83873 - MYELIN BASIC PROTEIN CEREBROSPINAL FLUID||28.09|0||0|10/01/2019 SH 78001|83872|83872 - MUCIN SYNOVIAL FLUID ROPES TEST||9.58|0||0|10/01/2019 SH 78001|83864|83864 - MUCOPOLYSACCHARIDES ACID QUANTITATIVE||32.52|0||0|10/01/2019 SH 78001|83861|83861 - MICROFLUIDIC ANALYSIS TEAR OSMOLARITY||26.98|0||0|10/01/2019 SH 78001|83857|83857 - METHEMALBUMIN||17.54|0||0|10/01/2019 SH 78001|83835|83835 - METANEPHRINES||27.66|0||0|10/01/2019 SH 78001|83825|83825 - ASSAY OF MERCURY QUANTITATIVE||26.54|0||0|10/01/2019 SH 78001|83789|83789 - MASS SPECT&TANDEM MASS SPECT NONDRG ANAL NES EA||9.8|0||0|10/01/2019 SH 78001|83788|83788 - MASS SPECTROMETRY QUAL||9.8|0||0|10/01/2019 SH 78001|83785|83785 - ASSAY OF MANGANESE||40.16|0||0|10/01/2019 SH 78001|83775|83775 - ASSAY OF MALATE DEHYDROGENASE||12.04|0||0|10/01/2019 SH 78001|83735|83735 - ASSAY OF MAGNESIUM||10.93|0||0|10/01/2019 SH 78001|83727|83727 - LUTEINIZING RELEASING FACTOR||28.08|0||0|10/01/2019 SH 78001|83721|83721 - LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL||15.59|0||0|10/01/2019 SH 78001|83719|83719 - LIPOPROTEIN DIRECT MEASUREMENT VLDL CHOLESTEROL||19.01|0||0|10/01/2019 SH 78001|83718|83718 - LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL||13.37|0||0|10/01/2019 SH 78001|83704|83704 - LIPOPROTEIN BLOOD QUAN NUMBERS & SUBCLASSES||51.52|0||0|10/01/2019 SH 78001|83701|83701 - LIPOPROTEIN BLOOD HIGH RESOLTJ&QUANTJ SUBCLASS||40.54|0||0|10/01/2019 SH 78001|83700|83700 - LIPOPROTEIN BLOOD ELECTROPHORECTIC SEP&QUAN||14.28|0||0|10/01/2019 SH 78001|83698|83698 - LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2||55.43|0||0|10/01/2019 SH 78001|83695|83695 - LIPOPROTEIN (A)||21.14|0||0|10/01/2019 SH 78001|83690|83690 - ASSAY OF LIPASE||11.26|0||0|10/01/2019 SH 78001|83670|83670 - LEUCINE AMINOPEPTIDASE LAP||14.96|0||0|10/01/2019 SH 78001|83664|83664 - FETAL LUNG MATURITY LAMELLAR BODY DENSITY||30.89|0||0|10/01/2019 SH 78001|83663|83663 - FETAL LUNG MATURITY FLUORESCENCE POLARIZATION||30.89|0||0|10/01/2019 SH 78001|83662|83662 - FETAL LUNG MATURITY FOAM STABILITY TEST||30.89|0||0|10/01/2019 SH 78001|83661|83661 - FETAL LUNG MATURITY LECITHIN SPHINGOMYELIN RATIO||35.9|0||0|10/01/2019 SH 78001|83655|83655 - ASSAY OF LEAD||19.76|0||0|10/01/2019 SH 78001|83633|83633 - LACTOSE URINE QUALITATIVE||8.98|0||0|10/01/2019 SH 78001|83632|83632 - LACTOGEN HPL HUMAN CHORIONIC SOMATOMAMMOTROPIN||33.01|0||0|10/01/2019 SH 78001|83631|83631 - LACTOFERRIN FECAL QUANTITATIVE||32.05|0||0|10/01/2019 SH 78001|83630|83630 - LACTOFERRIN FECAL QUALITATIVE||32.05|0||0|10/01/2019 SH 78001|83625|83625 - LACTATE DEHYDROGENASE ISOENZYMES SEP&QUAN||18.91|0||0|10/01/2019 SH 78001|83615|83615 - LACTATE DEHYDROGENASE LDH||9.85|0||0|10/01/2019 SH 78001|83605|83605 - ASSAY OF LACTATE||17.44|0||0|10/01/2019 SH 78001|83593|83593 - KETOSTEROIDS 17- FRACTIONATION||42.95|0||0|10/01/2019 SH 78001|83586|83586 - ASSAY OF KETOSTEROIDS 17- TOTAL||20.52|0||0|10/01/2019 SH 78001|83582|83582 - ASSAY OF KETOGENIC STEROIDS FRACTIONATION||23.14|0||0|10/01/2019 SH 78001|83570|83570 - ISOCITRIC DEHYDROGENASE||14.45|0||0|10/01/2019 SH 78001|83550|83550 - IRON BINDING CAPACITY||14.28|0||0|10/01/2019 SH 78001|83540|83540 - ASSAY OF IRON||10.57|0||0|10/01/2019 SH 78001|83528|83528 - ASSAY OF INTRINSIC FACTOR||25.98|0||0|10/01/2019 SH 78001|83527|83527 - ASSAY OF INSULIN FREE||21.14|0||0|10/01/2019 SH 78001|83525|83525 - ASSAY OF INSULIN TOTAL||18.66|0||0|10/01/2019 SH 78001|83520|83520 - IMMUNOASSAY ANALYTE QUANTITATIVE NOS||21.14|0||0|10/01/2019 SH 78001|83519|83519 - IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY||22.07|0||0|10/01/2019 SH 78001|83518|83518 - IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP||13.84|0||0|10/01/2019 SH 78001|83516|83516 - IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP||17.45|0||0|10/01/2019 SH 78001|83505|83505 - ASSAY OF HYDROXYPROLINE TOTAL||39.71|0||0|10/01/2019 SH 78001|83500|83500 - ASSAY OF HYDROXYPROLINE FREE||36.98|0||0|10/01/2019 SH 78001|83499|83499 - ASSAY OF HYDROXYPROGESTERONE 20-||41.17|0||0|10/01/2019 SH 78001|83498|83498 - ASSAY OF HYDROXYPROGESTERONE 17-D||44.36|0||0|10/01/2019 SH 78001|83497|83497 - ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA||21.06|0||0|10/01/2019 SH 78001|83491|83491 - HYDROXYCORTICOSTEROIDS 17||28.61|0||0|10/01/2019 SH 78001|83150|83150 - ASSAY OF HOMOVANILLIC ACID||31.6|0||0|10/01/2019 SH 78001|83090|83090 - ASSAY OF HOMOCYSTEINE||27.54|0||0|10/01/2019 SH 78001|83088|83088 - ASSAY OF HISTAMINE||48.23|0||0|10/01/2019 SH 78001|83080|83080 - ASSAY OF B-HEXOSAMINIDASE EACH ASSAY||27.54|0||0|10/01/2019 SH 78001|83070|83070 - ASSAY OF HEMOSIDERIN QUALITATIVE||7.75|0||0|10/01/2019 SH 78001|83069|83069 - ASSAY OF HEMOGLOBIN URINE||6.44|0||0|10/01/2019 SH 78001|83068|83068 - HEMOGLOBIN UNSTABLE SCREEN||13.81|0||0|10/01/2019 SH 78001|83065|83065 - HEMOGLOBIN THERMOLABILE||11.26|0||0|10/01/2019 SH 78001|83060|83060 - HEMOGLOBIN SULFHEMOGLOBIN QUANTITATIVE||13.5|0||0|10/01/2019 SH 78001|83051|83051 - ASSAY OF HEMOGLOBIN PLASMA||11.94|0||0|10/01/2019 SH 78001|83050|83050 - HEMOGLOBIN METHEMOGLOBIN QUANTITATIVE||11.98|0||0|10/01/2019 SH 78001|83045|83045 - HEMOGLOBIN METHEMOGLOBIN QUALITATIVE||6.72|0||0|10/01/2019 SH 78001|83037|83037 - HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE||15.85|0||0|10/01/2019 SH 78001|83036|83036 - HEMOGLOBIN GLYCOSYLATED A1C||15.85|0||0|10/01/2019 SH 78001|83033|83033 - HEMOGLOBIN F FETAL QUALITATIVE||9.73|0||0|10/01/2019 SH 78001|83030|83030 - HEMOGLOBIN F FETAL CHEMICAL||13.5|0||0|10/01/2019 SH 78001|83026|83026 - HEMOGLOBIN COPPER SULFATE METHOD NON-AUTOMATED||3.86|0||0|10/01/2019 SH 78001|83021|83021 - HEMOGLOBIN FRACTJ/QUANTJ CHROMOTOGRAPHY||9.8|0||0|10/01/2019 SH 78001|83020|83020 - HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS||15.97|22.16||0|10/01/2019 SH 78001|83018|83018 - HEAVY METAL QUANTIATIVE EACH NES||35.87|0||0|10/01/2019 SH 78001|83015|83015 - HEAVY METAL QUALITATIVE ANY ANALYTES||30.76|0||0|10/01/2019 SH 78001|83014|83014 - HPYLORI DRUG ADMINISTRATION||12.84|0||0|10/01/2019 SH 78001|83013|83013 - HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE||109.99|0||0|10/01/2019 SH 78001|83012|83012 - ASSAY OF HAPTOGLOBIN PHENOTYPES||28.08|0||0|10/01/2019 SH 78001|83010|83010 - ASSAY OF HAPTOGLOBIN QUANTITATIVE||6.08|0||0|10/01/2019 SH 78001|83009|83009 - HPYLORI BLOOD ANAL UREASE ACT NON-RADACT ISOTOPE||22.08|0||0|10/01/2019 SH 78001|83006|83006 - GROWTH STIMULATION EXPRESSED GENE 2||35.92|0||0|10/01/2019 SH 78001|83003|83003 - ASSAY OF GROWTH HORMONE HUMAN||23.24|0||0|10/01/2019 SH 78001|83002|83002 - GONADOTROPIN LUTEINIZING HORMONE||30.24|0||0|10/01/2019 SH 78001|83001|83001 - GONADOTROPIN FOLLICLE STIMULATING HORMONE||30.35|0||0|10/01/2019 SH 78001|82985|82985 - ASSAY OF GLYCATED PROTEIN||24.61|0||0|10/01/2019 SH 78001|82979|82979 - ASSAY OF GLUTATHIONE REDUCTASE RBC||11.26|0||0|10/01/2019 SH 78001|82978|82978 - ASSAY OF GLUTATHIONE||23.28|0||0|10/01/2019 SH 78001|82977|82977 - ASSAY OF GLUTAMYLTRASE GAMMA||11.76|0||0|10/01/2019 SH 78001|82965|82965 - ASSAY OF GLUTAMATE DEHYDROGENASE||12.62|0||0|10/01/2019 SH 78001|82963|82963 - ASSAY OF GLUCOSIDASE BETA||35.09|0||0|10/01/2019 SH 78001|82962|82962 - GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE||3.83|0||0|10/01/2019 SH 78001|82960|82960 - GLUC-6-PHOSPHATE DEHYDROGENASE SCREEN||9.89|0||0|10/01/2019 SH 78001|82955|82955 - GLUC-6-PHOSPHATE DEHYDROGENASE QUANTITATIVE||12.73|0||0|10/01/2019 SH 78001|82952|82952 - GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS||6.41|0||0|10/01/2019 SH 78001|82951|82951 - GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS||21.02|0||0|10/01/2019 SH 78001|82950|82950 - GLUCOSE POST GLUCOSE DOSE||7.75|0||0|10/01/2019 SH 78001|82948|82948 - GLUCOSE BLOOD REAGENT STRIP||5.17|0||0|10/01/2019 SH 78001|82947|82947 - GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP||6.41|0||0|10/01/2019 SH 78001|82946|82946 - GLUCOSE TOLERANCE TEST||24.61|0||0|10/01/2019 SH 78001|82945|82945 - GLUCOSE BODY FLUID OTHER THAN BLOOD||6.41|0||0|10/01/2019 SH 78001|82943|82943 - ASSAY OF GLUCAGON||23.33|0||0|10/01/2019 SH 78001|82941|82941 - ASSAY OF GASTRIN||28.8|0||0|10/01/2019 SH 78001|82938|82938 - GASTRIN AFTER SECRETIN STIMULATION||28.9|0||0|10/01/2019 SH 78001|82930|82930 - GASTRIC ACID ANALYIS W/PH EACH SPECIMEN||8.89|0||0|10/01/2019 SH 78001|82820|82820 - HGB-O2 AFFINITY PO2 50% SATURATION OXYGEN||16.31|0||0|10/01/2019 SH 78001|82810|82810 - GASES BLOOD O2 SATURATION ONLY DIRECT MEAS||14.26|0||0|10/01/2019 SH 78001|82805|82805 - GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY||46.34|0||0|10/01/2019 SH 78001|82803|82803 - BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3||31.6|0||0|10/01/2019 SH 78001|82800|82800 - GASES BLOOD PH ONLY||13.81|0||0|10/01/2019 SH 78001|82787|82787 - GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES||13.09|0||0|10/01/2019 SH 78001|82785|82785 - ASSAY OF GAMMAGLOBULIN IGE||26.89|0||0|10/01/2019 SH 78001|82784|82784 - ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH||15.18|0||0|10/01/2019 SH 78001|82777|82777 - GALECTIN-3||35.92|0||0|10/01/2019 SH 78001|82776|82776 - GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE SCREEN||13.69|0||0|10/01/2019 SH 78001|82775|82775 - GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE QUAN||34.4|0||0|10/01/2019 SH 78001|82760|82760 - ASSAY OF GALACTOSE||18.29|0||0|10/01/2019 SH 78001|82759|82759 - ASSAY OF GALACTOKINASE RBC||35.09|0||0|10/01/2019 SH 78001|82757|82757 - ASSAY OF FRUCTOSE SEMEN||28.32|0||0|10/01/2019 SH 78001|82747|82747 - ASSAY OF FOLIC ACID RBC||28.28|0||0|10/01/2019 SH 78001|82746|82746 - ASSAY OF FOLIC ACID SERUM||24.01|0||0|10/01/2019 SH 78001|82735|82735 - ASSAY OF FLUORIDE||30.28|0||0|10/01/2019 SH 78001|82731|82731 - FTL FIBRONECTIN CERVICOVAG SECRETIONS SEMI-QUAN||105.18|0||0|10/01/2019 SH 78001|82728|82728 - ASSAY OF FERRITIN||22.25|0||0|10/01/2019 SH 78001|82726|82726 - VERY LONG CHAIN FATTY ACIDS||9.8|0||0|10/01/2019 SH 78001|82725|82725 - FATTY ACIDS NONESTERIFIED||21.74|0||0|10/01/2019 SH 78001|82715|82715 - FAT DIFFIAL FECES QUANTITATIVE||28.1|0||0|10/01/2019 SH 78001|82710|82710 - FAT/LIPIDS FECES QUANTITATIVE||27.44|0||0|10/01/2019 SH 78001|82705|82705 - FAT/LIPIDS FECES QUALITATIVE||8.32|0||0|10/01/2019 SH 78001|82696|82696 - ASSAY OF ETIOCHOLANOLONE||38.51|0||0|10/01/2019 SH 78001|82693|82693 - ASSAY OF ETHYLENE GLYCOL||24.32|0||0|10/01/2019 SH 78001|82679|82679 - ASSAY OF ESTRONE||40.75|0||0|10/01/2019 SH 78001|82677|82677 - ASSAY OF ESTRIOL||39.49|0||0|10/01/2019 SH 78001|82672|82672 - ASSAY OF ESTROGENS TOTAL||27.19|0||0|10/01/2019 SH 78001|82671|82671 - ASSAY OF ESTROGENS FRACTIONATED||52.75|0||0|10/01/2019 SH 78001|82670|82670 - ASSAY OF ESTRADIOL||45.62|0||0|10/01/2019 SH 78001|82668|82668 - ASSAY OF ERYTHROPOIETIN||30.7|0||0|10/01/2019 SH 78001|82664|82664 - ELCTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED||56.1|0||0|10/01/2019 SH 78001|82658|82658 - NZYM ACTV BLOOD CELLS/TISS RADACT SUBSTRATE EA||9.8|0||0|10/01/2019 SH 78001|82657|82657 - NZYM ACTIV BLD CELLS/TISS NONRADACT SUBSTRATE EA||9.8|0||0|10/01/2019 SH 78001|82656|82656 - ELASTASE PANCREATIC FECAL QUAL/SEMI-QUAN||17.45|0||0|10/01/2019 SH 78001|82652|82652 - 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED||62.87|0||0|10/01/2019 SH 78001|82638|82638 - ASSAY OF DIBUCAINE NUMBER||19.99|0||0|10/01/2019 SH 78001|82634|82634 - DEOXYCORTISOL 11-||47.81|0||0|10/01/2019 SH 78001|82633|82633 - DESOXYCORTICOSTERONE 11-||50.59|0||0|10/01/2019 SH 78001|82627|82627 - DEHYDROEPIANDROSTERONE-SULFATE||36.31|0||0|10/01/2019 SH 78001|82626|82626 - DEHYDROEPIANDROSTERONE||41.27|0||0|10/01/2019 SH 78001|82615|82615 - CSTINE&HOMOCSTINE URINE QUALITATIVE||13.33|0||0|10/01/2019 SH 78001|82610|82610 - CYSTATIN C||22.2|0||0|10/01/2019 SH 78001|82608|82608 - CYANOCOBALAMIN VIT B-12 UNSAT BINDING CAPACITY||23.38|0||0|10/01/2019 SH 78001|82607|82607 - CYANOCOBALAMIN VITAMIN B-12||24.61|0||0|10/01/2019 SH 78001|82600|82600 - ASSAY OF CYANIDE||31.68|0||0|10/01/2019 SH 78001|82595|82595 - CRYOGLOBULIN QUALITATIVE/SEMI-QUANTITATIVE||10.57|0||0|10/01/2019 SH 78001|82585|82585 - ASSAY OF CRYOFIBRN||14.02|0||0|10/01/2019 SH 78001|82575|82575 - CREATININE CLEARANCE||15.43|0||0|10/01/2019 SH 78001|82570|82570 - CREATININE OTHER SOURCE||8.45|0||0|10/01/2019 SH 78001|82565|82565 - CREATININE BLOOD||8.36|0||0|10/01/2019 SH 78001|82554|82554 - CREATINE KINASE ISOFORMS||19.38|0||0|10/01/2019 SH 78001|82553|82553 - CREATINE KINASE MB FRACTION ONLY||18.86|0||0|10/01/2019 SH 78001|82552|82552 - CREATINE KINASE ISOENZYMES||21.88|0||0|10/01/2019 SH 78001|82550|82550 - CREATINE KINASE TOTAL||10.63|0||0|10/01/2019 SH 78001|82544|82544 - COLUMN CHROMOTOGRAPH/ISOTOPE||9.8|0||0|10/01/2019 SH 78001|82543|82543 - COLUMN CHROMOTOGRAPH/ISOTOPE||9.8|0||0|10/01/2019 SH 78001|82542|82542 - COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC||9.8|0||0|10/01/2019 SH 78001|82541|82541 - COLUMN CHROMOTOGRAPHY QUAL||9.8|0||0|10/01/2019 SH 78001|82540|82540 - ASSAY OF CREATINE||7.57|0||0|10/01/2019 SH 78001|82533|82533 - CORTISOL TOTAL||26.63|0||0|10/01/2019 SH 78001|82530|82530 - CORTISOL FREE||27.29|0||0|10/01/2019 SH 78001|82528|82528 - CORTICOSTERONE||36.77|0||0|10/01/2019 SH 78001|82525|82525 - ASSAY OF COPPER||20.27|0||0|10/01/2019 SH 78001|82523|82523 - COLLAGEN CROSS LINKS ANY METHOD||30.52|0||0|10/01/2019 SH 78001|82507|82507 - ASSAY OF CITRATE||45.41|0||0|10/01/2019 SH 78001|82495|82495 - ASSAY OF CHROMIUM||33.12|0||0|10/01/2019 SH 78001|82492|82492 - CHROMOTOGRAPHY QUANT MULT||9.8|0||0|10/01/2019 SH 78001|82491|82491 - CHROMOTOGRAPHY QUANT SING||9.8|0||0|10/01/2019 SH 78001|82489|82489 - THIN LAYER CHROMATOGRAPHY||30.2|0||0|10/01/2019 SH 78001|82488|82488 - PAPER CHROMATOGRAPHY||34.88|0||0|10/01/2019 SH 78001|82487|82487 - PAPER CHROMATOGRAPHY||26.08|0||0|10/01/2019 SH 78001|82486|82486 - GAS/LIQUID CHROMATOGRAPHY||9.8|0||0|10/01/2019 SH 78001|82485|82485 - CHONDROITIN B SULFATE QUANTITATIVE||33.72|0||0|10/01/2019 SH 78001|82482|82482 - CHOLINESTERASE RBC||12.54|0||0|10/01/2019 SH 78001|82480|82480 - CHOLINESTERASE SERUM||12.86|0||0|10/01/2019 SH 78001|82465|82465 - CHOLESTEROL SERUM/WHOLE BLOOD TOTAL||7.1|0||0|10/01/2019 SH 78001|82441|82441 - CHLORINATED HYDROCARBONS SCREEN||9.8|0||0|10/01/2019 SH 78001|82438|82438 - CHLORIDE OTHER SOURCE||7.98|0||0|10/01/2019 SH 78001|82436|82436 - CHLORIDE URINE||8.22|0||0|10/01/2019 SH 78001|82435|82435 - CHLORIDE BLD||7.51|0||0|10/01/2019 SH 78001|82415|82415 - CHLORAMPHENICOL||20.69|0||0|10/01/2019 SH 78001|82397|82397 - CHEMILUMINESCENT ASSAY||23.06|0||0|10/01/2019 SH 78001|82390|82390 - CERULOPLASMIN||17.54|0||0|10/01/2019 SH 78001|82387|82387 - CATHEPSIN-D||33.98|0||0|10/01/2019 SH 78001|82384|82384 - CATECHOLAMINES FRACTIONATED||41.23|0||0|10/01/2019 SH 78001|82383|82383 - CATECHOLAMINES BLOOD||40.92|0||0|10/01/2019 SH 78001|82382|82382 - CATECHOLAMINES TOTAL URINE||28.08|0||0|10/01/2019 SH 78001|82380|82380 - CAROTENE||15.06|0||0|10/01/2019 SH 78001|82379|82379 - CARNITINE QUANTITATIVE EACH SPECIMEN||27.54|0||0|10/01/2019 SH 78001|82378|82378 - CARCINOEMBRYONIC ANTIGEN CEA||30.97|0||0|10/01/2019 SH 78001|82376|82376 - CARBOXYHEMOGLOBIN QUALITATIVE||9.78|0||0|10/01/2019 SH 78001|82375|82375 - CARBOXYHEMOGLOBIN QUANTITATIVE||4.7|0||0|10/01/2019 SH 78001|82374|82374 - CARBON DIOXIDE BICARBONATE||7.98|0||0|10/01/2019 SH 78001|82373|82373 - CARBOHYDRATE DEFICIENT TRANSFERRIN||9.8|0||0|10/01/2019 SH 78001|82370|82370 - CALCULUS XRAY DIFFRACTION||20.46|0||0|10/01/2019 SH 78001|82365|82365 - CALCULUS INFRARED SPECTROSCOPY||21.06|0||0|10/01/2019 SH 78001|82360|82360 - CALCULUS QUANTITATIVE CHEMICAL||21.02|0||0|10/01/2019 SH 78001|82355|82355 - CALCULUS QUALITATIVE ANALYSIS||18.9|0||0|10/01/2019 SH 78001|82340|82340 - CALCIUM URINE QUANTITATIVE TIMED SPECIMEN||9.85|0||0|10/01/2019 SH 78001|82331|82331 - CALCIUM AFTER CALCIUM INFUSION TEST||8.45|0||0|10/01/2019 SH 78001|82330|82330 - CALCIUM IONIZED||22.32|0||0|10/01/2019 SH 78001|82310|82310 - CALCIUM TOTAL||8.42|0||0|10/01/2019 SH 78001|82308|82308 - CALCITONIN||43.74|0||0|10/01/2019 SH 78001|82306|82306 - 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED||48.35|0||0|10/01/2019 SH 78001|82300|82300 - CADMIUM||37.79|0||0|10/01/2019 SH 78001|82286|82286 - BRADYKININ||11.26|0||0|10/01/2019 SH 78001|82274|82274 - BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3||25.98|0||0|10/01/2019 SH 78001|82272|82272 - BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC||5.26|0||0|10/01/2019 SH 78001|82271|82271 - BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES||5.26|0||0|10/01/2019 SH 78001|82270|82270 - BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER||5.26|0||0|10/01/2019 SH 78001|82261|82261 - BIOTINIDASE EACH SPECIMEN||27.54|0||0|10/01/2019 SH 78001|82252|82252 - BILIRUBIN FECES QUALITATIVE||7.43|0||0|10/01/2019 SH 78001|82248|82248 - BILIRUBIN DIRECT||8.2|0||0|10/01/2019 SH 78001|82247|82247 - BILIRUBIN TOTAL||8.2|0||0|10/01/2019 SH 78001|82240|82240 - BILE ACIDS CHOLYLGLYCINE||43.4|0||0|10/01/2019 SH 78001|82239|82239 - BILE ACIDS TOTAL||27.97|0||0|10/01/2019 SH 78001|82232|82232 - BETA-2 MICROGLOBULIN||26.42|0||0|10/01/2019 SH 78001|82190|82190 - ATOMIC ABSRPJ SPECTROSCOPY EA ANALYTE||24.34|0||0|10/01/2019 SH 78001|82180|82180 - ASSAY OF ASCORBIC ACID BLOOD||14.42|0||0|10/01/2019 SH 78001|82175|82175 - ASSAY OF ARSENIC||30.98|0||0|10/01/2019 SH 78001|82172|82172 - APOLIPOPROTEIN EACH||25.31|0||0|10/01/2019 SH 78001|82164|82164 - ANGIOTENSIN I-CONVERTING ENZYME||23.84|0||0|10/01/2019 SH 78001|82163|82163 - ANGIOTENSIN II||33.52|0||0|10/01/2019 SH 78001|82160|82160 - ANDROSTERONE||40.84|0||0|10/01/2019 SH 78001|82157|82157 - ANDROSTENEDIONE||47.81|0||0|10/01/2019 SH 78001|82154|82154 - ANDROSTANEDIOL GLUCURONIDE||47.09|0||0|10/01/2019 SH 78001|82150|82150 - ASSAY OF AMYLASE||10.58|0||0|10/01/2019 SH 78001|82143|82143 - AMNIOTIC FLU SCAN||11.22|0||0|10/01/2019 SH 78001|82140|82140 - ASSAY OF AMMONIA||16.16|0||0|10/01/2019 SH 78001|82139|82139 - AMINO ACIDS 6/> AMINO ACIDS QUANTITATIVE EA SPE||27.54|0||0|10/01/2019 SH 78001|82136|82136 - AMINO ACIDS 2-5 AMINO ACIDS QUANTITATIVE EA SPEC||27.54|0||0|10/01/2019 SH 78001|82135|82135 - AMINOLEVULINIC ACID DELTA||26.87|0||0|10/01/2019 SH 78001|82131|82131 - AMINO ACIDS 1 QUANTITATIVE EACH SPECIMEN||27.54|0||0|10/01/2019 SH 78001|82128|82128 - AMINO ACIDS MULTIPLE QUALITATIVE EACH SPECIMEN||22.64|0||0|10/01/2019 SH 78001|82127|82127 - AMINO ACIDS 1 QUALITATIVE EACH SPECIMEN||22.64|0||0|10/01/2019 SH 78001|82120|82120 - AMINES VAGINAL FLUID QUALITATIVE||3.95|0||0|10/01/2019 SH 78001|82108|82108 - ASSAY OF ALUMINUM||27.53|0||0|10/01/2019 SH 78001|82107|82107 - AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO||105.18|0||0|10/01/2019 SH 78001|82106|82106 - ALPHA-FETOPROTEIN AMNIOTIC FLUID||27.4|0||0|10/01/2019 SH 78001|82105|82105 - ALPHA-FETOPROTEIN SERUM||27.4|0||0|10/01/2019 SH 78001|82104|82104 - ALPHA-1-ANTITRYPSIN PHENOTYPE||23.62|0||0|10/01/2019 SH 78001|82103|82103 - ALPHA-1-ANTITRYPSIN TOTAL||21.95|0||0|10/01/2019 SH 78001|82088|82088 - ASSAY OF ALDOSTERONE||66.55|0||0|10/01/2019 SH 78001|82085|82085 - ASSAY OF ALDOLASE||15.85|0||0|10/01/2019 SH 78001|82075|82075 - ASSAY OF ALCOHOL BREATH||19.68|0||0|10/01/2019 SH 78001|82045|82045 - ALBUMIN ISCHEMIA MODIFIED||55.43|0||0|10/01/2019 SH 78001|82044|82044 - URINE ALBUMIN SEMIQUANTITATIVE||7.46|0||0|10/01/2019 SH 78001|82043|82043 - URINE ALBUMIN QUANTITATIVE||9.44|0||0|10/01/2019 SH 78001|82042|82042 - OTHER SOURCE ALBUMIN QUANTITATIVE EACH SPECIMEN||8.45|0||0|10/01/2019 SH 78001|82040|82040 - ALBUMIN SERUM PLASMA/WHOLE BLOOD||4.7|0||0|10/01/2019 SH 78001|82030|82030 - ADENOSINE 5-MONOPHOSPHATE CYCLIC||42.13|0||0|10/01/2019 SH 78001|82024|82024 - ADRENOCORTICOTROPIC HORMONE ACTH||63.07|0||0|10/01/2019 SH 78001|82017|82017 - ACYLCARNITINES QUANTIATIVE EACH SPECIMEN||27.54|0||0|10/01/2019 SH 78001|82016|82016 - ACYLCARNITINES QUALITATIVE EACH SPECIMEN||22.64|0||0|10/01/2019 SH 78001|82013|82013 - ASSAY OF ACETYLCHOLINESTERASE||18.24|0||0|10/01/2019 SH 78001|82010|82010 - KETONE BODIES SERUM QUANTITATIVE||13.34|0||0|10/01/2019 SH 78001|82009|82009 - KETONE BODIES SERUM QUALITATIVE||5.38|0||0|10/01/2019 SH 78001|81595|81595 - CARDIOLOGY HRT TRNSPL MRNA GENE EXPRESS 20 GENES||0|0||0|10/01/2019 SH 78001|81545|81545 - ONCOLOGY THYROID GENE EXPRESSION 142 GENES||0|0||0|10/01/2019 SH 78001|81541|81541 - ONC PRST8 MRNA GENE XPRSN PRFL RT-PCR 46 GENES||4647.6|0||0|10/01/2019 SH 78001|81540|81540 - ONCOLOGY TUM UNKNOWN ORIGIN MRNA 92 GENES||0|0||0|10/01/2019 SH 78001|81539|81539 - ONCOLOGY PROSTATE BIOCHEMICAL ASSAY 4 PROTEINS||722.52|0||0|10/01/2019 SH 78001|81538|81538 - ONCOLOGY LUNG MS 8-PROTEIN SIGNATURE||0|0||0|10/01/2019 SH 78001|81536|81536 - ONCOLOGY GYNE LIVE TUM CELL CLTR&CHEMO RESP ADD||180.7|0||0|10/01/2019 SH 78001|81535|81535 - ONCOLOGY GYNE LIVE TUM CELL CLTR&CHEMO RESP 1ST||695.35|0||0|10/01/2019 SH 78001|81528|81528 - ONCOLOGY COLORECTAL SCREENING QUAN 10 DNA MARKRS||460.87|0||0|10/01/2019 SH 78001|81525|81525 - ONCOLOGY COLON MRNA GENE EXPRESSION 12 GENES||0|0||0|10/01/2019 SH 78001|81521|81521 - ONC BREAST MRNA MICRORA GENE XPRSN PRFL 70 GENES||4647.6|0||0|10/01/2019 SH 78001|81520|81520 - ONC BREAST MRNA GENE XPRSN PRFL HYBRD 58 GENES||3718.82|0||0|10/01/2019 SH 78001|81493|81493 - COR ART DISEASE MRNA GENE EXPRESSION 23 GENES||0|0||0|10/01/2019 SH 78001|81490|81490 - AUTOIMMUNE RHEUMATOID ARTHRTS ANALYS 12 BIOMRKRS||0|0||0|10/01/2019 SH 78001|81448|81448 - HEREDITARY PERIPHERAL NEUROPATHY GEN SEQ PNL||866.52|0||0|10/01/2019 SH 78001|81442|81442 - NOONAN SPECTRUM DISORDERS GEN SEQ ANALYS 12 GEN||0|0||0|10/01/2019 SH 78001|81439|81439 - HEREDITARY CARDIOMYOPATHY GEN SEQ ANALYS 5 GEN||962.8|0||0|10/01/2019 SH 78001|81438|81438 - HEREDTRY NURONDCRN TUM DSRDRS DUP/DEL ANALYSIS||0|0||0|10/01/2019 SH 78001|81437|81437 - HEREDTRY NURONDCRN TUM DSRDRS GEN SEQ ANAL 6 GEN||0|0||0|10/01/2019 SH 78001|81434|81434 - HEREDITARY RETINAL DSRDRS GEN SEQ ANALYS 15 GEN||0|0||0|10/01/2019 SH 78001|81433|81433 - HEREDITARY BRST CA-RELATED DUP/DEL ANALYSIS||0|0||0|10/01/2019 SH 78001|81432|81432 - HEREDITARY BRST CA-RELATED GEN SEQ ANALYS 10 GEN||0|0||0|10/01/2019 SH 78001|81422|81422 - FETAL CHROMOSOMAL MICRODELTJ GENOMIC SEQ ANALYS||962.8|0||0|10/01/2019 SH 78001|81414|81414 - CAR ION CHNNLPATH DUP/DEL GN ALYS PANEL 2 GENES||962.8|0||0|10/01/2019 SH 78001|81413|81413 - CAR ION CHNNLPATH GENOMIC SEQ ALYS INC 10 GNS||962.8|0||0|10/01/2019 SH 78001|81412|81412 - ASHKENAZI JEWISH ASSOC DSRDRS GEN SEQ ANAL 9 GEN||0|0||0|10/01/2019 SH 78001|81383|81383 - HLA II HIGH RESOLUTION 1 ALLELE/ALLELE GROUP||178.21|0||0|10/01/2019 SH 78001|81382|81382 - HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA||201.97|0||0|10/01/2019 SH 78001|81381|81381 - HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP||154.45|0||0|10/01/2019 SH 78001|81380|81380 - HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA||289.45|0||0|10/01/2019 SH 78001|81379|81379 - HLA CLASS I TYPING HIGH RESOLUTION COMPLETE||547.68|0||0|10/01/2019 SH 78001|81378|81378 - HLA I&II HIGH RESOLUTION HLA-A -B -C AND -DRB1||564.31|0||0|10/01/2019 SH 78001|81377|81377 - HLA II LOW RESOLUTION ONE ANTIGEN EQUIVALENT EA||149.93|0||0|10/01/2019 SH 78001|81376|81376 - HLA CLASS II TYPING LOW RESOLUTION ONE LOCUS EA||199.58|0||0|10/01/2019 SH 78001|81375|81375 - HLA II LOW RESOLUTION HLA-DRB1/3/4/5 AND -DQB1||360.48|0||0|10/01/2019 SH 78001|81374|81374 - HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH||118.8|0||0|10/01/2019 SH 78001|81373|81373 - HLA CLASS I TYPING LOW RESOLUTION ONE LOCUS EACH||181.86|0||0|10/01/2019 SH 78001|81372|81372 - HLA CLASS I TYPING LOW RESOLUTION COMPLETE||360.73|0||0|10/01/2019 SH 78001|81371|81371 - HLA I&LI LOW RESOLUTION HLA-A -B&-DRB1||393.05|0||0|10/01/2019 SH 78001|81370|81370 - HLA CLASS I&II LOW HLA-A -B -C -DRB1/3/4/5&DQB||656.68|0||0|10/01/2019 SH 78001|81364|81364 - HBB FULL GENE SEQUENCE||389.49|0||0|10/01/2019 SH 78001|81363|81363 - HBB DUPLICATION/DELETION VARIANTS||242.88|0||0|10/01/2019 SH 78001|81362|81362 - HBB KNOWN FAMILIAL VARIANTS||450.3|0||0|10/01/2019 SH 78001|81361|81361 - HBB COMMON VARIANTS||209.77|0||0|10/01/2019 SH 78001|81346|81346 - TYMS GENE ANALYSIS COMMON VARIANTS||209.77|0||0|10/01/2019 SH 78001|81342|81342 - TRG@ GENE REARRANGEMENT ANALYSIS||329.05|0||0|10/01/2019 SH 78001|81341|81341 - TRB@ REARRANGEMENT ANAL DIRECT PROBE METHODOLOGY||80.98|0||0|10/01/2019 SH 78001|81340|81340 - TRB@ REARRANGEMENT ANAL AMPLIFICATION METHOD||341.17|0||0|10/01/2019 SH 78001|81335|81335 - TPMT GENE ANALAYSIS COMMON VARIANTS||209.77|0||0|10/01/2019 SH 78001|81334|81334 - RUNX1 GENE ANALYSIS TARGETED SEQUENCE ANALYSIS||395.41|0||0|10/01/2019 SH 78001|81332|81332 - SERPINA1 GENE ANALYSIS COMMON VARIANTS||71.28|0||0|10/01/2019 SH 78001|81328|81328 - SLCO1B1 GENE ANALYSIS COMMON VARIANTS||209.77|0||0|10/01/2019 SH 78001|81327|81327 - SEPT9 GENE PROMOTER METHYLATION ANALYSIS||100.4|0||0|10/01/2019 SH 78001|81323|81323 - PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT||104.86|0||0|10/01/2019 SH 78001|81322|81322 - PTEN GENE ANALYSIS KNOWN FAMILIAL VARIANT||69.9|0||0|10/01/2019 SH 78001|81321|81321 - PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS||719.04|0||0|10/01/2019 SH 78001|81319|81319 - PMS2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS||265.33|0||0|10/01/2019 SH 78001|81318|81318 - PMS2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS||220.98|0||0|10/01/2019 SH 78001|81317|81317 - PMS2 GENE ANALYSIS FULL SEQUENCE||935.21|0||0|10/01/2019 SH 78001|81316|81316 - PML/RARALPHA SINGLE BREAKPOINT QUAL/QUAN||516.37|0||0|10/01/2019 SH 78001|81315|81315 - PML/RARALPHA COMMON BREAKPOINTS QUAL/QUANT||338.54|0||0|10/01/2019 SH 78001|81314|81314 - PDGFRA GENE ANALYS TARGETED SEQUENCE ANALYS||146.27|0||0|10/01/2019 SH 78001|81311|81311 - NRAS GENE ANALYSIS VARIANTS IN EXON 2&3||354.95|0||0|10/01/2019 SH 78001|81310|81310 - NPM1 NUCLEOPHOSMIN GENE ANAL EXON 12 VARIANTS||295.82|0||0|10/01/2019 SH 78001|81301|81301 - MICROSATELLITE INSTAB ANAL MISMATCH REPAIR DEF||472.86|0||0|10/01/2019 SH 78001|81300|81300 - MSH6 GENE ANALYSIS DUPLICATION/DELETION VARIA||193.54|0||0|10/01/2019 SH 78001|81299|81299 - MSH6 GENE ANALYSIS KNOWN FAMILIAL VARIANTS||193.01|0||0|10/01/2019 SH 78001|81298|81298 - MSH6 GENE ANALYSIS FULL SEQUENCE ANALYSIS||344.53|0||0|10/01/2019 SH 78001|81297|81297 - MSH2 GENE ANALYSIS DUPLICATION/DELETION VARIANTS||181.6|0||0|10/01/2019 SH 78001|81296|81296 - MSH2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS||155.05|0||0|10/01/2019 SH 78001|81295|81295 - MSH2 GENE ANALYSIS FULL SEQUENCE ANALYSIS||181.6|0||0|10/01/2019 SH 78001|81294|81294 - MLH1 GENE ANALYSIS DUPLICATION/DELETION VARIANTS||228.24|0||0|10/01/2019 SH 78001|81293|81293 - MLH1 GENE ANALYSIS KNOWN FAMILIAL VARIANTS||310.09|0||0|10/01/2019 SH 78001|81292|81292 - MLH1 GENE ANALYSIS FULL SEQUENCE ANALYSIS||773.54|0||0|10/01/2019 SH 78001|81291|81291 - MTHFR GENE ANALYSIS COMMON VARIANTS||71.28|0||0|10/01/2019 SH 78001|81283|81283 - IFNL3 GENE ANALYSIS RS12979860 VARIANT||90.53|0||0|10/01/2019 SH 78001|81276|81276 - KRAS GENE ANALYSIS ADDITIONAL VARIANT(S)||236.63|0||0|10/01/2019 SH 78001|81273|81273 - KIT GENE ANALYSIS D816 VARIANT(S)||107.04|0||0|10/01/2019 SH 78001|81272|81272 - KIT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS||146.27|0||0|10/01/2019 SH 78001|81270|81270 - JAK2 GENE ANALYSIS P.VAL617PHE VARIANT||236.39|0||0|10/01/2019 SH 78001|81269|81269 - HBA1/HBA2 GENE ANALYSIS DUP/DEL VARIANTS||242.88|0||0|10/01/2019 SH 78001|81268|81268 - CHIMERISM W/COMP TO BASELINE W/CELL SELECTION EA||149.7|0||0|10/01/2019 SH 78001|81267|81267 - CHIMERISM W/COMP TO BASELINE W/O CELL SELECTION||425.87|0||0|10/01/2019 SH 78001|81266|81266 - COMPARATIVE ANAL STR MARKERS EA ADDL SPECIMEN||338.78|0||0|10/01/2019 SH 78001|81265|81265 - COMPARATIVE ANAL STR MARKERS PATIENT&COMP SPEC||351.18|0||0|10/01/2019 SH 78001|81264|81264 - IGK@ GENE REARRANGE DETECT ABNORMAL CLONAL POP||243.85|0||0|10/01/2019 SH 78001|81263|81263 - IGH@ VARIABLE REGION SOMATIC MUTATION ANALYSIS||480.95|0||0|10/01/2019 SH 78001|81262|81262 - IGH@ REARRANGE ABNORMAL CLONAL POP DIRECT PROBE||71.28|0||0|10/01/2019 SH 78001|81261|81261 - IGH@ REARRANGE ABNORMAL CLONAL POP AMPLIFIED||323.32|0||0|10/01/2019 SH 78001|81259|81259 - HBA1/HBA2 GENE ANALYSIS FULL GENE SEQUENCE||720|0||0|10/01/2019 SH 78001|81258|81258 - HBA1/HBA2 GENE ANALYSIS KNOWN FAMILIAL VARIANT||450.3|0||0|10/01/2019 SH 78001|81256|81256 - HFE HEMOCHROMATOSIS GENE ANAL COMMON VARIANTS||106.74|0||0|10/01/2019 SH 78001|81249|81249 - G6PD GENE ANALYSIS FULL GENE SEQUENCE||720|0||0|10/01/2019 SH 78001|81248|81248 - G6PD GENE ANALYSIS KNOWN FAMILIAL VARIANTS||450.3|0||0|10/01/2019 SH 78001|81247|81247 - G6PD GENE ANALYSIS COMMON VARIANTS||209.77|0||0|10/01/2019 SH 78001|81245|81245 - FLT3 GENE ANALYSIS INTERNAL TANDEM DUP VARIANTS||198.61|0||0|10/01/2019 SH 78001|81241|81241 - F5 COAGULATION FACTOR V ANAL LEIDEN VARIANT||99.79|0||0|10/01/2019 SH 78001|81240|81240 - F2 GENE ANALYSIS 20210G >A VARIANT||80.35|0||0|10/01/2019 SH 78001|81238|81238 - F9 FULL GENE SEQUENCE||720|0||0|10/01/2019 SH 78001|81235|81235 - EGFR GENE ANALYSIS COMMON VARIANTS||395.02|0||0|10/01/2019 SH 78001|81232|81232 - DYPD GENE ANALYSIS COMMON VARIANTS||209.77|0||0|10/01/2019 SH 78001|81231|81231 - CYP3A5 GENE ANALYSIS COMMON VARIANTS||209.77|0||0|10/01/2019 SH 78001|81230|81230 - CYP3A4 GENE ANALYSIS COMMON VARIANTS||209.77|0||0|10/01/2019 SH 78001|81227|81227 - CYP2C9 GENE ANALYSIS COMMON VARIANTS||209.57|0||0|10/01/2019 SH 78001|81226|81226 - CYP2D6 GENE ANALYSIS COMMON VARIANTS||540.55|0||0|10/01/2019 SH 78001|81225|81225 - CYP2C19 GENE ANALYSIS COMMON VARIANTS||349.28|0||0|10/01/2019 SH 78001|81219|81219 - CALR GENE ANALYSIS COMMON VARIANTS IN EXON 9||146.27|0||0|10/01/2019 SH 78001|81218|81218 - CEBPA GENE ANALYSIS FULL GENE SEQUENCE||146.27|0||0|10/01/2019 SH 78001|81217|81217 - BRCA2 GENE ANALYSIS KNOWN FAMILIAL VARIANT||111.61|0||0|10/01/2019 SH 78001|81215|81215 - BRCA1 GENE ANALYSIS KNOWN FAMILIAL VARIANT||111.61|0||0|10/01/2019 SH 78001|81214|81214 - BRCA1 FULL SEQ ANAL&COMMON DUP/DEL VARIANTS||1721.45|0||0|10/01/2019 SH 78001|81213|81213 - BRCA1&BRCA2 ANAL UNCOMMON DUP/DEL VARIANTS||697.51|0||0|10/01/2019 SH 78001|81212|81212 - BRCA1 BRCA 2 GEN ALYS 185DELAG 5385INSC 6174DELT||211.51|0||0|10/01/2019 SH 78001|81211|81211 - BRCA1&BRCA2 FULL SEQ ANALYS/COMM DUP/DEL BRCA||2613.65|0||0|10/01/2019 SH 78001|81210|81210 - BRAF GENE ANALYSIS V600 VARIANT(S)||214.56|0||0|10/01/2019 SH 78001|81208|81208 - BCR/ABL1 OTHER BREAKPNT QUALITATIVE/QUANTITATIVE||262.66|0||0|10/01/2019 SH 78001|81207|81207 - BCR/ABL1 MINOR BREAKPNT QUALITATIVE/QUANTITATIVE||236.52|0||0|10/01/2019 SH 78001|81206|81206 - BCR/ABL1 MAJOR BREAKPNT QUALITATIVE/QUANTITATIVE||267.76|0||0|10/01/2019 SH 78001|81176|81176 - ASXL1 GENE ANALYSIS TARGETED SEQ ANALYSIS||358.37|0||0|10/01/2019 SH 78001|81175|81175 - ASXL1 GENE ANALYSIS FULL GENE SEQUENCE||848.42|0||0|10/01/2019 SH 78001|81170|81170 - ABL1 GENE ANALYSIS KINASE DOMAIN VARIANTS||2983.03|0||0|10/01/2019 SH 78001|81162|81162 - BRCA1 BRCA2 GENE ALYS FULL SEQ FULL DUP/DEL ALYS||146.27|0||0|10/01/2019 SH 78001|81121|81121 - IDH2 COMMON VARIANTS||354.95|0||0|10/01/2019 SH 78001|81120|81120 - IDH1 COMMON VARIANTS||231.9|0||0|10/01/2019 SH 78001|81112|81112 - HPA-15 GENOTYPING GENE ANALYSIS COMMON VARIANT||181.07|0||0|10/01/2019 SH 78001|81111|81111 - HPA-9 GENOTYPING GENE ANALYSIS COMMON VARIANT||181.07|0||0|10/01/2019 SH 78001|81110|81110 - HPA-6 GENOTYPING GENE ANALYSIS COMMON VARIANT||181.07|0||0|10/01/2019 SH 78001|81109|81109 - HPA-5 GENOTYPING GENE ANALYSIS COMMON VARIANT||181.07|0||0|10/01/2019 SH 78001|81108|81108 - HPA-4 GENOTYPING GENE ANALYSIS COMMON VARIANT||181.07|0||0|10/01/2019 SH 78001|81107|81107 - HPA-3 GENOTYPING GENE ANALYSIS COMMON VARIANT||181.07|0||0|10/01/2019 SH 78001|81106|81106 - HPA-2 GENOTYPING GENE ANALYSIS COMMON VARIANT||181.07|0||0|10/01/2019 SH 78001|81105|81105 - HPA-1 GENOTYPING GENE ANALYSIS COMMON VARIANT||181.07|0||0|10/01/2019 SH 78001|81050|81050 - VOLUME MEASUREMENT TIMED COLLECTION EACH||4.9|0||0|10/01/2019 SH 78001|81025|81025 - URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS||10.33|0||0|10/01/2019 SH 78001|81020|81020 - URINALYSIS 2/3 GLASS TEST||6.02|0||0|10/01/2019 SH 78001|81015|81015 - URINALYSIS MICROSCOPIC ONLY||4.97|0||0|10/01/2019 SH 78001|81007|81007 - URINALYSIS BACTERIURIA SCR XCPT CULTURE/DIPSTICK||4.19|0||0|10/01/2019 SH 78001|81005|81005 - URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS||3.54|0||0|10/01/2019 SH 78001|81003|81003 - URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY||3.67|0||0|10/01/2019 SH 78001|81002|81002 - URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP||4.18|0||0|10/01/2019 SH 78001|81001|81001 - URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY||5.17|0||0|10/01/2019 SH 78001|81000|81000 - URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY||5.17|0||0|10/01/2019 SH 78001|80502|80502 - CLINICAL PATHOLOGY CONSULTATION COMPREHENSIVE||81.78|0||0|10/01/2019 SH 78001|80500|80500 - CLINICAL PATHOLOGY CONSULTATION LIMITED||23.32|0||0|10/01/2019 SH 78001|80439|80439 - THYROTROPIN RELEASING HORMONE STMLJ PANEL 2 HR||109.76|0||0|10/01/2019 SH 78001|80438|80438 - THYROTROPIN RELEASING HORMONE STMLJ PANEL 1 HR||82.32|0||0|10/01/2019 SH 78001|80436|80436 - METYRAPONE PANEL||148.87|0||0|10/01/2019 SH 78001|80435|80435 - INSULIN TOLERANCE PANEL GROWTH HORM DEFNCY||148.27|0||0|10/01/2019 SH 78001|80434|80434 - INSULIN TOLERANCE PANEL ACTH INSUFFICIENCY||165.22|0||0|10/01/2019 SH 78001|80432|80432 - INSULIN-INDUCED C-PEPTIDE SUPRESSION PANEL||180.48|0||0|10/01/2019 SH 78001|80430|80430 - GROWTH HORMONE SUPRJ PANEL GLUCOSE ADMN||112.21|0||0|10/01/2019 SH 78001|80428|80428 - GROWTH HORMONE STIMULATION PANEL||92.98|0||0|10/01/2019 SH 78001|80426|80426 - GONADOTROPIN RELEASING HORMONE STIMJ PANEL||242.35|0||0|10/01/2019 SH 78001|80424|80424 - GLUCOSE TOLERANCE PANEL PHEOCHROMOCYTOMA||82.46|0||0|10/01/2019 SH 78001|80422|80422 - GLUCOSE TOLERANCE PANEL INSULINOMA||75.24|0||0|10/01/2019 SH 78001|80420|80420 - DEXMETHASONE SUPPRESSION PANEL 48 HR||117.65|0||0|10/01/2019 SH 78001|80418|80418 - COMBINED RAPID ANT PITUITARY EVALUATION PANEL||930.55|0||0|10/01/2019 SH 78001|80417|80417 - PERIPHERAL VEIN RENIN STIMULATION PANEL||71.83|0||0|10/01/2019 SH 78001|80416|80416 - RENAL VEIN RENIN STIMULATION PANEL||215.5|0||0|10/01/2019 SH 78001|80415|80415 - CHORNC GONAD STIMJ PANEL ESTRADIOL RESPONSE||91.26|0||0|10/01/2019 SH 78001|80414|80414 - CHORNC GONAD STIMJ PANEL TSTOSTERONE RESPONSE||84.32|0||0|10/01/2019 SH 78001|80412|80412 - CORTICOTROPIC RELEASING HORM STIMJ PANEL||538.28|0||0|10/01/2019 SH 78001|80410|80410 - CALCITONIN STIMULATION PANEL||131.2|0||0|10/01/2019 SH 78001|80408|80408 - ALDOSTERONE SUPPRESSION EVALUATION PANEL||204.94|0||0|10/01/2019 SH 78001|80406|80406 - ACTH STIMJ PANEL 3 BETA-HYDROXYDEHYD DEFNCY||127.79|0||0|10/01/2019 SH 78001|80402|80402 - ACTH STIMULATION PANEL 21 HYDROXYLASE DEFICIENCY||142|0||0|10/01/2019 SH 78001|80400|80400 - ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY||53.27|0||0|10/01/2019 SH 78001|80307|80307 - DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE||91.74|0||0|10/01/2019 SH 78001|80306|80306 - DRUG TST PRSMV READ INSTRMNT ASSTD DIR OPT OBS||22.93|0||0|10/01/2019 SH 78001|80305|80305 - DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE||17.21|0||0|10/01/2019 SH 78001|80299|80299 - QUANTITATION DRUG NOT ELSEWHERE SPECIFIED||19.68|0||0|10/01/2019 SH 78001|80203|80203 - DRUG SCREEN QUANTITATIVE ZONISAMIDE||21.65|0||0|10/01/2019 SH 78001|80202|80202 - DRUG SCREEN QUANTITATIVE VANCOMYCIN||18.54|0||0|10/01/2019 SH 78001|80201|80201 - DRUG SCREEN QUANTITATIVE TOPIRAMATE||19.48|0||0|10/01/2019 SH 78001|80200|80200 - DRUG SCREEN QUANTITATIVE TOBRAMYCIN||24.46|0||0|10/01/2019 SH 78001|80199|80199 - DRUG SCREEN QUANTITATIVE TIAGABINE||9.8|0||0|10/01/2019 SH 78001|80198|80198 - DRUG SCREEN QUANTITATIVE THEOPHYLLINE||23.1|0||0|10/01/2019 SH 78001|80197|80197 - DRUG SCREEN QUANTITATIVE TACROLIMUS||22.43|0||0|10/01/2019 SH 78001|80195|80195 - DRUG SCREEN QUANTITATIVE SIROLIMUS||22.43|0||0|10/01/2019 SH 78001|80194|80194 - DRUG SCREEN QUANTITATIVE QUINIDINE||23.84|0||0|10/01/2019 SH 78001|80192|80192 - DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE||27.36|0||0|10/01/2019 SH 78001|80190|80190 - DRUG SCREEN QUANTITATIVE PROCAINAMIDE||27.36|0||0|10/01/2019 SH 78001|80188|80188 - DRUG SCREEN QUANTITATIVE PRIMIDONE||27.1|0||0|10/01/2019 SH 78001|80186|80186 - DRUG SCREEN QUANTITATIVE PHENYTOIN FREE||22.48|0||0|10/01/2019 SH 78001|80185|80185 - DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL||21.65|0||0|10/01/2019 SH 78001|80184|80184 - DRUG SCREEN QUANTITATIVE PHENOBARBITAL||18.7|0||0|10/01/2019 SH 78001|80183|80183 - DRUG SCREEN QUANTITATIVE OXCARBAZEPINE||21.65|0||0|10/01/2019 SH 78001|80180|80180 - DRUG SCREEN QUANTITATIVE MYCOPHENOLATE||9.72|0||0|10/01/2019 SH 78001|80178|80178 - DRUG SCREEN QUANTITATIVE LITHIUM||10.8|0||0|10/01/2019 SH 78001|80177|80177 - DRUG SCREEN QUANTITATIVE LEVETIRACETAM||21.65|0||0|10/01/2019 SH 78001|80176|80176 - DRUG SCREEN QUANTITATIVE LIDOCAINE||23.99|0||0|10/01/2019 SH 78001|80175|80175 - DRUG SCREEN QUANTITATIVE LAMOTRIGINE||21.65|0||0|10/01/2019 SH 78001|80173|80173 - DRUG SCREEN QUANTITATIVE HALOPRIDOL||23.78|0||0|10/01/2019 SH 78001|80171|80171 - DRUG SCREEN QUANTITATIVE GABAPENTIN||21.65|0||0|10/01/2019 SH 78001|80170|80170 - DRUG SCREEN QUANTITATIVE GENTAMICIN||26.76|0||0|10/01/2019 SH 78001|80169|80169 - DRUG ASSAY EVEROLIMUS||22.43|0||0|10/01/2019 SH 78001|80168|80168 - DRUG SCREEN QUANTITATIVE ETHOSUXIMIDE||26.69|0||0|10/01/2019 SH 78001|80165|80165 - DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE||18.54|0||0|10/01/2019 SH 78001|80164|80164 - DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL||18.54|0||0|10/01/2019 SH 78001|80163|80163 - DRUG SCREEN QUANTITATIVE DIGOXIN FREE||21.68|0||0|10/01/2019 SH 78001|80162|80162 - DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL||21.68|0||0|10/01/2019 SH 78001|80159|80159 - DRUG ASSAY CLOZAPINE||30.2|0||0|10/01/2019 SH 78001|80158|80158 - DRUG ASSAY CYCLOSPORINE||9.72|0||0|10/01/2019 SH 78001|80157|80157 - DRUG ASSAY CARBAMAZEPINE FREE||21.65|0||0|10/01/2019 SH 78001|80156|80156 - DRUG ASSAY CARBAMAZEPINE TOTAL||23.78|0||0|10/01/2019 SH 78001|80155|80155 - DRUG ASSAY CAFFEINE||23.1|0||0|10/01/2019 SH 78001|80150|80150 - DRUG SCREEN QUANTITATIVE AMIKACIN||24.61|0||0|10/01/2019 SH 78001|80081|80081 - OBSTETRIC PANEL||122.36|0||0|10/01/2019 SH 78001|80076|80076 - HEPATIC FUNCTION PANEL||13.33|0||0|10/01/2019 SH 78001|80074|80074 - ACUTE HEPATITIS PANEL||77.8|0||0|10/01/2019 SH 78001|80069|80069 - RENAL FUNCTION PANEL||14.18|0||0|10/01/2019 SH 78001|80061|80061 - LIPID PANEL||21.86|0||0|10/01/2019 SH 78001|80053|80053 - COMPREHENSIVE METABOLIC PANEL||17.24|0||0|10/01/2019 SH 78001|80051|80051 - ELECTROLYTE PANEL||11.46|0||0|10/01/2019 SH 78001|80050|80050 - GENERAL HEALTH PANEL||61.25|0||0|10/01/2019 SH 78001|80048|80048 - BASIC METABOLIC PANEL CALCIUM TOTAL||13.81|0||0|10/01/2019 SH 78001|80047|80047 - BASIC METABOLIC PANEL CALCIUM IONIZED||13.81|0||0|10/01/2019 SH 78001|79999|79999 - RP THERAPY UNLISTED PROCEDURE||0|0||0|10/01/2019 SH 78001|79445|79445 - RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN||0|141.14||0|10/01/2019 SH 78001|79440|79440 - RP THERAPY INTRA-ARTICULAR ADMINISTRATION||149.79|105.99||0|10/01/2019 SH 78001|79403|79403 - RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS||218.38|130.38||0|10/01/2019 SH 78001|79300|79300 - RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN||0|86.45||0|10/01/2019 SH 78001|79200|79200 - RP THERAPY INRACAVITARY ADMINISTRATION||157.54|100.93||0|10/01/2019 SH 78001|79101|79101 - RP THERAPY INTRAVENOUS ADMINISTRATION||164.78|112.44||0|10/01/2019 SH 78001|79005|79005 - RP THERAPY ORAL ADMINISTRATION||157.49|103.99||0|10/01/2019 SH 78001|78999|78999 - UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE||0|0||0|10/01/2019 SH 78001|78816|78816 - PET IMAGING FOR CT ATTENUATION WHOLE BODY||0|147.39||0|10/01/2019 SH 78001|78815|78815 - PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH||0|146.35||0|10/01/2019 SH 78001|78814|78814 - PET IMAGING CT FOR ATTENUATION LIMITED AREA||0|133.29||0|10/01/2019 SH 78001|78813|78813 - PET IMAGING WHOLE BODY||0|120||0|10/01/2019 SH 78001|78812|78812 - PET IMAGING SKULL BASE TO MID-THIGH||0|115.05||0|10/01/2019 SH 78001|78811|78811 - PET IMAGING LIMITED AREA CHEST HEAD/NECK||0|93.57||0|10/01/2019 SH 78001|78808|78808 - NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS||50.02|0||0|10/01/2019 SH 78001|78807|78807 - RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT||388.54|61.35||0|10/01/2019 SH 78001|78806|78806 - RP LOCLZJ INFLAMMATORY PROCESS WHOLE BODY||379.01|49.88||0|10/01/2019 SH 78001|78805|78805 - RP LOCLZJ INFLAMMATORY PROCESS LIMITED AREA||207.48|42.73||0|10/01/2019 SH 78001|78804|78804 - RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING||646.25|62.04||0|10/01/2019 SH 78001|78803|78803 - RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING||388.15|62.13||0|10/01/2019 SH 78001|78802|78802 - RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING||368.93|50.27||0|10/01/2019 SH 78001|78801|78801 - RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D||296.13|47.26||0|10/01/2019 SH 78001|78800|78800 - RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING||216.87|39.32||0|10/01/2019 SH 78001|78799|78799 - UNLISTED GENITOURINARY PX DX NUCLEAR MEDICINE||0|0||0|10/01/2019 SH 78001|78761|78761 - TESTICULAR IMAGING WITH VASCULAR FLOW||239.96|42.64||0|10/01/2019 SH 78001|78740|78740 - URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM||248.26|33.11||0|10/01/2019 SH 78001|78730|78730 - URINARY BLADDER RESIDUAL STUDY||86.72|9.18||0|10/01/2019 SH 78001|78725|78725 - KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY||123|21.43||0|10/01/2019 SH 78001|78710|78710 - KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC||225.01|35.44||0|10/01/2019 SH 78001|78709|78709 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE||412.42|80.58||0|10/01/2019 SH 78001|78708|78708 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX||200.28|70.8||0|10/01/2019 SH 78001|78707|78707 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX||265.08|55.36||0|10/01/2019 SH 78001|78701|78701 - KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW||238.61|28.11||0|10/01/2019 SH 78001|78700|78700 - KIDNEY IMAGING MORPHOLOGY||194.63|26||0|10/01/2019 SH 78001|78699|78699 - UNLISTED NERVOUS SYSTEM PX DX NUCLEAR MEDICINE||0|0||0|10/01/2019 SH 78001|78660|78660 - RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY||200.4|30.61||0|10/01/2019 SH 78001|78650|78650 - CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO||378.69|36||0|10/01/2019 SH 78001|78647|78647 - CEREBROSPINAL FLUID FLOW W/O MATL TOMOG SPECT||398.95|52.38||0|10/01/2019 SH 78001|78645|78645 - CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ||366.89|33.11||0|10/01/2019 SH 78001|78635|78635 - CEREBROSPINAL FLUID FLOW W/O MATL VENTRICLGRAPHY||386.06|36.78||0|10/01/2019 SH 78001|78630|78630 - CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY||385.2|40.18||0|10/01/2019 SH 78001|78610|78610 - BRAIN IMAGING VASCULAR FLOW ONLY||197.08|17.59||0|10/01/2019 SH 78001|78609|78609 - BRAIN IMAGING PET PERFUSION EVALUATION||90.67|90.67||0|10/01/2019 SH 78001|78608|78608 - BRAIN IMAGING PET METABOLIC EVALUATION||0|87.58||0|10/01/2019 SH 78001|78607|78607 - BRAIN IMAGING TOMOGRAPHIC SPECT||401.94|70.49||0|10/01/2019 SH 78001|78606|78606 - BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW||377.27|37.29||0|10/01/2019 SH 78001|78605|78605 - BRAIN IMAGING MINIMUM 4 STATIC VIEWS||225.61|31.39||0|10/01/2019 SH 78001|78601|78601 - BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW||243.74|29.75||0|10/01/2019 SH 78001|78600|78600 - BRAIN IMAGING <4 STATIC VIEWS||208.93|25.95||0|10/01/2019 SH 78001|78599|78599 - UNLISTED RESPIRATORY PX DX NUCLEAR MEDICINE||0|0||0|10/01/2019 SH 78001|78598|78598 - QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN||348.34|49.45||0|10/01/2019 SH 78001|78597|78597 - QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING||230.44|42.82||0|10/01/2019 SH 78001|78582|78582 - PULMONARY VENTILATION & PERFUSION IMAGING||381.47|62.82||0|10/01/2019 SH 78001|78580|78580 - PULMONARY PERFUSION IMAGING PARTICULATE||271.49|43.16||0|10/01/2019 SH 78001|78579|78579 - PULMONARY VENTILATION IMAGING||209.53|27.72||0|10/01/2019 SH 78001|78499|78499 - UNLISTED CARDIOVASCULAR PX DX NUCLEAR MEDICINE||0|0||0|10/01/2019 SH 78001|78496|78496 - CARD BL POOL GATED 1 STDY REST RT VENT EJCT FRCT||51.8|28.93||0|10/01/2019 SH 78001|78494|78494 - CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT||256.78|68.77||0|10/01/2019 SH 78001|78492|78492 - MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS||0|108.96||0|10/01/2019 SH 78001|78491|78491 - MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS||0|86.8||0|10/01/2019 SH 78001|78483|78483 - CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT||273.51|84.72||0|10/01/2019 SH 78001|78481|78481 - CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT||200.43|56.61||0|10/01/2019 SH 78001|78473|78473 - CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT||330.88|84.33||0|10/01/2019 SH 78001|78472|78472 - CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS||262.85|57||0|10/01/2019 SH 78001|78469|78469 - MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ||259.87|54.02||0|10/01/2019 SH 78001|78468|78468 - MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ||220.58|46.13||0|10/01/2019 SH 78001|78466|78466 - MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN||222.04|41.39||0|10/01/2019 SH 78001|78459|78459 - MYOCRD IMG PET METAB EVAL SINGLE STUDY||0|86.41||0|10/01/2019 SH 78001|78458|78458 - VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL||234.58|53.16||0|10/01/2019 SH 78001|78457|78457 - VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL||200.29|44.45||0|10/01/2019 SH 78001|78456|78456 - ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE||364.89|57.86||0|10/01/2019 SH 78001|78454|78454 - MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES||495.85|78.72||0|10/01/2019 SH 78001|78453|78453 - MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS||346.66|58.25||0|10/01/2019 SH 78001|78452|78452 - MYOCARDIAL SPECT MULTIPLE STUDIES||538.55|93.9||0|10/01/2019 SH 78001|78451|78451 - MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS||389.8|79.67||0|10/01/2019 SH 78001|78445|78445 - NONCARDIAC VASCULAR FLOW IMAGING||204.11|28.11||0|10/01/2019 SH 78001|78428|78428 - CARDIAC SHUNT DETECTION||206.54|44.88||0|10/01/2019 SH 78001|78414|78414 - CARD-VASC HEMODYNAM W/WO PHARM/EXER 1/MLT DETERM||0|26.78||0|10/01/2019 SH 78001|78399|78399 - UNLISTED MUSCULOSKELETAL PX DX NUCLEAR MEDICINE||0|0||0|10/01/2019 SH 78001|78351|78351 - BONE DENSTY 1/> SITES DUAL PHOTON ABSORPTIOMETR||17.98|0||0|10/01/2019 SH 78001|78350|78350 - BONE DENSITY 1/> SITES 1 PHOTON ABSORPTIOMETRY||37.01|12.98||0|10/01/2019 SH 78001|78320|78320 - BONE &/JOINT IMAGING TOMOGRAPHIC SPECT||260.78|59.97||0|10/01/2019 SH 78001|78315|78315 - BONE &/JOINT IMAGING 3 PHASE STUDY||395.21|59.89||0|10/01/2019 SH 78001|78306|78306 - BONE &/JOINT IMAGING WHOLE BODY||287.13|50.27||0|10/01/2019 SH 78001|78305|78305 - BONE &/JOINT IMAGING MULTIPLE AREAS||262.97|48.59||0|10/01/2019 SH 78001|78300|78300 - BONE &/JOINT IMAGING LIMITED AREA||205.45|37.21||0|10/01/2019 SH 78001|78299|78299 - UNLISTED GASTROINTESTINAL PX DX NUCLEAR MEDICINE||0|0||0|10/01/2019 SH 78001|78291|78291 - PERITONEAL-VENOUS SHUNT PATENCY TEST||283.73|50.36||0|10/01/2019 SH 78001|78290|78290 - INTESTINE IMAGING||377.45|40.18||0|10/01/2019 SH 78001|78282|78282 - GASTROINTESTINAL PROTEIN LOSS||0|22.98||0|10/01/2019 SH 78001|78278|78278 - ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING||397.41|58.6||0|10/01/2019 SH 78001|78272|78272 - VITAMIN B-12 ABSRPJ STDY W/WO INTRINSIC FACT||110.11|15.91||0|10/01/2019 SH 78001|78271|78271 - VITAMIN B-12 ABSRPJ STUDY W/INTRINSIC FACTOR||102.44|12.12||0|10/01/2019 SH 78001|78270|78270 - VITAMIN B-12 ABSRPJ STUDY W/O INTRINSIC FACTOR||114.85|12.5||0|10/01/2019 SH 78001|78268|78268 - UREA BREATH TEST C-14 ISOTOPIC ANALYSIS||22.08|0||0|10/01/2019 SH 78001|78267|78267 - UREA BREATH TEST C-14 ISOTOPIC ACQUISJ ANALYSIS||12.84|0||0|10/01/2019 SH 78001|78266|78266 - GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY||537.74|63.41||0|10/01/2019 SH 78001|78265|78265 - GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT||415.25|358.07||0|10/01/2019 SH 78001|78264|78264 - GASTRIC EMPTYING IMAGING STUDY||329.13|46.91||0|10/01/2019 SH 78001|78262|78262 - GASTROESOPHAGEAL REFLUX STUDY||277.04|39.4||0|10/01/2019 SH 78001|78261|78261 - GASTRIC MUCOSA IMAGING||287.56|41.39||0|10/01/2019 SH 78001|78258|78258 - ESOPHAGEAL MOTILITY||250.55|42.77||0|10/01/2019 SH 78001|78232|78232 - SALIVARY GLAND FUNCTION STUDY||112.93|24.54||0|10/01/2019 SH 78001|78231|78231 - SALIVARY GLAND IMAGING SERIAL IMAGES||147.64|30.57||0|10/01/2019 SH 78001|78230|78230 - SALIVARY GLAND IMAGING||196.18|26.38||0|10/01/2019 SH 78001|78227|78227 - HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ||455.16|52.77||0|10/01/2019 SH 78001|78226|78226 - HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER||376.16|43.55||0|10/01/2019 SH 78001|78216|78216 - LIVER & SPLEEN IMAGING W/VASCULAR FLOW||143.6|33.11||0|10/01/2019 SH 78001|78215|78215 - LIVER & SPLEEN IMAGING STATIC ONLY||220.39|28.5||0|10/01/2019 SH 78001|78206|78206 - LIVER IMAGING SPECT W/VASCULAR FLOW||390.69|56.14||0|10/01/2019 SH 78001|78205|78205 - LIVER IMAGING SPECT||239.57|40.31||0|10/01/2019 SH 78001|78202|78202 - LIVER IMAGING W/VASCULAR FLOW||227.84|28.2||0|10/01/2019 SH 78001|78201|78201 - LIVER IMAGING STATIC ONLY||213.59|25.57||0|10/01/2019 SH 78001|78199|78199 - UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED||0|0||0|10/01/2019 SH 78001|78195|78195 - LYMPHATICS & LYMPH NODES IMAGING||405.69|69.98||0|10/01/2019 SH 78001|78191|78191 - PLATELET SURVIVAL STUDY||189.91|36.78||0|10/01/2019 SH 78001|78190|78190 - KINETICS PLATELET W/WO DIFFRNTL ORGAN/TIS LOCLZJ||366.83|64.84||0|10/01/2019 SH 78001|78185|78185 - SPLEEN IMAGING ONLY W/WO VASCULAR FLOW||240.16|23.84||0|10/01/2019 SH 78001|78140|78140 - LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE||155.01|35.61||0|10/01/2019 SH 78001|78135|78135 - RBC SURVIVAL STUDY DIFFERNTL ORGAN/TISS KINETICS||397.43|38.46||0|10/01/2019 SH 78001|78130|78130 - RED CELL SURVIVAL STUDY||179.44|34.45||0|10/01/2019 SH 78001|78122|78122 - WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU||109.73|24.83||0|10/01/2019 SH 78001|78121|78121 - RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS||119.63|18.84||0|10/01/2019 SH 78001|78120|78120 - RED CELL VOLUME DETERMINATION SPX 1 SAMPLING||106.45|13.8||0|10/01/2019 SH 78001|78111|78111 - PLASMA VOL RADIOPHARM VOL DILUTE SPX MULT SMPLES||109.12|12.98||0|10/01/2019 SH 78001|78110|78110 - PLASMA VOL RADIOPHARM VOL DILUTION SPX 1 SAMPLE||116.35|11.68||0|10/01/2019 SH 78001|78104|78104 - BONE MARROW IMAGING WHOLE BODY||278.72|44.96||0|10/01/2019 SH 78001|78103|78103 - BONE MARROW IMAGING MULTIPLE AREAS||251.37|42.03||0|10/01/2019 SH 78001|78102|78102 - BONE MARROW IMAGING LIMITED AREA||193.13|31.86||0|10/01/2019 SH 78001|78099|78099 - UNLISTED ENDOCRINE PX DX NUCLEAR MEDICINE||0|0||0|10/01/2019 SH 78001|78075|78075 - ADRENAL IMAGING CORTEX &/MEDULLA||512.23|44.32||0|10/01/2019 SH 78001|78072|78072 - PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT||467.91|91.1||0|10/01/2019 SH 78001|78071|78071 - PARATHYROID PLANAR IMAGING W/WO SUBTRACTION||408.01|69.98||0|10/01/2019 SH 78001|78070|78070 - PARATHYROID PLANAR IMAGING||341.53|46.91||0|10/01/2019 SH 78001|78020|78020 - THYROID CARCINOMA METASTASES UPTAKE||96.43|33.24||0|10/01/2019 SH 78001|78018|78018 - THYROID CARCINOMA METASTASES IMG WHOLE BODY||354.19|49.11||0|10/01/2019 SH 78001|78016|78016 - THYROID CARCINOMA METASTASES IMG ADDL STUDY||321.84|41.56||0|10/01/2019 SH 78001|78015|78015 - THYROID CARCINOMA METASTASES IMG LMTD AREA||250.64|38.59||0|10/01/2019 SH 78001|78014|78014 - THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS||273.16|28.93||0|10/01/2019 SH 78001|78013|78013 - THYROID IMAGING WITH VASCULAR FLOW||215.21|21.38||0|10/01/2019 SH 78001|78012|78012 - THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT||90.38|11.3||0|10/01/2019 SH 78001|77799|77799 - UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY||0|0||0|10/01/2019 SH 78001|77790|77790 - SUPERVISION HANDLING LOADING RADIATION SOURCE||109.64|62.73||0|10/01/2019 SH 78001|77789|77789 - SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE||134.06|68.94||0|10/01/2019 SH 78001|77787|77787 - HDR BRACHYTX OVER 12 CHAN||869.94|296.19||0|10/01/2019 SH 78001|77786|77786 - HDR BRACHYTX 2-12 CHANNEL||546.45|197.16||0|10/01/2019 SH 78001|77785|77785 - HDR BRACHYTX 1 CHANNEL||265.93|85.67||0|10/01/2019 SH 78001|77778|77778 - INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX||996.46|682.84||0|10/01/2019 SH 78001|77777|77777 - APPLY INTERSTIT RADIAT INTER||670.15|457.32||0|10/01/2019 SH 78001|77776|77776 - APPLY INTERSTIT RADIAT SIMPL||529.52|280.24||0|10/01/2019 SH 78001|77772|77772 - HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS||1018.51|327.85||0|10/01/2019 SH 78001|77771|77771 - HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL||667.77|230.9||0|10/01/2019 SH 78001|77770|77770 - HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL||358.44|118.56||0|10/01/2019 SH 78001|77768|77768 - HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES||390.42|84.88||0|10/01/2019 SH 78001|77767|77767 - HDR RDNCL SKN SURF BRACHYTX LES APPLICATORS||1108.13|126.58||0|10/01/2019 SH 78001|77610|77610 - HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS||1125.19|91.7||0|10/01/2019 SH 78001|77605|77605 - HYPERTHERMIA EXTERNAL GENERATED DEEP||838.32|125.81||0|10/01/2019 SH 78001|77600|77600 - HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL||444.86|94.42||0|10/01/2019 SH 78001|77525|77525 - PROTON TX DELIVERY COMPLEX||0|0||0|10/01/2019 SH 78001|77523|77523 - PROTON TX DELIVERY INTERMEDIATE||0|0||0|10/01/2019 SH 78001|77522|77522 - PROTON TX DELIVERY SIMPLE W/COMPENSATION||0|0||0|10/01/2019 SH 78001|77520|77520 - PROTON TX DELIVERY SIMPLE W/O COMPENSATION||0|0||0|10/01/2019 SH 78001|77499|77499 - UNLISTED PROCEDURE THERAPEUTIC RADIOLOGY TX MGMT||0|0||0|10/01/2019 SH 78001|77470|77470 - SPECIAL TREATMENT PROCEDURE||178.14|126.58||0|10/01/2019 SH 78001|77469|77469 - INTRAOPERATIVE RADIATION TREATMENT MANAGEMENT||374.4|0||0|10/01/2019 SH 78001|77435|77435 - STEREOTACTIC BODY RADIATION MANAGEMENT||736.87|0||0|10/01/2019 SH 78001|77432|77432 - STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION||488.57|0||0|10/01/2019 SH 78001|77431|77431 - RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY||118.78|0||0|10/01/2019 SH 78001|77427|77427 - RADIATION TREATMENT MANAGEMENT 5 TREATMENTS||217.09|0||0|10/01/2019 SH 78001|77425|77425 - INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS||0|0||0|10/01/2019 SH 78001|77424|77424 - INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION||0|0||0|10/01/2019 SH 78001|77423|77423 - HIGH ENERGY NEUTRON RADJ TX DLVR 1/> ISOCENTER||70.94|0||0|10/01/2019 SH 78001|77422|77422 - HIGH ENERGY NEUTRON RADJ TX DLVR 1 TX AREA||36.44|0||0|10/01/2019 SH 78001|77417|77417 - THERAPEUTIC RADIOLOGY PORT IMAGES(S)||11.63|0||0|10/01/2019 SH 78001|77412|77412 - RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX||0|0||0|10/01/2019 SH 78001|77407|77407 - RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE||0|0||0|10/01/2019 SH 78001|77402|77402 - RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE||0|0||0|10/01/2019 SH 78001|77401|77401 - RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTA||22.49|0||0|10/01/2019 SH 78001|77399|77399 - UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS||0|0||0|10/01/2019 SH 78001|77387|77387 - GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR||0|0||0|10/01/2019 SH 78001|77386|77386 - INTENSITY MODULATED RADIATION TX DLVR COMPLEX||0|0||0|10/01/2019 SH 78001|77385|77385 - INTENSITY MODULATED RADIATION TX DLVR SIMPLE||0|0||0|10/01/2019 SH 78001|77373|77373 - STEREOTACTIC BODY RADIATION DELIVERY||1463.4|0||0|10/01/2019 SH 78001|77372|77372 - RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR||1152.5|0||0|10/01/2019 SH 78001|77371|77371 - RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT||0|0||0|10/01/2019 SH 78001|77370|77370 - SPEC MEDICAL RADJ PHYSICS CONSLTJ||126.77|0||0|10/01/2019 SH 78001|77338|77338 - MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN||567.27|259.85||0|10/01/2019 SH 78001|77336|77336 - CONTINUING MEDICAL PHYSICS CONSLTJ PR WK||83.35|0||0|10/01/2019 SH 78001|77334|77334 - TX DEVICES DESIGN & CONSTRUCTION COMPLEX||170.55|74.8||0|10/01/2019 SH 78001|77333|77333 - TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE||61.04|50.96||0|10/01/2019 SH 78001|77332|77332 - TX DEVICES DESIGN & CONSTRUCTION SIMPLE||91.91|32.98||0|10/01/2019 SH 78001|77331|77331 - SPEC DOSIM ONLY PRESCRIBED TREATING PHYS||73.19|52.64||0|10/01/2019 SH 78001|77321|77321 - SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY||104.16|57.25||0|10/01/2019 SH 78001|77318|77318 - BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL||395.28|175.86||0|10/01/2019 SH 78001|77317|77317 - BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL||272.76|111.1||0|10/01/2019 SH 78001|77316|77316 - BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL||208.47|84.42||0|10/01/2019 SH 78001|77307|77307 - TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY||321.62|175.86||0|10/01/2019 SH 78001|77306|77306 - TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION||163.89|84.42||0|10/01/2019 SH 78001|77301|77301 - NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS||2139.49|483.39||0|10/01/2019 SH 78001|77300|77300 - BASIC RADIATION DOSIMETRY CALCULATION||71.32|37.6||0|10/01/2019 SH 78001|77299|77299 - UNLIS PX THER RADIOL CLINICAL TX PLANNING||0|0||0|10/01/2019 SH 78001|77295|77295 - 3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS||549.05|259.85||0|10/01/2019 SH 78001|77293|77293 - RESPIRATORY MOTION MANAGEMENT SIMULATION||512.29|121.15||0|10/01/2019 SH 78001|77290|77290 - THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX||560.76|94.03||0|10/01/2019 SH 78001|77285|77285 - THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED||468.21|63.5||0|10/01/2019 SH 78001|77280|77280 - THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE||297.28|42.21||0|10/01/2019 SH 78001|77263|77263 - THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX||193.6|0||0|10/01/2019 SH 78001|77262|77262 - THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE||132.11|0||0|10/01/2019 SH 78001|77261|77261 - THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE||88.64|0||0|10/01/2019 SH 78001|77086|77086 - VERTEBRAL FRACTURE ASSESSMENT VIA DXA||39.51|10.43||0|10/01/2019 SH 78001|77085|77085 - DXA BONE DENSITY STUDY AXIAL SKELETON||62.56|17.98||0|10/01/2019 SH 78001|77084|77084 - BONE MARROW BLOOD SUPPLY||405.5|96.54||0|10/01/2019 SH 78001|77081|77081 - DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL||31.59|12.98||0|10/01/2019 SH 78001|77080|77080 - DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL||45.84|12.12||0|10/01/2019 SH 78001|77078|77078 - CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE||79.01|14.66||0|10/01/2019 SH 78001|77077|77077 - JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS||42.45|19.97||0|10/01/2019 SH 78001|77076|77076 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT||106.56|41.82||0|10/01/2019 SH 78001|77075|77075 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL||96.95|32.21||0|10/01/2019 SH 78001|77074|77074 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED||71.36|26.77||0|10/01/2019 SH 78001|77073|77073 - BONE LENGTH STUDIES||40.72|17.46||0|10/01/2019 SH 78001|77072|77072 - BONE AGE STUDIES||26.03|11.3||0|10/01/2019 SH 78001|77071|77071 - MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS||54.52|0||0|10/01/2019 SH 78001|77067|77067 - SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD||165.8|45.22||0|10/01/2019 SH 78001|77066|77066 - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI||205.43|59.44||0|10/01/2019 SH 78001|77065|77065 - DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI||161.94|47.81||0|10/01/2019 SH 78001|77063|77063 - SCREENING DIGITAL BREAST TOMOSYNTHESIS BI||63.48|35.57||0|10/01/2019 SH 78001|77062|77062 - DIGITAL BREAST TOMOSYNTHESIS BILATERAL||0|0||0|10/01/2019 SH 78001|77061|77061 - DIGITAL BREAST TOMOSYNTHESIS UNILATERAL||0|0||0|10/01/2019 SH 78001|77059|77059 - MRI BREAST BILATERAL||589.38|97.44||0|10/01/2019 SH 78001|77058|77058 - MRI BREAST UNILATERAL||595.58|97.44||0|10/01/2019 SH 78001|77054|77054 - MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE||84.93|27.16||0|10/01/2019 SH 78001|77053|77053 - MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE||64.76|21.34||0|10/01/2019 SH 78001|77022|77022 - MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION||0|260.06||0|10/01/2019 SH 78001|77021|77021 - MRI GUIDANCE NEEDLE PLACEMENT RS&I||454.29|89.9||0|10/01/2019 SH 78001|77014|77014 - CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT||130.86|51.39||0|10/01/2019 SH 78001|77013|77013 - CT GUIDANCE &MONITORING VISC TISS ABLATION||0|239.2||0|10/01/2019 SH 78001|77012|77012 - CT GUIDANCE NEEDLE PLACEMENT||140.74|68.25||0|10/01/2019 SH 78001|77011|77011 - CT GUIDANCE STEREOTACTIC LOCALIZATION||244.46|73.12||0|10/01/2019 SH 78001|77003|77003 - FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON||95.66|35.96||0|10/01/2019 SH 78001|77002|77002 - FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON||102.76|32.98||0|10/01/2019 SH 78001|77001|77001 - FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT||78.03|22.2||0|10/01/2019 SH 78001|76999|76999 - UNLISTED US PROCEDURE||0|0||0|10/01/2019 SH 78001|76998|76998 - ULTRASONIC GUIDANCE INTRAOPERATIVE||0|77||0|10/01/2019 SH 78001|76977|76977 - US BONE DENSITY MEAS & INTERP PERIPH ANY METHO||7.98|3.32||0|10/01/2019 SH 78001|76975|76975 - GI ENDOSCOPIC US S&I||0|52.01||0|10/01/2019 SH 78001|76970|76970 - US STUDY FOLLOW UP||103.71|24.24||0|10/01/2019 SH 78001|76965|76965 - US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION||104.31|78.72||0|10/01/2019 SH 78001|76948|76948 - US GUIDANCE ASPIRATION OVA IMG S&I||37.72|23.37||0|10/01/2019 SH 78001|76946|76946 - US GUIDANCE AMNIOCENTESIS IMG S&I||37.72|23.37||0|10/01/2019 SH 78001|76945|76945 - US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I||0|41.7||0|10/01/2019 SH 78001|76942|76942 - US GUIDANCE NEEDLE PLACEMENT IMG S&I||68.83|39.37||0|10/01/2019 SH 78001|76941|76941 - US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I||0|81.85||0|10/01/2019 SH 78001|76940|76940 - US &MNTR PARENCHYMAL TISSUE ABLATION||258.38|125.46||0|10/01/2019 SH 78001|76937|76937 - US VASC ACCESS SITS VSL PATENCY NDL ENTRY||36.59|17.59||0|10/01/2019 SH 78001|76936|76936 - US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL||308.78|119.99||0|10/01/2019 SH 78001|76932|76932 - US ENDOMYOCARDIAL BIOPSY RS&I||0|39.37||0|10/01/2019 SH 78001|76930|76930 - US GUIDANCE PERICARDIOCENTESIS RS&I||0|39.76||0|10/01/2019 SH 78001|76886|76886 - US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ||119.39|37.21||0|10/01/2019 SH 78001|76885|76885 - US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ||142.01|43.15||0|10/01/2019 SH 78001|76882|76882 - US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG||41.68|29.28||0|10/01/2019 SH 78001|76881|76881 - US COMPL JOINT R-T W/IMAGE DOCUMENTATION||130.29|37.64||0|10/01/2019 SH 78001|76873|76873 - US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX||188.57|91.66||0|10/01/2019 SH 78001|76872|76872 - US TRANSRECTAL||105.35|39.84||0|10/01/2019 SH 78001|76870|76870 - US SCROTUM & CONTENTS||75.67|37.29||0|10/01/2019 SH 78001|76857|76857 - US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U||53.74|28.93||0|10/01/2019 SH 78001|76856|76856 - US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE||123.19|40.61||0|10/01/2019 SH 78001|76831|76831 - SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER||133.4|44.24||0|10/01/2019 SH 78001|76830|76830 - US TRANSVAGINAL||137.15|41.78||0|10/01/2019 SH 78001|76828|76828 - DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT||61.37|33.85||0|10/01/2019 SH 78001|76827|76827 - DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE||86.27|34.71||0|10/01/2019 SH 78001|76826|76826 - ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD||183.89|50.15||0|10/01/2019 SH 78001|76825|76825 - ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING||311.61|101.5||0|10/01/2019 SH 78001|76821|76821 - DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART||105.02|42.99||0|10/01/2019 SH 78001|76820|76820 - DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY||54.13|30.48||0|10/01/2019 SH 78001|76819|76819 - FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING||101.06|47.17||0|10/01/2019 SH 78001|76818|76818 - FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING||138.34|65.07||0|10/01/2019 SH 78001|76817|76817 - US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG||110.27|45.92||0|10/01/2019 SH 78001|76816|76816 - US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS||130.09|52.17||0|10/01/2019 SH 78001|76815|76815 - US PREGNANT UTERUS LIMITED 1/> FETUSES||95.88|39.67||0|10/01/2019 SH 78001|76814|76814 - US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION||94.27|61.32||0|10/01/2019 SH 78001|76813|76813 - US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION||138.9|73||0|10/01/2019 SH 78001|76812|76812 - US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT||234.57|110.52||0|10/01/2019 SH 78001|76811|76811 - US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION||208.34|117.24||0|10/01/2019 SH 78001|76810|76810 - US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO||108.57|60.5||0|10/01/2019 SH 78001|76805|76805 - US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION||160.94|60.93||0|10/01/2019 SH 78001|76802|76802 - US PREG UTERUS 14 WK TRANSABDL EACH GESTATION||75.74|50.92||0|10/01/2019 SH 78001|76801|76801 - US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT||140.79|60.93||0|10/01/2019 SH 78001|76800|76800 - ULTRASOUND SPINAL CANAL & CONTENTS||155.73|67.34||0|10/01/2019 SH 78001|76776|76776 - US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN||174.66|45.18||0|10/01/2019 SH 78001|76775|76775 - US RETROPERITONEAL REAL TIME W/IMAGE LIMITED||65.33|33.93||0|10/01/2019 SH 78001|76770|76770 - US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE||126.89|43.54||0|10/01/2019 SH 78001|76706|76706 - US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA||114.56|34.02||0|10/01/2019 SH 78001|76705|76705 - US ABDOMINAL REAL TIME W/IMAGE LIMITED||102.98|35.14||0|10/01/2019 SH 78001|76700|76700 - US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION||138.05|48.12||0|10/01/2019 SH 78001|76642|76642 - US BREAST UNI REAL TIME WITH IMAGE LIMITED||100.66|40.96||0|10/01/2019 SH 78001|76641|76641 - US BREAST UNI REAL TIME WITH IMAGE COMPLETE||121.81|43.89||0|10/01/2019 SH 78001|76604|76604 - US CHEST REAL TIME W/IMAGE DOCUMENTATION||98.93|32.64||0|10/01/2019 SH 78001|76536|76536 - US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM||129.59|33.07||0|10/01/2019 SH 78001|76529|76529 - OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION||89.71|38.15||0|10/01/2019 SH 78001|76519|76519 - OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL||94.62|36.47||0|10/01/2019 SH 78001|76516|76516 - OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN||88.41|36.47||0|10/01/2019 SH 78001|76514|76514 - OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI||17.41|11.6||0|10/01/2019 SH 78001|76513|76513 - OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM||107.93|42.42||0|10/01/2019 SH 78001|76512|76512 - OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN||105.66|62.24||0|10/01/2019 SH 78001|76511|76511 - OPHTHALMIC ULTRASOUND DX QUAN A-SCAN ONLY||116.52|62.63||0|10/01/2019 SH 78001|76510|76510 - OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR||192.83|104.05||0|10/01/2019 SH 78001|76506|76506 - ECHOENCEPHALOGRAPHY REAL TIME IMAGING||132.62|38.03||0|10/01/2019 SH 78001|76499|76499 - UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE||0|0||0|10/01/2019 SH 78001|76498|76498 - UNLISTED MAGNETIC RESONANCE PROCEDURE||0|0||0|10/01/2019 SH 78001|76497|76497 - UNLISTED COMPUTED TOMOGRAPHY PROCEDURE||0|0||0|10/01/2019 SH 78001|76496|76496 - UNLISTED FLUOROSCOPIC PROCEDURE||0|0||0|10/01/2019 SH 78001|76390|76390 - MRI SPECTROSCOPY||490.29|83.25||0|10/01/2019 SH 78001|76380|76380 - CT LIMITED/LOCALIZED FOLLOW UP STUDY||122.52|58.16||0|10/01/2019 SH 78001|76377|76377 - 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION||73.23|46.87||0|10/01/2019 SH 78001|76376|76376 - 3D RENDERING W/INTERP & POSTPROCESS SUPERVISION||25.68|11.73||0|10/01/2019 SH 78001|76140|76140 - CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT||0|0||0|10/01/2019 SH 78001|76125|76125 - CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE EXAMINATION||0|17.47||0|10/01/2019 SH 78001|76120|76120 - CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC||100.52|23.76||0|10/01/2019 SH 78001|76102|76102 - RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI||192.11|41.31||0|10/01/2019 SH 78001|76101|76101 - RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI||146.75|41.31||0|10/01/2019 SH 78001|76100|76100 - RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY||103.33|37.81||0|10/01/2019 SH 78001|76098|76098 - RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN||18.53|9.61||0|10/01/2019 SH 78001|76080|76080 - RADEX ABSCESS/FISTULA/SINUS TRACT RS&I||62.45|31.43||0|10/01/2019 SH 78001|76010|76010 - RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD||29.09|10.86||0|10/01/2019 SH 78001|76001|76001 - FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME||0|43.26||0|10/01/2019 SH 78001|76000|76000 - FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME||51.92|10.44||0|10/01/2019 SH 78001|75989|75989 - RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I||137.39|70.33||0|10/01/2019 SH 78001|75984|75984 - CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I||119.05|41.91||0|10/01/2019 SH 78001|75982|75982 - CONTRAST XRAY EXAM BILE DUCT||0|85.77||0|10/01/2019 SH 78001|75980|75980 - CONTRAST XRAY EXAM BILE DUCT||0|86.55||0|10/01/2019 SH 78001|75970|75970 - TRANSCATHETER BIOPSY RS&I||0|48.6||0|10/01/2019 SH 78001|75959|75959 - PLMT DSTL XTN PRSTH EVASC DESC THORAC AORTA RS&I||0|210.02||0|10/01/2019 SH 78001|75958|75958 - PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I||0|243.6||0|10/01/2019 SH 78001|75957|75957 - EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I||0|365.99||0|10/01/2019 SH 78001|75956|75956 - EVASC RPR DESCND THORCIC AORTA SUBCLAV ORIG RS&I||0|426.99||0|10/01/2019 SH 78001|75954|75954 - EVASC RPR ILIAC ART W/ILIO-ILIAC PROSTH RS&I||0|138.6||0|10/01/2019 SH 78001|75953|75953 - PLMT XTN PROSTH EVASC RPR INFRARENAL RS&I||0|83.13||0|10/01/2019 SH 78001|75952|75952 - EVASC RPR INFRARENAL AAA/DISSECTION RS&I||0|274.05||0|10/01/2019 SH 78001|75946|75946 - INTRAVASCULAR US ADD-ON||0|23.85||0|10/01/2019 SH 78001|75945|75945 - INTRAVASCULAR US||0|23.85||0|10/01/2019 SH 78001|75902|75902 - MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I||79.62|22.64||0|10/01/2019 SH 78001|75901|75901 - MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I||192.48|27.72||0|10/01/2019 SH 78001|75898|75898 - ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS||0|101.82||0|10/01/2019 SH 78001|75896|75896 - X-RAYS TRANSCATH THERAPY||0|82.12||0|10/01/2019 SH 78001|75894|75894 - TRANSCATHETER EMBOLIZATION ANY METH RS&I||0|79.4||0|10/01/2019 SH 78001|75893|75893 - VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&||131.84|32.21||0|10/01/2019 SH 78001|75891|75891 - HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I||164.31|67||0|10/01/2019 SH 78001|75889|75889 - HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I||162.37|65.84||0|10/01/2019 SH 78001|75887|75887 - PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP||181.13|84.21||0|10/01/2019 SH 78001|75885|75885 - PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I||178.8|83.05||0|10/01/2019 SH 78001|75880|75880 - VENOGRAPHY ORBITAL RS&I||161.99|42.59||0|10/01/2019 SH 78001|75872|75872 - VENOGRAPHY EPIDURAL RS&I||167.8|68.55||0|10/01/2019 SH 78001|75870|75870 - VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I||167.02|68.55||0|10/01/2019 SH 78001|75860|75860 - VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I||162.38|67.4||0|10/01/2019 SH 78001|75842|75842 - VENOGRAPHY ADRENAL BILATERAL SELECTIVE RS&I||203.83|89.86||0|10/01/2019 SH 78001|75840|75840 - VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I||167.41|68.55||0|10/01/2019 SH 78001|75833|75833 - VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I||190.69|91.45||0|10/01/2019 SH 78001|75831|75831 - VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I||158.49|65.07||0|10/01/2019 SH 78001|75827|75827 - VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I||155.79|66.63||0|10/01/2019 SH 78001|75825|75825 - VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I||154.63|67.79||0|10/01/2019 SH 78001|75822|75822 - VENOGRAPHY EXTREMITY BILATERAL RS&I||154.66|62.4||0|10/01/2019 SH 78001|75820|75820 - VENOGRAPHY EXTREMITY UNILATERAL RS&I||129.05|41.83||0|10/01/2019 SH 78001|75810|75810 - SPLENOPORTOGRAPY RS&I||0|70.11||0|10/01/2019 SH 78001|75809|75809 - SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I||109.82|28.02||0|10/01/2019 SH 78001|75807|75807 - LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I||0|71.8||0|10/01/2019 SH 78001|75805|75805 - LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I||0|49.29||0|10/01/2019 SH 78001|75803|75803 - LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I||0|71.8||0|10/01/2019 SH 78001|75801|75801 - LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I||0|53.58||0|10/01/2019 SH 78001|75774|75774 - ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I||97.33|21.35||0|10/01/2019 SH 78001|75756|75756 - ANGIOGRAPHY INTERNAL MAMMARY RS&I||190.31|69.75||0|10/01/2019 SH 78001|75746|75746 - ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I||172.05|66.22||0|10/01/2019 SH 78001|75743|75743 - ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I||192.94|96.41||0|10/01/2019 SH 78001|75741|75741 - ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I||171.64|76.28||0|10/01/2019 SH 78001|75736|75736 - ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I||182.94|69.35||0|10/01/2019 SH 78001|75733|75733 - ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I||204.97|75.88||0|10/01/2019 SH 78001|75731|75731 - ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I||191.05|67.39||0|10/01/2019 SH 78001|75726|75726 - ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I||168.97|67.4||0|10/01/2019 SH 78001|75716|75716 - ANGIOGRAPHY EXTREMITY BILATERAL RS&I||209.26|77.07||0|10/01/2019 SH 78001|75710|75710 - ANGIOGRAPHY EXTREMITY UNILATERAL RS&I||180.59|64.68||0|10/01/2019 SH 78001|75705|75705 - ANGIOGRAPHY SPINAL SELECTIVE RS&I||266.92|127.36||0|10/01/2019 SH 78001|75658|75658 - ANIOGRAPHY BRACHIAL RETROGRADE RS&I||187.95|78.24||0|10/01/2019 SH 78001|75635|75635 - CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP||423.34|142.28||0|10/01/2019 SH 78001|75630|75630 - AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I||195.86|106.69||0|10/01/2019 SH 78001|75625|75625 - AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I||156.96|67.8||0|10/01/2019 SH 78001|75605|75605 - AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I||156.95|67.4||0|10/01/2019 SH 78001|75600|75600 - AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I||220.02|30.84||0|10/01/2019 SH 78001|75574|75574 - CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST||373.7|140.73||0|10/01/2019 SH 78001|75573|75573 - CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT D||381.72|148.74||0|10/01/2019 SH 78001|75572|75572 - CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH||316.99|103.39||0|10/01/2019 SH 78001|75571|75571 - CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM||66.11|34.32||0|10/01/2019 SH 78001|75565|75565 - CARDIAC MRI FOR VELOCITY FLOW MAPPING||61.18|14.66||0|10/01/2019 SH 78001|75563|75563 - CARDIAC MRI W/W/O CONTRAST W/STRESS||560.46|175.91||0|10/01/2019 SH 78001|75561|75561 - CARDIAC MRI W/WO CONTRAST & FURTHER SEQ||472.66|153.23||0|10/01/2019 SH 78001|75559|75559 - CARDIAC MRI W/O CONTRAST W/STRESS IMAGING||479.22|170.26||0|10/01/2019 SH 78001|75557|75557 - CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST||356.05|138.57||0|10/01/2019 SH 78001|74775|74775 - PERINEOGRAM||0|37.6||0|10/01/2019 SH 78001|74742|74742 - TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I||0|37.17||0|10/01/2019 SH 78001|74740|74740 - HYSTEROSALPINGOGRAPHY RS&I||83.46|22.98||0|10/01/2019 SH 78001|74713|74713 - FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES||259.59|106.24||0|10/01/2019 SH 78001|74712|74712 - FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES||473.09|294.34||0|10/01/2019 SH 78001|74710|74710 - PELVIMETRY W/WOPLACENTAL LOCALIZATION||44.9|20.87||0|10/01/2019 SH 78001|74485|74485 - DILATION URETERS/URETHRA RS&I||101.98|30.65||0|10/01/2019 SH 78001|74480|74480 - X-RAY CONTROL CATH INSERT||102.76|31.43||0|10/01/2019 SH 78001|74475|74475 - X-RAY CONTROL CATH INSERT||102.76|31.43||0|10/01/2019 SH 78001|74470|74470 - RADEX RENAL CYST STUDY TRANSLUMBAR RS&I||0|31.44||0|10/01/2019 SH 78001|74455|74455 - URETHROCYSTOGRAPHY VOIDING RS&I||89.83|19.27||0|10/01/2019 SH 78001|74450|74450 - URETHROCYSTOGRAPHY RETROGRADE RS&I||0|19.66||0|10/01/2019 SH 78001|74445|74445 - CORPORA CAVERNOSOGRAPY RS&I||0|68.95||0|10/01/2019 SH 78001|74440|74440 - VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I||88.11|21.81||0|10/01/2019 SH 78001|74430|74430 - CYSTOGRAPHY MINIMUM 3 VIEWS RS&I||41.71|18.84||0|10/01/2019 SH 78001|74425|74425 - UROGRAPHY ANTEGRADE RS&I||0|21.34||0|10/01/2019 SH 78001|74420|74420 - X-RAY URINARY TRACT EXAM WITH CONTRAST MATERIAL||0|21.34||0|10/01/2019 SH 78001|74415|74415 - UROGRAPY INFUSION DRIP &/BOLUS TECHQ W/WO TOMO||150.22|28.89||0|10/01/2019 SH 78001|74410|74410 - UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE||117.66|28.11||0|10/01/2019 SH 78001|74400|74400 - UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY||120.76|28.89||0|10/01/2019 SH 78001|74363|74363 - PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I||0|52.7||0|10/01/2019 SH 78001|74360|74360 - INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I||0|33.76||0|10/01/2019 SH 78001|74355|74355 - PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I||0|46.74||0|10/01/2019 SH 78001|74340|74340 - INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I||0|32.6||0|10/01/2019 SH 78001|74330|74330 - CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I||0|55.1||0|10/01/2019 SH 78001|74329|74329 - ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I||0|42.99||0|10/01/2019 SH 78001|74328|74328 - ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I||0|43.38||0|10/01/2019 SH 78001|74327|74327 - X-RAY BILE STONE REMOVAL||149.2|41.05||0|10/01/2019 SH 78001|74320|74320 - CONTRAST X-RAY OF BILE DUCTS||103.54|31.43||0|10/01/2019 SH 78001|74305|74305 - X-RAY BILE DUCTS/PANCREAS||0|25.1||0|10/01/2019 SH 78001|74301|74301 - CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS||0|12.94||0|10/01/2019 SH 78001|74300|74300 - CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I||0|22.12||0|10/01/2019 SH 78001|74290|74290 - CHOLECYSTOGRAPHY ORAL CONTRST||77.38|19.23||0|10/01/2019 SH 78001|74283|74283 - THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ||234.45|123.97||0|10/01/2019 SH 78001|74280|74280 - RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY||222.19|59.37||0|10/01/2019 SH 78001|74270|74270 - RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY||165.83|41.39||0|10/01/2019 SH 78001|74263|74263 - CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING||830.61|135.55||0|10/01/2019 SH 78001|74262|74262 - CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST||409.81|150.09||0|10/01/2019 SH 78001|74261|74261 - CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST||273.7|144.22||0|10/01/2019 SH 78001|74260|74260 - DUODENOGRAPY HYPOTONIC||140.18|30.09||0|10/01/2019 SH 78001|74251|74251 - RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY||204.6|41.39||0|10/01/2019 SH 78001|74250|74250 - RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY||115.25|28.41||0|10/01/2019 SH 78001|74249|74249 - RADEX GI UPR W/WO GLUCOSE W/SM INTEST FOLLW-THRU||203.23|54.37||0|10/01/2019 SH 78001|74247|74247 - RADEX UPPER GI W/WO GLUCAGON/DELAY IMAGES W/KUB||156.14|41.39||0|10/01/2019 SH 78001|74246|74246 - RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY||142.19|42.17||0|10/01/2019 SH 78001|74245|74245 - RADEX GI TRACT UPR W/SM INT W/MULT SERIAL IMAGES||190.05|54.37||0|10/01/2019 SH 78001|74241|74241 - RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/KUB||130.55|41||0|10/01/2019 SH 78001|74240|74240 - RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY||126.68|41.78||0|10/01/2019 SH 78001|74235|74235 - RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I||0|74.97||0|10/01/2019 SH 78001|74230|74230 - RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY||141.48|31.78||0|10/01/2019 SH 78001|74220|74220 - RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY||98.15|27.59||0|10/01/2019 SH 78001|74210|74210 - RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY||85.69|21.34||0|10/01/2019 SH 78001|74190|74190 - PERITONEOGRAM RS&I||0|28.46||0|10/01/2019 SH 78001|74185|74185 - MRA ABDOMEN W/WO CONTRAST MATERIAL||445.91|106.71||0|10/01/2019 SH 78001|74183|74183 - MRI ABDOMEN W/O & W/CONTRAST MATERIAL||561.12|135.47||0|10/01/2019 SH 78001|74182|74182 - MRI ABDOMEN W/CONTRAST MATERIAL||501.81|103.31||0|10/01/2019 SH 78001|74181|74181 - MRI ABDOMEN W/O CONTRAST MATERIAL||367.67|86.62||0|10/01/2019 SH 78001|74178|74178 - CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE||392.17|120.03||0|10/01/2019 SH 78001|74177|74177 - CT ABDOMEN & PELVIS W/CONTRAST MATERIAL||346.76|109.13||0|10/01/2019 SH 78001|74176|74176 - CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL||225.46|104.12||0|10/01/2019 SH 78001|74175|74175 - CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST||341.33|107.96||0|10/01/2019 SH 78001|74174|74174 - CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG||432.54|131.34||0|10/01/2019 SH 78001|74170|74170 - CT ABDOMEN W/O & W/CONTRAST MATERIAL||291.04|83.25||0|10/01/2019 SH 78001|74160|74160 - CT ABDOMEN W/CONTRAST MATERIAL||255.97|75.71||0|10/01/2019 SH 78001|74150|74150 - CT ABDOMEN W/O CONTRAST MATERIAL||168.01|70.71||0|10/01/2019 SH 78001|74022|74022 - RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES||49.08|18.84||0|10/01/2019 SH 78001|74021|74021 - RADIOLOGIC EXAM ABDOMEN 3+ VIEWS||44.12|16.47||0|10/01/2019 SH 78001|74020|74020 - RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS||41.5|15.91||0|10/01/2019 SH 78001|74019|74019 - RADIOLOGIC EXAM ABDOMEN 2 VIEWS||37.66|13.89||0|10/01/2019 SH 78001|74018|74018 - RADIOLOGIC EXAM ABDOMEN 1 VIEW||30.68|10.8||0|10/01/2019 SH 78001|74010|74010 - RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS||39|13.8||0|10/01/2019 SH 78001|74000|74000 - RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW||26.37|10.86||0|10/01/2019 SH 78001|73725|73725 - MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL||446|107.57||0|10/01/2019 SH 78001|73723|73723 - MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL||521.48|128.4||0|10/01/2019 SH 78001|73722|73722 - MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL||421.87|97.4||0|10/01/2019 SH 78001|73721|73721 - MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL||261.36|80.71||0|10/01/2019 SH 78001|73720|73720 - MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR||555.59|128.4||0|10/01/2019 SH 78001|73719|73719 - MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL||446.67|96.62||0|10/01/2019 SH 78001|73718|73718 - MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL||388.9|79.93||0|10/01/2019 SH 78001|73706|73706 - CT ANGIOGRAPHY LOWER EXTREMITY||389.75|112.18||0|10/01/2019 SH 78001|73702|73702 - CT LOWER EXTREMITY W/O & W/CONTRAST MATRL||301.88|71.61||0|10/01/2019 SH 78001|73701|73701 - CT LOWER EXTREMITY W/CONTRAST MATERIAL||250.06|69.03||0|10/01/2019 SH 78001|73700|73700 - CT LOWER EXTREMITY W/O CONTRAST MATERIAL||188.89|59.41||0|10/01/2019 SH 78001|73660|73660 - RADEX TOE MINIMUM 2 VIEWS||30.81|7.93||0|10/01/2019 SH 78001|73650|73650 - RADEX CALCANEUS MINIMUM 2 VIEWS||29.77|9.61||0|10/01/2019 SH 78001|73630|73630 - RADEX FOOT COMPLETE MINIMUM 3 VIEWS||32.14|10.05||0|10/01/2019 SH 78001|73620|73620 - RADIOLOGIC EXAMINATION FOOT 2 VIEWS||28.61|9.23||0|10/01/2019 SH 78001|73615|73615 - RADEX ANKLE ARTHROGRAPHY RS&I||109.74|34.54||0|10/01/2019 SH 78001|73610|73610 - RADEX ANKLE COMPLETE MINIMUM 3 VIEWS||34.86|10.82||0|10/01/2019 SH 78001|73600|73600 - RADIOLOGIC EXAMINATION ANKLE 2 VIEWS||30.16|10||0|10/01/2019 SH 78001|73592|73592 - RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS||30.16|9.61||0|10/01/2019 SH 78001|73590|73590 - RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS||29.43|10.43||0|10/01/2019 SH 78001|73580|73580 - RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I||127.18|33.37||0|10/01/2019 SH 78001|73565|73565 - RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST||36.41|11.21||0|10/01/2019 SH 78001|73564|73564 - RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS||44.38|14.14||0|10/01/2019 SH 78001|73562|73562 - RADIOLOGIC EXAMINATION KNEE 3 VIEWS||38|11.64||0|10/01/2019 SH 78001|73560|73560 - RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS||32.53|11.21||0|10/01/2019 SH 78001|73552|73552 - RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS||35.93|11.21||0|10/01/2019 SH 78001|73551|73551 - RADIOLOGIC EXAMINATION FEMUR 1 VIEW||30.83|9.97||0|10/01/2019 SH 78001|73550|73550 - X-RAY EXAM OF THIGH||30.21|10.82||0|10/01/2019 SH 78001|73540|73540 - X-RAY EXAM OF PELVIS & HIPS||43.52|12.12||0|10/01/2019 SH 78001|73530|73530 - X-RAY EXAM OF HIP||0|17.55||0|10/01/2019 SH 78001|73525|73525 - RADEX HIP ARTHROGRAPHY RS&I||112.84|34.15||0|10/01/2019 SH 78001|73523|73523 - RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS||62.77|19.12||0|10/01/2019 SH 78001|73522|73522 - RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS||54.18|17.87||0|10/01/2019 SH 78001|73521|73521 - RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS||43.83|13.7||0|10/01/2019 SH 78001|73520|73520 - X-RAY EXAM OF HIPS||44.17|16.64||0|10/01/2019 SH 78001|73510|73510 - X-RAY EXAM OF HIP||41.24|13.32||0|10/01/2019 SH 78001|73503|73503 - RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS||57.19|17.01||0|10/01/2019 SH 78001|73502|73502 - RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS||45.76|13.32||0|10/01/2019 SH 78001|73501|73501 - RADEX HIP UNILATERAL WITH PELVIS 1 VIEW||32.84|11.21||0|10/01/2019 SH 78001|73500|73500 - X-RAY EXAM OF HIP||29.43|10.82||0|10/01/2019 SH 78001|73225|73225 - MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL||446.38|101.76||0|10/01/2019 SH 78001|73223|73223 - MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL||519.15|128.4||0|10/01/2019 SH 78001|73222|73222 - MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL||418.37|97.01||0|10/01/2019 SH 78001|73221|73221 - MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL||261.75|81.1||0|10/01/2019 SH 78001|73220|73220 - MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS||552.1|128.4||0|10/01/2019 SH 78001|73219|73219 - MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL||445.9|97.4||0|10/01/2019 SH 78001|73218|73218 - MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL||388.9|79.93||0|10/01/2019 SH 78001|73206|73206 - CT ANGIOGRAPHY UPPER EXTREMITY||362.61|107.14||0|10/01/2019 SH 78001|73202|73202 - CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL||306.92|72.39||0|10/01/2019 SH 78001|73201|73201 - CT UPPER EXTREMITY W/CONTRAST MATERIAL||246.57|69.03||0|10/01/2019 SH 78001|73200|73200 - CT UPPER EXTREMITY W/O CONTRAST MATERIAL||188.89|59.41||0|10/01/2019 SH 78001|73140|73140 - RADEX FINGR MINIMUM 2 VIEWS||34.3|8.32||0|10/01/2019 SH 78001|73130|73130 - RADEX HAND MINIMUM 3 VIEWS||33.69|10.43||0|10/01/2019 SH 78001|73120|73120 - RADEX HAND 2 VIEWS||29|10||0|10/01/2019 SH 78001|73115|73115 - RADEX WRIST ARTHROGRAPHY RS&I||118.66|33.76||0|10/01/2019 SH 78001|73110|73110 - RADEX WRIST COMPLETE MINIMUM 3 VIEWS||39.12|10.82||0|10/01/2019 SH 78001|73100|73100 - RADEX WRIST 2 VIEWS||32.49|10.39||0|10/01/2019 SH 78001|73092|73092 - RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS||30.16|9.61||0|10/01/2019 SH 78001|73090|73090 - RADEX FOREARM 2 VIEWS||28.61|10||0|10/01/2019 SH 78001|73085|73085 - RADEX ELBOW ARTHROGRAPHY RS&I||109.35|33.76||0|10/01/2019 SH 78001|73080|73080 - RADEX ELBOW COMPLETE MINIMUM 3 VIEWS||34.86|10.82||0|10/01/2019 SH 78001|73070|73070 - RADEX ELBOW 2 VIEWS||30.51|9.96||0|10/01/2019 SH 78001|73060|73060 - RADEX HUMERUS MINIMUM 2 VIEWS||29.82|10.82||0|10/01/2019 SH 78001|73050|73050 - RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ||39.64|12.89||0|10/01/2019 SH 78001|73040|73040 - RADEX SHOULDER ARTHROGRAPHY RS&I||111.68|32.98||0|10/01/2019 SH 78001|73030|73030 - RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS||32.19|11.64||0|10/01/2019 SH 78001|73020|73020 - RADEX SHOULDER 1 VIEW||25.86|9.57||0|10/01/2019 SH 78001|73010|73010 - RADEX SCAPULA COMPLETE||33.31|11.21||0|10/01/2019 SH 78001|73000|73000 - RADEX CLAVICLE COMPLETE||30.94|10.39||0|10/01/2019 SH 78001|72295|72295 - DISKOGRAPY LUMBAR RS&I||110.23|50.92||0|10/01/2019 SH 78001|72285|72285 - DISKOGRAPY CERVICAL/THORACIC RS&I||129.51|72.52||0|10/01/2019 SH 78001|72275|72275 - EPIDUROGRAPY RS&I||128.92|46.74||0|10/01/2019 SH 78001|72270|72270 - MYELOGRAPY 2/MORE REGIONS RS&I||144.2|79.46||0|10/01/2019 SH 78001|72265|72265 - MYELOGRAPY LUMBOSACRAL RS&I||103.64|49.76||0|10/01/2019 SH 78001|72255|72255 - MYELOGRAPHY THORACIC RS&I||110.19|54.76||0|10/01/2019 SH 78001|72240|72240 - MYELOGRAPHY CERVICAL RS&I||110.97|54.76||0|10/01/2019 SH 78001|72220|72220 - RADEX SACRUM & COCCYX MINIMUM 2 VIEWS||30.98|10.43||0|10/01/2019 SH 78001|72202|72202 - RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS||36.5|11.3||0|10/01/2019 SH 78001|72200|72200 - RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS||31.37|10.43||0|10/01/2019 SH 78001|72198|72198 - MRA PELVIS W/WO CONTRAST MATERIAL||444.75|106.71||0|10/01/2019 SH 78001|72197|72197 - MRI PELVIS W/O & W/CONTRAST MATERIAL||559.95|135.47||0|10/01/2019 SH 78001|72196|72196 - MRI PELVIS W/CONTRAST MATERIAL||454.52|103.69||0|10/01/2019 SH 78001|72195|72195 - MRI PELVIS W/O CONTRAST MATERIAL||395.96|87||0|10/01/2019 SH 78001|72194|72194 - CT PELVIS W/O & W/CONTRAST MATERIAL||287.93|72.39||0|10/01/2019 SH 78001|72193|72193 - CT PELVIS W/CONTRAST MATERIAL||250.06|69.03||0|10/01/2019 SH 78001|72192|72192 - CT PELVIS W/O CONTRAST MATERIAL||163.7|64.84||0|10/01/2019 SH 78001|72191|72191 - CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST||338.57|107.53||0|10/01/2019 SH 78001|72190|72190 - RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS||42.4|13.32||0|10/01/2019 SH 78001|72170|72170 - RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS||30.6|10.82||0|10/01/2019 SH 78001|72159|72159 - MRA SPINAL CANAL W/WO CONTRAST MATERIAL||461.81|108.65||0|10/01/2019 SH 78001|72158|72158 - MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL||421.31|137.15||0|10/01/2019 SH 78001|72157|72157 - MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL||423.63|137.15||0|10/01/2019 SH 78001|72156|72156 - MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL||422.46|136.37||0|10/01/2019 SH 78001|72149|72149 - MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL||355.11|106.62||0|10/01/2019 SH 78001|72148|72148 - MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL||247.58|88.25||0|10/01/2019 SH 78001|72147|72147 - MRI SPINAL CANAL THORACIC W/CONTRAST MATRL||357.05|106.62||0|10/01/2019 SH 78001|72146|72146 - MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL||248.74|87.87||0|10/01/2019 SH 78001|72142|72142 - MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL||359.37|106.62||0|10/01/2019 SH 78001|72141|72141 - MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL||248.74|87.87||0|10/01/2019 SH 78001|72133|72133 - CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL||299.39|75.71||0|10/01/2019 SH 78001|72132|72132 - CT LUMBAR SPINE W/CONTRAST MATERIAL||253.43|72.78||0|10/01/2019 SH 78001|72131|72131 - CT LUMBAR SPINE W/O CONTRAST MATERIAL||188.89|59.41||0|10/01/2019 SH 78001|72130|72130 - CT THORACIC SPINE W/O & W/CONTRAST MATERIAL||299.39|75.32||0|10/01/2019 SH 78001|72129|72129 - CT THORACIC SPINE W/CONTRAST MATERIAL||254.2|72.39||0|10/01/2019 SH 78001|72128|72128 - CT THORACIC SPINE W/O CONTRAST MATERIAL||188.89|59.41||0|10/01/2019 SH 78001|72127|72127 - CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL||299|75.32||0|10/01/2019 SH 78001|72126|72126 - CT CERVICAL SPINE W/CONTRAST MATERIAL||254.2|72.78||0|10/01/2019 SH 78001|72125|72125 - CT CERVICAL SPINE W/O CONTRAST MATERIAL||193.07|63.59||0|10/01/2019 SH 78001|72120|72120 - RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS||44.77|14.14||0|10/01/2019 SH 78001|72114|72114 - RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6||69.24|20.01||0|10/01/2019 SH 78001|72110|72110 - RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS||54.47|19.19||0|10/01/2019 SH 78001|72100|72100 - RADEX SPINE LUMBOSACRAL 2/3 VIEWS||38.95|13.75||0|10/01/2019 SH 78001|72090|72090 - X-RAY EXAM SCLOIOSIS ERECT||47.75|18.28||0|10/01/2019 SH 78001|72084|72084 - RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW||89.47|24.19||0|10/01/2019 SH 78001|72083|72083 - RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW||74.91|20.84||0|10/01/2019 SH 78001|72082|72082 - RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW||68.95|19.12||0|10/01/2019 SH 78001|72081|72081 - RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW||43.24|15.81||0|10/01/2019 SH 78001|72080|72080 - RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS||37.41|14.14||0|10/01/2019 SH 78001|72074|72074 - RADEX SPINE THORACIC MINIMUM 4 VIEWS||43.22|12.98||0|10/01/2019 SH 78001|72072|72072 - RADEX SPINE THORACIC 3 VIEWS||38.18|12.98||0|10/01/2019 SH 78001|72070|72070 - RADEX SPINE THORACIC 2 VIEWS||35.08|13.75||0|10/01/2019 SH 78001|72069|72069 - X-RAY EXAM TRUNK SPINE STAND||35.85|13.75||0|10/01/2019 SH 78001|72052|72052 - RADEX SPINE CERVICAL 6 OR MORE VIEWS||62.44|22.12||0|10/01/2019 SH 78001|72050|72050 - RADEX SPINE CERVICAL 4 OR 5 VIEWS||49.81|18.8||0|10/01/2019 SH 78001|72040|72040 - RADEX SPINE CERVICAL 2 OR 3 VIEWS||37.02|13.75||0|10/01/2019 SH 78001|72020|72020 - RADEX SPINE 1 VIEW SPECIFY LEVEL||24.3|9.18||0|10/01/2019 SH 78001|72010|72010 - X-RAY EXAM SPINE AP&LAT||78.34|27.94||0|10/01/2019 SH 78001|71555|71555 - MRA CHEST W/O & W/CONTRAST MATERIAL||440.53|107.14||0|10/01/2019 SH 78001|71552|71552 - MRI CHEST W/O & W/CONTRAST MATERIAL||640.2|135.47||0|10/01/2019 SH 78001|71551|71551 - MRI CHEST W/CONTRAST MATERIAL||504.92|103.31||0|10/01/2019 SH 78001|71550|71550 - MRI CHEST W/O CONTRAST MATERIAL||395.58|86.62||0|10/01/2019 SH 78001|71275|71275 - CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST||333.97|108.74||0|10/01/2019 SH 78001|71270|71270 - CT THORAX W/O & W/CONTRAST MATERIAL||304.52|82||0|10/01/2019 SH 78001|71260|71260 - CT THORAX W/CONTRAST MATERIAL||254.29|74.03||0|10/01/2019 SH 78001|71250|71250 - CT THORAX W/O CONTRAST MATERIAL||190.14|60.66||0|10/01/2019 SH 78001|71130|71130 - RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS||40.12|13.75||0|10/01/2019 SH 78001|71120|71120 - RADEX STERNUM MINIMUM 2 VIEWS||32.66|12.12||0|10/01/2019 SH 78001|71111|71111 - RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS||52.57|19.23||0|10/01/2019 SH 78001|71110|71110 - RADEX RIBS BILATERAL 3 VIEWS||41.5|16.3||0|10/01/2019 SH 78001|71101|71101 - RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS||40.33|15.91||0|10/01/2019 SH 78001|71100|71100 - RADEX RIBS UNILATERAL 2 VIEWS||33.91|13.37||0|10/01/2019 SH 78001|71048|71048 - RADIOLOGIC EXAM CHEST 4+ VIEWS||47.33|19.29||0|10/01/2019 SH 78001|71047|71047 - RADIOLOGIC EXAM CHEST 3 VIEWS||44.05|16.79||0|10/01/2019 SH 78001|71046|71046 - RADIOLOGIC EXAM CHEST 2 VIEWS||34.32|12.88||0|10/01/2019 SH 78001|71045|71045 - RADIOLOGIC EXAM CHEST SINGLE VIEW||22.68|10.96||0|10/01/2019 SH 78001|71035|71035 - RADEX CHEST SPECIAL VIEWS||36.06|10.86||0|10/01/2019 SH 78001|71034|71034 - RADEX CHEST COMPLETE MINIMUM 4 VIEWS W/FLUORO||93.5|27.59||0|10/01/2019 SH 78001|71030|71030 - RADEX CHEST COMPLETE MINIMUM 4 VIEWS||46.32|18.41||0|10/01/2019 SH 78001|71023|71023 - RADEX CH 2 VIEWS FRONTAL & LATERAL W/FLUORO||70.67|22.98||0|10/01/2019 SH 78001|71022|71022 - RADEX CH 2 VIEWS FRONTAL & LATERAL OBLIQUE PRJCJ||46.71|19.57||0|10/01/2019 SH 78001|71021|71021 - RADEX CH 2 VIEWS FRNT & LAT APICAL LORDOTIC PX||38.01|16.3||0|10/01/2019 SH 78001|71020|71020 - RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LATERAL||31.2|12.98||0|10/01/2019 SH 78001|71015|71015 - RADIOLOGIC EXAMINATION CHEST STERO FRONTAL||30.77|12.93||0|10/01/2019 SH 78001|71010|71010 - RADIOLOGIC EXAMINATION CHEST SINGLE VIEW FRONTAL||25.21|10.86||0|10/01/2019 SH 78001|70559|70559 - MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST||0|197.75||0|10/01/2019 SH 78001|70558|70558 - MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL||0|197.36||0|10/01/2019 SH 78001|70557|70557 - MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL||0|178.61||0|10/01/2019 SH 78001|70555|70555 - MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION||0|155.32||0|10/01/2019 SH 78001|70554|70554 - MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION||499.6|127.84||0|10/01/2019 SH 78001|70553|70553 - MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL||420.14|136.37||0|10/01/2019 SH 78001|70552|70552 - MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL||355.5|106.62||0|10/01/2019 SH 78001|70551|70551 - MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL||256.11|87.87||0|10/01/2019 SH 78001|70549|70549 - MRA NECK W/O &W/CONTRAST MATERIAL||628.49|107.49||0|10/01/2019 SH 78001|70548|70548 - MRA NECK W/CONTRAST MATERIAL||454.53|71.53||0|10/01/2019 SH 78001|70547|70547 - MRA NECK W/O CONTRST MATERIAL||380.1|71.14||0|10/01/2019 SH 78001|70546|70546 - MRA HEAD W/O & W/CONTRAST MATERIAL||628.49|107.49||0|10/01/2019 SH 78001|70545|70545 - MRA HEAD W/CONTRAST MATERIAL||424.68|71.14||0|10/01/2019 SH 78001|70544|70544 - MRA HEAD W/O CONTRST MATERIAL||380.48|71.53||0|10/01/2019 SH 78001|70543|70543 - MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL||543.96|127.62||0|10/01/2019 SH 78001|70542|70542 - MRI ORBIT FACE & NECK W/CONTRAST MATERIAL||444.74|96.62||0|10/01/2019 SH 78001|70540|70540 - MRI ORBIT FACE &/NECK W/O CONTRAST||388.51|79.55||0|10/01/2019 SH 78001|70498|70498 - CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST||326.68|104.17||0|10/01/2019 SH 78001|70496|70496 - CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST||328.62|104.56||0|10/01/2019 SH 78001|70492|70492 - CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL||307.92|86.19||0|10/01/2019 SH 78001|70491|70491 - CT SOFT TISSUE NECK W/CONTRAST MATERIAL||261.88|82.39||0|10/01/2019 SH 78001|70490|70490 - CT SOFT TISSUE NECK W/O CONTRAST MATERIAL||205.62|76.14||0|10/01/2019 SH 78001|70488|70488 - CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL||228.06|75.32||0|10/01/2019 SH 78001|70487|70487 - CT MAXILLOFACIAL W/CONTRAST MATERIAL||187.91|67.35||0|10/01/2019 SH 78001|70486|70486 - CT MAXILLOFACIAL W/O CONTRAST MATERIAL||155.67|50.62||0|10/01/2019 SH 78001|70482|70482 - CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR||333.9|86.19||0|10/01/2019 SH 78001|70481|70481 - CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL||305.29|82||0|10/01/2019 SH 78001|70480|70480 - CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL||205.62|76.14||0|10/01/2019 SH 78001|70470|70470 - CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL||213.71|75.71||0|10/01/2019 SH 78001|70460|70460 - CT HEAD/BRAIN W/CONTRAST MATERIAL||180.93|67.35||0|10/01/2019 SH 78001|70450|70450 - CT HEAD/BRAIN W/O CONTRAST MATERIAL||129.7|50.62||0|10/01/2019 SH 78001|70390|70390 - SIALOGRAPHY RS&I||103.61|22.59||0|10/01/2019 SH 78001|70380|70380 - RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS||39.9|11.21||0|10/01/2019 SH 78001|70373|70373 - CONTRAST X-RAY OF LARYNX||84.88|26.34||0|10/01/2019 SH 78001|70371|70371 - CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC||101.74|50.18||0|10/01/2019 SH 78001|70370|70370 - RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ||89.01|19.23||0|10/01/2019 SH 78001|70360|70360 - RADIOLOGIC EXAMINATION NECK SOFT TISSUE||30.98|10.05||0|10/01/2019 SH 78001|70355|70355 - ORTHOPANTOGRAM||22.97|13.28||0|10/01/2019 SH 78001|70350|70350 - CEPHALOGRAM ORTHODONTIC||22.07|11.99||0|10/01/2019 SH 78001|70336|70336 - MRI TEMPOROMANDIBULAR JOINT||354.19|87.48||0|10/01/2019 SH 78001|70332|70332 - TEMPOROMANDBLE JT ARTHROGRAPHY RS&I||91.53|37.64||0|10/01/2019 SH 78001|70330|70330 - RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT||52.22|15.39||0|10/01/2019 SH 78001|70328|70328 - RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT||34.51|11.25||0|10/01/2019 SH 78001|70320|70320 - RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH||59.11|14.92||0|10/01/2019 SH 78001|70310|70310 - RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH||42.57|10||0|10/01/2019 SH 78001|70300|70300 - RADIOLOGIC EXAMINATION TEETH 1 VIEW||16.72|7.03||0|10/01/2019 SH 78001|70260|70260 - RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS||50.33|20.48||0|10/01/2019 SH 78001|70250|70250 - RADIOLOGIC EXAMINATION SKULL 4/> VIEWS||39.81|15||0|10/01/2019 SH 78001|70240|70240 - RADIOLOGIC EXAMINATION SELLA TURCICA||33.4|12.07||0|10/01/2019 SH 78001|70220|70220 - RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS||41.41|15.05||0|10/01/2019 SH 78001|70210|70210 - RADEX SINUSES PARANASAL <3 VIEWS||32.92|10.43||0|10/01/2019 SH 78001|70200|70200 - RADEX ORBITS COMPLETE MINIMUM 4 VIEWS||46.97|16.73||0|10/01/2019 SH 78001|70190|70190 - RADEX OPTIC FORAMINA||38.91|13.32||0|10/01/2019 SH 78001|70170|70170 - DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I||0|18.37||0|10/01/2019 SH 78001|70160|70160 - RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS||36.02|10.43||0|10/01/2019 SH 78001|70150|70150 - RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS||46.1|15.87||0|10/01/2019 SH 78001|70140|70140 - RADEX FACIAL BONES < 3 VIEWS||33.01|12.46||0|10/01/2019 SH 78001|70134|70134 - RADEX INTERNAL AUDITORY MEATI COMPLETE||57.31|20.87||0|10/01/2019 SH 78001|70130|70130 - RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE||60.8|20.48||0|10/01/2019 SH 78001|70120|70120 - RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE||37.62|10.86||0|10/01/2019 SH 78001|70110|70110 - RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS||42.18|15.05||0|10/01/2019 SH 78001|70100|70100 - RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS||36.45|10.86||0|10/01/2019 SH 78001|70030|70030 - RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY||30.59|10.05||0|10/01/2019 SH 78001|70015|70015 - CISTERNOGRAPHY POSITIVE CONTRAST RS&I||173.44|71.49||0|10/01/2019 SH 78001|70010|70010 - MYELOGRAPY POST FOSSA RS&I||84.71|0||0|10/01/2019 SH 78001|69990|69990 - MICROSURG TQS REQ USE OPERATING MICROSCOPE||267.74|0||0|10/01/2019 SH 78001|69979|69979 - UNLISTED PROCEDURE TEMPORAL BONE MIDDLE FOSSA||0|0||0|10/01/2019 SH 78001|69970|69970 - REMOVAL TUMOR TEMPORAL BONE||2538.24|0||0|10/01/2019 SH 78001|69960|69960 - DECOMPRESSION INTERNAL AUDITORY CANAL||2282.46|0||0|10/01/2019 SH 78001|69955|69955 - TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR||2341.38|0||0|10/01/2019 SH 78001|69950|69950 - VESTIBULAR NRV SECTION TRANSCRANIAL APPROACH||2115.28|0||0|10/01/2019 SH 78001|69949|69949 - UNLISTED PROCEDURE INNER EAR||0|0||0|10/01/2019 SH 78001|69930|69930 - COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY||1446.96|0||0|10/01/2019 SH 78001|69915|69915 - VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR||1819.12|0||0|10/01/2019 SH 78001|69910|69910 - LABYRINTHECTOMY W/MASTOIDECTOMY||1196.84|0||0|10/01/2019 SH 78001|69905|69905 - LABYRINTHECTOMY TRANSCANAL||1073.18|0||0|10/01/2019 SH 78001|69840|69840 - REVISION FENESTRATION OPERATION||1062.05|0||0|10/01/2019 SH 78001|69820|69820 - FENESTRATION SEMICIRCULAR CANAL||1002.09|0||0|10/01/2019 SH 78001|69806|69806 - ENDOLYMPHATIC SAC SHUNT||1111.36|0||0|10/01/2019 SH 78001|69805|69805 - ENDOLYMPHATIC SAC W/O SHUNT||1241.82|0||0|10/01/2019 SH 78001|69801|69801 - LABYRINTHOTOMY TRANSCANAL||226.51|0||0|10/01/2019 SH 78001|69799|69799 - UNLISTED PROCEDURE MIDDLE EAR||0|0||0|10/01/2019 SH 78001|69745|69745 - SUTR NRV ITPRL W/WO GRF/DCMPRN MEDIAL GENICULATE||1461.68|0||0|10/01/2019 SH 78001|69740|69740 - SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE||1375.82|0||0|10/01/2019 SH 78001|69725|69725 - DCMPRN NRV INTRATEMPORAL MEDIAL GENICULATE||2223.1|0||0|10/01/2019 SH 78001|69720|69720 - DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION||1403.09|0||0|10/01/2019 SH 78001|69718|69718 - RPLMCT OSSEOINTEGRATE IMPLNT W/MASTOIDECTOMY||1584.09|0||0|10/01/2019 SH 78001|69717|69717 - RPLMCT OSSEOINTEGRATE IMPLNT W/O MASTOIDECTOMY||1329.88|0||0|10/01/2019 SH 78001|69715|69715 - IMPLJ OSSEOINTEGRATED TEMPORAL BONE W/O MASTOID||1567.88|0||0|10/01/2019 SH 78001|69714|69714 - IMPLTJ OSSEOINTEGRATED TEMPORAL BONE W/MASTOID||1268.22|0||0|10/01/2019 SH 78001|69711|69711 - RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE||1008.74|0||0|10/01/2019 SH 78001|69710|69710 - IMPLTJ/RPLCMT EMGNT BONE CNDJ DEV TEMPORAL BONE||0|0||0|10/01/2019 SH 78001|69700|69700 - CLOSURE POSTAURICULAR FISTULA MASTOID SPX||801.16|0||0|10/01/2019 SH 78001|69676|69676 - TYMPANIC NEURECTOMY||970.16|0||0|10/01/2019 SH 78001|69670|69670 - MASTOID OBLITERATION SEPARATE PROCEDURE||1104.32|0||0|10/01/2019 SH 78001|69667|69667 - REPAIR ROUND WINDOW FISTULA||947.43|0||0|10/01/2019 SH 78001|69666|69666 - REPAIR OVAL WINDOW FISTULA||948.16|0||0|10/01/2019 SH 78001|69662|69662 - REVISION STAPEDECTOMY/STAPEDOTOMY||1365.14|0||0|10/01/2019 SH 78001|69661|69661 - STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT||1418.48|0||0|10/01/2019 SH 78001|69660|69660 - STAPEDECTOMY/STAPEDOTOMY||1090.13|0||0|10/01/2019 SH 78001|69650|69650 - STAPES MOBILIZATION||940.02|0||0|10/01/2019 SH 78001|69646|69646 - TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR||1803.31|0||0|10/01/2019 SH 78001|69645|69645 - TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR||1697.96|0||0|10/01/2019 SH 78001|69644|69644 - TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR||1729.31|0||0|10/01/2019 SH 78001|69643|69643 - TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR||1436.03|0||0|10/01/2019 SH 78001|69642|69642 - TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ||1568.46|0||0|10/01/2019 SH 78001|69641|69641 - TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ||1218.72|0||0|10/01/2019 SH 78001|69637|69637 - TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP||1633.39|0||0|10/01/2019 SH 78001|69636|69636 - TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ||1607.83|0||0|10/01/2019 SH 78001|69635|69635 - TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ||1434.28|0||0|10/01/2019 SH 78001|69633|69633 - TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP||1218.12|0||0|10/01/2019 SH 78001|69632|69632 - TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ||1259.35|0||0|10/01/2019 SH 78001|69631|69631 - TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ||1031.05|0||0|10/01/2019 SH 78001|69620|69620 - MYRINGOPLASTY||797.1|0||0|10/01/2019 SH 78001|69610|69610 - TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH||446.41|0||0|10/01/2019 SH 78001|69605|69605 - REVJ MASTOIDECTOMY W/APICECTOMY||1823.32|0||0|10/01/2019 SH 78001|69604|69604 - REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY||1303.55|0||0|10/01/2019 SH 78001|69603|69603 - REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY||1468.69|0||0|10/01/2019 SH 78001|69602|69602 - REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC||1275.26|0||0|10/01/2019 SH 78001|69601|69601 - REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY||1227.38|0||0|10/01/2019 SH 78001|69554|69554 - EXCISION AURAL GLOMUS TUMOR EXTENDED||2974.07|0||0|10/01/2019 SH 78001|69552|69552 - EXCISION AURAL GLOMUS TUMOR TRANSMASTOID||1839.08|0||0|10/01/2019 SH 78001|69550|69550 - EXCISION AURAL GLOMUS TUMOR TRANSCANAL||1210.31|0||0|10/01/2019 SH 78001|69540|69540 - EXCISION AURAL POLYP||236.13|0||0|10/01/2019 SH 78001|69535|69535 - RESCJ TEMPORAL BONE EXTERNAL APPROACH||3157.29|0||0|10/01/2019 SH 78001|69530|69530 - PETROUS APICECTOMY RADICAL MASTOIDECTOMY||1934.23|0||0|10/01/2019 SH 78001|69511|69511 - MASTOIDECTOMY RADICAL||1435.48|0||0|10/01/2019 SH 78001|69505|69505 - MASTOIDECTOMY MODIFIED RADICAL||1400.6|0||0|10/01/2019 SH 78001|69502|69502 - MASTOIDECTOMY COMPLETE||1141.69|0||0|10/01/2019 SH 78001|69501|69501 - TRANSMASTOID ANTROTOMY||856.79|0||0|10/01/2019 SH 78001|69450|69450 - TYMPANOLYSIS TRANSCANAL||632.02|0||0|10/01/2019 SH 78001|69440|69440 - MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC||801.76|0||0|10/01/2019 SH 78001|69436|69436 - TYMPANOSTOMY GENERAL ANESTHESIA||188.3|0||0|10/01/2019 SH 78001|69433|69433 - TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA||230.95|0||0|10/01/2019 SH 78001|69424|69424 - VENTILATING TUBE RMVL REQUIRING GENERAL ANES||145.22|0||0|10/01/2019 SH 78001|69421|69421 - MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES||174.5|0||0|10/01/2019 SH 78001|69420|69420 - MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ||218.1|0||0|10/01/2019 SH 78001|69399|69399 - UNLISTED PROCEDURE EXTERNAL EAR||0|0||0|10/01/2019 SH 78001|69320|69320 - RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG||1779.86|0||0|10/01/2019 SH 78001|69310|69310 - RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX||1263.03|0||0|10/01/2019 SH 78001|69300|69300 - OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ||840.7|0||0|10/01/2019 SH 78001|69222|69222 - DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX||249.42|0||0|10/01/2019 SH 78001|69220|69220 - DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE||155.21|0||0|10/01/2019 SH 78001|69210|69210 - REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT||56.94|0||0|10/01/2019 SH 78001|69209|69209 - REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT||13.91|0||0|10/01/2019 SH 78001|69205|69205 - RMVL FB XTRNL AUDITORY CANAL ANES||118.5|0||0|10/01/2019 SH 78001|69200|69200 - RMVL FB XTRNL AUDITORY CANAL W/O ANES||139.05|0||0|10/01/2019 SH 78001|69155|69155 - RAD EXC XTRNL AUDITORY CANAL LES NCK DSJ||1961.61|0||0|10/01/2019 SH 78001|69150|69150 - RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ||1228.88|0||0|10/01/2019 SH 78001|69145|69145 - EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL||452.22|0||0|10/01/2019 SH 78001|69140|69140 - EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL||1012.98|0||0|10/01/2019 SH 78001|69120|69120 - EXCISION EXTERNAL EAR COMPLETE AMPUTATION||465.89|0||0|10/01/2019 SH 78001|69110|69110 - EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR||522.54|0||0|10/01/2019 SH 78001|69105|69105 - BIOPSY EXTERNAL AUDITORY CANAL||159.18|0||0|10/01/2019 SH 78001|69100|69100 - BIOPSY EXTERNAL EAR||114.03|0||0|10/01/2019 SH 78001|69090|69090 - EAR PIERCING||0|0||0|10/01/2019 SH 78001|69020|69020 - DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS||263.72|0||0|10/01/2019 SH 78001|69005|69005 - DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX||247.11|0||0|10/01/2019 SH 78001|69000|69000 - DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE||212.8|0||0|10/01/2019 SH 78001|68899|68899 - UNLISTED PROCEDURE LACRIMAL SYSTEM||0|0||0|10/01/2019 SH 78001|68850|68850 - INJECTION CONTRAST MEDIUM DACRYOCYSTOGRAPY||70.56|0||0|10/01/2019 SH 78001|68840|68840 - PROBE LACRIMAL CANALICULI W/WO IRRIGATION||145.62|0||0|10/01/2019 SH 78001|68816|68816 - PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION||823.57|0||0|10/01/2019 SH 78001|68815|68815 - PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT||505.58|0||0|10/01/2019 SH 78001|68811|68811 - PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES||236.71|0||0|10/01/2019 SH 78001|68810|68810 - PROBE NASOLACRIMAL DUCT W/WO IRRIGATION||273.39|0||0|10/01/2019 SH 78001|68801|68801 - DILATION LACRIMAL PUNCTUM W/WO IRRGATION||140.43|0||0|10/01/2019 SH 78001|68770|68770 - CLOSURE LACRIMAL FISTULA SPX||726.64|0||0|10/01/2019 SH 78001|68761|68761 - CLSR LACRIMAL PUNCTUM PLUG EACH||167.81|0||0|10/01/2019 SH 78001|68760|68760 - CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER||227.19|0||0|10/01/2019 SH 78001|68750|68750 - CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT||905.9|0||0|10/01/2019 SH 78001|68745|68745 - CONJUNCTIVORHINOSTOMY W/O TUBE||875.94|0||0|10/01/2019 SH 78001|68720|68720 - DACRYOCSTORHINOSTOMY||872.34|0||0|10/01/2019 SH 78001|68705|68705 - CORRECTION EVERTED PUNCTUM CAUTERY||267.4|0||0|10/01/2019 SH 78001|68700|68700 - PLASTIC REPAIR CANALICULI||696.89|0||0|10/01/2019 SH 78001|68550|68550 - EXC LACRIMAL GLAND TUMOR W/OSTEOTOMY||1248.37|0||0|10/01/2019 SH 78001|68540|68540 - EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH||1071.59|0||0|10/01/2019 SH 78001|68530|68530 - RMVL FB/DACRYOLITH LACRIMAL PASSAGES||483.68|0||0|10/01/2019 SH 78001|68525|68525 - BIOPSY LACRIMAL SAC||309.67|0||0|10/01/2019 SH 78001|68520|68520 - EXCISION LACRIMAL SAC||791.2|0||0|10/01/2019 SH 78001|68510|68510 - BIOPSY LACRIMAL GLAND||508.16|0||0|10/01/2019 SH 78001|68505|68505 - EXCISION LACRIMAL GLAND XCPT TUMOR PRTL||1119.57|0||0|10/01/2019 SH 78001|68500|68500 - EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL||1124.96|0||0|10/01/2019 SH 78001|68440|68440 - SNIP INCISION LACRIMAL PUNCTUM||115.97|0||0|10/01/2019 SH 78001|68420|68420 - INCISION DRAINAGE LACRIMAL SAC||360.71|0||0|10/01/2019 SH 78001|68400|68400 - INCISION DRAINAGE LACRIMAL GLAND||318.11|0||0|10/01/2019 SH 78001|68399|68399 - UNLISTED PROCEDURE CONJUNCTIVA||0|0||0|10/01/2019 SH 78001|68371|68371 - HARVESTING CONJUNCIVAL ALLOGRAPHY LIVING DONOR||474.63|0||0|10/01/2019 SH 78001|68362|68362 - CONJUNCTIVAL FLAP TOTAL||758.28|0||0|10/01/2019 SH 78001|68360|68360 - CONJUNCTIVAL FLAP BRIDGE/PARTIAL SPX||602.52|0||0|10/01/2019 SH 78001|68340|68340 - RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE||617.15|0||0|10/01/2019 SH 78001|68335|68335 - RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB||747.93|0||0|10/01/2019 SH 78001|68330|68330 - RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT||685.82|0||0|10/01/2019 SH 78001|68328|68328 - CONJUNCTPL CUL-DE-SAC W/BUCCAL MUC MEMB GRAFT||817.78|0||0|10/01/2019 SH 78001|68326|68326 - CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT||745.43|0||0|10/01/2019 SH 78001|68325|68325 - CONJUNCTIVOPLASTY W/BUCCAL MUC MEMB GRAFT||761.86|0||0|10/01/2019 SH 78001|68320|68320 - CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT||820.99|0||0|10/01/2019 SH 78001|68200|68200 - SUBCONJUNCTIVAL INJECTION||47.11|0||0|10/01/2019 SH 78001|68135|68135 - DESTRUCTION LESION CONJUNCTIVA||179.99|0||0|10/01/2019 SH 78001|68130|68130 - EXCISION LESION CONJUNCTIVA ADJACENT SCLERA||610.74|0||0|10/01/2019 SH 78001|68115|68115 - EXCISION LESION CONJUNCTIVA > 1 CM||350.11|0||0|10/01/2019 SH 78001|68110|68110 - EXCISION LESION CONJUNCTIVA SESS PRETERM INFANT||1350.1|0||0|10/01/2019 SH 78001|67228|67228 - TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION||1156.68|0||0|10/01/2019 SH 78001|67227|67227 - DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY||702.38|0||0|10/01/2019 SH 78001|67225|67225 - DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION||34.62|0||0|10/01/2019 SH 78001|67221|67221 - DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY||329.47|0||0|10/01/2019 SH 78001|67220|67220 - DSTRJ LESION CHOROID PC 1/> SESS||613.93|0||0|10/01/2019 SH 78001|67218|67218 - DSTRJ LESION RETINA 1/> SESS RADJ IMPLTJ||1604.71|0||0|10/01/2019 SH 78001|67210|67210 - DSTRJ LOCLZD LESION RETINA 1/> SESS PC||596.1|0||0|10/01/2019 SH 78001|67208|67208 - DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM||689.73|0||0|10/01/2019 SH 78001|67145|67145 - PROPH RTA DTCHMNT W/O DRG 1/> SESS||605.22|0||0|10/01/2019 SH 78001|67141|67141 - PROPH RTA DTCHMNT W/O DRG 1/> SESS CRTX DTHRM||600.99|0||0|10/01/2019 SH 78001|67121|67121 - RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR||1049.41|0||0|10/01/2019 SH 78001|67120|67120 - RMVL IMPLNT MATL POSTERIOR SEGMENT EXTRAOCULAR||750.51|0||0|10/01/2019 SH 78001|67115|67115 - RELEASE ENCIRCLING MATERIAL POSTERIOR SEGMENT||574.46|0||0|10/01/2019 SH 78001|67113|67113 - RPR COMPLEX RETINA DETACH VITRECT &MEMBRANE PEEL||2023.47|0||0|10/01/2019 SH 78001|67112|67112 - REREPAIR DETACHED RETINA||1536.03|0||0|10/01/2019 SH 78001|67110|67110 - RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS||996.48|0||0|10/01/2019 SH 78001|67108|67108 - RPR RETINAL DTCHMNT W/VITRECTOMY ANY METH||1859.59|0||0|10/01/2019 SH 78001|67107|67107 - REPAIR RETINAL DETACHMENT SCLERAL BUCKLING||1405|0||0|10/01/2019 SH 78001|67105|67105 - RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID PC||824.99|0||0|10/01/2019 SH 78001|67101|67101 - RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID CRTX||896.72|0||0|10/01/2019 SH 78001|67043|67043 - VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE||1410.73|0||0|10/01/2019 SH 78001|67042|67042 - VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA||1336.28|0||0|10/01/2019 SH 78001|67041|67041 - VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE||1336.28|0||0|10/01/2019 SH 78001|67040|67040 - VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC||1207.33|0||0|10/01/2019 SH 78001|67039|67039 - VITRECTOMY MCHNL PARS PLNA FOCAL ENDOLASER PC||1116.37|0||0|10/01/2019 SH 78001|67036|67036 - VITRECTOMY MECHANICAL PARS PLANA||1040.75|0||0|10/01/2019 SH 78001|67031|67031 - SEVERING VITREOUS STRANS LASER 1/> STAGES||444.79|0||0|10/01/2019 SH 78001|67030|67030 - DISCISSION VITREOUS STRANS PARS PLANA APPROACH||610.12|0||0|10/01/2019 SH 78001|67028|67028 - INTRAVITREAL NJX PHARMACOLOGIC AGT SPX||117.94|0||0|10/01/2019 SH 78001|67027|67027 - IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS||984.64|0||0|10/01/2019 SH 78001|67025|67025 - INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX||830.91|0||0|10/01/2019 SH 78001|67015|67015 - ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL||667.34|0||0|10/01/2019 SH 78001|67010|67010 - RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT||625.9|0||0|10/01/2019 SH 78001|67005|67005 - RMVL VITREOUS ANT APPR PARTIAL REMOVAL||543.65|0||0|10/01/2019 SH 78001|66999|66999 - UNLISTED PROCEDURE ANTERIOR SEGMENT EYE||0|0||0|10/01/2019 SH 78001|66990|66990 - USE OPHTHALMIC ENDOSCOPE||106.23|0||0|10/01/2019 SH 78001|66986|66986 - EXCHANGE INTRAOCULAR LENS||1049.07|0||0|10/01/2019 SH 78001|66985|66985 - INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL||887.53|0||0|10/01/2019 SH 78001|66984|66984 - XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP||738.88|0||0|10/01/2019 SH 78001|66983|66983 - ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG||849.93|0||0|10/01/2019 SH 78001|66982|66982 - XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX WO ECP||920.25|0||0|10/01/2019 SH 78001|66940|66940 - REMOVAL LENS MATERIAL EXTRACAPSULAR||902.81|0||0|10/01/2019 SH 78001|66930|66930 - REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS||989.63|0||0|10/01/2019 SH 78001|66920|66920 - RMVL LENS MATERIAL INTRACAPSULAR||871.14|0||0|10/01/2019 SH 78001|66852|66852 - RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY||975.58|0||0|10/01/2019 SH 78001|66850|66850 - RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR||914.84|0||0|10/01/2019 SH 78001|66840|66840 - RMVL LENS MATERIAL ASPIR TQ 1/> STAGES||804.19|0||0|10/01/2019 SH 78001|66830|66830 - RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ||822.12|0||0|10/01/2019 SH 78001|66825|66825 - REPOSITIONING IO LENS PROSTHESIS REQ INC SPX||871.67|0||0|10/01/2019 SH 78001|66821|66821 - POST-CATARACT LASER SURGERY||376.24|0||0|10/01/2019 SH 78001|66820|66820 - DISCISSION SECONDARY MEMBRANOUS CATARACT||448.21|0||0|10/01/2019 SH 78001|66770|66770 - DSTRJ CYST/LESION IRIS/CILIARY BODY||605.56|0||0|10/01/2019 SH 78001|66762|66762 - IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS||543.35|0||0|10/01/2019 SH 78001|66761|66761 - IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION||337.19|0||0|10/01/2019 SH 78001|66740|66740 - CILIARY BODY DESTRUCTION CYCLODIALYSIS||501.21|0||0|10/01/2019 SH 78001|66720|66720 - CILIARY BODY DESTRUCTION CRYOTHERAPY||542.08|0||0|10/01/2019 SH 78001|66711|66711 - ECP CILIARY BODY DSTRJ W/O RMVL CRYSTALLINE LENS||737.86|0||0|10/01/2019 SH 78001|66710|66710 - CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL||504.31|0||0|10/01/2019 SH 78001|66700|66700 - CILIARY BODY DESTRUCTION DIATHERMY||515.56|0||0|10/01/2019 SH 78001|66682|66682 - SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE||730.2|0||0|10/01/2019 SH 78001|66680|66680 - REPAIR IRIS CILIARY BODY||595.45|0||0|10/01/2019 SH 78001|66635|66635 - IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX||662.53|0||0|10/01/2019 SH 78001|66630|66630 - IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX||655.93|0||0|10/01/2019 SH 78001|66625|66625 - IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX||493.38|0||0|10/01/2019 SH 78001|66605|66605 - IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY||1220.45|0||0|10/01/2019 SH 78001|66600|66600 - IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES||955.99|0||0|10/01/2019 SH 78001|66505|66505 - IRIDOTOMY STAB INC SPX TRANSFIXION||443.31|0||0|10/01/2019 SH 78001|66500|66500 - IRIDOTOMY STAB INC SPX XCP TRANSFIXION||404.39|0||0|10/01/2019 SH 78001|66250|66250 - REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT||850.52|0||0|10/01/2019 SH 78001|66225|66225 - REPAIR SCLERAL STAPHYLOMA W/GRAFT||1076.66|0||0|10/01/2019 SH 78001|66220|66220 - REPAIR SCLERAL STAPHYLOMA W/O GRAFT||855.1|0||0|10/01/2019 SH 78001|66185|66185 - REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT||972.34|0||0|10/01/2019 SH 78001|66184|66184 - REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT||902.07|0||0|10/01/2019 SH 78001|66183|66183 - INSERT ANTER DRAINAGE DEV W/O EXTRAOC RESERVOIR||1186.92|0||0|10/01/2019 SH 78001|66180|66180 - AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT||1312.64|0||0|10/01/2019 SH 78001|66179|66179 - AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT||1242.75|0||0|10/01/2019 SH 78001|66175|66175 - TRLUML DILAT AQUEOUS CANAL W/DEVICE/STENT||1147.58|0||0|10/01/2019 SH 78001|66174|66174 - TRLUML DILAT AQUEOUS CANAL W/O DEVICE/STENT||1095.07|0||0|10/01/2019 SH 78001|66172|66172 - FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING||1741.58|0||0|10/01/2019 SH 78001|66170|66170 - FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO||1381.34|0||0|10/01/2019 SH 78001|66160|66160 - FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT||1136.47|0||0|10/01/2019 SH 78001|66155|66155 - FSTLJ SCLERA GLAUCOMA THERMOCAUT IRRIDEC||1005.8|0||0|10/01/2019 SH 78001|66150|66150 - FSTLJ SCLERA GLAUCOMA TREPHIN W/IRIDECTOMY||1001.2|0||0|10/01/2019 SH 78001|66130|66130 - EXCISION LESION SCLERA||795.95|0||0|10/01/2019 SH 78001|66030|66030 - INJX ANTERIOR CHAMBER EYE MEDICATION SPX||187.1|0||0|10/01/2019 SH 78001|66020|66020 - INJX ANTERIOR CHAMBER EYE AIR/LIQUID SPX||210.68|0||0|10/01/2019 SH 78001|65930|65930 - RMVL BLOOD CLOT ANTERIOR SEGMENT EYE||735.99|0||0|10/01/2019 SH 78001|65920|65920 - RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE||907.74|0||0|10/01/2019 SH 78001|65900|65900 - RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE||1111.03|0||0|10/01/2019 SH 78001|65880|65880 - SEVERING ADS ANT SEG INCAL SPX CORNEOVITREAL||763.39|0||0|10/01/2019 SH 78001|65875|65875 - SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE||724.15|0||0|10/01/2019 SH 78001|65870|65870 - SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE||680.06|0||0|10/01/2019 SH 78001|65865|65865 - SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE||543.9|0||0|10/01/2019 SH 78001|65860|65860 - SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX||354.11|0||0|10/01/2019 SH 78001|65855|65855 - TRABECULOPLASTY BY LASER SURGERY||387.65|0||0|10/01/2019 SH 78001|65850|65850 - TRABECULOTOMY AB EXTERNO||969.68|0||0|10/01/2019 SH 78001|65820|65820 - GONIOTOMY||858.44|0||0|10/01/2019 SH 78001|65815|65815 - PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN||724.38|0||0|10/01/2019 SH 78001|65810|65810 - PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX||535.98|0||0|10/01/2019 SH 78001|65800|65800 - PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX||137.33|0||0|10/01/2019 SH 78001|65785|65785 - IMPLANTATION INTRASTROMAL CORNEAL RING SEGMENTS||2336.07|0||0|10/01/2019 SH 78001|65782|65782 - OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT||1328.86|0||0|10/01/2019 SH 78001|65781|65781 - OCULAR SURFACE RECONSTRUCTION LIMBAL ALLOGRAFT||1541.12|0||0|10/01/2019 SH 78001|65780|65780 - OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE||1021.45|0||0|10/01/2019 SH 78001|65779|65779 - PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED||1357.63|0||0|10/01/2019 SH 78001|65778|65778 - PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES||1513.93|0||0|10/01/2019 SH 78001|65775|65775 - CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM||634.94|0||0|10/01/2019 SH 78001|65772|65772 - CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM||516.11|0||0|10/01/2019 SH 78001|65771|65771 - RADIAL KERATOTOMY||0|0||0|10/01/2019 SH 78001|65770|65770 - KERATOPROSTHESIS||1628.74|0||0|10/01/2019 SH 78001|65767|65767 - EPIKERATOPLASTY||0|0||0|10/01/2019 SH 78001|65765|65765 - KERATOPHAKIA||0|0||0|10/01/2019 SH 78001|65760|65760 - KERATOMILEUSIS||0|0||0|10/01/2019 SH 78001|65757|65757 - BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT||0|0||0|10/01/2019 SH 78001|65756|65756 - KERATOPLASTY ENDOTHELIAL||1373.01|0||0|10/01/2019 SH 78001|65755|65755 - KERATOPLASTY PENETRATING PSEUDOPHAKIA||1418.53|0||0|10/01/2019 SH 78001|65750|65750 - KERATOPLASTY PENETRAING APHAKIA||1426.38|0||0|10/01/2019 SH 78001|65730|65730 - KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA||1416.61|0||0|10/01/2019 SH 78001|65710|65710 - KERATOPLASTY ANTERIOR LAMELLAR||1275.73|0||0|10/01/2019 SH 78001|65600|65600 - MULTIPLE PUNCTURES ANTERIOR CORNEA||450.2|0||0|10/01/2019 SH 78001|65450|65450 - DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION||371.42|0||0|10/01/2019 SH 78001|65436|65436 - RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT||445.54|0||0|10/01/2019 SH 78001|65435|65435 - RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION||90.85|0||0|10/01/2019 SH 78001|65430|65430 - CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE||132.02|0||0|10/01/2019 SH 78001|65426|65426 - EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG||740.5|0||0|10/01/2019 SH 78001|65420|65420 - EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT||583.86|0||0|10/01/2019 SH 78001|65410|65410 - BIOPSY CORNEA||163.03|0||0|10/01/2019 SH 78001|65400|65400 - EXCISION LESION CORNEA XCP PTERYGIUM||776.68|0||0|10/01/2019 SH 78001|65290|65290 - RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU||566.21|0||0|10/01/2019 SH 78001|65286|65286 - RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA||799.63|0||0|10/01/2019 SH 78001|65285|65285 - RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T||1282.81|0||0|10/01/2019 SH 78001|65280|65280 - RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS||777.09|0||0|10/01/2019 SH 78001|65275|65275 - RPR LAC CORNEA NONPERFOR W/WO RMVL FOREIGN BODY||660.53|0||0|10/01/2019 SH 78001|65273|65273 - RPR LAC CJNC MOBLJ & REARGMT W/HOSPIZATION||439.66|0||0|10/01/2019 SH 78001|65272|65272 - RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION||569.88|0||0|10/01/2019 SH 78001|65270|65270 - RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR||300.43|0||0|10/01/2019 SH 78001|65265|65265 - RMVL FB IO FROM POST SEG NONMAGNETIC XTRJ||1245.01|0||0|10/01/2019 SH 78001|65260|65260 - RMVL FB IO FROM POST SEG MAG XTRJ ANT/POST ROUTE||1104.57|0||0|10/01/2019 SH 78001|65235|65235 - RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS||819.72|0||0|10/01/2019 SH 78001|65222|65222 - RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP||76.94|0||0|10/01/2019 SH 78001|65220|65220 - RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP||66.29|0||0|10/01/2019 SH 78001|65210|65210 - RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR||78.87|0||0|10/01/2019 SH 78001|65205|65205 - REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL||64.35|0||0|10/01/2019 SH 78001|65175|65175 - REMOVAL OCULAR IMPLANT||751.05|0||0|10/01/2019 SH 78001|65155|65155 - REINSERTION OCULAR IMPLT RNFCMT &/ ATTACH MUSCLE||969.47|0||0|10/01/2019 SH 78001|65150|65150 - REINSERTION OCULAR IMPLT W/WO CONJUNCTIVAL GRAFT||659.59|0||0|10/01/2019 SH 78001|65140|65140 - INSJ OC IMPLT AFTER ENCL MUSC ATTACHED||924.8|0||0|10/01/2019 SH 78001|65135|65135 - INSJ OC IMPLT AFTER ENCL MUSC X ATTACHED||849.72|0||0|10/01/2019 SH 78001|65130|65130 - INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL||837.3|0||0|10/01/2019 SH 78001|65125|65125 - MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX||513.97|0||0|10/01/2019 SH 78001|65114|65114 - EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP||1712.08|0||0|10/01/2019 SH 78001|65112|65112 - EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE||1631.5|0||0|10/01/2019 SH 78001|65110|65110 - EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY||1405.63|0||0|10/01/2019 SH 78001|65105|65105 - ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT||972.6|0||0|10/01/2019 SH 78001|65103|65103 - ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT||879.84|0||0|10/01/2019 SH 78001|65101|65101 - ENUCLEATION OF EYE W/O IMPLANT||843.76|0||0|10/01/2019 SH 78001|65093|65093 - EVISCERATION OCULAR CONTENTS W/IMPLANT||717.3|0||0|10/01/2019 SH 78001|65091|65091 - EVISCERATION OCULAR CONTENTS W/O IMPLANT||726.01|0||0|10/01/2019 SH 78001|64999|64999 - UNLISTED PROCEDURE NERVOUS SYSTEM||0|0||0|10/01/2019 SH 78001|64913|64913 - NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND||192.86|0||0|10/01/2019 SH 78001|64912|64912 - NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND||935.13|0||0|10/01/2019 SH 78001|64911|64911 - NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE||1195.91|0||0|10/01/2019 SH 78001|64910|64910 - NERVE REPAIR W/CONDUIT EACH NERVE||970.33|0||0|10/01/2019 SH 78001|64907|64907 - NERVE PEDICAL TRANSFER SECOND STAGE||1743.96|0||0|10/01/2019 SH 78001|64905|64905 - NERVE PEDICLE TRANSFER FIRST STAGE||1210.7|0||0|10/01/2019 SH 78001|64902|64902 - NERVE GRAFT EACH NERVE MULTIPLE STRANDS||779.82|0||0|10/01/2019 SH 78001|64901|64901 - NERVE GRAFT EACH NERVE 1 STRAND||673.52|0||0|10/01/2019 SH 78001|64898|64898 - NERVE GRAFT MLT STRANDS ARM/LEG >4 CM||1629.51|0||0|10/01/2019 SH 78001|64897|64897 - NERVE GRAFT MLT STRANDS ARM/LEG 4 CM||1918.46|0||0|10/01/2019 SH 78001|64895|64895 - NERVE GRAFT MLT STRANDS HAND/FOOT 4 CM||1342.09|0||0|10/01/2019 SH 78001|64892|64892 - NERVE GRAFT 1 STRAND ARM/LEG <4 CM||1248.11|0||0|10/01/2019 SH 78001|64891|64891 - NRV GRF 1 STRAND HAND/FOOT >4 CM||1377.15|0||0|10/01/2019 SH 78001|64890|64890 - NERVE GRAFT 1 STRAND HAND/FOOT 4 CM||1541.92|0||0|10/01/2019 SH 78001|64885|64885 - NERVE GRAFT HEAD/NECK MUSCLES||132.5|0||0|10/01/2019 SH 78001|64644|64644 - CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES||188.28|0||0|10/01/2019 SH 78001|64643|64643 - CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE||109.27|0||0|10/01/2019 SH 78001|64642|64642 - CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE||163.88|0||0|10/01/2019 SH 78001|64640|64640 - DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE||152.3|0||0|10/01/2019 SH 78001|64636|64636 - DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL||192.69|0||0|10/01/2019 SH 78001|64635|64635 - DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL||472.02|0||0|10/01/2019 SH 78001|64634|64634 - DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA||210.84|0||0|10/01/2019 SH 78001|64633|64633 - DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA||476.16|0||0|10/01/2019 SH 78001|64632|64632 - DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE||99.96|0||0|10/01/2019 SH 78001|64630|64630 - DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE||271.56|0||0|10/01/2019 SH 78001|64620|64620 - DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE||240.19|0||0|10/01/2019 SH 78001|64617|64617 - CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG||218.44|0||0|10/01/2019 SH 78001|64616|64616 - CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA||145.16|0||0|10/01/2019 SH 78001|64615|64615 - CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE||171.4|0||0|10/01/2019 SH 78001|64612|64612 - CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL||151.19|0||0|10/01/2019 SH 78001|64611|64611 - CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS||134.43|0||0|10/01/2019 SH 78001|64610|64610 - DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR||841.29|0||0|10/01/2019 SH 78001|64605|64605 - DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH||672.59|0||0|10/01/2019 SH 78001|64600|64600 - DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH||438.26|0||0|10/01/2019 SH 78001|64595|64595 - REVISION/RMVL PERIPHERAL/GASTRIC NPGR||278.77|0||0|10/01/2019 SH 78001|64590|64590 - INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR||303.03|0||0|10/01/2019 SH 78001|64585|64585 - REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE||279.83|0||0|10/01/2019 SH 78001|64581|64581 - INC IMPLTJ NEUROSTIMULATOR ELTRD SACRAL NERVE||792.7|0||0|10/01/2019 SH 78001|64580|64580 - INC IMPLTJ NSTIM ELTRD NEUROMUSCULAR||354.55|0||0|10/01/2019 SH 78001|64575|64575 - INC IMPLTJ PERIPH NERVE NEUROSTIMULATOR ELTRD||376.09|0||0|10/01/2019 SH 78001|64570|64570 - REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO||796.18|0||0|10/01/2019 SH 78001|64569|64569 - REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV||939.51|0||0|10/01/2019 SH 78001|64568|64568 - INC IMPLTJ CRNL NRV NSTIM ELTRDS & PULSE GENER||788|0||0|10/01/2019 SH 78001|64566|64566 - POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE||135.98|0||0|10/01/2019 SH 78001|64565|64565 - PRQ IMPLTJ NSTIM ELTRD NEUROMUSCULAR||217.26|0||0|10/01/2019 SH 78001|64561|64561 - PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING||923.18|0||0|10/01/2019 SH 78001|64555|64555 - PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV||243.91|0||0|10/01/2019 SH 78001|64553|64553 - PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE||246.4|0||0|10/01/2019 SH 78001|64550|64550 - APPLICATION OF SURFACE NEUROSTIMULATOR||18.23|0||0|10/01/2019 SH 78001|64530|64530 - INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG||217.02|0||0|10/01/2019 SH 78001|64520|64520 - INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC||210.58|0||0|10/01/2019 SH 78001|64517|64517 - INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS||208.87|0||0|10/01/2019 SH 78001|64510|64510 - NJX ANES STELLATE GANGLION CRV SYMPATHETIC||145.66|0||0|10/01/2019 SH 78001|64508|64508 - INJECTION ANESTHETIC AGENT CAROTID SINUS SPX||74.71|0||0|10/01/2019 SH 78001|64505|64505 - INJECTION ANES AGENT SPHENOPALATINE GANGLION||121.48|0||0|10/01/2019 SH 78001|64495|64495 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL||100.51|0||0|10/01/2019 SH 78001|64494|64494 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL||100.12|0||0|10/01/2019 SH 78001|64493|64493 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL||196.6|0||0|10/01/2019 SH 78001|64492|64492 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL||109.35|0||0|10/01/2019 SH 78001|64491|64491 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL||108.96|0||0|10/01/2019 SH 78001|64490|64490 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL||217.68|0||0|10/01/2019 SH 78001|64489|64489 - TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S)||241.62|0||0|10/01/2019 SH 78001|64488|64488 - TAP BLOCK BILATERAL BY INJECTION(S)||175.23|0||0|10/01/2019 SH 78001|64487|64487 - TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S)||173.55|0||0|10/01/2019 SH 78001|64486|64486 - TAP BLOCK UNILATERAL BY INJECTION(S)||142.39|0||0|10/01/2019 SH 78001|64484|64484 - NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC EA LV||100.51|0||0|10/01/2019 SH 78001|64483|64483 - NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL||249.43|0||0|10/01/2019 SH 78001|64480|64480 - NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC EA LV||129.69|0||0|10/01/2019 SH 78001|64479|64479 - NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC 1 LVL||269.74|0||0|10/01/2019 SH 78001|64463|64463 - PVB THORACIC CONT CATHETER INFUSION W/IMG GID||185.18|0||0|10/01/2019 SH 78001|64462|64462 - PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID||97.11|0||0|10/01/2019 SH 78001|64461|64461 - PVB THORACIC SINGLE INJECTION SITE W/IMG GID||170.63|0||0|10/01/2019 SH 78001|64455|64455 - NJX ANES&/STEROID PLANTAR COMMON DIGITAL NERVE||55.61|0||0|10/01/2019 SH 78001|64450|64450 - INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH||91.67|0||0|10/01/2019 SH 78001|64449|64449 - INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH||100.96|0||0|10/01/2019 SH 78001|64448|64448 - INJECTION AA&/STRD FEMORAL NERVE CONT NFS CATH||85.82|0||0|10/01/2019 SH 78001|64447|64447 - INJECTION AA&/STRD FEMORAL NERVE||137.97|0||0|10/01/2019 SH 78001|64446|64446 - INJECTION AA&/STRD SCIATIC NERVE CONT NFS CATH||96.3|0||0|10/01/2019 SH 78001|64445|64445 - INJECTION AA&/STRD SCIATIC NERVE||155.34|0||0|10/01/2019 SH 78001|64435|64435 - INJECTION AA&/STRD PARACERVICAL NERVE||155.6|0||0|10/01/2019 SH 78001|64430|64430 - INJECTION AA&/STRD PUDENDAL NERVE||160.68|0||0|10/01/2019 SH 78001|64425|64425 - INJECTION AA&/STRD ILIOINGUINAL IH NERVES||152.64|0||0|10/01/2019 SH 78001|64421|64421 - INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL||172.49|0||0|10/01/2019 SH 78001|64420|64420 - INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL||129.21|0||0|10/01/2019 SH 78001|64418|64418 - INJECTION AA&/STRD SUPRASCAPULAR NERVE||167.43|0||0|10/01/2019 SH 78001|64417|64417 - INJECTION AA&/STRD AXILLARY NERVE||148.57|0||0|10/01/2019 SH 78001|64416|64416 - INJECTION AA&/STRD BRACHIAL PLEXUS CONT NFS CATH||95.91|0||0|10/01/2019 SH 78001|64415|64415 - INJECTION AA&/STRD BRACHIAL PLEXUS||135.95|0||0|10/01/2019 SH 78001|64413|64413 - INJECTION ANESTHETIC AGENT CERVICAL PLEXUS||148.8|0||0|10/01/2019 SH 78001|64412|64412 - N BLOCK INJ SPINAL ACCESSOR||162.17|0||0|10/01/2019 SH 78001|64410|64410 - INJECTION ANESTHETIC AGENT PHRENIC NERVE||138.83|0||0|10/01/2019 SH 78001|64408|64408 - INJECTION AA&/STRD VAGUS NERVE||134.87|0||0|10/01/2019 SH 78001|64405|64405 - INJECTION AA&/STRD GREATER OCCIPITAL NERVE||115.78|0||0|10/01/2019 SH 78001|64402|64402 - INJECTION ANESTHETIC AGENT FACIAL NERVE||149.32|0||0|10/01/2019 SH 78001|64400|64400 - INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH||145.6|0||0|10/01/2019 SH 78001|63746|63746 - RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT||720.29|0||0|10/01/2019 SH 78001|63744|63744 - RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT||812.65|0||0|10/01/2019 SH 78001|63741|63741 - CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM||812.61|0||0|10/01/2019 SH 78001|63740|63740 - CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM||1152.06|0||0|10/01/2019 SH 78001|63710|63710 - DURAL GRAFT SPINAL||1292.67|0||0|10/01/2019 SH 78001|63709|63709 - RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM||1316.29|0||0|10/01/2019 SH 78001|63707|63707 - RPR DURAL/CEREBROSPINAL FLUID LEAK X REQ LAM||1095.63|0||0|10/01/2019 SH 78001|63706|63706 - REPAIR MYELOMENINGOCELE > 5 CM DIAMETER||2007.93|0||0|10/01/2019 SH 78001|63704|63704 - REPAIR MYELOMENINGOCELE < 5 CM DIAMETER||1770.25|0||0|10/01/2019 SH 78001|63702|63702 - REPAIR MENINGOCELE > 5 CM DIAMETER||1693.53|0||0|10/01/2019 SH 78001|63700|63700 - REPAIR MENINGOCELE < 5 CM DIAMETER||1390.23|0||0|10/01/2019 SH 78001|63688|63688 - REVJ/RMVL IMPLANTED SPINAL NEUROSTIM GENERATOR||439.67|0||0|10/01/2019 SH 78001|63685|63685 - INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING||435.31|0||0|10/01/2019 SH 78001|63664|63664 - REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR||1022.83|0||0|10/01/2019 SH 78001|63663|63663 - REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR||905.01|0||0|10/01/2019 SH 78001|63662|63662 - RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR||998.86|0||0|10/01/2019 SH 78001|63661|63661 - RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR||663.07|0||0|10/01/2019 SH 78001|63655|63655 - LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL||986.09|0||0|10/01/2019 SH 78001|63650|63650 - PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL||1494.67|0||0|10/01/2019 SH 78001|63621|63621 - STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION||310.07|0||0|10/01/2019 SH 78001|63620|63620 - STEREOTACTIC RADIOSURGERY 1 SPINAL LESION||1348.19|0||0|10/01/2019 SH 78001|63615|63615 - STRTCTC BX ASPIRAT/EXC LESION SPINAL CORD||1279.07|0||0|10/01/2019 SH 78001|63610|63610 - STRTCTC STIMJ SPI CORD PRQ SPX N/FLWD OTH SURG||474.23|0||0|10/01/2019 SH 78001|63600|63600 - CREATION LES SPINAL CORD STEREOTACTIC METHOD PRQ||1081.81|0||0|10/01/2019 SH 78001|63308|63308 - VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG||394.21|0||0|10/01/2019 SH 78001|63307|63307 - VCRPEC LES 1 SEG IDRL LMBR/SAC TRANSPRTL/RPR||2627.82|0||0|10/01/2019 SH 78001|63306|63306 - VERTEBRL CORPECT LES 1 SEG IDRL THRC THORACOLMBR||2408.47|0||0|10/01/2019 SH 78001|63305|63305 - VERTEBRAL CORPECTOMY LES 1 SEG IDRL THRC TTHRC||3047.24|0||0|10/01/2019 SH 78001|63304|63304 - VERTEBRAL CORPECTOMY EXC LES 1 SEG IDRL CERVICAL||2861.39|0||0|10/01/2019 SH 78001|63303|63303 - VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR||2819.74|0||0|10/01/2019 SH 78001|63302|63302 - VCRPEC LES 1 SEG XDRL THRC THORACOLMBR||2650.52|0||0|10/01/2019 SH 78001|63301|63301 - VCRPEC LES 1 SGM XDRL THORACIC TTHRC||2623.31|0||0|10/01/2019 SH 78001|63300|63300 - VCRPEC LES 1 SGM XDRL CERVICAL||2218.38|0||0|10/01/2019 SH 78001|63295|63295 - OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX||410.23|0||0|10/01/2019 SH 78001|63290|63290 - LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL||3404.47|0||0|10/01/2019 SH 78001|63287|63287 - LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR||3346.91|0||0|10/01/2019 SH 78001|63286|63286 - LAM BX/EXC ISPI NEO IDRL IMED THORACIC||3152.61|0||0|10/01/2019 SH 78001|63285|63285 - LAM BX/EXC ISPI NEO IDRL IMED CERVICAL||3188.25|0||0|10/01/2019 SH 78001|63283|63283 - LAM BX/EXC ISPI NEO IDRL SACRAL||2307.69|0||0|10/01/2019 SH 78001|63282|63282 - LAM BX/EXC ISPI NEO IDRL XMED LUMBAR||2380.77|0||0|10/01/2019 SH 78001|63281|63281 - LAM BX/EXC ISPI NEO IDRL XMED THORACIC||2531.25|0||0|10/01/2019 SH 78001|63280|63280 - LAM BX/EXC ISPI NEO IDRL XMED CERVICAL||2568.7|0||0|10/01/2019 SH 78001|63278|63278 - LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL||1928.09|0||0|10/01/2019 SH 78001|63277|63277 - LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR||1868.05|0||0|10/01/2019 SH 78001|63276|63276 - LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC||2157.72|0||0|10/01/2019 SH 78001|63275|63275 - LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL||2177.89|0||0|10/01/2019 SH 78001|63273|63273 - LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL||2267.64|0||0|10/01/2019 SH 78001|63272|63272 - LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR||2280.04|0||0|10/01/2019 SH 78001|63271|63271 - LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC||2510.4|0||0|10/01/2019 SH 78001|63270|63270 - LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL||2526.67|0||0|10/01/2019 SH 78001|63268|63268 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL||1745.86|0||0|10/01/2019 SH 78001|63267|63267 - LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR||1645.3|0||0|10/01/2019 SH 78001|63266|63266 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC||2073.35|0||0|10/01/2019 SH 78001|63265|63265 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL||2010.23|0||0|10/01/2019 SH 78001|63252|63252 - LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR||3701.69|0||0|10/01/2019 SH 78001|63251|63251 - LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC||3702.12|0||0|10/01/2019 SH 78001|63250|63250 - LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL||3623.06|0||0|10/01/2019 SH 78001|63200|63200 - LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR||1847.79|0||0|10/01/2019 SH 78001|63199|63199 - LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES THORACIC||2011.43|0||0|10/01/2019 SH 78001|63198|63198 - LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES CERVICAL||1916.96|0||0|10/01/2019 SH 78001|63197|63197 - LAM CORDOTOMY SCTJ BOTH SPINOTHALMIC TRACT THRC||2078.69|0||0|10/01/2019 SH 78001|63196|63196 - LAM CORDOTOMY SCTJ BOTH SPINOTHALMIC TRACTS CRV||1626.92|0||0|10/01/2019 SH 78001|63195|63195 - LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT THORACIC||1399.4|0||0|10/01/2019 SH 78001|63194|63194 - LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT CERVICAL||1937.69|0||0|10/01/2019 SH 78001|63191|63191 - LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE||1670.41|0||0|10/01/2019 SH 78001|63190|63190 - LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS||1505.95|0||0|10/01/2019 SH 78001|63185|63185 - LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS||1366.03|0||0|10/01/2019 SH 78001|63182|63182 - LAM&SCTJ DENTATE LIG W/WO DURAL GRF CRV >2 SEG||1980.44|0||0|10/01/2019 SH 78001|63180|63180 - LAM&SCTJ DENTATE LIG W/WO DURAL GRF CRV 1/2 SEG||1802.79|0||0|10/01/2019 SH 78001|63173|63173 - LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL||2096.77|0||0|10/01/2019 SH 78001|63172|63172 - LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID||1721.06|0||0|10/01/2019 SH 78001|63170|63170 - LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR||1933.53|0||0|10/01/2019 SH 78001|63103|63103 - VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG||357.41|0||0|10/01/2019 SH 78001|63102|63102 - VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG||2733.3|0||0|10/01/2019 SH 78001|63101|63101 - VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG||2794.87|0||0|10/01/2019 SH 78001|63091|63091 - VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG||214.15|0||0|10/01/2019 SH 78001|63090|63090 - VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG||2338.53|0||0|10/01/2019 SH 78001|63088|63088 - VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG||317.99|0||0|10/01/2019 SH 78001|63087|63087 - VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG||2901.57|0||0|10/01/2019 SH 78001|63086|63086 - VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG||231.57|0||0|10/01/2019 SH 78001|63085|63085 - VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG||2303.1|0||0|10/01/2019 SH 78001|63082|63082 - VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG||323.59|0||0|10/01/2019 SH 78001|63081|63081 - VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG||2109.92|0||0|10/01/2019 SH 78001|63078|63078 - DISCECTOMY ANT DCMPRN CORD THORACIC EA NTRSPC||229.97|0||0|10/01/2019 SH 78001|63077|63077 - DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC||1804.06|0||0|10/01/2019 SH 78001|63076|63076 - DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC||299.7|0||0|10/01/2019 SH 78001|63075|63075 - DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC||1623.37|0||0|10/01/2019 SH 78001|63066|63066 - COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG||253.68|0||0|10/01/2019 SH 78001|63064|63064 - COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG||2131.51|0||0|10/01/2019 SH 78001|63057|63057 - TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR||387.99|0||0|10/01/2019 SH 78001|63056|63056 - TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR||1779.87|0||0|10/01/2019 SH 78001|63055|63055 - TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC||1964.4|0||0|10/01/2019 SH 78001|63051|63051 - LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ||2054.92|0||0|10/01/2019 SH 78001|63050|63050 - LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG||1782.78|0||0|10/01/2019 SH 78001|63048|63048 - LAM FACETECTOMY&FORAMTOMY 1 SGM EA CRV THRC/LMBR||257.24|0||0|10/01/2019 SH 78001|63047|63047 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR||1318.16|0||0|10/01/2019 SH 78001|63046|63046 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT THORACIC||1446.28|0||0|10/01/2019 SH 78001|63045|63045 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT CERVICAL||1529.38|0||0|10/01/2019 SH 78001|63044|63044 - LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR||0|0||0|10/01/2019 SH 78001|63043|63043 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV||0|0||0|10/01/2019 SH 78001|63042|63042 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR||1549.37|0||0|10/01/2019 SH 78001|63040|63040 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL||1671.48|0||0|10/01/2019 SH 78001|63035|63035 - LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR||232.56|0||0|10/01/2019 SH 78001|63030|63030 - LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR||1154.96|0||0|10/01/2019 SH 78001|63020|63020 - LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC||1395.17|0||0|10/01/2019 SH 78001|63017|63017 - LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR||1503.4|0||0|10/01/2019 SH 78001|63016|63016 - LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC||1828.09|0||0|10/01/2019 SH 78001|63015|63015 - LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL||1785.38|0||0|10/01/2019 SH 78001|63012|63012 - LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR||1424.39|0||0|10/01/2019 SH 78001|63011|63011 - LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL||1317.36|0||0|10/01/2019 SH 78001|63005|63005 - LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR||1416.01|0||0|10/01/2019 SH 78001|63003|63003 - LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC||1488.5|0||0|10/01/2019 SH 78001|63001|63001 - LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG CRV||1494.2|0||0|10/01/2019 SH 78001|62370|62370 - ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP||144.27|0||0|10/01/2019 SH 78001|62369|62369 - ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL||135.9|0||0|10/01/2019 SH 78001|62368|62368 - ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG||65.34|0||0|10/01/2019 SH 78001|62367|62367 - ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL||47.07|0||0|10/01/2019 SH 78001|62365|62365 - RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS||352.64|0||0|10/01/2019 SH 78001|62362|62362 - IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP||459.6|0||0|10/01/2019 SH 78001|62361|62361 - IMPLTJ/RPLCMT FS NON-PRGRBL PUMP||511.06|0||0|10/01/2019 SH 78001|62360|62360 - IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR||360.96|0||0|10/01/2019 SH 78001|62355|62355 - RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH||319.16|0||0|10/01/2019 SH 78001|62351|62351 - IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM||1026.88|0||0|10/01/2019 SH 78001|62350|62350 - IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM||476.66|0||0|10/01/2019 SH 78001|62327|62327 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN||274.76|0||0|10/01/2019 SH 78001|62326|62326 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN||187.77|0||0|10/01/2019 SH 78001|62325|62325 - NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN||269.6|0||0|10/01/2019 SH 78001|62324|62324 - NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN||178.73|0||0|10/01/2019 SH 78001|62323|62323 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN||298.45|0||0|10/01/2019 SH 78001|62322|62322 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN||190.78|0||0|10/01/2019 SH 78001|62321|62321 - NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN||304.05|0||0|10/01/2019 SH 78001|62320|62320 - NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN||204.57|0||0|10/01/2019 SH 78001|62305|62305 - MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS||300.65|0||0|10/01/2019 SH 78001|62304|62304 - MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL||275.79|0||0|10/01/2019 SH 78001|62303|62303 - MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC||289.92|0||0|10/01/2019 SH 78001|62302|62302 - MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL||279.45|0||0|10/01/2019 SH 78001|62294|62294 - NJX ARTERIAL OCCLUSION ARVEN MALFRMJ SPINAL||941.33|0||0|10/01/2019 SH 78001|62292|62292 - INJECTION PX CHEMONUCLEOLYSIS 1/MLT LUMBAR||691.28|0||0|10/01/2019 SH 78001|62291|62291 - INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC||385.26|0||0|10/01/2019 SH 78001|62290|62290 - INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR||382.17|0||0|10/01/2019 SH 78001|62287|62287 - DCMPRN PERQ NUCLEUS PULPOSUS 1/> LEVELS LUMBAR||679.2|0||0|10/01/2019 SH 78001|62284|62284 - INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR||208.71|0||0|10/01/2019 SH 78001|62282|62282 - INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL||335.45|0||0|10/01/2019 SH 78001|62281|62281 - INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC||269.83|0||0|10/01/2019 SH 78001|62280|62280 - INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID||342.58|0||0|10/01/2019 SH 78001|62273|62273 - INJECTION EPIDURAL BLOOD/CLOT PATCH||200.9|0||0|10/01/2019 SH 78001|62272|62272 - THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF||228.85|0||0|10/01/2019 SH 78001|62270|62270 - DIAGNOSTIC LUMBAR SPINAL PUNCTURE||182.78|0||0|10/01/2019 SH 78001|62269|62269 - BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE||324.29|0||0|10/01/2019 SH 78001|62268|62268 - PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX||315.32|0||0|10/01/2019 SH 78001|62267|62267 - PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS||289.91|0||0|10/01/2019 SH 78001|62264|62264 - PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY||481.8|0||0|10/01/2019 SH 78001|62263|62263 - PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS||720.02|0||0|10/01/2019 SH 78001|62258|62258 - RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT||1354.92|0||0|10/01/2019 SH 78001|62256|62256 - RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT||719.33|0||0|10/01/2019 SH 78001|62252|62252 - REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT||98.64|55.61||0|10/01/2019 SH 78001|62230|62230 - RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS||1015.24|0||0|10/01/2019 SH 78001|62225|62225 - RPLCMT/IRRIGATION VENTRICULAR CATHETER||627.6|0||0|10/01/2019 SH 78001|62223|62223 - CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS||1260.22|0||0|10/01/2019 SH 78001|62220|62220 - CRTJ SHUNT VENTRICULO-ATR-JUG-AUR||1236.05|0||0|10/01/2019 SH 78001|62201|62201 - VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC||1452.53|0||0|10/01/2019 SH 78001|62200|62200 - VENTRICULOCISTERNOSTOMY 3RD VENTRICLE||1671.28|0||0|10/01/2019 SH 78001|62194|62194 - RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER||583.15|0||0|10/01/2019 SH 78001|62192|62192 - CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH||1177.66|0||0|10/01/2019 SH 78001|62190|62190 - CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR||710.67|0||0|10/01/2019 SH 78001|62180|62180 - VENTRICULOCISTERNOSTOMY||1944.87|0||0|10/01/2019 SH 78001|62165|62165 - NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID||1859.19|0||0|10/01/2019 SH 78001|62164|62164 - NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY||2537.81|0||0|10/01/2019 SH 78001|62163|62163 - NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY||1482.24|0||0|10/01/2019 SH 78001|62162|62162 - NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG||2296.62|0||0|10/01/2019 SH 78001|62161|62161 - NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS||1844.28|0||0|10/01/2019 SH 78001|62160|62160 - NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS||233.91|0||0|10/01/2019 SH 78001|62148|62148 - INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT||155.81|0||0|10/01/2019 SH 78001|62147|62147 - CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER||1771.62|0||0|10/01/2019 SH 78001|62146|62146 - CRANIOPLASTY W/AUTOGRAFT 5 CM DIAMETER||1377.69|0||0|10/01/2019 SH 78001|62140|62140 - CRANIOPLASTY SKULL DEFECT ELTRDS||1007.05|0||0|10/01/2019 SH 78001|61885|61885 - INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR||612.2|0||0|10/01/2019 SH 78001|61880|61880 - REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS||679.8|0||0|10/01/2019 SH 78001|61870|61870 - CRNEC IMPLTJ NSTIM ELTRD CEREBELLAR CORTICAL||1434.88|0||0|10/01/2019 SH 78001|61868|61868 - STRTCTC IMPLTJ NSTIM ELTRD W/RECORD EA ARRAY||612.37|0||0|10/01/2019 SH 78001|61867|61867 - STRTCTC IMPLTJ NSTIM ELTRD W/RECORD 1ST ARRAY||2763.84|0||0|10/01/2019 SH 78001|61864|61864 - STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD EA ARRAY||350.25|0||0|10/01/2019 SH 78001|61863|61863 - STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY||1819.84|0||0|10/01/2019 SH 78001|61860|61860 - CRNEC/CRX IMPLTJ NSTIM ELTRD CERE CORTICAL||1903.13|0||0|10/01/2019 SH 78001|61850|61850 - TWIST/BURR HOLE IMPLTJ NSTIM ELTRD CORTICAL||1188.94|0||0|10/01/2019 SH 78001|61800|61800 - APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY||188.32|0||0|10/01/2019 SH 78001|61799|61799 - STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX||373.76|0||0|10/01/2019 SH 78001|61798|61798 - STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES||1678.75|0||0|10/01/2019 SH 78001|61797|61797 - STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE||271.33|0||0|10/01/2019 SH 78001|61796|61796 - STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES||1226.82|0||0|10/01/2019 SH 78001|61791|61791 - CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC||1362.13|0||0|10/01/2019 SH 78001|61790|61790 - CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN||1058.3|0||0|10/01/2019 SH 78001|61783|61783 - STEREOTACTIC COMPUTER ASSISTED PX SPINAL||284.5|0||0|10/01/2019 SH 78001|61782|61782 - STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL||211.66|0||0|10/01/2019 SH 78001|61781|61781 - STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL||288.4|0||0|10/01/2019 SH 78001|61770|61770 - STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC||1975.49|0||0|10/01/2019 SH 78001|61760|61760 - STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING||1921.54|0||0|10/01/2019 SH 78001|61751|61751 - STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR||1665.94|0||0|10/01/2019 SH 78001|61750|61750 - STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES||1700.01|0||0|10/01/2019 SH 78001|61735|61735 - CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN||1931.44|0||0|10/01/2019 SH 78001|61720|61720 - CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS||1540.97|0||0|10/01/2019 SH 78001|61711|61711 - ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES||3148.21|0||0|10/01/2019 SH 78001|61710|61710 - ARYSM VASC MALFRMJ IA EMBOLIZATION||2621.68|0||0|10/01/2019 SH 78001|61708|61708 - ARYSM VASC MALFRMJ/ICRA ELECTROTHROMBOSIS||3103.45|0||0|10/01/2019 SH 78001|61705|61705 - ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART||3174.13|0||0|10/01/2019 SH 78001|61703|61703 - ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART||1648.17|0||0|10/01/2019 SH 78001|61702|61702 - SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ||4920.39|0||0|10/01/2019 SH 78001|61700|61700 - SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION||4143.35|0||0|10/01/2019 SH 78001|61698|61698 - CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ||5667.79|0||0|10/01/2019 SH 78001|61697|61697 - COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION||5139.44|0||0|10/01/2019 SH 78001|61692|61692 - INTRACRANIAL ARVEN MALFRMJ DURAL CMPL||4472.45|0||0|10/01/2019 SH 78001|61690|61690 - INTRACRANIAL ARVEN MALFRMJ DURAL SMPL||2660.28|0||0|10/01/2019 SH 78001|61686|61686 - INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL||5501.71|0||0|10/01/2019 SH 78001|61684|61684 - INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL||3468.21|0||0|10/01/2019 SH 78001|61682|61682 - INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL||5085.63|0||0|10/01/2019 SH 78001|61680|61680 - INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL||2725.22|0||0|10/01/2019 SH 78001|61651|61651 - EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL||265.81|0||0|10/01/2019 SH 78001|61650|61650 - EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST||625.87|0||0|10/01/2019 SH 78001|61645|61645 - PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL||938.3|0||0|10/01/2019 SH 78001|61642|61642 - PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER||524.74|0||0|10/01/2019 SH 78001|61641|61641 - PERQ BALO DILA IC VSPSM EA VSL SM VASC TER||262.75|0||0|10/01/2019 SH 78001|61640|61640 - BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL||745.79|0||0|10/01/2019 SH 78001|61635|61635 - TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD||1683.88|0||0|10/01/2019 SH 78001|61630|61630 - BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS||1590.6|0||0|10/01/2019 SH 78001|61626|61626 - TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS||1044.32|0||0|10/01/2019 SH 78001|61624|61624 - TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS||1380.03|0||0|10/01/2019 SH 78001|61623|61623 - EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK||681.17|0||0|10/01/2019 SH 78001|61619|61619 - SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP||1731.14|0||0|10/01/2019 SH 78001|61618|61618 - SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT||1558.98|0||0|10/01/2019 SH 78001|61616|61616 - RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL||3992.59|0||0|10/01/2019 SH 78001|61615|61615 - RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL||3249.05|0||0|10/01/2019 SH 78001|61613|61613 - OBLTRJ CAROTID ARYSM ARTVEN CAROTID FISTULA DSJ||3979.87|0||0|10/01/2019 SH 78001|61612|61612 - TRNSXJ/LIG CRTD ART PETROUS CANAL RPR ANAST/GRF||1686.61|0||0|10/01/2019 SH 78001|61611|61611 - TRNSXJ/LIG CAROTID ARTERY PETROUS CANAL W/O RPR||449.49|0||0|10/01/2019 SH 78001|61610|61610 - TRNSXJ/LIG CAROTID ARTERY SINUS W/RPR ANAST/GRFT||2283.24|0||0|10/01/2019 SH 78001|61608|61608 - RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL||3931.82|0||0|10/01/2019 SH 78001|61607|61607 - RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL||3211.52|0||0|10/01/2019 SH 78001|61606|61606 - RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR||3672.77|0||0|10/01/2019 SH 78001|61605|61605 - RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL||2582.12|0||0|10/01/2019 SH 78001|61601|61601 - RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF||2884.36|0||0|10/01/2019 SH 78001|61600|61600 - RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL||2530.59|0||0|10/01/2019 SH 78001|61598|61598 - TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM||3419.9|0||0|10/01/2019 SH 78001|61597|61597 - TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL||3494.02|0||0|10/01/2019 SH 78001|61596|61596 - TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART||2915.6|0||0|10/01/2019 SH 78001|61595|61595 - TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV||2814.62|0||0|10/01/2019 SH 78001|61592|61592 - ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE||3828.25|0||0|10/01/2019 SH 78001|61591|61591 - INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI||3718.16|0||0|10/01/2019 SH 78001|61590|61590 - INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN||3625.54|0||0|10/01/2019 SH 78001|61586|61586 - BICORONAL TRANSZYGMTC&/LEFORT I W/O BONE GRFT||2881.9|0||0|10/01/2019 SH 78001|61585|61585 - ORBITOCRANIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ||3881.32|0||0|10/01/2019 SH 78001|61584|61584 - ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ||3427.62|0||0|10/01/2019 SH 78001|61583|61583 - CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE||3476.9|0||0|10/01/2019 SH 78001|61582|61582 - CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT||3595.91|0||0|10/01/2019 SH 78001|61581|61581 - CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ||3128.27|0||0|10/01/2019 SH 78001|61580|61580 - CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ||2969.21|0||0|10/01/2019 SH 78001|61576|61576 - TRNSRL SKUL BSE/BR STM/CORD BX/DCMP/ SPLT TONGUE||4075.72|0||0|10/01/2019 SH 78001|61575|61575 - TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES||3053.7|0||0|10/01/2019 SH 78001|61571|61571 - CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN||2418.96|0||0|10/01/2019 SH 78001|61570|61570 - CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN||2270.53|0||0|10/01/2019 SH 78001|61567|61567 - CRANIOTOMY MULTIPLE SUBPIAL TRANSECTIONS W/ECOG||2872.3|0||0|10/01/2019 SH 78001|61566|61566 - CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY||2737.71|0||0|10/01/2019 SH 78001|61564|61564 - EXC BENIGN TUM CRANIAL BONE W/OPTIC NRV DCMPRN||2929.7|0||0|10/01/2019 SH 78001|61563|61563 - EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN||2409.36|0||0|10/01/2019 SH 78001|61559|61559 - XTN CRNEC MLT SUTR CRANIOSYNOSTOSIS W/BONE GRAFT||2907.11|0||0|10/01/2019 SH 78001|61558|61558 - XTN CRANIECT MULTIPLE SUTURE CRANIOSYNOSTOSIS||2035.57|0||0|10/01/2019 SH 78001|61557|61557 - CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP||2038.82|0||0|10/01/2019 SH 78001|61556|61556 - CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP||2070.59|0||0|10/01/2019 SH 78001|61552|61552 - CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES||1335.84|0||0|10/01/2019 SH 78001|61550|61550 - CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE||1160.48|0||0|10/01/2019 SH 78001|61548|61548 - HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL||1897.61|0||0|10/01/2019 SH 78001|61546|61546 - CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR||2811.11|0||0|10/01/2019 SH 78001|61545|61545 - CRANIOTOMY EXCISION CRANIOPHARYNGIOMA||3880.26|0||0|10/01/2019 SH 78001|61544|61544 - CRANIOTOMY EXCISION/COAGULATION CHOROID PLEXUS||2315.01|0||0|10/01/2019 SH 78001|61543|61543 - CRANIOTOMY PARTIAL/SUBTOTAL HEMISPHERECTOMY||2644.64|0||0|10/01/2019 SH 78001|61541|61541 - CRANIOTOMY TRANSECTION CORPUS CALLOSUM||2615.86|0||0|10/01/2019 SH 78001|61540|61540 - CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG||2657.19|0||0|10/01/2019 SH 78001|61539|61539 - CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/ECOG||2876.09|0||0|10/01/2019 SH 78001|61538|61538 - CRANIOT LOBEC TEMPORAL LOBE W/ELECTROCORTCOGRPHY||3257.28|0||0|10/01/2019 SH 78001|61537|61537 - CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY||2982.9|0||0|10/01/2019 SH 78001|61536|61536 - CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY||3144.14|0||0|10/01/2019 SH 78001|61535|61535 - CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX||1207.09|0||0|10/01/2019 SH 78001|61534|61534 - CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY||1997.17|0||0|10/01/2019 SH 78001|61533|61533 - CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING||1846.07|0||0|10/01/2019 SH 78001|61531|61531 - SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING||1478.21|0||0|10/01/2019 SH 78001|61530|61530 - CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA||3755.45|0||0|10/01/2019 SH 78001|61526|61526 - CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM||4455.45|0||0|10/01/2019 SH 78001|61524|61524 - CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST||2533.65|0||0|10/01/2019 SH 78001|61522|61522 - CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS||2662.72|0||0|10/01/2019 SH 78001|61521|61521 - CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL||3838.36|0||0|10/01/2019 SH 78001|61520|61520 - CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM||4556.6|0||0|10/01/2019 SH 78001|61519|61519 - CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA||3575.65|0||0|10/01/2019 SH 78001|61518|61518 - CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA||3336.22|0||0|10/01/2019 SH 78001|61517|61517 - IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT||107.7|0||0|10/01/2019 SH 78001|61516|61516 - CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR||2252.51|0||0|10/01/2019 SH 78001|61514|61514 - CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR||2311.27|0||0|10/01/2019 SH 78001|61512|61512 - CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR||3087.93|0||0|10/01/2019 SH 78001|61510|61510 - CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR||2641.62|0||0|10/01/2019 SH 78001|61501|61501 - CRANIECTOMY OSTEOMYELITIS||1390|0||0|10/01/2019 SH 78001|61500|61500 - CRANIECTOMY W/EXCISION TUMOR/LESION SKULL||1585.47|0||0|10/01/2019 SH 78001|61480|61480 - CRNEC SUBOCPTL MESENCEPHAL TRCOTOMY/PEDUNCULOTMY||2363.05|0||0|10/01/2019 SH 78001|61460|61460 - CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NR||2561.19|0||0|10/01/2019 SH 78001|61458|61458 - CRNEC SOPL EXPL/DCMPRN CRNL NRV||2430.82|0||0|10/01/2019 SH 78001|61450|61450 - CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION||2341.29|0||0|10/01/2019 SH 78001|61345|61345 - OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA||2482.65|0||0|10/01/2019 SH 78001|61343|61343 - CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD||2660.52|0||0|10/01/2019 SH 78001|61340|61340 - SUBTEMPORAL CRANIAL DECOMPRESSION||1754.4|0||0|10/01/2019 SH 78001|61333|61333 - EXPL ORBIT TRANSCRANIAL APPROACH W/RMVL LESION||2160.77|0||0|10/01/2019 SH 78001|61332|61332 - EXPLORATION ORBIT TRANSCRANIAL APPROACH W/BIOPSY||2114.04|0||0|10/01/2019 SH 78001|61330|61330 - DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH||1830.59|0||0|10/01/2019 SH 78001|61323|61323 - CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY||2909.76|0||0|10/01/2019 SH 78001|61322|61322 - CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY||2879.79|0||0|10/01/2019 SH 78001|61321|61321 - CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL||2591.16|0||0|10/01/2019 SH 78001|61320|61320 - CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL||2295.37|0||0|10/01/2019 SH 78001|61316|61316 - INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF||107.74|0||0|10/01/2019 SH 78001|61315|61315 - CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL||2504.98|0||0|10/01/2019 SH 78001|61314|61314 - CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL||2205.68|0||0|10/01/2019 SH 78001|61313|61313 - CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL||2397.62|0||0|10/01/2019 SH 78001|61312|61312 - CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL||2520.85|0||0|10/01/2019 SH 78001|61305|61305 - CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL||2443.59|0||0|10/01/2019 SH 78001|61304|61304 - CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL||1981.38|0||0|10/01/2019 SH 78001|61253|61253 - BURR HOLE/TREPHINE INFRATENTORIAL UNI/BI||1122.55|0||0|10/01/2019 SH 78001|61250|61250 - BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG||1048.53|0||0|10/01/2019 SH 78001|61215|61215 - INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH||601.28|0||0|10/01/2019 SH 78001|61210|61210 - BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE||452.33|0||0|10/01/2019 SH 78001|61156|61156 - BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL||1512.3|0||0|10/01/2019 SH 78001|61154|61154 - BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL||1529.55|0||0|10/01/2019 SH 78001|61151|61151 - BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST||1203.95|0||0|10/01/2019 SH 78001|61150|61150 - BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST||1644.74|0||0|10/01/2019 SH 78001|61140|61140 - BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION||1521.34|0||0|10/01/2019 SH 78001|61120|61120 - BURR HOLE VENTRICULAR PUNCTURE||900.95|0||0|10/01/2019 SH 78001|61108|61108 - TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA||1095.3|0||0|10/01/2019 SH 78001|61107|61107 - TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE||384.62|0||0|10/01/2019 SH 78001|61105|61105 - TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE||555.32|0||0|10/01/2019 SH 78001|61070|61070 - PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX||68.65|0||0|10/01/2019 SH 78001|61055|61055 - CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION||145.68|0||0|10/01/2019 SH 78001|61050|61050 - CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX||102.36|0||0|10/01/2019 SH 78001|61026|61026 - VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ||123.33|0||0|10/01/2019 SH 78001|61020|61020 - VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX||125.7|0||0|10/01/2019 SH 78001|61001|61001 - SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI SBSQ||97.61|0||0|10/01/2019 SH 78001|61000|61000 - SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT||129.14|0||0|10/01/2019 SH 78001|60699|60699 - UNLISTED PROCEDURE ENDOCRINE SYSTEM||0|0||0|10/01/2019 SH 78001|60659|60659 - UNLISTED LAPAROSCOPY PROCEDURE ENDOCRINE SYSTEM||0|0||0|10/01/2019 SH 78001|60650|60650 - LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL||1424.29|0||0|10/01/2019 SH 78001|60605|60605 - EXC CAROTID BODY TUMOR W EXC CAROTID ARTERY||2385.7|0||0|10/01/2019 SH 78001|60600|60600 - EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY||1685.52|0||0|10/01/2019 SH 78001|60545|60545 - ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR||1453.84|0||0|10/01/2019 SH 78001|60540|60540 - ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX||1261.53|0||0|10/01/2019 SH 78001|60522|60522 - THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX||1634.64|0||0|10/01/2019 SH 78001|60521|60521 - THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX||1348.22|0||0|10/01/2019 SH 78001|60520|60520 - THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX||1248.21|0||0|10/01/2019 SH 78001|60512|60512 - PARATHYROID AUTOTRANSPLANTATION ADD-ON||293.6|0||0|10/01/2019 SH 78001|60505|60505 - PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC||1655.85|0||0|10/01/2019 SH 78001|60502|60502 - PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR||1534.74|0||0|10/01/2019 SH 78001|60500|60500 - PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS||1148.24|0||0|10/01/2019 SH 78001|60300|60300 - ASPIRATION AND/OR INJECTION THYROID CYST||135.66|0||0|10/01/2019 SH 78001|60281|60281 - EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT||695.76|0||0|10/01/2019 SH 78001|60280|60280 - EXCISION THYROGLOSSAL DUCT CYST/SINUS||522.07|0||0|10/01/2019 SH 78001|60271|60271 - THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH||1260.95|0||0|10/01/2019 SH 78001|60270|60270 - THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC||1635.57|0||0|10/01/2019 SH 78001|60260|60260 - THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL||1303.3|0||0|10/01/2019 SH 78001|60254|60254 - THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT||2001.51|0||0|10/01/2019 SH 78001|60252|60252 - THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT||1574.11|0||0|10/01/2019 SH 78001|60240|60240 - THYROIDECTOMY TOTAL/COMPLETE||1094.57|0||0|10/01/2019 SH 78001|60225|60225 - TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC||1108.2|0||0|10/01/2019 SH 78001|60220|60220 - TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY||839.6|0||0|10/01/2019 SH 78001|60212|60212 - PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC||1201.07|0||0|10/01/2019 SH 78001|60210|60210 - PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY||839.8|0||0|10/01/2019 SH 78001|60200|60200 - EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS||781.35|0||0|10/01/2019 SH 78001|60100|60100 - BIOPSY THYROID PERCUTANEOUS CORE NEEDLE||132.43|0||0|10/01/2019 SH 78001|60000|60000 - I&D THYROGLOSSAL DUCT CYST INFECTED||184.71|0||0|10/01/2019 SH 78001|59899|59899 - UNLISTED PROCEDURE MATERNITY CARE & DELIVERY||0|0||0|10/01/2019 SH 78001|59898|59898 - UNLISTED LAPAROSCOPY PX MATERNITY CARE&DELIVERY||0|0||0|10/01/2019 SH 78001|59897|59897 - UNLISTED FETAL INVASIVE PX W/ULTRASOUND||0|0||0|10/01/2019 SH 78001|59871|59871 - REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA||159.8|0||0|10/01/2019 SH 78001|59870|59870 - UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE||556.58|0||0|10/01/2019 SH 78001|59866|59866 - MULTIFETAL PREGNANCY REDUCTION||258.56|0||0|10/01/2019 SH 78001|59857|59857 - INDUCED ABORT 1/> VAG SUPPOS DLVR FETUS HYSTOT||616.05|0||0|10/01/2019 SH 78001|59856|59856 - INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC||581.73|0||0|10/01/2019 SH 78001|59855|59855 - INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS||493.94|0||0|10/01/2019 SH 78001|59852|59852 - INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS HYSTOTM||594.96|0||0|10/01/2019 SH 78001|59851|59851 - INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS D&C||472.3|0||0|10/01/2019 SH 78001|59850|59850 - INDUCED ABORTION 1/> AMNIOTIC INJX W/D&C/EVACJ||412.27|0||0|10/01/2019 SH 78001|59841|59841 - INDUCED ABORTION DILATION & EVACUATION||453.28|0||0|10/01/2019 SH 78001|59840|59840 - INDUCED ABORTION DILATION AND CURETTAGE||256.73|0||0|10/01/2019 SH 78001|59830|59830 - TX SEPTIC ABORTION SURGICAL||518.68|0||0|10/01/2019 SH 78001|59821|59821 - TX MISSED ABORTION SECOND TRIMESTER SURGICAL||449.26|0||0|10/01/2019 SH 78001|59820|59820 - TX MISSED ABORTION FIRST TRIMESTER SURGICAL||445.06|0||0|10/01/2019 SH 78001|59812|59812 - TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL||375.06|0||0|10/01/2019 SH 78001|59622|59622 - CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA||1555.79|0||0|10/01/2019 SH 78001|59620|59620 - CESAREAN DELIVERY ATTEMPTED VBAC||1143.81|0||0|10/01/2019 SH 78001|59618|59618 - ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC||2791.69|0||0|10/01/2019 SH 78001|59614|59614 - VAGINAL DELIVERY & POSTPARTUM CARE VBAC||1372.89|0||0|10/01/2019 SH 78001|59612|59612 - VAGINAL DELIVERY AFTER CESAREAN DELIVERY||1104.47|0||0|10/01/2019 SH 78001|59610|59610 - ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB||2611.41|0||0|10/01/2019 SH 78001|59525|59525 - STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY||585.78|0||0|10/01/2019 SH 78001|59515|59515 - CESAREAN DELIVERY ONLY W/POSTPARTUM CARE||1515.45|0||0|10/01/2019 SH 78001|59514|59514 - CESAREAN DELIVERY ONLY||1105.39|0||0|10/01/2019 SH 78001|59510|59510 - OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM||2753.32|0||0|10/01/2019 SH 78001|59430|59430 - POSTPARTUM CARE ONLY SEPARATE PROCEDURE||218.28|0||0|10/01/2019 SH 78001|59426|59426 - ANTEPARTUM CARE ONLY 7/> VISITS||962.11|0||0|10/01/2019 SH 78001|59425|59425 - ANTEPARTUM CARE ONLY 4-6 VISITS||537.58|0||0|10/01/2019 SH 78001|59414|59414 - DELIVERY PLACENTA SEPARATE PROCEDURE||110.61|0||0|10/01/2019 SH 78001|59412|59412 - EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS||124.62|0||0|10/01/2019 SH 78001|59410|59410 - VAGINAL DELIVERY ONLY W/POSTPARTUM CARE||1254.01|0||0|10/01/2019 SH 78001|59409|59409 - VAGINAL DELIVERY ONLY||984.04|0||0|10/01/2019 SH 78001|59400|59400 - OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM||2491.78|0||0|10/01/2019 SH 78001|59350|59350 - HYSTERORRHAPHY RUPTURED UTERUS||339.67|0||0|10/01/2019 SH 78001|59325|59325 - CERCLAGE CERVIX PREGNANCY ABDOMINAL||291.59|0||0|10/01/2019 SH 78001|59320|59320 - CERCLAGE CERVIX PREGNANCY VAGINAL||183.06|0||0|10/01/2019 SH 78001|59300|59300 - EPISIOTOMY/VAG RPR OTH/THN ATTENDING||226.94|0||0|10/01/2019 SH 78001|59200|59200 - INSERTION CERVICAL DILATOR SEPARATE PROCEDURE||83.73|0||0|10/01/2019 SH 78001|59160|59160 - CURETTAGE POSTPARTUM||240.12|0||0|10/01/2019 SH 78001|59151|59151 - LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY||893.85|0||0|10/01/2019 SH 78001|59150|59150 - LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY||919.46|0||0|10/01/2019 SH 78001|59140|59140 - TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION||475.88|0||0|10/01/2019 SH 78001|59136|59136 - TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER||1050.61|0||0|10/01/2019 SH 78001|59135|59135 - TX ECTOPIC PREGNANCY NTRSTL REQ TOT HYST||988.97|0||0|10/01/2019 SH 78001|59130|59130 - TX ECTOPIC PREGNANCY ABDL PREGNANCY||1001.3|0||0|10/01/2019 SH 78001|59121|59121 - TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY||949.36|0||0|10/01/2019 SH 78001|59120|59120 - TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR||948.27|0||0|10/01/2019 SH 78001|59100|59100 - HYSTEROTOMY ABDOMINAL||996.72|0||0|10/01/2019 SH 78001|59076|59076 - FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE||560.68|0||0|10/01/2019 SH 78001|59074|59074 - FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE||462.33|0||0|10/01/2019 SH 78001|59072|59072 - FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE||560.68|0||0|10/01/2019 SH 78001|59070|59070 - TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE||480.93|0||0|10/01/2019 SH 78001|59051|59051 - FETAL MONITR LABOR PHYS WRTTN REPRT INTERPJ ONLY||50.56|0||0|10/01/2019 SH 78001|59050|59050 - FETAL MONITORING LABOR PHYS WRITTEN REPORT||61.3|0||0|10/01/2019 SH 78001|59030|59030 - FETAL SCALP BLOOD SAMPLING||120.73|0||0|10/01/2019 SH 78001|59025|59025 - FETAL NONSTRESS TEST||55.83|35.67||0|10/01/2019 SH 78001|59020|59020 - FETAL CONTRACTION STRESS TEST||81.99|44.78||0|10/01/2019 SH 78001|59015|59015 - CHORIONIC VILLUS SAMPLING||184.15|0||0|10/01/2019 SH 78001|59012|59012 - CORDOCENTESIS INTRAUTERINE||244.28|0||0|10/01/2019 SH 78001|59001|59001 - AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID||216.37|0||0|10/01/2019 SH 78001|59000|59000 - AMNIOCENTESIS DIAGNOSIC||145.68|0||0|10/01/2019 SH 78001|58999|58999 - UNLISTED PX FEMALE GENITAL SYSTEM NONOBSTETRICAL||0|0||0|10/01/2019 SH 78001|58976|58976 - GAMETE ZYGOTE/EMBRYO FALLOPIAN TRANSFER ANY METH||285.72|0||0|10/01/2019 SH 78001|58974|58974 - EMBRYO TRANSFER INTRAUTERINE||0|0||0|10/01/2019 SH 78001|58970|58970 - FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD||260.42|0||0|10/01/2019 SH 78001|58960|58960 - LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK||1154.92|0||0|10/01/2019 SH 78001|58958|58958 - RESECTION RECRT MAL W/OMENTECTOMY PEL LMPHADEC||2070.28|0||0|10/01/2019 SH 78001|58957|58957 - RESECJ RECUR OVARIAN/TUBAL/PERITONEAL MALIGNANCY||1883.85|0||0|10/01/2019 SH 78001|58956|58956 - BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC||1638.11|0||0|10/01/2019 SH 78001|58954|58954 - BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY||2614.08|0||0|10/01/2019 SH 78001|58953|58953 - BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION||2410.16|0||0|10/01/2019 SH 78001|58952|58952 - RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING||1949.01|0||0|10/01/2019 SH 78001|58951|58951 - RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD||1719.34|0||0|10/01/2019 SH 78001|58950|58950 - RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO||1337.2|0||0|10/01/2019 SH 78001|58943|58943 - OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY||1389.91|0||0|10/01/2019 SH 78001|58940|58940 - OOPHORECTOMY PARTIAL/TOTAL UNI/BI||618.37|0||0|10/01/2019 SH 78001|58925|58925 - OVARIAN CYSTECTOMY UNI/BI||881.04|0||0|10/01/2019 SH 78001|58920|58920 - WEDGE RESCJ/BISCTJ OVARY UNI/BI||838.91|0||0|10/01/2019 SH 78001|58900|58900 - BIOPSY OVARY UNI/BI SEPARATE PROCEDURE||482.82|0||0|10/01/2019 SH 78001|58825|58825 - TRANSPOSITION OVARY||894.28|0||0|10/01/2019 SH 78001|58822|58822 - DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH||821.63|0||0|10/01/2019 SH 78001|58820|58820 - DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN||363.28|0||0|10/01/2019 SH 78001|58805|58805 - DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL||472.38|0||0|10/01/2019 SH 78001|58800|58800 - DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR||369.52|0||0|10/01/2019 SH 78001|58770|58770 - SALPINGOSTOMY||1002.45|0||0|10/01/2019 SH 78001|58760|58760 - FIMBRIOPLASTY||951.87|0||0|10/01/2019 SH 78001|58752|58752 - TUBOUTERINE IMPLANTATION||1027.78|0||0|10/01/2019 SH 78001|58750|58750 - TUBOTUBAL ANASTATOMOSIS||1073.33|0||0|10/01/2019 SH 78001|58740|58740 - LYSIS OF ADHESIONS SALPINX/OVARY||1042.66|0||0|10/01/2019 SH 78001|58720|58720 - SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX||867.47|0||0|10/01/2019 SH 78001|58700|58700 - SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX||921.71|0||0|10/01/2019 SH 78001|58679|58679 - UNLISTED LAPAROSCOPY PROCEDURE OVIDUCT/OVARY||0|0||0|10/01/2019 SH 78001|58674|58674 - LAPS ABLTJ UTERINE FIBROIDS W/INTRAOP US GDN||1000.43|0||0|10/01/2019 SH 78001|58673|58673 - LAPAROSCOPY SALPINGOSTOMY||941.1|0||0|10/01/2019 SH 78001|58672|58672 - LAPAROSCOPY FIMBRIOPLASTY||865.21|0||0|10/01/2019 SH 78001|58671|58671 - LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS||426.34|0||0|10/01/2019 SH 78001|58670|58670 - LAPAROSCOPY FULGURATION OVIDUCTS||427.12|0||0|10/01/2019 SH 78001|58662|58662 - LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE||836.73|0||0|10/01/2019 SH 78001|58661|58661 - LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES||766.94|0||0|10/01/2019 SH 78001|58660|58660 - LAPAROSCOPY W/LYSIS OF ADHESIONS||794.73|0||0|10/01/2019 SH 78001|58615|58615 - OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR||285.52|0||0|10/01/2019 SH 78001|58611|58611 - LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG||91.64|0||0|10/01/2019 SH 78001|58605|58605 - LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX||385.59|0||0|10/01/2019 SH 78001|58600|58600 - LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI||425.95|0||0|10/01/2019 SH 78001|58579|58579 - UNLISTED HYSTEROSCOPY PROCEDURE UTERUS||0|0||0|10/01/2019 SH 78001|58578|58578 - UNLISTED LAPAROSCOPY PROCEDURE UTERUS||0|0||0|10/01/2019 SH 78001|58575|58575 - LAPS TOT HYSTERECTOMY RESJ MALIGNANCY W/OMNTC||2262.38|0||0|10/01/2019 SH 78001|58573|58573 - LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR||1433.73|0||0|10/01/2019 SH 78001|58572|58572 - LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM||1201.07|0||0|10/01/2019 SH 78001|58571|58571 - LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY||1059.83|0||0|10/01/2019 SH 78001|58570|58570 - LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<||917.99|0||0|10/01/2019 SH 78001|58565|58565 - HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS||2072.95|0||0|10/01/2019 SH 78001|58563|58563 - HYSTEROSCOPY ENDOMETRIAL ABLATION||1843.14|0||0|10/01/2019 SH 78001|58562|58562 - HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY||474.79|0||0|10/01/2019 SH 78001|58561|58561 - HYSTEROSCOPY REMOVAL LEIOMYOMATA||646.58|0||0|10/01/2019 SH 78001|58560|58560 - HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM||456.27|0||0|10/01/2019 SH 78001|58559|58559 - HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS||403.4|0||0|10/01/2019 SH 78001|58558|58558 - HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C||456.5|0||0|10/01/2019 SH 78001|58555|58555 - HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE||347.59|0||0|10/01/2019 SH 78001|58554|58554 - LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR||1565.14|0||0|10/01/2019 SH 78001|58553|58553 - LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS||1336.55|0||0|10/01/2019 SH 78001|58552|58552 - LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES||1165.8|0||0|10/01/2019 SH 78001|58550|58550 - LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<||1038.41|0||0|10/01/2019 SH 78001|58548|58548 - LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY||2251.87|0||0|10/01/2019 SH 78001|58546|58546 - LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS||1324.76|0||0|10/01/2019 SH 78001|58545|58545 - LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<||1068.36|0||0|10/01/2019 SH 78001|58544|58544 - LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY||1065.83|0||0|10/01/2019 SH 78001|58543|58543 - LAPS SUPRACERVICAL HYSTERECTOMY >250||976.36|0||0|10/01/2019 SH 78001|58542|58542 - LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR||964.9|0||0|10/01/2019 SH 78001|58541|58541 - LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<||843.89|0||0|10/01/2019 SH 78001|58540|58540 - HYSTEROPLASTY RPR UTERINE ANOMALY||1068.59|0||0|10/01/2019 SH 78001|58520|58520 - HYSTERORRHAPHY REPAIR RUPT UTERUS NONOBSTETRICAL||941.75|0||0|10/01/2019 SH 78001|58410|58410 - UTERINE SUSP W/WO SHORT LIGAMNTS W/SYMPATHECTOMY||944.7|0||0|10/01/2019 SH 78001|58400|58400 - UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX||514.69|0||0|10/01/2019 SH 78001|58356|58356 - ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR||2080.31|0||0|10/01/2019 SH 78001|58353|58353 - ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID||1114.38|0||0|10/01/2019 SH 78001|58350|58350 - CHROMOTUBATION OVIDUCT W/MATERIALS||110.86|0||0|10/01/2019 SH 78001|58346|58346 - INSERTION HEYMAN CAPSULES CLINICAL BRACHYTHERAPY||521.1|0||0|10/01/2019 SH 78001|58345|58345 - TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING||327.61|0||0|10/01/2019 SH 78001|58340|58340 - CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI||134.1|0||0|10/01/2019 SH 78001|58323|58323 - SPERM WASHING ARTIFICIAL INSEMINATION||18.06|0||0|10/01/2019 SH 78001|58322|58322 - ARTIFICIAL INSEMINATION INTRA-UTERINE||99.02|0||0|10/01/2019 SH 78001|58321|58321 - ARTIFICIAL INSEMINATION INTRA-CERVICAL||87.76|0||0|10/01/2019 SH 78001|58301|58301 - REMOVAL INTRAUTERINE DEVICE IUD||109.84|0||0|10/01/2019 SH 78001|58300|58300 - INSERTION INTRAUTERINE DEVICE IUD||81.17|0||0|10/01/2019 SH 78001|58294|58294 - VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE||1433.77|0||0|10/01/2019 SH 78001|58293|58293 - VAG HYST >250 GM COLPOURTCSTOPEXY W/WO NDSC CTR||1609.15|0||0|10/01/2019 SH 78001|58292|58292 - VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE||1547.48|0||0|10/01/2019 SH 78001|58291|58291 - VAG HYST > 250 GM RMVL TUBE&/OVARY||1466.63|0||0|10/01/2019 SH 78001|58290|58290 - VAGINAL HYSTERECTOMY UTERUS > 250 GM||1353.73|0||0|10/01/2019 SH 78001|58285|58285 - VAGINAL HYSTERECTOMY RADICAL SCHAUTA OPERATION||1696.28|0||0|10/01/2019 SH 78001|58280|58280 - VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE||1237.85|0||0|10/01/2019 SH 78001|58275|58275 - VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY||1163.18|0||0|10/01/2019 SH 78001|58270|58270 - VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE||1038.9|0||0|10/01/2019 SH 78001|58267|58267 - VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY||1243.82|0||0|10/01/2019 SH 78001|58263|58263 - VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL||1165.19|0||0|10/01/2019 SH 78001|58262|58262 - VAG HYST 250 GM/< W/RMVL TUBE&/OVARY||1086.67|0||0|10/01/2019 SH 78001|58260|58260 - VAGINAL HYSTERECTOMY UTERUS 250 GM/<||972.6|0||0|10/01/2019 SH 78001|58240|58240 - PEL EXNTJ GYNECOLOGIC MAL||3459.26|0||0|10/01/2019 SH 78001|58210|58210 - RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY||2186.27|0||0|10/01/2019 SH 78001|58200|58200 - TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM||1622.71|0||0|10/01/2019 SH 78001|58180|58180 - SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY||1137.68|0||0|10/01/2019 SH 78001|58152|58152 - TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY||1479.38|0||0|10/01/2019 SH 78001|58150|58150 - TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY||1197.83|0||0|10/01/2019 SH 78001|58146|58146 - MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA||1357.52|0||0|10/01/2019 SH 78001|58145|58145 - MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR||643.42|0||0|10/01/2019 SH 78001|58140|58140 - MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR||1087.62|0||0|10/01/2019 SH 78001|58120|58120 - DILATION & CURETTAGE DX&/THER NONOBSTETRIC||300.28|0||0|10/01/2019 SH 78001|58110|58110 - ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY||56.48|0||0|10/01/2019 SH 78001|58100|58100 - ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX||126.49|0||0|10/01/2019 SH 78001|57800|57800 - DILATION CERVICAL CANAL INSTRUMENTAL SPX||70.44|0||0|10/01/2019 SH 78001|57720|57720 - TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG||357.45|0||0|10/01/2019 SH 78001|57700|57700 - CERCLAGE UTERINE CERVIX NONOBSTETRICAL||360.19|0||0|10/01/2019 SH 78001|57558|57558 - DILATION & CURETTAGE CERVICAL STUMP||145.15|0||0|10/01/2019 SH 78001|57556|57556 - EXC CRV STUMP VAG APPR W/RPR NTRCL||666.29|0||0|10/01/2019 SH 78001|57555|57555 - EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR||704.89|0||0|10/01/2019 SH 78001|57550|57550 - EXCISION CERVICAL STUMP VAGINAL APPROACH||475.13|0||0|10/01/2019 SH 78001|57545|57545 - EXC CERVICAL STUMP ABDL APPR W/PELVIC FLOOR RPR||966.18|0||0|10/01/2019 SH 78001|57540|57540 - EXCISION CERVICAL STUMP ABDOMINAL APPROACH||944.02|0||0|10/01/2019 SH 78001|57531|57531 - RAD TRACHELECTOMY W/BI PEL LMPHADEC||2190.41|0||0|10/01/2019 SH 78001|57530|57530 - TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX||407.67|0||0|10/01/2019 SH 78001|57522|57522 - CONIZATION CERVIX W/WO D&C RPR ELTRD EXC||305.66|0||0|10/01/2019 SH 78001|57520|57520 - CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER||355.67|0||0|10/01/2019 SH 78001|57513|57513 - CAUTERY CERVIX LASER ABLATION||168.65|0||0|10/01/2019 SH 78001|57511|57511 - CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT||168.65|0||0|10/01/2019 SH 78001|57510|57510 - CAUTERY CERVIX ELECTRO/THERMAL||152.53|0||0|10/01/2019 SH 78001|57505|57505 - ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C||117.25|0||0|10/01/2019 SH 78001|57500|57500 - BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX||145.98|0||0|10/01/2019 SH 78001|57461|57461 - COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX||366.25|0||0|10/01/2019 SH 78001|57460|57460 - COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX||322.52|0||0|10/01/2019 SH 78001|57456|57456 - COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE||156.58|0||0|10/01/2019 SH 78001|57455|57455 - COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX||166.5|0||0|10/01/2019 SH 78001|57454|57454 - COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE||178.84|0||0|10/01/2019 SH 78001|57452|57452 - COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA||126.75|0||0|10/01/2019 SH 78001|57426|57426 - REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC||993.41|0||0|10/01/2019 SH 78001|57425|57425 - LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX||1143.77|0||0|10/01/2019 SH 78001|57423|57423 - PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH||1078.75|0||0|10/01/2019 SH 78001|57421|57421 - COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX||183.71|0||0|10/01/2019 SH 78001|57420|57420 - COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT||137.66|0||0|10/01/2019 SH 78001|57415|57415 - REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL||187.68|0||0|10/01/2019 SH 78001|57410|57410 - PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL||127.46|0||0|10/01/2019 SH 78001|57400|57400 - DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL||156.87|0||0|10/01/2019 SH 78001|57335|57335 - VAGINOPLASTY INTERSEX STATE||1322.54|0||0|10/01/2019 SH 78001|57330|57330 - CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR||880.06|0||0|10/01/2019 SH 78001|57320|57320 - CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH||624.64|0||0|10/01/2019 SH 78001|57311|57311 - CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL||620.88|0||0|10/01/2019 SH 78001|57310|57310 - CLOSURE URETHROVAGINAL FISTULA||544.42|0||0|10/01/2019 SH 78001|57308|57308 - CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ||749.99|0||0|10/01/2019 SH 78001|57307|57307 - CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST||1275.83|0||0|10/01/2019 SH 78001|57305|57305 - CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH||1109.89|0||0|10/01/2019 SH 78001|57300|57300 - CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR||666.63|0||0|10/01/2019 SH 78001|57296|57296 - REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR||1103.33|0||0|10/01/2019 SH 78001|57295|57295 - REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP||560.31|0||0|10/01/2019 SH 78001|57292|57292 - CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT||960.35|0||0|10/01/2019 SH 78001|57291|57291 - CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT||620.89|0||0|10/01/2019 SH 78001|57289|57289 - PEREYRA PX W/ANTERIOR COLPORRHAPHY||866.63|0||0|10/01/2019 SH 78001|57288|57288 - SLING OPERATION STRESS INCONTINENCE||843.17|0||0|10/01/2019 SH 78001|57287|57287 - RMVL/REVJ SLING STRESS INCONTINENCE||799.72|0||0|10/01/2019 SH 78001|57285|57285 - PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH||792.4|0||0|10/01/2019 SH 78001|57284|57284 - PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR||962.92|0||0|10/01/2019 SH 78001|57283|57283 - COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH||811.29|0||0|10/01/2019 SH 78001|57282|57282 - COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH||586.16|0||0|10/01/2019 SH 78001|57280|57280 - COLPOPEXY ABDOMINAL APPROACH||1126.13|0||0|10/01/2019 SH 78001|57270|57270 - REPAIR ENTEROCELE ABDOMINAL APPROACH SPX||939.5|0||0|10/01/2019 SH 78001|57268|57268 - REPAIR ENTEROCELE VAGINAL APPROACH SPX||565.81|0||0|10/01/2019 SH 78001|57267|57267 - INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE||304.75|0||0|10/01/2019 SH 78001|57265|57265 - CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR||1076.19|0||0|10/01/2019 SH 78001|57260|57260 - CMBND ANTERPOST COLPORRAPHY W/CYSTO||982.4|0||0|10/01/2019 SH 78001|57250|57250 - POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY||796.24|0||0|10/01/2019 SH 78001|57240|57240 - ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO||790.8|0||0|10/01/2019 SH 78001|57230|57230 - PLASTIC REPAIR URETHROCELE||461.78|0||0|10/01/2019 SH 78001|57220|57220 - PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH||372.47|0||0|10/01/2019 SH 78001|57210|57210 - COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU||430.52|0||0|10/01/2019 SH 78001|57200|57200 - COLPORRHAPHY SUTURE INJURY VAGINA||353.16|0||0|10/01/2019 SH 78001|57180|57180 - INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX||162.21|0||0|10/01/2019 SH 78001|57170|57170 - DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS||70.66|0||0|10/01/2019 SH 78001|57160|57160 - FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI||88.02|0||0|10/01/2019 SH 78001|57156|57156 - INSERTION VAGINAL RADIATION DEVICE||228.07|0||0|10/01/2019 SH 78001|57155|57155 - INSERTION UTERINE TANDEM&/VAGINAL OVOIDS||493.85|0||0|10/01/2019 SH 78001|57150|57150 - IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE||52.03|0||0|10/01/2019 SH 78001|57135|57135 - EXCISION VAGINAL CYST/TUMOR||223.11|0||0|10/01/2019 SH 78001|57130|57130 - EXCISION VAGINAL SEPTUM||205.77|0||0|10/01/2019 SH 78001|57120|57120 - COLPOCLEISIS LE FORT TYPE||597.22|0||0|10/01/2019 SH 78001|57112|57112 - VAGNC COMPL RMVL VAG WALL TOT PEL LMPHADEC BX||2221.99|0||0|10/01/2019 SH 78001|57111|57111 - VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS||1889.42|0||0|10/01/2019 SH 78001|57110|57110 - VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL||1053.63|0||0|10/01/2019 SH 78001|57109|57109 - VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC||2075.42|0||0|10/01/2019 SH 78001|57107|57107 - VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T||1725.62|0||0|10/01/2019 SH 78001|57106|57106 - VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL||579.52|0||0|10/01/2019 SH 78001|57105|57105 - BIOPSY VAGINAL MUCOSA EXTENSIVE||158.04|0||0|10/01/2019 SH 78001|57100|57100 - BIOPSY VAGINAL MUCOSA SIMPLE||103.73|0||0|10/01/2019 SH 78001|57065|57065 - DESTRUCTION VAGINAL LESIONS EXTENSIVE||227.99|0||0|10/01/2019 SH 78001|57061|57061 - DESTRUCTION VAGINAL LESIONS SIMPLE||131.3|0||0|10/01/2019 SH 78001|57023|57023 - I&D VAGINAL HEMATOMA NON-OBSTETRICAL||365.39|0||0|10/01/2019 SH 78001|57022|57022 - I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM||197.26|0||0|10/01/2019 SH 78001|57020|57020 - COLPOCENTESIS SEPARATE PROCEDURE||108.52|0||0|10/01/2019 SH 78001|57010|57010 - COLPOTOMY W/DRAINAGE PELVIC ABSCESS||506.78|0||0|10/01/2019 SH 78001|57000|57000 - COLPOTOMY W/EXPLORATION||216.75|0||0|10/01/2019 SH 78001|56821|56821 - COLPOSCOPY VULVA W/BIOPSY||172.2|0||0|10/01/2019 SH 78001|56820|56820 - COLPOSCOPY VULVA||130.24|0||0|10/01/2019 SH 78001|56810|56810 - PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX||305.67|0||0|10/01/2019 SH 78001|56805|56805 - CLITOROPLASTY INTERSEX STATE||1346.59|0||0|10/01/2019 SH 78001|56800|56800 - PLASTIC REPAIR INTROITUS||283.54|0||0|10/01/2019 SH 78001|56740|56740 - EXC BARTHOLINS GLAND/CYST||354.01|0||0|10/01/2019 SH 78001|56700|56700 - PRTL HYMENECTOMY/REVJ HYMENAL RING||218.29|0||0|10/01/2019 SH 78001|56640|56640 - VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY||1814.48|0||0|10/01/2019 SH 78001|56637|56637 - VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY||1795.23|0||0|10/01/2019 SH 78001|56634|56634 - VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY||1546.67|0||0|10/01/2019 SH 78001|56633|56633 - VULVECTOMY RADICAL COMPLETE||1436.14|0||0|10/01/2019 SH 78001|56632|56632 - VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY||1632.86|0||0|10/01/2019 SH 78001|56631|56631 - VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY||1393.81|0||0|10/01/2019 SH 78001|56630|56630 - VULVECTOMY RADICAL PARTIAL||1096.26|0||0|10/01/2019 SH 78001|56625|56625 - VULVECTOMY SIMPLE COMPLETE||742.28|0||0|10/01/2019 SH 78001|56620|56620 - VULVECTOMY SIMPLE PARTIAL||609.14|0||0|10/01/2019 SH 78001|56606|56606 - BIOPSY VULVA/PERINEUM EACH ADDL LESION||43.89|0||0|10/01/2019 SH 78001|56605|56605 - BIOPSY VULVA/PERINEUM 1 LESION SPX||95.53|0||0|10/01/2019 SH 78001|56515|56515 - DESTRUCTION LESIONS VULVA EXTENSIVE||263.55|0||0|10/01/2019 SH 78001|56501|56501 - DESTRUCTION LESIONS VULVA SIMPLE||151.13|0||0|10/01/2019 SH 78001|56442|56442 - HYMENOTOMY SIMPLE INCISION||55.31|0||0|10/01/2019 SH 78001|56441|56441 - LYSIS LABIAL ADHESIONS||168.96|0||0|10/01/2019 SH 78001|56440|56440 - MARSUPIALIZATION BARTHOLINS GLAND CYST||213.86|0||0|10/01/2019 SH 78001|56420|56420 - I&D OF BARTHOLINS GLAND ABSCESS||140.44|0||0|10/01/2019 SH 78001|56405|56405 - I&D VULVA/PERINEAL ABSCESS||127.48|0||0|10/01/2019 SH 78001|55980|55980 - INTERSEX SURG FEMALE MALE||0|0||0|10/01/2019 SH 78001|55970|55970 - INTERSEX SURG MALE FEMALE||0|0||0|10/01/2019 SH 78001|55920|55920 - PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL||531.79|0||0|10/01/2019 SH 78001|55899|55899 - UNLISTED PROCEDURE MALE GENITAL SYSTEM||0|0||0|10/01/2019 SH 78001|55876|55876 - PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT||156.82|0||0|10/01/2019 SH 78001|55875|55875 - TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ||906.72|0||0|10/01/2019 SH 78001|55874|55874 - TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX||4112.61|0||0|10/01/2019 SH 78001|55873|55873 - CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI||7830.81|0||0|10/01/2019 SH 78001|55870|55870 - ELECTROEJACULATION||205.51|0||0|10/01/2019 SH 78001|55866|55866 - LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT||2069.73|0||0|10/01/2019 SH 78001|55865|55865 - EXPOS PROSTATE INSJ RADIOAC SBST W/BI PELV LYMPH||1592.69|0||0|10/01/2019 SH 78001|55862|55862 - EXPOS PROSTATE INSJ RADIOACT SBST W/LYMPH BX||1317.98|0||0|10/01/2019 SH 78001|55860|55860 - EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST||1042.76|0||0|10/01/2019 SH 78001|55845|55845 - PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM||1627.92|0||0|10/01/2019 SH 78001|55842|55842 - PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX||1396.04|0||0|10/01/2019 SH 78001|55840|55840 - PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING||1397.21|0||0|10/01/2019 SH 78001|55831|55831 - PROSTATECTOMY RETROPUBIC SUBTOTAL||1127.36|0||0|10/01/2019 SH 78001|55821|55821 - PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES||1040.86|0||0|10/01/2019 SH 78001|55815|55815 - PROSTATECTOMY PERINEAL RAD W/BI PELVIC LYMPH EXC||2106.97|0||0|10/01/2019 SH 78001|55812|55812 - PROSTATECTOMY PERINEAL RADICAL W/LYMPH NODE BX||1921.84|0||0|10/01/2019 SH 78001|55810|55810 - PROSTATECTOMY PERINEAL RADICAL||1572.89|0||0|10/01/2019 SH 78001|55801|55801 - PROSTATECTOMY PERINEAL SUBTOTAL||1302.38|0||0|10/01/2019 SH 78001|55725|55725 - PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED||749.53|0||0|10/01/2019 SH 78001|55720|55720 - PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE||535.47|0||0|10/01/2019 SH 78001|55706|55706 - BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID||441.51|0||0|10/01/2019 SH 78001|55705|55705 - BIOPSY PROSTATE INCISIONAL ANY APPROACH||316.74|0||0|10/01/2019 SH 78001|55700|55700 - PROSTATE NEEDLE BIOPSY ANY APPROACH||250.87|0||0|10/01/2019 SH 78001|55680|55680 - EXCISION MULLERIAN DUCT CYST||414.75|0||0|10/01/2019 SH 78001|55650|55650 - VESICULECTOMY ANY APPROACH||852.01|0||0|10/01/2019 SH 78001|55605|55605 - VESICULOTOMY COMPLICATED||625.96|0||0|10/01/2019 SH 78001|55600|55600 - VESICULOTOMY||498.59|0||0|10/01/2019 SH 78001|55559|55559 - UNLISTED LAPROSCOPY PROCEDURE SPERMATIC CORD||0|0||0|10/01/2019 SH 78001|55550|55550 - LAPS LIGATION SPERMATIC VEINS VARICOCELE||507.18|0||0|10/01/2019 SH 78001|55540|55540 - EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR||654.88|0||0|10/01/2019 SH 78001|55535|55535 - EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL||509.46|0||0|10/01/2019 SH 78001|55530|55530 - EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX||417.11|0||0|10/01/2019 SH 78001|55520|55520 - EXC LESION SPERMATIC CORD SEPARATE PROCEDURE||535.21|0||0|10/01/2019 SH 78001|55500|55500 - EXC HYDROCELE SPRMATIC CORD UNI SPX||467.66|0||0|10/01/2019 SH 78001|55450|55450 - LIGATION PRQ VAS DEFERENS UNI/BI SPX||414.41|0||0|10/01/2019 SH 78001|55400|55400 - VASOVASOSTOMY VASOVASORRHAPHY||591.66|0||0|10/01/2019 SH 78001|55300|55300 - VASOTOMY VASOGRAMS UNI/BI||223.88|0||0|10/01/2019 SH 78001|55250|55250 - VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS||436.52|0||0|10/01/2019 SH 78001|55200|55200 - VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX||499.06|0||0|10/01/2019 SH 78001|55180|55180 - SCROTOPLASTY COMPLICATED||817.98|0||0|10/01/2019 SH 78001|55175|55175 - SCROTOPLASTY SIMPLE||428.48|0||0|10/01/2019 SH 78001|55150|55150 - RESECTION SCROTUM||583.8|0||0|10/01/2019 SH 78001|55120|55120 - REMOVAL FOREIGN BODY SCROTUM||422.39|0||0|10/01/2019 SH 78001|55110|55110 - SCROTAL EXPLORATION||458.02|0||0|10/01/2019 SH 78001|55100|55100 - DRAINAGE SCROTAL WALL ABSCESS||248.37|0||0|10/01/2019 SH 78001|55060|55060 - RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE||449.87|0||0|10/01/2019 SH 78001|55041|55041 - EXCISION HYDROCELE BILATERAL||604.54|0||0|10/01/2019 SH 78001|55040|55040 - EXCISION HYDROCELE UNILATERAL||399.9|0||0|10/01/2019 SH 78001|55000|55000 - PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED||135.74|0||0|10/01/2019 SH 78001|54901|54901 - EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI||1268.9|0||0|10/01/2019 SH 78001|54900|54900 - EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI||961.79|0||0|10/01/2019 SH 78001|54865|54865 - EXPLORATION EPIDIDYMIS W/WO BIOPSY||423.38|0||0|10/01/2019 SH 78001|54861|54861 - EPIDIDYMECTOMY BILATERAL||671.64|0||0|10/01/2019 SH 78001|54860|54860 - EPIDIDYMECTOMY UNILATERAL||495.62|0||0|10/01/2019 SH 78001|54840|54840 - EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY||379.33|0||0|10/01/2019 SH 78001|54830|54830 - EXCISION LOCAL LESION EPIDIDYMIS||439.95|0||0|10/01/2019 SH 78001|54800|54800 - BIOPSY EPIDIDYMIS NEEDLE||150.92|0||0|10/01/2019 SH 78001|54700|54700 - I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE||254.39|0||0|10/01/2019 SH 78001|54699|54699 - UNLISTED LAPAROSCOPY PROCEDURE TESTIS||0|0||0|10/01/2019 SH 78001|54692|54692 - LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS||904.86|0||0|10/01/2019 SH 78001|54690|54690 - LAPAROSCOPY SURGICAL ORCHIECTOMY||782.34|0||0|10/01/2019 SH 78001|54680|54680 - TRANSPLANTATION TESTIS TO THIGH||936.8|0||0|10/01/2019 SH 78001|54670|54670 - SUTURE/REPAIR TESTICULAR INJURY||478.8|0||0|10/01/2019 SH 78001|54660|54660 - INSJ TESTICULAR PROSTH SEPARATE PROCEDURE||421.7|0||0|10/01/2019 SH 78001|54650|54650 - ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS||845.06|0||0|10/01/2019 SH 78001|54640|54640 - ORCHIOPEXY INGUINAL OR SCROTAL APPROACH||566.9|0||0|10/01/2019 SH 78001|54620|54620 - FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE||356.58|0||0|10/01/2019 SH 78001|54600|54600 - RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS||536.24|0||0|10/01/2019 SH 78001|54560|54560 - EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL||807.93|0||0|10/01/2019 SH 78001|54550|54550 - EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA||583.8|0||0|10/01/2019 SH 78001|54535|54535 - ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL||885.79|0||0|10/01/2019 SH 78001|54530|54530 - ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH||597.98|0||0|10/01/2019 SH 78001|54522|54522 - ORCHIECTOMY PARTIAL||700.79|0||0|10/01/2019 SH 78001|54520|54520 - ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH||386.07|0||0|10/01/2019 SH 78001|54512|54512 - EXC XTRPARENCHYMAL LESION TESTIS||642.9|0||0|10/01/2019 SH 78001|54505|54505 - BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE||248.3|0||0|10/01/2019 SH 78001|54500|54500 - BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE||89.08|0||0|10/01/2019 SH 78001|54450|54450 - FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING||82.05|0||0|10/01/2019 SH 78001|54440|54440 - PLASTIC OPERATION PENIS INJURY||0|0||0|10/01/2019 SH 78001|54438|54438 - REPLANTATION PENIS COMP AMPUTATION W/URETH REP||1631.59|0||0|10/01/2019 SH 78001|54437|54437 - REPAIR OF TRAUMATIC CORPOREAL TEAR(S)||806.5|0||0|10/01/2019 SH 78001|54435|54435 - CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM||492.29|0||0|10/01/2019 SH 78001|54430|54430 - CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI||759.77|0||0|10/01/2019 SH 78001|54420|54420 - CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI||837.31|0||0|10/01/2019 SH 78001|54417|54417 - RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD||1070.25|0||0|10/01/2019 SH 78001|54416|54416 - RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI||841.38|0||0|10/01/2019 SH 78001|54415|54415 - RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT||626.96|0||0|10/01/2019 SH 78001|54411|54411 - RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL||1221.99|0||0|10/01/2019 SH 78001|54410|54410 - RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS||1022.03|0||0|10/01/2019 SH 78001|54408|54408 - RPR COMPONENT INFLATABLE PENILE PROSTHESIS||939.72|0||0|10/01/2019 SH 78001|54406|54406 - RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH||868.97|0||0|10/01/2019 SH 78001|54405|54405 - INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH||962.55|0||0|10/01/2019 SH 78001|54401|54401 - INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED||773.34|0||0|10/01/2019 SH 78001|54400|54400 - INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID||628.61|0||0|10/01/2019 SH 78001|54390|54390 - PLASTIC RPR PENIS EPISPADIAS W/EXSTROPHY BLADDER||1491.17|0||0|10/01/2019 SH 78001|54385|54385 - PLASTIC PENIS EPISPADIAS DSTL SPHNCTR W/INCONT||1230.17|0||0|10/01/2019 SH 78001|54380|54380 - PLASTIC RPR PENIS EPISPADIAS DSTL SPHNCTR||950.98|0||0|10/01/2019 SH 78001|54360|54360 - PLASTIC RPR PENIS CORRECT ANGULATION||857.63|0||0|10/01/2019 SH 78001|54352|54352 - RPR HYPOSPADIAS CRIPPLE W/DSJ & EXC & GRFS/FLAP||1691|0||0|10/01/2019 SH 78001|54348|54348 - RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF||1218.59|0||0|10/01/2019 SH 78001|54344|54344 - RPR HYPOSPADIAS COMPLCTJS MOBLJ FLAPS & URTP||1129.12|0||0|10/01/2019 SH 78001|54340|54340 - RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE||675.94|0||0|10/01/2019 SH 78001|54336|54336 - 1 STG PERINEAL HYPOSPADIAS RPR W/GRF&/FLAP||1418.12|0||0|10/01/2019 SH 78001|54332|54332 - 1 STAGE PROX PENILE/PENOSCROTAL HYPOSPADIAS RPR||1208.89|0||0|10/01/2019 SH 78001|54328|54328 - 1 STAGE DSTL HYPOSPADIAS RPR W/EXTENSIVE DSJ||1119.46|0||0|10/01/2019 SH 78001|54326|54326 - 1 STG DSTL HYPOSPADIAS RPR URTP SKN FLAPS||1127|0||0|10/01/2019 SH 78001|54324|54324 - 1 STG DSTL HYPOSPADIAS RPR W/URTP SKIN FLAPS||1155.3|0||0|10/01/2019 SH 78001|54322|54322 - 1 STG DSTL HYPOSPADIAS RPR W/SMPL MEATAL ADVMNT||929.56|0||0|10/01/2019 SH 78001|54318|54318 - URETHROPLASTY 3RD STG HYPOSPADIAS RPR RLS PENIS||854.04|0||0|10/01/2019 SH 78001|54316|54316 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR SKIN GRF||1189.66|0||0|10/01/2019 SH 78001|54312|54312 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR > 3 CM||973.36|0||0|10/01/2019 SH 78001|54308|54308 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR <3 CM||849.95|0||0|10/01/2019 SH 78001|54304|54304 - PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR||892.38|0||0|10/01/2019 SH 78001|54300|54300 - PENIS STRAIGHTENING CHORDEE||762.33|0||0|10/01/2019 SH 78001|54250|54250 - NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST||143.84|131.82||0|10/01/2019 SH 78001|54240|54240 - PENILE PLETHYSMOGRAPHY||115.43|77.05||0|10/01/2019 SH 78001|54235|54235 - NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT||105.23|0||0|10/01/2019 SH 78001|54231|54231 - DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS||163.99|0||0|10/01/2019 SH 78001|54230|54230 - INJECTION CORPORA CAVERNOSOGRAPY||112.86|0||0|10/01/2019 SH 78001|54220|54220 - IRRIGATION CORPORA CAVERNOSA PRIAPISM||236.22|0||0|10/01/2019 SH 78001|54205|54205 - NJX PEYRONIE W/SURG EXPOS PLAQUE||630.45|0||0|10/01/2019 SH 78001|54200|54200 - INJECTION PEYRONIE DISEASE||122.71|0||0|10/01/2019 SH 78001|54164|54164 - FRENULOTOMY PENIS||227.11|0||0|10/01/2019 SH 78001|54163|54163 - REPAIR INCOMPLETE CIRCUMCISION||257.21|0||0|10/01/2019 SH 78001|54162|54162 - LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS||297.14|0||0|10/01/2019 SH 78001|54161|54161 - CIRCUMCISION AGE >28 DAYS||233.17|0||0|10/01/2019 SH 78001|54160|54160 - CIRCUMCISION NEONATE||252.98|0||0|10/01/2019 SH 78001|54150|54150 - CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK||178.5|0||0|10/01/2019 SH 78001|54135|54135 - AMPUTATION PENIS RADICAL W/LYMPH NODES||1806.15|0||0|10/01/2019 SH 78001|54130|54130 - AMPUTATION PENIS RADW/BI INGUINOFEMORAL LMPHADE||1422.96|0||0|10/01/2019 SH 78001|54125|54125 - AMPUTATION PENIS COMPLETE||966.99|0||0|10/01/2019 SH 78001|54120|54120 - AMPUTATION PENIS PARTIAL||751.03|0||0|10/01/2019 SH 78001|54115|54115 - REMOVAL FOREIGN BODY DEEP PENILE TISSUE||530.89|0||0|10/01/2019 SH 78001|54112|54112 - EXC PENILE PLAQUE GRAFT > 5 CM LENGTH||1117.53|0||0|10/01/2019 SH 78001|54111|54111 - EXC PENILE PLAQUE GRAFT &/5 CM LENGTH||953.97|0||0|10/01/2019 SH 78001|54110|54110 - EXCISION OF PENILE PLAQUE||741.33|0||0|10/01/2019 SH 78001|54105|54105 - BIOPSY PENIS DEEP STRUCTURES||307.02|0||0|10/01/2019 SH 78001|54100|54100 - BIOPSY PENIS SEPARATE PROCEDURE||226.57|0||0|10/01/2019 SH 78001|54065|54065 - DSTRJ LESION PENIS EXTENSIVE||251.17|0||0|10/01/2019 SH 78001|54060|54060 - DSTRJ LESION PENIS SIMPLE SURG EXCISION||205.99|0||0|10/01/2019 SH 78001|54057|54057 - DSTRJ LESION PENIS SIMPLE LASER||154.51|0||0|10/01/2019 SH 78001|54056|54056 - DSTRJ LESION PENIS SIMPLE CRYOSURGERY||161.88|0||0|10/01/2019 SH 78001|54055|54055 - DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION||136.5|0||0|10/01/2019 SH 78001|54050|54050 - DSTRJ LESION PENIS SIMPLE CHEMICAL||151.41|0||0|10/01/2019 SH 78001|54015|54015 - I&D PENIS DEEP||363.83|0||0|10/01/2019 SH 78001|54001|54001 - SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN||213.33|0||0|10/01/2019 SH 78001|54000|54000 - SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN||170.16|0||0|10/01/2019 SH 78001|53899|53899 - UNLISTED PROCEDURE URINARY SYSTEM||0|0||0|10/01/2019 SH 78001|53860|53860 - TRURL RF FEMALE BLADDER NECK STRS URIN INCONT||1728.48|0||0|10/01/2019 SH 78001|53855|53855 - INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT||854.2|0||0|10/01/2019 SH 78001|53852|53852 - TRURL DSTRJ PRSTATE TISS RF THERMOTH||2136.48|0||0|10/01/2019 SH 78001|53850|53850 - TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH||2309.96|0||0|10/01/2019 SH 78001|53665|53665 - DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES||46.75|0||0|10/01/2019 SH 78001|53661|53661 - DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ||78.74|0||0|10/01/2019 SH 78001|53660|53660 - DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI||80.25|0||0|10/01/2019 SH 78001|53621|53621 - DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ||126.47|0||0|10/01/2019 SH 78001|53620|53620 - DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST||135.02|0||0|10/01/2019 SH 78001|53605|53605 - DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES||77.71|0||0|10/01/2019 SH 78001|53601|53601 - DILAT URETHRAL STRIX DILATOR MALE SBSQ||93.45|0||0|10/01/2019 SH 78001|53600|53600 - DILAT URETHRAL STRIX DILATOR MALE 1ST||97.17|0||0|10/01/2019 SH 78001|53520|53520 - CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX||659.43|0||0|10/01/2019 SH 78001|53515|53515 - URTORR SUTR URETHRAL WND/INJ PROSTATOMEMBRANOUS||947.28|0||0|10/01/2019 SH 78001|53510|53510 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL||749.26|0||0|10/01/2019 SH 78001|53505|53505 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE||576.17|0||0|10/01/2019 SH 78001|53502|53502 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE||576.95|0||0|10/01/2019 SH 78001|53500|53500 - URETHROLSS TRVG SEC OPN W/CSTO||889.62|0||0|10/01/2019 SH 78001|53460|53460 - URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM||542.15|0||0|10/01/2019 SH 78001|53450|53450 - URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT||483.98|0||0|10/01/2019 SH 78001|53449|53449 - RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER||725.8|0||0|10/01/2019 SH 78001|53448|53448 - RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD||1526.88|0||0|10/01/2019 SH 78001|53447|53447 - RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC||961.5|0||0|10/01/2019 SH 78001|53446|53446 - REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER||761.54|0||0|10/01/2019 SH 78001|53445|53445 - INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER||894.26|0||0|10/01/2019 SH 78001|53444|53444 - INSERTION TANDEM CUFF||944.05|0||0|10/01/2019 SH 78001|53442|53442 - RMVL/REVJ SLING MALE URINARY INCONTINENCE||929.35|0||0|10/01/2019 SH 78001|53440|53440 - SLING OPRATION CORRJ MALE URINARY INCONTINENCE||895.83|0||0|10/01/2019 SH 78001|53431|53431 - URTP W/TUBULARIZATION POST URT&/LWR BLDR||1377.04|0||0|10/01/2019 SH 78001|53430|53430 - URETHROPLASTY RCNSTJ FEMALE URETHRA||1148.59|0||0|10/01/2019 SH 78001|53425|53425 - URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE||1116.37|0||0|10/01/2019 SH 78001|53420|53420 - URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE||1001.44|0||0|10/01/2019 SH 78001|53415|53415 - URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT||1348.19|0||0|10/01/2019 SH 78001|53410|53410 - URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA||1167.11|0||0|10/01/2019 SH 78001|53405|53405 - URETHROPLASTY 2ND STAGE W/URINARY DIVERSION||1040.42|0||0|10/01/2019 SH 78001|53400|53400 - URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX||952.7|0||0|10/01/2019 SH 78001|53275|53275 - EXCISION/FULGURATION URETHRAL PROLAPSE||312.3|0||0|10/01/2019 SH 78001|53270|53270 - EXCISION OR FULGURATION SKENES GLANDS||241.3|0||0|10/01/2019 SH 78001|53265|53265 - EXC/FULGURATION URETHRAL CARUNCLE||255|0||0|10/01/2019 SH 78001|53260|53260 - EXC/FULGURATION URETHRAL POLYP DSTL URETHRA||235.78|0||0|10/01/2019 SH 78001|53250|53250 - EXCISION OF BULBOURETHRAL GLAND||467.76|0||0|10/01/2019 SH 78001|53240|53240 - MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE||502.39|0||0|10/01/2019 SH 78001|53235|53235 - EXC URETHRAL DIVERTICULUM SPX MALE||750.94|0||0|10/01/2019 SH 78001|53230|53230 - EXC URETHRAL DIVERTICULUM SPX FEMALE||719.85|0||0|10/01/2019 SH 78001|53220|53220 - EXC/FULGURATION CARCINOMA URETHRA||539.7|0||0|10/01/2019 SH 78001|53215|53215 - URETHRECTOMY TOT W/CYSTOST MALE||1106.49|0||0|10/01/2019 SH 78001|53210|53210 - URETHRECTOMY TOT W/CYSTOST FEMALE||919.12|0||0|10/01/2019 SH 78001|53200|53200 - BIOPSY URETHRA||185.02|0||0|10/01/2019 SH 78001|53085|53085 - DRG PERINEAL URINARY XTRVASATION COMPLIC||770.38|0||0|10/01/2019 SH 78001|53080|53080 - DRG PERINEAL URINARY XTRVASATION UNCOMP SPX||504.34|0||0|10/01/2019 SH 78001|53060|53060 - DRG OF SKENE'S GLAND ABSCESS OR CYST||215.65|0||0|10/01/2019 SH 78001|53040|53040 - DRAINAGE DEEP PERIURETHRAL ABSCESS||464.4|0||0|10/01/2019 SH 78001|53025|53025 - MEATOTOMY CUTTING MEATUS SPX INFANT||80.93|0||0|10/01/2019 SH 78001|53020|53020 - MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT||115.52|0||0|10/01/2019 SH 78001|53010|53010 - URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA||346.28|0||0|10/01/2019 SH 78001|53000|53000 - URTT/URTS XTRNL SPX PENDULOUS URETHRA||175.34|0||0|10/01/2019 SH 78001|52700|52700 - TRURL DRAINAGE PROSTATIC ABSCESS||522.01|0||0|10/01/2019 SH 78001|52649|52649 - LASER ENUCLEATION PROSTATE W/MORCELLATION||979|0||0|10/01/2019 SH 78001|52648|52648 - LASER VAPORIZATION OF PROSTATE FOR URINE FLOW||2057.75|0||0|10/01/2019 SH 78001|52647|52647 - LASER COAGULATION OF PROSTATE FOR URINE FLOW||1997.04|0||0|10/01/2019 SH 78001|52640|52640 - TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE||370.25|0||0|10/01/2019 SH 78001|52630|52630 - TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS||472.54|0||0|10/01/2019 SH 78001|52601|52601 - TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE||1007.27|0||0|10/01/2019 SH 78001|52500|52500 - TRANSURETHRAL RESECTION BLADDER NECK||577.97|0||0|10/01/2019 SH 78001|52450|52450 - TRANSURETHRAL INCISION PROSTATE||555.46|0||0|10/01/2019 SH 78001|52442|52442 - CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL||1039.9|0||0|10/01/2019 SH 78001|52441|52441 - CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE||1372.61|0||0|10/01/2019 SH 78001|52402|52402 - CSTO W/TRURL RESCJ/INC EJACULATORY DUXS||320.79|0||0|10/01/2019 SH 78001|52400|52400 - CYSTO INC FULG/RESCJ URTL VALVES/FOLDS||569.91|0||0|10/01/2019 SH 78001|52356|52356 - CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT||499.05|0||0|10/01/2019 SH 78001|52355|52355 - CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR||560.41|0||0|10/01/2019 SH 78001|52354|52354 - CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION||500.21|0||0|10/01/2019 SH 78001|52353|52353 - CYSTO W/URETEROSCOPY W/LITHOTRIPSY||470.5|0||0|10/01/2019 SH 78001|52352|52352 - CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES||425.74|0||0|10/01/2019 SH 78001|52351|52351 - CYSTO W/URTROSCOPY&/PYELOSCOPY DX||363.21|0||0|10/01/2019 SH 78001|52346|52346 - CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE||536.87|0||0|10/01/2019 SH 78001|52345|52345 - CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX||473.43|0||0|10/01/2019 SH 78001|52344|52344 - CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE||443.72|0||0|10/01/2019 SH 78001|52343|52343 - CYSTO W/TX INTRA-RENAL STRICTURE||413.23|0||0|10/01/2019 SH 78001|52342|52342 - CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE||371.02|0||0|10/01/2019 SH 78001|52341|52341 - CYSTO W/TX URETERAL STRICTURE||340.14|0||0|10/01/2019 SH 78001|52334|52334 - CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR||306.8|0||0|10/01/2019 SH 78001|52332|52332 - CYSTO W/INSERT URETERAL STENT||546.92|0||0|10/01/2019 SH 78001|52330|52330 - CYSTO MANJ W/O RMVL URETERAL STONE||563.19|0||0|10/01/2019 SH 78001|52327|52327 - CYSTO W/SUBURTRIC NJX IMPLT MATRL||315.36|0||0|10/01/2019 SH 78001|52325|52325 - CYSTO FRAGMENTATION URETERAL STONE||385.12|0||0|10/01/2019 SH 78001|52320|52320 - CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS||295.77|0||0|10/01/2019 SH 78001|52318|52318 - LITHOLAPAXY COMP/LG > 2.5 CM||568.96|0||0|10/01/2019 SH 78001|52317|52317 - LITHOLAPAXY SMPL/SM <2.5 CM||910.52|0||0|10/01/2019 SH 78001|52315|52315 - CYSTO W/COMPLEX REMOVAL STONE & STENT||477.49|0||0|10/01/2019 SH 78001|52310|52310 - CYSTO W/SIMPLE REMOVAL STONE & STENT||279.4|0||0|10/01/2019 SH 78001|52305|52305 - CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT||334.11|0||0|10/01/2019 SH 78001|52301|52301 - CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI||348.55|0||0|10/01/2019 SH 78001|52300|52300 - CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI||336.43|0||0|10/01/2019 SH 78001|52290|52290 - CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI||292.57|0||0|10/01/2019 SH 78001|52287|52287 - CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER||355.53|0||0|10/01/2019 SH 78001|52285|52285 - CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME||322.79|0||0|10/01/2019 SH 78001|52283|52283 - CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE||320.25|0||0|10/01/2019 SH 78001|52282|52282 - CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT||404.4|0||0|10/01/2019 SH 78001|52281|52281 - CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS||310.53|0||0|10/01/2019 SH 78001|52277|52277 - CYSTOURETHROSCOPY W/RESECJ EXTERNAL SPHINCTER||388.27|0||0|10/01/2019 SH 78001|52276|52276 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE||317.24|0||0|10/01/2019 SH 78001|52275|52275 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE||546.58|0||0|10/01/2019 SH 78001|52270|52270 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE||404.69|0||0|10/01/2019 SH 78001|52265|52265 - CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA||414.1|0||0|10/01/2019 SH 78001|52260|52260 - CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH||252.43|0||0|10/01/2019 SH 78001|52250|52250 - CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG||287.14|0||0|10/01/2019 SH 78001|52240|52240 - CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE||470.5|0||0|10/01/2019 SH 78001|52235|52235 - CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM||345.96|0||0|10/01/2019 SH 78001|52234|52234 - CYSTO W/REMOVAL OF TUMORS SMALL||294.69|0||0|10/01/2019 SH 78001|52224|52224 - CYSTO W/REMOVAL OF LESIONS SMALL||773.27|0||0|10/01/2019 SH 78001|52214|52214 - CYSTO W/DESTRUCTION OF LESIONS||736.36|0||0|10/01/2019 SH 78001|52204|52204 - CYSTOURETHROSCOPY WITH BIOPSY||415.66|0||0|10/01/2019 SH 78001|52010|52010 - CYSTO W/EJACULATORY DUCT CATHETERIZATION||414.83|0||0|10/01/2019 SH 78001|52007|52007 - CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS||498.95|0||0|10/01/2019 SH 78001|52005|52005 - CYSTO BLADDER W/URETERAL CATHETERIZATION||301.51|0||0|10/01/2019 SH 78001|52001|52001 - CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS||433.57|0||0|10/01/2019 SH 78001|52000|52000 - CYSTOURETHROSCOPY||234.61|0||0|10/01/2019 SH 78001|51999|51999 - UNLISTED LAPAROSCOPY PROCEDURE BLADDER||0|0||0|10/01/2019 SH 78001|51992|51992 - LAPAROSCOPY SLING OPERATION STRESS INCONT||1002.5|0||0|10/01/2019 SH 78001|51990|51990 - LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT||894.29|0||0|10/01/2019 SH 78001|51980|51980 - CUTANEOUS VESICOSTOMY||847.4|0||0|10/01/2019 SH 78001|51960|51960 - ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS||1656.43|0||0|10/01/2019 SH 78001|51940|51940 - CLOSURE EXSTROPHY BLADDER||1961.26|0||0|10/01/2019 SH 78001|51925|51925 - CLSR VESICOUTERINE FISTULA W/HYSTERECTOMY||1329.75|0||0|10/01/2019 SH 78001|51920|51920 - CLOSURE VESICOUTERINE FISTULA||907.29|0||0|10/01/2019 SH 78001|51900|51900 - CLSR VESICOVAGINAL FISTUL AABDL APPROACH||990.55|0||0|10/01/2019 SH 78001|51880|51880 - CLOSURE CYSTOSTOMY SEPARATE PROCEDURE||555.5|0||0|10/01/2019 SH 78001|51865|51865 - CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED||1068.24|0||0|10/01/2019 SH 78001|51860|51860 - CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE||885.24|0||0|10/01/2019 SH 78001|51845|51845 - ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL||695.7|0||0|10/01/2019 SH 78001|51841|51841 - ANT VESICOURETHROPEXY/URETHROPEXY COMP||920.88|0||0|10/01/2019 SH 78001|51840|51840 - ANT VESICOURETHROPEXY/URETHROPEXY SMPL||778.93|0||0|10/01/2019 SH 78001|51820|51820 - CSTOURTP W/UNI/BI URTRONEOCSTOST||1445.43|0||0|10/01/2019 SH 78001|51800|51800 - CSTOPLASTY/CSTOURTP PLSTC ANY||1244.14|0||0|10/01/2019 SH 78001|51798|51798 - MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP||20.55|0||0|10/01/2019 SH 78001|51797|51797 - VOID PRESSURE STUDIES INTRAABDOMINAL||126|47.69||0|10/01/2019 SH 78001|51792|51792 - STIMULUS EVOKED RESPONSE||235.85|66.06||0|10/01/2019 SH 78001|51785|51785 - NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ||283.51|100.14||0|10/01/2019 SH 78001|51784|51784 - EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL||217.58|92.36||0|10/01/2019 SH 78001|51741|51741 - COMPLEX UROFLOMETRY||18.19|10.05||0|10/01/2019 SH 78001|51736|51736 - SIMPLE UROFLOMETRY||17.8|10.05||0|10/01/2019 SH 78001|51729|51729 - COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL||383.52|152.08||0|10/01/2019 SH 78001|51728|51728 - COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES||353.07|125.52||0|10/01/2019 SH 78001|51727|51727 - COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE||350.36|128.63||0|10/01/2019 SH 78001|51726|51726 - BLADDER PRESSURE MEASUREMENT DURING FILLING||295.51|102.84||0|10/01/2019 SH 78001|51725|51725 - SIMPLE CYSTOMETROGRAM||212.45|91.89||0|10/01/2019 SH 78001|51720|51720 - BLADDER INSTILLATION ANTICARCINOGENIC AGENT||126.74|0||0|10/01/2019 SH 78001|51715|51715 - NDSC NJX IMPLT MATRL URT&/BLDR NCK||336.93|0||0|10/01/2019 SH 78001|51710|51710 - CHANGE CYSTOSTOMY TUBE COMPLICATED||147.4|0||0|10/01/2019 SH 78001|51705|51705 - CHANGE CYSTOSTOMY TUBE SIMPLE||103.96|0||0|10/01/2019 SH 78001|51703|51703 - INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED||149.09|0||0|10/01/2019 SH 78001|51702|51702 - INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE||78.94|0||0|10/01/2019 SH 78001|51701|51701 - INSJ NON-NDWELLG BLADDER CATHETER||61.89|0||0|10/01/2019 SH 78001|51700|51700 - BLDR IRRIGATION SMPL LAVAGE &/INSTLJ||95.34|0||0|10/01/2019 SH 78001|51610|51610 - NJX RETROGRADE URETHROCSTOGRAPY||122.44|0||0|10/01/2019 SH 78001|51605|51605 - NJX & PLACEMENT CHAIN CONTRAST&/URETHROCSTOGRAPY||45.05|0||0|10/01/2019 SH 78001|51600|51600 - NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY||205.43|0||0|10/01/2019 SH 78001|51597|51597 - PELVIC EXENTERATION COMPLETE MALIGNANCY||2742.76|0||0|10/01/2019 SH 78001|51596|51596 - CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR||2810.08|0||0|10/01/2019 SH 78001|51595|51595 - CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC||2617.73|0||0|10/01/2019 SH 78001|51590|51590 - CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST||2311.35|0||0|10/01/2019 SH 78001|51585|51585 - CYSTECTOMY W/URETEROSIGMOID BI PELV LYMPH NODES||2523.53|0||0|10/01/2019 SH 78001|51580|51580 - CYSTECTOMY W/URETEROSIGMOIDOSTOMY W/NODES||2265.26|0||0|10/01/2019 SH 78001|51575|51575 - CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY||2177.49|0||0|10/01/2019 SH 78001|51570|51570 - CYSTECTOMY COMPLETE SEPARATE PROCEDURE||1767.41|0||0|10/01/2019 SH 78001|51565|51565 - CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST||1552.02|0||0|10/01/2019 SH 78001|51555|51555 - CYSTECTOMY PARTIAL COMPLICATED||1514.17|0||0|10/01/2019 SH 78001|51550|51550 - CYSTECTOMY PARTIAL SIMPLE||1148.92|0||0|10/01/2019 SH 78001|51535|51535 - CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE||927.66|0||0|10/01/2019 SH 78001|51530|51530 - CYSTOTOMY EXCISION BLADDER TUMOR||931.09|0||0|10/01/2019 SH 78001|51525|51525 - CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE||1023.48|0||0|10/01/2019 SH 78001|51520|51520 - CYSTOTOMY SIMPLE EXCISION VESICAL NECK||704.88|0||0|10/01/2019 SH 78001|51500|51500 - EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR||755.46|0||0|10/01/2019 SH 78001|51102|51102 - ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER||262.25|0||0|10/01/2019 SH 78001|51101|51101 - ASPIRATION BLADDER TROCAR/INTRACATHETER||142.08|0||0|10/01/2019 SH 78001|51100|51100 - ASPIRATION BLADDER NEEDLE||72.03|0||0|10/01/2019 SH 78001|51080|51080 - DRG PRIVESICAL/PREVESICAL SPACE ABSC||482.55|0||0|10/01/2019 SH 78001|51065|51065 - CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO||686.3|0||0|10/01/2019 SH 78001|51060|51060 - TRANSVESICAL URETROLITHOTOMY||689.01|0||0|10/01/2019 SH 78001|51050|51050 - CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS||559|0||0|10/01/2019 SH 78001|51045|51045 - CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX||579.69|0||0|10/01/2019 SH 78001|51040|51040 - CYSTOSTOMY CYSTOTOMY W/DRAINAGE||340.25|0||0|10/01/2019 SH 78001|51030|51030 - CSTOTOMY/CSTOST CRYOSURG DSTRJ INTRAVESICAL LES||556.36|0||0|10/01/2019 SH 78001|51020|51020 - CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL||553.13|0||0|10/01/2019 SH 78001|50980|50980 - NDSC URETEROTOMY RMVL FB/CALCULUS||428.46|0||0|10/01/2019 SH 78001|50976|50976 - URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX||559.77|0||0|10/01/2019 SH 78001|50974|50974 - URETERAL ENDOSCOPY VIA URETEROT W/O IMAGING W/BX||567.71|0||0|10/01/2019 SH 78001|50972|50972 - NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER||430.57|0||0|10/01/2019 SH 78001|50970|50970 - URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING||445.62|0||0|10/01/2019 SH 78001|50961|50961 - URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE||455.19|0||0|10/01/2019 SH 78001|50957|50957 - URETERAL ENDOSCOPY W/DEST&/INC W/WO BIOPSY||505.73|0||0|10/01/2019 SH 78001|50955|50955 - URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY||500.9|0||0|10/01/2019 SH 78001|50953|50953 - URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER||468.43|0||0|10/01/2019 SH 78001|50951|50951 - URETERAL ENDOSCOPY VIA URETEROSTOMY||441.87|0||0|10/01/2019 SH 78001|50949|50949 - UNLISTED LAPAROSCOPY PROCEDURE URETER||0|0||0|10/01/2019 SH 78001|50948|50948 - LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT||1523.89|0||0|10/01/2019 SH 78001|50947|50947 - LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT||1658.86|0||0|10/01/2019 SH 78001|50945|50945 - LAPAROSCOPY URTROLITHOTOMY||1162.18|0||0|10/01/2019 SH 78001|50940|50940 - DELIGATION URETER||1056.72|0||0|10/01/2019 SH 78001|50930|50930 - CLOSURE URETEROCUTANEOUS FISTULA W/VISC RPR||1315.33|0||0|10/01/2019 SH 78001|50920|50920 - CLOSURE URETEROCUTANEOUS FISTULA||1049.6|0||0|10/01/2019 SH 78001|50900|50900 - URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE||1010.95|0||0|10/01/2019 SH 78001|50860|50860 - URETEROSTOMY TRANSPLANTATION URETER SKIN||1126.88|0||0|10/01/2019 SH 78001|50845|50845 - CUTANANEOUS APPENDICO-VESICOSTOMY||1487.31|0||0|10/01/2019 SH 78001|50840|50840 - RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST||1465.29|0||0|10/01/2019 SH 78001|50830|50830 - URINARY UNIDIVERSION||2153.97|0||0|10/01/2019 SH 78001|50825|50825 - CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN||1976.47|0||0|10/01/2019 SH 78001|50820|50820 - URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS||1571.94|0||0|10/01/2019 SH 78001|50815|50815 - URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS||1457.75|0||0|10/01/2019 SH 78001|50810|50810 - URETEROSIGMOIDOSTOMY W/SIGMOID BLADDER & COLOSTO||1666.13|0||0|10/01/2019 SH 78001|50800|50800 - URETEROENTEROSTOMY ANAST URETER INTESTINE||1103.05|0||0|10/01/2019 SH 78001|50785|50785 - URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP||1447.96|0||0|10/01/2019 SH 78001|50783|50783 - URETERONEOCYSTOSTOMY W/URETERAL TAILORING||1345.47|0||0|10/01/2019 SH 78001|50782|50782 - URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR||1333.94|0||0|10/01/2019 SH 78001|50780|50780 - URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER||1323.28|0||0|10/01/2019 SH 78001|50770|50770 - TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR||1376.44|0||0|10/01/2019 SH 78001|50760|50760 - URETEROURETEROSTOMY||1346.75|0||0|10/01/2019 SH 78001|50750|50750 - URETEROCALYCOSTOMY ANAST URETER RENAL CALYX||1376.44|0||0|10/01/2019 SH 78001|50740|50740 - EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR||1460.34|0||0|10/01/2019 SH 78001|50728|50728 - REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA||829.41|0||0|10/01/2019 SH 78001|50727|50727 - REVJ URINARY-CUTANEOUS ANASTAMOSIS||601.09|0||0|10/01/2019 SH 78001|50725|50725 - URTROLSS RETROCAVAL URTR W/REANAST||1325.9|0||0|10/01/2019 SH 78001|50722|50722 - URETEROLYSIS FOR OVARIAN VEIN SYNDROME||1227.27|0||0|10/01/2019 SH 78001|50715|50715 - URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS||1454.09|0||0|10/01/2019 SH 78001|50706|50706 - BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I||856.29|0||0|10/01/2019 SH 78001|50705|50705 - URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I||1889.39|0||0|10/01/2019 SH 78001|50700|50700 - URETEROPLASTY PLASTIC OPERATION URETER||1103.08|0||0|10/01/2019 SH 78001|50694|50694 - PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH||1304.41|0||0|10/01/2019 SH 78001|50693|50693 - PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT||1180.98|0||0|10/01/2019 SH 78001|50690|50690 - NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG||114.01|0||0|10/01/2019 SH 78001|50688|50688 - CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL||94.41|0||0|10/01/2019 SH 78001|50686|50686 - MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH||181.06|0||0|10/01/2019 SH 78001|50684|50684 - INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH||120.01|0||0|10/01/2019 SH 78001|50660|50660 - URETERECTOMY TOT ECTOPIC URETER CMBN APPR||1364.32|0||0|10/01/2019 SH 78001|50650|50650 - URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE||1234.13|0||0|10/01/2019 SH 78001|50630|50630 - URTROLITHOTOMY LOWER ONE-THIRD URETER||1064.53|0||0|10/01/2019 SH 78001|50620|50620 - URTROLITHOTOMY MIDDLE ONE-THIRD URETER||1078.29|0||0|10/01/2019 SH 78001|50610|50610 - URTROLITHOTOMY UPPER ONE-THIRD URETER||1127.62|0||0|10/01/2019 SH 78001|50606|50606 - ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC||593.95|0||0|10/01/2019 SH 78001|50605|50605 - URETEROTOMY INSERTION INDWELLING STENT ALL TYPES||1172.4|0||0|10/01/2019 SH 78001|50600|50600 - URTROTOMY W/EXPL/DRG SEPARATE PROCEDURE||1120.3|0||0|10/01/2019 SH 78001|50593|50593 - ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY||5144.16|0||0|10/01/2019 SH 78001|50592|50592 - ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY||3493.42|0||0|10/01/2019 SH 78001|50590|50590 - LITHOTRIPSY XTRCORP SHOCK WAVE||837.86|0||0|10/01/2019 SH 78001|50580|50580 - RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS||729.46|0||0|10/01/2019 SH 78001|50576|50576 - RNL NDSC NFROT FULGURATION &/INCISION W/WO BX||676.81|0||0|10/01/2019 SH 78001|50575|50575 - RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY||857.75|0||0|10/01/2019 SH 78001|50574|50574 - RENAL NDSC NEPHROTOMY W/BIOPSY||678.49|0||0|10/01/2019 SH 78001|50572|50572 - RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER||638.34|0||0|10/01/2019 SH 78001|50570|50570 - RENAL NDSC NEPHROTOMY W/WO IRRIGATION||589.87|0||0|10/01/2019 SH 78001|50562|50562 - RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR||695.11|0||0|10/01/2019 SH 78001|50561|50561 - RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS||559.23|0||0|10/01/2019 SH 78001|50557|50557 - RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI||493.74|0||0|10/01/2019 SH 78001|50555|50555 - RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY||485.59|0||0|10/01/2019 SH 78001|50553|50553 - RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA||452.6|0||0|10/01/2019 SH 78001|50551|50551 - RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION||422.98|0||0|10/01/2019 SH 78001|50549|50549 - UNLISTED LAPAROSCOPY PROCEDURE RENAL||0|0||0|10/01/2019 SH 78001|50548|50548 - LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY||1610.88|0||0|10/01/2019 SH 78001|50547|50547 - LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR||1912.64|0||0|10/01/2019 SH 78001|50546|50546 - LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT||1434.37|0||0|10/01/2019 SH 78001|50545|50545 - LAPAROSCOPY RADICAL NEPHRECTOMY||1601.04|0||0|10/01/2019 SH 78001|50544|50544 - LAPAROSCOPY SURG PYELOPLASTY||1488.19|0||0|10/01/2019 SH 78001|50543|50543 - LAPAROSCOPY SURG PARTIAL NEPHRECTOMY||1774.91|0||0|10/01/2019 SH 78001|50542|50542 - LAPS ABLTJ RENAL MASS LESION W/INTRAOP US||1390.62|0||0|10/01/2019 SH 78001|50541|50541 - LAPAROSCOPY SURG ABLATION RENAL CYSTS||1096.07|0||0|10/01/2019 SH 78001|50540|50540 - SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI||1369.32|0||0|10/01/2019 SH 78001|50526|50526 - CLSR NEPHROVISCERAL FISTULA W/VISC RPR THRC APPR||1702.02|0||0|10/01/2019 SH 78001|50525|50525 - CLSR NEPHROVISCERAL FISTULA W/VISC RPR ABDL APPR||1803.94|0||0|10/01/2019 SH 78001|50520|50520 - CLOSURE NEPHROCUTANEOUS/PYELOCUTANEOUS FISTULA||1235.55|0||0|10/01/2019 SH 78001|50500|50500 - NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY||1376.44|0||0|10/01/2019 SH 78001|50435|50435 - EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I||526.68|0||0|10/01/2019 SH 78001|50434|50434 - CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ||1005.87|0||0|10/01/2019 SH 78001|50433|50433 - PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I||1272.25|0||0|10/01/2019 SH 78001|50432|50432 - PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I||946.7|0||0|10/01/2019 SH 78001|50431|50431 - NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS||182.86|0||0|10/01/2019 SH 78001|50430|50430 - NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS||586.16|0||0|10/01/2019 SH 78001|50405|50405 - PYELOPLASTY COMPLICATED||1668.11|0||0|10/01/2019 SH 78001|50400|50400 - PYELOPLASTY SIMPLE||1379.75|0||0|10/01/2019 SH 78001|50398|50398 - CHANGE KIDNEY TUBE||556.85|0||0|10/01/2019 SH 78001|50396|50396 - MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH||142.5|0||0|10/01/2019 SH 78001|50395|50395 - INTRO GUIDE PELVIS&/URETER W/DILAT NFROS TRACT||215.94|0||0|10/01/2019 SH 78001|50394|50394 - INJECTION FOR KIDNEY X-RAY||118.07|0||0|10/01/2019 SH 78001|50393|50393 - INSERT URETERAL TUBE||262.77|0||0|10/01/2019 SH 78001|50392|50392 - INSERT KIDNEY DRAIN||215.94|0||0|10/01/2019 SH 78001|50391|50391 - INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB||144.26|0||0|10/01/2019 SH 78001|50390|50390 - ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ||117.51|0||0|10/01/2019 SH 78001|50389|50389 - RMVL NFROS TUBE REQ FLUORO GUIDANCE||331.99|0||0|10/01/2019 SH 78001|50387|50387 - RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH||608.06|0||0|10/01/2019 SH 78001|50386|50386 - REMOVE INT DWELL URETERAL STENT TRANSURETHRAL||832.78|0||0|10/01/2019 SH 78001|50385|50385 - REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL||1277.75|0||0|10/01/2019 SH 78001|50384|50384 - REMOVAL INDWELLING URETERAL STENT PRQ||1063.5|0||0|10/01/2019 SH 78001|50382|50382 - RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ||1332.78|0||0|10/01/2019 SH 78001|50380|50380 - RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY||2375.25|0||0|10/01/2019 SH 78001|50370|50370 - RMVL TRNSPLED RENAL ALLOGRAFT||1424.78|0||0|10/01/2019 SH 78001|50365|50365 - RENAL ALTRNSPLJ IMPLTJ GRF W/RCP NEPHRECTOMY||3379.46|0||0|10/01/2019 SH 78001|50360|50360 - RENAL ALTRNSPLJ IMPLTJ GRF W/O RCP NEPHRECTOMY||2885.7|0||0|10/01/2019 SH 78001|50340|50340 - RECIPIENT NEPHRECTOMY SEPARATE PROCEDURE||1122.48|0||0|10/01/2019 SH 78001|50329|50329 - BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA||220.56|0||0|10/01/2019 SH 78001|50328|50328 - BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA||229|0||0|10/01/2019 SH 78001|50327|50327 - BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA||261.44|0||0|10/01/2019 SH 78001|50325|50325 - BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT||0|0||0|10/01/2019 SH 78001|50323|50323 - BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT||0|0||0|10/01/2019 SH 78001|50320|50320 - DONOR NEPHRECTOMY OPEN LIVING DONOR||1781.25|0||0|10/01/2019 SH 78001|50300|50300 - DONOR NEPHRECTOMY CADAVER DONOR UNI/BILATERAL||0|0||0|10/01/2019 SH 78001|50290|50290 - EXCISION PERINEPHRIC CYST||1069.7|0||0|10/01/2019 SH 78001|50280|50280 - EXCISION/UNROOFING CYST KIDNEY||1137.82|0||0|10/01/2019 SH 78001|50250|50250 - OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND||1450.59|0||0|10/01/2019 SH 78001|50240|50240 - NEPHRECTOMY PARTIAL||1578.72|0||0|10/01/2019 SH 78001|50236|50236 - NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN||1750.38|0||0|10/01/2019 SH 78001|50234|50234 - NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC||1552.44|0||0|10/01/2019 SH 78001|50230|50230 - NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD||1531.25|0||0|10/01/2019 SH 78001|50225|50225 - NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL||1432.11|0||0|10/01/2019 SH 78001|50220|50220 - NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ||1246.79|0||0|10/01/2019 SH 78001|50205|50205 - RENAL BIOPSY SURG EXPOSURE KIDNEY||895.69|0||0|10/01/2019 SH 78001|50200|50200 - RENAL BIOPSY PRQ TROCAR/NEEDLE||689.52|0||0|10/01/2019 SH 78001|50135|50135 - PYELOTOMY COMPLICATED||1339.57|0||0|10/01/2019 SH 78001|50130|50130 - PYELOTOMY W/REMOVAL CALCULUS||1232.19|0||0|10/01/2019 SH 78001|50125|50125 - PYELOTOMY W/DRAINAGE PYELOSTOMY||1171.6|0||0|10/01/2019 SH 78001|50120|50120 - PYELOTOMY W/EXPLORATION||1131.71|0||0|10/01/2019 SH 78001|50100|50100 - TRNSXJ/REPOSITIONING ABERRANT RENAL VESSEL SPX||1285.98|0||0|10/01/2019 SH 78001|50081|50081 - PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY > 2 CM||1523.65|0||0|10/01/2019 SH 78001|50080|50080 - PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY INCARCERATED||562.27|0||0|10/01/2019 SH 78001|49585|49585 - RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE||526|0||0|10/01/2019 SH 78001|49582|49582 - RPR UMBILICAL HERNIA < 5 YRS INCARCERATED||571.03|0||0|10/01/2019 SH 78001|49580|49580 - RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE||391.07|0||0|10/01/2019 SH 78001|49572|49572 - RPR EPIGASTRIC HERNIA INCARCERATED||611.5|0||0|10/01/2019 SH 78001|49570|49570 - RPR EPIGASTRIC HERNIA REDUCIBLE SPX||490.28|0||0|10/01/2019 SH 78001|49568|49568 - IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE||322.31|0||0|10/01/2019 SH 78001|49566|49566 - RPR RECRT INCAL/VNT HERNIA INCARCERATED||1119.72|0||0|10/01/2019 SH 78001|49565|49565 - RPR RECRT INCAL/VNT HERNIA REDUCIBLE||914.29|0||0|10/01/2019 SH 78001|49561|49561 - RPR 1ST INCAL/VNT HERNIA INCARCERATED||1110.14|0||0|10/01/2019 SH 78001|49560|49560 - REPAIR FIRST ABDOMINAL WALL HERNIA||877.42|0||0|10/01/2019 SH 78001|49557|49557 - RPR RECRT FEM HRNA INCARCERATED||860.99|0||0|10/01/2019 SH 78001|49555|49555 - RPR RECRT FEM HERNIA REDUCIBLE||708.12|0||0|10/01/2019 SH 78001|49553|49553 - RPR 1ST FEM HERNIA ANY AGE INCARCERATED||750|0||0|10/01/2019 SH 78001|49550|49550 - RPR 1ST FEM HRNA ANY AGE REDUCIBLE||683.49|0||0|10/01/2019 SH 78001|49540|49540 - REPAIR LUMBAR HERNIA||800.52|0||0|10/01/2019 SH 78001|49525|49525 - RPR INGUN HERNIA SLIDING ANY AGE||679.73|0||0|10/01/2019 SH 78001|49521|49521 - RPR RECRT INGUN HERNIA ANY AGE INCARCERATED||851.85|0||0|10/01/2019 SH 78001|49520|49520 - RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE||751.08|0||0|10/01/2019 SH 78001|49507|49507 - RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED||694.79|0||0|10/01/2019 SH 78001|49505|49505 - RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE||616.93|0||0|10/01/2019 SH 78001|49501|49501 - RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED||719.64|0||0|10/01/2019 SH 78001|49500|49500 - RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE||485.1|0||0|10/01/2019 SH 78001|49496|49496 - RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER||652.11|0||0|10/01/2019 SH 78001|49495|49495 - RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC||442.64|0||0|10/01/2019 SH 78001|49492|49492 - RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED||1026.87|0||0|10/01/2019 SH 78001|49491|49491 - RPR 1ST INGUN HRNA PRETERM INFT RDC||891.77|0||0|10/01/2019 SH 78001|49465|49465 - CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE||181.81|0||0|10/01/2019 SH 78001|49460|49460 - OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE||812.45|0||0|10/01/2019 SH 78001|49452|49452 - REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS||1004.9|0||0|10/01/2019 SH 78001|49451|49451 - REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ||810.1|0||0|10/01/2019 SH 78001|49450|49450 - REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS||741.33|0||0|10/01/2019 SH 78001|49446|49446 - CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ||1117.35|0||0|10/01/2019 SH 78001|49442|49442 - INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS||1085.09|0||0|10/01/2019 SH 78001|49441|49441 - INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ||1305.58|0||0|10/01/2019 SH 78001|49440|49440 - INSERT GASTROSTOMY TUBE PERCUTANEOUS||1165.75|0||0|10/01/2019 SH 78001|49436|49436 - DELAYED CREATION EXIT SITE EMBEDDED CATHETER||221.31|0||0|10/01/2019 SH 78001|49435|49435 - INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER||144.42|0||0|10/01/2019 SH 78001|49429|49429 - RMVL PERITONEAL-VENOUS SHUNT||547.2|0||0|10/01/2019 SH 78001|49428|49428 - LIGATION PERITONEAL-VENOUS SHUNT||629.47|0||0|10/01/2019 SH 78001|49427|49427 - INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT||54.68|0||0|10/01/2019 SH 78001|49426|49426 - REVIS PERITONEAL-VENOUS SHUNT||730.43|0||0|10/01/2019 SH 78001|49425|49425 - INSERTION PERITONEAL-VENOUS SHUNT||870.51|0||0|10/01/2019 SH 78001|49424|49424 - CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX||164.59|0||0|10/01/2019 SH 78001|49423|49423 - EXCHNG ABSC/CST DRG CATH RAD GID SPX||611.9|0||0|10/01/2019 SH 78001|49422|49422 - REMOVAL TUNNELED INTRAPERITONEAL CATHETER||453.33|0||0|10/01/2019 SH 78001|49421|49421 - INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN||277.88|0||0|10/01/2019 SH 78001|49419|49419 - INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT||530.04|0||0|10/01/2019 SH 78001|49418|49418 - INSJ INTRAPERITONEAL CATHETER W/IMG GUID||1597.73|0||0|10/01/2019 SH 78001|49412|49412 - PLACEMENT INTRSTL DEV OPN W/IMG GUID 1/MLT||99.25|0||0|10/01/2019 SH 78001|49411|49411 - INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT||622.23|0||0|10/01/2019 SH 78001|49407|49407 - IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL||827.56|0||0|10/01/2019 SH 78001|49406|49406 - IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ||984.24|0||0|10/01/2019 SH 78001|49405|49405 - IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ||983.08|0||0|10/01/2019 SH 78001|49402|49402 - REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY||1020.71|0||0|10/01/2019 SH 78001|49400|49400 - INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX||160.2|0||0|10/01/2019 SH 78001|49329|49329 - UNLISTED LAPAROSCOPIC PX ABD PERTONEUM & OMENTUM||0|0||0|10/01/2019 SH 78001|49327|49327 - LAPS W/INSERTION NTRSTL DEV W/IMG GUID 1/MLT||157.41|0||0|10/01/2019 SH 78001|49326|49326 - LAPAROSCOPY W/OMENTOPEXY||228.63|0||0|10/01/2019 SH 78001|49325|49325 - LAPS W/REVISION INTRAPERITONEAL CATHETER||496.38|0||0|10/01/2019 SH 78001|49324|49324 - LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER||465.1|0||0|10/01/2019 SH 78001|49323|49323 - LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY||760.22|0||0|10/01/2019 SH 78001|49322|49322 - LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE||437.72|0||0|10/01/2019 SH 78001|49321|49321 - LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE||409.26|0||0|10/01/2019 SH 78001|49320|49320 - LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX||386.22|0||0|10/01/2019 SH 78001|49255|49255 - OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX||939.51|0||0|10/01/2019 SH 78001|49250|49250 - UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX||694.03|0||0|10/01/2019 SH 78001|49220|49220 - STAGING LAPAROTOMY HODGKINS DISEASE/LYMPHOMA||1159.27|0||0|10/01/2019 SH 78001|49215|49215 - EXC PRESAC/SACROCOCCYGEAL TUMOR||2632.13|0||0|10/01/2019 SH 78001|49205|49205 - EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM||2102.69|0||0|10/01/2019 SH 78001|49204|49204 - EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM||1832.3|0||0|10/01/2019 SH 78001|49203|49203 - EXCISION/DESTRUCTION OPEN ABDOMINAL TUMOR 5 CM/<||1431.81|0||0|10/01/2019 SH 78001|49185|49185 - SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID||1102.2|0||0|10/01/2019 SH 78001|49180|49180 - BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE||188.99|0||0|10/01/2019 SH 78001|49084|49084 - PERITONEAL LAVAGE W/WO IMAGING GUIDANCE||131.3|0||0|10/01/2019 SH 78001|49083|49083 - ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE||332.05|0||0|10/01/2019 SH 78001|49082|49082 - ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE||219.03|0||0|10/01/2019 SH 78001|49062|49062 - DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN||883.76|0||0|10/01/2019 SH 78001|49060|49060 - DRAINAGE OF RETROPERITONEAL ABSCESS OPEN||1313.91|0||0|10/01/2019 SH 78001|49040|49040 - DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN||1194.61|0||0|10/01/2019 SH 78001|49020|49020 - DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN||1904.13|0||0|10/01/2019 SH 78001|49010|49010 - EXPL RETROPERITONEUM W/WO BX SPX||1115.8|0||0|10/01/2019 SH 78001|49002|49002 - REOPENING RECENT LAPAROTOMY||1251.05|0||0|10/01/2019 SH 78001|49000|49000 - EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX||918.52|0||0|10/01/2019 SH 78001|48999|48999 - UNLISTED PROCEDURE PANCREAS||0|0||0|10/01/2019 SH 78001|48556|48556 - RMVL TRANSPLANTED PANCREATIC ALLOGRAFT||1514.68|0||0|10/01/2019 SH 78001|48554|48554 - TRANSPLANTATION PANCREATIC ALLOGRAFT||3033.2|0||0|10/01/2019 SH 78001|48552|48552 - BKBENCH RCNSTJ CDVR PNCRS ALGRFT VEN ANAST EA||285.27|0||0|10/01/2019 SH 78001|48551|48551 - BKBENCH PREPJ CADAVER DONOR PANCREAS ALLOGRAFT||0|0||0|10/01/2019 SH 78001|48550|48550 - DONOR PANCREATECTOMY DUODENAL SGM TRANSPLANT||0|0||0|10/01/2019 SH 78001|48548|48548 - PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST||1996.13|0||0|10/01/2019 SH 78001|48547|48547 - DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ||2148.89|0||0|10/01/2019 SH 78001|48545|48545 - PANCREATORRHAPHY INJURY||1607.86|0||0|10/01/2019 SH 78001|48540|48540 - INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y||1568.6|0||0|10/01/2019 SH 78001|48520|48520 - INT ANAST PANCREATIC CYST GI TRACT DIRECT||1306.85|0||0|10/01/2019 SH 78001|48510|48510 - EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN||1306.93|0||0|10/01/2019 SH 78001|48500|48500 - MARSUPIALIZATION PANCREATIC CYST||1371.29|0||0|10/01/2019 SH 78001|48400|48400 - INJECTION INTRAOPERATIVE PANCREATOGRAPHY||129.54|0||0|10/01/2019 SH 78001|48160|48160 - PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS||0|0||0|10/01/2019 SH 78001|48155|48155 - PANCREATECTOMY TOTAL||2164.93|0||0|10/01/2019 SH 78001|48154|48154 - PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY||3472.83|0||0|10/01/2019 SH 78001|48153|48153 - PNCRTECT W/PANCREATOJEJUNOSTOMY||3705.93|0||0|10/01/2019 SH 78001|48152|48152 - PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY||3457.09|0||0|10/01/2019 SH 78001|48150|48150 - PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY||3724.78|0||0|10/01/2019 SH 78001|48148|48148 - EXCISION AMPULLA VATER||1491.21|0||0|10/01/2019 SH 78001|48146|48146 - PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX||2244.44|0||0|10/01/2019 SH 78001|48145|48145 - PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY||1955.06|0||0|10/01/2019 SH 78001|48140|48140 - PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY||1869.3|0||0|10/01/2019 SH 78001|48120|48120 - EXCISION LESION PANCREAS||1322.35|0||0|10/01/2019 SH 78001|48105|48105 - RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS||3413.95|0||0|10/01/2019 SH 78001|48102|48102 - BIOPSY PANCREA PERCUTANEOUS NEEDLE||611.74|0||0|10/01/2019 SH 78001|48100|48100 - BIOPSY PANCREAS OPEN||1051.8|0||0|10/01/2019 SH 78001|48020|48020 - REMOVAL PANCREATIC CALCULUS||1405.63|0||0|10/01/2019 SH 78001|48001|48001 - PLACE DRAIN PERIPANCREATIC W/CHOLECYSTOSTOMY||2770.62|0||0|10/01/2019 SH 78001|48000|48000 - PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS||2252.33|0||0|10/01/2019 SH 78001|47999|47999 - UNLISTED PROCEDURE BILIARY TRACT||0|0||0|10/01/2019 SH 78001|47900|47900 - SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY||1640.17|0||0|10/01/2019 SH 78001|47802|47802 - U-TUBE HEPATICOENTEROSTOMY||1823.28|0||0|10/01/2019 SH 78001|47801|47801 - PLACEMENT CHOLEDOCHAL STENT||1201.76|0||0|10/01/2019 SH 78001|47800|47800 - RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST||1888.81|0||0|10/01/2019 SH 78001|47785|47785 - ANAST ROUX-EN-Y INTRAHEPATC BILIARY DUCTS & GI||3893.42|0||0|10/01/2019 SH 78001|47780|47780 - ANAST ROUX-EN-Y XTRHEPATC BILIARY DUCTS & GI||2959.32|0||0|10/01/2019 SH 78001|47765|47765 - ANAST INTRAHEPATC DUCTS & GI TRACT||3645.97|0||0|10/01/2019 SH 78001|47760|47760 - ANAST XTRHEPATC BILIARY DUCTS & GI TRACT||2701.74|0||0|10/01/2019 SH 78001|47741|47741 - CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM||1763.89|0||0|10/01/2019 SH 78001|47740|47740 - CHOLECYSTOENTEROSTOMY ROUX-EN-Y||1567.02|0||0|10/01/2019 SH 78001|47721|47721 - CHOLECYSTOENTEROSTOMY W/GASTROENTEROSTOMY||1616.88|0||0|10/01/2019 SH 78001|47720|47720 - CHOLECYSTOENTEROSTOMY DIRECT||1375.57|0||0|10/01/2019 SH 78001|47715|47715 - EXCISION CHOLEDOCHAL CYST||1587.81|0||0|10/01/2019 SH 78001|47712|47712 - EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC||2393.87|0||0|10/01/2019 SH 78001|47711|47711 - EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC||1855.04|0||0|10/01/2019 SH 78001|47701|47701 - PORTOENETEROSTOMY||2074.94|0||0|10/01/2019 SH 78001|47700|47700 - EXPL CONGENITAL ATRESIA BILE DUCTS||1252.72|0||0|10/01/2019 SH 78001|47630|47630 - REMOVE BILE DUCT STONE||641.57|0||0|10/01/2019 SH 78001|47620|47620 - CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP||1649.55|0||0|10/01/2019 SH 78001|47612|47612 - CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY||1517.67|0||0|10/01/2019 SH 78001|47610|47610 - CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT||1499.34|0||0|10/01/2019 SH 78001|47605|47605 - CHOLECYSTECTOMY W/CHOLANGIOGRAPHY||1340.12|0||0|10/01/2019 SH 78001|47600|47600 - CHOLECYSTECTOMY||1273.29|0||0|10/01/2019 SH 78001|47579|47579 - UNLISTED LAPAROSCOPY PROCEDURE BILIARY TRACT||0|0||0|10/01/2019 SH 78001|47570|47570 - LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY||925.24|0||0|10/01/2019 SH 78001|47564|47564 - LAPS SURG CHOLECSTC W/EXPL COMMON DUCT||1325.21|0||0|10/01/2019 SH 78001|47563|47563 - LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY||850.25|0||0|10/01/2019 SH 78001|47562|47562 - LAPAROSCOPY SURG CHOLECYSTECTOMY||782.66|0||0|10/01/2019 SH 78001|47561|47561 - LAPARO W/CHOLANGIO/BIOPSY||354.61|0||0|10/01/2019 SH 78001|47560|47560 - LAPAROSCOPY W/CHOLANGIO||323.87|0||0|10/01/2019 SH 78001|47556|47556 - BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT||511.13|0||0|10/01/2019 SH 78001|47555|47555 - BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT||450.16|0||0|10/01/2019 SH 78001|47554|47554 - BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS||581.63|0||0|10/01/2019 SH 78001|47553|47553 - BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE||378.96|0||0|10/01/2019 SH 78001|47552|47552 - BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH||380.32|0||0|10/01/2019 SH 78001|47550|47550 - BILIARY NDSC INTRAOPERATIVE||199.77|0||0|10/01/2019 SH 78001|47544|47544 - REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I||915.24|0||0|10/01/2019 SH 78001|47542|47542 - BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT||578.77|0||0|10/01/2019 SH 78001|47541|47541 - PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW||1321.52|0||0|10/01/2019 SH 78001|47540|47540 - PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH||5665.34|0||0|10/01/2019 SH 78001|47539|47539 - PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH||5443.34|0||0|10/01/2019 SH 78001|47538|47538 - PLMT BILE DUCT STENT PRQ EXISTING ACCESS||4974.01|0||0|10/01/2019 SH 78001|47537|47537 - REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I||451.03|0||0|10/01/2019 SH 78001|47536|47536 - EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I||908.67|0||0|10/01/2019 SH 78001|47535|47535 - CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH||1234.04|0||0|10/01/2019 SH 78001|47534|47534 - PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT||1845.43|0||0|10/01/2019 SH 78001|47533|47533 - PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL||1495.12|0||0|10/01/2019 SH 78001|47532|47532 - NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS||918.9|0||0|10/01/2019 SH 78001|47531|47531 - NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS||416.89|0||0|10/01/2019 SH 78001|47530|47530 - REVISE/REINSERT BILE TUBE||1546.85|0||0|10/01/2019 SH 78001|47525|47525 - CHANGE BILE DUCT CATHETER||580.46|0||0|10/01/2019 SH 78001|47511|47511 - INSERT BILE DUCT DRAIN||694.51|0||0|10/01/2019 SH 78001|47510|47510 - INSERT CATHETER BILE DUCT||563.9|0||0|10/01/2019 SH 78001|47505|47505 - INJECTION FOR LIVER X-RAYS||45.19|0||0|10/01/2019 SH 78001|47500|47500 - INJECTION FOR LIVER X-RAYS||117.12|0||0|10/01/2019 SH 78001|47490|47490 - CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT||393.75|0||0|10/01/2019 SH 78001|47480|47480 - CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX||1039.9|0||0|10/01/2019 SH 78001|47460|47460 - TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS||1513.49|0||0|10/01/2019 SH 78001|47425|47425 - CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP||1632.25|0||0|10/01/2019 SH 78001|47420|47420 - CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP||1601.92|0||0|10/01/2019 SH 78001|47400|47400 - HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1||2581.11|0||0|10/01/2019 SH 78001|47399|47399 - UNLISTED PROCEDURE LIVER||0|0||0|10/01/2019 SH 78001|47383|47383 - ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION||8394.22|0||0|10/01/2019 SH 78001|47382|47382 - ABLTJ 1/> LVR TUM PRQ RF||5587.92|0||0|10/01/2019 SH 78001|47381|47381 - ABLTJ OPN 1/> LVR TUM CRYOSURG||1617.62|0||0|10/01/2019 SH 78001|47380|47380 - ABLTJ OPN 1/> LVR TUM RF||1723.49|0||0|10/01/2019 SH 78001|47379|47379 - UNLIS LAPAROSCOPIC PROCEDURE LIVER||0|0||0|10/01/2019 SH 78001|47371|47371 - LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG||1501.55|0||0|10/01/2019 SH 78001|47370|47370 - LAPS SURG ABLTJ 1/> LVR TUM RF||1489.89|0||0|10/01/2019 SH 78001|47362|47362 - MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING||1731.48|0||0|10/01/2019 SH 78001|47361|47361 - MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR||3634.08|0||0|10/01/2019 SH 78001|47360|47360 - MGMT LVR HEMRRG CPLX SUTR WND/INJ||2235.94|0||0|10/01/2019 SH 78001|47350|47350 - MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ||1635.71|0||0|10/01/2019 SH 78001|47300|47300 - MARSUPIALIZATION CST/ABSC LVR||1352.19|0||0|10/01/2019 SH 78001|47147|47147 - BKBENCH RCNSTJ LVR GRF ARTL ANAST EA||461.9|0||0|10/01/2019 SH 78001|47146|47146 - BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA||398.2|0||0|10/01/2019 SH 78001|47145|47145 - BKBENCH PREPJ CADAVER DONOR WHL LVR GRF I&V VI||0|0||0|10/01/2019 SH 78001|47144|47144 - BKBENCH PREPJ CADAVER WHOLE LIVER GRF I&IV VII||0|0||0|10/01/2019 SH 78001|47143|47143 - BKBENCH PREP CADAVER DONOR||0|0||0|10/01/2019 SH 78001|47142|47142 - DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI||5630.27|0||0|10/01/2019 SH 78001|47141|47141 - DONOR HEPATECTOMY LIVING DONOR SEG II III & IV||5104.13|0||0|10/01/2019 SH 78001|47140|47140 - DONOR HEPATECTOMY LIVING DONOR SEG II & III||3856.98|0||0|10/01/2019 SH 78001|47136|47136 - TRANSPLANTATION OF LIVER||5024.41|0||0|10/01/2019 SH 78001|47135|47135 - LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE||5852.58|0||0|10/01/2019 SH 78001|47133|47133 - DONOR HEPATECTOMY CADAVER DONOR||0|0||0|10/01/2019 SH 78001|47130|47130 - HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY||3957.55|0||0|10/01/2019 SH 78001|47125|47125 - HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY||3681.84|0||0|10/01/2019 SH 78001|47122|47122 - HEPATECTOMY RESCJ TRISEGMENTECTOMY||4114.55|0||0|10/01/2019 SH 78001|47120|47120 - HEPATECTOMY RESCJ PARTIAL LOBECTOMY||2785.41|0||0|10/01/2019 SH 78001|47100|47100 - BIOPSY LIVER WEDGE||1004.29|0||0|10/01/2019 SH 78001|47015|47015 - LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS||1385.58|0||0|10/01/2019 SH 78001|47010|47010 - HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES||1435.24|0||0|10/01/2019 SH 78001|47001|47001 - BX LVR NDL DONE PURPOSE TM OTH MAJOR PX||125.44|0||0|10/01/2019 SH 78001|47000|47000 - BIOPSY LIVER NEEDLE PERCUTANEOUS||409.53|0||0|10/01/2019 SH 78001|46999|46999 - UNLISTED PROCEDURE ANUS||0|0||0|10/01/2019 SH 78001|46947|46947 - HEMORRHOIDOPEXY STAPLING||450.54|0||0|10/01/2019 SH 78001|46946|46946 - INT HRHC BY LIGATION 2+ HROID W/O IMG GDN||361.61|0||0|10/01/2019 SH 78001|46945|46945 - INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN||352.4|0||0|10/01/2019 SH 78001|46942|46942 - CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ||250.2|0||0|10/01/2019 SH 78001|46940|46940 - CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST||265|0||0|10/01/2019 SH 78001|46930|46930 - DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY||236.16|0||0|10/01/2019 SH 78001|46924|46924 - DSTRJ LESION ANUS EXTENSIVE||606.22|0||0|10/01/2019 SH 78001|46922|46922 - DSTRJ LESION ANUS SIMPLE SURG EXCISION||304.17|0||0|10/01/2019 SH 78001|46917|46917 - DSTRJ LESION ANUS SIMPLE LASER SURG||506.9|0||0|10/01/2019 SH 78001|46916|46916 - DSTRJ LESION ANUS SIMPLE CRYOSURGERY||261.12|0||0|10/01/2019 SH 78001|46910|46910 - DSTRJ LESION ANUS SMPL ELTRDSICCATION||291.76|0||0|10/01/2019 SH 78001|46900|46900 - DSTRJ LESION ANUS SIMPLE CHEMICAL||277.8|0||0|10/01/2019 SH 78001|46762|46762 - SPHNCTROP ANAL IMPLTJ ARTIF SPHNCTR||1097.67|0||0|10/01/2019 SH 78001|46761|46761 - SPHNCTROP ANAL LEVATOR MUSC IMBRCJ||1100.92|0||0|10/01/2019 SH 78001|46760|46760 - SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT||1299.93|0||0|10/01/2019 SH 78001|46754|46754 - RMVL THIERSCH WIRE/SUTURE ANAL CANAL||341.88|0||0|10/01/2019 SH 78001|46753|46753 - GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE||684.41|0||0|10/01/2019 SH 78001|46751|46751 - SPHNCTROP ANAL INCONTINENCE/PROLAPSE CHLD||682.2|0||0|10/01/2019 SH 78001|46750|46750 - SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT||896.05|0||0|10/01/2019 SH 78001|46748|46748 - RPR CLOACAL ANOMALY CMBN ABDL & SACROPRNL W/GRF||4567.74|0||0|10/01/2019 SH 78001|46746|46746 - RPR CLOACAL ANOMALY CMBN ABDL&SACROPRNL||4180.91|0||0|10/01/2019 SH 78001|46744|46744 - RPR CLOACAL ANOMALY SACROPERINEAL||4211.45|0||0|10/01/2019 SH 78001|46742|46742 - RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL||2667.62|0||0|10/01/2019 SH 78001|46740|46740 - RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR||2552.82|0||0|10/01/2019 SH 78001|46735|46735 - RPR HI IMPRF ANUS W/O FISTULA CMBN APPR||2424.92|0||0|10/01/2019 SH 78001|46730|46730 - RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR||2333.43|0||0|10/01/2019 SH 78001|46716|46716 - RPR LW IMPERFORATE ANUS W/TRPOS FISTULA||1269.84|0||0|10/01/2019 SH 78001|46715|46715 - RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK||638.7|0||0|10/01/2019 SH 78001|46712|46712 - RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR||2400.68|0||0|10/01/2019 SH 78001|46710|46710 - RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR||1247.01|0||0|10/01/2019 SH 78001|46707|46707 - REPAIR ANORECTAL FISTULA PLUG||557.25|0||0|10/01/2019 SH 78001|46706|46706 - REPAIR ANAL FISTULA W/FIBRIN GLUE||207.29|0||0|10/01/2019 SH 78001|46705|46705 - ANOPLASTY PLASTIC OPERATION STRICTURE INFANT||571.69|0||0|10/01/2019 SH 78001|46700|46700 - ANOPLASTY PLASTIC OPERATION STRICTURE ADULT||774.18|0||0|10/01/2019 SH 78001|46615|46615 - ANOSCOPY ABLATION LESION||166.69|0||0|10/01/2019 SH 78001|46614|46614 - ANOSCOPY CONTROL BLEEDING||147.04|0||0|10/01/2019 SH 78001|46612|46612 - ANOSC RMVL MULT TUMORS CAUTERY/SNARE||310.92|0||0|10/01/2019 SH 78001|46611|46611 - ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ||199.15|0||0|10/01/2019 SH 78001|46610|46610 - ANOSCOPY W/RMVL LESION CAUTERY||256.06|0||0|10/01/2019 SH 78001|46608|46608 - ANOSCOPY W/RMVL FOREIGN BODY||268.94|0||0|10/01/2019 SH 78001|46607|46607 - ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX||0|0||0|10/01/2019 SH 78001|46606|46606 - ANOSCOPY W/BX SINGLE/MULTIPLE||254.53|0||0|10/01/2019 SH 78001|46604|46604 - ANOSCOPY W/DILATION||696.86|0||0|10/01/2019 SH 78001|46601|46601 - ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT||0|0||0|10/01/2019 SH 78001|46600|46600 - ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD||100.1|0||0|10/01/2019 SH 78001|46505|46505 - CHEMODENERVATION INTERNAL ANAL SPHINCTER||329.9|0||0|10/01/2019 SH 78001|46500|46500 - INJECTION SCLEROSING SOLUTION HEMORRHOIDS||272.96|0||0|10/01/2019 SH 78001|46320|46320 - EXC THROMBOSED HEMORRHOID XTRNL||210.72|0||0|10/01/2019 SH 78001|46288|46288 - CLSR ANAL FSTL W/RCT ADVMNT FLAP||649.12|0||0|10/01/2019 SH 78001|46285|46285 - SURG TX ANAL FISTULA 2ND STAGE||616.91|0||0|10/01/2019 SH 78001|46280|46280 - TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON||552.56|0||0|10/01/2019 SH 78001|46275|46275 - SURG TX ANAL FISTULA INTERSPHINCTERIC||622.73|0||0|10/01/2019 SH 78001|46270|46270 - SURG TX ANAL FISTULA SUBQ||586.45|0||0|10/01/2019 SH 78001|46262|46262 - HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY||653.45|0||0|10/01/2019 SH 78001|46261|46261 - HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU||615.95|0||0|10/01/2019 SH 78001|46260|46260 - HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO||561.07|0||0|10/01/2019 SH 78001|46258|46258 - HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY||548.86|0||0|10/01/2019 SH 78001|46257|46257 - HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO||495.15|0||0|10/01/2019 SH 78001|46255|46255 - HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP||585.46|0||0|10/01/2019 SH 78001|46250|46250 - HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP||533.1|0||0|10/01/2019 SH 78001|46230|46230 - EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS||314.27|0||0|10/01/2019 SH 78001|46221|46221 - HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS||310.01|0||0|10/01/2019 SH 78001|46220|46220 - EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS||235.79|0||0|10/01/2019 SH 78001|46200|46200 - FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED||511.58|0||0|10/01/2019 SH 78001|46083|46083 - INCISION THROMBOSED HEMORRHOID EXTERNAL||200.97|0||0|10/01/2019 SH 78001|46080|46080 - SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX||285.54|0||0|10/01/2019 SH 78001|46070|46070 - INCISION ANAL SEPTUM INFANT||257.57|0||0|10/01/2019 SH 78001|46060|46060 - I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON||559.86|0||0|10/01/2019 SH 78001|46050|46050 - I&D PERIANAL ABSCESS SUPERFICIAL||228.74|0||0|10/01/2019 SH 78001|46045|46045 - I&D INTRAMURAL IM/ABSC TRANSANAL ANES||511.16|0||0|10/01/2019 SH 78001|46040|46040 - I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX||618.67|0||0|10/01/2019 SH 78001|46030|46030 - REMOVAL ANAL SETON OTHER MARKER||160.21|0||0|10/01/2019 SH 78001|46020|46020 - PLACEMENT SETON||320.2|0||0|10/01/2019 SH 78001|45999|45999 - UNLISTED PROCEDURE RECTUM||0|0||0|10/01/2019 SH 78001|45990|45990 - ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX||128.86|0||0|10/01/2019 SH 78001|45915|45915 - RMVL FECAL IMPACTION/FB SPX UNDER ANES||381.88|0||0|10/01/2019 SH 78001|45910|45910 - DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL||230.38|0||0|10/01/2019 SH 78001|45905|45905 - DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL||199.89|0||0|10/01/2019 SH 78001|45900|45900 - RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE||241.87|0||0|10/01/2019 SH 78001|45825|45825 - CLOSURE RECTOURETHRAL FISTULA W/COLOSTOMY||1726.34|0||0|10/01/2019 SH 78001|45820|45820 - CLOSURE RECTOURETHRAL FISTULA||1345.58|0||0|10/01/2019 SH 78001|45805|45805 - CLSR RECTOVESICAL FISTULA W/COLOSTOMY||1648.96|0||0|10/01/2019 SH 78001|45800|45800 - CLOSURE RECTOVESICAL FISTULA||1478.45|0||0|10/01/2019 SH 78001|45563|45563 - EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY||1966.9|0||0|10/01/2019 SH 78001|45562|45562 - EXPL RPR & PRESACRAL DRG RECTAL INJURY||1363.14|0||0|10/01/2019 SH 78001|45560|45560 - REPAIR RECTOCELE SEPARATE PROCEDURE||820.68|0||0|10/01/2019 SH 78001|45550|45550 - PROCTOPEXY W/SIGMOID RESCJ ABDL APPR||1746.77|0||0|10/01/2019 SH 78001|45541|45541 - PROCTOPEXY PERINEAL APPROACH||1117.4|0||0|10/01/2019 SH 78001|45540|45540 - PROCTOPEXY ABDOMINAL APPROACH||1268.92|0||0|10/01/2019 SH 78001|45520|45520 - PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE||178.01|0||0|10/01/2019 SH 78001|45505|45505 - PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE||701.96|0||0|10/01/2019 SH 78001|45500|45500 - PROCTOPLASTY STENOSIS||620.79|0||0|10/01/2019 SH 78001|45499|45499 - UNLISTED LAPAROSCOPY PROCEDURE RECTUM||0|0||0|10/01/2019 SH 78001|45402|45402 - LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ||1822.9|0||0|10/01/2019 SH 78001|45400|45400 - LAPAROSCOPY PROCTOPEXY PROLAPSE||1362.68|0||0|10/01/2019 SH 78001|45399|45399 - UNLISTED PROCEDURE COLON||0|0||0|10/01/2019 SH 78001|45398|45398 - COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)||0|0||0|10/01/2019 SH 78001|45397|45397 - LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR||2581.19|0||0|10/01/2019 SH 78001|45395|45395 - LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY||2368.18|0||0|10/01/2019 SH 78001|45393|45393 - COLONOSCOPY FLEXIBLE WITH DECOMPRESSION||0|0||0|10/01/2019 SH 78001|45392|45392 - COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL||444.63|0||0|10/01/2019 SH 78001|45391|45391 - COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX||349.11|0||0|10/01/2019 SH 78001|45390|45390 - COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION||0|0||0|10/01/2019 SH 78001|45389|45389 - COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT||0|0||0|10/01/2019 SH 78001|45388|45388 - COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES||0|0||0|10/01/2019 SH 78001|45386|45386 - COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT||755.04|0||0|10/01/2019 SH 78001|45385|45385 - COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ||600.08|0||0|10/01/2019 SH 78001|45384|45384 - COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS||532.67|0||0|10/01/2019 SH 78001|45382|45382 - COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD||688.57|0||0|10/01/2019 SH 78001|45381|45381 - COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST||531.63|0||0|10/01/2019 SH 78001|45380|45380 - COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE||530.36|0||0|10/01/2019 SH 78001|45379|45379 - COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)||572.94|0||0|10/01/2019 SH 78001|45378|45378 - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD||155.78|0||0|10/01/2019 SH 78001|45350|45350 - SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S)||0|0||0|10/01/2019 SH 78001|45349|45349 - SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION||0|0||0|10/01/2019 SH 78001|45347|45347 - SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT||0|0||0|10/01/2019 SH 78001|45346|45346 - SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES||0|0||0|10/01/2019 SH 78001|45342|45342 - SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX||280.2|0||0|10/01/2019 SH 78001|45341|45341 - SIGMOIDOSCOPY FLX NDSC US XM||184.3|0||0|10/01/2019 SH 78001|45340|45340 - SIGMOIDOSCOPY FLX TNDSC BALO DILAT||545.58|0||0|10/01/2019 SH 78001|45338|45338 - SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ||362.25|0||0|10/01/2019 SH 78001|45337|45337 - SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE||168.91|0||0|10/01/2019 SH 78001|45335|45335 - SGMDSC FLX DIRED SBMCSL NJX ANY SBST||309.94|0||0|10/01/2019 SH 78001|45334|45334 - SIGMOIDOSCOPY FLX CONTROL BLEEDING||193.4|0||0|10/01/2019 SH 78001|45333|45333 - SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS||335.81|0||0|10/01/2019 SH 78001|45332|45332 - SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY||330.38|0||0|10/01/2019 SH 78001|45331|45331 - SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE||184.91|0||0|10/01/2019 SH 78001|45330|45330 - SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD||155.78|0||0|10/01/2019 SH 78001|45327|45327 - PROCTOSGMDSC RIGID TNDSC STENT PLMT||146|0||0|10/01/2019 SH 78001|45321|45321 - PROCTOSGMDSC RIGID DCMPRN VOLVULUS||127.86|0||0|10/01/2019 SH 78001|45320|45320 - PROCTOSGMDSC RIGID ABLATION LESION||279.59|0||0|10/01/2019 SH 78001|45317|45317 - PROCTOSGMDSC RIGID CONTROL BLEEDING||277.42|0||0|10/01/2019 SH 78001|45315|45315 - PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE||283.17|0||0|10/01/2019 SH 78001|45309|45309 - PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ||251.57|0||0|10/01/2019 SH 78001|45308|45308 - PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY||249.61|0||0|10/01/2019 SH 78001|45307|45307 - PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY||255.17|0||0|10/01/2019 SH 78001|45305|45305 - PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE||221.8|0||0|10/01/2019 SH 78001|45303|45303 - PROCTOSGMDSC RIGID W/DILATION||1075.74|0||0|10/01/2019 SH 78001|45300|45300 - PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX||140.35|0||0|10/01/2019 SH 78001|45190|45190 - DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH||822.62|0||0|10/01/2019 SH 78001|45172|45172 - EXC RCT TUM INCL MUSCULARIS PROPRIA||960.39|0||0|10/01/2019 SH 78001|45171|45171 - EXC RCT TUM NOT INCL MUSCULARIS PROPRIA||707.93|0||0|10/01/2019 SH 78001|45160|45160 - EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL||1219.8|0||0|10/01/2019 SH 78001|45150|45150 - DIVISION STRICTURE RECTUM||426.45|0||0|10/01/2019 SH 78001|45136|45136 - EXC ILEOANAL RSVR W/ILEOSTOMY||2157.49|0||0|10/01/2019 SH 78001|45135|45135 - EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH||1644.49|0||0|10/01/2019 SH 78001|45130|45130 - EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH||1301.95|0||0|10/01/2019 SH 78001|45126|45126 - PELVIC EXENTERATION COLORECTAL MALIGNANCY||3260.64|0||0|10/01/2019 SH 78001|45123|45123 - PRCTECT PRTL W/O ANAST PRNL APPR||1340.77|0||0|10/01/2019 SH 78001|45121|45121 - PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS||1973.48|0||0|10/01/2019 SH 78001|45120|45120 - PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS||1903.02|0||0|10/01/2019 SH 78001|45119|45119 - PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM||2336.93|0||0|10/01/2019 SH 78001|45116|45116 - PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY||1859.75|0||0|10/01/2019 SH 78001|45114|45114 - PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH||2178.22|0||0|10/01/2019 SH 78001|45113|45113 - PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR||2264.15|0||0|10/01/2019 SH 78001|45112|45112 - PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX||2258.49|0||0|10/01/2019 SH 78001|45111|45111 - PRCTECT PRTL RESCJ RECTUM TABDL APPR||1299.17|0||0|10/01/2019 SH 78001|45110|45110 - PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST||2209.57|0||0|10/01/2019 SH 78001|45108|45108 - ANORECTAL MYOMECTOMY||435.41|0||0|10/01/2019 SH 78001|45100|45100 - BX ANORECTAL WALL ANAL APPROACH||353.08|0||0|10/01/2019 SH 78001|45020|45020 - I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC||674.95|0||0|10/01/2019 SH 78001|45005|45005 - I&D SUBMUCOSAL ABSCESS RECTUM||310.1|0||0|10/01/2019 SH 78001|45000|45000 - TRANSRECTAL DRAINAGE OF PELVIC ABSCESS||498.68|0||0|10/01/2019 SH 78001|44979|44979 - UNLISTED LAPAROSCOPY PROCEDURE APPENDIX||0|0||0|10/01/2019 SH 78001|44970|44970 - LAPAROSCOPIC APPENDECTOMY||714.2|0||0|10/01/2019 SH 78001|44960|44960 - APPENDEC RPTD APPENDIX ABSC/PRITONITIS||1043.08|0||0|10/01/2019 SH 78001|44955|44955 - APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX||100.93|0||0|10/01/2019 SH 78001|44950|44950 - APPENDECTOMY||766.17|0||0|10/01/2019 SH 78001|44900|44900 - INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN||924.51|0||0|10/01/2019 SH 78001|44899|44899 - UNLISTED PX MECKEL'S DIVERTICULUM & MESENTERY||0|0||0|10/01/2019 SH 78001|44850|44850 - SUTURE MESENTERY SEPARATE PROCEDURE||896.09|0||0|10/01/2019 SH 78001|44820|44820 - EXCISION LESION MESENTERY SEPARATE PROCEDURE||1012.19|0||0|10/01/2019 SH 78001|44800|44800 - EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT||911.32|0||0|10/01/2019 SH 78001|44799|44799 - UNLISTED PROCEDURE SMALL INTESTINE||0|0||0|10/01/2019 SH 78001|44721|44721 - BKBENCH RCNSTJ INT ALGRFT ARTL ANAST EA||463.85|0||0|10/01/2019 SH 78001|44720|44720 - BKBENCH RCNSTJ INT ALGRFT VEN ANAST EA||331.77|0||0|10/01/2019 SH 78001|44715|44715 - BKBENCH PREP CADAVER/LIVING DONOR INTESTINE||0|0||0|10/01/2019 SH 78001|44705|44705 - PREPARE FECAL MICROBIOTA FOR INSTILLATION||0|0||0|10/01/2019 SH 78001|44701|44701 - INTRAOPERATIVE COLONIC LAVAGE||202.82|0||0|10/01/2019 SH 78001|44700|44700 - EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS||1221.56|0||0|10/01/2019 SH 78001|44680|44680 - INTESTINAL PLICATION SEPARATE PROCEDURE||1275.76|0||0|10/01/2019 SH 78001|44661|44661 - CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ||1861.23|0||0|10/01/2019 SH 78001|44660|44660 - CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ||1602.92|0||0|10/01/2019 SH 78001|44650|44650 - CLSR ENTEROENTERIC/ENTEROCOLIC FSTL||1741.05|0||0|10/01/2019 SH 78001|44640|44640 - CLOSURE INTESTINAL CUTANEOUS FISTULA||1679.61|0||0|10/01/2019 SH 78001|44626|44626 - CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS||1921.91|0||0|10/01/2019 SH 78001|44625|44625 - CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT||1218.8|0||0|10/01/2019 SH 78001|44620|44620 - CLOSURE ENTEROSTOMY LG/SMALL INTESTINE||1038.05|0||0|10/01/2019 SH 78001|44615|44615 - INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ||1282.44|0||0|10/01/2019 SH 78001|44605|44605 - SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY||1562.54|0||0|10/01/2019 SH 78001|44604|44604 - SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY||1268.12|0||0|10/01/2019 SH 78001|44603|44603 - ENTERORRHAPHY MULTIPLE PERFORATIONS||1943.25|0||0|10/01/2019 SH 78001|44602|44602 - ENTERORRHAPHY SINGLE PERFORATION||1692.03|0||0|10/01/2019 SH 78001|44500|44500 - INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE||29.67|0||0|10/01/2019 SH 78001|44408|44408 - COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION||0|0||0|10/01/2019 SH 78001|44407|44407 - COLONOSCOPY STOMA W/US GID NDL ASPIR/BX||0|0||0|10/01/2019 SH 78001|44406|44406 - COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM||0|0||0|10/01/2019 SH 78001|44405|44405 - COLONOSCOPY STOMA W/BALLOON DILATION||0|0||0|10/01/2019 SH 78001|44404|44404 - COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION||0|0||0|10/01/2019 SH 78001|44403|44403 - COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ||0|0||0|10/01/2019 SH 78001|44402|44402 - COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT||0|0||0|10/01/2019 SH 78001|44401|44401 - COLONOSCOPY STOMA ABLATION LESION||0|0||0|10/01/2019 SH 78001|44394|44394 - COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE||567.92|0||0|10/01/2019 SH 78001|44392|44392 - COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS||502.05|0||0|10/01/2019 SH 78001|44391|44391 - COLONOSCOPY STOMA CONTROL BLEEDING||569.37|0||0|10/01/2019 SH 78001|44390|44390 - COLONOSCOPY STOMA W/RMVL FOREIGN BODY||528.84|0||0|10/01/2019 SH 78001|44389|44389 - COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE||450.62|0||0|10/01/2019 SH 78001|44388|44388 - COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX||402.36|0||0|10/01/2019 SH 78001|44386|44386 - NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE||400.83|0||0|10/01/2019 SH 78001|44385|44385 - NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX||301.82|0||0|10/01/2019 SH 78001|44384|44384 - ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT||0|0||0|10/01/2019 SH 78001|44382|44382 - ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE||95.89|0||0|10/01/2019 SH 78001|44381|44381 - ILEOSCOPY STOMA W/BALLOON DILATION||0|0||0|10/01/2019 SH 78001|44380|44380 - ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD||80.58|0||0|10/01/2019 SH 78001|44379|44379 - ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT||514.96|0||0|10/01/2019 SH 78001|44378|44378 - ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING||484|0||0|10/01/2019 SH 78001|44377|44377 - ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE||378.14|0||0|10/01/2019 SH 78001|44376|44376 - ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX||357.18|0||0|10/01/2019 SH 78001|44373|44373 - ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE||243.25|0||0|10/01/2019 SH 78001|44372|44372 - ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE||303.45|0||0|10/01/2019 SH 78001|44370|44370 - ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT||336.56|0||0|10/01/2019 SH 78001|44369|44369 - ENTEROSCOPY > 2ND PRTN ABLTJ LESION||311.68|0||0|10/01/2019 SH 78001|44366|44366 - ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING||304.61|0||0|10/01/2019 SH 78001|44365|44365 - ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY||226.15|0||0|10/01/2019 SH 78001|44364|44364 - ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE||259.41|0||0|10/01/2019 SH 78001|44363|44363 - ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY||243.25|0||0|10/01/2019 SH 78001|44361|44361 - ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY||202.92|0||0|10/01/2019 SH 78001|44360|44360 - ENDOSCOPY UPPER SMALL INTESTINE||183.86|0||0|10/01/2019 SH 78001|44346|44346 - REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX||1412.92|0||0|10/01/2019 SH 78001|44345|44345 - REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX||1255.41|0||0|10/01/2019 SH 78001|44340|44340 - REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX||740.56|0||0|10/01/2019 SH 78001|44322|44322 - COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX||1179.78|0||0|10/01/2019 SH 78001|44320|44320 - COLOSTOMY/SKIN LEVEL CECOSTOMY||1435.12|0||0|10/01/2019 SH 78001|44316|44316 - CONTINENT ILEOSTOMY KOCK PROCEDURE SPX||1692.16|0||0|10/01/2019 SH 78001|44314|44314 - REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX||1199.34|0||0|10/01/2019 SH 78001|44312|44312 - REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX||702.78|0||0|10/01/2019 SH 78001|44310|44310 - ILEOSTOMY/JEJUNOSTOMY NON-TUBE||1248.49|0||0|10/01/2019 SH 78001|44300|44300 - PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN||1003.33|0||0|10/01/2019 SH 78001|44238|44238 - UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM||0|0||0|10/01/2019 SH 78001|44227|44227 - LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS||1999.89|0||0|10/01/2019 SH 78001|44213|44213 - LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY||227.83|0||0|10/01/2019 SH 78001|44212|44212 - LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY||2455.35|0||0|10/01/2019 SH 78001|44211|44211 - LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS||2604.66|0||0|10/01/2019 SH 78001|44210|44210 - LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS||2132.15|0||0|10/01/2019 SH 78001|44208|44208 - LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST||2384.69|0||0|10/01/2019 SH 78001|44207|44207 - LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST||2186.4|0||0|10/01/2019 SH 78001|44206|44206 - LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM||2099.99|0||0|10/01/2019 SH 78001|44205|44205 - LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM||1603.12|0||0|10/01/2019 SH 78001|44204|44204 - LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS||1842.85|0||0|10/01/2019 SH 78001|44203|44203 - LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS||294.41|0||0|10/01/2019 SH 78001|44202|44202 - LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA||1657.48|0||0|10/01/2019 SH 78001|44188|44188 - LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY||1459.37|0||0|10/01/2019 SH 78001|44187|44187 - LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE||1319.34|0||0|10/01/2019 SH 78001|44186|44186 - LAPAROSCOPY SURGICAL JEJUNOSTOMY||777.23|0||0|10/01/2019 SH 78001|44180|44180 - LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE||1097.62|0||0|10/01/2019 SH 78001|44160|44160 - COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS||1484.8|0||0|10/01/2019 SH 78001|44158|44158 - COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR||2536.42|0||0|10/01/2019 SH 78001|44157|44157 - COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST||2608.44|0||0|10/01/2019 SH 78001|44156|44156 - COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST||2764.1|0||0|10/01/2019 SH 78001|44155|44155 - COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY||2486.18|0||0|10/01/2019 SH 78001|44151|44151 - COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST||2570.11|0||0|10/01/2019 SH 78001|44150|44150 - COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS||2232.75|0||0|10/01/2019 SH 78001|44147|44147 - COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH||2331.19|0||0|10/01/2019 SH 78001|44146|44146 - COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY||2538.23|0||0|10/01/2019 SH 78001|44145|44145 - COLECTOMY PRTL W/COLOPROCTOSTOMY||1986.49|0||0|10/01/2019 SH 78001|44144|44144 - COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA||2118.42|0||0|10/01/2019 SH 78001|44143|44143 - COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT||1990.46|0||0|10/01/2019 SH 78001|44141|44141 - COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY||2179.66|0||0|10/01/2019 SH 78001|44140|44140 - COLECTOMY PARTIAL W/ANASTOMOSIS||1604.73|0||0|10/01/2019 SH 78001|44139|44139 - MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT||146.27|0||0|10/01/2019 SH 78001|44137|44137 - RMVL TRNSPLED INTESTINAL ALLOGRAFT COMPL||0|0||0|10/01/2019 SH 78001|44136|44136 - INTESTINAL ALLOTRANSPLANTATION LIVING DONOR||0|0||0|10/01/2019 SH 78001|44135|44135 - INTESTINAL ALLOTRANSPLANTATION CADAVER DONOR||0|0||0|10/01/2019 SH 78001|44133|44133 - DONOR ENTERECTOMY OPEN LIVING DONOR||0|0||0|10/01/2019 SH 78001|44132|44132 - DONOR ENTERECTOMY OPEN CADAVER DONOR||0|0||0|10/01/2019 SH 78001|44130|44130 - ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX||1569.65|0||0|10/01/2019 SH 78001|44128|44128 - ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS||294.41|0||0|10/01/2019 SH 78001|44127|44127 - ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING||3423.51|0||0|10/01/2019 SH 78001|44126|44126 - ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING||2958.58|0||0|10/01/2019 SH 78001|44125|44125 - ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY||1412.4|0||0|10/01/2019 SH 78001|44121|44121 - ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA||292.07|0||0|10/01/2019 SH 78001|44120|44120 - ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST||1463.59|0||0|10/01/2019 SH 78001|44111|44111 - EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE||1175.6|0||0|10/01/2019 SH 78001|44110|44110 - EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM||1017.39|0||0|10/01/2019 SH 78001|44100|44100 - BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS||134.03|0||0|10/01/2019 SH 78001|44055|44055 - CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS||1782.86|0||0|10/01/2019 SH 78001|44050|44050 - RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT||1116.96|0||0|10/01/2019 SH 78001|44025|44025 - COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL||1179.43|0||0|10/01/2019 SH 78001|44021|44021 - ENTEROTOMY SM INT OTH/THN DUO DCMPRN||1166.16|0||0|10/01/2019 SH 78001|44020|44020 - ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL||1164.62|0||0|10/01/2019 SH 78001|44015|44015 - TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD||172.03|0||0|10/01/2019 SH 78001|44010|44010 - DUODENOTOMY EXPLORATION/BX/FOREIGN BODY REMOVAL||1035.38|0||0|10/01/2019 SH 78001|44005|44005 - ENTEROLSS FRING INTSTINAL ADHESION SPX||1307.83|0||0|10/01/2019 SH 78001|43999|43999 - UNLISTED PROCEDURE STOMACH||0|0||0|10/01/2019 SH 78001|43888|43888 - GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT||542.79|0||0|10/01/2019 SH 78001|43887|43887 - GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY||384.59|0||0|10/01/2019 SH 78001|43886|43886 - GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY||425.54|0||0|10/01/2019 SH 78001|43882|43882 - REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN||0|0||0|10/01/2019 SH 78001|43881|43881 - IMPLTJ/RPLCMT GASTRIC NSTIM ELTRDE ANTRUM OPEN||0|0||0|10/01/2019 SH 78001|43880|43880 - CLOSURE GASTROCOLIC FISTULA||1908.73|0||0|10/01/2019 SH 78001|43870|43870 - CLOSURE GASTROSTOMY SURG||849.72|0||0|10/01/2019 SH 78001|43865|43865 - REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY||2048.83|0||0|10/01/2019 SH 78001|43860|43860 - REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY||1960.32|0||0|10/01/2019 SH 78001|43855|43855 - REVJ GASTRODUOL ANAST W/RCNSTJ W/VGTMY||2025.14|0||0|10/01/2019 SH 78001|43850|43850 - REVJ GASTRODUOL ANAST W/RCNSTJ W/O VAGOTOMY||1951.25|0||0|10/01/2019 SH 78001|43848|43848 - REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE||2304.26|0||0|10/01/2019 SH 78001|43847|43847 - GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ||2158.53|0||0|10/01/2019 SH 78001|43846|43846 - GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<||1930.3|0||0|10/01/2019 SH 78001|43845|43845 - GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM||2350.51|0||0|10/01/2019 SH 78001|43843|43843 - GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP||1531.66|0||0|10/01/2019 SH 78001|43842|43842 - GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY||1372.32|0||0|10/01/2019 SH 78001|43840|43840 - GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ||1624.04|0||0|10/01/2019 SH 78001|43832|43832 - GASTROSTOMY OPN W/CONSTJ GSTR TUBE||1243.98|0||0|10/01/2019 SH 78001|43831|43831 - GASTROSTOMY OPN NEONATAL FEEDING||703.78|0||0|10/01/2019 SH 78001|43830|43830 - GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX||830.84|0||0|10/01/2019 SH 78001|43825|43825 - GASTROJEJUNOSTOMY W/VAGOTOMY ANY TYPE||1565.86|0||0|10/01/2019 SH 78001|43820|43820 - GASTROJEJUNOSTOMY W/O VAGOTOMY||1603.34|0||0|10/01/2019 SH 78001|43810|43810 - GASTRODUODENOSTOMY||1217.96|0||0|10/01/2019 SH 78001|43800|43800 - PYLOROPLASTY||1110.37|0||0|10/01/2019 SH 78001|43775|43775 - LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY||0|0||0|10/01/2019 SH 78001|43774|43774 - LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT||1145.15|0||0|10/01/2019 SH 78001|43773|43773 - LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE||1527.47|0||0|10/01/2019 SH 78001|43772|43772 - LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE||1135.97|0||0|10/01/2019 SH 78001|43771|43771 - LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE||1516.2|0||0|10/01/2019 SH 78001|43770|43770 - LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE||1333.35|0||0|10/01/2019 SH 78001|43761|43761 - REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO||139.05|0||0|10/01/2019 SH 78001|43760|43760 - CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GDNCE||545.89|0||0|10/01/2019 SH 78001|43757|43757 - DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN||331.93|0||0|10/01/2019 SH 78001|43756|43756 - DUODENAL INTUBAT W/IMAG GUIDED SINGLE SPECIMEN||231.7|0||0|10/01/2019 SH 78001|43755|43755 - GASTRIC INTUBATION DX & ASPIRATJ MULTIPLE SPEC||158.43|0||0|10/01/2019 SH 78001|43754|43754 - GASTRIC INTUBAT DX W/ASPIRATION SINGLE SPECIMEN||146.57|0||0|10/01/2019 SH 78001|43753|43753 - GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE||26|0||0|10/01/2019 SH 78001|43752|43752 - NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE||49.68|0||0|10/01/2019 SH 78001|43659|43659 - UNLISTED LAPAROSCOPIC PROCEDURE STOMACH||0|0||0|10/01/2019 SH 78001|43653|43653 - LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX||678.54|0||0|10/01/2019 SH 78001|43652|43652 - LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV||911.33|0||0|10/01/2019 SH 78001|43651|43651 - LAPS SURG TRNSXJ VAGUS NRV TRUNCAL||778.85|0||0|10/01/2019 SH 78001|43648|43648 - LAPS REVISION/RMVL GASTRIC NSTIM ELTRD ANTRUM||0|0||0|10/01/2019 SH 78001|43647|43647 - LAPS IMPLTJ/RPLCMT GASTRIC NSTIM ELTRD ANTRUM||0|0||0|10/01/2019 SH 78001|43645|43645 - LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ||2215.93|0||0|10/01/2019 SH 78001|43644|43644 - LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM||2073.19|0||0|10/01/2019 SH 78001|43641|43641 - VGTMY W/PYLOROPLASTY W/WO GASTROST PARIETAL CELL||1436.71|0||0|10/01/2019 SH 78001|43640|43640 - VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV||1406.89|0||0|10/01/2019 SH 78001|43635|43635 - VAGOTOMY PFRMD W/PRTL DSTL GSTRCT||135.84|0||0|10/01/2019 SH 78001|43634|43634 - GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH||2551.72|0||0|10/01/2019 SH 78001|43633|43633 - GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ||2301.72|0||0|10/01/2019 SH 78001|43632|43632 - GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY||2435.75|0||0|10/01/2019 SH 78001|43631|43631 - GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY||1735.73|0||0|10/01/2019 SH 78001|43622|43622 - GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYPE||2776.77|0||0|10/01/2019 SH 78001|43621|43621 - GSTRCT TOT W/ROUX-EN-Y RCNSTJ||2723.74|0||0|10/01/2019 SH 78001|43620|43620 - GSTRCT TOT W/ESOPHAGOENTEROSTOMY||2360.74|0||0|10/01/2019 SH 78001|43611|43611 - EXC LOCAL MALIGNANT TUMOR STOMACH||1459.34|0||0|10/01/2019 SH 78001|43610|43610 - EXC LOCAL ULCER/BENIGN TUMOR STOMACH||1172.91|0||0|10/01/2019 SH 78001|43605|43605 - BIOPSY STOMACH LAPAROTOMY||997|0||0|10/01/2019 SH 78001|43520|43520 - PYLOROMYOTOMY CUTTING PYLORIC MUSC||819.61|0||0|10/01/2019 SH 78001|43510|43510 - GSTRT W/ESOPHGL DILAT&INSJ PRM INTRAL TUBE||1127.72|0||0|10/01/2019 SH 78001|43502|43502 - GASTROTOMY W/SUTR RPR PRE-ESOPG/GASTRIC LAC||1826.24|0||0|10/01/2019 SH 78001|43501|43501 - GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER||1611.4|0||0|10/01/2019 SH 78001|43500|43500 - GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL||935.51|0||0|10/01/2019 SH 78001|43499|43499 - UNLISTED PROCEDURE ESOPHAGUS||0|0||0|10/01/2019 SH 78001|43496|43496 - FREE JEJUNUM TRSF W/MICROVASC ANASTOMOSIS||0|0||0|10/01/2019 SH 78001|43460|43460 - ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE||263.95|0||0|10/01/2019 SH 78001|43453|43453 - DILATION ESOPHAGUS GUIDE WIRE||1088.94|0||0|10/01/2019 SH 78001|43450|43450 - DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS||243.3|0||0|10/01/2019 SH 78001|43425|43425 - CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR||1746.62|0||0|10/01/2019 SH 78001|43420|43420 - CLSR ESOPHAGOSTOMY/FSTL CRV APPR||1217.18|0||0|10/01/2019 SH 78001|43415|43415 - SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR||3089.95|0||0|10/01/2019 SH 78001|43410|43410 - SUTR ESOPHGL WND/INJ CRV APPR||1255.04|0||0|10/01/2019 SH 78001|43405|43405 - LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J||1840.62|0||0|10/01/2019 SH 78001|43401|43401 - TRNSXJ ESOPH W/RPR ESOPHAGEAL VARICES||1881.32|0||0|10/01/2019 SH 78001|43400|43400 - LIGATION DIRECT ESOPHAGEAL VARICES||1822.35|0||0|10/01/2019 SH 78001|43361|43361 - GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT||3091.23|0||0|10/01/2019 SH 78001|43360|43360 - GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH||2855.42|0||0|10/01/2019 SH 78001|43352|43352 - ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR||1287.57|0||0|10/01/2019 SH 78001|43351|43351 - ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR||1662.11|0||0|10/01/2019 SH 78001|43341|43341 - ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR||1771.73|0||0|10/01/2019 SH 78001|43340|43340 - ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR||1649.2|0||0|10/01/2019 SH 78001|43338|43338 - ESOPHAGUS LENGTHENING||140.76|0||0|10/01/2019 SH 78001|43337|43337 - RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH||1961.25|0||0|10/01/2019 SH 78001|43336|43336 - RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH||1825.22|0||0|10/01/2019 SH 78001|43335|43335 - RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH||1625.22|0||0|10/01/2019 SH 78001|43334|43334 - RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH||1511.6|0||0|10/01/2019 SH 78001|43333|43333 - LAPT RPR PARAESOPH HIATAL HERNIA W/MESH||1514.89|0||0|10/01/2019 SH 78001|43332|43332 - RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH||1391.27|0||0|10/01/2019 SH 78001|43331|43331 - ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH||1620.82|0||0|10/01/2019 SH 78001|43330|43330 - ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH||1596.05|0||0|10/01/2019 SH 78001|43328|43328 - ESOPG/GSTR FUNDOPLASTY W/THORACOTOMY||1367.37|0||0|10/01/2019 SH 78001|43327|43327 - ESOPG/GSTR FUNDOPLASTY W/LAPAROTOMY||975.61|0||0|10/01/2019 SH 78001|43325|43325 - ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH||1610.63|0||0|10/01/2019 SH 78001|43320|43320 - EGST W/WO VAGOTOMY&PYLOROPLASTY TABDL/TTHRC AP||1671.16|0||0|10/01/2019 SH 78001|43314|43314 - ESPHGP CGEN DFCT THRC APPR W/RPR FSTL||3381.99|0||0|10/01/2019 SH 78001|43313|43313 - ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL||3129.19|0||0|10/01/2019 SH 78001|43312|43312 - ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL||1940|0||0|10/01/2019 SH 78001|43310|43310 - ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL||1782.61|0||0|10/01/2019 SH 78001|43305|43305 - ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL||1305.54|0||0|10/01/2019 SH 78001|43300|43300 - ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL||731.72|0||0|10/01/2019 SH 78001|43289|43289 - UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS||0|0||0|10/01/2019 SH 78001|43288|43288 - ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ||4599.62|0||0|10/01/2019 SH 78001|43287|43287 - ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ||4410.45|0||0|10/01/2019 SH 78001|43286|43286 - ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ||3857.14|0||0|10/01/2019 SH 78001|43285|43285 - REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE||818.69|0||0|10/01/2019 SH 78001|43284|43284 - LAPS ESOPHGL SPHNCTR AGMNTJ PLMT DEV CRRPL||809.22|0||0|10/01/2019 SH 78001|43283|43283 - LAPS ESOPHAGEAL LENGTHENING ADDL||192.09|0||0|10/01/2019 SH 78001|43282|43282 - LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH||2082.87|0||0|10/01/2019 SH 78001|43281|43281 - LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH||1851.53|0||0|10/01/2019 SH 78001|43280|43280 - LAPS SURG ESOPG/GSTR FUNDOPLASTY||1293.47|0||0|10/01/2019 SH 78001|43279|43279 - LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED||1550.28|0||0|10/01/2019 SH 78001|43278|43278 - ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE||543.38|0||0|10/01/2019 SH 78001|43277|43277 - ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA||475.72|0||0|10/01/2019 SH 78001|43276|43276 - ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE||604.02|0||0|10/01/2019 SH 78001|43275|43275 - ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT||473.22|0||0|10/01/2019 SH 78001|43274|43274 - ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT||580.34|0||0|10/01/2019 SH 78001|43273|43273 - ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC||148.6|0||0|10/01/2019 SH 78001|43270|43270 - EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE||861.83|0||0|10/01/2019 SH 78001|43266|43266 - EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION||286.55|0||0|10/01/2019 SH 78001|43265|43265 - ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD||543.82|0||0|10/01/2019 SH 78001|43264|43264 - ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT||458.26|0||0|10/01/2019 SH 78001|43263|43263 - ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI||450.71|0||0|10/01/2019 SH 78001|43262|43262 - ERCP W/SPHINCTEROTOMY/PAPILLOTOMY||449.55|0||0|10/01/2019 SH 78001|43261|43261 - ERCP W/BIOPSY SINGLE/MULTIPLE||425.91|0||0|10/01/2019 SH 78001|43260|43260 - ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING||406.77|0||0|10/01/2019 SH 78001|43259|43259 - EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM||286.8|0||0|10/01/2019 SH 78001|43257|43257 - EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD||294.27|0||0|10/01/2019 SH 78001|43255|43255 - EGD TRANSORAL CONTROL BLEEDING ANY METHOD||496.74|0||0|10/01/2019 SH 78001|43254|43254 - EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION||341.61|0||0|10/01/2019 SH 78001|43253|43253 - EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER||333.24|0||0|10/01/2019 SH 78001|43252|43252 - EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY||423.95|0||0|10/01/2019 SH 78001|43251|43251 - EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH||574.65|0||0|10/01/2019 SH 78001|43250|43250 - EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS||522.46|0||0|10/01/2019 SH 78001|43249|43249 - EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM||1215.03|0||0|10/01/2019 SH 78001|43248|43248 - EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS||471.79|0||0|10/01/2019 SH 78001|43247|43247 - EGD FLEXIBLE FOREIGN BODY REMOVAL||468.02|0||0|10/01/2019 SH 78001|43246|43246 - EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE||252.92|0||0|10/01/2019 SH 78001|43245|43245 - EGD DILATION GASTRIC/DUODENAL STRICTURE||699.71|0||0|10/01/2019 SH 78001|43244|43244 - EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES||311.25|0||0|10/01/2019 SH 78001|43243|43243 - EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES||300.22|0||0|10/01/2019 SH 78001|43242|43242 - EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY||333.24|0||0|10/01/2019 SH 78001|43241|43241 - EGD INTRALUMINAL TUBE/CATHETER INSERTION||181.93|0||0|10/01/2019 SH 78001|43240|43240 - EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST||492.72|0||0|10/01/2019 SH 78001|43239|43239 - EGD TRANSORAL BIOPSY SINGLE/MULTIPLE||455.94|0||0|10/01/2019 SH 78001|43238|43238 - EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS||295.47|0||0|10/01/2019 SH 78001|43237|43237 - ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS||248.25|0||0|10/01/2019 SH 78001|43236|43236 - ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION||445.09|0||0|10/01/2019 SH 78001|43235|43235 - ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC||358.11|0||0|10/01/2019 SH 78001|43233|43233 - EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER||286.15|0||0|10/01/2019 SH 78001|43232|43232 - ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX||549.58|0||0|10/01/2019 SH 78001|43231|43231 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM||461.62|0||0|10/01/2019 SH 78001|43229|43229 - ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION||825.17|0||0|10/01/2019 SH 78001|43227|43227 - ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL||452.33|0||0|10/01/2019 SH 78001|43226|43226 - ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION||433.2|0||0|10/01/2019 SH 78001|43220|43220 - ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM||1268.69|0||0|10/01/2019 SH 78001|43217|43217 - ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE||510.09|0||0|10/01/2019 SH 78001|43216|43216 - ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS||477.26|0||0|10/01/2019 SH 78001|43215|43215 - ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY||465.87|0||0|10/01/2019 SH 78001|43214|43214 - ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM||242.51|0||0|10/01/2019 SH 78001|43213|43213 - ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER||1390.71|0||0|10/01/2019 SH 78001|43212|43212 - ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT||239.83|0||0|10/01/2019 SH 78001|43211|43211 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN||300.69|0||0|10/01/2019 SH 78001|43210|43210 - EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY||512.8|0||0|10/01/2019 SH 78001|43206|43206 - ESOPHAGOSCOPY TRANSORAL W/OPTICAL ENDOMICROSCOPY||377.21|0||0|10/01/2019 SH 78001|43205|43205 - ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES||179.77|0||0|10/01/2019 SH 78001|43204|43204 - ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES||174.25|0||0|10/01/2019 SH 78001|43202|43202 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY||411.15|0||0|10/01/2019 SH 78001|43201|43201 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ||315.01|0||0|10/01/2019 SH 78001|43200|43200 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC||307.1|0||0|10/01/2019 SH 78001|43198|43198 - ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY||242.9|0||0|10/01/2019 SH 78001|43197|43197 - ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC||215.61|0||0|10/01/2019 SH 78001|43196|43196 - ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION||235.86|0||0|10/01/2019 SH 78001|43195|43195 - ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION||222.41|0||0|10/01/2019 SH 78001|43194|43194 - ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY||230.93|0||0|10/01/2019 SH 78001|43193|43193 - ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY||203.35|0||0|10/01/2019 SH 78001|43192|43192 - ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL||203.74|0||0|10/01/2019 SH 78001|43191|43191 - ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH||183.42|0||0|10/01/2019 SH 78001|43180|43180 - ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH||666.88|0||0|10/01/2019 SH 78001|43135|43135 - DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR||1798.5|0||0|10/01/2019 SH 78001|43130|43130 - DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR||939.27|0||0|10/01/2019 SH 78001|43124|43124 - TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY||4625.98|0||0|10/01/2019 SH 78001|43123|43123 - PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ||5722.85|0||0|10/01/2019 SH 78001|43122|43122 - PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL||3077.59|0||0|10/01/2019 SH 78001|43121|43121 - PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY||3468.94|0||0|10/01/2019 SH 78001|43118|43118 - PRTL ESOPH DSTL W/WO PROX GASTRC W/COLON NTRPSTJ||4606.24|0||0|10/01/2019 SH 78001|43117|43117 - PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY||2974.87|0||0|10/01/2019 SH 78001|43116|43116 - PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF||6284.33|0||0|10/01/2019 SH 78001|43113|43113 - TOT ESOPHG W/THORCOM W/COLON NTRPSTJ/INT RCNSTJ||5292.23|0||0|10/01/2019 SH 78001|43112|43112 - TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY||3251.1|0||0|10/01/2019 SH 78001|43108|43108 - TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ||5653.13|0||0|10/01/2019 SH 78001|43107|43107 - TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY||3079.94|0||0|10/01/2019 SH 78001|43101|43101 - EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR||1271.13|0||0|10/01/2019 SH 78001|43100|43100 - EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR||746.74|0||0|10/01/2019 SH 78001|43045|43045 - ESOPHAGOTOMY THORACIC APPR W/RMVL FB||1569.1|0||0|10/01/2019 SH 78001|43030|43030 - CRICOPHARYNGEAL MYOTOMY||618.1|0||0|10/01/2019 SH 78001|43020|43020 - ESOPHAGOTOMY CERVICAL APPR W/RMVL FB||671.24|0||0|10/01/2019 SH 78001|42999|42999 - UNLISTED PROCEDURE PHARYNX ADENOIDS/TONSILS||0|0||0|10/01/2019 SH 78001|42972|42972 - CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ||608.57|0||0|10/01/2019 SH 78001|42971|42971 - CTRL NASOPHARYNGEAL HEMRRG COMP REQ HOSPIZATION||542.98|0||0|10/01/2019 SH 78001|42970|42970 - CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS||491.1|0||0|10/01/2019 SH 78001|42962|42962 - CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ||615.88|0||0|10/01/2019 SH 78001|42961|42961 - CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ||500.96|0||0|10/01/2019 SH 78001|42960|42960 - CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE||202.33|0||0|10/01/2019 SH 78001|42955|42955 - PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING||879.44|0||0|10/01/2019 SH 78001|42953|42953 - PHARYNGOESOPHAGEAL REPAIR||1113.71|0||0|10/01/2019 SH 78001|42950|42950 - PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX||927.1|0||0|10/01/2019 SH 78001|42900|42900 - SUTURE PHARYNX WOUND/INJURY||403.88|0||0|10/01/2019 SH 78001|42894|42894 - RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS||2788.66|0||0|10/01/2019 SH 78001|42892|42892 - RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR||2220.29|0||0|10/01/2019 SH 78001|42890|42890 - LIMITED PHARYNGECTOMY||1667.47|0||0|10/01/2019 SH 78001|42870|42870 - EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX||674.3|0||0|10/01/2019 SH 78001|42860|42860 - EXCISION TONSIL TAGS||222.14|0||0|10/01/2019 SH 78001|42845|42845 - RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP||2631.16|0||0|10/01/2019 SH 78001|42844|42844 - RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP||1616.58|0||0|10/01/2019 SH 78001|42842|42842 - RADICAL RESECTION TONSIL W/O CLOSURE||1172.42|0||0|10/01/2019 SH 78001|42836|42836 - ADENOIDECTOMY SECONDARY AGE 12/>||284.88|0||0|10/01/2019 SH 78001|42835|42835 - ADENOIDECTOMY SECONDARY||263.14|0||0|10/01/2019 SH 78001|42830|42830 - ADENOIDECTOMY PRIMARY ||297.34|0||0|10/01/2019 SH 78001|42825|42825 - TONSILLECTOMY PRIMARY/SECONDARY ||357.16|0||0|10/01/2019 SH 78001|42820|42820 - TONSILLECTOMY & ADENOIDECTOMY 2 CM/COMPLEX||375.94|0||0|10/01/2019 SH 78001|42180|42180 - REPAIR LACERATION PALATE SITES PR SESSION||3603.23|0||0|10/01/2019 SH 78001|41520|41520 - FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY||413.65|0||0|10/01/2019 SH 78001|41512|41512 - TONGUE BASE SUSPENSION PERMANENT SUTURE TQ||746.08|0||0|10/01/2019 SH 78001|41510|41510 - SUTURE TONGUE LIP MICROGNATHIA||464.63|0||0|10/01/2019 SH 78001|41500|41500 - FIXJ TONGUE MECHANICAL OTHER/THAN SUTURE||531.08|0||0|10/01/2019 SH 78001|41252|41252 - RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX||368.73|0||0|10/01/2019 SH 78001|41251|41251 - RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE||339.69|0||0|10/01/2019 SH 78001|41250|41250 - RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG||311.35|0||0|10/01/2019 SH 78001|41155|41155 - GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ & RAD NECK||3559.57|0||0|10/01/2019 SH 78001|41153|41153 - GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ||2820.99|0||0|10/01/2019 SH 78001|41150|41150 - GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ||2579.79|0||0|10/01/2019 SH 78001|41145|41145 - GLSSC COMPL/TOT W/WO TRACHS W/UNI RAD NECK DSJ||3250.54|0||0|10/01/2019 SH 78001|41140|41140 - GLSSC COMPL/TOT W/WOTRACHS W/O RAD NECK DSJ||2565.03|0||0|10/01/2019 SH 78001|41135|41135 - GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ||2557.77|0||0|10/01/2019 SH 78001|41130|41130 - GLOSSECTOMY HEMIGLOSSECTOMY||1530.11|0||0|10/01/2019 SH 78001|41120|41120 - GLOSSECTOMY 2.5 CM/CPL||391.56|0||0|10/01/2019 SH 78001|40830|40830 - CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<||308.03|0||0|10/01/2019 SH 78001|40820|40820 - DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS||305.92|0||0|10/01/2019 SH 78001|40819|40819 - EXC FRENUM LABIAL/BUCCAL||366.5|0||0|10/01/2019 SH 78001|40818|40818 - EXC MUCOSA VESTIBULE MOUTH AS DON GRF||418.66|0||0|10/01/2019 SH 78001|40816|40816 - EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC||471.65|0||0|10/01/2019 SH 78001|40814|40814 - EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR||452.33|0||0|10/01/2019 SH 78001|40812|40812 - EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR||336.81|0||0|10/01/2019 SH 78001|40810|40810 - EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR||238.95|0||0|10/01/2019 SH 78001|40808|40808 - BIOPSY VESTIBULE MOUTH||215.32|0||0|10/01/2019 SH 78001|40806|40806 - INCISION LABIAL FRENUM FRENOTOMY||122.7|0||0|10/01/2019 SH 78001|40805|40805 - RMVL EMBEDDED FB VESTIBULE MOUTH COMP||377.81|0||0|10/01/2019 SH 78001|40804|40804 - RMVL EMBEDDED FB VESTIBULE MOUTH SMPL||244.88|0||0|10/01/2019 SH 78001|40801|40801 - DRG ABSC CST HMTMA VESTIBULE MOUTH COMP||369.74|0||0|10/01/2019 SH 78001|40800|40800 - DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL||244.58|0||0|10/01/2019 SH 78001|40799|40799 - UNLISTED PROCEDURE LIPS||0|0||0|10/01/2019 SH 78001|40761|40761 - PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP||1163.44|0||0|10/01/2019 SH 78001|40720|40720 - PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL||1216.35|0||0|10/01/2019 SH 78001|40702|40702 - PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS||1115.26|0||0|10/01/2019 SH 78001|40701|40701 - PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX||1169.64|0||0|10/01/2019 SH 78001|40700|40700 - PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI||1189.13|0||0|10/01/2019 SH 78001|40654|40654 - RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE||658.64|0||0|10/01/2019 SH 78001|40652|40652 - RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT||569.13|0||0|10/01/2019 SH 78001|40650|40650 - RPR LIP FULL THICKNESS VERMILION ONLY||504.64|0||0|10/01/2019 SH 78001|40530|40530 - RESCJ LIP > ONE-FOURTH W/O RCNSTJ||627.11|0||0|10/01/2019 SH 78001|40527|40527 - EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP||733.61|0||0|10/01/2019 SH 78001|40525|40525 - EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP||651.41|0||0|10/01/2019 SH 78001|40520|40520 - EXC LIP V-EXC W/PRIM DIR LINR CLSR||568.39|0||0|10/01/2019 SH 78001|40510|40510 - EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR||562.71|0||0|10/01/2019 SH 78001|40500|40500 - VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT||584.03|0||0|10/01/2019 SH 78001|40490|40490 - BIOPSY OF LIP||148|0||0|10/01/2019 SH 78001|39599|39599 - UNLISTED PROCEDURE DIAPHRAGM||0|0||0|10/01/2019 SH 78001|39561|39561 - RESCJ DIAPHRAGM W/COMPLEX REPAIR||1478.95|0||0|10/01/2019 SH 78001|39560|39560 - RESCJ DIAPHRAGM W/SIMPLE REPAIR||952.61|0||0|10/01/2019 SH 78001|39545|39545 - IMBRICATION DIAPHRAGM EVENTRATION||1069.03|0||0|10/01/2019 SH 78001|39541|39541 - RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC||1132.72|0||0|10/01/2019 SH 78001|39540|39540 - RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT||1039.52|0||0|10/01/2019 SH 78001|39503|39503 - RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ||7396.41|0||0|10/01/2019 SH 78001|39501|39501 - REPAIR LACERATION DIAPHRAGM ANY APPROACH||1015.19|0||0|10/01/2019 SH 78001|39499|39499 - UNLISTED PROCEDURE MEDIASTINUM||0|0||0|10/01/2019 SH 78001|39402|39402 - MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES||488.39|0||0|10/01/2019 SH 78001|39401|39401 - MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY||373.45|0||0|10/01/2019 SH 78001|39400|39400 - MEDIASTINOSCOPY INCL BIOPSY||608.42|0||0|10/01/2019 SH 78001|39220|39220 - RESECTION MEDIASTINAL TUMOR||1369.6|0||0|10/01/2019 SH 78001|39200|39200 - RESECTION OF MEDIASTINAL CYST||1057.72|0||0|10/01/2019 SH 78001|39010|39010 - MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR||945.43|0||0|10/01/2019 SH 78001|39000|39000 - MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR||591.94|0||0|10/01/2019 SH 78001|38999|38999 - UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM||0|0||0|10/01/2019 SH 78001|38900|38900 - INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION||165.69|0||0|10/01/2019 SH 78001|38794|38794 - CANNULATION THORACIC DUCT||357.48|0||0|10/01/2019 SH 78001|38792|38792 - INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE||46.47|0||0|10/01/2019 SH 78001|38790|38790 - INJECTION PROCEDURE LYMPHANGIOGRAPHY||99.48|0||0|10/01/2019 SH 78001|38780|38780 - RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL||1225.13|0||0|10/01/2019 SH 78001|38770|38770 - PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR||963.37|0||0|10/01/2019 SH 78001|38765|38765 - INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC||1543.51|0||0|10/01/2019 SH 78001|38760|38760 - INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX||1001.95|0||0|10/01/2019 SH 78001|38747|38747 - ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC||321.92|0||0|10/01/2019 SH 78001|38746|38746 - THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC||261.59|0||0|10/01/2019 SH 78001|38745|38745 - AXILLARY LYMPHADENECTOMY COMPLETE||1040.7|0||0|10/01/2019 SH 78001|38740|38740 - AXILLARY LYMPHADENECTOMY SUPERFICIAL||823.61|0||0|10/01/2019 SH 78001|38724|38724 - CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ||1733.24|0||0|10/01/2019 SH 78001|38720|38720 - CERVICAL LYMPHADENECTOMY||1600.86|0||0|10/01/2019 SH 78001|38700|38700 - SUPRAHYOID LYMPHADENECTOMY||958.67|0||0|10/01/2019 SH 78001|38589|38589 - UNLISTED LAPAROSCOPY PX LYMPHATIC SYSTEM||0|0||0|10/01/2019 SH 78001|38573|38573 - LAPS W/BI TOT PEL LMPHADEC & OMNTC LYMPH BX||1417.86|0||0|10/01/2019 SH 78001|38572|38572 - LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1||1177.37|0||0|10/01/2019 SH 78001|38571|38571 - LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY||956.29|0||0|10/01/2019 SH 78001|38570|38570 - LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT||642.27|0||0|10/01/2019 SH 78001|38564|38564 - LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC||838.58|0||0|10/01/2019 SH 78001|38562|38562 - LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC||836.35|0||0|10/01/2019 SH 78001|38555|38555 - EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ||1195.6|0||0|10/01/2019 SH 78001|38550|38550 - EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ||599.24|0||0|10/01/2019 SH 78001|38542|38542 - DISSECTION DEEP JUGULAR NODE||613.69|0||0|10/01/2019 SH 78001|38530|38530 - BX/EXC LYMPH NODE OPEN INT MAMMARY NODE||648.04|0||0|10/01/2019 SH 78001|38525|38525 - BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE||516|0||0|10/01/2019 SH 78001|38520|38520 - BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD||549.61|0||0|10/01/2019 SH 78001|38510|38510 - BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE||608.01|0||0|10/01/2019 SH 78001|38505|38505 - BX/EXC LYMPH NODE NEEDLE SUPERFICIAL||145.71|0||0|10/01/2019 SH 78001|38500|38500 - BX/EXC LYMPH NODE OPEN SUPERFICIAL||384.57|0||0|10/01/2019 SH 78001|38382|38382 - SUTR&/LIG THORACIC DUCT ABDOMINAL APPROACH||807.89|0||0|10/01/2019 SH 78001|38381|38381 - SUTR&/LIG THORACIC DUCT THORACIC APPROACH||961.78|0||0|10/01/2019 SH 78001|38380|38380 - SUTR&/LIG THORACIC DUCT CERVICAL APPROACH||662.78|0||0|10/01/2019 SH 78001|38308|38308 - LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS||526.18|0||0|10/01/2019 SH 78001|38305|38305 - DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV||546.56|0||0|10/01/2019 SH 78001|38300|38300 - DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL||314.69|0||0|10/01/2019 SH 78001|38243|38243 - TRNSPLJ HEMATOPOIETIC CELL BOOST||141.88|0||0|10/01/2019 SH 78001|38242|38242 - ALLOGENEIC LYMPHOCYTE INFUSIONS||141.8|0||0|10/01/2019 SH 78001|38241|38241 - TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR||200.34|0||0|10/01/2019 SH 78001|38240|38240 - TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR||266.35|0||0|10/01/2019 SH 78001|38232|38232 - BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS||242.56|0||0|10/01/2019 SH 78001|38230|38230 - BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC||236.3|0||0|10/01/2019 SH 78001|38222|38222 - DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS||195|0||0|10/01/2019 SH 78001|38221|38221 - DIAGNOSTIC BONE MARROW BIOPSIES||190.51|0||0|10/01/2019 SH 78001|38220|38220 - DIAGNOSTIC BONE MARROW ASPIRATIONS||185.77|0||0|10/01/2019 SH 78001|38215|38215 - TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM||56.83|0||0|10/01/2019 SH 78001|38214|38214 - TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ||48.89|0||0|10/01/2019 SH 78001|38213|38213 - TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ||14.23|0||0|10/01/2019 SH 78001|38212|38212 - TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL||56.83|0||0|10/01/2019 SH 78001|38211|38211 - TRNSPL PREPJ HEMATOP PROGEN TUM CELL DEPLJ||86.06|0||0|10/01/2019 SH 78001|38210|38210 - TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL||95.25|0||0|10/01/2019 SH 78001|38209|38209 - TRNSP PREP HMATOP PROG THAW PREV HRV WSH PER DNR||14.23|0||0|10/01/2019 SH 78001|38208|38208 - TRNSPL PREP HEMATOP PROGEN THAW PREV HRV PER DNR||33.46|0||0|10/01/2019 SH 78001|38207|38207 - TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR||53.51|0||0|10/01/2019 SH 78001|38206|38206 - BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL||98.82|0||0|10/01/2019 SH 78001|38205|38205 - BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC||98.04|0||0|10/01/2019 SH 78001|38204|38204 - MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ||121.55|0||0|10/01/2019 SH 78001|38200|38200 - INJECTION PROCEDURE SPLENOPORTOGRAPY||162.74|0||0|10/01/2019 SH 78001|38129|38129 - UNLISTED LAPAROSCOPY PROCEDURE SPLEEN||0|0||0|10/01/2019 SH 78001|38120|38120 - LAPAROSCOPIC SURGICAL SPLENECTOMY||1255.6|0||0|10/01/2019 SH 78001|38115|38115 - RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT||1528.33|0||0|10/01/2019 SH 78001|38102|38102 - SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX||315.71|0||0|10/01/2019 SH 78001|38101|38101 - SPLENECTOMY TOTAL EN BLOC W/OTHER PROCEDURE||1394.09|0||0|10/01/2019 SH 78001|38100|38100 - SPLENECTOMY TOTAL SEPARATE PROCEDURE||1379.7|0||0|10/01/2019 SH 78001|37799|37799 - UNLISTED PROCEDURE VASCULAR SURGERY||0|0||0|10/01/2019 SH 78001|37790|37790 - PENILE VENOUS OCCLUSIVE PROCEDURE||578.46|0||0|10/01/2019 SH 78001|37788|37788 - PENILE REVASCULARIZATION ARTERY W/WO VEIN GRAFT||1507.78|0||0|10/01/2019 SH 78001|37785|37785 - LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG||419.3|0||0|10/01/2019 SH 78001|37780|37780 - LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX||310.77|0||0|10/01/2019 SH 78001|37766|37766 - STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS||912.39|0||0|10/01/2019 SH 78001|37765|37765 - STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS||766.59|0||0|10/01/2019 SH 78001|37761|37761 - LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG||672.46|0||0|10/01/2019 SH 78001|37760|37760 - LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG||746.03|0||0|10/01/2019 SH 78001|37735|37735 - LIGJ & DIVJ RADICAL STRIP LONG/SHORT SAPHENOUS||716.34|0||0|10/01/2019 SH 78001|37722|37722 - LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW||580.21|0||0|10/01/2019 SH 78001|37718|37718 - LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN||528.76|0||0|10/01/2019 SH 78001|37700|37700 - LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ||300.58|0||0|10/01/2019 SH 78001|37660|37660 - LIGATION OF COMMON ILIAC VEIN||1574.74|0||0|10/01/2019 SH 78001|37650|37650 - LIGATION OF FEMORAL VEIN||565.39|0||0|10/01/2019 SH 78001|37619|37619 - INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I||1981.2|0||0|10/01/2019 SH 78001|37618|37618 - LIGATION MAJOR ARTERY EXTREMITY||459.56|0||0|10/01/2019 SH 78001|37617|37617 - LIGATION MAJOR ARTERY ABDOMEN||1624.73|0||0|10/01/2019 SH 78001|37616|37616 - LIGATION MAJOR ARTERY CHEST||1335.32|0||0|10/01/2019 SH 78001|37615|37615 - LIGATION MAJOR ARTERY NECK||604.45|0||0|10/01/2019 SH 78001|37609|37609 - LIGATION/BIOPSY TEMPORAL ARTERY||358.82|0||0|10/01/2019 SH 78001|37607|37607 - LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA||456.66|0||0|10/01/2019 SH 78001|37606|37606 - LIG INT/COMMON CAROTID ART W/GRADUAL OCCLUSION||589.67|0||0|10/01/2019 SH 78001|37605|37605 - LIGATION INTERNAL/COMMON CAROTID ARTERY||964.21|0||0|10/01/2019 SH 78001|37600|37600 - LIGATION EXTERNAL CAROTID ARTERY||874.99|0||0|10/01/2019 SH 78001|37565|37565 - LIGATION INTERNAL JUGULAR VEIN||881.27|0||0|10/01/2019 SH 78001|37501|37501 - UNLISTED VASCULAR ENDOSCOPY PROCEDURE||0|0||0|10/01/2019 SH 78001|37500|37500 - VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX||783.31|0||0|10/01/2019 SH 78001|37253|37253 - INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL||245.41|0||0|10/01/2019 SH 78001|37252|37252 - INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL||1545.97|0||0|10/01/2019 SH 78001|37251|37251 - IV US EACH ADD VESSEL ADD-ON||98.53|0||0|10/01/2019 SH 78001|37250|37250 - IV US FIRST VESSEL ADD-ON||130.97|0||0|10/01/2019 SH 78001|37249|37249 - TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN||774.77|0||0|10/01/2019 SH 78001|37248|37248 - TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN||1807.93|0||0|10/01/2019 SH 78001|37247|37247 - TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART||1055.99|0||0|10/01/2019 SH 78001|37246|37246 - TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART||2609.83|0||0|10/01/2019 SH 78001|37244|37244 - VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE||7605.81|0||0|10/01/2019 SH 78001|37243|37243 - VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT||10833.11|0||0|10/01/2019 SH 78001|37242|37242 - VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I||8583.99|0||0|10/01/2019 SH 78001|37241|37241 - VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I||5106.04|0||0|10/01/2019 SH 78001|37239|37239 - OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL||2251.75|0||0|10/01/2019 SH 78001|37238|37238 - OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST||4563.93|0||0|10/01/2019 SH 78001|37237|37237 - OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL||2762.11|0||0|10/01/2019 SH 78001|37236|37236 - OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL||4616.15|0||0|10/01/2019 SH 78001|37235|37235 - REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL||4630.69|0||0|10/01/2019 SH 78001|37234|37234 - REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL||4303.88|0||0|10/01/2019 SH 78001|37233|37233 - REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL||1652.09|0||0|10/01/2019 SH 78001|37232|37232 - REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL||1359.65|0||0|10/01/2019 SH 78001|37231|37231 - REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL||14809.16|0||0|10/01/2019 SH 78001|37230|37230 - REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL||9237.21|0||0|10/01/2019 SH 78001|37229|37229 - REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL||12063.12|0||0|10/01/2019 SH 78001|37228|37228 - REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI||6062.81|0||0|10/01/2019 SH 78001|37227|37227 - REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL||16490.91|0||0|10/01/2019 SH 78001|37226|37226 - REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL||10049.89|0||0|10/01/2019 SH 78001|37225|37225 - REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL||12217.3|0||0|10/01/2019 SH 78001|37224|37224 - REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI||4268.87|0||0|10/01/2019 SH 78001|37223|37223 - REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL||2882.67|0||0|10/01/2019 SH 78001|37222|37222 - REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL||994.46|0||0|10/01/2019 SH 78001|37221|37221 - REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY||5183.87|0||0|10/01/2019 SH 78001|37220|37220 - REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL||3521.63|0||0|10/01/2019 SH 78001|37218|37218 - TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE||998.69|0||0|10/01/2019 SH 78001|37217|37217 - TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE||1366.73|0||0|10/01/2019 SH 78001|37216|37216 - TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ||0|0||0|10/01/2019 SH 78001|37215|37215 - TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ||1323.3|0||0|10/01/2019 SH 78001|37214|37214 - CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL||166.7|0||0|10/01/2019 SH 78001|37213|37213 - THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX||302.98|0||0|10/01/2019 SH 78001|37212|37212 - THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX||429.51|0||0|10/01/2019 SH 78001|37211|37211 - THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX||489.87|0||0|10/01/2019 SH 78001|37202|37202 - TRANSCATHETER THERAPY INFUSE||365.32|0||0|10/01/2019 SH 78001|37200|37200 - TRANSCATHETER BIOPSY||269.95|0||0|10/01/2019 SH 78001|37197|37197 - PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING||1707.69|0||0|10/01/2019 SH 78001|37195|37195 - THROMBOLYSIS CEREBRAL IV INFUSION||0|0||0|10/01/2019 SH 78001|37193|37193 - RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I||1802.65|0||0|10/01/2019 SH 78001|37192|37192 - REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I||1886.69|0||0|10/01/2019 SH 78001|37191|37191 - INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I||2927.27|0||0|10/01/2019 SH 78001|37188|37188 - PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX||1971.07|0||0|10/01/2019 SH 78001|37187|37187 - PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN||2315.42|0||0|10/01/2019 SH 78001|37186|37186 - SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL||1543.95|0||0|10/01/2019 SH 78001|37185|37185 - PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ||809.12|0||0|10/01/2019 SH 78001|37184|37184 - PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST||2549.7|0||0|10/01/2019 SH 78001|37183|37183 - REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT||6551.37|0||0|10/01/2019 SH 78001|37182|37182 - INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT||1020.91|0||0|10/01/2019 SH 78001|37181|37181 - VENOUS ANASTOMOSIS OPEN SPLENORENAL DISTAL||2781.29|0||0|10/01/2019 SH 78001|37180|37180 - VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL||2548|0||0|10/01/2019 SH 78001|37160|37160 - VENOUS ANASTOMOSIS OPEN CAVAL-MESENTERIC||2648.42|0||0|10/01/2019 SH 78001|37145|37145 - VENOUS ANASTOMOSIS OPEN RENOPORTAL||2578.5|0||0|10/01/2019 SH 78001|37140|37140 - VENOUS ANASTOMOSIS OPEN PORTOCAVAL||2781.29|0||0|10/01/2019 SH 78001|36909|36909 - DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I||2382.44|0||0|10/01/2019 SH 78001|36908|36908 - STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR||3266.16|0||0|10/01/2019 SH 78001|36907|36907 - TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I||886.74|0||0|10/01/2019 SH 78001|36906|36906 - PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT||8240.76|0||0|10/01/2019 SH 78001|36905|36905 - PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP||2764.87|0||0|10/01/2019 SH 78001|36904|36904 - PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH||2160.64|0||0|10/01/2019 SH 78001|36903|36903 - INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT||6795.88|0||0|10/01/2019 SH 78001|36902|36902 - INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP||1481.92|0||0|10/01/2019 SH 78001|36901|36901 - INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I||696.81|0||0|10/01/2019 SH 78001|36861|36861 - XTRNL CANNULA DECLTNG SPX W/BALO CATH||160.34|0||0|10/01/2019 SH 78001|36860|36860 - XTRNL CANNULA DECLTNG SPX W/O BALO CATH||238.28|0||0|10/01/2019 SH 78001|36838|36838 - DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS||1407.36|0||0|10/01/2019 SH 78001|36835|36835 - INSERTION THOMAS SHUNT SEPARATE PROCEDURE||601.78|0||0|10/01/2019 SH 78001|36833|36833 - REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF||991.52|0||0|10/01/2019 SH 78001|36832|36832 - REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF||926.65|0||0|10/01/2019 SH 78001|36831|36831 - THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF||755.92|0||0|10/01/2019 SH 78001|36830|36830 - CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF||817.83|0||0|10/01/2019 SH 78001|36825|36825 - CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF||979.61|0||0|10/01/2019 SH 78001|36823|36823 - INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL||1665.05|0||0|10/01/2019 SH 78001|36821|36821 - ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT||812.99|0||0|10/01/2019 SH 78001|36820|36820 - ARVEN ANAST OPN F/ARM VEIN TRPOS||891.81|0||0|10/01/2019 SH 78001|36819|36819 - ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS||898.59|0||0|10/01/2019 SH 78001|36818|36818 - ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS||846.94|0||0|10/01/2019 SH 78001|36815|36815 - INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR||168.15|0||0|10/01/2019 SH 78001|36810|36810 - INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL||259.29|0||0|10/01/2019 SH 78001|36800|36800 - INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN||149.44|0||0|10/01/2019 SH 78001|36680|36680 - PLACEMENT NEEDLE INTRAOSSEOUS INFUSION||71.17|0||0|10/01/2019 SH 78001|36660|36660 - CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY||73.96|0||0|10/01/2019 SH 78001|36640|36640 - ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN||142.53|0||0|10/01/2019 SH 78001|36625|36625 - ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN||124.78|0||0|10/01/2019 SH 78001|36620|36620 - ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ||62.01|0||0|10/01/2019 SH 78001|36600|36600 - ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX||36.29|0||0|10/01/2019 SH 78001|36598|36598 - CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT||124.57|0||0|10/01/2019 SH 78001|36597|36597 - RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE||147.18|0||0|10/01/2019 SH 78001|36596|36596 - MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN||150.6|0||0|10/01/2019 SH 78001|36595|36595 - MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS||661.94|0||0|10/01/2019 SH 78001|36593|36593 - DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH||33.73|0||0|10/01/2019 SH 78001|36592|36592 - COLLECT BLOOD FROM CATHETER VENOUS NOS||28.69|0||0|10/01/2019 SH 78001|36591|36591 - COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE||25.59|0||0|10/01/2019 SH 78001|36590|36590 - RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ||340.35|0||0|10/01/2019 SH 78001|36589|36589 - RMVL TUN CVC W/O SUBQ PORT/PMP||193.75|0||0|10/01/2019 SH 78001|36585|36585 - RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT||1300.88|0||0|10/01/2019 SH 78001|36584|36584 - COMPLETE REPLACEMENT PICC RS&I||230.86|0||0|10/01/2019 SH 78001|36583|36583 - RPLCMT COMPL TUN CTR VAD W/SUBQ PMP||1532.44|0||0|10/01/2019 SH 78001|36582|36582 - RPLCMT COMPL TUN CTR VAD W/SUBQ PORT||1235.21|0||0|10/01/2019 SH 78001|36581|36581 - RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP||863.05|0||0|10/01/2019 SH 78001|36580|36580 - RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP||243.37|0||0|10/01/2019 SH 78001|36578|36578 - RPLCMT CATH CTR VAD SUBQ PORT/PMP||592.36|0||0|10/01/2019 SH 78001|36576|36576 - RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT||444.54|0||0|10/01/2019 SH 78001|36575|36575 - RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP||186.3|0||0|10/01/2019 SH 78001|36571|36571 - INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>||1467.87|0||0|10/01/2019 SH 78001|36570|36570 - INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR||1336.01|0||0|10/01/2019 SH 78001|36569|36569 - INSERTION PICC W/O IMG GDN 5 YR/>||283.97|0||0|10/01/2019 SH 78001|36568|36568 - INSERTION PICC W/O IMG GDN < 5 YR||343.33|0||0|10/01/2019 SH 78001|36566|36566 - INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT||6132.71|0||0|10/01/2019 SH 78001|36565|36565 - INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP||1094.18|0||0|10/01/2019 SH 78001|36563|36563 - INSJ TUNNELED CTR VAD W/SUBQ PUMP||1504.04|0||0|10/01/2019 SH 78001|36561|36561 - INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>||1325.55|0||0|10/01/2019 SH 78001|36560|36560 - INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR||1211.02|0||0|10/01/2019 SH 78001|36558|36558 - INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>||886.08|0||0|10/01/2019 SH 78001|36557|36557 - INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR||1152.26|0||0|10/01/2019 SH 78001|36556|36556 - INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>||268.74|0||0|10/01/2019 SH 78001|36555|36555 - INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y||291.99|0||0|10/01/2019 SH 78001|36522|36522 - PHOTOPHERESIS EXTRACORPOREAL||1536.58|0||0|10/01/2019 SH 78001|36516|36516 - THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION||2284.77|0||0|10/01/2019 SH 78001|36515|36515 - THER APHERESIS W/XTRCORP IMMUNODSPTJ& PLSM RENFJ||2265.3|0||0|10/01/2019 SH 78001|36514|36514 - THERAPEUTIC APHERESIS PLASMA PHERESIS||595.3|0||0|10/01/2019 SH 78001|36513|36513 - THERAPEUTIC APHERESIS PLATELETS||115.79|0||0|10/01/2019 SH 78001|36512|36512 - THERAPEUTIC APHERESIS RED BLOOD CELLS||113.05|0||0|10/01/2019 SH 78001|36511|36511 - THERAPEUTIC APHERESIS WHITE BLOOD CELLS||110.34|0||0|10/01/2019 SH 78001|36510|36510 - CATHJ UMBILICAL VEIN DX/THER NB||107.12|0||0|10/01/2019 SH 78001|36500|36500 - VEN CATHJ SLCTV ORGAN BLD SAMPLING||219.7|0||0|10/01/2019 SH 78001|36483|36483 - ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN||168.64|0||0|10/01/2019 SH 78001|36482|36482 - ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN||2353.05|0||0|10/01/2019 SH 78001|36481|36481 - PRQ PORTAL VEIN CATHETERIZATION ANY METHOD||2304.52|0||0|10/01/2019 SH 78001|36479|36479 - ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS||352.01|0||0|10/01/2019 SH 78001|36478|36478 - ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN||1347.91|0||0|10/01/2019 SH 78001|36476|36476 - ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS||339.22|0||0|10/01/2019 SH 78001|36475|36475 - ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN||1715.8|0||0|10/01/2019 SH 78001|36474|36474 - ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS||334.63|0||0|10/01/2019 SH 78001|36473|36473 - ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN||1826.88|0||0|10/01/2019 SH 78001|36471|36471 - INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS||200.69|0||0|10/01/2019 SH 78001|36470|36470 - INJECTION SCLEROSANT SINGLE INCMPTNT VEIN||170.36|0||0|10/01/2019 SH 78001|36468|36468 - INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK||0|0||0|10/01/2019 SH 78001|36466|36466 - NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS||1848.35|0||0|10/01/2019 SH 78001|36465|36465 - NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN||1766.16|0||0|10/01/2019 SH 78001|36460|36460 - TRANSFUSION INTRAUTERINE FETAL||416.1|0||0|10/01/2019 SH 78001|36456|36456 - PRTL EXCHANGE TRANSFUSE BLOOD/PLSM/CRYST NEWBORN||133.08|0||0|10/01/2019 SH 78001|36455|36455 - EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN||154.91|0||0|10/01/2019 SH 78001|36450|36450 - EXCHNG TRANSFUSION BLOOD NEWBORN||142.36|0||0|10/01/2019 SH 78001|36440|36440 - PUSH TRANSFUSION BLOOD 2 YR/UNDER||67.34|0||0|10/01/2019 SH 78001|36430|36430 - TRANSFUSION BLOOD/BLOOD COMPONENTS||37.99|0||0|10/01/2019 SH 78001|36425|36425 - VENIPUNCTURE CUTDOWN AGE 1 YR/>||47.91|0||0|10/01/2019 SH 78001|36420|36420 - VENIPUNCTURE CUTDOWN UNDER AGE 1 YR||61.01|0||0|10/01/2019 SH 78001|36416|36416 - COLLECTION CAPILLARY BLOOD SPECIMEN||0|0||0|10/01/2019 SH 78001|36415|36415 - COLLECTION VENOUS BLOOD VENIPUNCTURE||3.6|0||0|10/01/2019 SH 78001|36410|36410 - VNPNXR 3 YEARS/> PHYS/QHP SKILL||19.4|0||0|10/01/2019 SH 78001|36406|36406 - VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN||23.27|0||0|10/01/2019 SH 78001|36405|36405 - VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN||30.43|0||0|10/01/2019 SH 78001|36400|36400 - VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN||32.67|0||0|10/01/2019 SH 78001|36299|36299 - UNLISTED PROCEDURE VASCULAR INJECTION||0|0||0|10/01/2019 SH 78001|36262|36262 - REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP||360.79|0||0|10/01/2019 SH 78001|36261|36261 - REVJ IMPLANTED INTRA-ARTERIAL INFUSION PUMP||431.45|0||0|10/01/2019 SH 78001|36260|36260 - INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM||768.96|0||0|10/01/2019 SH 78001|36254|36254 - SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I||2468.39|0||0|10/01/2019 SH 78001|36253|36253 - SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I||2533.44|0||0|10/01/2019 SH 78001|36252|36252 - SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL||1736.05|0||0|10/01/2019 SH 78001|36251|36251 - SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN||1593.52|0||0|10/01/2019 SH 78001|36248|36248 - SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH||173.05|0||0|10/01/2019 SH 78001|36247|36247 - SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH||1768.19|0||0|10/01/2019 SH 78001|36246|36246 - SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH||1008.58|0||0|10/01/2019 SH 78001|36245|36245 - SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH||1531.42|0||0|10/01/2019 SH 78001|36228|36228 - SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT||1410.4|0||0|10/01/2019 SH 78001|36227|36227 - SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC||298.79|0||0|10/01/2019 SH 78001|36226|36226 - SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY||2073.11|0||0|10/01/2019 SH 78001|36225|36225 - SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY||1646.03|0||0|10/01/2019 SH 78001|36224|36224 - SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART||2121.96|0||0|10/01/2019 SH 78001|36223|36223 - SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART||1704.55|0||0|10/01/2019 SH 78001|36222|36222 - SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART||1422.6|0||0|10/01/2019 SH 78001|36221|36221 - NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART||1225.49|0||0|10/01/2019 SH 78001|36218|36218 - SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH||207.96|0||0|10/01/2019 SH 78001|36217|36217 - SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH||2117.1|0||0|10/01/2019 SH 78001|36216|36216 - SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH||1315.99|0||0|10/01/2019 SH 78001|36215|36215 - SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH||1262.92|0||0|10/01/2019 SH 78001|36200|36200 - INTRODUCTION CATHETER AORTA||703.31|0||0|10/01/2019 SH 78001|36160|36160 - INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR||557.63|0||0|10/01/2019 SH 78001|36140|36140 - INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY||491.08|0||0|10/01/2019 SH 78001|36120|36120 - INTRO NEEDLE/INTRACATH RETROGRADE BRACHIAL ART||472.47|0||0|10/01/2019 SH 78001|36100|36100 - INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY||555.62|0||0|10/01/2019 SH 78001|36015|36015 - SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART||966.67|0||0|10/01/2019 SH 78001|36014|36014 - SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY||909.87|0||0|10/01/2019 SH 78001|36013|36013 - INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY||872.02|0||0|10/01/2019 SH 78001|36012|36012 - SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC||967.08|0||0|10/01/2019 SH 78001|36011|36011 - SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH||934.84|0||0|10/01/2019 SH 78001|36010|36010 - INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA||563.85|0||0|10/01/2019 SH 78001|36005|36005 - NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH||360.03|0||0|10/01/2019 SH 78001|36002|36002 - INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM||189.63|0||0|10/01/2019 SH 78001|36000|36000 - INTRODUCTION NEEDLE/INTRACATHETER VEIN||28.7|0||0|10/01/2019 SH 78001|35907|35907 - EXCISION INFECTED GRAFT ABDOMEN||2359.86|0||0|10/01/2019 SH 78001|35905|35905 - EXCISION INFECTED GRAFT THORAX||2166.58|0||0|10/01/2019 SH 78001|35903|35903 - EXCISION INFECTED GRAFT EXTREMITY||688.97|0||0|10/01/2019 SH 78001|35901|35901 - EXCISION INFECTED NECK GRAFT||601.73|0||0|10/01/2019 SH 78001|35884|35884 - REVISION FEMORAL ANAST OPEN W/AUTOG GRAFT||1535.94|0||0|10/01/2019 SH 78001|35883|35883 - REVISION FEMORAL ANAST OPEN NONAUTOG GRAFT||1491.32|0||0|10/01/2019 SH 78001|35881|35881 - REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS||1254.38|0||0|10/01/2019 SH 78001|35879|35879 - REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP||1135.76|0||0|10/01/2019 SH 78001|35876|35876 - THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF||1162.75|0||0|10/01/2019 SH 78001|35875|35875 - THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL||728.72|0||0|10/01/2019 SH 78001|35870|35870 - RPR GRF-ENTERIC FSTL||1538.77|0||0|10/01/2019 SH 78001|35860|35860 - EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR||1027|0||0|10/01/2019 SH 78001|35840|35840 - EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD||1433.05|0||0|10/01/2019 SH 78001|35820|35820 - EXPL PO HEMRRG THROMBOSIS/INFCTJ CH||2432.15|0||0|10/01/2019 SH 78001|35800|35800 - EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK||862.99|0||0|10/01/2019 SH 78001|35761|35761 - EXPL N/FLWD SURG RPR W/WO LYSIS OTHER ARTERY||471.13|0||0|10/01/2019 SH 78001|35741|35741 - EXPL N/FLWD SURG RPR W/WO LYSIS POPLITEAL ARTERY||622.46|0||0|10/01/2019 SH 78001|35721|35721 - EXPL N/FLWD SURG RPR W/WO LYSIS FEMORAL ARTERY||555.78|0||0|10/01/2019 SH 78001|35701|35701 - EXPLORATION N/FLWD SURG NECK ARTERY||683.14|0||0|10/01/2019 SH 78001|35700|35700 - ROPRTJ > 1 MO AFTER ORIGINAL OPRATION||189.17|0||0|10/01/2019 SH 78001|35697|35697 - RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART||183.01|0||0|10/01/2019 SH 78001|35695|35695 - TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART||1266.85|0||0|10/01/2019 SH 78001|35694|35694 - TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART||1219.6|0||0|10/01/2019 SH 78001|35693|35693 - TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART||1027.58|0||0|10/01/2019 SH 78001|35691|35691 - TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART||1167.31|0||0|10/01/2019 SH 78001|35686|35686 - CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO||200.4|0||0|10/01/2019 SH 78001|35685|35685 - PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT||246.51|0||0|10/01/2019 SH 78001|35683|35683 - BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION||509.18|0||0|10/01/2019 SH 78001|35682|35682 - BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS||437.93|0||0|10/01/2019 SH 78001|35681|35681 - BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN||98.92|0||0|10/01/2019 SH 78001|35671|35671 - BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART||1375.77|0||0|10/01/2019 SH 78001|35666|35666 - BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL||1557.53|0||0|10/01/2019 SH 78001|35665|35665 - BYP OTH/THN VEIN ILIOFEMORAL||1445.92|0||0|10/01/2019 SH 78001|35663|35663 - BYP OTH/THN VEIN ILIOILIAC||1557.19|0||0|10/01/2019 SH 78001|35661|35661 - BYP OTH/THN VEIN FEMORAL-FEMORAL||1337.1|0||0|10/01/2019 SH 78001|35656|35656 - BYP OTH/THN VEIN FEMORAL-POPLITEAL||1336.47|0||0|10/01/2019 SH 78001|35654|35654 - BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL||1693.9|0||0|10/01/2019 SH 78001|35650|35650 - BYP OTH/THN VEIN AXILLARY-AXILLARY||1340.55|0||0|10/01/2019 SH 78001|35647|35647 - BYP OTH/THN VEIN AORTOFEMORAL||1912.21|0||0|10/01/2019 SH 78001|35646|35646 - BYP OTH/THN VEIN AORTOBIFEMORAL||2119.2|0||0|10/01/2019 SH 78001|35645|35645 - BYP OTH/THN VEIN SUBCLAVIAN-VERTEBRAL||1168.57|0||0|10/01/2019 SH 78001|35642|35642 - BYP OTH/THN VEIN CAROTID-VERTEBRAL||1397.99|0||0|10/01/2019 SH 78001|35638|35638 - BYP OTH/THN VEIN AORTOBI-ILIAC||2175.44|0||0|10/01/2019 SH 78001|35637|35637 - BYP OTH/THN VEIN AORTOILIAC||2146.29|0||0|10/01/2019 SH 78001|35636|35636 - BYP OTH/THN VEIN SPLENORENAL||1974.26|0||0|10/01/2019 SH 78001|35634|35634 - BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL||2261.39|0||0|10/01/2019 SH 78001|35633|35633 - BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC||2487.76|0||0|10/01/2019 SH 78001|35632|35632 - BYPASS GRAFT W/OTHER THAN VEIN ILIO-CELIAC||2238.55|0||0|10/01/2019 SH 78001|35631|35631 - BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL||2286.93|0||0|10/01/2019 SH 78001|35626|35626 - BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE||1928.62|0||0|10/01/2019 SH 78001|35623|35623 - BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL||1624.88|0||0|10/01/2019 SH 78001|35621|35621 - BYP OTH/THN VEIN AXILLARY-FEMORAL||1358.32|0||0|10/01/2019 SH 78001|35616|35616 - BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY||1364.15|0||0|10/01/2019 SH 78001|35612|35612 - BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN||1290.61|0||0|10/01/2019 SH 78001|35606|35606 - BYP OTH/THN VEIN CAROTID-SUBCLAVIAN||1452.23|0||0|10/01/2019 SH 78001|35601|35601 - BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID||1731.58|0||0|10/01/2019 SH 78001|35600|35600 - HARVEST UPPER EXTREMITY ARTERY 1 SEGMENT CABG||311.33|0||0|10/01/2019 SH 78001|35587|35587 - IN-SITU VEIN BYP POP-TIBL PRONEAL||1692.42|0||0|10/01/2019 SH 78001|35585|35585 - IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART||2073.78|0||0|10/01/2019 SH 78001|35583|35583 - IN-SITU VEIN BYPASS FEMORAL-POPLITEAL||1791.46|0||0|10/01/2019 SH 78001|35572|35572 - HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX||426.18|0||0|10/01/2019 SH 78001|35571|35571 - BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL||1640.93|0||0|10/01/2019 SH 78001|35570|35570 - BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL||1873.64|0||0|10/01/2019 SH 78001|35566|35566 - BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL||2063.31|0||0|10/01/2019 SH 78001|35565|35565 - BYPASS W/VEIN ILIOFEMORAL||1636.49|0||0|10/01/2019 SH 78001|35563|35563 - BYPASS W/VEIN ILIOILIAC||1854.5|0||0|10/01/2019 SH 78001|35560|35560 - BYPASS W/VEIN AORTORENAL||2111.07|0||0|10/01/2019 SH 78001|35558|35558 - BYPASS W/VEIN FEMORAL-FEMORAL||1511.75|0||0|10/01/2019 SH 78001|35556|35556 - BYPASS W/VEIN FEMORAL-POPLITEAL||1726.97|0||0|10/01/2019 SH 78001|35540|35540 - BYPASS W/VEIN AORTOBIFEMORAL||3165.41|0||0|10/01/2019 SH 78001|35539|35539 - BYPASS W/VEIN AORTOFEMORAL||2717.57|0||0|10/01/2019 SH 78001|35538|35538 - BYPASS W/VEIN AORTOBI-ILIAC||2893.25|0||0|10/01/2019 SH 78001|35537|35537 - BYPASS W/VEIN AORTOILIAC||2903.54|0||0|10/01/2019 SH 78001|35536|35536 - BYPASS W/VEIN SPLENORENAL||2093.07|0||0|10/01/2019 SH 78001|35535|35535 - BYPASS W/VEIN HEPATORENAL||2357.84|0||0|10/01/2019 SH 78001|35533|35533 - BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL||1864.63|0||0|10/01/2019 SH 78001|35531|35531 - BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC||2494.74|0||0|10/01/2019 SH 78001|35526|35526 - BYPASS W/VEIN AORTOSUBCLAV/CAROTID/INNOMINATE||2122.64|0||0|10/01/2019 SH 78001|35525|35525 - BYPASS W/VEIN BRACHIAL-BRACHIAL||1415.1|0||0|10/01/2019 SH 78001|35523|35523 - BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL||1590.21|0||0|10/01/2019 SH 78001|35522|35522 - BYPASS W/VEIN AXILLARY-BRACHIAL||1497.55|0||0|10/01/2019 SH 78001|35521|35521 - BYPASS W/VEIN AXILLARY-FEMORAL||1516.98|0||0|10/01/2019 SH 78001|35518|35518 - BYPASS W/VEIN AXILLARY-AXILLARY||1413.93|0||0|10/01/2019 SH 78001|35516|35516 - BYPASS W/VEIN SUBCLAVIAN-AXILLARY||1510.74|0||0|10/01/2019 SH 78001|35515|35515 - BYPASS W/VEIN SUBCLAVIAN-VERTEBRAL||1864.03|0||0|10/01/2019 SH 78001|35512|35512 - BYPASS W/VEIN SUBCLAVIAN-BRACHIAL||1686.49|0||0|10/01/2019 SH 78001|35511|35511 - BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN||1387.14|0||0|10/01/2019 SH 78001|35510|35510 - BYPASS W/VEIN CAROTID-BRACHIAL||1522.78|0||0|10/01/2019 SH 78001|35509|35509 - BYPASS W/VEIN CAROTID-CONTRALATERAL CAROTID||1751.12|0||0|10/01/2019 SH 78001|35508|35508 - BYPASS W/VEIN CAROTID-VERTEBRAL||1643.07|0||0|10/01/2019 SH 78001|35506|35506 - BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID||1578.09|0||0|10/01/2019 SH 78001|35501|35501 - BYPASS W/VEIN COMMON-IPSILATERAL CAROTID||1855.13|0||0|10/01/2019 SH 78001|35500|35500 - HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX||395.09|0||0|10/01/2019 SH 78001|35472|35472 - REPAIR ARTERIAL BLOCKAGE||2097.72|0||0|10/01/2019 SH 78001|35460|35460 - REPAIR VENOUS BLOCKAGE||385.53|0||0|10/01/2019 SH 78001|35400|35400 - ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ||184.56|0||0|10/01/2019 SH 78001|35390|35390 - ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO||197.41|0||0|10/01/2019 SH 78001|35372|35372 - TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL||1208.75|0||0|10/01/2019 SH 78001|35371|35371 - TEAEC W/WO PATCH GRAFT COMMON FEMORAL||1007.88|0||0|10/01/2019 SH 78001|35363|35363 - TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL||2153.67|0||0|10/01/2019 SH 78001|35361|35361 - TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC||1883.48|0||0|10/01/2019 SH 78001|35355|35355 - TEAEC W/WO PATCH GRAFT ILIOFEMORAL||1276.03|0||0|10/01/2019 SH 78001|35351|35351 - TEAEC W/WO PATCH GRAFT ILIAC||1577.6|0||0|10/01/2019 SH 78001|35341|35341 - TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL||1676.54|0||0|10/01/2019 SH 78001|35331|35331 - TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA||1792.11|0||0|10/01/2019 SH 78001|35321|35321 - TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL||1091.83|0||0|10/01/2019 SH 78001|35311|35311 - TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC||1907.66|0||0|10/01/2019 SH 78001|35306|35306 - TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART||554.39|0||0|10/01/2019 SH 78001|35305|35305 - TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL||1508.81|0||0|10/01/2019 SH 78001|35304|35304 - TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY||1582.6|0||0|10/01/2019 SH 78001|35303|35303 - TEAEC W/GRAFT POPLITEAL ARTERY||1528.96|0||0|10/01/2019 SH 78001|35302|35302 - TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY||1387.25|0||0|10/01/2019 SH 78001|35301|35301 - TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC||1391.47|0||0|10/01/2019 SH 78001|35286|35286 - RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY||1144.87|0||0|10/01/2019 SH 78001|35281|35281 - RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL||1988.13|0||0|10/01/2019 SH 78001|35276|35276 - RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP||1777.22|0||0|10/01/2019 SH 78001|35271|35271 - RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP||1675.97|0||0|10/01/2019 SH 78001|35266|35266 - RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY||1059.79|0||0|10/01/2019 SH 78001|35261|35261 - REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK||1309.29|0||0|10/01/2019 SH 78001|35256|35256 - REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY||1250.02|0||0|10/01/2019 SH 78001|35251|35251 - REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL||2090.07|0||0|10/01/2019 SH 78001|35246|35246 - RPR BLOOD VESSEL VEIN GRF INTRATHORACIC W/O BYP||1916.51|0||0|10/01/2019 SH 78001|35241|35241 - RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP||1745.89|0||0|10/01/2019 SH 78001|35236|35236 - REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY||1200.83|0||0|10/01/2019 SH 78001|35231|35231 - REPAIR BLOOD VESSEL W/VEIN GRAFT NECK||1485.85|0||0|10/01/2019 SH 78001|35226|35226 - RPR BLOOD VESSEL DIRECT LOWER EXTREMITY||1019.08|0||0|10/01/2019 SH 78001|35221|35221 - RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL||1771.37|0||0|10/01/2019 SH 78001|35216|35216 - RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS||2482.52|0||0|10/01/2019 SH 78001|35211|35211 - RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS||1666.98|0||0|10/01/2019 SH 78001|35207|35207 - REPAIR BLOOD VESSEL DIRECT HAND FINGER||891.6|0||0|10/01/2019 SH 78001|35206|35206 - REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY||945.18|0||0|10/01/2019 SH 78001|35201|35201 - REPAIR BLOOD VESSEL DIRECT NECK||1166.18|0||0|10/01/2019 SH 78001|35190|35190 - RPR/TRAUMATIC AV FISTULA EXTREMITIES||927.85|0||0|10/01/2019 SH 78001|35189|35189 - RPR/TRAUMATIC AV FISTULA THORAX & ABDOMEN||1868|0||0|10/01/2019 SH 78001|35188|35188 - RPR/TRAUMATIC AV FISTULA HEAD & NECK||1291.89|0||0|10/01/2019 SH 78001|35184|35184 - RPR CONGENITAL AV FISTULA EXTREMITIES||1355.59|0||0|10/01/2019 SH 78001|35182|35182 - RPR CONGENITAL AV FISTULA THORAX & ABDOMEN||1995.79|0||0|10/01/2019 SH 78001|35180|35180 - REPAIR CONGENITAL AV FISTULA HEAD & NECK||1090.41|0||0|10/01/2019 SH 78001|35152|35152 - DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY||1728.68|0||0|10/01/2019 SH 78001|35151|35151 - DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY||1531.43|0||0|10/01/2019 SH 78001|35142|35142 - DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART||1625.39|0||0|10/01/2019 SH 78001|35141|35141 - DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY||1363.99|0||0|10/01/2019 SH 78001|35132|35132 - DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY||2023.61|0||0|10/01/2019 SH 78001|35131|35131 - DIR RPR ANEURYSM & GRAFT ILIAC ARTERY||1710.71|0||0|10/01/2019 SH 78001|35122|35122 - DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN||2634.37|0||0|10/01/2019 SH 78001|35121|35121 - DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC||2025.58|0||0|10/01/2019 SH 78001|35112|35112 - DIR RPR RUPTD ANEURYSM SPLENIC ARTERY||2281.81|0||0|10/01/2019 SH 78001|35111|35111 - DIR RPR ANEURYSM SPLENIC ARTERY||1642.75|0||0|10/01/2019 SH 78001|35103|35103 - DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS||2777.79|0||0|10/01/2019 SH 78001|35102|35102 - DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS||2331.39|0||0|10/01/2019 SH 78001|35092|35092 - DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS||3222.26|0||0|10/01/2019 SH 78001|35091|35091 - DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS||2215.72|0||0|10/01/2019 SH 78001|35082|35082 - DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA||2702.44|0||0|10/01/2019 SH 78001|35081|35081 - DIR RPR ANEURYSM ABDOMINAL AORTA||2152.25|0||0|10/01/2019 SH 78001|35045|35045 - DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY||1216.3|0||0|10/01/2019 SH 78001|35022|35022 - DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN||1760.77|0||0|10/01/2019 SH 78001|35021|35021 - DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY||1536.27|0||0|10/01/2019 SH 78001|35013|35013 - DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS||1529.67|0||0|10/01/2019 SH 78001|35011|35011 - DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION||1229.69|0||0|10/01/2019 SH 78001|35005|35005 - DIR RPR ANEURYSM VERTEBRAL ARTERY||1400.69|0||0|10/01/2019 SH 78001|35002|35002 - DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY||1402.78|0||0|10/01/2019 SH 78001|35001|35001 - DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY||1387.22|0||0|10/01/2019 SH 78001|34900|34900 - EVASC RPR ILIAC ART ILIO-ILIAC PROSTHESIS||1098.37|0||0|10/01/2019 SH 78001|34848|34848 - VISCER AND INFRARENAL ABDOM AORTA 4+ PROSTHESIS||0|0||0|10/01/2019 SH 78001|34847|34847 - VISCER AND INFRARENAL ABDOM AORTA 3 PROSTHESIS||0|0||0|10/01/2019 SH 78001|34846|34846 - VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS||0|0||0|10/01/2019 SH 78001|34845|34845 - VISCER AND INFRARENAL ABDOM AORTA 1 PROSTHESIS||0|0||0|10/01/2019 SH 78001|34844|34844 - ENDOVASC VISCER AORTA REPR FENEST 4+ ENDOGRAFT||0|0||0|10/01/2019 SH 78001|34843|34843 - ENDOVASC VISCER AORTA REPAIR FENEST 3 ENDOGRAFT||0|0||0|10/01/2019 SH 78001|34842|34842 - ENDOVASC VISCER AORTA REPAIR FENEST 2 ENDOGRAFT||0|0||0|10/01/2019 SH 78001|34841|34841 - ENDOVASC VISCER AORTA REPAIR FENEST 1 ENDOGRAFT||0|0||0|10/01/2019 SH 78001|34839|34839 - PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT||0|0||0|10/01/2019 SH 78001|34834|34834 - OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI||335.58|0||0|10/01/2019 SH 78001|34833|34833 - OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP||753.66|0||0|10/01/2019 SH 78001|34832|34832 - OPN RPR ARYSM RPR ARTL TRMA AORTO-BIFEM PROSTH||2347.88|0||0|10/01/2019 SH 78001|34831|34831 - OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH||2347.88|0||0|10/01/2019 SH 78001|34830|34830 - OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH||2183.03|0||0|10/01/2019 SH 78001|34826|34826 - PLMT XTN PROSTH EVASC RPR ARYSM/DSJ EA VSL||253.84|0||0|10/01/2019 SH 78001|34825|34825 - PLMT XTN PROSTH EVASC RPR ARYSM/DSJ 1ST VSL||852.2|0||0|10/01/2019 SH 78001|34820|34820 - OPN ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI||605.39|0||0|10/01/2019 SH 78001|34813|34813 - PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR||292.85|0||0|10/01/2019 SH 78001|34812|34812 - OPN FEM ART EXPOS DLVR EVASC PROSTH UNI||416.57|0||0|10/01/2019 SH 78001|34808|34808 - EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE||257.34|0||0|10/01/2019 SH 78001|34806|34806 - TCAT PLACEMENT PHYSIOLOGIC SENSOR ANEURYSMAL SAC||123.82|0||0|10/01/2019 SH 78001|34805|34805 - EVASC RPR AAA AORTO-UNIILIAC/AORTO-UNIFEM PROSTH||1475.28|0||0|10/01/2019 SH 78001|34804|34804 - EVASC RPR AAA W/UNIBDY BFRC PROSTH||1531.32|0||0|10/01/2019 SH 78001|34803|34803 - EVASC RPR AAA W/MDLR BFRC PROSTH 2 LIMBS||1584.31|0||0|10/01/2019 SH 78001|34802|34802 - EVASC RPR AAA W/MDLR BFRC PROSTH 1 LIMB||1533.64|0||0|10/01/2019 SH 78001|34800|34800 - EVASC RPR AAA W/AORTO-AORTIC TUBE PROSTH||1386.9|0||0|10/01/2019 SH 78001|34716|34716 - OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ||464.82|0||0|10/01/2019 SH 78001|34715|34715 - OPN AX/SUBCLA ART EXPOS DLVR EVASC PROSTH UNI||375.19|0||0|10/01/2019 SH 78001|34714|34714 - OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH||335.51|0||0|10/01/2019 SH 78001|34713|34713 - PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT||159.99|0||0|10/01/2019 SH 78001|34712|34712 - TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I||841.93|0||0|10/01/2019 SH 78001|34711|34711 - DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL||372.2|0||0|10/01/2019 SH 78001|34710|34710 - DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL||992.22|0||0|10/01/2019 SH 78001|34709|34709 - PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR||403.09|0||0|10/01/2019 SH 78001|34708|34708 - EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT||2297.05|0||0|10/01/2019 SH 78001|34707|34707 - EVASC RPR DPLMNT ILIO-ILIAC NDGFT||1425.5|0||0|10/01/2019 SH 78001|34706|34706 - EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT||2858.94|0||0|10/01/2019 SH 78001|34705|34705 - EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT||1897.67|0||0|10/01/2019 SH 78001|34704|34704 - EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT||2869.5|0||0|10/01/2019 SH 78001|34703|34703 - EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT||1723.6|0||0|10/01/2019 SH 78001|34702|34702 - EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT||2283.88|0||0|10/01/2019 SH 78001|34701|34701 - EVASC RPR DPLMNT AORTO-AORTIC NDGFT||1527.59|0||0|10/01/2019 SH 78001|34530|34530 - SAPHENOPOPLITEAL VEIN ANASTOMOSIS||1332.68|0||0|10/01/2019 SH 78001|34520|34520 - CROSS-OVER VEIN GRAFT VENOUS SYSTEM||1220.32|0||0|10/01/2019 SH 78001|34510|34510 - VENOUS VALVE TRANSPOSITION ANY VEIN DONOR||1437.54|0||0|10/01/2019 SH 78001|34502|34502 - RECONSTRUCTION VENA CAVA ANY METHOD||1867.62|0||0|10/01/2019 SH 78001|34501|34501 - VALVULOPLASTY FEMORAL VEIN||1099.97|0||0|10/01/2019 SH 78001|34490|34490 - THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN||746.61|0||0|10/01/2019 SH 78001|34471|34471 - THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC||1332.33|0||0|10/01/2019 SH 78001|34451|34451 - THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN ABDL&LEG||2006.95|0||0|10/01/2019 SH 78001|34421|34421 - THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC||892.73|0||0|10/01/2019 SH 78001|34401|34401 - THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC||1785.7|0||0|10/01/2019 SH 78001|34203|34203 - EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC||1171.47|0||0|10/01/2019 SH 78001|34201|34201 - EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART||1269.32|0||0|10/01/2019 SH 78001|34151|34151 - EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART||1724.02|0||0|10/01/2019 SH 78001|34111|34111 - EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC||733.9|0||0|10/01/2019 SH 78001|34101|34101 - EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART||737.39|0||0|10/01/2019 SH 78001|34051|34051 - EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY||1096.71|0||0|10/01/2019 SH 78001|34001|34001 - EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART||1208.01|0||0|10/01/2019 SH 78001|33999|33999 - UNLISTED CARDIAC SURGERY||0|0||0|10/01/2019 SH 78001|33993|33993 - REPOSITION VAD W/IMAGING DIFFERENT SESSION||228.28|0||0|10/01/2019 SH 78001|33992|33992 - REMOVAL PERCUTANEOUS VAD DIFFERENT SESSION||259.13|0||0|10/01/2019 SH 78001|33991|33991 - INSJ PERQ VAD TRNSPTAL W/IMAGE ART&VENOUS ACCESS||770.27|0||0|10/01/2019 SH 78001|33990|33990 - INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY||531.7|0||0|10/01/2019 SH 78001|33989|33989 - RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS||600.83|0||0|10/01/2019 SH 78001|33988|33988 - INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS||945.25|0||0|10/01/2019 SH 78001|33987|33987 - ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS||254.26|0||0|10/01/2019 SH 78001|33986|33986 - ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER||633.67|0||0|10/01/2019 SH 78001|33985|33985 - ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH-5 YRS||664.19|0||0|10/01/2019 SH 78001|33984|33984 - ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER||347.35|0||0|10/01/2019 SH 78001|33983|33983 - RPLCMT VAD PMP IMPLTBL ICORP 1 VNTR W/BYPASS||2824.11|0||0|10/01/2019 SH 78001|33982|33982 - PLCMT VAD PMP IMPLTBL ICORP 1 VENTR W/O BYPASS||2392.33|0||0|10/01/2019 SH 78001|33981|33981 - RPLCMT XTRCORP VAD 1/BIVENTR PUMP 1/EA PUMP||1018.02|0||0|10/01/2019 SH 78001|33980|33980 - RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC||2163.73|0||0|10/01/2019 SH 78001|33979|33979 - INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC||2377.13|0||0|10/01/2019 SH 78001|33978|33978 - REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR||1627.43|0||0|10/01/2019 SH 78001|33977|33977 - REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE||1370.74|0||0|10/01/2019 SH 78001|33976|33976 - INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR||1943.5|0||0|10/01/2019 SH 78001|33975|33975 - INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE||1593.66|0||0|10/01/2019 SH 78001|33974|33974 - RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA||1074.51|0||0|10/01/2019 SH 78001|33973|33973 - INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA||625.57|0||0|10/01/2019 SH 78001|33971|33971 - RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF||854.47|0||0|10/01/2019 SH 78001|33970|33970 - INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN||430.9|0||0|10/01/2019 SH 78001|33969|33969 - ECMO/ECLS RMVL OF PERPH CANNULA OPEN BIRTH-5 YRS||352.49|0||0|10/01/2019 SH 78001|33968|33968 - REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ||40.42|0||0|10/01/2019 SH 78001|33967|33967 - INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ||313.99|0||0|10/01/2019 SH 78001|33966|33966 - ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER||288.47|0||0|10/01/2019 SH 78001|33965|33965 - ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS||239.14|0||0|10/01/2019 SH 78001|33964|33964 - ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER||622.95|0||0|10/01/2019 SH 78001|33963|33963 - ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH-5YRS||607.18|0||0|10/01/2019 SH 78001|33962|33962 - ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER||286.4|0||0|10/01/2019 SH 78001|33959|33959 - ECMO/ECLS REPOS PERPH CANNULA OPEN BIRTH-5 YRS||303.84|0||0|10/01/2019 SH 78001|33958|33958 - ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER||231.77|0||0|10/01/2019 SH 78001|33957|33957 - ECMO/ECLS REPOS PERIPH CANNULA PERQ BIRTH-5 YRS||239.14|0||0|10/01/2019 SH 78001|33956|33956 - ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER||1023.35|0||0|10/01/2019 SH 78001|33955|33955 - ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH-5 YRS||1077.62|0||0|10/01/2019 SH 78001|33954|33954 - ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN||583.23|0||0|10/01/2019 SH 78001|33953|33953 - ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS OPEN||597.97|0||0|10/01/2019 SH 78001|33952|33952 - ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ||522.02|0||0|10/01/2019 SH 78001|33951|33951 - ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS PERQ||535.99|0||0|10/01/2019 SH 78001|33949|33949 - ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL||288.08|0||0|10/01/2019 SH 78001|33948|33948 - ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS||296.01|0||0|10/01/2019 SH 78001|33947|33947 - ECMO/ECLS INITIATION VENO-ARTERIAL||414.08|0||0|10/01/2019 SH 78001|33946|33946 - ECMO/ECLS INITIATION VENO-VENOUS||374.87|0||0|10/01/2019 SH 78001|33945|33945 - HEART TRANSPLANT W/WO RECIPIENT CARDIECTOMY||5882.24|0||0|10/01/2019 SH 78001|33944|33944 - BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT||0|0||0|10/01/2019 SH 78001|33940|33940 - DONOR CARDIECTOMY||0|0||0|10/01/2019 SH 78001|33935|33935 - HEART-LUNG TRNSPL W/RECIPIENT CARDIECTOMY-PNUMEC||6017.21|0||0|10/01/2019 SH 78001|33933|33933 - BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT||0|0||0|10/01/2019 SH 78001|33930|33930 - DONOR CARDIECTOMY-PNEUMONECTOMY||0|0||0|10/01/2019 SH 78001|33927|33927 - IMPLTJ TOTAL RPLCMT HEART SYS W/RCP CARDIECTOMY||3166.62|0||0|10/01/2019 SH 78001|33926|33926 - RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/BYPASS||3068.04|0||0|10/01/2019 SH 78001|33925|33925 - RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS||2090.91|0||0|10/01/2019 SH 78001|33924|33924 - LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART||347.1|0||0|10/01/2019 SH 78001|33922|33922 - TRANSECTION PULMONARY ARTERY W/CARD BYPASS||1669.73|0||0|10/01/2019 SH 78001|33920|33920 - RPR PULMONARY ATRESIA W/CONSTJ/RPLCMT CONDUIT||2199.2|0||0|10/01/2019 SH 78001|33917|33917 - RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT||1765.59|0||0|10/01/2019 SH 78001|33916|33916 - PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS||5106.39|0||0|10/01/2019 SH 78001|33915|33915 - PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS||1558.59|0||0|10/01/2019 SH 78001|33910|33910 - PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS||3185.6|0||0|10/01/2019 SH 78001|33891|33891 - BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC||1198.35|0||0|10/01/2019 SH 78001|33889|33889 - OPN SUBCLA CRTD ART TRPOS NCK INC ULAT||974.92|0||0|10/01/2019 SH 78001|33886|33886 - PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA||1182.93|0||0|10/01/2019 SH 78001|33884|33884 - PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN||508.68|0||0|10/01/2019 SH 78001|33883|33883 - PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN||1370.95|0||0|10/01/2019 SH 78001|33881|33881 - EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN||1894.86|0||0|10/01/2019 SH 78001|33880|33880 - EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH||2205.67|0||0|10/01/2019 SH 78001|33877|33877 - RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS||4429.9|0||0|10/01/2019 SH 78001|33875|33875 - DESCENDING THORACIC AORTA GRAFT W/WO BYPASS||3326.58|0||0|10/01/2019 SH 78001|33870|33870 - TRANSVERSE ARCH GRAFT W/CARDIOPULMONARY BYPASS||3047.46|0||0|10/01/2019 SH 78001|33864|33864 - ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL||3908.93|0||0|10/01/2019 SH 78001|33863|33863 - AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT||3814.45|0||0|10/01/2019 SH 78001|33860|33860 - ASCENDING AORTA GRF W/CARD BYP & VALVE SSP||3884.85|0||0|10/01/2019 SH 78001|33853|33853 - RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/BYPASS||2207.1|0||0|10/01/2019 SH 78001|33852|33852 - RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/O BYPASS||1681.42|0||0|10/01/2019 SH 78001|33851|33851 - EXC COARCJ AORTA W/L SUBCLAV ART/PROSTC GUSSET||1603.69|0||0|10/01/2019 SH 78001|33845|33845 - EXCISION COARCTATION AORTA W/WO PDA W/GRAFT||1602.02|0||0|10/01/2019 SH 78001|33840|33840 - EXC COARCJ AORTA W/WO PDA W/DIRECT ANASTOMOSIS||1559.77|0||0|10/01/2019 SH 78001|33824|33824 - RPR PATENT DUXUS ARTERIOSUS DIV 18 YR & OLDER||1416.46|0||0|10/01/2019 SH 78001|33822|33822 - RPR PATENT DUXUS ARTERIOSUS DIV UNDER 18 YR||1290.25|0||0|10/01/2019 SH 78001|33820|33820 - REPAIR PATENT DUCTUS ARTERIOSUS LIGATION||1164.39|0||0|10/01/2019 SH 78001|33814|33814 - OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/BYPASS||1846.78|0||0|10/01/2019 SH 78001|33813|33813 - OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/O BYPASS||1561.41|0||0|10/01/2019 SH 78001|33803|33803 - DIVISION ABERRANT VESSEL W/REANASTOMOSIS||1457.55|0||0|10/01/2019 SH 78001|33802|33802 - DIVISION ABERRANT VESSEL VASCULAR RING||1371.82|0||0|10/01/2019 SH 78001|33800|33800 - AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX||1251.5|0||0|10/01/2019 SH 78001|33788|33788 - REIMPLANTATION ANOMALOUS PULMONARY ARTERY||1862.16|0||0|10/01/2019 SH 78001|33786|33786 - TOTAL REPAIR TRUNCUS ARTERIOSUS||2915.18|0||0|10/01/2019 SH 78001|33783|33783 - A-ROOT TLCJ VSD PULM STNS RPR W/RIMPLTJ C OSTIA||4486.3|0||0|10/01/2019 SH 78001|33782|33782 - A-ROOT TLCJ VSD PULM STNS RPR W/O C OST RIMPLTJ||3934.24|0||0|10/01/2019 SH 78001|33781|33781 - RPR TGV AORTIC P-ART RCNSTJ RPR SBPULMC OBSTRCJ||2974.19|0||0|10/01/2019 SH 78001|33780|33780 - RPR TGV AORTIC P-ART RCNSTJ W/CLSR V-SEPTL DFCT||3040.42|0||0|10/01/2019 SH 78001|33779|33779 - RPR TGV AORTIC PULM ART RCNSTJ W/RMVL PULM BAND||2987.85|0||0|10/01/2019 SH 78001|33778|33778 - RPR TRPOS GRT VESSEL AORTIC PULMONARY ART RCNSTJ||3000.46|0||0|10/01/2019 SH 78001|33777|33777 - RPR TRPOS GRT VSL ATR BAFFLE W/BYP SBPULM OBSTRC||2411.4|0||0|10/01/2019 SH 78001|33776|33776 - RPR TRPOS GRT VSL ATR BAFFLE W/CLSR V-SEPTL DFCT||2486.06|0||0|10/01/2019 SH 78001|33775|33775 - RPR TRPOS GREAT VSLS ATR BAFFLE W/RMVL PULM BAND||2354.26|0||0|10/01/2019 SH 78001|33774|33774 - RPR TRPOS GREAT VSLS ATRIAL BAFFLE PX W/BYPASS||2183.9|0||0|10/01/2019 SH 78001|33771|33771 - RPR TRPOS GREAT VSLS W/ENLGMNT V-SEPTL DFCT||2800.78|0||0|10/01/2019 SH 78001|33770|33770 - RPR TRPOS GREAT VSLS W/O ENLGMNT V-SEPTL DFCT||2714.44|0||0|10/01/2019 SH 78001|33768|33768 - ANASTOMOSIS CAVOPULMARY 2ND SUPRIOR VENA CAVA||539.98|0||0|10/01/2019 SH 78001|33767|33767 - SHUNT SUPERIOR VENA CAVA PULM ARTERY BOTH LUNGS||1712.87|0||0|10/01/2019 SH 78001|33766|33766 - SHUNT SUPERIOR VENA CAVA PULMONARY ART 1 LUNG||1688.19|0||0|10/01/2019 SH 78001|33764|33764 - SHUNT CENTRAL W/PROSTHETIC GRAFT||1657.2|0||0|10/01/2019 SH 78001|33762|33762 - SHUNT DESCENDING AORTA PULMONARY ARTERY||1623.48|0||0|10/01/2019 SH 78001|33755|33755 - SHUNT ASCENDING AORTA PULMONARY ARTERY||1653.69|0||0|10/01/2019 SH 78001|33750|33750 - SHUNT SUBCLAVIAN PULMONARY ARTERY||1598.9|0||0|10/01/2019 SH 78001|33737|33737 - ATRIAL SEPTECT/SEPTOST OPN HRT W/INFL OCCLUSION||1636.47|0||0|10/01/2019 SH 78001|33736|33736 - ATRIAL SEPTECTOMY/SEPTOSTOMY OPEN HEART W/BYPASS||1689.17|0||0|10/01/2019 SH 78001|33735|33735 - ATRIAL SEPTECTOMY/SEPTOSTOMY CLOSED HEART||1568.96|0||0|10/01/2019 SH 78001|33732|33732 - RPR COR TRIATM/SUPVALVR RING RESCJ L ATRIAL MEMB||1999.58|0||0|10/01/2019 SH 78001|33730|33730 - COMPLETE RPR ANOMALOUS PULMONARY VENOUS RETURN||2437.48|0||0|10/01/2019 SH 78001|33726|33726 - REPAIR PULMONARY VENOUS STENOSIS||2475.91|0||0|10/01/2019 SH 78001|33724|33724 - REPAIR ISOLATED PARTIAL PULM VENOUS RETURN||1856.49|0||0|10/01/2019 SH 78001|33722|33722 - CLOSURE AORTICO-LEFT VENTRICULAR TUNNEL||1973.53|0||0|10/01/2019 SH 78001|33720|33720 - RPR SINUS VALSALVA ANEURYSM||1876.96|0||0|10/01/2019 SH 78001|33710|33710 - RPR SINUS VALSALVA FISTULA W/RPR V-SEPTAL DEFECT||2533.4|0||0|10/01/2019 SH 78001|33702|33702 - RPR SINUS VALSALVA FISTULA||1861.36|0||0|10/01/2019 SH 78001|33697|33697 - COMPL RPR T-FALLOT W/PULM ATRESIA||2536.42|0||0|10/01/2019 SH 78001|33694|33694 - COMPL RPR T-FALLOT W/O PULM ATRESIA TANULR PATCH||2357.04|0||0|10/01/2019 SH 78001|33692|33692 - COMPL RPR TETRALOGY FALLOT W/O PULM ATRESIA||2510.07|0||0|10/01/2019 SH 78001|33690|33690 - BANDING PULMONARY ARTERY||1451.14|0||0|10/01/2019 SH 78001|33688|33688 - CLSR V-SEPTAL DFCT W/RMVL P-ART BAND W/WO GUSSET||2278.22|0||0|10/01/2019 SH 78001|33684|33684 - CLSR V-SEPTL DFCT W/PULM VLVT/INFUND RESCJ||2299.43|0||0|10/01/2019 SH 78001|33681|33681 - CLSR 1 VENTRICULAR SEPTAL DEFECT W/WO PATCH||2219.92|0||0|10/01/2019 SH 78001|33677|33677 - CLOSURE MULTIPLE VSD W/REMOVAL ARTERY BAND||2674.79|0||0|10/01/2019 SH 78001|33676|33676 - CLOSURE MULTIPLE VSD W/RESECTION||2588.02|0||0|10/01/2019 SH 78001|33675|33675 - CLOSURE MULTIPLE VENTRICULAR SEPTAL DEFECTS||2400.98|0||0|10/01/2019 SH 78001|33670|33670 - RPR COMPL AV CANAL W/WO PROSTC VALVE||2404.36|0||0|10/01/2019 SH 78001|33665|33665 - RPR INTRM/TRANSJ AV CANAL W/WO AV VALVE RPR||2311.61|0||0|10/01/2019 SH 78001|33660|33660 - RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR||2138.61|0||0|10/01/2019 SH 78001|33647|33647 - RPR ATRIAL & VENTRIC SEPTAL DFCT DIR/PATCH CLS||2193.75|0||0|10/01/2019 SH 78001|33645|33645 - DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG||2088.19|0||0|10/01/2019 SH 78001|33641|33641 - RPR ATRIAL SEPTAL DFCT SECUNDUM W/BYP W/WO PATCH||1973.55|0||0|10/01/2019 SH 78001|33622|33622 - RECONSTRUCTION COMPLEX CARDIAC ANOMALY||4116.26|0||0|10/01/2019 SH 78001|33621|33621 - TRANSTHORACIC CATHETER INSERTION FOR STENT PLMT||1126.48|0||0|10/01/2019 SH 78001|33620|33620 - APPLICATION RIGHT & LEFT PULMONARY ARTERY BAND||1837.85|0||0|10/01/2019 SH 78001|33619|33619 - RPR 1 VNTRC W/O/F OBSTRCJ&AORTIC ARCH HYPOPLAS||3466.16|0||0|10/01/2019 SH 78001|33617|33617 - RPR COMPLEX CARDIAC ANOMALY MODIFIED FONTAN PX||2609.79|0||0|10/01/2019 SH 78001|33615|33615 - RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX||2427.07|0||0|10/01/2019 SH 78001|33612|33612 - RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ||2420.37|0||0|10/01/2019 SH 78001|33611|33611 - RPR 2 OUTLET R VNTRC W/INTRAVENTR TUNNEL RPR||2493.94|0||0|10/01/2019 SH 78001|33610|33610 - RPR CAR ANOMAL SURG ENLGMENT VENTR SEPTL DFCT||2154.93|0||0|10/01/2019 SH 78001|33608|33608 - RPR CAR ANOMAL XCP PULM ATRESIA VENTR SEPTL DFCT||2167.5|0||0|10/01/2019 SH 78001|33606|33606 - ANAST PULMONARY ART AORTA DAMUS-KAYE-STANSEL PX||2255.95|0||0|10/01/2019 SH 78001|33602|33602 - CLOSURE SEMILUNAR VALVE AORTIC/PULM SUTURE/PATCH||2022.18|0||0|10/01/2019 SH 78001|33600|33600 - CLOSURE ATRIOVENTRICULAR VALVE SUTURE/PATCH||2085.39|0||0|10/01/2019 SH 78001|33572|33572 - CORONARY ENDARTERCOMY OPEN ANY METHOD||280.05|0||0|10/01/2019 SH 78001|33548|33548 - SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD||3579.95|0||0|10/01/2019 SH 78001|33545|33545 - RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT||3746.49|0||0|10/01/2019 SH 78001|33542|33542 - MYOCARDIAL RESECTION||3171.65|0||0|10/01/2019 SH 78001|33536|33536 - CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS||3197.41|0||0|10/01/2019 SH 78001|33535|33535 - CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS||2962.55|0||0|10/01/2019 SH 78001|33534|33534 - CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS||2654.26|0||0|10/01/2019 SH 78001|33533|33533 - CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT||2255.12|0||0|10/01/2019 SH 78001|33530|33530 - ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ||639.66|0||0|10/01/2019 SH 78001|33523|33523 - CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN||1017.5|0||0|10/01/2019 SH 78001|33522|33522 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN||890.29|0||0|10/01/2019 SH 78001|33521|33521 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN||792.37|0||0|10/01/2019 SH 78001|33519|33519 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN||661.01|0||0|10/01/2019 SH 78001|33518|33518 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN||500.1|0||0|10/01/2019 SH 78001|33517|33517 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN||227.55|0||0|10/01/2019 SH 78001|33516|33516 - CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT||3320.87|0||0|10/01/2019 SH 78001|33514|33514 - CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS||3173.03|0||0|10/01/2019 SH 78001|33513|33513 - CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS||3001.37|0||0|10/01/2019 SH 78001|33512|33512 - CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS||2915.37|0||0|10/01/2019 SH 78001|33511|33511 - CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS||2562.29|0||0|10/01/2019 SH 78001|33510|33510 - CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT||2331.47|0||0|10/01/2019 SH 78001|33508|33508 - NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG||19.19|0||0|10/01/2019 SH 78001|33507|33507 - RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ||2080.88|0||0|10/01/2019 SH 78001|33506|33506 - RPR ANOM CORONARY ART FROM PULM ART TO AORTA||2609.77|0||0|10/01/2019 SH 78001|33505|33505 - RPR ANOM CORON ART W/CONSTJ INTRAPULM ART TUNNEL||2495.5|0||0|10/01/2019 SH 78001|33504|33504 - RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP||1761.25|0||0|10/01/2019 SH 78001|33503|33503 - RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT||1590.87|0||0|10/01/2019 SH 78001|33502|33502 - RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION||1534.07|0||0|10/01/2019 SH 78001|33501|33501 - RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/O BYPASS||1352.81|0||0|10/01/2019 SH 78001|33500|33500 - RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS||1895.45|0||0|10/01/2019 SH 78001|33496|33496 - RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS||2023.22|0||0|10/01/2019 SH 78001|33478|33478 - OUTFLOW TRACT AGMNTJ W/WO COMMISSUR/INFUND RESCJ||1890.98|0||0|10/01/2019 SH 78001|33477|33477 - TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH||1560.46|0||0|10/01/2019 SH 78001|33476|33476 - R VENTRIC RESCJ INFUND STEN W/WO COMMISSUROTOMY||1838.61|0||0|10/01/2019 SH 78001|33475|33475 - REPLACEMENT PULMONARY VALVE||2835.26|0||0|10/01/2019 SH 78001|33474|33474 - VALVOTOMY PULMONARY VALVE OPEN HEART W/BYPASS||2627.44|0||0|10/01/2019 SH 78001|33471|33471 - VALVOTOMY PULM VALVE CLSD HEART VIA PULM ARTERY||1669.25|0||0|10/01/2019 SH 78001|33470|33470 - VALVOTOMY PULMONARY VALVE CLSD HEART TRANSVENTR||1488.13|0||0|10/01/2019 SH 78001|33468|33468 - TRICUSPID VALVE RPSG&PLCTJ EBSTEIN ANOMALY||2962.81|0||0|10/01/2019 SH 78001|33465|33465 - REPLACEMENT TRICUSPID VALVE W/CARD BYPASS||3333.1|0||0|10/01/2019 SH 78001|33464|33464 - VALVULOPLASTY TRICUSPID VALVE W/RING INSERTION||2949.18|0||0|10/01/2019 SH 78001|33463|33463 - VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION||3741|0||0|10/01/2019 SH 78001|33460|33460 - VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP||2953.94|0||0|10/01/2019 SH 78001|33430|33430 - REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP||3378.21|0||0|10/01/2019 SH 78001|33427|33427 - VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING||2953.22|0||0|10/01/2019 SH 78001|33426|33426 - VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING||2874.69|0||0|10/01/2019 SH 78001|33425|33425 - VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS||3299.53|0||0|10/01/2019 SH 78001|33422|33422 - VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS||2021.57|0||0|10/01/2019 SH 78001|33420|33420 - VALVOTOMY MITRAL VALVE CLOSED HEART||1737.71|0||0|10/01/2019 SH 78001|33419|33419 - TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS||526.84|0||0|10/01/2019 SH 78001|33418|33418 - TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS||2235.29|0||0|10/01/2019 SH 78001|33417|33417 - AORTOPLASTY SUPRAVALVULAR STENOSIS||2001.17|0||0|10/01/2019 SH 78001|33416|33416 - VENTRICULOMYOTOMY-MYECTOMY||2452.03|0||0|10/01/2019 SH 78001|33415|33415 - RESECTION/INCISION SUBVALVULAR TISSUE||2456.65|0||0|10/01/2019 SH 78001|33414|33414 - RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC||2597.07|0||0|10/01/2019 SH 78001|33413|33413 - REPLACEMENT AORTIC&PULMON VALVES ROSS PROCEDUR||3963.95|0||0|10/01/2019 SH 78001|33412|33412 - REPLACEMENT AORTIC VALVE KONNO PROCEDURE||3848.07|0||0|10/01/2019 SH 78001|33411|33411 - RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS||4057.98|0||0|10/01/2019 SH 78001|33410|33410 - RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE||3066.77|0||0|10/01/2019 SH 78001|33406|33406 - RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND||3474.33|0||0|10/01/2019 SH 78001|33405|33405 - RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT||2740.46|0||0|10/01/2019 SH 78001|33404|33404 - CONSTRUCTION APICAL-AORTIC CONDUIT||2141.22|0||0|10/01/2019 SH 78001|33391|33391 - VALVULOPLASTY AORTIC VALVE OPEN CARD BYP COMPLEX||2825.59|0||0|10/01/2019 SH 78001|33390|33390 - VALVULOPLASTY AORTIC VALVE OPEN CARD BYP SIMPLE||2384.59|0||0|10/01/2019 SH 78001|33369|33369 - REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH||1200.15|0||0|10/01/2019 SH 78001|33368|33368 - REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH||909.26|0||0|10/01/2019 SH 78001|33367|33367 - REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH||756.7|0||0|10/01/2019 SH 78001|33366|33366 - TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE||2332|0||0|10/01/2019 SH 78001|33365|33365 - REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH||2154.29|0||0|10/01/2019 SH 78001|33364|33364 - REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH||1956.46|0||0|10/01/2019 SH 78001|33363|33363 - REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH||1885.49|0||0|10/01/2019 SH 78001|33362|33362 - REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH||1797.05|0||0|10/01/2019 SH 78001|33361|33361 - REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH||1643.45|0||0|10/01/2019 SH 78001|33340|33340 - PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT||1000|0||0|10/01/2019 SH 78001|33335|33335 - INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS||2283.45|0||0|10/01/2019 SH 78001|33330|33330 - INSJ GRAFT AORTA/GREAT VESSEL W/O SHUNT/BYPASS||1728.72|0||0|10/01/2019 SH 78001|33322|33322 - SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS||1670.57|0||0|10/01/2019 SH 78001|33321|33321 - SUTR RPR AORTA/GREAT VESSEL W/SHUNT BYPASS||1450.41|0||0|10/01/2019 SH 78001|33320|33320 - SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP||1283.03|0||0|10/01/2019 SH 78001|33315|33315 - CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP||2316.47|0||0|10/01/2019 SH 78001|33310|33310 - CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP||1440.98|0||0|10/01/2019 SH 78001|33305|33305 - REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS||4969.3|0||0|10/01/2019 SH 78001|33300|33300 - REPAIR CARDIAC WOUND W/O BYPASS||2958.91|0||0|10/01/2019 SH 78001|33284|33284 - RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER||250.46|0||0|10/01/2019 SH 78001|33282|33282 - IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER||282.89|0||0|10/01/2019 SH 78001|33273|33273 - REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB||479.08|0||0|10/01/2019 SH 78001|33272|33272 - RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE||433.23|0||0|10/01/2019 SH 78001|33271|33271 - INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE||589.31|0||0|10/01/2019 SH 78001|33270|33270 - INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD||701.41|0||0|10/01/2019 SH 78001|33266|33266 - NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS||2232.27|0||0|10/01/2019 SH 78001|33265|33265 - NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS||1635.25|0||0|10/01/2019 SH 78001|33264|33264 - RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD||496.58|0||0|10/01/2019 SH 78001|33263|33263 - RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD||476.78|0||0|10/01/2019 SH 78001|33262|33262 - RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD||457.76|0||0|10/01/2019 SH 78001|33261|33261 - OPRATIVE ABLTJ VENTR ARRHYTHMOGENIC FOC W/BYPASS||1957.53|0||0|10/01/2019 SH 78001|33259|33259 - ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS||1012.4|0||0|10/01/2019 SH 78001|33258|33258 - ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP||789.66|0||0|10/01/2019 SH 78001|33257|33257 - ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE||697.93|0||0|10/01/2019 SH 78001|33256|33256 - ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS||2353.7|0||0|10/01/2019 SH 78001|33255|33255 - ABLATION & RCNSTJ ATRIA EXTNSV W/O BYPASS||1977.06|0||0|10/01/2019 SH 78001|33254|33254 - ABLATION & RECONSTRUCTION ATRIA LIMITED||1639.96|0||0|10/01/2019 SH 78001|33251|33251 - ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS||1957.53|0||0|10/01/2019 SH 78001|33250|33250 - ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/O BYPASS||1781.42|0||0|10/01/2019 SH 78001|33249|33249 - INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR||1107.27|0||0|10/01/2019 SH 78001|33244|33244 - RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ||1037.72|0||0|10/01/2019 SH 78001|33243|33243 - RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM||1647.46|0||0|10/01/2019 SH 78001|33241|33241 - REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY||270.73|0||0|10/01/2019 SH 78001|33240|33240 - INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD||449.96|0||0|10/01/2019 SH 78001|33238|33238 - RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY||1121.83|0||0|10/01/2019 SH 78001|33237|33237 - RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY||1008.01|0||0|10/01/2019 SH 78001|33236|33236 - RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS||937.61|0||0|10/01/2019 SH 78001|33235|33235 - RMVL TRANSVNS PM ELTRD DUAL LEAD SYS||770.39|0||0|10/01/2019 SH 78001|33234|33234 - RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR||592.67|0||0|10/01/2019 SH 78001|33233|33233 - REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY||287.06|0||0|10/01/2019 SH 78001|33231|33231 - INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS||495.37|0||0|10/01/2019 SH 78001|33230|33230 - INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS||470.15|0||0|10/01/2019 SH 78001|33229|33229 - REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD||456.5|0||0|10/01/2019 SH 78001|33228|33228 - REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS||435.16|0||0|10/01/2019 SH 78001|33227|33227 - REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD||417.69|0||0|10/01/2019 SH 78001|33226|33226 - RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD||594.12|0||0|10/01/2019 SH 78001|33225|33225 - INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN||562.34|0||0|10/01/2019 SH 78001|33224|33224 - INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN||618.58|0||0|10/01/2019 SH 78001|33223|33223 - RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR||499.85|0||0|10/01/2019 SH 78001|33222|33222 - RELOCATION OF SKIN POCKET FOR PACEMAKER||412.83|0||0|10/01/2019 SH 78001|33221|33221 - INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS||443.04|0||0|10/01/2019 SH 78001|33220|33220 - RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB||476.76|0||0|10/01/2019 SH 78001|33218|33218 - RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB||476.02|0||0|10/01/2019 SH 78001|33217|33217 - INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB||446.32|0||0|10/01/2019 SH 78001|33216|33216 - INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB||454.59|0||0|10/01/2019 SH 78001|33215|33215 - RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE||369.39|0||0|10/01/2019 SH 78001|33214|33214 - UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS||582.27|0||0|10/01/2019 SH 78001|33213|33213 - INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS||414.72|0||0|10/01/2019 SH 78001|33212|33212 - INS PM PLS GEN W/EXIST SINGLE LEAD||396.86|0||0|10/01/2019 SH 78001|33211|33211 - INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX||219.99|0||0|10/01/2019 SH 78001|33210|33210 - INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH||215.72|0||0|10/01/2019 SH 78001|33208|33208 - INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT||636.39|0||0|10/01/2019 SH 78001|33207|33207 - INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR||587.86|0||0|10/01/2019 SH 78001|33206|33206 - INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL||551.22|0||0|10/01/2019 SH 78001|33203|33203 - INSERTION EPICARDIAL ELECTRODE ENDOSCOPIC||969.43|0||0|10/01/2019 SH 78001|33202|33202 - INSERTION EPICARDIAL ELECTRODE OPEN||932.31|0||0|10/01/2019 SH 78001|33141|33141 - TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX||159.27|0||0|10/01/2019 SH 78001|33140|33140 - TRANSMYOCARDIAL LASER REVASCULAR THORACOTOMY SPX||1913.5|0||0|10/01/2019 SH 78001|33130|33130 - RESECTION EXTERNAL CARDIAC TUMOR||1671.84|0||0|10/01/2019 SH 78001|33120|33120 - EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP||2536.33|0||0|10/01/2019 SH 78001|33050|33050 - RESECTION PERICARDIAL CYST/TUMOR||1208.66|0||0|10/01/2019 SH 78001|33031|33031 - PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS||2978.41|0||0|10/01/2019 SH 78001|33030|33030 - PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS||2417.02|0||0|10/01/2019 SH 78001|33025|33025 - CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX||959.69|0||0|10/01/2019 SH 78001|33020|33020 - PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY||1058.63|0||0|10/01/2019 SH 78001|33015|33015 - TUBE PERICARDIOSTOMY||608.87|0||0|10/01/2019 SH 78001|33011|33011 - PERICARDIOCENTESIS SUBSEQUENT||146.32|0||0|10/01/2019 SH 78001|33010|33010 - PERICARDIOCENTESIS INITIAL||145.15|0||0|10/01/2019 SH 78001|32999|32999 - UNLISTED PROCEDURE LUNGS & PLEURA||0|0||0|10/01/2019 SH 78001|32998|32998 - ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY||3282.29|0||0|10/01/2019 SH 78001|32997|32997 - TOTAL LUNG LAVAGE UNILATERAL||414.57|0||0|10/01/2019 SH 78001|32994|32994 - ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION||6851.54|0||0|10/01/2019 SH 78001|32960|32960 - PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR||147.99|0||0|10/01/2019 SH 78001|32940|32940 - PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX||1492.3|0||0|10/01/2019 SH 78001|32906|32906 - THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL||1997.98|0||0|10/01/2019 SH 78001|32905|32905 - THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL||1615.63|0||0|10/01/2019 SH 78001|32900|32900 - RESECTION RIBS EXTRAPLEURAL ALL STAGES||1712.12|0||0|10/01/2019 SH 78001|32856|32856 - BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT BI||0|0||0|10/01/2019 SH 78001|32855|32855 - BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT UNI||0|0||0|10/01/2019 SH 78001|32854|32854 - LUNG TRANSPLANT 2 W/CARDIOPULMONARY BYPASS||5908.51|0||0|10/01/2019 SH 78001|32853|32853 - LUNG TRANSPLANT 2 W/O CARDIOPULMONARY BYPASS||5565.19|0||0|10/01/2019 SH 78001|32852|32852 - LUNG TRANSPLANT 1 W/CARDIOPULMONARY BYPASS||4360.52|0||0|10/01/2019 SH 78001|32851|32851 - LUNG TRANSPLANT 1 W/O CARDIOPULMONARY BYPASS||3977.61|0||0|10/01/2019 SH 78001|32850|32850 - DONOR PNEUMONECTOMY FROM CADAVER DONOR||0|0||0|10/01/2019 SH 78001|32820|32820 - MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC||1679.65|0||0|10/01/2019 SH 78001|32815|32815 - OPEN CLOSURE MAJOR BRONCHIAL FISTULA||3380.9|0||0|10/01/2019 SH 78001|32810|32810 - CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA||1085.79|0||0|10/01/2019 SH 78001|32800|32800 - REPAIR LUNG HERNIA THROUGH CHEST WALL||1144.18|0||0|10/01/2019 SH 78001|32701|32701 - THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE||259.89|0||0|10/01/2019 SH 78001|32674|32674 - THORCOSCPY W/MEDIASTINL & REGIONL LYMPHDENECTOMY||262.37|0||0|10/01/2019 SH 78001|32673|32673 - THORACOSCOPY RESEXN THYMUS UNI/BILATERAL||1465.74|0||0|10/01/2019 SH 78001|32672|32672 - THORACOSCOPY W/RESEXN-PLICAJ EMPHYSEMA LUNG UNIL||1832.72|0||0|10/01/2019 SH 78001|32671|32671 - THORACOSCOPY W/PNEUMONECTOMY||2155.28|0||0|10/01/2019 SH 78001|32670|32670 - THORACOSCOPY W/BILOBECTOMY||1934.4|0||0|10/01/2019 SH 78001|32669|32669 - THORACOSCOPY W/SEGMENTECTOMY||1619.37|0||0|10/01/2019 SH 78001|32668|32668 - THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN||190.76|0||0|10/01/2019 SH 78001|32667|32667 - THORACOSCOPY W/THERA WEDGE RESEXN ADDL IPSILATRL||191.15|0||0|10/01/2019 SH 78001|32666|32666 - THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT||1044.63|0||0|10/01/2019 SH 78001|32665|32665 - THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE||1491.19|0||0|10/01/2019 SH 78001|32664|32664 - THORACOSCOPY W/THORACIC SYMPATHECTOMY||1021.97|0||0|10/01/2019 SH 78001|32663|32663 - THORACOSCOPY W/LOBECTOMY SINGLE LOBE||1687.05|0||0|10/01/2019 SH 78001|32662|32662 - THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS||1072.76|0||0|10/01/2019 SH 78001|32661|32661 - THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS||961.58|0||0|10/01/2019 SH 78001|32659|32659 - THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC||877.13|0||0|10/01/2019 SH 78001|32658|32658 - THORACOSCOPY W/RMVL CLOT/FB FROM PERICARDIAL SAC||858.69|0||0|10/01/2019 SH 78001|32656|32656 - THORACOSCOPY W/PARIETAL PLEURECTOMY||962.03|0||0|10/01/2019 SH 78001|32655|32655 - THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX||1146.57|0||0|10/01/2019 SH 78001|32654|32654 - THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE||1377.6|0||0|10/01/2019 SH 78001|32653|32653 - THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT||1272.05|0||0|10/01/2019 SH 78001|32652|32652 - THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS||1999.51|0||0|10/01/2019 SH 78001|32651|32651 - THORACOSCOPY W/PARTIAL PULMONARY DECORTICATION||1317.78|0||0|10/01/2019 SH 78001|32650|32650 - THORACOSCOPY W/PLEURODESIS||795.86|0||0|10/01/2019 SH 78001|32609|32609 - THORACOSCOPY WITH BIOPSYIES OF PLEURA||312.45|0||0|10/01/2019 SH 78001|32608|32608 - THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL||457.32|0||0|10/01/2019 SH 78001|32607|32607 - THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL||372.33|0||0|10/01/2019 SH 78001|32606|32606 - THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX||557.17|0||0|10/01/2019 SH 78001|32604|32604 - THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX||584.46|0||0|10/01/2019 SH 78001|32601|32601 - THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX||371.55|0||0|10/01/2019 SH 78001|32562|32562 - INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY||98.86|0||0|10/01/2019 SH 78001|32561|32561 - INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY||109.21|0||0|10/01/2019 SH 78001|32560|32560 - INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS||275.79|0||0|10/01/2019 SH 78001|32557|32557 - PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING||576.52|0||0|10/01/2019 SH 78001|32556|32556 - PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING||621.89|0||0|10/01/2019 SH 78001|32555|32555 - THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING||328.19|0||0|10/01/2019 SH 78001|32554|32554 - THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING||229.32|0||0|10/01/2019 SH 78001|32553|32553 - PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT||669.43|0||0|10/01/2019 SH 78001|32552|32552 - RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF||218.11|0||0|10/01/2019 SH 78001|32551|32551 - TUBE THORACOSTOMY INCLUDES WATER SEAL||205.56|0||0|10/01/2019 SH 78001|32550|32550 - INSERTION INDWELLING TUNNELED PLEURAL CATHETER||882.76|0||0|10/01/2019 SH 78001|32540|32540 - EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY||2085.52|0||0|10/01/2019 SH 78001|32507|32507 - THORACOTOMY W/DX WEDGE RESEXN & ANTOM LUNG RESE||190.37|0||0|10/01/2019 SH 78001|32506|32506 - THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL||190.76|0||0|10/01/2019 SH 78001|32505|32505 - THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL||1118.75|0||0|10/01/2019 SH 78001|32504|32504 - RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ||2503.21|0||0|10/01/2019 SH 78001|32503|32503 - RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ||2181.23|0||0|10/01/2019 SH 78001|32501|32501 - RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY||297.4|0||0|10/01/2019 SH 78001|32491|32491 - RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG||1776.57|0||0|10/01/2019 SH 78001|32488|32488 - RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC||2913.07|0||0|10/01/2019 SH 78001|32486|32486 - RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY||2841.98|0||0|10/01/2019 SH 78001|32484|32484 - RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY||1731.41|0||0|10/01/2019 SH 78001|32482|32482 - RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC||1905.23|0||0|10/01/2019 SH 78001|32480|32480 - RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT||1777.52|0||0|10/01/2019 SH 78001|32445|32445 - REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL||4285.36|0||0|10/01/2019 SH 78001|32442|32442 - REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA||3721.42|0||0|10/01/2019 SH 78001|32440|32440 - REMOVAL OF LUNG PNEUMONECTOMY||1881.26|0||0|10/01/2019 SH 78001|32405|32405 - BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE||504.64|0||0|10/01/2019 SH 78001|32400|32400 - BIOPSY PLEURA PERCUTANEOUS NEEDLE||175.94|0||0|10/01/2019 SH 78001|32320|32320 - DECORTICATION & PARIETAL PLEURECTOMY||1918.72|0||0|10/01/2019 SH 78001|32310|32310 - PLEURECTOMY PARIETAL SEPARATE PROCEDURE||1082.9|0||0|10/01/2019 SH 78001|32225|32225 - DECORTICATION PULMONARY PARTIAL SEPARATE PROC||1190.98|0||0|10/01/2019 SH 78001|32220|32220 - DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE||1899.02|0||0|10/01/2019 SH 78001|32215|32215 - PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX||958.79|0||0|10/01/2019 SH 78001|32200|32200 - PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST||1371.64|0||0|10/01/2019 SH 78001|32160|32160 - THORACOTOMY W/CARDIAC MASSAGE||943.85|0||0|10/01/2019 SH 78001|32151|32151 - THORCOM W/RMVL IPUL FB||1213.56|0||0|10/01/2019 SH 78001|32150|32150 - THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP||1206.81|0||0|10/01/2019 SH 78001|32141|32141 - THORACOTOMY W/RESECTION BULLAE||1835.84|0||0|10/01/2019 SH 78001|32140|32140 - THORCOM W/REMOVAL OF CYST||1196.05|0||0|10/01/2019 SH 78001|32124|32124 - THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS||1112|0||0|10/01/2019 SH 78001|32120|32120 - THORACOTOMY POSTOPERATIVE COMPLICATIONS||1041.42|0||0|10/01/2019 SH 78001|32110|32110 - THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR||1756.92|0||0|10/01/2019 SH 78001|32100|32100 - THORACOTOMY WITH EXPLORATION||971.16|0||0|10/01/2019 SH 78001|32098|32098 - THORACOTOMY W/BIOPSY OF PLEURA||915.5|0||0|10/01/2019 SH 78001|32097|32097 - THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL||966.5|0||0|10/01/2019 SH 78001|32096|32096 - THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL||966.5|0||0|10/01/2019 SH 78001|32036|32036 - THORACOSTOMY OPEN FLAP DRAINAGE EMPYEMA||928.72|0||0|10/01/2019 SH 78001|32035|32035 - THORACOSTOMY W/RIB RESECTION EMPYEMA||864.59|0||0|10/01/2019 SH 78001|31899|31899 - UNLISTED PROCEDURE TRACHEA BRONCHI||0|0||0|10/01/2019 SH 78001|31830|31830 - REVISION TRACHEOSTOMY SCAR||511.83|0||0|10/01/2019 SH 78001|31825|31825 - SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR||700.1|0||0|10/01/2019 SH 78001|31820|31820 - SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR||501.44|0||0|10/01/2019 SH 78001|31805|31805 - SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC||979.81|0||0|10/01/2019 SH 78001|31800|31800 - SUTURE TRACHEAL WOUND/INJURY CERVICAL||827.08|0||0|10/01/2019 SH 78001|31786|31786 - EXCISION TRACHEAL TUMOR/CARCINOMA THORACIC||1889.01|0||0|10/01/2019 SH 78001|31785|31785 - EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL||1280.28|0||0|10/01/2019 SH 78001|31781|31781 - EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC||1676.39|0||0|10/01/2019 SH 78001|31780|31780 - EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA||1413.73|0||0|10/01/2019 SH 78001|31775|31775 - BRONCHOPLASTY EXCISION STENOSIS & ANASTOMOSIS||1487.53|0||0|10/01/2019 SH 78001|31770|31770 - BRONCHOPLASTY GRAFT REPAIR||1610.92|0||0|10/01/2019 SH 78001|31766|31766 - CARINAL RECONSTRUCTION||2034.4|0||0|10/01/2019 SH 78001|31760|31760 - TRACHEOPLASTY INTRATHORACIC||1654.07|0||0|10/01/2019 SH 78001|31755|31755 - TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG||1988.06|0||0|10/01/2019 SH 78001|31750|31750 - TRACHEOPLASTY CERVICAL||1597.65|0||0|10/01/2019 SH 78001|31730|31730 - TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER||1365.04|0||0|10/01/2019 SH 78001|31725|31725 - CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX||108.2|0||0|10/01/2019 SH 78001|31720|31720 - CATHETER ASPIRATION NASOTRACHEAL SPX||61.62|0||0|10/01/2019 SH 78001|31717|31717 - CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY||297.68|0||0|10/01/2019 SH 78001|31661|31661 - BRONCHOSCOPIC THERMOPLASTY 2/> LOBES||263.89|0||0|10/01/2019 SH 78001|31660|31660 - BRONCHOSCOPIC THERMOPLASTY ONE LOBE||251.95|0||0|10/01/2019 SH 78001|31654|31654 - BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES||164.47|0||0|10/01/2019 SH 78001|31653|31653 - BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX||1078.35|0||0|10/01/2019 SH 78001|31652|31652 - BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX||1013.6|0||0|10/01/2019 SH 78001|31651|31651 - BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE||89.86|0||0|10/01/2019 SH 78001|31649|31649 - BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL||82.27|0||0|10/01/2019 SH 78001|31648|31648 - BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL||245.52|0||0|10/01/2019 SH 78001|31647|31647 - BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE||268.92|0||0|10/01/2019 SH 78001|31646|31646 - BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ||333.26|0||0|10/01/2019 SH 78001|31645|31645 - BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST||371.24|0||0|10/01/2019 SH 78001|31643|31643 - BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL||212.97|0||0|10/01/2019 SH 78001|31641|31641 - BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC||310.4|0||0|10/01/2019 SH 78001|31640|31640 - BRONCHOSCOPY W/EXCISION TUMOR||306.92|0||0|10/01/2019 SH 78001|31638|31638 - BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS||305.93|0||0|10/01/2019 SH 78001|31637|31637 - BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED||89.86|0||0|10/01/2019 SH 78001|31636|31636 - BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS||267.33|0||0|10/01/2019 SH 78001|31635|31635 - BRONCHOSCOPY W/REMOVAL FOREIGN BODY||402.56|0||0|10/01/2019 SH 78001|31634|31634 - BRONCHOSCOPY BALLOON OCCLUSION||2091.46|0||0|10/01/2019 SH 78001|31633|31633 - BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE||103.07|0||0|10/01/2019 SH 78001|31632|31632 - BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE||83.19|0||0|10/01/2019 SH 78001|31631|31631 - BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT||278.86|0||0|10/01/2019 SH 78001|31630|31630 - BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX||241.14|0||0|10/01/2019 SH 78001|31629|31629 - BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON||668.37|0||0|10/01/2019 SH 78001|31628|31628 - BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE||427.53|0||0|10/01/2019 SH 78001|31627|31627 - BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION||1564.4|0||0|10/01/2019 SH 78001|31626|31626 - BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT||512.86|0||0|10/01/2019 SH 78001|31625|31625 - BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES||382.58|0||0|10/01/2019 SH 78001|31624|31624 - BRNCHSC W/BRNCL ALVEOLAR LAVAGE||358.77|0||0|10/01/2019 SH 78001|31623|31623 - BRNCHSC BRUSHING/PROTECTED BRUSHINGS||378.15|0||0|10/01/2019 SH 78001|31622|31622 - BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX||357.96|0||0|10/01/2019 SH 78001|31620|31620 - ENDOBRONCHIAL US ADD-ON||324|0||0|10/01/2019 SH 78001|31615|31615 - TRACHEOBRNCHSC THRU EST TRACHS INC||210.74|0||0|10/01/2019 SH 78001|31614|31614 - TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION||878.68|0||0|10/01/2019 SH 78001|31613|31613 - TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION||525.02|0||0|10/01/2019 SH 78001|31612|31612 - TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX||99.76|0||0|10/01/2019 SH 78001|31611|31611 - CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH||626.02|0||0|10/01/2019 SH 78001|31610|31610 - TRACHEOSTOMY FENESTRATION W/SKIN FLAPS||837.02|0||0|10/01/2019 SH 78001|31605|31605 - TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE||221.92|0||0|10/01/2019 SH 78001|31603|31603 - TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL||268.61|0||0|10/01/2019 SH 78001|31601|31601 - TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX||326.2|0||0|10/01/2019 SH 78001|31600|31600 - TRACHEOSTOMY PLANNED SEPARATE PROCEDURE||476.93|0||0|10/01/2019 SH 78001|31599|31599 - UNLISTED PROCEDURE LARYNX||0|0||0|10/01/2019 SH 78001|31595|31595 - SECTION RECURRENT LARYNGEAL NERVE THER UNI SPX||886.96|0||0|10/01/2019 SH 78001|31592|31592 - CRICOTRACHEAL RESECTION||2080.11|0||0|10/01/2019 SH 78001|31591|31591 - LARYNGOPLASTY MEDIALIZATION UNLIATERAL||1285.53|0||0|10/01/2019 SH 78001|31590|31590 - LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE||1021.01|0||0|10/01/2019 SH 78001|31587|31587 - LARYNGOPLASTY CRICOID SPLIT W/O GRAFT PLACEMENT||1181.1|0||0|10/01/2019 SH 78001|31584|31584 - LARYNGOPLASTY W/OPEN REDUCTION FRACTURE W/TRACHS||1767.94|0||0|10/01/2019 SH 78001|31580|31580 - LARYNGOPLASTY LARYN WEB W/KEEL STENT INSERTION||1419.92|0||0|10/01/2019 SH 78001|31579|31579 - LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY||243.28|0||0|10/01/2019 SH 78001|31578|31578 - LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER||320.64|0||0|10/01/2019 SH 78001|31577|31577 - LARYNGOSCOPY FLX RMVL FOREIGN BODY(S)||279.09|0||0|10/01/2019 SH 78001|31576|31576 - LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES)||256.35|0||0|10/01/2019 SH 78001|31575|31575 - LARYNGOSCOPY FLEXIBLE DIAGNOSTIC||131.59|0||0|10/01/2019 SH 78001|31574|31574 - LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI||1934.11|0||0|10/01/2019 SH 78001|31573|31573 - LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI||1773.91|0||0|10/01/2019 SH 78001|31572|31572 - LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI||1754.53|0||0|10/01/2019 SH 78001|31571|31571 - LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE||300.12|0||0|10/01/2019 SH 78001|31570|31570 - LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC||394.13|0||0|10/01/2019 SH 78001|31561|31561 - LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE||412.38|0||0|10/01/2019 SH 78001|31560|31560 - LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY||377.06|0||0|10/01/2019 SH 78001|31554|31554 - LARYNGOPLASTY LARYNGEAL STEN W/STENT 12 YRS >||1255.82|0||0|10/01/2019 SH 78001|31553|31553 - LARYNGOPLASTY LARYNGEAL STEN W/STENT < 12 YRS||324.29|0||0|10/01/2019 SH 78001|31552|31552 - LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >||609.39|0||0|10/01/2019 SH 78001|31551|31551 - LARYNGOPLASTY LARYNGEAL STEN W/O STENT < 12 YRS||2036.61|0||0|10/01/2019 SH 78001|31546|31546 - LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD GRAFT||662.54|0||0|10/01/2019 SH 78001|31545|31545 - LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP||435.06|0||0|10/01/2019 SH 78001|31541|31541 - LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP||317.55|0||0|10/01/2019 SH 78001|31540|31540 - LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT||290.6|0||0|10/01/2019 SH 78001|31536|31536 - LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE||252.82|0||0|10/01/2019 SH 78001|31535|31535 - LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY||227.46|0||0|10/01/2019 SH 78001|31531|31531 - LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE||254.88|0||0|10/01/2019 SH 78001|31530|31530 - LARYNGOSCOPY W/FOREIGN BODY REMOVAL||235.78|0||0|10/01/2019 SH 78001|31529|31529 - LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ||193.95|0||0|10/01/2019 SH 78001|31528|31528 - LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN||172.82|0||0|10/01/2019 SH 78001|31527|31527 - LARYNGOSCOPY W/WO TRACHEOSCOPY INSERT OBTURATOR||234.53|0||0|10/01/2019 SH 78001|31526|31526 - LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE||187.65|0||0|10/01/2019 SH 78001|31525|31525 - LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN||291.81|0||0|10/01/2019 SH 78001|31520|31520 - LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN||187.22|0||0|10/01/2019 SH 78001|31515|31515 - LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION||237.38|0||0|10/01/2019 SH 78001|31513|31513 - LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION||157.68|0||0|10/01/2019 SH 78001|31512|31512 - LARYNGOSCOPY INDIRECT W/REMOVAL LESION||238.57|0||0|10/01/2019 SH 78001|31511|31511 - LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY||243.62|0||0|10/01/2019 SH 78001|31510|31510 - LARYNGOSCOPY INDIRECT W/BIOPSY||243.34|0||0|10/01/2019 SH 78001|31505|31505 - LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX||94.16|0||0|10/01/2019 SH 78001|31502|31502 - TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT||41.61|0||0|10/01/2019 SH 78001|31500|31500 - INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE||133.1|0||0|10/01/2019 SH 78001|31420|31420 - EPIGLOTTIDECTOMY||975.85|0||0|10/01/2019 SH 78001|31400|31400 - ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH||1158.4|0||0|10/01/2019 SH 78001|31395|31395 - PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/RCNSTJ||3528.65|0||0|10/01/2019 SH 78001|31390|31390 - PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/O RCNSTJ||3356.69|0||0|10/01/2019 SH 78001|31382|31382 - PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL||2485.73|0||0|10/01/2019 SH 78001|31380|31380 - PARTIAL LARYNGECTOMY HEMILARYNG ANTEROVERTICAL||2264.02|0||0|10/01/2019 SH 78001|31375|31375 - PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL||2298|0||0|10/01/2019 SH 78001|31370|31370 - PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL||2420.88|0||0|10/01/2019 SH 78001|31368|31368 - LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ||2863.54|0||0|10/01/2019 SH 78001|31367|31367 - LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ||2581.72|0||0|10/01/2019 SH 78001|31365|31365 - LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION||3029.96|0||0|10/01/2019 SH 78001|31360|31360 - LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION||2441.61|0||0|10/01/2019 SH 78001|31320|31320 - LARYNGOTOMY THYROTOMY LARYNGOFISSURE DX||751.21|0||0|10/01/2019 SH 78001|31300|31300 - LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY||1471.56|0||0|10/01/2019 SH 78001|31299|31299 - UNLISTED PROCEDURE ACCESSORY SINUSES||0|0||0|10/01/2019 SH 78001|31298|31298 - NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS||4290.23|0||0|10/01/2019 SH 78001|31297|31297 - NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS||2264.6|0||0|10/01/2019 SH 78001|31296|31296 - NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS||2308.94|0||0|10/01/2019 SH 78001|31295|31295 - NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS||2274.56|0||0|10/01/2019 SH 78001|31294|31294 - NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN||1470.68|0||0|10/01/2019 SH 78001|31293|31293 - NASAL/SINUS NDSC SURG MEDIAL&INF ORB WALL DCMPRN||1283.39|0||0|10/01/2019 SH 78001|31292|31292 - NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN||1181.92|0||0|10/01/2019 SH 78001|31291|31291 - NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID||1463.67|0||0|10/01/2019 SH 78001|31290|31290 - NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID||1373.74|0||0|10/01/2019 SH 78001|31288|31288 - NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS||320.87|0||0|10/01/2019 SH 78001|31287|31287 - NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY||276.49|0||0|10/01/2019 SH 78001|31276|31276 - NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS||602.04|0||0|10/01/2019 SH 78001|31267|31267 - NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS||379|0||0|10/01/2019 SH 78001|31259|31259 - NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL||573.18|0||0|10/01/2019 SH 78001|31257|31257 - NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY||540.58|0||0|10/01/2019 SH 78001|31256|31256 - NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY||235.78|0||0|10/01/2019 SH 78001|31255|31255 - NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY||477.45|0||0|10/01/2019 SH 78001|31254|31254 - NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY||325.44|0||0|10/01/2019 SH 78001|31253|31253 - NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL||607.51|0||0|10/01/2019 SH 78001|31241|31241 - NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY||542.35|0||0|10/01/2019 SH 78001|31240|31240 - NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION||190.93|0||0|10/01/2019 SH 78001|31239|31239 - NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY||720.3|0||0|10/01/2019 SH 78001|31238|31238 - NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG||297.33|0||0|10/01/2019 SH 78001|31237|31237 - NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX||297.1|0||0|10/01/2019 SH 78001|31235|31235 - NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY||342.24|0||0|10/01/2019 SH 78001|31233|31233 - NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY||299.91|0||0|10/01/2019 SH 78001|31231|31231 - NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX||236.25|0||0|10/01/2019 SH 78001|31230|31230 - MAXILLECTOMY W/ORBITAL EXENTERATION||2436.68|0||0|10/01/2019 SH 78001|31225|31225 - MAXILLECTOMY W/O ORBITAL EXENTERATION||2196.89|0||0|10/01/2019 SH 78001|31205|31205 - ETHMOIDECTOMY EXTRANASAL TOTAL||1033.24|0||0|10/01/2019 SH 78001|31201|31201 - ETHMOIDECTOMY INTRANASAL TOTAL||856.05|0||0|10/01/2019 SH 78001|31200|31200 - ETHMOIDECTOMY INTRANASAL ANTERIOR||649.7|0||0|10/01/2019 SH 78001|31090|31090 - SINUSOT UNI 3/> PARANSL SINUSES||1179.78|0||0|10/01/2019 SH 78001|31087|31087 - SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC||1260.21|0||0|10/01/2019 SH 78001|31086|31086 - SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC||1301.93|0||0|10/01/2019 SH 78001|31085|31085 - SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC||1695.97|0||0|10/01/2019 SH 78001|31084|31084 - SINUSOT FRNT OBLIT W/OSTPL FLAP BROW INC||1339.79|0||0|10/01/2019 SH 78001|31081|31081 - SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC||1754.43|0||0|10/01/2019 SH 78001|31080|31080 - SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC||1194.81|0||0|10/01/2019 SH 78001|31075|31075 - SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL||904.63|0||0|10/01/2019 SH 78001|31070|31070 - SINUSOTOMY FRONTAL EXTERNAL SIMPLE||504.25|0||0|10/01/2019 SH 78001|31051|31051 - SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP||744.69|0||0|10/01/2019 SH 78001|31050|31050 - SINUSOTOMY SPHENOID W/WO BIOPSY||559.29|0||0|10/01/2019 SH 78001|31040|31040 - PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH||892.97|0||0|10/01/2019 SH 78001|31032|31032 - SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS||665.1|0||0|10/01/2019 SH 78001|31030|31030 - SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS||793.54|0||0|10/01/2019 SH 78001|31020|31020 - SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL||551.92|0||0|10/01/2019 SH 78001|31002|31002 - LAVAGE CANNULATION SPHENOID SINUS||222.19|0||0|10/01/2019 SH 78001|31000|31000 - LAVAGE CANNULATION MAXILLARY SINUS||208.39|0||0|10/01/2019 SH 78001|30999|30999 - UNLISTED PROCEDURE NOSE||0|0||0|10/01/2019 SH 78001|30930|30930 - FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC||142.2|0||0|10/01/2019 SH 78001|30920|30920 - LIGATION ARTERIES INT MAXILLARY TRANSANTRAL||972.64|0||0|10/01/2019 SH 78001|30915|30915 - LIGATION ARTERIES ETHMOIDAL||669.94|0||0|10/01/2019 SH 78001|30906|30906 - CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ||320.87|0||0|10/01/2019 SH 78001|30905|30905 - CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST||293.18|0||0|10/01/2019 SH 78001|30903|30903 - CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX||234.31|0||0|10/01/2019 SH 78001|30901|30901 - CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE||110.27|0||0|10/01/2019 SH 78001|30802|30802 - ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL||330.49|0||0|10/01/2019 SH 78001|30801|30801 - ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC||257.75|0||0|10/01/2019 SH 78001|30630|30630 - REPAIR NASAL SEPTAL PERFORATIONS||724.33|0||0|10/01/2019 SH 78001|30620|30620 - SEPTAL/OTHER INTRANASAL DERMATOPLASTY||717.04|0||0|10/01/2019 SH 78001|30600|30600 - REPAIR FISTULA ORONASAL||658.5|0||0|10/01/2019 SH 78001|30580|30580 - REPAIR FISTULA OROMAXILLARY||755.5|0||0|10/01/2019 SH 78001|30560|30560 - LYSIS INTRANASAL SYNECHIA||302.69|0||0|10/01/2019 SH 78001|30545|30545 - REPAIR CHOANAL ATRESIA TRANSPALATINE||995.87|0||0|10/01/2019 SH 78001|30540|30540 - REPAIR CHOANAL ATRESIA INTRANASAL||794.93|0||0|10/01/2019 SH 78001|30520|30520 - SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF||719.99|0||0|10/01/2019 SH 78001|30465|30465 - REPAIR NASAL VESTIBULAR STENOSIS||1139.26|0||0|10/01/2019 SH 78001|30462|30462 - RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT||1655.17|0||0|10/01/2019 SH 78001|30460|30460 - RHINP DFRM W/COLUM LNGTH TIP ONLY||945.44|0||0|10/01/2019 SH 78001|30450|30450 - RHINOPLASTY SECONDARY MAJOR REVISION||1740.35|0||0|10/01/2019 SH 78001|30435|30435 - RHINOPLASTY SECONDARY INTERMEDIATE REVISION||1434.39|0||0|10/01/2019 SH 78001|30430|30430 - RHINOPLASTY SECONDARY MINOR REVISION||992.9|0||0|10/01/2019 SH 78001|30420|30420 - RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR||1592.96|0||0|10/01/2019 SH 78001|30410|30410 - RHINP PRIM COMPLETE XTRNL PARTS||1366.63|0||0|10/01/2019 SH 78001|30400|30400 - RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI||1159.42|0||0|10/01/2019 SH 78001|30320|30320 - RMVL FOREIGN BODY INTRANASAL LATERAL RHINOTOMY||520.43|0||0|10/01/2019 SH 78001|30310|30310 - REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES||235.59|0||0|10/01/2019 SH 78001|30300|30300 - REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE||259.46|0||0|10/01/2019 SH 78001|30220|30220 - INSERTION NASAL SEPTAL PROSTHESIS BUTTON||341.13|0||0|10/01/2019 SH 78001|30210|30210 - DISPLACEMENT THERAPY PROETZ TYPE||171.26|0||0|10/01/2019 SH 78001|30200|30200 - INJECTION TURBINATE THERAPEUTIC||129.02|0||0|10/01/2019 SH 78001|30160|30160 - RHINECTOMY TOTAL||899.37|0||0|10/01/2019 SH 78001|30150|30150 - RHINECTOMY PARTIAL||892.42|0||0|10/01/2019 SH 78001|30140|30140 - SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL||502.55|0||0|10/01/2019 SH 78001|30130|30130 - EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE||436.21|0||0|10/01/2019 SH 78001|30125|30125 - EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG||704.21|0||0|10/01/2019 SH 78001|30124|30124 - EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS||329.2|0||0|10/01/2019 SH 78001|30120|30120 - EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA||596.99|0||0|10/01/2019 SH 78001|30118|30118 - EXCISION/DESTRUCTION INTRANASAL LESION XTRNL||891.7|0||0|10/01/2019 SH 78001|30117|30117 - EXCISION/DESTRUCTION INTRANASAL LESION INT APPR||983.04|0||0|10/01/2019 SH 78001|30115|30115 - EXCISION NASAL POLYP EXTENSIVE||497.45|0||0|10/01/2019 SH 78001|30110|30110 - EXCISION NASAL POLYP SIMPLE||262.45|0||0|10/01/2019 SH 78001|30100|30100 - BIOPSY INTRANASAL||160.73|0||0|10/01/2019 SH 78001|30020|30020 - DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM||263.89|0||0|10/01/2019 SH 78001|30000|30000 - DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH||260.79|0||0|10/01/2019 SH 78001|29999|29999 - UNLISTED PROCEDURE ARTHROSCOPY||0|0||0|10/01/2019 SH 78001|29916|29916 - ARTHROSCOPY HIP W/LABRAL REPAIR||1196.24|0||0|10/01/2019 SH 78001|29915|29915 - ARTHROSCOPY HIP W/ACETABULOPLASTY||1193.14|0||0|10/01/2019 SH 78001|29914|29914 - ARTHROSCOPY HIP W/FEMOROPLASTY||1171.15|0||0|10/01/2019 SH 78001|29907|29907 - ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS||1035.13|0||0|10/01/2019 SH 78001|29906|29906 - ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT||833.27|0||0|10/01/2019 SH 78001|29905|29905 - ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY||765.03|0||0|10/01/2019 SH 78001|29904|29904 - ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY||752.89|0||0|10/01/2019 SH 78001|29902|29902 - ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM||571.78|0||0|10/01/2019 SH 78001|29901|29901 - ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT||613.5|0||0|10/01/2019 SH 78001|29900|29900 - ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY||491.26|0||0|10/01/2019 SH 78001|29899|29899 - ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS||1236.9|0||0|10/01/2019 SH 78001|29898|29898 - ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE||669.9|0||0|10/01/2019 SH 78001|29897|29897 - ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED||598.89|0||0|10/01/2019 SH 78001|29895|29895 - ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL||571.28|0||0|10/01/2019 SH 78001|29894|29894 - ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY||592.42|0||0|10/01/2019 SH 78001|29893|29893 - ENDOSCOPIC PLANTAR FASCIOTOMY||711.45|0||0|10/01/2019 SH 78001|29892|29892 - ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX||742.66|0||0|10/01/2019 SH 78001|29891|29891 - ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT||801.87|0||0|10/01/2019 SH 78001|29889|29889 - ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ||1448.12|0||0|10/01/2019 SH 78001|29888|29888 - ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ||1164.2|0||0|10/01/2019 SH 78001|29887|29887 - ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ||878.91|0||0|10/01/2019 SH 78001|29886|29886 - ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION||750.25|0||0|10/01/2019 SH 78001|29885|29885 - ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG||887.68|0||0|10/01/2019 SH 78001|29884|29884 - ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX||721.35|0||0|10/01/2019 SH 78001|29883|29883 - ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL||995.32|0||0|10/01/2019 SH 78001|29882|29882 - ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL||825.68|0||0|10/01/2019 SH 78001|29881|29881 - ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG||635.26|0||0|10/01/2019 SH 78001|29880|29880 - ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING||660.88|0||0|10/01/2019 SH 78001|29879|29879 - ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX||780.34|0||0|10/01/2019 SH 78001|29877|29877 - ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG||731.56|0||0|10/01/2019 SH 78001|29876|29876 - ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS||775.18|0||0|10/01/2019 SH 78001|29875|29875 - ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX||581.55|0||0|10/01/2019 SH 78001|29874|29874 - ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY||632.09|0||0|10/01/2019 SH 78001|29873|29873 - ARTHROSCOPY KNEE LATERAL RELEASE||613.2|0||0|10/01/2019 SH 78001|29871|29871 - ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE||603.93|0||0|10/01/2019 SH 78001|29870|29870 - ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX||673.31|0||0|10/01/2019 SH 78001|29868|29868 - ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT||1990.17|0||0|10/01/2019 SH 78001|29867|29867 - ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT||1515.62|0||0|10/01/2019 SH 78001|29866|29866 - ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST||1240.69|0||0|10/01/2019 SH 78001|29863|29863 - ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY||945.68|0||0|10/01/2019 SH 78001|29862|29862 - ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG||948.01|0||0|10/01/2019 SH 78001|29861|29861 - ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB||842.92|0||0|10/01/2019 SH 78001|29860|29860 - ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX||786.22|0||0|10/01/2019 SH 78001|29856|29856 - ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR||1179.66|0||0|10/01/2019 SH 78001|29855|29855 - ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR||924.97|0||0|10/01/2019 SH 78001|29851|29851 - ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ||1103.07|0||0|10/01/2019 SH 78001|29850|29850 - ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ||734.55|0||0|10/01/2019 SH 78001|29848|29848 - NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM||596|0||0|10/01/2019 SH 78001|29847|29847 - ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY||639.61|0||0|10/01/2019 SH 78001|29846|29846 - ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT||608.25|0||0|10/01/2019 SH 78001|29845|29845 - ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE||674.17|0||0|10/01/2019 SH 78001|29844|29844 - ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL||577.88|0||0|10/01/2019 SH 78001|29843|29843 - ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE||567.83|0||0|10/01/2019 SH 78001|29840|29840 - ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX||530.1|0||0|10/01/2019 SH 78001|29838|29838 - ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE||687.82|0||0|10/01/2019 SH 78001|29837|29837 - ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED||614.59|0||0|10/01/2019 SH 78001|29836|29836 - ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE||679.02|0||0|10/01/2019 SH 78001|29835|29835 - ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL||591.22|0||0|10/01/2019 SH 78001|29834|29834 - ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB||568.58|0||0|10/01/2019 SH 78001|29830|29830 - ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX||536.02|0||0|10/01/2019 SH 78001|29828|29828 - ARTHROSCOPY SHOULDER BICEPS TENODESIS||1071.1|0||0|10/01/2019 SH 78001|29827|29827 - ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR||1244.18|0||0|10/01/2019 SH 78001|29826|29826 - ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE||210.89|0||0|10/01/2019 SH 78001|29825|29825 - ARTHROSCOPY SHOULDER AHESIOLYSIS W/WO MANIPJ||677.7|0||0|10/01/2019 SH 78001|29824|29824 - ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY||781.77|0||0|10/01/2019 SH 78001|29823|29823 - ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE||724.39|0||0|10/01/2019 SH 78001|29822|29822 - ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED||664.47|0||0|10/01/2019 SH 78001|29821|29821 - ARTHROSCOPY SHOULDER SURG SYNOVECTOMY COMPLETE||684.35|0||0|10/01/2019 SH 78001|29820|29820 - ARTHROSCOPY SHOULDER SURG SYNOVECTOMY PARTIAL||627.49|0||0|10/01/2019 SH 78001|29819|29819 - ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB||689.79|0||0|10/01/2019 SH 78001|29807|29807 - ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION||1224.01|0||0|10/01/2019 SH 78001|29806|29806 - ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY||1253.99|0||0|10/01/2019 SH 78001|29805|29805 - ARTHROSCOPY SHOULDER DX W/WO SYNOVIAL BIOPSY SPX||553.74|0||0|10/01/2019 SH 78001|29804|29804 - ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL||755.72|0||0|10/01/2019 SH 78001|29800|29800 - ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX||608.41|0||0|10/01/2019 SH 78001|29799|29799 - UNLISTED PROCEDURE CASTING/STRAPPING||0|0||0|10/01/2019 SH 78001|29750|29750 - WEDGING CLUBFOOT CAST||111.75|0||0|10/01/2019 SH 78001|29740|29740 - WEDGING CAST EXCEPT CLUBFOOT CASTS||115.8|0||0|10/01/2019 SH 78001|29730|29730 - WINDOWING CAST||74.23|0||0|10/01/2019 SH 78001|29720|29720 - REPAIR SPICA BODY CAST/JACKET||97.97|0||0|10/01/2019 SH 78001|29710|29710 - RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET||144.29|0||0|10/01/2019 SH 78001|29705|29705 - REMOVAL/BIVALVING FULL ARM/FULL LEG CAST||78.16|0||0|10/01/2019 SH 78001|29700|29700 - REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST||70.34|0||0|10/01/2019 SH 78001|29584|29584 - APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING||79.45|0||0|10/01/2019 SH 78001|29583|29583 - APPL MLTLAYR COMPRES SYSTEM UPPER & LOWER ARM||49.94|0||0|10/01/2019 SH 78001|29582|29582 - APPL MLTLAYR COMPRES THGH LEG ANKLE FT WHEN DONE||79.45|0||0|10/01/2019 SH 78001|29581|29581 - APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT||69.71|0||0|10/01/2019 SH 78001|29580|29580 - STRAPPING UNNA BOOT||60.17|0||0|10/01/2019 SH 78001|29550|29550 - STRAPPING TOES||22.03|0||0|10/01/2019 SH 78001|29540|29540 - STRAPPING ANKLE &/FOOT||30|0||0|10/01/2019 SH 78001|29530|29530 - STRAPPING KNEE||32.71|0||0|10/01/2019 SH 78001|29520|29520 - STRAPPING HIP||35.82|0||0|10/01/2019 SH 78001|29515|29515 - APPLICATION SHORT LEG SPLINT CALF FOOT||82.67|0||0|10/01/2019 SH 78001|29505|29505 - APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES||95.29|0||0|10/01/2019 SH 78001|29450|29450 - APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG||168.81|0||0|10/01/2019 SH 78001|29445|29445 - APPLICATION RIGID TOTAL CONTACT LEG CAST||158.6|0||0|10/01/2019 SH 78001|29440|29440 - ADDING WALKER PREVIOUSLY APPLIED CAST||50.95|0||0|10/01/2019 SH 78001|29435|29435 - APPLICATION PATELLAR TENDON BEARING CAST||136.6|0||0|10/01/2019 SH 78001|29425|29425 - APPLICATION SHORT LEG CAST WALKING/AMBULATORY||90.34|0||0|10/01/2019 SH 78001|29405|29405 - APPLICATION SHORT LEG CAST BELOW KNEE-TOE||94.22|0||0|10/01/2019 SH 78001|29365|29365 - APPLICATION CYLINDER CAST THIGH ANKLE||141.64|0||0|10/01/2019 SH 78001|29358|29358 - APPLICATION LONG LEG CAST BRACE||185.39|0||0|10/01/2019 SH 78001|29355|29355 - APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE||163.33|0||0|10/01/2019 SH 78001|29345|29345 - APPLICATION LONG LEG CAST THIGH-TOE||158.11|0||0|10/01/2019 SH 78001|29325|29325 - APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS||314.9|0||0|10/01/2019 SH 78001|29305|29305 - APPLICATION HIP SPICA CAST 1 LEG||284.17|0||0|10/01/2019 SH 78001|29280|29280 - STRAPPING HAND/FINGER||33.88|0||0|10/01/2019 SH 78001|29260|29260 - STRAPPING ELBOW/WRIST||33.49|0||0|10/01/2019 SH 78001|29240|29240 - STRAPPING SHOULDER||33.49|0||0|10/01/2019 SH 78001|29200|29200 - STRAPPING THORAX||34.65|0||0|10/01/2019 SH 78001|29131|29131 - APPLICATION FINGER SPLINT DYNAMIC||59.01|0||0|10/01/2019 SH 78001|29130|29130 - APPLICATION FINGER SPLINT STATIC||47.16|0||0|10/01/2019 SH 78001|29126|29126 - APPLICATION SHORT ARM SPLINT DYNAMIC||88.65|0||0|10/01/2019 SH 78001|29125|29125 - APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC||73.13|0||0|10/01/2019 SH 78001|29105|29105 - APPLICATION LONG ARM SPLINT SHOULDER HAND||101.89|0||0|10/01/2019 SH 78001|29086|29086 - APPLICATION CAST FINGER||88.38|0||0|10/01/2019 SH 78001|29085|29085 - APPLICATION CAST HAND & LOWER FOREARM GAUNTLET||110.04|0||0|10/01/2019 SH 78001|29075|29075 - APPLICATION CAST ELBOW FINGER SHORT ARM||99.91|0||0|10/01/2019 SH 78001|29065|29065 - APPLICATION CAST SHOULDER HAND LONG ARM||110.82|0||0|10/01/2019 SH 78001|29058|29058 - APPLICATION CAST PLASTER VELPEAU||144.54|0||0|10/01/2019 SH 78001|29055|29055 - APPLICATION CAST SHOULDER SPICA||255.15|0||0|10/01/2019 SH 78001|29049|29049 - APPLICATION CAST FIGURE-OF-8||85.32|0||0|10/01/2019 SH 78001|29046|29046 - APPLICATION BODY CAST SHOULDER HIPS BOTH THIGHS||273.36|0||0|10/01/2019 SH 78001|29044|29044 - APPLICATION BODY CAST SHOULDER HIPS W/ONE THIGH||296.11|0||0|10/01/2019 SH 78001|29040|29040 - APPLICATION BODY CAST SHOULDER HIPS HEAD MINERVA||253.53|0||0|10/01/2019 SH 78001|29035|29035 - APPLICATION BODY CAST SHOULDER HIPS||255.88|0||0|10/01/2019 SH 78001|29015|29015 - APPLICATION RISSER JACKET LOCALIZER BODY W/HEAD||317.24|0||0|10/01/2019 SH 78001|29010|29010 - APPLICATION RISSER JACKET LOCALIZER BODY ONLY||254.46|0||0|10/01/2019 SH 78001|29000|29000 - APPLICATION HALO TYPE BODY CAST||348.04|0||0|10/01/2019 SH 78001|28899|28899 - UNLISTED PROCEDURE FOOT/TOES||0|0||0|10/01/2019 SH 78001|28890|28890 - ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA||376.77|0||0|10/01/2019 SH 78001|28825|28825 - AMPUTATION TOE INTERPHALANGEAL JOINT||629.44|0||0|10/01/2019 SH 78001|28820|28820 - AMPUTATION TOE METATARSOPHALANGEAL JOINT||660.1|0||0|10/01/2019 SH 78001|28810|28810 - AMPUTATION METATARSAL W/TOE SINGLE||513.34|0||0|10/01/2019 SH 78001|28805|28805 - AMPUTATION FOOT TRANSMETARSAL||877.19|0||0|10/01/2019 SH 78001|28800|28800 - AMPUTATION FOOT MIDTARSAL||648.31|0||0|10/01/2019 SH 78001|28760|28760 - ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK||926.2|0||0|10/01/2019 SH 78001|28755|28755 - ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT||590.44|0||0|10/01/2019 SH 78001|28750|28750 - ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT||951.28|0||0|10/01/2019 SH 78001|28740|28740 - ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT||988.93|0||0|10/01/2019 SH 78001|28737|28737 - ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR||821.69|0||0|10/01/2019 SH 78001|28735|28735 - ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT||927.01|0||0|10/01/2019 SH 78001|28730|28730 - ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS||863.73|0||0|10/01/2019 SH 78001|28725|28725 - ARTHRODESIS SUBTALAR||918.37|0||0|10/01/2019 SH 78001|28715|28715 - ARTHRODESIS TRIPLE||1108.71|0||0|10/01/2019 SH 78001|28705|28705 - ARTHRODESIS PANTALAR||1495.63|0||0|10/01/2019 SH 78001|28675|28675 - OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION||686.36|0||0|10/01/2019 SH 78001|28666|28666 - PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ||226.07|0||0|10/01/2019 SH 78001|28665|28665 - CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES||181.13|0||0|10/01/2019 SH 78001|28660|28660 - CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES||135.47|0||0|10/01/2019 SH 78001|28645|28645 - OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION||765.63|0||0|10/01/2019 SH 78001|28636|28636 - PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ||403.72|0||0|10/01/2019 SH 78001|28635|28635 - CLTX METATARSOPHLNGL JT DISLC REQ ANES||199.69|0||0|10/01/2019 SH 78001|28630|28630 - CLTX METATARSOPHLNGL JT DISLC W/O ANES||181.72|0||0|10/01/2019 SH 78001|28615|28615 - OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION||927.34|0||0|10/01/2019 SH 78001|28606|28606 - PRQ SKEL FIXJ TARS JT DISLC W/MANJ||461.56|0||0|10/01/2019 SH 78001|28605|28605 - CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES||377.5|0||0|10/01/2019 SH 78001|28600|28600 - CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES||249.98|0||0|10/01/2019 SH 78001|28585|28585 - OPEN TREATMENT TALOTARSAL JOINT DISLOCATION||1003.11|0||0|10/01/2019 SH 78001|28576|28576 - PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ||462.16|0||0|10/01/2019 SH 78001|28575|28575 - CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES||419.29|0||0|10/01/2019 SH 78001|28570|28570 - CLOSED TX TALOTARSAL JOINT DISLC W/O ANES||198.08|0||0|10/01/2019 SH 78001|28555|28555 - OPEN TREATMENT TARSAL BONE DISLOCATION||1030.1|0||0|10/01/2019 SH 78001|28546|28546 - PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ||661.18|0||0|10/01/2019 SH 78001|28545|28545 - CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES||340.94|0||0|10/01/2019 SH 78001|28540|28540 - CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES||223.56|0||0|10/01/2019 SH 78001|28531|28531 - OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION||394.23|0||0|10/01/2019 SH 78001|28530|28530 - CLOSED TREATMENT SESAMOID FRACTURE||133.17|0||0|10/01/2019 SH 78001|28525|28525 - OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE||649.89|0||0|10/01/2019 SH 78001|28515|28515 - CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ||187.86|0||0|10/01/2019 SH 78001|28510|28510 - CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ||143.13|0||0|10/01/2019 SH 78001|28505|28505 - OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES||788.53|0||0|10/01/2019 SH 78001|28496|28496 - PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ||506.33|0||0|10/01/2019 SH 78001|28495|28495 - CLTX FX GRT TOE PHLX/PHLG W/MANJ||207.39|0||0|10/01/2019 SH 78001|28490|28490 - CLTX FX GRT TOE PHLX/PHLG W/O MANJ||167.17|0||0|10/01/2019 SH 78001|28485|28485 - OPEN TREATMENT METATARSAL FRACTURE EACH||619.9|0||0|10/01/2019 SH 78001|28476|28476 - PRQ SKEL FIXJ METAR FX W/MANJ||406.95|0||0|10/01/2019 SH 78001|28475|28475 - CLTX METAR FX W/MANJ||298.11|0||0|10/01/2019 SH 78001|28470|28470 - CLOSED TX METATARSAL FRACTURE W/O MANIPULATION||252.35|0||0|10/01/2019 SH 78001|28465|28465 - OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA||727.46|0||0|10/01/2019 SH 78001|28456|28456 - PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ||368.45|0||0|10/01/2019 SH 78001|28455|28455 - TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ||334.78|0||0|10/01/2019 SH 78001|28450|28450 - TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ||248.47|0||0|10/01/2019 SH 78001|28446|28446 - OPEN OSTEOCHONDRAL AUTOGRAFT TALUS||1450.21|0||0|10/01/2019 SH 78001|28445|28445 - OPEN TREATMENT TALUS FRACTURE||1263.6|0||0|10/01/2019 SH 78001|28436|28436 - PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ||522.79|0||0|10/01/2019 SH 78001|28435|28435 - CLOSED TX TALUS FRACTURE W/MANIPULATION||375.32|0||0|10/01/2019 SH 78001|28430|28430 - CLOSED TX TALUS FRACTURE W/O MANIPULATION||272.96|0||0|10/01/2019 SH 78001|28420|28420 - OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT||1482.33|0||0|10/01/2019 SH 78001|28415|28415 - OPEN TREATMENT CALCANEAL FRACTURE||1308.11|0||0|10/01/2019 SH 78001|28406|28406 - PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ||616.51|0||0|10/01/2019 SH 78001|28405|28405 - CLOSED TX CALCANEAL FRACTURE W/MANIPULATION||463.11|0||0|10/01/2019 SH 78001|28400|28400 - CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION||286.15|0||0|10/01/2019 SH 78001|28360|28360 - RECONSTRUCTION CLEFT FOOT||978.52|0||0|10/01/2019 SH 78001|28345|28345 - RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB||611.97|0||0|10/01/2019 SH 78001|28344|28344 - RECONSTRUCTION TOE POLYDACTYLY||639.99|0||0|10/01/2019 SH 78001|28341|28341 - RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION||789.77|0||0|10/01/2019 SH 78001|28340|28340 - RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION||679.4|0||0|10/01/2019 SH 78001|28322|28322 - RPR NON/MALUNION METARSAL W/WO BONE GRAFT||922.05|0||0|10/01/2019 SH 78001|28320|28320 - REPAIR NONUNION/MALUNION TARSAL BONES||719.48|0||0|10/01/2019 SH 78001|28315|28315 - SESAMOIDECTOMY FIRST TOE SPX||563.04|0||0|10/01/2019 SH 78001|28313|28313 - RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY||616.07|0||0|10/01/2019 SH 78001|28312|28312 - OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE||601.24|0||0|10/01/2019 SH 78001|28310|28310 - OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE||638.42|0||0|10/01/2019 SH 78001|28309|28309 - OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT||1080.89|0||0|10/01/2019 SH 78001|28308|28308 - OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA||656.64|0||0|10/01/2019 SH 78001|28307|28307 - OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE||824.45|0||0|10/01/2019 SH 78001|28306|28306 - OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR||714.38|0||0|10/01/2019 SH 78001|28305|28305 - OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT||775.08|0||0|10/01/2019 SH 78001|28304|28304 - OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS||970.07|0||0|10/01/2019 SH 78001|28302|28302 - OSTEOTOMY TALUS||842.97|0||0|10/01/2019 SH 78001|28300|28300 - OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION||772.65|0||0|10/01/2019 SH 78001|28299|28299 - CORRJ HALLUX VALGUS W/SESMDC W/2 OSTEOT||1056.2|0||0|10/01/2019 SH 78001|28298|28298 - CORRJ HALLUX VALGUS W/SESMDC W/PROX PHLNX OSTEOT||841.52|0||0|10/01/2019 SH 78001|28297|28297 - CORRJ HALLUX VALGUS W/SESMDC W/1METAR MEDIAL CNF||949.57|0||0|10/01/2019 SH 78001|28296|28296 - CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT||835.09|0||0|10/01/2019 SH 78001|28295|28295 - CORRJ HALLUX VALGUS W/SESMDC W/PROX METAR OSTEOT||1167.1|0||0|10/01/2019 SH 78001|28292|28292 - CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL||923.83|0||0|10/01/2019 SH 78001|28291|28291 - HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/IMPLT||910.42|0||0|10/01/2019 SH 78001|28289|28289 - HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT||857.83|0||0|10/01/2019 SH 78001|28288|28288 - OSTC PRTL EXOSTC/CONDYLC METAR HEAD||701.64|0||0|10/01/2019 SH 78001|28286|28286 - CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE||524.1|0||0|10/01/2019 SH 78001|28285|28285 - CORRECTION HAMMERTOE||623.51|0||0|10/01/2019 SH 78001|28280|28280 - SYNDACTYLIZATION TOES||599.38|0||0|10/01/2019 SH 78001|28272|28272 - CAPSULOTOMY IPHAL JOINT EACH JOINT SPX||459.84|0||0|10/01/2019 SH 78001|28270|28270 - CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX||573.2|0||0|10/01/2019 SH 78001|28264|28264 - CAPSULOTOMY MIDTARSAL||991.64|0||0|10/01/2019 SH 78001|28262|28262 - CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH||1724.8|0||0|10/01/2019 SH 78001|28261|28261 - CAPSULOTOMY MIDFOOT W/TENDON LENGTHENING||1175.02|0||0|10/01/2019 SH 78001|28260|28260 - CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX||805.36|0||0|10/01/2019 SH 78001|28250|28250 - DIVISION PLANTAR FASCIA & MUSCLE SPX||677.43|0||0|10/01/2019 SH 78001|28240|28240 - TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC||513.85|0||0|10/01/2019 SH 78001|28238|28238 - RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR||793.1|0||0|10/01/2019 SH 78001|28234|28234 - TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON||474.86|0||0|10/01/2019 SH 78001|28232|28232 - TX OPEN TENDON FLEXOR TOE 1 TENDON SPX||449.52|0||0|10/01/2019 SH 78001|28230|28230 - TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX||509.07|0||0|10/01/2019 SH 78001|28226|28226 - TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON||513.89|0||0|10/01/2019 SH 78001|28225|28225 - TENOLYSIS EXTENSOR FOOT SINGLE TENDON||473.19|0||0|10/01/2019 SH 78001|28222|28222 - TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS||588.44|0||0|10/01/2019 SH 78001|28220|28220 - TENOLYSIS FLEXOR FOOT SINGLE TENDON||525.92|0||0|10/01/2019 SH 78001|28210|28210 - RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON||680.91|0||0|10/01/2019 SH 78001|28208|28208 - REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON||551.99|0||0|10/01/2019 SH 78001|28202|28202 - RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON||694.58|0||0|10/01/2019 SH 78001|28200|28200 - RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON||568.5|0||0|10/01/2019 SH 78001|28193|28193 - REMOVAL FOREIGN BODY FOOT COMPLICATED||623.18|0||0|10/01/2019 SH 78001|28192|28192 - REMOVAL FOREIGN BODY FOOT DEEP||546.96|0||0|10/01/2019 SH 78001|28190|28190 - REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS||295.65|0||0|10/01/2019 SH 78001|28175|28175 - RADICAL RESECTION TUMOR PHALANX OR TOE||582.44|0||0|10/01/2019 SH 78001|28173|28173 - RADICAL RESECTION TUMOR METATARSAL||912.45|0||0|10/01/2019 SH 78001|28171|28171 - RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS||1018.76|0||0|10/01/2019 SH 78001|28160|28160 - HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE||489.91|0||0|10/01/2019 SH 78001|28153|28153 - RESECTION CONDYLE DISTAL END PHALANX EACH TOE||478.7|0||0|10/01/2019 SH 78001|28150|28150 - PHALANGECTOMY TOE EACH TOE||497.65|0||0|10/01/2019 SH 78001|28140|28140 - METATARSECTOMY||698.05|0||0|10/01/2019 SH 78001|28130|28130 - TALECTOMY ASTRAGALECTOMY||722.24|0||0|10/01/2019 SH 78001|28126|28126 - RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH||459.01|0||0|10/01/2019 SH 78001|28124|28124 - PARTICAL EXCISION BONE PHALANX TOE||555.66|0||0|10/01/2019 SH 78001|28122|28122 - PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS||700.23|0||0|10/01/2019 SH 78001|28120|28120 - PARTIAL EXCISION BONE TALUS/CALCANEUS||789.9|0||0|10/01/2019 SH 78001|28119|28119 - OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS||612.78|0||0|10/01/2019 SH 78001|28118|28118 - OSTECTOMY CALCANEUS||691.68|0||0|10/01/2019 SH 78001|28116|28116 - OSTECTOMY TARSAL COALITION||885.09|0||0|10/01/2019 SH 78001|28114|28114 - OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC||1262.47|0||0|10/01/2019 SH 78001|28113|28113 - OSTECTOMY COMPLETE 5TH METATARSAL HEAD||692.73|0||0|10/01/2019 SH 78001|28112|28112 - OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4||570.74|0||0|10/01/2019 SH 78001|28111|28111 - OSTECTOMY COMPLETE 1ST METATARSAL HEAD||577.67|0||0|10/01/2019 SH 78001|28110|28110 - OSTECTOMY PRTL 5TH METAR HEAD SPX||538.31|0||0|10/01/2019 SH 78001|28108|28108 - EXC/CURTG CST/B9 TUM PHALANGES FOOT||515.39|0||0|10/01/2019 SH 78001|28107|28107 - EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT||603.03|0||0|10/01/2019 SH 78001|28106|28106 - EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT||509.71|0||0|10/01/2019 SH 78001|28104|28104 - EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL||619.64|0||0|10/01/2019 SH 78001|28103|28103 - EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT||465.26|0||0|10/01/2019 SH 78001|28102|28102 - EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT||712.46|0||0|10/01/2019 SH 78001|28100|28100 - EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS||709.76|0||0|10/01/2019 SH 78001|28092|28092 - EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA||490.25|0||0|10/01/2019 SH 78001|28090|28090 - EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT||547.9|0||0|10/01/2019 SH 78001|28088|28088 - SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR||508.16|0||0|10/01/2019 SH 78001|28086|28086 - SYNOVECTOMY TENDON SHEATH FOOT FLEXOR||639.5|0||0|10/01/2019 SH 78001|28080|28080 - EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH||610.89|0||0|10/01/2019 SH 78001|28072|28072 - SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH||598.29|0||0|10/01/2019 SH 78001|28070|28070 - SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX||614.89|0||0|10/01/2019 SH 78001|28062|28062 - FASCIOTOMY PLANTAR FASCIA RADICAL SPX||681.29|0||0|10/01/2019 SH 78001|28060|28060 - FASCIECTOMY PLANTAR FASCIA PARTIAL SPX||602.78|0||0|10/01/2019 SH 78001|28055|28055 - NEURECTOMY INTRINSIC MUSCULATURE OF FOOT||449.66|0||0|10/01/2019 SH 78001|28054|28054 - ARTHRTOMY W/BX INTERPHALANGEAL JOINT||435.82|0||0|10/01/2019 SH 78001|28052|28052 - ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT||509.68|0||0|10/01/2019 SH 78001|28050|28050 - ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT||557.25|0||0|10/01/2019 SH 78001|28047|28047 - RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/>||1279.52|0||0|10/01/2019 SH 78001|28046|28046 - RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM||869.85|0||0|10/01/2019 SH 78001|28045|28045 - EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM||577.02|0||0|10/01/2019 SH 78001|28043|28043 - EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM||464.29|0||0|10/01/2019 SH 78001|28041|28041 - EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>||542.54|0||0|10/01/2019 SH 78001|28039|28039 - EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>||592.82|0||0|10/01/2019 SH 78001|28035|28035 - RELEASE TARSAL TUNNEL||613.69|0||0|10/01/2019 SH 78001|28024|28024 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT||538.07|0||0|10/01/2019 SH 78001|28022|28022 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT||569.59|0||0|10/01/2019 SH 78001|28020|28020 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT||633.52|0||0|10/01/2019 SH 78001|28011|28011 - TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON||378.47|0||0|10/01/2019 SH 78001|28010|28010 - TENOTOMY PERCUTANEOUS TOE SINGLE TENDON||271.55|0||0|10/01/2019 SH 78001|28008|28008 - FASCIOTOMY FOOT&/TOE||504.25|0||0|10/01/2019 SH 78001|28005|28005 - INCISION BONE CORTEX FOOT||687.92|0||0|10/01/2019 SH 78001|28003|28003 - I&D BELOW FASCIA FOOT MULTIPLE AREAS||829.32|0||0|10/01/2019 SH 78001|28002|28002 - I&D BELOW FASCIA FOOT 1 BURSAL SPACE||516.46|0||0|10/01/2019 SH 78001|28001|28001 - INCISION&DRAINAGE BURSA FOOT||325|0||0|10/01/2019 SH 78001|27899|27899 - UNLISTED PROCEDURE LEG/ANKLE||0|0||0|10/01/2019 SH 78001|27894|27894 - DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS||1022.55|0||0|10/01/2019 SH 78001|27893|27893 - DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV||715.48|0||0|10/01/2019 SH 78001|27892|27892 - DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE||646.63|0||0|10/01/2019 SH 78001|27889|27889 - ANKLE DISARTICULATION||779.32|0||0|10/01/2019 SH 78001|27888|27888 - AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV||817.8|0||0|10/01/2019 SH 78001|27886|27886 - AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION||788.41|0||0|10/01/2019 SH 78001|27884|27884 - AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV||689.05|0||0|10/01/2019 SH 78001|27882|27882 - AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR||721.89|0||0|10/01/2019 SH 78001|27881|27881 - AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST||1034.62|0||0|10/01/2019 SH 78001|27880|27880 - AMPUTATION LEG THROUGH TIBIA&FIBULA||1107.36|0||0|10/01/2019 SH 78001|27871|27871 - ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL||806.77|0||0|10/01/2019 SH 78001|27870|27870 - ARTHRODESIS ANKLE OPEN||1221.36|0||0|10/01/2019 SH 78001|27860|27860 - MANIPULATION ANKLE UNDER GENERAL ANESTHESIA||203.93|0||0|10/01/2019 SH 78001|27848|27848 - OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ||961.16|0||0|10/01/2019 SH 78001|27846|27846 - OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ||863.92|0||0|10/01/2019 SH 78001|27842|27842 - CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ||581.97|0||0|10/01/2019 SH 78001|27840|27840 - CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA||428.36|0||0|10/01/2019 SH 78001|27832|27832 - OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB||890.22|0||0|10/01/2019 SH 78001|27831|27831 - CLTX PROX TIBFIB JT DISLC REQ ANES||466.22|0||0|10/01/2019 SH 78001|27830|27830 - CLTX PROX TIBFIB JT DISLC W/O ANES||434.89|0||0|10/01/2019 SH 78001|27829|27829 - OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION||802.36|0||0|10/01/2019 SH 78001|27828|27828 - OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA||1529.32|0||0|10/01/2019 SH 78001|27827|27827 - OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY||1273.35|0||0|10/01/2019 SH 78001|27826|27826 - OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA||977.62|0||0|10/01/2019 SH 78001|27825|27825 - CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ||635.7|0||0|10/01/2019 SH 78001|27824|27824 - CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ||360.33|0||0|10/01/2019 SH 78001|27823|27823 - OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP||1126.24|0||0|10/01/2019 SH 78001|27822|27822 - OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP||987.02|0||0|10/01/2019 SH 78001|27818|27818 - CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION||560.73|0||0|10/01/2019 SH 78001|27816|27816 - CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION||368.57|0||0|10/01/2019 SH 78001|27814|27814 - OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE||909.61|0||0|10/01/2019 SH 78001|27810|27810 - CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ||541.67|0||0|10/01/2019 SH 78001|27808|27808 - CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ||382.74|0||0|10/01/2019 SH 78001|27792|27792 - OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS||768.42|0||0|10/01/2019 SH 78001|27788|27788 - CLTX DSTL FIBULAR FX LAT MALLS W/MANJ||486.73|0||0|10/01/2019 SH 78001|27786|27786 - CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ||363.31|0||0|10/01/2019 SH 78001|27784|27784 - OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE||843.42|0||0|10/01/2019 SH 78001|27781|27781 - CLTX PROX FIBULA/SHFT FX W/MANJ||489.62|0||0|10/01/2019 SH 78001|27780|27780 - CLTX PROX FIBULA/SHFT FX W/O MANJ||350.46|0||0|10/01/2019 SH 78001|27769|27769 - OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE||855.2|0||0|10/01/2019 SH 78001|27768|27768 - CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ||513.39|0||0|10/01/2019 SH 78001|27767|27767 - CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ||323.27|0||0|10/01/2019 SH 78001|27766|27766 - OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE||718.13|0||0|10/01/2019 SH 78001|27762|27762 - CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ||549.3|0||0|10/01/2019 SH 78001|27760|27760 - CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION||382.75|0||0|10/01/2019 SH 78001|27759|27759 - TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA||1180|0||0|10/01/2019 SH 78001|27758|27758 - OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE||1051.42|0||0|10/01/2019 SH 78001|27756|27756 - PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE||676.65|0||0|10/01/2019 SH 78001|27752|27752 - CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ||624.17|0||0|10/01/2019 SH 78001|27750|27750 - CLTX TIBIAL SHAFT FX W/O MANIPULATION||398.59|0||0|10/01/2019 SH 78001|27745|27745 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA||893.93|0||0|10/01/2019 SH 78001|27742|27742 - ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR||916.66|0||0|10/01/2019 SH 78001|27740|27740 - ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA||834.26|0||0|10/01/2019 SH 78001|27734|27734 - ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA||771.51|0||0|10/01/2019 SH 78001|27732|27732 - ARREST EPIPHYSEAL OPEN DISTAL FIBULA||522.54|0||0|10/01/2019 SH 78001|27730|27730 - ARREST EPIPHYSEAL OPEN DISTAL TIBIA||688.24|0||0|10/01/2019 SH 78001|27727|27727 - REPAIR CONGENITAL PSEUDARTHROSIS TIBIA||1016.53|0||0|10/01/2019 SH 78001|27726|27726 - REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION||1143.84|0||0|10/01/2019 SH 78001|27725|27725 - RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH||1443.85|0||0|10/01/2019 SH 78001|27724|27724 - RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT||1503.35|0||0|10/01/2019 SH 78001|27722|27722 - REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT||1051.05|0||0|10/01/2019 SH 78001|27720|27720 - REPAIR NONUNION/MALUNION TIBIA W/O GRAFT||1032.4|0||0|10/01/2019 SH 78001|27715|27715 - OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN||1243.95|0||0|10/01/2019 SH 78001|27712|27712 - OSTEOT MLT W/RELIGNMT IMED ROD||1307.99|0||0|10/01/2019 SH 78001|27709|27709 - OSTEOTOMY TIBIA & FIBULA||1389.85|0||0|10/01/2019 SH 78001|27707|27707 - OSTEOTOMY FIBULA||469.92|0||0|10/01/2019 SH 78001|27705|27705 - OSTEOTOMY TIBIA||886.99|0||0|10/01/2019 SH 78001|27704|27704 - REMOVAL ANKLE IMPLANT||677.44|0||0|10/01/2019 SH 78001|27703|27703 - ARTHROPLASTY ANKLE REVISION TOTAL ANKLE||1318.02|0||0|10/01/2019 SH 78001|27702|27702 - ARTHROPLASTY ANKLE W/IMPLANT||1148.02|0||0|10/01/2019 SH 78001|27700|27700 - ARTHROPLASTY ANKLE||691.93|0||0|10/01/2019 SH 78001|27698|27698 - REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL||755.06|0||0|10/01/2019 SH 78001|27696|27696 - RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS||651.64|0||0|10/01/2019 SH 78001|27695|27695 - RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL||560.48|0||0|10/01/2019 SH 78001|27692|27692 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN||124.9|0||0|10/01/2019 SH 78001|27691|27691 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP||883.79|0||0|10/01/2019 SH 78001|27690|27690 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC||741.47|0||0|10/01/2019 SH 78001|27687|27687 - GASTROCNEMIUS RECESSION||535.95|0||0|10/01/2019 SH 78001|27686|27686 - LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA||662.83|0||0|10/01/2019 SH 78001|27685|27685 - LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX||766.25|0||0|10/01/2019 SH 78001|27681|27681 - TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN||641.57|0||0|10/01/2019 SH 78001|27680|27680 - TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH||506.12|0||0|10/01/2019 SH 78001|27676|27676 - REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT||698.86|0||0|10/01/2019 SH 78001|27675|27675 - RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY||569.5|0||0|10/01/2019 SH 78001|27665|27665 - RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH||480.31|0||0|10/01/2019 SH 78001|27664|27664 - RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH||425.85|0||0|10/01/2019 SH 78001|27659|27659 - RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH||565.7|0||0|10/01/2019 SH 78001|27658|27658 - REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH||439.19|0||0|10/01/2019 SH 78001|27656|27656 - REPAIR FASCIAL DEFECT LEG||727.03|0||0|10/01/2019 SH 78001|27654|27654 - REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT||835.44|0||0|10/01/2019 SH 78001|27652|27652 - RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT||813.27|0||0|10/01/2019 SH 78001|27650|27650 - REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON||775.41|0||0|10/01/2019 SH 78001|27648|27648 - INJECTION ANKLE ARTHROGRAPHY||183.3|0||0|10/01/2019 SH 78001|27647|27647 - RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS||1232.51|0||0|10/01/2019 SH 78001|27646|27646 - RADICAL RESECTION TUMOR BONE FIBULA||1836.09|0||0|10/01/2019 SH 78001|27645|27645 - RADICAL RESECTION OF TUMOR TIBIA||2118.85|0||0|10/01/2019 SH 78001|27641|27641 - PARTIAL EXCISION BONE FIBULA||789.84|0||0|10/01/2019 SH 78001|27640|27640 - PARTIAL EXCISION BONE TIBIA||988.82|0||0|10/01/2019 SH 78001|27638|27638 - EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT||916.7|0||0|10/01/2019 SH 78001|27637|27637 - EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT||899.36|0||0|10/01/2019 SH 78001|27635|27635 - EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA||691.2|0||0|10/01/2019 SH 78001|27634|27634 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>||809.78|0||0|10/01/2019 SH 78001|27632|27632 - EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>||488.08|0||0|10/01/2019 SH 78001|27630|27630 - EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK||644.25|0||0|10/01/2019 SH 78001|27626|27626 - ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY||728.02|0||0|10/01/2019 SH 78001|27625|27625 - ARTHROTOMY W/SYNOVECTOMY ANKLE||688.52|0||0|10/01/2019 SH 78001|27620|27620 - ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB||538.32|0||0|10/01/2019 SH 78001|27619|27619 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM||557.16|0||0|10/01/2019 SH 78001|27618|27618 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM||516.71|0||0|10/01/2019 SH 78001|27616|27616 - RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>||1504.4|0||0|10/01/2019 SH 78001|27615|27615 - RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM||1208.84|0||0|10/01/2019 SH 78001|27614|27614 - BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP||660.82|0||0|10/01/2019 SH 78001|27613|27613 - BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL||286.52|0||0|10/01/2019 SH 78001|27612|27612 - ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH||665.69|0||0|10/01/2019 SH 78001|27610|27610 - ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB||767.74|0||0|10/01/2019 SH 78001|27607|27607 - INCISION LEG/ANKLE||719.77|0||0|10/01/2019 SH 78001|27606|27606 - TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES||337.01|0||0|10/01/2019 SH 78001|27605|27605 - TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES||389.58|0||0|10/01/2019 SH 78001|27604|27604 - INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA||564.03|0||0|10/01/2019 SH 78001|27603|27603 - INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA||610.68|0||0|10/01/2019 SH 78001|27602|27602 - DCMPRN FASCT LEG ANT&/LAT&PST CMPRT||586.84|0||0|10/01/2019 SH 78001|27601|27601 - DCMPRN FASCT LEG POST COMPARTMENT ONLY||526.69|0||0|10/01/2019 SH 78001|27600|27600 - DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY||490.17|0||0|10/01/2019 SH 78001|27599|27599 - UNLISTED PROCEDURE FEMUR/KNEE||0|0||0|10/01/2019 SH 78001|27598|27598 - DISARTICULATION KNEE||858.82|0||0|10/01/2019 SH 78001|27596|27596 - AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION||860.68|0||0|10/01/2019 SH 78001|27594|27594 - AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION||600.4|0||0|10/01/2019 SH 78001|27592|27592 - AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR||819.77|0||0|10/01/2019 SH 78001|27591|27591 - AMP THI THRU FEMUR LVL IMMT FITG TQ W/1ST CST||1142.89|0||0|10/01/2019 SH 78001|27590|27590 - AMPUTATION THIGH THROUGH FEMUR ANY LEVEL||967.21|0||0|10/01/2019 SH 78001|27580|27580 - ARTHRODESIS KNEE ANY TECHNIQUE||1698.07|0||0|10/01/2019 SH 78001|27570|27570 - MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA||176.5|0||0|10/01/2019 SH 78001|27566|27566 - OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY||1055.29|0||0|10/01/2019 SH 78001|27562|27562 - CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA||565.54|0||0|10/01/2019 SH 78001|27560|27560 - CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA||415.64|0||0|10/01/2019 SH 78001|27558|27558 - OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION||1421.42|0||0|10/01/2019 SH 78001|27557|27557 - OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR||1244.55|0||0|10/01/2019 SH 78001|27556|27556 - OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR||1039.12|0||0|10/01/2019 SH 78001|27552|27552 - CLOSED TX KNEE DISLOCATION W/ANESTHESIA||733.36|0||0|10/01/2019 SH 78001|27550|27550 - CLOSED TX KNEE DISLOCATION W/O ANESTHESIA||584.89|0||0|10/01/2019 SH 78001|27540|27540 - OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE||956.03|0||0|10/01/2019 SH 78001|27538|27538 - CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN||548.81|0||0|10/01/2019 SH 78001|27536|27536 - OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ||1408.47|0||0|10/01/2019 SH 78001|27535|27535 - OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR||1062.61|0||0|10/01/2019 SH 78001|27532|27532 - CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ||720.52|0||0|10/01/2019 SH 78001|27530|27530 - CLTX TIBIAL FX PROXIMAL W/O MANIPULATION||345.81|0||0|10/01/2019 SH 78001|27524|27524 - OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR||886.82|0||0|10/01/2019 SH 78001|27520|27520 - CLOSED TX PATELLAR FRACTURE W/O MANIPULATION||370.77|0||0|10/01/2019 SH 78001|27519|27519 - OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION||1057.67|0||0|10/01/2019 SH 78001|27517|27517 - CLTX DSTL FEM EPIPHYSL SEP W/MANJ W/WO SKIN/SKEL||806.52|0||0|10/01/2019 SH 78001|27516|27516 - CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ||590.57|0||0|10/01/2019 SH 78001|27514|27514 - OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE||1146.54|0||0|10/01/2019 SH 78001|27513|27513 - OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN||1474.79|0||0|10/01/2019 SH 78001|27511|27511 - OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN||1182.51|0||0|10/01/2019 SH 78001|27510|27510 - CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ||805.98|0||0|10/01/2019 SH 78001|27509|27509 - PRQ SKELETAL FIXJ FEMORAL FX DISTAL END||752.95|0||0|10/01/2019 SH 78001|27508|27508 - CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ||610.67|0||0|10/01/2019 SH 78001|27507|27507 - OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE||1151.44|0||0|10/01/2019 SH 78001|27506|27506 - OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW||1583.93|0||0|10/01/2019 SH 78001|27503|27503 - CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ||945.05|0||0|10/01/2019 SH 78001|27502|27502 - CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ||904.71|0||0|10/01/2019 SH 78001|27501|27501 - CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ||588.53|0||0|10/01/2019 SH 78001|27500|27500 - CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION||606.08|0||0|10/01/2019 SH 78001|27499|27499 - DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE||824.16|0||0|10/01/2019 SH 78001|27498|27498 - DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS||769.6|0||0|10/01/2019 SH 78001|27497|27497 - DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE||693.72|0||0|10/01/2019 SH 78001|27496|27496 - DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT||636.9|0||0|10/01/2019 SH 78001|27495|27495 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR||1334.17|0||0|10/01/2019 SH 78001|27488|27488 - RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER||1421.01|0||0|10/01/2019 SH 78001|27487|27487 - REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE||2087.71|0||0|10/01/2019 SH 78001|27486|27486 - REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT||1667.13|0||0|10/01/2019 SH 78001|27485|27485 - ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA||789.5|0||0|10/01/2019 SH 78001|27479|27479 - ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB||1088.29|0||0|10/01/2019 SH 78001|27477|27477 - ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL||864.11|0||0|10/01/2019 SH 78001|27475|27475 - ARREST EPIPHYSEAL DISTAL FEMUR||778.54|0||0|10/01/2019 SH 78001|27472|27472 - RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE||1497.66|0||0|10/01/2019 SH 78001|27470|27470 - RPR NON/MAL FEMUR DSTL H/N W/O GRF||1390.3|0||0|10/01/2019 SH 78001|27468|27468 - OSTPL FEMUR CMBN LNGTH&SHRT W/FEMORAL SGM TRNSFR||1593.51|0||0|10/01/2019 SH 78001|27466|27466 - OSTEOPLASTY FEMUR LENGTHENING||1402.97|0||0|10/01/2019 SH 78001|27465|27465 - OSTEOPLASTY FEMUR SHORTENING EXCLUDING 64876||1480.88|0||0|10/01/2019 SH 78001|27457|27457 - OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL||1136.3|0||0|10/01/2019 SH 78001|27455|27455 - OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL||1113.2|0||0|10/01/2019 SH 78001|27454|27454 - OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT||1541.53|0||0|10/01/2019 SH 78001|27450|27450 - OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION||1191.93|0||0|10/01/2019 SH 78001|27448|27448 - OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION||904.92|0||0|10/01/2019 SH 78001|27447|27447 - ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS||1609.55|0||0|10/01/2019 SH 78001|27446|27446 - ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT||1374.73|0||0|10/01/2019 SH 78001|27445|27445 - ARTHROPLASTY KNEE HINGE PROSTHESIS||1483.83|0||0|10/01/2019 SH 78001|27443|27443 - ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL||963.12|0||0|10/01/2019 SH 78001|27442|27442 - ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE||1025.47|0||0|10/01/2019 SH 78001|27441|27441 - ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT||972.61|0||0|10/01/2019 SH 78001|27440|27440 - ARTHROPLASTY KNEE TIBIAL PLATEAU||940.78|0||0|10/01/2019 SH 78001|27438|27438 - ARTHROPLASTY PATELLA W/PROSTHESIS||990.79|0||0|10/01/2019 SH 78001|27437|27437 - ARTHROPLASTY PATELLA W/O PROSTHESIS||777.77|0||0|10/01/2019 SH 78001|27435|27435 - CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE||946.81|0||0|10/01/2019 SH 78001|27430|27430 - QUADRICEPSPLASTY||866.49|0||0|10/01/2019 SH 78001|27429|27429 - LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR||1477.76|0||0|10/01/2019 SH 78001|27428|27428 - LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR||1315.24|0||0|10/01/2019 SH 78001|27427|27427 - LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR||839.68|0||0|10/01/2019 SH 78001|27425|27425 - LATERAL RETINACULAR RELEASE OPEN||523.01|0||0|10/01/2019 SH 78001|27424|27424 - RCNSTJ DISLC PATELLA W/PATELLECTOMY||881.22|0||0|10/01/2019 SH 78001|27422|27422 - RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL||873.7|0||0|10/01/2019 SH 78001|27420|27420 - RCNSTJ DISLOCATING PATELLA||870.43|0||0|10/01/2019 SH 78001|27418|27418 - ANTERIOR TIBIAL TUBERCLEPLASTY||974.01|0||0|10/01/2019 SH 78001|27416|27416 - OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY||1159.36|0||0|10/01/2019 SH 78001|27415|27415 - OSTEOCHONDRAL ALLOGRAFT KNEE OPEN||1629.3|0||0|10/01/2019 SH 78001|27412|27412 - AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE||1963.77|0||0|10/01/2019 SH 78001|27409|27409 - RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE||1139.55|0||0|10/01/2019 SH 78001|27407|27407 - REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT||933.14|0||0|10/01/2019 SH 78001|27405|27405 - RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL||794.69|0||0|10/01/2019 SH 78001|27403|27403 - ARTHROTOMY W/MENISCUS REPAIR KNEE||752.75|0||0|10/01/2019 SH 78001|27400|27400 - TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR||817.52|0||0|10/01/2019 SH 78001|27397|27397 - TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN||1080.27|0||0|10/01/2019 SH 78001|27396|27396 - TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON||723.17|0||0|10/01/2019 SH 78001|27395|27395 - LENGTHENING HAMSTRING TENDON MULTIPLE BILATERAL||1035.78|0||0|10/01/2019 SH 78001|27394|27394 - LENGTHENING HAMSTRING TENDON MULTIPLE 1 LEG||764.34|0||0|10/01/2019 SH 78001|27393|27393 - LENGTHENING HAMSTRING TENDON SINGLE||597.68|0||0|10/01/2019 SH 78001|27392|27392 - TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI||838.22|0||0|10/01/2019 SH 78001|27391|27391 - TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG||676.85|0||0|10/01/2019 SH 78001|27390|27390 - TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON||524.02|0||0|10/01/2019 SH 78001|27386|27386 - SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ||972.72|0||0|10/01/2019 SH 78001|27385|27385 - SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY||670.1|0||0|10/01/2019 SH 78001|27381|27381 - SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF||934.65|0||0|10/01/2019 SH 78001|27380|27380 - SUTURE INFRAPATELLAR TENDON PRIMARY||694.1|0||0|10/01/2019 SH 78001|27372|27372 - REMOVAL FOREIGN BODY DEEP THIGH/KNEE||696.65|0||0|10/01/2019 SH 78001|27370|27370 - INJECTION KNEE ARTHROGRAPHY||174.77|0||0|10/01/2019 SH 78001|27365|27365 - RADICAL RESECTION TUMOR FEMOR OR KNEE||2458.29|0||0|10/01/2019 SH 78001|27364|27364 - RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>||1859.56|0||0|10/01/2019 SH 78001|27360|27360 - PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA||1000.15|0||0|10/01/2019 SH 78001|27358|27358 - EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION||335.2|0||0|10/01/2019 SH 78001|27357|27357 - EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT||956.98|0||0|10/01/2019 SH 78001|27356|27356 - EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT||869.32|0||0|10/01/2019 SH 78001|27355|27355 - EXCISION/CURETTAGE CYST/TUMOR FEMUR||708.15|0||0|10/01/2019 SH 78001|27350|27350 - PATELLECTOMY/HEMIPATELLECTOMY||764.16|0||0|10/01/2019 SH 78001|27347|27347 - EXCISION LESION MENISCUS/CAPSULE KNEE||618.83|0||0|10/01/2019 SH 78001|27345|27345 - EXCISION SYNOVIAL CYST POPLITEAL SPACE||562.52|0||0|10/01/2019 SH 78001|27340|27340 - EXCISION PREPATELLAR BURSA||432.24|0||0|10/01/2019 SH 78001|27339|27339 - EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>||890.19|0||0|10/01/2019 SH 78001|27337|27337 - EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>||491.59|0||0|10/01/2019 SH 78001|27335|27335 - ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA||898.46|0||0|10/01/2019 SH 78001|27334|27334 - ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR||803.32|0||0|10/01/2019 SH 78001|27333|27333 - ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT||686.8|0||0|10/01/2019 SH 78001|27332|27332 - ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT||754.77|0||0|10/01/2019 SH 78001|27331|27331 - ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB||556.4|0||0|10/01/2019 SH 78001|27330|27330 - ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY||484.95|0||0|10/01/2019 SH 78001|27329|27329 - RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM||1225.54|0||0|10/01/2019 SH 78001|27328|27328 - EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM||732.08|0||0|10/01/2019 SH 78001|27327|27327 - EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM||526.03|0||0|10/01/2019 SH 78001|27326|27326 - NEURECTOMY POPLITEAL||601.03|0||0|10/01/2019 SH 78001|27325|27325 - NEURECTOMY HAMSTRING MUSCLE||600.02|0||0|10/01/2019 SH 78001|27324|27324 - BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP||463.73|0||0|10/01/2019 SH 78001|27323|27323 - BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL||307.95|0||0|10/01/2019 SH 78001|27310|27310 - ARTHRT KNE W/EXPL DRG/RMVL FB||859.6|0||0|10/01/2019 SH 78001|27307|27307 - TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON||561.62|0||0|10/01/2019 SH 78001|27306|27306 - TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX||420.46|0||0|10/01/2019 SH 78001|27305|27305 - FASCIOTOMY ILIOTIBIAL OPEN||563.29|0||0|10/01/2019 SH 78001|27303|27303 - INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE||748.14|0||0|10/01/2019 SH 78001|27301|27301 - I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION||763.65|0||0|10/01/2019 SH 78001|27299|27299 - UNLISTED PROCEDURE PELVIS/HIP JOINT||0|0||0|10/01/2019 SH 78001|27295|27295 - DISARTICULATION HIP||1495.23|0||0|10/01/2019 SH 78001|27290|27290 - INTERPELVIABDOMINAL AMPUTATION||1931.15|0||0|10/01/2019 SH 78001|27286|27286 - ARTHRD HIP JT W/OBTG GRF W/SUBTRCHNTRIC OSTEOT||1966.44|0||0|10/01/2019 SH 78001|27284|27284 - ARTHRODESIS HIP JOINT W/OBTAINING GRAFT||1822.91|0||0|10/01/2019 SH 78001|27282|27282 - ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT||885.59|0||0|10/01/2019 SH 78001|27280|27280 - ARTHRODESIS SACROILIAC JOINT W/OBTAINING GRAFT||1272.2|0||0|10/01/2019 SH 78001|27279|27279 - ARTHRODESIS SACROILIAC JOINT PERCUTANEOUS||661.75|0||0|10/01/2019 SH 78001|27275|27275 - MANIPULATION HIP JOINT GENERAL ANESTHESIA||213.72|0||0|10/01/2019 SH 78001|27269|27269 - OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD||1476.7|0||0|10/01/2019 SH 78001|27268|27268 - CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ||632.58|0||0|10/01/2019 SH 78001|27267|27267 - CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ||506.04|0||0|10/01/2019 SH 78001|27266|27266 - CLTX POST HIP ARTHRP DISLC REQ ANES||683.16|0||0|10/01/2019 SH 78001|27265|27265 - CLTX POST HIP ARTHRP DISLC W/O ANES||464.15|0||0|10/01/2019 SH 78001|27259|27259 - OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM SHRT||1844.84|0||0|10/01/2019 SH 78001|27258|27258 - OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM||1314.39|0||0|10/01/2019 SH 78001|27257|27257 - TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES||405.48|0||0|10/01/2019 SH 78001|27256|27256 - TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES||354.12|0||0|10/01/2019 SH 78001|27254|27254 - OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD||1508.73|0||0|10/01/2019 SH 78001|27253|27253 - OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ||1111.43|0||0|10/01/2019 SH 78001|27252|27252 - CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA||897.86|0||0|10/01/2019 SH 78001|27250|27250 - CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA||219.51|0||0|10/01/2019 SH 78001|27248|27248 - OPEN TREATMENT GREATER TROCHANTERIC FRACTURE||878.54|0||0|10/01/2019 SH 78001|27246|27246 - CLTX GREATER TROCHANTERIC FX W/O MANJ||449.6|0||0|10/01/2019 SH 78001|27245|27245 - TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW||1458.07|0||0|10/01/2019 SH 78001|27244|27244 - TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT||1458.46|0||0|10/01/2019 SH 78001|27240|27240 - CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ||1130.66|0||0|10/01/2019 SH 78001|27238|27238 - CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ||537.37|0||0|10/01/2019 SH 78001|27236|27236 - OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT||1416.4|0||0|10/01/2019 SH 78001|27235|27235 - PRQ SKEL FIXJ FEMORAL FX PROX END NECK||1074.39|0||0|10/01/2019 SH 78001|27232|27232 - CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ||894.28|0||0|10/01/2019 SH 78001|27230|27230 - CLTX FEM FX PROX END NCK W/O MANJ||553.14|0||0|10/01/2019 SH 78001|27228|27228 - OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT||2250.25|0||0|10/01/2019 SH 78001|27227|27227 - OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT||1972.11|0||0|10/01/2019 SH 78001|27226|27226 - OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ||1252.77|0||0|10/01/2019 SH 78001|27222|27222 - CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ||1155.25|0||0|10/01/2019 SH 78001|27220|27220 - CLTX ACETABULUM HIP/SOCKT FX W/O MANJ||620.43|0||0|10/01/2019 SH 78001|27218|27218 - OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD||1373.04|0||0|10/01/2019 SH 78001|27217|27217 - OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR||993.22|0||0|10/01/2019 SH 78001|27216|27216 - PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS||1058.8|0||0|10/01/2019 SH 78001|27215|27215 - OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD||713.2|0||0|10/01/2019 SH 78001|27202|27202 - OPEN TREATMENT COCCYGEAL FRACTURE||627.21|0||0|10/01/2019 SH 78001|27200|27200 - CLOSED TREATMENT COCCYGEAL FRACTURE||208.46|0||0|10/01/2019 SH 78001|27198|27198 - CLSD TX PELVIC RING FX W/MANIPULATION W/ANES||367.79|0||0|10/01/2019 SH 78001|27197|27197 - CLSD TX PELVIC RING FX W/O MANIPULATION||144.27|0||0|10/01/2019 SH 78001|27187|27187 - PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR||1171.28|0||0|10/01/2019 SH 78001|27185|27185 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR||694.42|0||0|10/01/2019 SH 78001|27181|27181 - OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ||1329.12|0||0|10/01/2019 SH 78001|27179|27179 - OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX||1153.87|0||0|10/01/2019 SH 78001|27178|27178 - OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN||1083.74|0||0|10/01/2019 SH 78001|27177|27177 - OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT||1318.26|0||0|10/01/2019 SH 78001|27176|27176 - TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU||1083.74|0||0|10/01/2019 SH 78001|27175|27175 - TX SLP FEMORAL EPIPHYSIS TRCJ W/O REDUCTION||787.5|0||0|10/01/2019 SH 78001|27170|27170 - B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA||1395.86|0||0|10/01/2019 SH 78001|27165|27165 - OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL||1623.93|0||0|10/01/2019 SH 78001|27161|27161 - OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE||1439.35|0||0|10/01/2019 SH 78001|27158|27158 - OSTEOTOMY PELVIS BILATERAL||1665.67|0||0|10/01/2019 SH 78001|27156|27156 - OSTEOT ILIAC ACTBLR/INNOMINATE BONE OSTEOT RDCTJ||2041.27|0||0|10/01/2019 SH 78001|27151|27151 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT||1892.04|0||0|10/01/2019 SH 78001|27147|27147 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ||1746.96|0||0|10/01/2019 SH 78001|27146|27146 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE||1519.5|0||0|10/01/2019 SH 78001|27140|27140 - OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX||1059.48|0||0|10/01/2019 SH 78001|27138|27138 - REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT||1818.42|0||0|10/01/2019 SH 78001|27137|27137 - REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT||1750.06|0||0|10/01/2019 SH 78001|27134|27134 - REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT||2280.36|0||0|10/01/2019 SH 78001|27132|27132 - CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT||1989.21|0||0|10/01/2019 SH 78001|27130|27130 - ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT||1609.94|0||0|10/01/2019 SH 78001|27125|27125 - HEMIARTHROPLASTY HIP PARTIAL||1341.59|0||0|10/01/2019 SH 78001|27122|27122 - ACETABULOPLASTY RESECTION FEMORAL HEAD||1298.46|0||0|10/01/2019 SH 78001|27120|27120 - ACETABULOPLASTY||1542.27|0||0|10/01/2019 SH 78001|27111|27111 - TRANSFER ILIOPSOAS FEMORAL NECK||1061.4|0||0|10/01/2019 SH 78001|27110|27110 - TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR||1143.69|0||0|10/01/2019 SH 78001|27105|27105 - TR PARASPI MUSC HIP FASC/TDN XTN GRF||1021.33|0||0|10/01/2019 SH 78001|27100|27100 - TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF||972.55|0||0|10/01/2019 SH 78001|27098|27098 - TRANSFER ADDUCTOR ISCHIUM||816.7|0||0|10/01/2019 SH 78001|27097|27097 - RELEASE/RECESSION HAMSTRING PROXIMAL||802.52|0||0|10/01/2019 SH 78001|27096|27096 - INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA||183.24|0||0|10/01/2019 SH 78001|27095|27095 - INJECTION HIP ARTHROGRAPHY W/ANESTHESIA||272.89|0||0|10/01/2019 SH 78001|27093|27093 - INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA||212.31|0||0|10/01/2019 SH 78001|27091|27091 - RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA||1895.72|0||0|10/01/2019 SH 78001|27090|27090 - REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE||974.02|0||0|10/01/2019 SH 78001|27087|27087 - REMOVAL FOREIGN BODY PELVIS/HIP DEEP||735.83|0||0|10/01/2019 SH 78001|27086|27086 - RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS||335.24|0||0|10/01/2019 SH 78001|27080|27080 - COCCYGECTOMY PRIMARY||603.29|0||0|10/01/2019 SH 78001|27078|27078 - RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR||2469.58|0||0|10/01/2019 SH 78001|27077|27077 - RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL||3390.08|0||0|10/01/2019 SH 78001|27076|27076 - RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC||3035.47|0||0|10/01/2019 SH 78001|27075|27075 - RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL||2504.34|0||0|10/01/2019 SH 78001|27071|27071 - PARTIAL EXCISION DEEP PELVIS||1074.41|0||0|10/01/2019 SH 78001|27070|27070 - PARTIAL EXCISION SUPERFICIAL PELVIS||997.1|0||0|10/01/2019 SH 78001|27067|27067 - EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC||1222.3|0||0|10/01/2019 SH 78001|27066|27066 - EXCISION BONE CYST/BENIGN TUMOR DEEP||956.76|0||0|10/01/2019 SH 78001|27065|27065 - EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL||606.02|0||0|10/01/2019 SH 78001|27062|27062 - EXCISION TROCHANTERIC BURSA/CALCIFICATION||534.29|0||0|10/01/2019 SH 78001|27060|27060 - EXCISION ISCHIAL BURSA||544.12|0||0|10/01/2019 SH 78001|27059|27059 - RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5 CM/>||2166.61|0||0|10/01/2019 SH 78001|27057|27057 - DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI||1201.04|0||0|10/01/2019 SH 78001|27054|27054 - ARTHROTOMY W/SYNOVECTOMY HIP JOINT||803.4|0||0|10/01/2019 SH 78001|27052|27052 - ARTHROTOMY W/BIOPSY HIP JOINT||679.25|0||0|10/01/2019 SH 78001|27050|27050 - ARTHROTOMY W/BIOPSY SACROILIAC JOINT||468.21|0||0|10/01/2019 SH 78001|27049|27049 - RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM||1590.37|0||0|10/01/2019 SH 78001|27048|27048 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM||718.9|0||0|10/01/2019 SH 78001|27047|27047 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM||542.75|0||0|10/01/2019 SH 78001|27045|27045 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>||885.53|0||0|10/01/2019 SH 78001|27043|27043 - EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>||554.02|0||0|10/01/2019 SH 78001|27041|27041 - BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM||810.75|0||0|10/01/2019 SH 78001|27040|27040 - BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL||393.88|0||0|10/01/2019 SH 78001|27036|27036 - CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC||1193.25|0||0|10/01/2019 SH 78001|27035|27035 - DNRVTJ HIP JT INTRAPEL/XTRPEL INTRA-ARTCLR BRNCH||1271.07|0||0|10/01/2019 SH 78001|27033|27033 - ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY||1147.49|0||0|10/01/2019 SH 78001|27030|27030 - ARTHROTOMY HIP W/DRAINAGE||1107.47|0||0|10/01/2019 SH 78001|27027|27027 - DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI||1048.17|0||0|10/01/2019 SH 78001|27025|27025 - FASCIOTOMY HIP/THIGH ANY TYPE||1072.7|0||0|10/01/2019 SH 78001|27006|27006 - TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX||865.12|0||0|10/01/2019 SH 78001|27005|27005 - TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE||853.31|0||0|10/01/2019 SH 78001|27003|27003 - TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY||699.58|0||0|10/01/2019 SH 78001|27001|27001 - TENOTOMY ADDUCTOR HIP OPEN||633.04|0||0|10/01/2019 SH 78001|27000|27000 - TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX||488.07|0||0|10/01/2019 SH 78001|26992|26992 - INCISION BONE CORTEX PELVIS&/HIP JOINT||1125.67|0||0|10/01/2019 SH 78001|26991|26991 - I&D PELVIS/HIP JOINT AREA INFECTED BURSA||809.83|0||0|10/01/2019 SH 78001|26990|26990 - I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA||732.37|0||0|10/01/2019 SH 78001|26989|26989 - UNLISTED PROCEDURE HANDS/FINGERS||0|0||0|10/01/2019 SH 78001|26952|26952 - AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP||731.67|0||0|10/01/2019 SH 78001|26951|26951 - AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR||739.06|0||0|10/01/2019 SH 78001|26910|26910 - AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER||817.3|0||0|10/01/2019 SH 78001|26863|26863 - ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT||273.31|0||0|10/01/2019 SH 78001|26862|26862 - ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT||824.8|0||0|10/01/2019 SH 78001|26861|26861 - ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT||123.55|0||0|10/01/2019 SH 78001|26860|26860 - ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ||636.26|0||0|10/01/2019 SH 78001|26852|26852 - ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT||905.83|0||0|10/01/2019 SH 78001|26850|26850 - ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ||784.96|0||0|10/01/2019 SH 78001|26844|26844 - ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT||920.92|0||0|10/01/2019 SH 78001|26843|26843 - ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH||845.2|0||0|10/01/2019 SH 78001|26842|26842 - ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT||895.19|0||0|10/01/2019 SH 78001|26841|26841 - ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ||824.65|0||0|10/01/2019 SH 78001|26820|26820 - FUSION OPPOSITION THUMB W/AUTOGENOUS GRAFT||902.81|0||0|10/01/2019 SH 78001|26785|26785 - OPEN TX INTERPHALANGEAL JOINT DISLOCATION||634.91|0||0|10/01/2019 SH 78001|26776|26776 - PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ||511.93|0||0|10/01/2019 SH 78001|26775|26775 - CLTX IPHAL JT DISLC W/MANJ REQ ANES||439.67|0||0|10/01/2019 SH 78001|26770|26770 - CLTX IPHAL JT DISLC W/MANJ W/O ANES||316.57|0||0|10/01/2019 SH 78001|26765|26765 - OPEN TX DISTAL PHALANGEAL FRACTURE EACH||580.87|0||0|10/01/2019 SH 78001|26756|26756 - PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA||481.04|0||0|10/01/2019 SH 78001|26755|26755 - CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA||359.97|0||0|10/01/2019 SH 78001|26750|26750 - CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA||210.25|0||0|10/01/2019 SH 78001|26746|26746 - OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA||866.05|0||0|10/01/2019 SH 78001|26742|26742 - CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ||421.46|0||0|10/01/2019 SH 78001|26740|26740 - CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ||261.45|0||0|10/01/2019 SH 78001|26735|26735 - OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA||694.72|0||0|10/01/2019 SH 78001|26727|26727 - PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T||543.28|0||0|10/01/2019 SH 78001|26725|26725 - CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA||386.66|0||0|10/01/2019 SH 78001|26720|26720 - CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA||225.59|0||0|10/01/2019 SH 78001|26715|26715 - OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION||665.09|0||0|10/01/2019 SH 78001|26706|26706 - PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ||505.54|0||0|10/01/2019 SH 78001|26705|26705 - CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES||480.19|0||0|10/01/2019 SH 78001|26700|26700 - CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES||371.12|0||0|10/01/2019 SH 78001|26686|26686 - OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ||731.4|0||0|10/01/2019 SH 78001|26685|26685 - OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB||671.09|0||0|10/01/2019 SH 78001|26676|26676 - PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT||579.57|0||0|10/01/2019 SH 78001|26675|26675 - CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES||525.59|0||0|10/01/2019 SH 78001|26670|26670 - CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES||388.18|0||0|10/01/2019 SH 78001|26665|26665 - OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB||733.84|0||0|10/01/2019 SH 78001|26650|26650 - PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB||554.22|0||0|10/01/2019 SH 78001|26645|26645 - CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ||494.64|0||0|10/01/2019 SH 78001|26641|26641 - CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ||434.47|0||0|10/01/2019 SH 78001|26615|26615 - OPEN TX METACARPAL FRACTURE SINGLE EA BONE||670.7|0||0|10/01/2019 SH 78001|26608|26608 - PRQ SKELETAL FIXJ METACARPAL FX EACH BONE||551.6|0||0|10/01/2019 SH 78001|26607|26607 - CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE||532.32|0||0|10/01/2019 SH 78001|26605|26605 - CLTX METACARPAL FX W/MANIPULATION EACH BONE||368.4|0||0|10/01/2019 SH 78001|26600|26600 - CLTX METACARPAL FX W/O MANIPULATION EACH BONE||335.11|0||0|10/01/2019 SH 78001|26596|26596 - EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES||865.03|0||0|10/01/2019 SH 78001|26593|26593 - RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE||677.74|0||0|10/01/2019 SH 78001|26591|26591 - REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE||487|0||0|10/01/2019 SH 78001|26590|26590 - REPAIR MACRODACTYLIA EACH DIGIT||1640.9|0||0|10/01/2019 SH 78001|26587|26587 - RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE||1130.71|0||0|10/01/2019 SH 78001|26580|26580 - REPAIR CLEFT HAND||1761.17|0||0|10/01/2019 SH 78001|26568|26568 - OSTEOPLASTY LENGTHENING METACARPAL/PHALANX||1030.85|0||0|10/01/2019 SH 78001|26567|26567 - OSTEOTOMY PHALANX FINGER EACH||771.12|0||0|10/01/2019 SH 78001|26565|26565 - OSTEOTOMY METACARPAL EACH||774.7|0||0|10/01/2019 SH 78001|26562|26562 - REPAIR SYNDACTYLY EACH SPACE COMPLEX||1533.14|0||0|10/01/2019 SH 78001|26561|26561 - REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT||1066.71|0||0|10/01/2019 SH 78001|26560|26560 - REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS||671.66|0||0|10/01/2019 SH 78001|26556|26556 - TRANSFER FREE TOE JOINT W/MVASC ANASTOMOSIS||3364.32|0||0|10/01/2019 SH 78001|26555|26555 - TR FNGR AXH POS W/O MVASC ANAST||1591.26|0||0|10/01/2019 SH 78001|26554|26554 - TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 2||3772.11|0||0|10/01/2019 SH 78001|26553|26553 - TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 1||3221.39|0||0|10/01/2019 SH 78001|26551|26551 - TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND||3890.19|0||0|10/01/2019 SH 78001|26550|26550 - POLLICIZATION DIGIT||1917.75|0||0|10/01/2019 SH 78001|26548|26548 - RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL||864.91|0||0|10/01/2019 SH 78001|26546|26546 - RPR NON-UNION MTCRPL/PHALANX||1136.89|0||0|10/01/2019 SH 78001|26545|26545 - RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT||808.14|0||0|10/01/2019 SH 78001|26542|26542 - RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS||771.33|0||0|10/01/2019 SH 78001|26541|26541 - RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF||914.03|0||0|10/01/2019 SH 78001|26540|26540 - RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT||744.6|0||0|10/01/2019 SH 78001|26536|26536 - ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA||803.72|0||0|10/01/2019 SH 78001|26535|26535 - ARTHROPLASTY INTERPHALANGEAL JOINT EACH||490.09|0||0|10/01/2019 SH 78001|26531|26531 - ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT||727.29|0||0|10/01/2019 SH 78001|26530|26530 - ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH||626.05|0||0|10/01/2019 SH 78001|26525|26525 - CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH||733.18|0||0|10/01/2019 SH 78001|26520|26520 - CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH||732.66|0||0|10/01/2019 SH 78001|26518|26518 - CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS||940.03|0||0|10/01/2019 SH 78001|26517|26517 - CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS||947.83|0||0|10/01/2019 SH 78001|26516|26516 - CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT||794.26|0||0|10/01/2019 SH 78001|26510|26510 - CROSS INTRINSIC TRANSFER EACH TENDON||671.58|0||0|10/01/2019 SH 78001|26508|26508 - RELEASE THENAR MUSCLE||716.44|0||0|10/01/2019 SH 78001|26502|26502 - RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX||811.73|0||0|10/01/2019 SH 78001|26500|26500 - RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX||706.1|0||0|10/01/2019 SH 78001|26499|26499 - CORRECTION CLAW FINGER OTHER METHODS||932.23|0||0|10/01/2019 SH 78001|26498|26498 - TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS||1332.08|0||0|10/01/2019 SH 78001|26497|26497 - TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR||995.4|0||0|10/01/2019 SH 78001|26496|26496 - OPPONENSPLASTY OTHER METHODS||975.61|0||0|10/01/2019 SH 78001|26494|26494 - OPPONENSPLASTY HYPOTHENAR MUSC TR||890.48|0||0|10/01/2019 SH 78001|26492|26492 - OPPONENSPLASTY TDN TR W/GRF EA TDN||1014.36|0||0|10/01/2019 SH 78001|26490|26490 - OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN||913.16|0||0|10/01/2019 SH 78001|26489|26489 - TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH||1072.6|0||0|10/01/2019 SH 78001|26485|26485 - TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH||914.63|0||0|10/01/2019 SH 78001|26483|26483 - TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT||956|0||0|10/01/2019 SH 78001|26480|26480 - TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN||848.24|0||0|10/01/2019 SH 78001|26479|26479 - SHORTENING TENDON FLEXOR HAND/FINGER EACH||692.31|0||0|10/01/2019 SH 78001|26478|26478 - LENGTHENING TENDON FLEXOR HAND/FINGER EACH||699.19|0||0|10/01/2019 SH 78001|26477|26477 - SHORTENING TENDON EXTENSOR HAND/FINGER EACH||650.95|0||0|10/01/2019 SH 78001|26476|26476 - LENGTHENING TENDON EXTENSOR HAND/FINGER EACH||663.55|0||0|10/01/2019 SH 78001|26474|26474 - TENODESIS DISTAL JOINT EACH||683.16|0||0|10/01/2019 SH 78001|26471|26471 - TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH||694.22|0||0|10/01/2019 SH 78001|26460|26460 - TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON||443.31|0||0|10/01/2019 SH 78001|26455|26455 - TENOTOMY FLEXOR FINGER OPEN EACH TENDON||457.28|0||0|10/01/2019 SH 78001|26450|26450 - TENOTOMY FLEXOR PALM OPEN EACH TENDON||460.12|0||0|10/01/2019 SH 78001|26449|26449 - TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA||808.39|0||0|10/01/2019 SH 78001|26445|26445 - TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH||645.61|0||0|10/01/2019 SH 78001|26442|26442 - TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO||1096.87|0||0|10/01/2019 SH 78001|26440|26440 - TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON||696.8|0||0|10/01/2019 SH 78001|26437|26437 - REALIGNMENT EXTENSOR TENDON HAND EACH TENDON||705.88|0||0|10/01/2019 SH 78001|26434|26434 - REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT||737.33|0||0|10/01/2019 SH 78001|26433|26433 - REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF||599.42|0||0|10/01/2019 SH 78001|26432|26432 - CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING||563.32|0||0|10/01/2019 SH 78001|26428|26428 - RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER||839.17|0||0|10/01/2019 SH 78001|26426|26426 - RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR||582.89|0||0|10/01/2019 SH 78001|26420|26420 - REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH||802.31|0||0|10/01/2019 SH 78001|26418|26418 - REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH||648.42|0||0|10/01/2019 SH 78001|26416|26416 - RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD||1017.01|0||0|10/01/2019 SH 78001|26415|26415 - EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA||783.41|0||0|10/01/2019 SH 78001|26412|26412 - REPAIR EXTENSOR TENDON HAND W/GRAFT EACH||787.53|0||0|10/01/2019 SH 78001|26410|26410 - REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH||635.78|0||0|10/01/2019 SH 78001|26392|26392 - RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD||1118.06|0||0|10/01/2019 SH 78001|26390|26390 - EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F||962.17|0||0|10/01/2019 SH 78001|26373|26373 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA||943.62|0||0|10/01/2019 SH 78001|26372|26372 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA||1012.65|0||0|10/01/2019 SH 78001|26370|26370 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN||860.4|0||0|10/01/2019 SH 78001|26358|26358 - RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON||1023.77|0||0|10/01/2019 SH 78001|26357|26357 - RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON||995.7|0||0|10/01/2019 SH 78001|26356|26356 - RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON||1244.13|0||0|10/01/2019 SH 78001|26352|26352 - RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON||921.96|0||0|10/01/2019 SH 78001|26350|26350 - RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON||803.37|0||0|10/01/2019 SH 78001|26341|26341 - MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD||113.32|0||0|10/01/2019 SH 78001|26340|26340 - MANIPULATION FINGER JOINT UNDER ANES EACH JOINT||380.18|0||0|10/01/2019 SH 78001|26320|26320 - REMOVAL IMPLANT FROM FINGER/HAND||401.4|0||0|10/01/2019 SH 78001|26262|26262 - RADICAL RESECTION TUMOR DISTAL PHALANX FINGER||743.94|0||0|10/01/2019 SH 78001|26260|26260 - RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER||947.29|0||0|10/01/2019 SH 78001|26250|26250 - RADICAL RESECTION TUMOR METACARPAL||1264.24|0||0|10/01/2019 SH 78001|26236|26236 - PARTIAL EXCISION DISTAL PHALANX FINGER||511.66|0||0|10/01/2019 SH 78001|26235|26235 - PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER||574.4|0||0|10/01/2019 SH 78001|26230|26230 - PARTIAL EXCISION BONE METACARPAL||581.6|0||0|10/01/2019 SH 78001|26215|26215 - EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT||659.6|0||0|10/01/2019 SH 78001|26210|26210 - EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER||512.59|0||0|10/01/2019 SH 78001|26205|26205 - EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT||706.3|0||0|10/01/2019 SH 78001|26200|26200 - EXCISION/CURETTAGE CYST/TUMOR METACARPAL||521.8|0||0|10/01/2019 SH 78001|26185|26185 - SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE||629.08|0||0|10/01/2019 SH 78001|26180|26180 - EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH||514.26|0||0|10/01/2019 SH 78001|26170|26170 - EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH||471.24|0||0|10/01/2019 SH 78001|26160|26160 - EXC LESION TDN SHTH/JT CAPSL HAND/FNGR||647.95|0||0|10/01/2019 SH 78001|26145|26145 - SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN||596.44|0||0|10/01/2019 SH 78001|26140|26140 - SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT||586.08|0||0|10/01/2019 SH 78001|26135|26135 - SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD||639.55|0||0|10/01/2019 SH 78001|26130|26130 - SYNOVECTOMY CARPOMETACARPAL JOINT||539.4|0||0|10/01/2019 SH 78001|26125|26125 - FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR||326.85|0||0|10/01/2019 SH 78001|26123|26123 - FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR||972.75|0||0|10/01/2019 SH 78001|26121|26121 - FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT||696.86|0||0|10/01/2019 SH 78001|26118|26118 - RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>||1241.62|0||0|10/01/2019 SH 78001|26117|26117 - RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM||872.93|0||0|10/01/2019 SH 78001|26116|26116 - EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM||614.2|0||0|10/01/2019 SH 78001|26115|26115 - EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM||573.68|0||0|10/01/2019 SH 78001|26113|26113 - EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>||639.17|0||0|10/01/2019 SH 78001|26111|26111 - EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>||488.23|0||0|10/01/2019 SH 78001|26110|26110 - ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH||371.52|0||0|10/01/2019 SH 78001|26105|26105 - ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH||391.71|0||0|10/01/2019 SH 78001|26100|26100 - ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH||389.21|0||0|10/01/2019 SH 78001|26080|26080 - ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA||451.1|0||0|10/01/2019 SH 78001|26075|26075 - ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA||386.61|0||0|10/01/2019 SH 78001|26070|26070 - ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT||366.78|0||0|10/01/2019 SH 78001|26060|26060 - TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT||303.14|0||0|10/01/2019 SH 78001|26055|26055 - TENDON SHEATH INCISION||628.49|0||0|10/01/2019 SH 78001|26045|26045 - FASCIOTOMY PALMAR OPEN PARTIAL||544.65|0||0|10/01/2019 SH 78001|26040|26040 - FASCIOTOMY PALMAR PERCUTANEOUS||359.44|0||0|10/01/2019 SH 78001|26037|26037 - DECOMPRESSIVE FASCIOTOMY HAND||660.1|0||0|10/01/2019 SH 78001|26035|26035 - DECOMPRESSION FINGERS&/HAND INJECTION INJURY||1006.75|0||0|10/01/2019 SH 78001|26034|26034 - INCISION BONE CORTEX HAND/FINGER||626.91|0||0|10/01/2019 SH 78001|26030|26030 - DRAINAGE OF PALMAR BURSA MULTIPLE BURSA||572.89|0||0|10/01/2019 SH 78001|26025|26025 - DRAINAGE OF PALMAR BURSA SINGLE BURSA||491|0||0|10/01/2019 SH 78001|26020|26020 - DRAINAGE TENDON SHEATH DIGIT&/PALM EACH||503.02|0||0|10/01/2019 SH 78001|26011|26011 - DRAINAGE FINGER ABSCESS COMPLICATED||438.97|0||0|10/01/2019 SH 78001|26010|26010 - DRAINAGE FINGER ABSCESS SIMPLE||297.33|0||0|10/01/2019 SH 78001|25999|25999 - UNLISTED PROCEDURE FOREARM/WRIST||0|0||0|10/01/2019 SH 78001|25931|25931 - TRANSMETACARPAL AMPUTATION RE-AMPUTATION||863.4|0||0|10/01/2019 SH 78001|25929|25929 - TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ||643.46|0||0|10/01/2019 SH 78001|25927|25927 - TRANSMETACARPAL AMPUTATION||942.45|0||0|10/01/2019 SH 78001|25924|25924 - DISARTICULATION THRU WRIST RE-AMPUTATION||797.4|0||0|10/01/2019 SH 78001|25922|25922 - DISARTICULATION THRU WRIST SEC CLOSURE/SCAR REVJ||715.15|0||0|10/01/2019 SH 78001|25920|25920 - DISARTICULATION THROUGH WRIST||816.97|0||0|10/01/2019 SH 78001|25915|25915 - KRUKENBERG PROCEDURE||1161.21|0||0|10/01/2019 SH 78001|25909|25909 - AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION||806.19|0||0|10/01/2019 SH 78001|25907|25907 - AMP F/ARM THRU RADIUS&ULNA SEC CLOSURE/SCAR RE||719.42|0||0|10/01/2019 SH 78001|25905|25905 - AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR||825.64|0||0|10/01/2019 SH 78001|25900|25900 - AMPUTATION FOREARM THROUGH RADIUS & ULNA||827.25|0||0|10/01/2019 SH 78001|25830|25830 - ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE||1108.1|0||0|10/01/2019 SH 78001|25825|25825 - ARTHRODESIS WRIST LIMITED W/AUTOGRAFT||882.23|0||0|10/01/2019 SH 78001|25820|25820 - ARTHRODESIS WRIST LIMITED W/O BONE GRAFT||715.84|0||0|10/01/2019 SH 78001|25810|25810 - ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT||1016.21|0||0|10/01/2019 SH 78001|25805|25805 - ARTHRODESIS WRIST W/SLIDING GRAFT||995.16|0||0|10/01/2019 SH 78001|25800|25800 - ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT||857.54|0||0|10/01/2019 SH 78001|25695|25695 - OPEN TREATMENT LUNATE DISLOCATION||744.13|0||0|10/01/2019 SH 78001|25690|25690 - CLOSED TX LUNATE DISLOCATION W/MANIPULATION||560.13|0||0|10/01/2019 SH 78001|25685|25685 - OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC||866.61|0||0|10/01/2019 SH 78001|25680|25680 - CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ||545.64|0||0|10/01/2019 SH 78001|25676|25676 - OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC||737.35|0||0|10/01/2019 SH 78001|25675|25675 - CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ||504.1|0||0|10/01/2019 SH 78001|25671|25671 - PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION||618.43|0||0|10/01/2019 SH 78001|25670|25670 - OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES||707.74|0||0|10/01/2019 SH 78001|25660|25660 - CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ||475.03|0||0|10/01/2019 SH 78001|25652|25652 - OPEN TREATMENT ULNAR STYLOID FRACTURE||729.34|0||0|10/01/2019 SH 78001|25651|25651 - PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE||562.47|0||0|10/01/2019 SH 78001|25650|25650 - CLOSED TREATMENT ULNAR STYLOID FRACTURE||366.17|0||0|10/01/2019 SH 78001|25645|25645 - OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA||668.01|0||0|10/01/2019 SH 78001|25635|25635 - CLTX CARPAL BONE FX W/MANJ EACH BONE||514.15|0||0|10/01/2019 SH 78001|25630|25630 - CLTX CARPAL BONE FX W/O MANJ EACH BONE||349.79|0||0|10/01/2019 SH 78001|25628|25628 - OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE||843.39|0||0|10/01/2019 SH 78001|25624|25624 - CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ||551.68|0||0|10/01/2019 SH 78001|25622|25622 - CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ||346.8|0||0|10/01/2019 SH 78001|25609|25609 - OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG||1228.89|0||0|10/01/2019 SH 78001|25608|25608 - OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG||965.86|0||0|10/01/2019 SH 78001|25607|25607 - OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP||859.2|0||0|10/01/2019 SH 78001|25606|25606 - PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP||775.03|0||0|10/01/2019 SH 78001|25605|25605 - CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF||631.43|0||0|10/01/2019 SH 78001|25600|25600 - CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ||373.89|0||0|10/01/2019 SH 78001|25575|25575 - OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA||1057.29|0||0|10/01/2019 SH 78001|25574|25574 - OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA||789.58|0||0|10/01/2019 SH 78001|25565|25565 - CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ||600.6|0||0|10/01/2019 SH 78001|25560|25560 - CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN||317.23|0||0|10/01/2019 SH 78001|25545|25545 - OPEN TREATMENT OF ULNAR SHAFT FRACTURE||728.42|0||0|10/01/2019 SH 78001|25535|25535 - CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION||565.89|0||0|10/01/2019 SH 78001|25530|25530 - CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION||299.03|0||0|10/01/2019 SH 78001|25526|25526 - OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE||1126.23|0||0|10/01/2019 SH 78001|25525|25525 - OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE||920.93|0||0|10/01/2019 SH 78001|25520|25520 - CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT||659.31|0||0|10/01/2019 SH 78001|25515|25515 - OPEN TREATMENT RADIAL SHAFT FRACTURE||784.93|0||0|10/01/2019 SH 78001|25505|25505 - CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION||579.06|0||0|10/01/2019 SH 78001|25500|25500 - CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION||311.85|0||0|10/01/2019 SH 78001|25492|25492 - PROPH TX N/P/PLTWR W/WO METHYLMECRYLATE RAD&UL||1065.54|0||0|10/01/2019 SH 78001|25491|25491 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE ULNA||871.13|0||0|10/01/2019 SH 78001|25490|25490 - PROPH TX N/P/PLTWR W/WO METHYLACRYLATE RADIUS||782.84|0||0|10/01/2019 SH 78001|25455|25455 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA||698.73|0||0|10/01/2019 SH 78001|25450|25450 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U||589.17|0||0|10/01/2019 SH 78001|25449|25449 - REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT||1211.52|0||0|10/01/2019 SH 78001|25447|25447 - ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS||968.07|0||0|10/01/2019 SH 78001|25446|25446 - ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS||1378.52|0||0|10/01/2019 SH 78001|25445|25445 - ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM||845.87|0||0|10/01/2019 SH 78001|25444|25444 - ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE||972.47|0||0|10/01/2019 SH 78001|25443|25443 - ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL||919.51|0||0|10/01/2019 SH 78001|25442|25442 - ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA||933.81|0||0|10/01/2019 SH 78001|25441|25441 - ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS||1093.35|0||0|10/01/2019 SH 78001|25440|25440 - RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC||900.93|0||0|10/01/2019 SH 78001|25431|25431 - REPAIR NONUNION CARPAL BONE EACH BONE||917.68|0||0|10/01/2019 SH 78001|25430|25430 - INSERTION VASCULAR PEDICLE CARPAL BONE||859.51|0||0|10/01/2019 SH 78001|25426|25426 - REPAIR DEFECT W/AUTOGRAFT RADIUS&ULNA||1329.92|0||0|10/01/2019 SH 78001|25425|25425 - REPAIR DEFECT W/AUTOGRAFT RADIUS/ULNA||1136.1|0||0|10/01/2019 SH 78001|25420|25420 - RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT||1382.14|0||0|10/01/2019 SH 78001|25415|25415 - RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF||1142.27|0||0|10/01/2019 SH 78001|25405|25405 - RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT||1218.47|0||0|10/01/2019 SH 78001|25400|25400 - RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT||943.12|0||0|10/01/2019 SH 78001|25394|25394 - OSTEOPLASTY CARPAL BONE SHORTENING||935.46|0||0|10/01/2019 SH 78001|25393|25393 - OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAF||1326.34|0||0|10/01/2019 SH 78001|25392|25392 - OSTEOPLASTY RADIUS & ULNA SHORTENING||1186.24|0||0|10/01/2019 SH 78001|25391|25391 - OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT||1176.17|0||0|10/01/2019 SH 78001|25390|25390 - OSTEOPLASTY RADIUS/ULNA SHORTENING||902.18|0||0|10/01/2019 SH 78001|25375|25375 - MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA||1124.11|0||0|10/01/2019 SH 78001|25370|25370 - MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA||1186.23|0||0|10/01/2019 SH 78001|25365|25365 - OSTEOTOMY RADIUS & ULNA||1078.65|0||0|10/01/2019 SH 78001|25360|25360 - OSTEOTOMY ULNA||766.05|0||0|10/01/2019 SH 78001|25355|25355 - OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD||902.27|0||0|10/01/2019 SH 78001|25350|25350 - OSTEOTOMY RADIUS DISTAL THIRD||788.88|0||0|10/01/2019 SH 78001|25337|25337 - RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ||1038.12|0||0|10/01/2019 SH 78001|25335|25335 - CENTRALIZATION WRST ULNA||1112.56|0||0|10/01/2019 SH 78001|25332|25332 - ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ||985.04|0||0|10/01/2019 SH 78001|25320|25320 - CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS||1151.92|0||0|10/01/2019 SH 78001|25316|25316 - FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFE||1077.45|0||0|10/01/2019 SH 78001|25315|25315 - FLEXOR ORIGIN SLIDE FOREARM &/WRIST||908.75|0||0|10/01/2019 SH 78001|25312|25312 - TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR||841.33|0||0|10/01/2019 SH 78001|25310|25310 - TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN||722.81|0||0|10/01/2019 SH 78001|25301|25301 - TENODESIS WRIST EXTENSORS FINGERS||751.81|0||0|10/01/2019 SH 78001|25300|25300 - TENODESIS WRIST FLEXORS FINGERS||803.75|0||0|10/01/2019 SH 78001|25295|25295 - TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA||609.07|0||0|10/01/2019 SH 78001|25290|25290 - TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA||507.26|0||0|10/01/2019 SH 78001|25280|25280 - LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN||656.19|0||0|10/01/2019 SH 78001|25275|25275 - RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT||784.05|0||0|10/01/2019 SH 78001|25274|25274 - RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN||787.89|0||0|10/01/2019 SH 78001|25272|25272 - RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU||649.64|0||0|10/01/2019 SH 78001|25270|25270 - RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN||569.82|0||0|10/01/2019 SH 78001|25265|25265 - RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA||880.61|0||0|10/01/2019 SH 78001|25263|25263 - RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS||734.31|0||0|10/01/2019 SH 78001|25260|25260 - RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU||735.05|0||0|10/01/2019 SH 78001|25259|25259 - MANIPULATION WRIST UNDER ANESTHESIA||479.06|0||0|10/01/2019 SH 78001|25251|25251 - REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST||830.83|0||0|10/01/2019 SH 78001|25250|25250 - REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE||620.57|0||0|10/01/2019 SH 78001|25248|25248 - EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST||483.51|0||0|10/01/2019 SH 78001|25246|25246 - INJECTION WRIST ARTHROGRAPHY||185.44|0||0|10/01/2019 SH 78001|25240|25240 - EXCISION DISTAL ULNA PARTIAL/COMPLETE||496.65|0||0|10/01/2019 SH 78001|25230|25230 - RADICAL STYLOIDECTOMY SEPARATE PROCEDURE||503.51|0||0|10/01/2019 SH 78001|25215|25215 - CARPECTOMY ALL BONES PROXIMAL ROW||721.52|0||0|10/01/2019 SH 78001|25210|25210 - CARPECTOMY 1 BONE||566.49|0||0|10/01/2019 SH 78001|25170|25170 - RADICAL RESECTION TUMOR RADIUS OR ULNA||1756.1|0||0|10/01/2019 SH 78001|25151|25151 - PARTIAL EXCISION BONE RADIUS||688.15|0||0|10/01/2019 SH 78001|25150|25150 - PARTIAL EXCISION BONE ULNA||664.73|0||0|10/01/2019 SH 78001|25145|25145 - SEQUESTRECTOMY FOREARM &/WRIST||604.44|0||0|10/01/2019 SH 78001|25136|25136 - EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT||576.32|0||0|10/01/2019 SH 78001|25135|25135 - EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT||653.33|0||0|10/01/2019 SH 78001|25130|25130 - EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES||517.72|0||0|10/01/2019 SH 78001|25126|25126 - EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT||700.04|0||0|10/01/2019 SH 78001|25125|25125 - EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT||700.9|0||0|10/01/2019 SH 78001|25120|25120 - EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA||579.19|0||0|10/01/2019 SH 78001|25119|25119 - SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA||581.67|0||0|10/01/2019 SH 78001|25118|25118 - SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT||441.58|0||0|10/01/2019 SH 78001|25116|25116 - RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS||697.65|0||0|10/01/2019 SH 78001|25115|25115 - RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS||886.32|0||0|10/01/2019 SH 78001|25112|25112 - EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT||447.33|0||0|10/01/2019 SH 78001|25111|25111 - EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY||370.22|0||0|10/01/2019 SH 78001|25110|25110 - EXCISION LESION TENDON SHEATH FOREARM&/WRIST||395.72|0||0|10/01/2019 SH 78001|25109|25109 - EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA||626.69|0||0|10/01/2019 SH 78001|25107|25107 - ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE||719.21|0||0|10/01/2019 SH 78001|25105|25105 - ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY||559.86|0||0|10/01/2019 SH 78001|25101|25101 - ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB||468.97|0||0|10/01/2019 SH 78001|25100|25100 - ARTHROTOMY WRIST JOINT WITH BIOPSY||402.24|0||0|10/01/2019 SH 78001|25085|25085 - CAPSULOTOMY WRIST||526.83|0||0|10/01/2019 SH 78001|25078|25078 - RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>||1377.24|0||0|10/01/2019 SH 78001|25077|25077 - RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM||1044.24|0||0|10/01/2019 SH 78001|25076|25076 - EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM||603.36|0||0|10/01/2019 SH 78001|25075|25075 - EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM||545.01|0||0|10/01/2019 SH 78001|25073|25073 - EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>||623.69|0||0|10/01/2019 SH 78001|25071|25071 - EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>||499.33|0||0|10/01/2019 SH 78001|25066|25066 - BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP||418.06|0||0|10/01/2019 SH 78001|25065|25065 - BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL||289.61|0||0|10/01/2019 SH 78001|25040|25040 - ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB||657.85|0||0|10/01/2019 SH 78001|25035|25035 - INCISION DEEP BONE CORTEX FOREARM&/WRIST||681.01|0||0|10/01/2019 SH 78001|25031|25031 - INCISION & DRAINAGE FOREARM&/WRIST BURSA||423.84|0||0|10/01/2019 SH 78001|25028|25028 - I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA||604.41|0||0|10/01/2019 SH 78001|25025|25025 - DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT||1452.39|0||0|10/01/2019 SH 78001|25024|25024 - DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB||913.85|0||0|10/01/2019 SH 78001|25023|25023 - DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT||1284.62|0||0|10/01/2019 SH 78001|25020|25020 - DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT||662.39|0||0|10/01/2019 SH 78001|25001|25001 - INCISION FLEXOR TENDON SHEATH WRIST||397.72|0||0|10/01/2019 SH 78001|25000|25000 - INCISION EXTENSOR TENDON SHEATH WRIST||388.14|0||0|10/01/2019 SH 78001|24999|24999 - UNLISTED PROCEDURE HUMERUS/ELBOW||0|0||0|10/01/2019 SH 78001|24940|24940 - CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE||0|0||0|10/01/2019 SH 78001|24935|24935 - STUMP ELONGATION UPPER EXTREMITY||1083.09|0||0|10/01/2019 SH 78001|24931|24931 - AMPUTATION ARM THRU HUMERUS W/IMPLANT||916.22|0||0|10/01/2019 SH 78001|24930|24930 - AMPUTATION ARM THRU HUMERUS RE-AMPUTATION||913.67|0||0|10/01/2019 SH 78001|24925|24925 - AMP ARM THRU HUMERUS SECONDARY CLSR/SCAR REVJ||600.81|0||0|10/01/2019 SH 78001|24920|24920 - AMPUTATION ARM THRU HUMERUS OPEN CIRCULAR||863.29|0||0|10/01/2019 SH 78001|24900|24900 - AMPUTATION ARM THRU HUMERUS W/PRIMARY CLOSURE||852.27|0||0|10/01/2019 SH 78001|24802|24802 - ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT||1182.93|0||0|10/01/2019 SH 78001|24800|24800 - ARTHRODESIS ELBOW JOINT LOCAL||976.69|0||0|10/01/2019 SH 78001|24685|24685 - OPEN TREATMENT ULNAR FRACTURE PROXIMAL END||765.21|0||0|10/01/2019 SH 78001|24675|24675 - CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ||525.92|0||0|10/01/2019 SH 78001|24670|24670 - CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ||333.18|0||0|10/01/2019 SH 78001|24666|24666 - OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC||860.53|0||0|10/01/2019 SH 78001|24665|24665 - OPEN TX RADIAL HEAD/NECK FRACTURE||762.44|0||0|10/01/2019 SH 78001|24655|24655 - CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION||500.6|0||0|10/01/2019 SH 78001|24650|24650 - CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION||298.17|0||0|10/01/2019 SH 78001|24640|24640 - CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ||159.78|0||0|10/01/2019 SH 78001|24635|24635 - OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW||788.03|0||0|10/01/2019 SH 78001|24620|24620 - CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ||637.24|0||0|10/01/2019 SH 78001|24615|24615 - OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION||834.42|0||0|10/01/2019 SH 78001|24605|24605 - TREATMENT CLOSED ELBOW DISLOCATION REQ ANES||547.36|0||0|10/01/2019 SH 78001|24600|24600 - TREATMENT CLOSED ELBOW DISLOCATION W/O ANES||421.18|0||0|10/01/2019 SH 78001|24587|24587 - OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR||1287.09|0||0|10/01/2019 SH 78001|24586|24586 - OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO||1279.64|0||0|10/01/2019 SH 78001|24582|24582 - PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ||945.91|0||0|10/01/2019 SH 78001|24579|24579 - OPEN TREATMENT HUMERAL CONDYLAR FRACTURE||981.83|0||0|10/01/2019 SH 78001|24577|24577 - CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ||636.61|0||0|10/01/2019 SH 78001|24576|24576 - CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ||389.47|0||0|10/01/2019 SH 78001|24575|24575 - OPEN TX HUMERAL EPICONDYLAR FRACTURE||861.04|0||0|10/01/2019 SH 78001|24566|24566 - PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ||839.98|0||0|10/01/2019 SH 78001|24565|24565 - CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ||617.38|0||0|10/01/2019 SH 78001|24560|24560 - CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ||366.24|0||0|10/01/2019 SH 78001|24546|24546 - OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN||1225.42|0||0|10/01/2019 SH 78001|24545|24545 - OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN||1095.58|0||0|10/01/2019 SH 78001|24538|24538 - PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX||872.95|0||0|10/01/2019 SH 78001|24535|24535 - CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ||711.2|0||0|10/01/2019 SH 78001|24530|24530 - CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ||436.05|0||0|10/01/2019 SH 78001|24516|24516 - TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE||1013.83|0||0|10/01/2019 SH 78001|24515|24515 - OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE||1030.57|0||0|10/01/2019 SH 78001|24505|24505 - CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ||576.88|0||0|10/01/2019 SH 78001|24500|24500 - CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION||411.17|0||0|10/01/2019 SH 78001|24498|24498 - PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT||1024.33|0||0|10/01/2019 SH 78001|24495|24495 - DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL||635.98|0||0|10/01/2019 SH 78001|24470|24470 - HEMIEPIPHYSEAL ARREST||788.62|0||0|10/01/2019 SH 78001|24435|24435 - REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT||1268.8|0||0|10/01/2019 SH 78001|24430|24430 - REPAIR NON/MALUNION HUMERUS W/O GRAFT||1247.46|0||0|10/01/2019 SH 78001|24420|24420 - OSTEOPLASTY HUMERUS||1170.26|0||0|10/01/2019 SH 78001|24410|24410 - MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT||1249.21|0||0|10/01/2019 SH 78001|24400|24400 - OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION||962.75|0||0|10/01/2019 SH 78001|24371|24371 - REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT||2132.53|0||0|10/01/2019 SH 78001|24370|24370 - REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT||1839.44|0||0|10/01/2019 SH 78001|24366|24366 - ARTHROPLASTY RADIAL HEAD W/IMPLANT||799.79|0||0|10/01/2019 SH 78001|24365|24365 - ARTHROPLASTY RADIAL HEAD||751.59|0||0|10/01/2019 SH 78001|24363|24363 - ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM||1724.08|0||0|10/01/2019 SH 78001|24362|24362 - ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ||1253.24|0||0|10/01/2019 SH 78001|24361|24361 - ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT||1188.76|0||0|10/01/2019 SH 78001|24360|24360 - ARTHROPLASTY ELBOW W/MEMBRANE||1061.71|0||0|10/01/2019 SH 78001|24359|24359 - TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR||772.13|0||0|10/01/2019 SH 78001|24358|24358 - TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN||610.37|0||0|10/01/2019 SH 78001|24357|24357 - TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS||503.8|0||0|10/01/2019 SH 78001|24346|24346 - RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF||1295.39|0||0|10/01/2019 SH 78001|24345|24345 - REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW||830.73|0||0|10/01/2019 SH 78001|24344|24344 - RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT||1295.39|0||0|10/01/2019 SH 78001|24343|24343 - REPAIR LATERAL COLLATERAL LIGAMENT ELBOW||826.43|0||0|10/01/2019 SH 78001|24342|24342 - RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF||912.6|0||0|10/01/2019 SH 78001|24341|24341 - REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA||872.47|0||0|10/01/2019 SH 78001|24340|24340 - TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE||717.02|0||0|10/01/2019 SH 78001|24332|24332 - TENOLYSIS TRICEPS||718.23|0||0|10/01/2019 SH 78001|24331|24331 - FLEXOR-PLASTY ELBOW W/EXTENSOR ADVANCEMENT||926.99|0||0|10/01/2019 SH 78001|24330|24330 - FLEXOR-PLASTY ELBOW||845.13|0||0|10/01/2019 SH 78001|24320|24320 - TENOPLASTY ELBOW TO SHOULDER SINGLE||920.78|0||0|10/01/2019 SH 78001|24310|24310 - TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON||552.16|0||0|10/01/2019 SH 78001|24305|24305 - TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON||672.71|0||0|10/01/2019 SH 78001|24301|24301 - MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE||875.96|0||0|10/01/2019 SH 78001|24300|24300 - MANIPULATION ELBOW UNDER ANESTHESIA||481|0||0|10/01/2019 SH 78001|24220|24220 - INJECTION ELBOW ARTHROGRAPHY||182.89|0||0|10/01/2019 SH 78001|24201|24201 - REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP||638.99|0||0|10/01/2019 SH 78001|24200|24200 - RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS||237.05|0||0|10/01/2019 SH 78001|24164|24164 - PROSTHESIS REMOVAL RADIAL HEAD||855.72|0||0|10/01/2019 SH 78001|24160|24160 - PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS||1489.47|0||0|10/01/2019 SH 78001|24155|24155 - RESECTION ELBOW JOINT ARTHRECTOMY||1007.21|0||0|10/01/2019 SH 78001|24152|24152 - RADICAL RESECTION TUMOR RADIAL HEAD/NECK||1603.68|0||0|10/01/2019 SH 78001|24150|24150 - RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS||1849.21|0||0|10/01/2019 SH 78001|24149|24149 - RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT||1379.23|0||0|10/01/2019 SH 78001|24147|24147 - PARTIAL EXCISION BONE OLECRANON PROCESS||728.77|0||0|10/01/2019 SH 78001|24145|24145 - PARTIAL EXCISION BONE RADIAL HEAD/NECK||694.92|0||0|10/01/2019 SH 78001|24140|24140 - PARTIAL EXCISION BONE HUMERUS||826.61|0||0|10/01/2019 SH 78001|24138|24138 - SEQUESTRECTOMY OLECRANON PROCESS||790.61|0||0|10/01/2019 SH 78001|24136|24136 - SEQUESTRECTOMY RADIAL HEAD OR NECK||682.45|0||0|10/01/2019 SH 78001|24134|24134 - SEQUESTRECTOMY SHAFT/DISTAL HUMERUS||880.36|0||0|10/01/2019 SH 78001|24130|24130 - EXCISION RADIAL HEAD||592.27|0||0|10/01/2019 SH 78001|24126|24126 - EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT||762.06|0||0|10/01/2019 SH 78001|24125|24125 - EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/AGRFT||728.55|0||0|10/01/2019 SH 78001|24120|24120 - EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN||616.5|0||0|10/01/2019 SH 78001|24116|24116 - EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT||1017.9|0||0|10/01/2019 SH 78001|24115|24115 - EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT||868.68|0||0|10/01/2019 SH 78001|24110|24110 - EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS||688.87|0||0|10/01/2019 SH 78001|24105|24105 - EXCISION OLECRANON BURSA||405.83|0||0|10/01/2019 SH 78001|24102|24102 - ARTHROTOMY ELBOW W/SYNOVECTOMY||720.91|0||0|10/01/2019 SH 78001|24101|24101 - ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB||583.98|0||0|10/01/2019 SH 78001|24100|24100 - ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY||487.49|0||0|10/01/2019 SH 78001|24079|24079 - RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5CM/>||1571.91|0||0|10/01/2019 SH 78001|24077|24077 - RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM||1222.84|0||0|10/01/2019 SH 78001|24076|24076 - EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM||635.79|0||0|10/01/2019 SH 78001|24075|24075 - EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM||560.98|0||0|10/01/2019 SH 78001|24073|24073 - EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>||819.49|0||0|10/01/2019 SH 78001|24071|24071 - EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>||476.71|0||0|10/01/2019 SH 78001|24066|24066 - BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP||716.29|0||0|10/01/2019 SH 78001|24065|24065 - BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL||291.56|0||0|10/01/2019 SH 78001|24006|24006 - ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX||835.56|0||0|10/01/2019 SH 78001|24000|24000 - ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB||558.21|0||0|10/01/2019 SH 78001|23935|23935 - INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW||590.93|0||0|10/01/2019 SH 78001|23931|23931 - INCISION&DRAINAGE UPPER ARM/ELBOW BURSA||324.8|0||0|10/01/2019 SH 78001|23930|23930 - I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA||401.58|0||0|10/01/2019 SH 78001|23929|23929 - UNLISTED PROCEDURE SHOULDER||0|0||0|10/01/2019 SH 78001|23921|23921 - DISRTCJ SHOULDER SECONDARY CLSR/SCAR REVISION||536.43|0||0|10/01/2019 SH 78001|23920|23920 - DISARTICULATION SHOULDER||1333.61|0||0|10/01/2019 SH 78001|23900|23900 - INTERTHORACOSCAPULAR AMPUTATION||1647.59|0||0|10/01/2019 SH 78001|23802|23802 - ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT||1519.63|0||0|10/01/2019 SH 78001|23800|23800 - ARTHRODESIS GLENOHUMERAL JOINT||1212.65|0||0|10/01/2019 SH 78001|23700|23700 - MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS||230.72|0||0|10/01/2019 SH 78001|23680|23680 - OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE||1095.97|0||0|10/01/2019 SH 78001|23675|23675 - CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ||640.84|0||0|10/01/2019 SH 78001|23670|23670 - OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX||1034|0||0|10/01/2019 SH 78001|23665|23665 - CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ||490.32|0||0|10/01/2019 SH 78001|23660|23660 - OPEN TX ACUTE SHOULDER DISLOCATION||679.51|0||0|10/01/2019 SH 78001|23655|23655 - CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES||466.34|0||0|10/01/2019 SH 78001|23650|23650 - CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES||361.28|0||0|10/01/2019 SH 78001|23630|23630 - OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE||917.93|0||0|10/01/2019 SH 78001|23625|23625 - CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION||439.02|0||0|10/01/2019 SH 78001|23620|23620 - CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ||309.31|0||0|10/01/2019 SH 78001|23616|23616 - OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT||1468.97|0||0|10/01/2019 SH 78001|23615|23615 - OPEN TREATMENT PROXIMAL HUMERAL FRACTURE||1041.05|0||0|10/01/2019 SH 78001|23605|23605 - CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ||535.89|0||0|10/01/2019 SH 78001|23600|23600 - CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION||372.92|0||0|10/01/2019 SH 78001|23585|23585 - OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD||1156.92|0||0|10/01/2019 SH 78001|23575|23575 - CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION||463.25|0||0|10/01/2019 SH 78001|23570|23570 - CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION||266.61|0||0|10/01/2019 SH 78001|23552|23552 - OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF||766.01|0||0|10/01/2019 SH 78001|23550|23550 - OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC||664.85|0||0|10/01/2019 SH 78001|23545|23545 - CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION||391.08|0||0|10/01/2019 SH 78001|23540|23540 - CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION||258.85|0||0|10/01/2019 SH 78001|23532|23532 - OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF||732.69|0||0|10/01/2019 SH 78001|23530|23530 - OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC||672.15|0||0|10/01/2019 SH 78001|23525|23525 - CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION||443.48|0||0|10/01/2019 SH 78001|23520|23520 - CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION||266.31|0||0|10/01/2019 SH 78001|23515|23515 - OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION||845.44|0||0|10/01/2019 SH 78001|23505|23505 - CLSD TX CLAVICULAR FRACTURE W/MANIPULATION||407.2|0||0|10/01/2019 SH 78001|23500|23500 - CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION||250.05|0||0|10/01/2019 SH 78001|23491|23491 - PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS||1196.31|0||0|10/01/2019 SH 78001|23490|23490 - PROPH TX W/WO METHYLMETHACRYLATE CLAVICLE||1017.6|0||0|10/01/2019 SH 78001|23485|23485 - OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL||1126.84|0||0|10/01/2019 SH 78001|23480|23480 - OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION||968.74|0||0|10/01/2019 SH 78001|23474|23474 - REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT||2088.92|0||0|10/01/2019 SH 78001|23473|23473 - REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT||1930.73|0||0|10/01/2019 SH 78001|23472|23472 - ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER||1727.38|0||0|10/01/2019 SH 78001|23470|23470 - ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY||1423.82|0||0|10/01/2019 SH 78001|23466|23466 - CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS||1325.13|0||0|10/01/2019 SH 78001|23465|23465 - CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK||1326.17|0||0|10/01/2019 SH 78001|23462|23462 - CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR||1260.81|0||0|10/01/2019 SH 78001|23460|23460 - CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK||1289.55|0||0|10/01/2019 SH 78001|23455|23455 - CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR||1183.28|0||0|10/01/2019 SH 78001|23450|23450 - CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON||1121.67|0||0|10/01/2019 SH 78001|23440|23440 - RESECTION/TRANSPLANTATION LONG TENDON BICEPS||890.32|0||0|10/01/2019 SH 78001|23430|23430 - TENODESIS LONG TENDON BICEPS||877.78|0||0|10/01/2019 SH 78001|23420|23420 - RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC||1140.71|0||0|10/01/2019 SH 78001|23415|23415 - CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY||819.4|0||0|10/01/2019 SH 78001|23412|23412 - OPEN REPAIR OF ROTATOR CUFF CHRONIC||1003.37|0||0|10/01/2019 SH 78001|23410|23410 - OPEN REPAIR OF ROTATOR CUFF ACUTE||967.67|0||0|10/01/2019 SH 78001|23406|23406 - TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION||908.22|0||0|10/01/2019 SH 78001|23405|23405 - TENOTOMY SHOULDER AREA 1 TENDON||734.16|0||0|10/01/2019 SH 78001|23400|23400 - SCAPULOPEXY||1146.84|0||0|10/01/2019 SH 78001|23397|23397 - MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE||1352.22|0||0|10/01/2019 SH 78001|23395|23395 - MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE||1515.83|0||0|10/01/2019 SH 78001|23350|23350 - INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG||148.97|0||0|10/01/2019 SH 78001|23335|23335 - PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT||1509.32|0||0|10/01/2019 SH 78001|23334|23334 - PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT||1265.22|0||0|10/01/2019 SH 78001|23333|23333 - REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM||533.43|0||0|10/01/2019 SH 78001|23330|23330 - REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS||275.06|0||0|10/01/2019 SH 78001|23220|23220 - RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS||2324.32|0||0|10/01/2019 SH 78001|23210|23210 - RADICAL RESECTION TUMOR SCAPULA||2118.85|0||0|10/01/2019 SH 78001|23200|23200 - RADICAL RESECTION TUMOR CLAVICLE||1800.56|0||0|10/01/2019 SH 78001|23195|23195 - RESECTION HUMERAL HEAD||889.89|0||0|10/01/2019 SH 78001|23190|23190 - OSTECTOMY SCAPULA PARTIAL||670.55|0||0|10/01/2019 SH 78001|23184|23184 - PARTIAL EXCISION BONE PROXIMAL HUMERUS||863.82|0||0|10/01/2019 SH 78001|23182|23182 - PARTIAL EXCISION BONE SCAPULA||773.26|0||0|10/01/2019 SH 78001|23180|23180 - PARTIAL EXCISION BONE CLAVICLE||784.63|0||0|10/01/2019 SH 78001|23174|23174 - SEQUESTRECTOMY HUMERAL HEAD SURGERY NECK||890.85|0||0|10/01/2019 SH 78001|23172|23172 - SEQUESTRECTOMY SCAPULA||663.65|0||0|10/01/2019 SH 78001|23170|23170 - SEQUESTRECTOMY CLAVICLE||657.01|0||0|10/01/2019 SH 78001|23156|23156 - EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT||797.56|0||0|10/01/2019 SH 78001|23155|23155 - EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT||934.35|0||0|10/01/2019 SH 78001|23150|23150 - EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS||778.46|0||0|10/01/2019 SH 78001|23146|23146 - EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT||729.06|0||0|10/01/2019 SH 78001|23145|23145 - EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/AGRFT||818.22|0||0|10/01/2019 SH 78001|23140|23140 - EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA||619.79|0||0|10/01/2019 SH 78001|23130|23130 - PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE||714.52|0||0|10/01/2019 SH 78001|23125|23125 - CLAVICULECTOMY TOTAL||834.78|0||0|10/01/2019 SH 78001|23120|23120 - CLAVICULECTOMY PARTIAL||683.76|0||0|10/01/2019 SH 78001|23107|23107 - ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB||774.38|0||0|10/01/2019 SH 78001|23106|23106 - ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX||580.54|0||0|10/01/2019 SH 78001|23105|23105 - ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY||747.47|0||0|10/01/2019 SH 78001|23101|23101 - ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG||525.63|0||0|10/01/2019 SH 78001|23100|23100 - ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY||585.11|0||0|10/01/2019 SH 78001|23078|23078 - RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5 CM/>||1697.13|0||0|10/01/2019 SH 78001|23077|23077 - RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM||1351.16|0||0|10/01/2019 SH 78001|23076|23076 - EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM||633.48|0||0|10/01/2019 SH 78001|23075|23075 - EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM||537.21|0||0|10/01/2019 SH 78001|23073|23073 - EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>||818.34|0||0|10/01/2019 SH 78001|23071|23071 - EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>||493.14|0||0|10/01/2019 SH 78001|23066|23066 - BIOPSY SOFT TISSUE SHOULDER DEEP||635.68|0||0|10/01/2019 SH 78001|23065|23065 - BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL||248.89|0||0|10/01/2019 SH 78001|23044|23044 - ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB||671.47|0||0|10/01/2019 SH 78001|23040|23040 - ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB||845.33|0||0|10/01/2019 SH 78001|23035|23035 - INCISION BONE CORTEX SHOULDER AREA||799.7|0||0|10/01/2019 SH 78001|23031|23031 - I&D SHOULDER INFECTED BURSA||485.59|0||0|10/01/2019 SH 78001|23030|23030 - I&D SHOULDER DEEP ABSCESS/HEMATOMA||504.48|0||0|10/01/2019 SH 78001|23020|23020 - CAPSULAR CONTRACTURE RELEASE||809.88|0||0|10/01/2019 SH 78001|23000|23000 - REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN||670.97|0||0|10/01/2019 SH 78001|22999|22999 - UNLISTED PX ABDOMEN MUSCULOSKELETAL SYSTEM||0|0||0|10/01/2019 SH 78001|22905|22905 - RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>||1580.1|0||0|10/01/2019 SH 78001|22904|22904 - RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM||1249.62|0||0|10/01/2019 SH 78001|22903|22903 - EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>||518.14|0||0|10/01/2019 SH 78001|22902|22902 - EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM||505.58|0||0|10/01/2019 SH 78001|22901|22901 - EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>||786.88|0||0|10/01/2019 SH 78001|22900|22900 - EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM||665.8|0||0|10/01/2019 SH 78001|22899|22899 - UNLISTED PROCEDURE SPINE||0|0||0|10/01/2019 SH 78001|22870|22870 - INSJ STABLJ DEV W/O DCMPRN LUMBAR SECOND LEVEL||179.16|0||0|10/01/2019 SH 78001|22869|22869 - INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE LEVEL||676.14|0||0|10/01/2019 SH 78001|22868|22868 - INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL||307.49|0||0|10/01/2019 SH 78001|22867|22867 - INSJ STABLJ DEV W/DCMPRN LUMBAR SINGLE LEVEL||1229.55|0||0|10/01/2019 SH 78001|22865|22865 - RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR||2445.85|0||0|10/01/2019 SH 78001|22864|22864 - RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL||2518.68|0||0|10/01/2019 SH 78001|22862|22862 - REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR||2108.37|0||0|10/01/2019 SH 78001|22861|22861 - REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC CRV||2314.92|0||0|10/01/2019 SH 78001|22859|22859 - INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD||425.93|0||0|10/01/2019 SH 78001|22858|22858 - TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL||599.99|0||0|10/01/2019 SH 78001|22857|22857 - TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC LMBR||2117.72|0||0|10/01/2019 SH 78001|22856|22856 - TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV||1907.31|0||0|10/01/2019 SH 78001|22855|22855 - REMOVAL ANTERIOR INSTRUMENTATION||1324.58|0||0|10/01/2019 SH 78001|22852|22852 - REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION||824.05|0||0|10/01/2019 SH 78001|22850|22850 - REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION||860.16|0||0|10/01/2019 SH 78001|22849|22849 - REINSERTION SPINAL FIXATION DEVICE||1557.38|0||0|10/01/2019 SH 78001|22848|22848 - PELVIC FIXATION OTHER THAN SACRUM||435.79|0||0|10/01/2019 SH 78001|22847|22847 - ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS||966.19|0||0|10/01/2019 SH 78001|22846|22846 - ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS||922.44|0||0|10/01/2019 SH 78001|22845|22845 - ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS||888.62|0||0|10/01/2019 SH 78001|22844|22844 - POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE||1194.33|0||0|10/01/2019 SH 78001|22843|22843 - POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG||989.77|0||0|10/01/2019 SH 78001|22842|22842 - POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG||925.02|0||0|10/01/2019 SH 78001|22841|22841 - INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS||0|0||0|10/01/2019 SH 78001|22840|22840 - POSTERIOR NON-SEGMENTAL INSTRUMENTATION||922.52|0||0|10/01/2019 SH 78001|22830|22830 - EXPLORATION SPINAL FUSION||966.34|0||0|10/01/2019 SH 78001|22819|22819 - KYPHECTOMY 3 OR MORE SEGMENTS||3335.27|0||0|10/01/2019 SH 78001|22818|22818 - KYPHECTOMY SINGLE OR TWO SEGMENTS||2595.98|0||0|10/01/2019 SH 78001|22812|22812 - ARTHRODESIS ANTERIOR SPINAL DFRM 8/> VRT SEG||2639.04|0||0|10/01/2019 SH 78001|22810|22810 - ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SEG||2422.68|0||0|10/01/2019 SH 78001|22808|22808 - ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SEG||2210.63|0||0|10/01/2019 SH 78001|22804|22804 - ARTHRODESIS POSTERIOR SPINAL DFRM 13/> VRT SEG||2911.18|0||0|10/01/2019 SH 78001|22802|22802 - ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SEG||2510.14|0||0|10/01/2019 SH 78001|22800|22800 - ARTHRODESIS POSTERIOR SPINAL DFRM UP 6 VRT SEG||1611.45|0||0|10/01/2019 SH 78001|22634|22634 - ARTHDSIS POST/POSTERLATRL/POSTINTRBDYADL SPC/SEG||602.05|0||0|10/01/2019 SH 78001|22633|22633 - ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR||2223.34|0||0|10/01/2019 SH 78001|22632|22632 - ARTHRODESIS POSTERIOR INTERBODY EA ADDL||389.82|0||0|10/01/2019 SH 78001|22630|22630 - ARTHRODESIS POSTERIOR INTERBODY LUMBAR||1877.14|0||0|10/01/2019 SH 78001|22614|22614 - ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL||475.78|0||0|10/01/2019 SH 78001|22612|22612 - ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR||1898.72|0||0|10/01/2019 SH 78001|22610|22610 - ARTHRODESIS POSTERIOR/POSTEROLATERAL THORACIC||1506.09|0||0|10/01/2019 SH 78001|22600|22600 - ARTHRODESIS PST/PSTLAT CERVICAL BELW C2 SGM||1539.67|0||0|10/01/2019 SH 78001|22595|22595 - ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2||1806.09|0||0|10/01/2019 SH 78001|22590|22590 - ARTHRODESIS POSTERIOR CRANIOCERVICAL||1889.75|0||0|10/01/2019 SH 78001|22586|22586 - ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5-S1||2416.08|0||0|10/01/2019 SH 78001|22585|22585 - ARTHRODESIS ANTERIOR INTERBODY EA ADDL NTRSPC||399.24|0||0|10/01/2019 SH 78001|22558|22558 - ARTHRODESIS ANTERIOR INTERBODY LUMBAR||1842.81|0||0|10/01/2019 SH 78001|22556|22556 - ARTHRD ANT MIN DISCECTOMY INTERBODY THORACIC||2003.25|0||0|10/01/2019 SH 78001|22554|22554 - ARTHRD ANT MIN DISCECT INTERBODY CERV BELOW C2||1501.71|0||0|10/01/2019 SH 78001|22552|22552 - ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC||485.04|0||0|10/01/2019 SH 78001|22551|22551 - ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2||2057.47|0||0|10/01/2019 SH 78001|22548|22548 - ARTHRD ANT TRANSORL/XTRORAL C1-C2 W/WO EXC ODNTD||2374.93|0||0|10/01/2019 SH 78001|22534|22534 - ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR||435.41|0||0|10/01/2019 SH 78001|22533|22533 - ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR||1967.65|0||0|10/01/2019 SH 78001|22532|22532 - ARTHRODESIS LATERAL EXTRACAVITARY THORACIC||2126.03|0||0|10/01/2019 SH 78001|22527|22527 - PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL||2186.8|0||0|10/01/2019 SH 78001|22526|22526 - PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LEVEL||2638.26|0||0|10/01/2019 SH 78001|22515|22515 - PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH||4898.13|0||0|10/01/2019 SH 78001|22514|22514 - PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR||8080.38|0||0|10/01/2019 SH 78001|22513|22513 - PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION||8125.93|0||0|10/01/2019 SH 78001|22512|22512 - VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL||1097.94|0||0|10/01/2019 SH 78001|22511|22511 - PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL||1957.91|0||0|10/01/2019 SH 78001|22510|22510 - PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC||1978.24|0||0|10/01/2019 SH 78001|22505|22505 - MANIPULATION SPINE REQUIRING ANESTHESIA||156.7|0||0|10/01/2019 SH 78001|22328|22328 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA||343.27|0||0|10/01/2019 SH 78001|22327|22327 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH||1792.92|0||0|10/01/2019 SH 78001|22326|22326 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR||1787.91|0||0|10/01/2019 SH 78001|22325|22325 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM||1704.73|0||0|10/01/2019 SH 78001|22319|22319 - OPTX&/RDCTJ ODNTD FX&/DISLC ANT W/INT FIXJ||2211.01|0||0|10/01/2019 SH 78001|22318|22318 - OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT||1964.68|0||0|10/01/2019 SH 78001|22315|22315 - CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ||1035.44|0||0|10/01/2019 SH 78001|22310|22310 - CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING||359.03|0||0|10/01/2019 SH 78001|22305|22305 - CLOSED TX SPINE PROCESS FX||221.41|0||0|10/01/2019 SH 78001|22226|22226 - OSTEOT SPI W/DSKC ANT APPR 1 VRT SGM EA VRT SGM||437.13|0||0|10/01/2019 SH 78001|22224|22224 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM LMBR||1880.72|0||0|10/01/2019 SH 78001|22222|22222 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM THRC||1856.11|0||0|10/01/2019 SH 78001|22220|22220 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM CRV||1901.16|0||0|10/01/2019 SH 78001|22216|22216 - OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM||439.47|0||0|10/01/2019 SH 78001|22214|22214 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR||1765.47|0||0|10/01/2019 SH 78001|22212|22212 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC||1767.3|0||0|10/01/2019 SH 78001|22210|22210 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV||2134.62|0||0|10/01/2019 SH 78001|22208|22208 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM||691.89|0||0|10/01/2019 SH 78001|22207|22207 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR||2866.93|0||0|10/01/2019 SH 78001|22206|22206 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC||2928.2|0||0|10/01/2019 SH 78001|22116|22116 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA||170.74|0||0|10/01/2019 SH 78001|22114|22114 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR||1176.41|0||0|10/01/2019 SH 78001|22112|22112 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC||1342.6|0||0|10/01/2019 SH 78001|22110|22110 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV||1241.15|0||0|10/01/2019 SH 78001|22103|22103 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA||169.26|0||0|10/01/2019 SH 78001|22102|22102 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR||941.94|0||0|10/01/2019 SH 78001|22101|22101 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC||970.98|0||0|10/01/2019 SH 78001|22100|22100 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV||1103.33|0||0|10/01/2019 SH 78001|22015|22015 - I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC||1071.4|0||0|10/01/2019 SH 78001|22010|22010 - I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR||1125.84|0||0|10/01/2019 SH 78001|21936|21936 - RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>||1677.78|0||0|10/01/2019 SH 78001|21935|21935 - RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM||1214.31|0||0|10/01/2019 SH 78001|21933|21933 - EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>||874.32|0||0|10/01/2019 SH 78001|21932|21932 - EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM||781.33|0||0|10/01/2019 SH 78001|21931|21931 - EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>||554.4|0||0|10/01/2019 SH 78001|21930|21930 - EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM||545.07|0||0|10/01/2019 SH 78001|21925|21925 - BIOPSY SOFT TISSUE BACK/FLANK DEEP||516.18|0||0|10/01/2019 SH 78001|21920|21920 - BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL||292.24|0||0|10/01/2019 SH 78001|21899|21899 - UNLISTED PROCEDURE NECK/THORAX||0|0||0|10/01/2019 SH 78001|21825|21825 - OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION||638.91|0||0|10/01/2019 SH 78001|21820|21820 - CLOSED TREATMENT STERNUM FRACTURE||163.75|0||0|10/01/2019 SH 78001|21813|21813 - OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS||1183.87|0||0|10/01/2019 SH 78001|21812|21812 - OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS||870.13|0||0|10/01/2019 SH 78001|21811|21811 - OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS||725.5|0||0|10/01/2019 SH 78001|21805|21805 - TREATMENT OF RIB FRACTURE||315.43|0||0|10/01/2019 SH 78001|21750|21750 - CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX||817.37|0||0|10/01/2019 SH 78001|21743|21743 - REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC||0|0||0|10/01/2019 SH 78001|21742|21742 - REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC||0|0||0|10/01/2019 SH 78001|21740|21740 - REPAIR PECTUS EXCAVATUM/CARINATUM OPEN||1234.56|0||0|10/01/2019 SH 78001|21725|21725 - DIVISION STERNOCLEIDOMASTOID OPEN W/CAST||635.21|0||0|10/01/2019 SH 78001|21720|21720 - DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST||561.59|0||0|10/01/2019 SH 78001|21705|21705 - DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB||658.13|0||0|10/01/2019 SH 78001|21700|21700 - DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB||439.88|0||0|10/01/2019 SH 78001|21685|21685 - HYOID MYOTOMY & SUSPENSION||1177.57|0||0|10/01/2019 SH 78001|21632|21632 - RADICAL RESECTION STERNUM W/MEDSTNL LMPHADEC||1435.74|0||0|10/01/2019 SH 78001|21630|21630 - RADICAL RESECTION STERNUM||1427.82|0||0|10/01/2019 SH 78001|21627|21627 - STERNAL DEBRIDEMENT||638.42|0||0|10/01/2019 SH 78001|21620|21620 - OSTECTOMY STERNUM PARTIAL||596.08|0||0|10/01/2019 SH 78001|21616|21616 - EXCISION 1ST &/CERVICAL RIB W/SYMPATHECTOMY||875.41|0||0|10/01/2019 SH 78001|21615|21615 - EXCISION 1ST &/CERVICAL RIB||746.12|0||0|10/01/2019 SH 78001|21610|21610 - COSTOTRANSVERSECTOMY SEPARATE PROCEDURE||1445.76|0||0|10/01/2019 SH 78001|21600|21600 - EXCISION RIB PARTIAL||654.52|0||0|10/01/2019 SH 78001|21558|21558 - RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>||1597.85|0||0|10/01/2019 SH 78001|21557|21557 - RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM||1135.55|0||0|10/01/2019 SH 78001|21556|21556 - EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM||624.85|0||0|10/01/2019 SH 78001|21555|21555 - EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM||477.95|0||0|10/01/2019 SH 78001|21554|21554 - EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>||866.14|0||0|10/01/2019 SH 78001|21552|21552 - EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>||526.71|0||0|10/01/2019 SH 78001|21550|21550 - BIOPSY SOFT TISSUE NECK/THORAX||299.61|0||0|10/01/2019 SH 78001|21510|21510 - INCISION DEEP OPENING BONE CORTEX THORAX||519.25|0||0|10/01/2019 SH 78001|21502|21502 - I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI||601.18|0||0|10/01/2019 SH 78001|21501|21501 - I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX||519.51|0||0|10/01/2019 SH 78001|21499|21499 - UNLISTED MUSCULOSKELETAL PROCEDURE HEAD||0|0||0|10/01/2019 SH 78001|21497|21497 - INTERDENTAL WIRING OTHER THAN FRACTURE||844.91|0||0|10/01/2019 SH 78001|21490|21490 - OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION||1088.41|0||0|10/01/2019 SH 78001|21485|21485 - CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ||810.2|0||0|10/01/2019 SH 78001|21480|21480 - CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ||111.99|0||0|10/01/2019 SH 78001|21470|21470 - OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION||1429.91|0||0|10/01/2019 SH 78001|21465|21465 - OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE||1102.72|0||0|10/01/2019 SH 78001|21462|21462 - OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION||2583.18|0||0|10/01/2019 SH 78001|21461|21461 - OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION||2424.15|0||0|10/01/2019 SH 78001|21454|21454 - OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION||675.04|0||0|10/01/2019 SH 78001|21453|21453 - CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION||1054.88|0||0|10/01/2019 SH 78001|21452|21452 - PERCUTANEOUS TX MANDIBULAR FX W/EXTERNAL FIXJ||652.88|0||0|10/01/2019 SH 78001|21451|21451 - CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION||945.09|0||0|10/01/2019 SH 78001|21450|21450 - CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION||715.23|0||0|10/01/2019 SH 78001|21445|21445 - OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX||893.5|0||0|10/01/2019 SH 78001|21440|21440 - CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX||660.93|0||0|10/01/2019 SH 78001|21436|21436 - OPTX CRNFCL SEP LFT III TYP COMP INT FIXJ W/BONE||2410.51|0||0|10/01/2019 SH 78001|21435|21435 - OPEN TX CRANIOFACIAL SEP COMP W/INT&/XTRNL FIX||1497.6|0||0|10/01/2019 SH 78001|21433|21433 - OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR||2056.03|0||0|10/01/2019 SH 78001|21432|21432 - OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ||753.91|0||0|10/01/2019 SH 78001|21431|21431 - CLOSED TX CRANIOFACIAL SEPARATION||913.88|0||0|10/01/2019 SH 78001|21423|21423 - OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR||931.1|0||0|10/01/2019 SH 78001|21422|21422 - OPEN TREATMENT PALATAL/MAXILLARY FRACTURE||791.91|0||0|10/01/2019 SH 78001|21421|21421 - CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT||965.33|0||0|10/01/2019 SH 78001|21408|21408 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT||1057.81|0||0|10/01/2019 SH 78001|21407|21407 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT||757.08|0||0|10/01/2019 SH 78001|21406|21406 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT||669.88|0||0|10/01/2019 SH 78001|21401|21401 - CLOSED TX FX ORBIT EXCEPT BLOWOUT W/MANIPULATION||563.14|0||0|10/01/2019 SH 78001|21400|21400 - CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION||221.73|0||0|10/01/2019 SH 78001|21395|21395 - OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF||1187.97|0||0|10/01/2019 SH 78001|21390|21390 - OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC||931.91|0||0|10/01/2019 SH 78001|21387|21387 - OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR||837.87|0||0|10/01/2019 SH 78001|21386|21386 - OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL||817.33|0||0|10/01/2019 SH 78001|21385|21385 - OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL||802.16|0||0|10/01/2019 SH 78001|21366|21366 - OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT||1376.05|0||0|10/01/2019 SH 78001|21365|21365 - OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG||1314.86|0||0|10/01/2019 SH 78001|21360|21360 - OPEN TX DEPRESSED MALAR FRACTURE||631.24|0||0|10/01/2019 SH 78001|21356|21356 - OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE||579.81|0||0|10/01/2019 SH 78001|21355|21355 - PERCUTANEOUS TX MALAR AREA FRACTURE||557.22|0||0|10/01/2019 SH 78001|21348|21348 - OPTX NASOMAX CPLX FX LEFT II TYPE W/BONE GRAFT||1423.25|0||0|10/01/2019 SH 78001|21347|21347 - OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN||1327.81|0||0|10/01/2019 SH 78001|21346|21346 - OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ||1058.12|0||0|10/01/2019 SH 78001|21345|21345 - CLOSED TX NASOMAXILLARY COMPLEX FRACTURE||908.08|0||0|10/01/2019 SH 78001|21344|21344 - OPEN TX COMPLICATED FRONTAL SINUS FRACTURE||1647.55|0||0|10/01/2019 SH 78001|21343|21343 - OPEN TX DEPRESSED FRONTAL SINUS FRACTURE||1417.34|0||0|10/01/2019 SH 78001|21340|21340 - PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE||939.88|0||0|10/01/2019 SH 78001|21339|21339 - OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION||986.3|0||0|10/01/2019 SH 78001|21338|21338 - OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION||867.49|0||0|10/01/2019 SH 78001|21337|21337 - CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION||465.71|0||0|10/01/2019 SH 78001|21336|21336 - OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION||747.25|0||0|10/01/2019 SH 78001|21335|21335 - OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM||847.82|0||0|10/01/2019 SH 78001|21330|21330 - OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI||663.5|0||0|10/01/2019 SH 78001|21325|21325 - OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED||549.43|0||0|10/01/2019 SH 78001|21320|21320 - CLOSED TREATMENT NASAL FRACTURE W/STABILIZATION||292.79|0||0|10/01/2019 SH 78001|21315|21315 - CLOSED TX NASAL FRACTURE W/O STABILIZATION||316.99|0||0|10/01/2019 SH 78001|21310|21310 - CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION||147.91|0||0|10/01/2019 SH 78001|21299|21299 - UNLISTED CRANIOFACIAL & MAXILLOFACIAL PROCEDURE||0|0||0|10/01/2019 SH 78001|21296|21296 - REDUCTION MASSETER MUSCLE & BONE INTRAORAL||488.48|0||0|10/01/2019 SH 78001|21295|21295 - REDUCTION MASSETER MUSCLE & BONE EXTRAORAL||218.05|0||0|10/01/2019 SH 78001|21282|21282 - LATERAL CANTHOPEXY||438.92|0||0|10/01/2019 SH 78001|21280|21280 - MEDIAL CANTHOPEXY SEPARATE PROCEDURE||660.74|0||0|10/01/2019 SH 78001|21275|21275 - SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ||983.56|0||0|10/01/2019 SH 78001|21270|21270 - MALAR AUGMENTATION PROSTHETIC MATERIAL||1116.77|0||0|10/01/2019 SH 78001|21268|21268 - ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC||2178.73|0||0|10/01/2019 SH 78001|21267|21267 - ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL||1843.78|0||0|10/01/2019 SH 78001|21263|21263 - PERIORBITAL OSTEOTOMIES W/BONE GRAFTS W/FOREHEAD||2230.38|0||0|10/01/2019 SH 78001|21261|21261 - PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA & XTR||2415.48|0||0|10/01/2019 SH 78001|21260|21260 - PERIORBITAL OSTEOTOMIES BONE GRAFTS EXTRACRANIAL||1355.54|0||0|10/01/2019 SH 78001|21256|21256 - RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS||1407.6|0||0|10/01/2019 SH 78001|21255|21255 - RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG||1552.5|0||0|10/01/2019 SH 78001|21249|21249 - RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE||1794.68|0||0|10/01/2019 SH 78001|21248|21248 - RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL||1303.01|0||0|10/01/2019 SH 78001|21247|21247 - RCNSTJ MNDBLR CONDYLE W/BONE CARTLG AUTOGRAFTS||1811.41|0||0|10/01/2019 SH 78001|21246|21246 - RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE||1062.3|0||0|10/01/2019 SH 78001|21245|21245 - RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL||1289.12|0||0|10/01/2019 SH 78001|21244|21244 - RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE||1253.74|0||0|10/01/2019 SH 78001|21243|21243 - ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT||2017.29|0||0|10/01/2019 SH 78001|21242|21242 - ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT||1216.17|0||0|10/01/2019 SH 78001|21240|21240 - ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT||1328.11|0||0|10/01/2019 SH 78001|21235|21235 - GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR||838.83|0||0|10/01/2019 SH 78001|21230|21230 - GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR||899.17|0||0|10/01/2019 SH 78001|21215|21215 - GRAFT BONE MANDIBLE||4629.15|0||0|10/01/2019 SH 78001|21210|21210 - GRAFT BONE NASAL/MAXILLARY/MALAR AREAS||2613.7|0||0|10/01/2019 SH 78001|21209|21209 - OSTEOPLASTY FACIAL BONES REDUCTION||935.21|0||0|10/01/2019 SH 78001|21208|21208 - OSTEOPLASTY FACIAL BONES AUGMENTATION||2177.19|0||0|10/01/2019 SH 78001|21206|21206 - OSTEOTOMY MAXILLA SEGMENTAL||1453.54|0||0|10/01/2019 SH 78001|21199|21199 - OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT||1196.41|0||0|10/01/2019 SH 78001|21198|21198 - OSTEOTOMY MANDIBLE SEGMENTAL||1371.45|0||0|10/01/2019 SH 78001|21196|21196 - RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI||1745.09|0||0|10/01/2019 SH 78001|21195|21195 - RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD||1584.34|0||0|10/01/2019 SH 78001|21194|21194 - RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT||1772.02|0||0|10/01/2019 SH 78001|21193|21193 - RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF||1411|0||0|10/01/2019 SH 78001|21188|21188 - RCNSTJ MDFC OTH/THN LEFORT OSTEOT & BONE GRAFTS||1849.47|0||0|10/01/2019 SH 78001|21184|21184 - RCNSTJ ORBIT/FHD/NASETHMD EXC BONE TUM GRF>80SQ||2858.34|0||0|10/01/2019 SH 78001|21183|21183 - RCNSTJ ORBIT/FHD/NASETHMD EXC BONE GRF>40 <80||2642.04|0||0|10/01/2019 SH 78001|21182|21182 - RCNSTJ ORBIT/FHD/NASETHMD EXCBONE TUM GRF<40SQCM||2282.37|0||0|10/01/2019 SH 78001|21181|21181 - RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC||868.9|0||0|10/01/2019 SH 78001|21180|21180 - RCNSTJ FOREHEAD &/ SUPRAORBITAL RIMS W/AUTOGRAFT||1821.75|0||0|10/01/2019 SH 78001|21179|21179 - RCNSTJ FOREHEAD &/ SUPRAORB RIMS W/ALGRF/PROSTC||1559.28|0||0|10/01/2019 SH 78001|21175|21175 - RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD||2739.15|0||0|10/01/2019 SH 78001|21172|21172 - RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD||2096.4|0||0|10/01/2019 SH 78001|21160|21160 - RCNSTJ MIDFACE LEFORT III W/FHD W/LEFORT I||3124.07|0||0|10/01/2019 SH 78001|21159|21159 - RCNSTJ MIDFACE LEFORT III W/FHD W/O LEFORT I||2877.66|0||0|10/01/2019 SH 78001|21155|21155 - RCNSTJ MIDFACE LEFORT III W/LEFORT I||2782.98|0||0|10/01/2019 SH 78001|21154|21154 - RCNSTJ MIDFACE LEFORT III W/O LEFORT I||2609.84|0||0|10/01/2019 SH 78001|21151|21151 - RCNSTJ MIDFACE LEFORT II W/BONE GRAFTS||2425.82|0||0|10/01/2019 SH 78001|21150|21150 - RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION||1993.21|0||0|10/01/2019 SH 78001|21147|21147 - RCNSTJ MIDFACE LEFORT I 3/> PIECE W/BONE GRAFTS||2132.02|0||0|10/01/2019 SH 78001|21146|21146 - RCNSTJ MIDFACE LEFORT I 2 PIECES W/BONE GRAFTS||2016.45|0||0|10/01/2019 SH 78001|21145|21145 - RCNSTJ MIDFACE LEFORT I 1 PIECE W/BONE GRAFTS||1936.39|0||0|10/01/2019 SH 78001|21143|21143 - RCNSTJ MIDFACE LEFORT I 3/> PIECE W/O BONE GRAFT||1722.9|0||0|10/01/2019 SH 78001|21142|21142 - RCNSTJ MIDFACE LEFORT I 2 PIECES W/O BONE GRAFT||1705.17|0||0|10/01/2019 SH 78001|21141|21141 - RCNSTJ MIDFACE LEFORT I 1 PIECE W/O BONE GRAFT||1597|0||0|10/01/2019 SH 78001|21139|21139 - RDCTJ FHD CNTRG & SETBACK ANT FRONTAL SINUS WALL||1320.01|0||0|10/01/2019 SH 78001|21138|21138 - RDCTJ FHD CNTRG & PROSTHETIC MATRL/BONE GRAFT||1037.01|0||0|10/01/2019 SH 78001|21137|21137 - REDUCTION FOREHEAD CONTOURING ONLY||818.1|0||0|10/01/2019 SH 78001|21127|21127 - AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL||4879.72|0||0|10/01/2019 SH 78001|21125|21125 - AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL||3534.73|0||0|10/01/2019 SH 78001|21123|21123 - GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS||910.92|0||0|10/01/2019 SH 78001|21122|21122 - GENIOPLASTY 2/> SLIDING OSTEOTOMIES||752.12|0||0|10/01/2019 SH 78001|21121|21121 - GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE||928.61|0||0|10/01/2019 SH 78001|21120|21120 - GENIOPLASTY AUGMENTATION||690.7|0||0|10/01/2019 SH 78001|21116|21116 - INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY||167.53|0||0|10/01/2019 SH 78001|21110|21110 - APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC||931.47|0||0|10/01/2019 SH 78001|21100|21100 - APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX||1306.26|0||0|10/01/2019 SH 78001|21087|21087 - IMPRESSION & PREPARATION NASAL PROSTHESIS||2213.03|0||0|10/01/2019 SH 78001|21086|21086 - IMPRESSION & PREPARATION AURICULAR PROSTHESIS||2213.03|0||0|10/01/2019 SH 78001|21085|21085 - IMPRESSION & PREPARATION ORAL SURGICAL SPLINT||895.41|0||0|10/01/2019 SH 78001|21084|21084 - IMPRESSION & PREPARATION SPEECH AID PROSTHESIS||2135.82|0||0|10/01/2019 SH 78001|21083|21083 - IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS||1865.1|0||0|10/01/2019 SH 78001|21082|21082 - IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES||1960.38|0||0|10/01/2019 SH 78001|21081|21081 - IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES||2072.32|0||0|10/01/2019 SH 78001|21080|21080 - IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES||2240.94|0||0|10/01/2019 SH 78001|21079|21079 - IMPRESSION & PREPARATION INTERIM OBTURATOR PROST||2001.72|0||0|10/01/2019 SH 78001|21077|21077 - IMPRESSION & PREPARATION ORBITAL PROSTHESIS||2979|0||0|10/01/2019 SH 78001|21076|21076 - IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES||1186.52|0||0|10/01/2019 SH 78001|21073|21073 - MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA||456.3|0||0|10/01/2019 SH 78001|21070|21070 - CORONOIDECTOMY SEPARATE PROCEDURE||728.26|0||0|10/01/2019 SH 78001|21060|21060 - MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX||957.65|0||0|10/01/2019 SH 78001|21050|21050 - CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX||993.25|0||0|10/01/2019 SH 78001|21049|21049 - EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC||1441.53|0||0|10/01/2019 SH 78001|21048|21048 - EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT||1355.85|0||0|10/01/2019 SH 78001|21047|21047 - EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB||1571.26|0||0|10/01/2019 SH 78001|21046|21046 - EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT||1319.94|0||0|10/01/2019 SH 78001|21045|21045 - EXCISION MALIGNANT TUMOR MANDIBLE RADICAL||1453.29|0||0|10/01/2019 SH 78001|21044|21044 - EXCISION MALIGNANT TUMOR MANDIBLE||1041.2|0||0|10/01/2019 SH 78001|21040|21040 - EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT||607.3|0||0|10/01/2019 SH 78001|21034|21034 - EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA||1552.85|0||0|10/01/2019 SH 78001|21032|21032 - EXCISION MAXILLARY TORUS PALATINUS||462.79|0||0|10/01/2019 SH 78001|21031|21031 - EXCISION TORUS MANDIBULARIS||456.41|0||0|10/01/2019 SH 78001|21030|21030 - EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG||601.87|0||0|10/01/2019 SH 78001|21029|21029 - REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE||888.1|0||0|10/01/2019 SH 78001|21026|21026 - EXCISION FACIAL BONE||716.21|0||0|10/01/2019 SH 78001|21025|21025 - EXCISION BONE MANDIBLE||1042.63|0||0|10/01/2019 SH 78001|21016|21016 - RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>||1206.36|0||0|10/01/2019 SH 78001|21015|21015 - RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM||830.39|0||0|10/01/2019 SH 78001|21014|21014 - EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>||610.49|0||0|10/01/2019 SH 78001|21013|21013 - EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM||597.92|0||0|10/01/2019 SH 78001|21012|21012 - EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>||395.59|0||0|10/01/2019 SH 78001|21011|21011 - EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM||398.07|0||0|10/01/2019 SH 78001|21010|21010 - ARTHROTOMY TEMPOROMANDIBULAR JOINT||898.6|0||0|10/01/2019 SH 78001|20985|20985 - CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS||176.52|0||0|10/01/2019 SH 78001|20983|20983 - ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD||7637.71|0||0|10/01/2019 SH 78001|20982|20982 - ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE||4147.53|0||0|10/01/2019 SH 78001|20979|20979 - LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE||59.7|0||0|10/01/2019 SH 78001|20975|20975 - ELECTRICAL STIMULATION BONE HEALING INVASIVE||212.66|0||0|10/01/2019 SH 78001|20974|20974 - ELECTRICAL STIMULATION BONE HEALING NONINVASIVE||87.63|0||0|10/01/2019 SH 78001|20973|20973 - FR OSTQ FLAP W/MVASC ANAST GRT TOE W/WEB SPACE||3032.55|0||0|10/01/2019 SH 78001|20972|20972 - FREE OSTQ FLAP W/MVASC ANASTOMOSIS METATARSAL||2757.31|0||0|10/01/2019 SH 78001|20970|20970 - FREE OSTQ FLAP W/MVASC ANASTOMOSIS ILIAC CREST||3414.45|0||0|10/01/2019 SH 78001|20969|20969 - FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE||3281.18|0||0|10/01/2019 SH 78001|20962|20962 - BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR||2434.49|0||0|10/01/2019 SH 78001|20957|20957 - BONE GRAFT MICROVASCULAR ANAST METATARSAL||2538.9|0||0|10/01/2019 SH 78001|20956|20956 - BONE GRAFT MICROVASCULAR ANAST ILIAC CREST||3156.04|0||0|10/01/2019 SH 78001|20955|20955 - BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA||2995.37|0||0|10/01/2019 SH 78001|20950|20950 - MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME||277.67|0||0|10/01/2019 SH 78001|20939|20939 - BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY||81.83|0||0|10/01/2019 SH 78001|20938|20938 - AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC||224.24|0||0|10/01/2019 SH 78001|20937|20937 - AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION||202.65|0||0|10/01/2019 SH 78001|20936|20936 - AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION||0|0||0|10/01/2019 SH 78001|20931|20931 - ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL||136.33|0||0|10/01/2019 SH 78001|20930|20930 - ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED||0|0||0|10/01/2019 SH 78001|20926|20926 - TISSUE GRAFTS OTHER||504.2|0||0|10/01/2019 SH 78001|20924|20924 - TENDON GRAFT FROM A DISTANCE||595.34|0||0|10/01/2019 SH 78001|20922|20922 - FASCIA LATA GRAFT INCISION & AREA EXPOSURE||701.55|0||0|10/01/2019 SH 78001|20920|20920 - FASCIA LATA GRAFT BY STRIPPER||462.6|0||0|10/01/2019 SH 78001|20912|20912 - CARTILAGE GRAFT NASAL SEPTUM||561.72|0||0|10/01/2019 SH 78001|20910|20910 - CARTILAGE GRAFT COSTOCHONDRAL||532.49|0||0|10/01/2019 SH 78001|20902|20902 - BONE GRAFT ANY DONOR AREA MAJOR/LARGE||341.11|0||0|10/01/2019 SH 78001|20900|20900 - BONE GRAFT ANY DONOR AREA MINOR/SMALL||477.59|0||0|10/01/2019 SH 78001|20838|20838 - REPLANTATION FOOT COMPLETE AMPUTATION||2598.28|0||0|10/01/2019 SH 78001|20827|20827 - RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION||2181.43|0||0|10/01/2019 SH 78001|20824|20824 - RPLJ THMB CARP/MTCRPL JT MP JT COMPL AMPUTATION||2411.55|0||0|10/01/2019 SH 78001|20822|20822 - RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP||2122|0||0|10/01/2019 SH 78001|20816|20816 - RPLJ DGT EXCEPT THMB MTCARPHLNGL JT COMPL AMP||2485.59|0||0|10/01/2019 SH 78001|20808|20808 - REPLANTATION HAND COMPLETE AMPUTATION||4716.63|0||0|10/01/2019 SH 78001|20805|20805 - REPLANTATION FOREARM COMPLETE AMPUTATION||3893.01|0||0|10/01/2019 SH 78001|20802|20802 - REPLANTATION ARM COMPLETE AMPUTATION||3281|0||0|10/01/2019 SH 78001|20697|20697 - XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT||2325.13|0||0|10/01/2019 SH 78001|20696|20696 - XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ||1428.58|0||0|10/01/2019 SH 78001|20694|20694 - REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES||489.81|0||0|10/01/2019 SH 78001|20693|20693 - ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES||525.52|0||0|10/01/2019 SH 78001|20692|20692 - APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM||1319.33|0||0|10/01/2019 SH 78001|20690|20690 - APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM||703.04|0||0|10/01/2019 SH 78001|20680|20680 - REMOVAL IMPLANT DEEP||710.77|0||0|10/01/2019 SH 78001|20670|20670 - REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE||427.3|0||0|10/01/2019 SH 78001|20665|20665 - REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL||121.47|0||0|10/01/2019 SH 78001|20664|20664 - APPL HALO 6/> PINS THIN SKULL OSTEOLOGY||1035.19|0||0|10/01/2019 SH 78001|20663|20663 - APPLICATION HALO FEMORAL INCLUDING REMOVAL||463.21|0||0|10/01/2019 SH 78001|20662|20662 - APPLICATION HALO PELVIC INCLUDING REMOVAL||545.2|0||0|10/01/2019 SH 78001|20661|20661 - APPLICATION HALO CRANIAL INCLUDING REMOVAL||590.84|0||0|10/01/2019 SH 78001|20660|20660 - APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX||296.43|0||0|10/01/2019 SH 78001|20650|20650 - INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX||237.55|0||0|10/01/2019 SH 78001|20615|20615 - ASPIRATION & INJECTION TREATMENT BONE CYST||282.73|0||0|10/01/2019 SH 78001|20612|20612 - ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ||70.13|0||0|10/01/2019 SH 78001|20611|20611 - ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US||106.39|0||0|10/01/2019 SH 78001|20610|20610 - ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US||69.75|0||0|10/01/2019 SH 78001|20606|20606 - ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US||92.38|0||0|10/01/2019 SH 78001|20605|20605 - ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US||57.64|0||0|10/01/2019 SH 78001|20604|20604 - ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT||83.37|0||0|10/01/2019 SH 78001|20600|20600 - ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US||55.22|0||0|10/01/2019 SH 78001|20555|20555 - PLACEMENT NEEDLES MUSCLE SUBSEQUENT RADIOELEMENT||396.89|0||0|10/01/2019 SH 78001|20553|20553 - INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES||73.45|0||0|10/01/2019 SH 78001|20552|20552 - INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES||63.36|0||0|10/01/2019 SH 78001|20551|20551 - INJECTION SINGLE TENDON ORIGIN/INSERTION||69.96|0||0|10/01/2019 SH 78001|20550|20550 - INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS||68.41|0||0|10/01/2019 SH 78001|20527|20527 - INJECTION ENZYME PALMAR FASCIAL CORD||97.43|0||0|10/01/2019 SH 78001|20526|20526 - INJECTION THERAPEUTIC CARPAL TUNNEL||89.41|0||0|10/01/2019 SH 78001|20525|20525 - RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP||546.64|0||0|10/01/2019 SH 78001|20520|20520 - REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE||232.78|0||0|10/01/2019 SH 78001|20501|20501 - INJECTION SINUS TRACT DIAGNOSTIC||133.58|0||0|10/01/2019 SH 78001|20500|20500 - INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC||121.12|0||0|10/01/2019 SH 78001|20251|20251 - BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL||495.85|0||0|10/01/2019 SH 78001|20250|20250 - BIOPSY VERTEBRAL BODY OPEN THORACIC||462.9|0||0|10/01/2019 SH 78001|20245|20245 - BIOPSY BONE OPEN DEEP||725.45|0||0|10/01/2019 SH 78001|20240|20240 - BIOPSY BONE OPEN SUPERFICIAL||255.9|0||0|10/01/2019 SH 78001|20225|20225 - BIOPSY BONE TROCAR/NEEDLE DEEP||587.34|0||0|10/01/2019 SH 78001|20220|20220 - BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL||191.24|0||0|10/01/2019 SH 78001|20206|20206 - BIOPSY MUSCLE PERCUTANEOUS NEEDLE||264.45|0||0|10/01/2019 SH 78001|20205|20205 - BIOPSY MUSCLE DEEP||329.8|0||0|10/01/2019 SH 78001|20200|20200 - BIOPSY MUSCLE SUPERFICIAL||235.54|0||0|10/01/2019 SH 78001|20150|20150 - EXCISION EPIPHYSEAL BAR||1075.46|0||0|10/01/2019 SH 78001|20103|20103 - EXPLORATION PENETRATING WOUND SPX EXTREMITY||665.79|0||0|10/01/2019 SH 78001|20102|20102 - EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK||559.07|0||0|10/01/2019 SH 78001|20101|20101 - EXPLORATION PENETRATING WOUND SPX CHEST||513.14|0||0|10/01/2019 SH 78001|20100|20100 - EXPLORATION PENETRATING WOUND SPX NECK||726.38|0||0|10/01/2019 SH 78001|20005|20005 - I&D SOFT TISSUE ABSCESS SUBFASC||355.29|0||0|10/01/2019 SH 78001|19396|19396 - PREPARATION MOULAGE CUSTOM BREAST IMPLANT||330.89|0||0|10/01/2019 SH 78001|19380|19380 - REVISION RECONSTRUCTED BREAST||903.59|0||0|10/01/2019 SH 78001|19371|19371 - PERIPROSTHETIC CAPSULECTOMY BREAST||917.31|0||0|10/01/2019 SH 78001|19370|19370 - OPEN PERIPROSTHETIC CAPSULOTOMY BREAST||801.23|0||0|10/01/2019 SH 78001|19369|19369 - BREAST RECONSTRUCTION TRAM FLAP DOUBLE PEDICLE||2411.84|0||0|10/01/2019 SH 78001|19368|19368 - BREAST RECONSTRUCTION TRAM 1 PEDCL MVASC ANAST||2599.59|0||0|10/01/2019 SH 78001|19367|19367 - BREAST RECONSTRUCTION TRAM FLAP 1 PEDICLE||2110.2|0||0|10/01/2019 SH 78001|19366|19366 - BREAST RECONSTRUCTION OTHER TECHNIQUE||1662.48|0||0|10/01/2019 SH 78001|19364|19364 - BREAST RECONSTRUCTION FREE FLAP||3255.25|0||0|10/01/2019 SH 78001|19361|19361 - BRST RCNSTJ W/LATSMS D/SI FLAP WO PRSTHC IMPL||1853.22|0||0|10/01/2019 SH 78001|19357|19357 - BRST RCNSTJ IMMT/DLYD W/TISS EXPANDER SBSQ XPNSJ||1751.63|0||0|10/01/2019 SH 78001|19355|19355 - CORRECTION INVERTED NIPPLES||815.17|0||0|10/01/2019 SH 78001|19350|19350 - NIPPLE/AREOLA RECONSTRUCTION||949.05|0||0|10/01/2019 SH 78001|19342|19342 - DLYD INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ||1079.63|0||0|10/01/2019 SH 78001|19340|19340 - IMMT INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ||1175.55|0||0|10/01/2019 SH 78001|19330|19330 - REMOVAL MAMMARY IMPLANT MATERIAL||741.1|0||0|10/01/2019 SH 78001|19328|19328 - REMOVAL INTACT MAMMARY IMPLANT||577.77|0||0|10/01/2019 SH 78001|19325|19325 - MAMMAPLASTY AUGMENTATION W/PROSTHETIC IMPLANT||750.83|0||0|10/01/2019 SH 78001|19324|19324 - MAMMAPLASTY AUGMENTATION W/O PROSTHETIC IMPLANT||575.39|0||0|10/01/2019 SH 78001|19318|19318 - REDUCTION MAMMAPLASTY||1294.98|0||0|10/01/2019 SH 78001|19316|19316 - MASTOPEXY||904.66|0||0|10/01/2019 SH 78001|19307|19307 - MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN||1413.45|0||0|10/01/2019 SH 78001|19306|19306 - MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES||1414.58|0||0|10/01/2019 SH 78001|19305|19305 - MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES||1332.13|0||0|10/01/2019 SH 78001|19304|19304 - MASTECTOMY SUBCUTANEOUS||673.87|0||0|10/01/2019 SH 78001|19303|19303 - MASTECTOMY SIMPLE COMPLETE||1195.18|0||0|10/01/2019 SH 78001|19302|19302 - MASTECTOMY PARTIAL W/AXILLARY LYMPHADENECTOMY||1064.1|0||0|10/01/2019 SH 78001|19301|19301 - MASTECTOMY PARTIAL||771.08|0||0|10/01/2019 SH 78001|19300|19300 - MASTECTOMY GYNECOMASTIA||602.14|0||0|10/01/2019 SH 78001|19298|19298 - PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST||1176.48|0||0|10/01/2019 SH 78001|19297|19297 - PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST||113.79|0||0|10/01/2019 SH 78001|19296|19296 - PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST||4316.58|0||0|10/01/2019 SH 78001|19294|19294 - PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY||200.61|0||0|10/01/2019 SH 78001|19288|19288 - PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID||774.71|0||0|10/01/2019 SH 78001|19287|19287 - PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID||968.7|0||0|10/01/2019 SH 78001|19286|19286 - PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE||420.06|0||0|10/01/2019 SH 78001|19285|19285 - PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG||497.43|0||0|10/01/2019 SH 78001|19284|19284 - PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC||226.5|0||0|10/01/2019 SH 78001|19283|19283 - PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE||309.18|0||0|10/01/2019 SH 78001|19282|19282 - PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE||188.9|0||0|10/01/2019 SH 78001|19281|19281 - PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE||272.35|0||0|10/01/2019 SH 78001|19272|19272 - EXC CHEST TUMOR W/RCNSTJ W/MEDSTNL LMPHADEC||2104.94|0||0|10/01/2019 SH 78001|19271|19271 - EXC CHEST TUMOR W/RCNSTJ W/O MEDSTNL LMPHADEC||1914.28|0||0|10/01/2019 SH 78001|19260|19260 - EXCISION CHEST WALL TUMOR INCLUDING RIBS||1420.75|0||0|10/01/2019 SH 78001|19126|19126 - EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL||194.33|0||0|10/01/2019 SH 78001|19125|19125 - EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES||635.38|0||0|10/01/2019 SH 78001|19120|19120 - EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION||571.11|0||0|10/01/2019 SH 78001|19112|19112 - EXCISION LACTIFEROUS DUCT FISTULA||526.16|0||0|10/01/2019 SH 78001|19110|19110 - NIPPLE EXPLORATION||554.13|0||0|10/01/2019 SH 78001|19105|19105 - ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA||2761.91|0||0|10/01/2019 SH 78001|19101|19101 - BIOPSY BREAST OPEN INCISIONAL||390.25|0||0|10/01/2019 SH 78001|19100|19100 - BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX||172.67|0||0|10/01/2019 SH 78001|19086|19086 - BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID||909.65|0||0|10/01/2019 SH 78001|19085|19085 - BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID||1144.87|0||0|10/01/2019 SH 78001|19084|19084 - BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID||583.61|0||0|10/01/2019 SH 78001|19083|19083 - BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID||728.05|0||0|10/01/2019 SH 78001|19082|19082 - BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID||606.53|0||0|10/01/2019 SH 78001|19081|19081 - BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID||745.51|0||0|10/01/2019 SH 78001|19030|19030 - INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM||189.28|0||0|10/01/2019 SH 78001|19020|19020 - MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP||536.7|0||0|10/01/2019 SH 78001|19001|19001 - PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST||31.69|0||0|10/01/2019 SH 78001|19000|19000 - PUNCTURE ASPIRATION CYST BREAST||128.12|0||0|10/01/2019 SH 78001|17380|17380 - ELECTROLYSIS EPILATION EACH 30 MINUTES||0|0||0|10/01/2019 SH 78001|17360|17360 - CHEMICAL EXFOLIATION ACNE||147.12|0||0|10/01/2019 SH 78001|17340|17340 - CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE||60.36|0||0|10/01/2019 SH 78001|17315|17315 - MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE||91.03|0||0|10/01/2019 SH 78001|17314|17314 - MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE||420.45|0||0|10/01/2019 SH 78001|17313|17313 - MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS||700.05|0||0|10/01/2019 SH 78001|17312|17312 - MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE||438.95|0||0|10/01/2019 SH 78001|17311|17311 - MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS||749.38|0||0|10/01/2019 SH 78001|17286|17286 - DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM||413.11|0||0|10/01/2019 SH 78001|17284|17284 - DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM||319.5|0||0|10/01/2019 SH 78001|17283|17283 - DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM||278.49|0||0|10/01/2019 SH 78001|17282|17282 - DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM||232.45|0||0|10/01/2019 SH 78001|17281|17281 - DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM||201.97|0||0|10/01/2019 SH 78001|17280|17280 - DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<||159.25|0||0|10/01/2019 SH 78001|17276|17276 - DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM||323.59|0||0|10/01/2019 SH 78001|17274|17274 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM||279.05|0||0|10/01/2019 SH 78001|17273|17273 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM||236.37|0||0|10/01/2019 SH 78001|17272|17272 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM||211.11|0||0|10/01/2019 SH 78001|17271|17271 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM||185.46|0||0|10/01/2019 SH 78001|17270|17270 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>||170.76|0||0|10/01/2019 SH 78001|17266|17266 - DESTRUCTION MAL LESION TRUNK/ARM/LEG > 4.0 CM||264.39|0||0|10/01/2019 SH 78001|17264|17264 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM||233.17|0||0|10/01/2019 SH 78001|17263|17263 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM||216.62|0||0|10/01/2019 SH 78001|17262|17262 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM||198.26|0||0|10/01/2019 SH 78001|17261|17261 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM||162.35|0||0|10/01/2019 SH 78001|17260|17260 - DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<||107.71|0||0|10/01/2019 SH 78001|17250|17250 - CHEMICAL CAUTERIZATION OF GRANULATION TISSUE||89.02|0||0|10/01/2019 SH 78001|17111|17111 - DESTRUCTION BENIGN LESIONS 15/>||147.68|0||0|10/01/2019 SH 78001|17110|17110 - DESTRUCTION BENIGN LESIONS UP TO 14||124.01|0||0|10/01/2019 SH 78001|17108|17108 - DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM||737.22|0||0|10/01/2019 SH 78001|17107|17107 - DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM||493.93|0||0|10/01/2019 SH 78001|17106|17106 - DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM||391.03|0||0|10/01/2019 SH 78001|17004|17004 - DESTRUCTION PREMALIGNANT LESION 15/>||169.98|0||0|10/01/2019 SH 78001|17003|17003 - DESTRUCTION PREMALIGNANT LESION 2-14 EA||6.38|0||0|10/01/2019 SH 78001|17000|17000 - DESTRUCTION PREMALIGNANT LESION 1ST||75.16|0||0|10/01/2019 SH 78001|16036|16036 - ESCHAROTOMY EACH ADDITIONAL INCISION||97.3|0||0|10/01/2019 SH 78001|16035|16035 - ESCHAROTOMY FIRST INCISION||233.1|0||0|10/01/2019 SH 78001|16030|16030 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE||210.32|0||0|10/01/2019 SH 78001|16025|16025 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM||170.84|0||0|10/01/2019 SH 78001|16020|16020 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL||93.05|0||0|10/01/2019 SH 78001|16000|16000 - INITIAL TX 1ST DEGREE BURN LOCAL TX||79.49|0||0|10/01/2019 SH 78001|15999|15999 - UNLISTED PROCEDURE EXCISION PRESSURE ULCER||0|0||0|10/01/2019 SH 78001|15958|15958 - EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC||1379.62|0||0|10/01/2019 SH 78001|15956|15956 - EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN||1351.11|0||0|10/01/2019 SH 78001|15953|15953 - EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY||1162.85|0||0|10/01/2019 SH 78001|15952|15952 - EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE||1055.36|0||0|10/01/2019 SH 78001|15951|15951 - EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY||1025.02|0||0|10/01/2019 SH 78001|15950|15950 - EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR||690.86|0||0|10/01/2019 SH 78001|15946|15946 - EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN||1921.76|0||0|10/01/2019 SH 78001|15945|15945 - EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY||1143.87|0||0|10/01/2019 SH 78001|15944|15944 - EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE||1049.76|0||0|10/01/2019 SH 78001|15941|15941 - EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT||1055.47|0||0|10/01/2019 SH 78001|15940|15940 - EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE||821.72|0||0|10/01/2019 SH 78001|15937|15937 - EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC||1207.81|0||0|10/01/2019 SH 78001|15936|15936 - EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR||1044.06|0||0|10/01/2019 SH 78001|15935|15935 - EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY||1291.27|0||0|10/01/2019 SH 78001|15934|15934 - EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR||1095.6|0||0|10/01/2019 SH 78001|15933|15933 - EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY||994.16|0||0|10/01/2019 SH 78001|15931|15931 - EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE||808.01|0||0|10/01/2019 SH 78001|15922|15922 - EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR||911.6|0||0|10/01/2019 SH 78001|15920|15920 - EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR||703.63|0||0|10/01/2019 SH 78001|15879|15879 - SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY||0|0||0|10/01/2019 SH 78001|15878|15878 - SUCTION ASSISTED LIPECTOMY UPPER EXTREMITY||0|0||0|10/01/2019 SH 78001|15877|15877 - SUCTION ASSISTED LIPECTOMY TRUNK||0|0||0|10/01/2019 SH 78001|15876|15876 - SUCTION ASSISTED LIPECTOMY HEAD & NECK||0|0||0|10/01/2019 SH 78001|15860|15860 - IV INJECTION TEST VASCULAR FLOW FLAP/GRAFT||132.62|0||0|10/01/2019 SH 78001|15852|15852 - DRESSING CHANGE UNDER ANESTHESIA||56.5|0||0|10/01/2019 SH 78001|15851|15851 - REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON||112.31|0||0|10/01/2019 SH 78001|15850|15850 - REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON||98.77|0||0|10/01/2019 SH 78001|15847|15847 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN||0|0||0|10/01/2019 SH 78001|15845|15845 - GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR||1172.5|0||0|10/01/2019 SH 78001|15842|15842 - GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG||2904.31|0||0|10/01/2019 SH 78001|15841|15841 - GRAFT FACIAL NERVE PARALYSIS FREE MUSCLE GRAFT||1897.59|0||0|10/01/2019 SH 78001|15840|15840 - GRAFT FACIAL NERVE PARALYSIS FREE FASCIAL GRAFT||1182.19|0||0|10/01/2019 SH 78001|15839|15839 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA||1019.12|0||0|10/01/2019 SH 78001|15838|15838 - EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD||670|0||0|10/01/2019 SH 78001|15837|15837 - EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND||1022.07|0||0|10/01/2019 SH 78001|15836|15836 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM||921.52|0||0|10/01/2019 SH 78001|15835|15835 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK||1096.33|0||0|10/01/2019 SH 78001|15834|15834 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP||1038.07|0||0|10/01/2019 SH 78001|15833|15833 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG||1019.06|0||0|10/01/2019 SH 78001|15832|15832 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH||1070.92|0||0|10/01/2019 SH 78001|15830|15830 - EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY||1379.25|0||0|10/01/2019 SH 78001|15829|15829 - RHYTIDECTOMY SMAS FLAP||0|0||0|10/01/2019 SH 78001|15828|15828 - RHYTIDECTOMY CHEEK CHIN & NECK||0|0||0|10/01/2019 SH 78001|15826|15826 - RHYTIDECTOMY GLABELLAR FROWN LINES||0|0||0|10/01/2019 SH 78001|15825|15825 - RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING||0|0||0|10/01/2019 SH 78001|15824|15824 - RHYTIDECTOMY FOREHEAD||0|0||0|10/01/2019 SH 78001|15823|15823 - BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN||695.37|0||0|10/01/2019 SH 78001|15822|15822 - BLEPHAROPLASTY UPPER EYELID||509.44|0||0|10/01/2019 SH 78001|15821|15821 - BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD||694.75|0||0|10/01/2019 SH 78001|15820|15820 - BLEPHAROPLASTY LOWER EYELID||655.01|0||0|10/01/2019 SH 78001|15819|15819 - CERVICOPLASTY||924.8|0||0|10/01/2019 SH 78001|15793|15793 - CHEMICAL PEEL NONFACIAL DERMAL||557.36|0||0|10/01/2019 SH 78001|15792|15792 - CHEMICAL PEEL NONFACIAL EPIDERMAL||483.03|0||0|10/01/2019 SH 78001|15789|15789 - CHEMICAL PEEL FACIAL DERMAL||632.47|0||0|10/01/2019 SH 78001|15788|15788 - CHEMICAL PEEL FACIAL EPIDERMAL||513.88|0||0|10/01/2019 SH 78001|15787|15787 - ABRASION EACH ADDITIONAL 4 LESIONS OR LESS||54.94|0||0|10/01/2019 SH 78001|15786|15786 - ABRASION 1 LESION||275.03|0||0|10/01/2019 SH 78001|15783|15783 - DERMABRASION SUPERFICIAL ANY SITE||550.8|0||0|10/01/2019 SH 78001|15782|15782 - DERMABRASION REGIONAL OTHER THAN FACE||723.47|0||0|10/01/2019 SH 78001|15781|15781 - DERMABRASION SEGMENTAL FACE||629.87|0||0|10/01/2019 SH 78001|15780|15780 - DERMABRASION TOTAL FACE||973.29|0||0|10/01/2019 SH 78001|15777|15777 - IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT||254.84|0||0|10/01/2019 SH 78001|15776|15776 - PUNCH GRAFT HAIR TRANSPLANT >15 PUNCH GRAFTS||549.94|0||0|10/01/2019 SH 78001|15775|15775 - PUNCH GRAFT HAIR TRANSPLANT 1-15 PUNCH GRAFTS||338.63|0||0|10/01/2019 SH 78001|15770|15770 - GRAFT DERMA-FAT-FASCIA||784.41|0||0|10/01/2019 SH 78001|15760|15760 - GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA||982.9|0||0|10/01/2019 SH 78001|15758|15758 - FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS||2725.9|0||0|10/01/2019 SH 78001|15757|15757 - FREE SKIN FLAP W/MICROVASCULAR ANASTOMOSIS||2732.79|0||0|10/01/2019 SH 78001|15756|15756 - FREE MUSCLE/MYOCUTANEOUS FLAP W/MVASC ANAST||2754.8|0||0|10/01/2019 SH 78001|15750|15750 - FLAP NEUROVASCULAR PEDICLE||1082.66|0||0|10/01/2019 SH 78001|15740|15740 - FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY||1173.62|0||0|10/01/2019 SH 78001|15738|15738 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR||1632.72|0||0|10/01/2019 SH 78001|15736|15736 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR||1530.89|0||0|10/01/2019 SH 78001|15734|15734 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK||1748.03|0||0|10/01/2019 SH 78001|15733|15733 - MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL||1256.19|0||0|10/01/2019 SH 78001|15732|15732 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP HEAD&NC||1487.9|0||0|10/01/2019 SH 78001|15731|15731 - FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE||1309.79|0||0|10/01/2019 SH 78001|15730|15730 - MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES||1790.7|0||0|10/01/2019 SH 78001|15650|15650 - TRANSFER ANY PEDICLE FLAP ANY LOCATION||579.15|0||0|10/01/2019 SH 78001|15630|15630 - DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS||523.4|0||0|10/01/2019 SH 78001|15620|15620 - DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F||499.08|0||0|10/01/2019 SH 78001|15610|15610 - DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS||402.59|0||0|10/01/2019 SH 78001|15600|15600 - DELAY FLAP/SECTIONING FLAP TRUNK||364.3|0||0|10/01/2019 SH 78001|15576|15576 - FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL||927.65|0||0|10/01/2019 SH 78001|15574|15574 - FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F||1053.69|0||0|10/01/2019 SH 78001|15572|15572 - FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS||1020.93|0||0|10/01/2019 SH 78001|15570|15570 - FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK||1050.03|0||0|10/01/2019 SH 78001|15278|15278 - SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM ADL 100SQ CM||98.21|0||0|10/01/2019 SH 78001|15277|15277 - SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM 1ST 100SQ CM||374.2|0||0|10/01/2019 SH 78001|15276|15276 - SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM||39.79|0||0|10/01/2019 SH 78001|15275|15275 - SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM||172.37|0||0|10/01/2019 SH 78001|15274|15274 - APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM||81.82|0||0|10/01/2019 SH 78001|15273|15273 - APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM||342.94|0||0|10/01/2019 SH 78001|15272|15272 - APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC||31.3|0||0|10/01/2019 SH 78001|15271|15271 - APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25||161.64|0||0|10/01/2019 SH 78001|15261|15261 - FTH/GFT FREE W/DIR CLSR N/E/E/L EA 20 SQ CM/<||245.86|0||0|10/01/2019 SH 78001|15260|15260 - FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<||1162.82|0||0|10/01/2019 SH 78001|15241|15241 - FTH/GT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA20CM/<||212.07|0||0|10/01/2019 SH 78001|15240|15240 - FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<||1071.79|0||0|10/01/2019 SH 78001|15221|15221 - FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<||156.02|0||0|10/01/2019 SH 78001|15220|15220 - FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<||882.52|0||0|10/01/2019 SH 78001|15201|15201 - FTH/GFT FR W/DIR CLSR TRNK EA ADDL 20 CM/<||168.61|0||0|10/01/2019 SH 78001|15200|15200 - FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<||953.1|0||0|10/01/2019 SH 78001|15157|15157 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT EA 100 EA||186.39|0||0|10/01/2019 SH 78001|15156|15156 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM||193.15|0||0|10/01/2019 SH 78001|15155|15155 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<||807.6|0||0|10/01/2019 SH 78001|15152|15152 - CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA||176.55|0||0|10/01/2019 SH 78001|15151|15151 - CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM||142.94|0||0|10/01/2019 SH 78001|15150|15150 - CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<||813.19|0||0|10/01/2019 SH 78001|15136|15136 - DERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA||112.03|0||0|10/01/2019 SH 78001|15135|15135 - DERMAL AUTOGRAFT F/S/N/H/F/G/M/D GT 1ST 100||977.56|0||0|10/01/2019 SH 78001|15131|15131 - DERMAL AUTOGRAFT TRUNK/ARM/LEG EA 100 CM/EA||108.17|0||0|10/01/2019 SH 78001|15130|15130 - DERMAL AUTOGRAFT TRUNK/ARM/LEG 1ST 100 CM||782.82|0||0|10/01/2019 SH 78001|15121|15121 - SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %||238.28|0||0|10/01/2019 SH 78001|15120|15120 - SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/30.0 CM||665.19|0||0|10/01/2019 SH 78001|12056|12056 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM||570.25|0||0|10/01/2019 SH 78001|12055|12055 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM||541.53|0||0|10/01/2019 SH 78001|12054|12054 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM||417.74|0||0|10/01/2019 SH 78001|12053|12053 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM||391.86|0||0|10/01/2019 SH 78001|12052|12052 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM||333.95|0||0|10/01/2019 SH 78001|12051|12051 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<||292.04|0||0|10/01/2019 SH 78001|12047|12047 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM||635.78|0||0|10/01/2019 SH 78001|12046|12046 - RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM||548.87|0||0|10/01/2019 SH 78001|12045|12045 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM||459.94|0||0|10/01/2019 SH 78001|12044|12044 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM||407.46|0||0|10/01/2019 SH 78001|12042|12042 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM||327.78|0||0|10/01/2019 SH 78001|12041|12041 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<||273.59|0||0|10/01/2019 SH 78001|12037|12037 - REPAIR INTERMEDIATE S/A/T/E >30.0 CM||550.74|0||0|10/01/2019 SH 78001|12036|12036 - REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM||478.73|0||0|10/01/2019 SH 78001|12035|12035 - REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM||434.03|0||0|10/01/2019 SH 78001|12034|12034 - REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM||354.17|0||0|10/01/2019 SH 78001|12032|12032 - REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM||342.1|0||0|10/01/2019 SH 78001|12031|12031 - REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<||267.72|0||0|10/01/2019 SH 78001|12021|12021 - TX SUPERFICIAL WOUND DEHISCENCE W/PACKING||188.56|0||0|10/01/2019 SH 78001|12020|12020 - TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE||319.9|0||0|10/01/2019 SH 78001|12018|12018 - SIMPLE REPAIR F/E/E/N/L/M >30.0 CM||210.46|0||0|10/01/2019 SH 78001|12017|12017 - SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM||185.31|0||0|10/01/2019 SH 78001|12016|12016 - SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM||245.9|0||0|10/01/2019 SH 78001|12015|12015 - SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM||197.08|0||0|10/01/2019 SH 78001|12014|12014 - SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM||162.72|0||0|10/01/2019 SH 78001|12013|12013 - SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM||137.15|0||0|10/01/2019 SH 78001|12011|12011 - SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<||124.86|0||0|10/01/2019 SH 78001|12007|12007 - SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM||267.03|0||0|10/01/2019 SH 78001|12006|12006 - SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM||229.12|0||0|10/01/2019 SH 78001|12005|12005 - SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM||191.61|0||0|10/01/2019 SH 78001|12004|12004 - SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM||147.42|0||0|10/01/2019 SH 78001|12002|12002 - SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM||124.78|0||0|10/01/2019 SH 78001|12001|12001 - SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<||101.76|0||0|10/01/2019 SH 78001|11983|11983 - RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT||259.46|0||0|10/01/2019 SH 78001|11982|11982 - REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT||183.81|0||0|10/01/2019 SH 78001|11981|11981 - INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT||161.95|0||0|10/01/2019 SH 78001|11980|11980 - SUBCUTANEOUS HORMONE PELLET IMPLANTATION||107.93|0||0|10/01/2019 SH 78001|11976|11976 - REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES||164.8|0||0|10/01/2019 SH 78001|11971|11971 - REMOVAL TISS EXPANDER W/O INSERTION PROSTHESIS||531.71|0||0|10/01/2019 SH 78001|11970|11970 - REPLACEMENT TISS EXPANDER PERMANENT PROSTHESIS||709.69|0||0|10/01/2019 SH 78001|11960|11960 - INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ||1095.17|0||0|10/01/2019 SH 78001|11954|11954 - SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC||182.57|0||0|10/01/2019 SH 78001|11952|11952 - SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC||149.3|0||0|10/01/2019 SH 78001|11951|11951 - SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC||121.91|0||0|10/01/2019 SH 78001|11950|11950 - SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<||89.36|0||0|10/01/2019 SH 78001|11922|11922 - TATTOOING INCL MICROPIGMENTATION EA 20.0 CM||69.21|0||0|10/01/2019 SH 78001|11921|11921 - TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM||225.56|0||0|10/01/2019 SH 78001|11920|11920 - TATTOOING INCL MICROPIGMENTATION 6.0 CM/<||194.69|0||0|10/01/2019 SH 78001|11901|11901 - INJECTION INTRALESIONAL >7 LESIONS||79.48|0||0|10/01/2019 SH 78001|11900|11900 - INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS||62.75|0||0|10/01/2019 SH 78001|11772|11772 - EXCISION PILONIDAL CYST/SINUS COMPLICATED||800.29|0||0|10/01/2019 SH 78001|11771|11771 - EXCISION PILONIDAL CYST/SINUS EXTENSIVE||658.29|0||0|10/01/2019 SH 78001|11770|11770 - EXCISION PILONIDAL CYST/SINUS SIMPLE||315.62|0||0|10/01/2019 SH 78001|11765|11765 - WEDGE EXCISION SKIN NAIL FOLD||188.69|0||0|10/01/2019 SH 78001|11762|11762 - RECONSTRUCTION NAIL BED W/GRAFT||322.99|0||0|10/01/2019 SH 78001|11760|11760 - REPAIR NAIL BED||257.96|0||0|10/01/2019 SH 78001|11755|11755 - BIOPSY NAIL UNIT SEPARATE PROCEDURE||151.87|0||0|10/01/2019 SH 78001|11750|11750 - EXCISION NAIL MATRIX PERMANENT REMOVAL||255.54|0||0|10/01/2019 SH 78001|11740|11740 - EVACUATION SUBUNGUAL HEMATOMA||55.89|0||0|10/01/2019 SH 78001|11732|11732 - AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL||41.08|0||0|10/01/2019 SH 78001|11730|11730 - AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1||112.96|0||0|10/01/2019 SH 78001|11721|11721 - DEBRIDEMENT NAIL ANY METHOD 6/>||51.2|0||0|10/01/2019 SH 78001|11720|11720 - DEBRIDEMENT NAIL ANY METHOD 1-5||36.67|0||0|10/01/2019 SH 78001|11719|11719 - TRIMMING NONDYSTROPHIC NAILS ANY NUMBER||15.86|0||0|10/01/2019 SH 78001|11646|11646 - EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM||594.62|0||0|10/01/2019 SH 78001|11644|11644 - EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM||452.05|0||0|10/01/2019 SH 78001|11643|11643 - EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM||365.44|0||0|10/01/2019 SH 78001|11642|11642 - EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM||308.04|0||0|10/01/2019 SH 78001|11641|11641 - EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM||269.63|0||0|10/01/2019 SH 78001|11640|11640 - EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<||226.35|0||0|10/01/2019 SH 78001|11626|11626 - EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM||468.76|0||0|10/01/2019 SH 78001|11624|11624 - EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM||386.87|0||0|10/01/2019 SH 78001|11623|11623 - EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM||342.76|0||0|10/01/2019 SH 78001|11622|11622 - EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM||290.84|0||0|10/01/2019 SH 78001|11621|11621 - EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM||260.71|0||0|10/01/2019 SH 78001|11620|11620 - EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<||220.01|0||0|10/01/2019 SH 78001|11606|11606 - EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM||516.3|0||0|10/01/2019 SH 78001|11604|11604 - EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM||358.53|0||0|10/01/2019 SH 78001|11603|11603 - EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM||322.1|0||0|10/01/2019 SH 78001|11602|11602 - EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM||280.53|0||0|10/01/2019 SH 78001|11601|11601 - EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM||259.11|0||0|10/01/2019 SH 78001|11600|11600 - EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<||217.64|0||0|10/01/2019 SH 78001|11471|11471 - EXCISION H/P/P/U COMPLEX REPAIR||578.93|0||0|10/01/2019 SH 78001|11470|11470 - EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR||468.07|0||0|10/01/2019 SH 78001|11463|11463 - EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR||562.2|0||0|10/01/2019 SH 78001|11462|11462 - EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR||421.01|0||0|10/01/2019 SH 78001|11451|11451 - EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR||551.74|0||0|10/01/2019 SH 78001|11450|11450 - EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR||435.55|0||0|10/01/2019 SH 78001|11446|11446 - EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM||450.59|0||0|10/01/2019 SH 78001|11444|11444 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM||322.57|0||0|10/01/2019 SH 78001|11443|11443 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM||255.65|0||0|10/01/2019 SH 78001|11442|11442 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM||213.61|0||0|10/01/2019 SH 78001|11441|11441 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM||191.23|0||0|10/01/2019 SH 78001|11440|11440 - EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<||151.91|0||0|10/01/2019 SH 78001|11426|11426 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM||384.3|0||0|10/01/2019 SH 78001|11424|11424 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM||267.13|0||0|10/01/2019 SH 78001|11423|11423 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM||230.78|0||0|10/01/2019 SH 78001|11422|11422 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM||199.64|0||0|10/01/2019 SH 78001|11421|11421 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM||178.56|0||0|10/01/2019 SH 78001|11420|11420 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<||138.64|0||0|10/01/2019 SH 78001|11406|11406 - EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM||359.71|0||0|10/01/2019 SH 78001|11404|11404 - EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM||247.29|0||0|10/01/2019 SH 78001|11403|11403 - EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM||218.19|0||0|10/01/2019 SH 78001|11402|11402 - EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM||187.78|0||0|10/01/2019 SH 78001|11401|11401 - EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM||168.81|0||0|10/01/2019 SH 78001|11400|11400 - EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<||140.01|0||0|10/01/2019 SH 78001|11313|11313 - SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM||210.11|0||0|10/01/2019 SH 78001|11312|11312 - SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM||180.92|0||0|10/01/2019 SH 78001|11311|11311 - SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM||126.54|0||0|10/01/2019 SH 78001|11310|11310 - SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<||127.55|0||0|10/01/2019 SH 78001|11308|11308 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM||171.53|0||0|10/01/2019 SH 78001|11307|11307 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM||162.25|0||0|10/01/2019 SH 78001|11306|11306 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM||137.17|0||0|10/01/2019 SH 78001|11305|11305 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<||111.26|0||0|10/01/2019 SH 78001|11303|11303 - SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM||175.66|0||0|10/01/2019 SH 78001|11302|11302 - SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM||158.89|0||0|10/01/2019 SH 78001|11301|11301 - SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM||134.97|0||0|10/01/2019 SH 78001|11300|11300 - SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<||108.84|0||0|10/01/2019 SH 78001|11201|11201 - REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10||21.81|0||0|10/01/2019 SH 78001|11200|11200 - REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15||100.12|0||0|10/01/2019 SH 78001|11101|11101 - BIOPSY SKIN SUBQ&/MUCOUS MEMBRANE EA ADDL LESN||37.46|0||0|10/01/2019 SH 78001|11100|11100 - BX SKIN SUBCUTANEOUS&/MUCOUS MEMBRANE 1 LESION||116.74|0||0|10/01/2019 SH 78001|11057|11057 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4||74.55|0||0|10/01/2019 SH 78001|11056|11056 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4||66.15|0||0|10/01/2019 SH 78001|11055|11055 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1||53.86|0||0|10/01/2019 SH 78001|11047|11047 - DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM||144.75|0||0|10/01/2019 SH 78001|11046|11046 - DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM||84.77|0||0|10/01/2019 SH 78001|11045|11045 - DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM||47.55|0||0|10/01/2019 SH 78001|11044|11044 - DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<||365.34|0||0|10/01/2019 SH 78001|11043|11043 - DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<||263.04|0||0|10/01/2019 SH 78001|11042|11042 - DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<||132.74|0||0|10/01/2019 SH 78001|11012|11012 - DBRDMT FX&/DISLC SUBQ T/M/F BONE||811.33|0||0|10/01/2019 SH 78001|11011|11011 - DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC||602.42|0||0|10/01/2019 SH 78001|11010|11010 - DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS||558.79|0||0|10/01/2019 SH 78001|11008|11008 - REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION||330.59|0||0|10/01/2019 SH 78001|11006|11006 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL||843.36|0||0|10/01/2019 SH 78001|11005|11005 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL||939.57|0||0|10/01/2019 SH 78001|11004|11004 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR||696.4|0||0|10/01/2019 SH 78001|11001|11001 - DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF||24.18|0||0|10/01/2019 SH 78001|11000|11000 - DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF||62.32|0||0|10/01/2019 SH 78001|10180|10180 - INCISION & DRAINAGE COMPLEX PO WOUND INFECTION||281.09|0||0|10/01/2019 SH 78001|10160|10160 - PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST||148.52|0||0|10/01/2019 SH 78001|10140|10140 - I&D HEMATOMA SEROMA/FLUID COLLECTION||186.02|0||0|10/01/2019 SH 78001|10121|10121 - INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL||312.45|0||0|10/01/2019 SH 78001|10120|10120 - INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE||172.81|0||0|10/01/2019 SH 78001|10081|10081 - INCISION & DRAINAGE PILONIDAL CYST COMPLICATED||305.97|0||0|10/01/2019 SH 78001|10080|10080 - INCISION & DRAINAGE PILONIDAL CYST SIMPLE||202.28|0||0|10/01/2019 SH 78001|10061|10061 - INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE||237.51|0||0|10/01/2019 SH 78001|10060|10060 - INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE||133.65|0||0|10/01/2019 SH 78001|10040|10040 - ACNE SURGERY||116.17|0||0|10/01/2019 SH 78001|10036|10036 - PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE||513.57|0||0|10/01/2019 SH 78001|10035|10035 - PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE||593.75|0||0|10/01/2019 SH 78001|10030|10030 - IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE||868.29|0||0|10/01/2019 SH 78001|10022|10022 - FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE||161.4|0||0|10/01/2019 SH 78001|10021|10021 - FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION||169.55|0||0|10/01/2019