RAX_TABL|RAX_CODE|RAX_MODF|RAX_GLOB|RAX_PROF|RAX_TECH|RAX_ANES|RAX_STAT|RAX_DESC|RAX_ASC|RAX_FILL 80001|_CMMT||0|0|0|0|%|RCVD 20160921|| 80001|_CMMT||0|0|0|0|%|RCVD 20170328|| 80001|_CMMT||0|0|0|0|%|RCVD 20170912|| 80001|_CMMT||0|0|0|0|%|RCVD 20180319|| 80001|10021||169.55|0|83.1|0||FNA W/O IMAGE|| 80001|10022||161.4|0|79.22|0||FNA W/IMAGE|| 80001|10030||868.29|0|186.41|0||GUIDE CATHET FLUID DRAINAGE|| 80001|10035||593.75|0|103.98|0||PERQ DEV SOFT TISS 1ST IMAG|| 80001|10036||513.57|0|52.38|0||PERQ DEV SOFT TISS ADD IMAG|| 80001|10040||116.17|0|102.21|0||ACNE SURGERY|| 80001|10060||133.65|0|112.33|0||DRAINAGE OF SKIN ABSCESS|| 80001|10061||237.51|0|209.6|0||DRAINAGE OF SKIN ABSCESS|| 80001|10080||202.28|0|119.71|0||DRAINAGE OF PILONIDAL CYST|| 80001|10081||305.97|0|199.36|0||DRAINAGE OF PILONIDAL CYST|| 80001|10120||172.81|0|120.09|0||REMOVE FOREIGN BODY|| 80001|10121||312.45|0|217.86|0||REMOVE FOREIGN BODY|| 80001|10140||186.02|0|137.95|0||DRAINAGE OF HEMATOMA/FLUID|| 80001|10160||148.52|0|111.69|0||PUNCTURE DRAINAGE OF LESION|| 80001|10180||281.09|0|208.99|0||COMPLEX DRAINAGE - WOUND|| 80001|11000||62.32|0|34.41|0||DEBRIDE INFECTED SKIN|| 80001|11001||24.18|0|16.82|0||DEBRIDE INFECTED SKIN ADD-ON|| 80001|11004||696.4|0|696.4|0||DEBRIDE GENITALIA & PERINEUM|| 80001|11005||939.57|0|939.57|0||DEBRIDE ABDOM WALL|| 80001|11006||843.36|0|843.36|0||DEBRIDE GENIT/PER/ABDOM WALL|| 80001|11008||330.59|0|330.59|0||REMOVE MESH FROM ABD WALL|| 80001|11010||558.79|0|330.08|0||DEBRIDE SKIN - FX|| 80001|11011||602.42|0|353.55|0||DEBRIDE SKIN/MUSCLE - FX|| 80001|11012||811.33|0|503.53|0||DEBRIDE SKIN/MUSCLE/BONE - FX|| 80001|11042||132.74|0|73.04|0||DEBRIDE SKIN/TISSUE|| 80001|11043||263.04|0|185.12|0||DEBRIDE TISSUE/MUSCLE|| 80001|11044||365.34|0|276.95|0||DEBRIDE TISSUE/MUSCLE/BONE|| 80001|11045||47.55|0|31.27|0||DEB SUBQ TISSUE ADD-ON|| 80001|11046||84.77|0|66.55|0||DEB MUSC/FASCIA ADD-ON|| 80001|11047||144.75|0|118.78|0||DEB BONE ADD-ON|| 80001|11055||53.86|0|19.36|0||TRIM SKIN LESION|| 80001|11056||66.15|0|27.38|0||TRIM SKIN LESIONS - 2 TO 4|| 80001|11057||74.55|0|35.79|0||TRIM SKIN LESIONS - OVER 4|| 80001|11100||116.74|0|57.43|0||BIOPSY - SKIN LESION|| 80001|11101||37.46|0|29.32|0||BIOPSY - SKIN ADD-ON|| 80001|11200||100.12|0|84.61|0||REMOVAL OF SKIN TAGS|| 80001|11201||21.81|0|19.49|0||REMOVE SKIN TAGS ADD-ON|| 80001|11300||108.84|0|41.39|0||SHAVE SKIN LESION|| 80001|11301||134.97|0|63.25|0||SHAVE SKIN LESION|| 80001|11302||158.89|0|74.38|0||SHAVE SKIN LESION|| 80001|11303||175.66|0|87.66|0||SHAVE SKIN LESION|| 80001|11305||111.26|0|46.53|0||SHAVE SKIN LESION|| 80001|11306||137.17|0|61.57|0||SHAVE SKIN LESION|| 80001|11307||162.25|0|78.91|0||SHAVE SKIN LESION|| 80001|11308||171.53|0|88.18|0||SHAVE SKIN LESION|| 80001|11310||127.55|0|55.84|0||SHAVE SKIN LESION|| 80001|11311||126.54|0|77.7|0||SHAVE SKIN LESION|| 80001|11312||180.92|0|92.14|0||SHAVE SKIN LESION|| 80001|11313||210.11|0|118.62|0||SHAVE SKIN LESION|| 80001|11400||140.01|0|92.72|0||EXC TR-EXT B9+MARG 0.5 < CM|| 80001|11401||168.81|0|120.36|0||EXC TR-EXT B9+MARG 0.6-1 CM|| 80001|11402||187.78|0|132.74|0||EXC TR-EXT B9+MARG 1.1-2 CM|| 80001|11403||218.19|0|171.67|0||EXC TR-EXT B9+MARG 2.1-3 CM|| 80001|11404||247.29|0|189.14|0||EXC TR-EXT B9+MARG 3.1-4 CM|| 80001|11406||359.71|0|289.55|0||EXC TR-EXT B9+MARG > 4.0 CM|| 80001|11420||138.64|0|94.44|0||EXC H-F-NK-SP B9+MARG 0.5 <|| 80001|11421||178.56|0|128.17|0||EXC H-F-NK-SP B9+MARG 0.6-1|| 80001|11422||199.64|0|157.39|0||EXC H-F-NK-SP B9+MARG 1.1-2|| 80001|11423||230.78|0|183.87|0||EXC H-F-NK-SP B9+MARG 2.1-3|| 80001|11424||267.13|0|210.92|0||EXC H-F-NK-SP B9+MARG 3.1-4|| 80001|11426||384.3|0|323.44|0||EXC H-F-NK-SP B9+MARG > 4 CM|| 80001|11440||151.91|0|118.18|0||EXC FACE-MM B9+MARG 0.5 < CM|| 80001|11441||191.23|0|152.47|0||EXC FACE-MM B9+MARG 0.6-1 CM|| 80001|11442||213.61|0|169.03|0||EXC FACE-MM B9+MARG 1.1-2 CM|| 80001|11443||255.65|0|207.97|0||EXC FACE-MM B9+MARG 2.1-3 CM|| 80001|11444||322.57|0|266.36|0||EXC FACE-MM B9+MARG 3.1-4 CM|| 80001|11446||450.59|0|381.97|0||EXC FACE-MM B9+MARG > 4 CM|| 80001|11450||435.55|0|294.84|0||REMOVAL - SWEAT GLAND LESION|| 80001|11451||551.74|0|378.85|0||REMOVAL - SWEAT GLAND LESION|| 80001|11462||421.01|0|279.91|0||REMOVAL - SWEAT GLAND LESION|| 80001|11463||562.2|0|381.94|0||REMOVAL - SWEAT GLAND LESION|| 80001|11470||468.07|0|327.35|0||REMOVAL - SWEAT GLAND LESION|| 80001|11471||578.93|0|404.87|0||REMOVAL - SWEAT GLAND LESION|| 80001|11600||217.64|0|139.72|0||EXC TR-EXT MLG+MARG 0.5 < CM|| 80001|11601||259.11|0|174.22|0||EXC TR-EXT MLG+MARG 0.6-1 CM|| 80001|11602||280.53|0|190.99|0||EXC TR-EXT MLG+MARG 1.1-2 CM|| 80001|11603||322.1|0|229.45|0||EXC TR-EXT MLG+MARG 2.1-3 CM|| 80001|11604||358.53|0|253.09|0||EXC TR-EXT MLG+MARG 3.1-4 CM|| 80001|11606||516.3|0|377.14|0||EXC TR-EXT MLG+MARG > 4 CM|| 80001|11620||220.01|0|141.32|0||EXC H-F-NK-SP MLG+MARG 0.5 <|| 80001|11621||260.71|0|175.81|0||EXC H-F-NK-SP MLG+MARG 0.6-1|| 80001|11622||290.84|0|200.91|0||EXC H-F-NK-SP MLG+MARG 1.1-2|| 80001|11623||342.76|0|249.34|0||EXC H-F-NK-SP MLG+MARG 2.1-3|| 80001|11624||386.87|0|282.59|0||EXC H-F-NK-SP MLG+MARG 3.1-4|| 80001|11626||468.76|0|348.59|0||EXC H-F-NK-SP MLG+MAR > 4 CM|| 80001|11640||226.35|0|146.1|0||EXC FACE-MM MALIG+MARG 0.5 <|| 80001|11641||269.63|0|182.8|0||EXC FACE-MM MALIG+MARG 0.6-1|| 80001|11642||308.04|0|215.78|0||EXC FACE-MM MALIG+MARG 1.1-2|| 80001|11643||365.44|0|271.24|0||EXC FACE-MM MALIG+MARG 2.1-3|| 80001|11644||452.05|0|335.76|0||EXC FACE-MM MALIG+MARG 3.1-4|| 80001|11646||594.62|0|468.24|0||EXC FACE-MM MLG+MARG > 4 CM|| 80001|11719||15.86|0|9.27|0||TRIM NAIL(S)|| 80001|11720||36.67|0|17.68|0||DEBRIDE NAIL - 1-5|| 80001|11721||51.2|0|29.49|0||DEBRIDE NAIL - 6 OR MORE|| 80001|11730||112.96|0|60.63|0||REMOVAL OF NAIL PLATE|| 80001|11732||41.08|0|24.41|0||REMOVE NAIL PLATE - ADD-ON|| 80001|11740||55.89|0|37.67|0||DRAIN BLOOD FROM UNDER NAIL|| 80001|11750||255.54|0|202.82|0||REMOVAL OF NAIL BED|| 80001|11752||372.93|0|307.42|0||REMOVE NAIL BED/FINGER TIP|| 80001|11755||151.87|0|91.79|0||BIOPSY - NAIL UNIT|| 80001|11760||257.96|0|152.9|0||REPAIR OF NAIL BED|| 80001|11762||322.99|0|218.71|0||RECONSTRUCTION OF NAIL BED|| 80001|11765||188.69|0|109.22|0||EXCISION OF NAIL FOLD - TOE|| 80001|11770||315.62|0|217.16|0||REMOVAL OF PILONIDAL LESION|| 80001|11771||658.29|0|508.66|0||REMOVAL OF PILONIDAL LESION|| 80001|11772||800.29|0|673.14|0||REMOVAL OF PILONIDAL LESION|| 80001|11900||62.75|0|36.78|0||INJECTION INTO SKIN LESIONS|| 80001|11901||79.48|0|56.61|0||ADDED SKIN LESIONS INJECTION|| 80001|11920||194.69|0|133.83|0||CORRECT SKIN COLOR DEFECTS|| 80001|11921||225.56|0|157.72|0||CORRECT SKIN COLOR DEFECTS|| 80001|11922||69.21|0|35.1|0||CORRECT SKIN COLOR DEFECTS|| 80001|11950||89.36|0|63|0||THERAPY FOR CONTOUR DEFECTS|| 80001|11951||121.91|0|88.57|0||THERAPY FOR CONTOUR DEFECTS|| 80001|11952||149.3|0|114.02|0||THERAPY FOR CONTOUR DEFECTS|| 80001|11954||182.57|0|136.44|0||THERAPY FOR CONTOUR DEFECTS|| 80001|11960||1095.17|0|1095.17|0||INSERT TISSUE EXPANDER(S)|| 80001|11970||709.69|0|709.69|0||REPLACE TISSUE EXPANDER|| 80001|11971||531.71|0|367.35|0||REMOVE TISSUE EXPANDER(S)|| 80001|11976||164.8|0|112.47|0||REMOVAL OF CONTRACEPTIVE CAP|| 80001|11980||107.93|0|67.23|0||IMPLANT HORMONE PELLET(S)|| 80001|11981||161.95|0|99.15|0||INSERT DRUG IMPLANT DEVICE|| 80001|11982||183.81|0|119.85|0||REMOVE DRUG IMPLANT DEVICE|| 80001|11983||259.46|0|208.29|0||REMOVE/INSERT DRUG IMPLANT|| 80001|12001||101.76|0|52.91|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12002||124.78|0|70.12|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12004||147.42|0|87.72|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12005||191.61|0|118.73|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12006||229.12|0|144.22|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12007||267.03|0|179.42|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12011||124.86|0|65.94|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12013||137.15|0|74.35|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12014||162.72|0|94.5|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12015||197.08|0|118|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12016||245.9|0|159.84|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12017||185.31|0|185.31|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12018||210.46|0|210.46|0||REPAIR SUPERFICIAL WOUND(S)|| 80001|12020||319.9|0|221.44|0||CLOSURE OF SPLIT WOUND|| 80001|12021||188.56|0|162.58|0||CLOSURE OF SPLIT WOUND|| 80001|12031||267.72|0|178.56|0||LAYER CLOSURE OF WOUND(S)|| 80001|12032||342.1|0|227.36|0||LAYER CLOSURE OF WOUND(S)|| 80001|12034||354.17|0|242.91|0||LAYER CLOSURE OF WOUND(S)|| 80001|12035||434.03|0|282.85|0||LAYER CLOSURE OF WOUND(S)|| 80001|12036||478.73|0|328.71|0||LAYER CLOSURE OF WOUND(S)|| 80001|12037||550.74|0|388.31|0||LAYER CLOSURE OF WOUND(S)|| 80001|12041||273.59|0|183.27|0||LAYER CLOSURE OF WOUND(S)|| 80001|12042||327.78|0|234.36|0||LAYER CLOSURE OF WOUND(S)|| 80001|12044||407.46|0|253.56|0||LAYER CLOSURE OF WOUND(S)|| 80001|12045||459.94|0|319.22|0||LAYER CLOSURE OF WOUND(S)|| 80001|12046||548.87|0|365.9|0||LAYER CLOSURE OF WOUND(S)|| 80001|12047||635.78|0|440.4|0||LAYER CLOSURE OF WOUND(S)|| 80001|12051||292.04|0|200.56|0||LAYER CLOSURE OF WOUND(S)|| 80001|12052||333.95|0|238.97|0||LAYER CLOSURE OF WOUND(S)|| 80001|12053||391.86|0|255.8|0||LAYER CLOSURE OF WOUND(S)|| 80001|12054||417.74|0|268.49|0||LAYER CLOSURE OF WOUND(S)|| 80001|12055||541.53|0|355.46|0||LAYER CLOSURE OF WOUND(S)|| 80001|12056||570.25|0|411.31|0||LAYER CLOSURE OF WOUND(S)|| 80001|12057||665.19|0|446.95|0||LAYER CLOSURE OF WOUND(S)|| 80001|13100||379.1|0|242.26|0||REPAIR OF WOUND OR LESION|| 80001|13101||447.97|0|296.01|0||REPAIR OF WOUND OR LESION|| 80001|13102||139.19|0|88.4|0||REPAIR WOUND/LESION ADD-ON|| 80001|13120||396.78|0|276.61|0||REPAIR OF WOUND OR LESION|| 80001|13121||483.88|0|314.09|0||REPAIR OF WOUND OR LESION|| 80001|13122||152.85|0|101.68|0||REPAIR WOUND/LESION ADD-ON|| 80001|13131||437.73|0|294.3|0||REPAIR OF WOUND OR LESION|| 80001|13132||542.35|0|369.85|0||REPAIR OF WOUND OR LESION|| 80001|13133||205.76|0|155.75|0||REPAIR WOUND/LESION ADD-ON|| 80001|13151||481.5|0|338.07|0||REPAIR OF WOUND OR LESION|| 80001|13152||578.14|0|409.52|0||REPAIR OF WOUND OR LESION|| 80001|13153||223.65|0|168.22|0||REPAIR WOUND/LESION ADD-ON|| 80001|13160||951.49|0|951.49|0||LATE CLOSURE OF WOUND|| 80001|14000||711.4|0|585.02|0||SKIN TISSUE REARRANGEMENT|| 80001|14001||917.37|0|764.63|0||SKIN TISSUE REARRANGEMENT|| 80001|14020||796.13|0|662|0||SKIN TISSUE REARRANGEMENT|| 80001|14021||998.98|0|839.66|0||SKIN TISSUE REARRANGEMENT|| 80001|14040||873.88|0|739.36|0||SKIN TISSUE REARRANGEMENT|| 80001|14041||1082.13|0|909.63|0||SKIN TISSUE REARRANGEMENT|| 80001|14060||893.31|0|787.48|0||SKIN TISSUE REARRANGEMENT|| 80001|14061||1163.68|0|972.95|0||SKIN TISSUE REARRANGEMENT|| 80001|14301||1240.57|0|1035.89|0||SKIN TISSUE REARRANGEMENT|| 80001|14302||263.7|0|263.7|0||SKIN TISSUE REARRANGE ADD-ON|| 80001|14350||817.87|0|817.87|0||SKIN TISSUE REARRANGEMENT|| 80001|15002||397.87|0|269.17|0||WND PREP - CH/INF - TRK/ARM/LG|| 80001|15003||87.25|0|54.69|0||WND PREP - CH/INF ADDL 100 CM|| 80001|15004||462.78|0|322.84|0||WND PREP CH/INF - F/N/HF/G|| 80001|15005||144.64|0|108.59|0||WND PREP - F/N/HF/G - ADDL CM|| 80001|15040||288.29|0|151.06|0||HARVEST CULTURED SKIN GRAFT|| 80001|15050||650.11|0|521.41|0||SKIN PINCH GRAFT|| 80001|15100||990.94|0|840.53|0||SKIN SPLT GRFT - TRNK/ARM/LEG|| 80001|15101||212.63|0|131.61|0||SKIN SPLT GRFT T/A/L - ADD-ON|| 80001|15110||949.85|0|836.66|0||EPIDRM AUTOGRFT TRNK/ARM/LEG|| 80001|15111||136.85|0|124.44|0||EPIDRM AUTOGRFT T/A/L ADD-ON|| 80001|15115||963.57|0|849.99|0||EPIDRM A-GRFT FACE/NCK/HF/G|| 80001|15116||197.44|0|181.16|0||EPIDRM A-GRFT F/N/HF/G ADDL|| 80001|15120||982.29|0|821.03|0||SKN SPLT A-GRFT FAC/NCK/HF/G|| 80001|15121||238.28|0|157.26|0||SKN SPLT A-GRFT F/N/HF/G ADD|| 80001|15130||782.82|0|666.13|0||DERM AUTOGRAFT - TRNK/ARM/LEG|| 80001|15131||108.17|0|99.65|0||DERM AUTOGRAFT T/A/L ADD-ON|| 80001|15135||977.56|0|865.92|0||DERM AUTOGRAFT FACE/NCK/HF/G|| 80001|15136||112.03|0|105.05|0||DERM AUTOGRAFT - F/N/HF/G ADD|| 80001|15150||813.19|0|748.46|0||CULT EPIDERM GRFT T/ARM/LEG|| 80001|15151||142.94|0|132.86|0||CULT EPIDERM GRFT T/A/L ADDL|| 80001|15152||176.55|0|166.47|0||CULT EPIDERM GRAFT T/A/L +%|| 80001|15155||807.6|0|749.07|0||CULT EPIDERM GRAFT - F/N/HF/G|| 80001|15156||193.15|0|183.46|0||CULT EPIDRM GRFT F/N/HFG ADD|| 80001|15157||186.39|0|174.38|0||CULT EPIDERM GRFT F/N/HFG +%|| 80001|15200||953.1|0|786.41|0||SKIN FULL GRAFT - TRUNK|| 80001|15201||168.61|0|93.8|0||SKIN FULL GRAFT TRUNK ADD-ON|| 80001|15220||882.52|0|718.16|0||SKIN FULL GRAFT SCLP/ARM/LEG|| 80001|15221||156.02|0|85.08|0||SKIN FULL GRAFT ADD-ON|| 80001|15240||1071.79|0|934.17|0||SKIN FULL GRFT FACE/GENIT/HF|| 80001|15241||212.07|0|132.6|0||SKIN FULL GRAFT ADD-ON|| 80001|15260||1162.82|0|1003.1|0||SKIN FULL GRAFT EEN & LIPS|| 80001|15261||245.86|0|166.01|0||SKIN FULL GRAFT ADD-ON|| 80001|15271||161.64|0|101.17|0||SKIN SUB GRAFT TRNK/ARM/LEG|| 80001|15272||31.3|0|20.83|0||SKIN SUB GRAFT T/A/L ADD-ON|| 80001|15273||342.94|0|241.77|0||SKIN SUB GRFT T/ARM/LG CHILD|| 80001|15274||81.82|0|54.69|0||SKN SUB GRFT T/A/L CHILD ADD|| 80001|15275||172.37|0|115.39|0||SKIN SUB GRAFT FACE/NK/HF/G|| 80001|15276||39.79|0|29.71|0||SKIN SUB GRAFT F/N/HF/G ADDL|| 80001|15277||374.2|0|269.93|0||SKN SUB GRFT F/N/HF/G CHILD|| 80001|15278||98.21|0|68.36|0||SKN SUB GRFT F/N/HF/G CH ADD|| 80001|15570||1050.03|0|862.02|0||FORM SKIN PEDICLE FLAP|| 80001|15572||1020.93|0|872.84|0||FORM SKIN PEDICLE FLAP|| 80001|15574||1053.69|0|900.18|0||FORM SKIN PEDICLE FLAP|| 80001|15576||927.65|0|785.77|0||FORM SKIN PEDICLE FLAP|| 80001|15600||364.3|0|238.31|0||SKIN GRAFT|| 80001|15610||402.59|0|279.32|0||SKIN GRAFT|| 80001|15620||499.08|0|377.75|0||SKIN GRAFT|| 80001|15630||523.4|0|402.45|0||SKIN GRAFT|| 80001|15650||579.15|0|446.97|0||TRANSFER SKIN PEDICLE FLAP|| 80001|15730||1790.7|0|1098.64|0||MDFC FLAP W/PRSRV VASC PEDCL|| 80001|15731||1309.79|0|1185.74|0||FOREHEAD FLAP W/VASC PEDICLE|| 80001|15732||1487.9|0|1313.07|0||MUSCLE-SKIN GRAFT - HEAD/NECK|| 80001|15733||1256.19|0|1256.19|0||MUSC MYOQ/FSCQ FLP H&N PEDCL|| 80001|15734||1748.03|0|1557.31|0||MUSCLE-SKIN GRAFT - TRUNK|| 80001|15736||1530.89|0|1342.88|0||MUSCLE-SKIN GRAFT - ARM|| 80001|15738||1632.72|0|1455.95|0||MUSCLE-SKIN GRAFT - LEG|| 80001|15740||1173.62|0|999.96|0||ISLAND PEDICLE FLAP GRAFT|| 80001|15750||1082.66|0|1082.66|0||NEUROVASCULAR PEDICLE GRAFT|| 80001|15756||2754.8|0|2754.8|0||FREE MYO/SKIN FLAP MICROVASC|| 80001|15757||2732.79|0|2732.79|0||FREE SKIN FLAP - MICROVASC|| 80001|15758||2725.9|0|2725.9|0||FREE FASCIAL FLAP - MICROVASC|| 80001|15760||982.9|0|830.95|0||COMPOSITE SKIN GRAFT|| 80001|15770||784.41|0|784.41|0||DERMA-FAT-FASCIA GRAFT|| 80001|15775||338.63|0|256.06|0||HAIR TRANSPLANT PUNCH GRAFTS|| 80001|15776||549.94|0|407.67|0||HAIR TRANSPLANT PUNCH GRAFTS|| 80001|15777||254.84|0|254.84|0||ACELLULAR DERM MATRIX IMPLT|| 80001|15780||973.29|0|747.68|0||ABRASION TREATMENT OF SKIN|| 80001|15781||629.87|0|500.78|0||ABRASION TREATMENT OF SKIN|| 80001|15782||723.47|0|518.02|0||ABRASION TREATMENT OF SKIN|| 80001|15783||550.8|0|432.96|0||ABRASION TREATMENT OF SKIN|| 80001|15786||275.03|0|158.35|0||ABRASION - LESION - SINGLE|| 80001|15787||54.94|0|20.44|0||ABRASION - LESIONS - ADD-ON|| 80001|15788||513.88|0|281.29|0||CHEMICAL PEEL - FACE - EPIDERM|| 80001|15789||632.47|0|490.97|0||CHEMICAL PEEL - FACE - DERMAL|| 80001|15792||483.03|0|290.75|0||CHEMICAL PEEL - NONFACIAL|| 80001|15793||557.36|0|422.07|0||CHEMICAL PEEL - NONFACIAL|| 80001|15819||924.8|0|924.8|0||PLASTIC SURGERY - NECK|| 80001|15820||655.01|0|589.89|0||REVISION OF LOWER EYELID|| 80001|15821||694.75|0|627.69|0||REVISION OF LOWER EYELID|| 80001|15822||509.44|0|449.74|0||REVISION OF UPPER EYELID|| 80001|15823||695.37|0|627.15|0||REVISION OF UPPER EYELID|| 80001|15824||0|0|0|0||REMOVAL OF FOREHEAD WRINKLES|| 80001|15825||0|0|0|0||REMOVAL OF NECK WRINKLES|| 80001|15826||0|0|0|0||REMOVAL OF BROW WRINKLES|| 80001|15828||0|0|0|0||REMOVAL OF FACE WRINKLES|| 80001|15829||0|0|0|0||REMOVAL OF SKIN WRINKLES|| 80001|15830||1379.25|0|1379.25|0||EXC SKIN ABD|| 80001|15832||1070.92|0|1070.92|0||EXCISE EXCESSIVE SKIN TISSUE|| 80001|15833||1019.06|0|1019.06|0||EXCISE EXCESSIVE SKIN TISSUE|| 80001|15834||1038.07|0|1038.07|0||EXCISE EXCESSIVE SKIN TISSUE|| 80001|15835||1096.33|0|1096.33|0||EXCISE EXCESSIVE SKIN TISSUE|| 80001|15836||921.52|0|921.52|0||EXCISE EXCESSIVE SKIN TISSUE|| 80001|15837||1022.07|0|868.17|0||EXCISE EXCESSIVE SKIN TISSUE|| 80001|15838||670|0|670|0||EXCISE EXCESSIVE SKIN TISSUE|| 80001|15839||1019.12|0|864.45|0||EXCISE EXCESSIVE SKIN TISSUE|| 80001|15840||1182.19|0|1182.19|0||GRAFT FOR FACE NERVE PALSY|| 80001|15841||1897.59|0|1897.59|0||GRAFT FOR FACE NERVE PALSY|| 80001|15842||2904.31|0|2904.31|0||FLAP FOR FACE NERVE PALSY|| 80001|15845||1172.5|0|1172.5|0||SKIN AND MUSCLE REPAIR - FACE|| 80001|15847||0|0|0|0||EXC SKIN ABD ADD-ON|| 80001|15850||98.77|0|47.21|0||REMOVAL OF SUTURES|| 80001|15851||112.31|0|54.55|0||REMOVAL OF SUTURES|| 80001|15852||56.5|0|56.5|0||DRESSING CHANGE NOT FOR BURN|| 80001|15860||132.62|0|132.62|0||TEST FOR BLOOD FLOW IN GRAFT|| 80001|15876||0|0|0|0||SUCTION ASSISTED LIPECTOMY|| 80001|15877||0|0|0|0||SUCTION ASSISTED LIPECTOMY|| 80001|15878||0|0|0|0||SUCTION ASSISTED LIPECTOMY|| 80001|15879||0|0|0|0||SUCTION ASSISTED LIPECTOMY|| 80001|15920||703.63|0|703.63|0||REMOVAL OF TAIL BONE ULCER|| 80001|15922||911.6|0|911.6|0||REMOVAL OF TAIL BONE ULCER|| 80001|15931||808.01|0|808.01|0||REMOVE SACRUM PRESSURE SORE|| 80001|15933||994.16|0|994.16|0||REMOVE SACRUM PRESSURE SORE|| 80001|15934||1095.6|0|1095.6|0||REMOVE SACRUM PRESSURE SORE|| 80001|15935||1291.27|0|1291.27|0||REMOVE SACRUM PRESSURE SORE|| 80001|15936||1044.06|0|1044.06|0||REMOVE SACRUM PRESSURE SORE|| 80001|15937||1207.81|0|1207.81|0||REMOVE SACRUM PRESSURE SORE|| 80001|15940||821.72|0|821.72|0||REMOVE HIP PRESSURE SORE|| 80001|15941||1055.47|0|1055.47|0||REMOVE HIP PRESSURE SORE|| 80001|15944||1049.76|0|1049.76|0||REMOVE HIP PRESSURE SORE|| 80001|15945||1143.87|0|1143.87|0||REMOVE HIP PRESSURE SORE|| 80001|15946||1921.76|0|1921.76|0||REMOVE HIP PRESSURE SORE|| 80001|15950||690.86|0|690.86|0||REMOVE THIGH PRESSURE SORE|| 80001|15951||1025.02|0|1025.02|0||REMOVE THIGH PRESSURE SORE|| 80001|15952||1055.36|0|1055.36|0||REMOVE THIGH PRESSURE SORE|| 80001|15953||1162.85|0|1162.85|0||REMOVE THIGH PRESSURE SORE|| 80001|15956||1351.11|0|1351.11|0||REMOVE THIGH PRESSURE SORE|| 80001|15958||1379.62|0|1379.62|0||REMOVE THIGH PRESSURE SORE|| 80001|15999||0|0|0|0||REMOVAL OF PRESSURE SORE|| 80001|16000||79.49|0|55.07|0||INITIAL TREATMENT OF BURN(S)|| 80001|16020||93.05|0|63.2|0||DRESS/DEBRID P-THICK BURN - S|| 80001|16025||170.84|0|132.07|0||DRESS/DEBRID P-THICK BURN - M|| 80001|16030||210.32|0|156.05|0||DRESS/DEBRID P-THICK BURN - L|| 80001|16035||233.1|0|233.1|0||INCISION OF BURN SCAB - INITI|| 80001|16036||97.3|0|97.3|0||ESCHAROTOMY; ADD'L INCISION|| 80001|17000||75.16|0|60.82|0||DESTROY BENIGN/PREMLG LESION|| 80001|17003||6.38|0|2.89|0||DESTROY LESIONS - 2-14|| 80001|17004||169.98|0|115.71|0||DESTROY LESIONS - 15 OR MORE|| 80001|17106||391.03|0|320.87|0||DESTRUCTION OF SKIN LESIONS|| 80001|17107||493.93|0|402.06|0||DESTRUCTION OF SKIN LESIONS|| 80001|17108||737.22|0|616.27|0||DESTRUCTION OF SKIN LESIONS|| 80001|17110||124.01|0|79.43|0||DESTRUCT LESION - 1-14|| 80001|17111||147.68|0|98.45|0||DESTRUCT LESION - 15 OR MORE|| 80001|17250||89.02|0|42.89|0||CHEMICAL CAUTERY - TISSUE|| 80001|17260||107.71|0|81.35|0||DESTRUCTION OF SKIN LESIONS|| 80001|17261||162.35|0|106.52|0||DESTRUCTION OF SKIN LESIONS|| 80001|17262||198.26|0|135.84|0||DESTRUCTION OF SKIN LESIONS|| 80001|17263||216.62|0|150.72|0||DESTRUCTION OF SKIN LESIONS|| 80001|17264||233.17|0|161.46|0||DESTRUCTION OF SKIN LESIONS|| 80001|17266||264.39|0|189.57|0||DESTRUCTION OF SKIN LESIONS|| 80001|17270||170.76|0|116.49|0||DESTRUCTION OF SKIN LESIONS|| 80001|17271||185.46|0|129.64|0||DESTRUCTION OF SKIN LESIONS|| 80001|17272||211.11|0|149.47|0||DESTRUCTION OF SKIN LESIONS|| 80001|17273||236.37|0|169.31|0||DESTRUCTION OF SKIN LESIONS|| 80001|17274||279.05|0|206.56|0||DESTRUCTION OF SKIN LESIONS|| 80001|17276||323.59|0|248|0||DESTRUCTION OF SKIN LESIONS|| 80001|17280||159.25|0|105.75|0||DESTRUCTION OF SKIN LESIONS|| 80001|17281||201.97|0|145.76|0||DESTRUCTION OF SKIN LESIONS|| 80001|17282||232.45|0|168.87|0||DESTRUCTION OF SKIN LESIONS|| 80001|17283||278.49|0|210.66|0||DESTRUCTION OF SKIN LESIONS|| 80001|17284||319.5|0|247.01|0||DESTRUCTION OF SKIN LESIONS|| 80001|17286||413.11|0|333.64|0||DESTRUCTION OF SKIN LESIONS|| 80001|17311||749.38|0|445.46|0||MOHS - 1 STAGE - H/N/HF/G|| 80001|17312||438.95|0|237.76|0||MOHS ADDL STAGE|| 80001|17313||700.05|0|400.01|0||MOHS - 1 STAGE - T/A/L|| 80001|17314||420.45|0|220.03|0||MOHS - ADDL STAGE - T/A/L|| 80001|17315||91.03|0|62.35|0||MOHS SURG - ADDL BLOCK|| 80001|17340||60.36|0|57.64|0||CRYOTHERAPY OF SKIN|| 80001|17360||147.12|0|114.94|0||SKIN PEEL THERAPY|| 80001|17380||0|0|0|0||HAIR REMOVAL BY ELECTROLYSIS|| 80001|19000||128.12|0|52.53|0||DRAINAGE OF BREAST LESION|| 80001|19001||31.69|0|26.26|0||DRAIN BREAST LESION ADD-ON|| 80001|19020||536.7|0|354.89|0||INCISION OF BREAST LESION|| 80001|19030||189.28|0|94.31|0||INJECTION FOR BREAST X-RAY|| 80001|19081||745.51|0|202.02|0||BX BREAST 1ST LESION STRTCTC|| 80001|19082||606.53|0|101.03|0||BX BREAST ADD LESION STRTCTC|| 80001|19083||728.05|0|198.52|0||BX BREAST 1ST LESION US IMAG|| 80001|19084||583.61|0|95.17|0||BX BREAST ADD LESION US IMAG|| 80001|19085||1144.87|0|240.86|0||BX BREAST 1ST LESION MR IMAG|| 80001|19086||909.65|0|113.8|0||BX BREAST ADD LESION MR IMAG|| 80001|19100||172.67|0|84.29|0||BX BREAST PERCUT W/O IMAGE|| 80001|19101||390.25|0|261.16|0||BIOPSY OF BREAST - OPEN|| 80001|19105||2761.91|0|244.12|0||CRYOSURG ABLATE FA - EACH|| 80001|19110||554.13|0|398.68|0||NIPPLE EXPLORATION|| 80001|19112||526.16|0|364.13|0||EXCISE BREAST DUCT FISTULA|| 80001|19120||571.11|0|485.06|0||REMOVAL OF BREAST LESION|| 80001|19125||635.38|0|540.01|0||EXCISION - BREAST LESION|| 80001|19126||194.33|0|194.33|0||EXCISION - ADDL BREAST LESION|| 80001|19260||1420.75|0|1420.75|0||REMOVAL OF CHEST WALL LESION|| 80001|19271||1914.28|0|1914.28|0||REVISION OF CHEST WALL|| 80001|19272||2104.94|0|2104.94|0||EXTENSIVE CHEST WALL SURGERY|| 80001|19281||272.35|0|122.72|0||PERQ DEVICE BREAST 1ST IMAG|| 80001|19282||188.9|0|62.14|0||PERQ DEVICE BREAST EA IMAG|| 80001|19283||309.18|0|123.11|0||PERQ DEV BREAST 1ST STRTCTC|| 80001|19284||226.5|0|62.53|0||PERQ DEV BREAST ADD STRTCTC|| 80001|19285||497.43|0|104.74|0||PERQ DEV BREAST 1ST US IMAG|| 80001|19286||420.06|0|52.96|0||PERQ DEV BREAST ADD US IMAG|| 80001|19287||968.7|0|164.71|0||PERQ DEV BREAST 1ST MR GUIDE|| 80001|19288||774.71|0|80.43|0||PERQ DEV BREAST ADD MR GUIDE|| 80001|19294||200.61|0|200.61|0||PREP TUM CAV IORT PRTL MAST|| 80001|19296||4316.58|0|251.68|0||PLACE PO BREAST CATH FOR RAD|| 80001|19297||113.79|0|113.79|0||PLACE BREAST CATH FOR RAD|| 80001|19298||1176.48|0|390.32|0||PLACE BREAST RAD TUBE/CATHS|| 80001|19300||602.14|0|481.97|0||REMOVAL OF BREAST TISSUE|| 80001|19301||771.08|0|771.08|0||PARTICAL MASTECTOMY|| 80001|19302||1064.1|0|1064.1|0||P-MASTECTOMY W/LN REMOVAL|| 80001|19303||1195.18|0|1195.18|0||MAST - SIMPLE - COMPLETE|| 80001|19304||673.87|0|673.87|0||MAST - SUBQ|| 80001|19305||1332.13|0|1332.13|0||MAST - RADICAL|| 80001|19306||1414.58|0|1414.58|0||MAST - RAD - URBAN TYPE|| 80001|19307||1413.45|0|1413.45|0||MAST - MOD RAD|| 80001|19316||904.66|0|904.66|0||SUSPENSION OF BREAST|| 80001|19318||1294.98|0|1294.98|0||REDUCTION OF LARGE BREAST|| 80001|19324||575.39|0|575.39|0||ENLARGE BREAST|| 80001|19325||750.83|0|750.83|0||ENLARGE BREAST WITH IMPLANT|| 80001|19328||577.77|0|577.77|0||REMOVAL OF BREAST IMPLANT|| 80001|19330||741.1|0|741.1|0||REMOVAL OF IMPLANT MATERIAL|| 80001|19340||1175.55|0|1175.55|0||IMMEDIATE BREAST PROSTHESIS|| 80001|19342||1079.63|0|1079.63|0||DELAYED BREAST PROSTHESIS|| 80001|19350||949.05|0|787.4|0||BREAST RECONSTRUCTION|| 80001|19355||815.17|0|673.68|0||CORRECT INVERTED NIPPLE(S)|| 80001|19357||1751.63|0|1751.63|0||BREAST RECONSTRUCTION|| 80001|19361||1853.22|0|1853.22|0||BREAST RECONSTRUCTION|| 80001|19364||3255.25|0|3255.25|0||BREAST RECONSTRUCTION|| 80001|19366||1662.48|0|1662.48|0||BREAST RECONSTRUCTION|| 80001|19367||2110.2|0|2110.2|0||BREAST RECONSTRUCTION|| 80001|19368||2599.59|0|2599.59|0||BREAST RECONSTRUCTION|| 80001|19369||2411.84|0|2411.84|0||BREAST RECONSTRUCTION|| 80001|19370||801.23|0|801.23|0||SURGERY OF BREAST CAPSULE|| 80001|19371||917.31|0|917.31|0||REMOVAL OF BREAST CAPSULE|| 80001|19380||903.59|0|903.59|0||REVISE BREAST RECONSTRUCTION|| 80001|19396||330.89|0|171.95|0||DESIGN CUSTOM BREAST IMPLANT|| 80001|20005||355.29|0|275.05|0||INCISION OF DEEP ABSCESS|| 80001|20100||726.38|0|726.38|0||EXPLORE WOUND - NECK|| 80001|20101||513.14|0|248.38|0||EXPLORE WOUND - CHEST|| 80001|20102||559.07|0|302.84|0||EXPLORE WOUND - ABDOMEN|| 80001|20103||665.79|0|410.33|0||EXPLORE WOUND - EXTREMITY|| 80001|20150||1075.46|0|1075.46|0||EXCISE EPIPHYSEAL BAR|| 80001|20200||235.54|0|113.43|0||MUSCLE BIOPSY|| 80001|20205||329.8|0|185.2|0||DEEP MUSCLE BIOPSY|| 80001|20206||264.45|0|70.62|0||NEEDLE BIOPSY - MUSCLE|| 80001|20220||191.24|0|86.96|0||BONE BIOPSY - TROCAR/NEEDLE|| 80001|20225||587.34|0|130.69|0||BONE BIOPSY - TROCAR/NEEDLE|| 80001|20240||255.9|0|255.9|0||BONE BIOPSY - EXCISIONAL|| 80001|20245||725.45|0|725.45|0||BONE BIOPSY - EXCISIONAL|| 80001|20250||462.9|0|462.9|0||OPEN BONE BIOPSY|| 80001|20251||495.85|0|495.85|0||OPEN BONE BIOPSY|| 80001|20500||121.12|0|100.19|0||INJECTION OF SINUS TRACT|| 80001|20501||133.58|0|45.97|0||INJECT SINUS TRACT FOR X-RAY|| 80001|20520||232.78|0|171.54|0||REMOVAL OF FOREIGN BODY|| 80001|20525||546.64|0|293.89|0||REMOVAL OF FOREIGN BODY|| 80001|20526||89.41|0|68.48|0||THER INJECTION - CARP TUNNEL|| 80001|20527||97.43|0|78.44|0||INJ DUPUYTREN CORD W/ENZYME|| 80001|20550||68.41|0|49.8|0||INJ TENDON SHEATH/LIGAMENT|| 80001|20551||69.96|0|50.97|0||INJ TENDON ORIGIN/INSERTION|| 80001|20552||63.36|0|44.75|0||INJ TRIGGER POINT - 1/2 MUSCL|| 80001|20553||73.45|0|50.96|0||INJECT TRIGGER POINTS - =/> 3|| 80001|20555||396.89|0|396.89|0||PLACE NDL MUSC/TIS FOR RT|| 80001|20600||55.22|0|42.43|0||DRAIN/INJECT - JOINT/BURSA|| 80001|20604||83.37|0|55.07|0||DRAIN/INJ JOINT/BURSA W/US|| 80001|20605||57.64|0|44.07|0||DRAIN/INJECT - JOINT/BURSA|| 80001|20606||92.38|0|62.92|0||DRAIN/INJ JOINT/BURSA W/US|| 80001|20610||69.75|0|54.63|0||DRAIN/INJECT - JOINT/BURSA|| 80001|20611||106.39|0|73.83|0||DRAIN/INJ JOINT/BURSA W/US|| 80001|20612||70.13|0|49.59|0||ASPIRATE/INJ GANGLION CYST|| 80001|20615||282.73|0|193.96|0||TREATMENT OF BONE CYST|| 80001|20650||237.55|0|183.66|0||INSERT AND REMOVE BONE PIN|| 80001|20660||296.43|0|296.43|0||APPLY - REM FIXATION DEVICE|| 80001|20661||590.84|0|590.84|0||APPLICATION OF HEAD BRACE|| 80001|20662||545.2|0|545.2|0||APPLICATION OF PELVIS BRACE|| 80001|20663||463.21|0|463.21|0||APPLICATION OF THIGH BRACE|| 80001|20664||1035.19|0|1035.19|0||HALO BRACE APPLICATION|| 80001|20665||121.47|0|105.57|0||REMOVAL OF FIXATION DEVICE|| 80001|20670||427.3|0|172.22|0||REMOVAL OF SUPPORT IMPLANT|| 80001|20680||710.77|0|497.95|0||REMOVAL OF SUPPORT IMPLANT|| 80001|20690||703.04|0|703.04|0||APPLY BONE FIXATION DEVICE|| 80001|20692||1319.33|0|1319.33|0||APPLY BONE FIXATION DEVICE|| 80001|20693||525.52|0|525.52|0||ADJUST BONE FIXATION DEVICE|| 80001|20694||489.81|0|394.83|0||REMOVE BONE FIXATION DEVICE|| 80001|20696||1428.58|0|1428.58|0||COMP MULTIPLANE EXT FIXATION|| 80001|20697||2325.13|0|2325.13|0||COMP EXT FIXATE STRUT CHANGE|| 80001|20802||3281|0|3281|0||REPLANTATION - ARM - COMPLETE|| 80001|20805||3893.01|0|3893.01|0||REPLANT FOREARM - COMPLETE|| 80001|20808||4716.63|0|4716.63|0||REPLANTATION HAND - COMPLETE|| 80001|20816||2485.59|0|2485.59|0||REPLANTATION DIGIT - COMPLETE|| 80001|20822||2122|0|2122|0||REPLANTATION DIGIT - COMPLETE|| 80001|20824||2411.55|0|2411.55|0||REPLANTATION THUMB - COMPLETE|| 80001|20827||2181.43|0|2181.43|0||REPLANTATION THUMB - COMPLETE|| 80001|20838||2598.28|0|2598.28|0||REPLANTATION FOOT - COMPLETE|| 80001|20900||477.59|0|226|0||REMOVAL OF BONE FOR GRAFT|| 80001|20902||341.11|0|341.11|0||REMOVAL OF BONE FOR GRAFT|| 80001|20910||532.49|0|532.49|0||REMOVE CARTILAGE FOR GRAFT|| 80001|20912||561.72|0|561.72|0||REMOVE CARTILAGE FOR GRAFT|| 80001|20920||462.6|0|462.6|0||REMOVAL OF FASCIA FOR GRAFT|| 80001|20922||701.55|0|586.42|0||REMOVAL OF FASCIA FOR GRAFT|| 80001|20924||595.34|0|595.34|0||REMOVAL OF TENDON FOR GRAFT|| 80001|20926||504.2|0|504.2|0||REMOVAL OF TISSUE FOR GRAFT|| 80001|20930||0|0|0|0||SPINAL BONE ALLOGRAFT|| 80001|20931||136.33|0|136.33|0||SPINAL BONE ALLOGRAFT|| 80001|20936||0|0|0|0||SPINAL BONE AUTOGRAFT|| 80001|20937||202.65|0|202.65|0||SPINAL BONE AUTOGRAFT|| 80001|20938||224.24|0|224.24|0||SPINAL BONE AUTOGRAFT|| 80001|20939||81.83|0|81.83|0||BONE MARROW ASPIR BONE GRFG|| 80001|20950||277.67|0|106.71|0||FLUID PRESSURE - MUSCLE|| 80001|20955||2995.37|0|2995.37|0||FIBULA BONE GRAFT - MICROVASC|| 80001|20956||3156.04|0|3156.04|0||ILIAC BONE GRAFT - MICROVASC|| 80001|20957||2538.9|0|2538.9|0||MT BONE GRAFT - MICROVASC|| 80001|20962||2434.49|0|2434.49|0||OTHER BONE GRAFT - MICROVASC|| 80001|20969||3281.18|0|3281.18|0||BONE/SKIN GRAFT - MICROVASC|| 80001|20970||3414.45|0|3414.45|0||BONE/SKIN GRAFT - ILIAC CREST|| 80001|20972||2757.31|0|2757.31|0||BONE/SKIN GRAFT - METATARSAL|| 80001|20973||3032.55|0|3032.55|0||BONE/SKIN GRAFT - GREAT TOE|| 80001|20974||87.63|0|58.94|0||ELECTRICAL BONE STIMULATION|| 80001|20975||212.66|0|212.66|0||ELECTRICAL BONE STIMULATION|| 80001|20979||59.7|0|38.38|0||US BONE STIMULATION|| 80001|20982||4147.53|0|458.65|0||ABLATE - BONE TUMOR(S) PERQ|| 80001|20983||7637.71|0|473.15|0||ABLATE BONE TUMOR(S) PERQ|| 80001|20985||176.52|0|176.52|0||CPTR-ASST DIR MS PX|| 80001|21010||898.6|0|898.6|0||INCISION OF JAW JOINT|| 80001|21011||398.07|0|300.77|0||EXC FACE LES SC < 2 CM|| 80001|21012||395.59|0|395.59|0||EXC FACE LES SC = 2 CM|| 80001|21013||597.92|0|469.99|0||EXC FACE TUM DEEP < 2 CM|| 80001|21014||610.49|0|610.49|0||EXC FACE TUM DEEP = 2 CM|| 80001|21015||830.39|0|830.39|0||RESECTION OF FACIAL TUMOR|| 80001|21016||1206.36|0|1206.36|0||RESECT FACE TUM = 2 CM|| 80001|21025||1042.63|0|889.12|0||EXCISION OF BONE - LOWER JAW|| 80001|21026||716.21|0|585.18|0||EXCISION OF FACIAL BONE(S)|| 80001|21029||888.1|0|747.77|0||CONTOUR OF FACE BONE LESION|| 80001|21030||601.87|0|490.23|0||EXCISE MAX/ZYGOMA B9 TUMOR|| 80001|21031||456.41|0|345.93|0||REMOVE EXOSTOSIS - MANDIBLE|| 80001|21032||462.79|0|342.62|0||REMOVE EXOSTOSIS - MAXILLA|| 80001|21034||1552.85|0|1378.79|0||EXCISE MAX/ZYGOMA MLG TUMOR|| 80001|21040||607.3|0|492.17|0||EXCISE MANDIBLE LESION|| 80001|21044||1041.2|0|1041.2|0||REMOVAL OF JAW BONE LESION|| 80001|21045||1453.29|0|1453.29|0||EXTENSIVE JAW SURGERY|| 80001|21046||1319.94|0|1319.94|0||REMOVE MANDIBLE CYST COMPLEX|| 80001|21047||1571.26|0|1571.26|0||EXCISE LWR JAW CYST W/REPAIR|| 80001|21048||1355.85|0|1355.85|0||REMOVE MAXILLA CYST COMPLEX|| 80001|21049||1441.53|0|1441.53|0||EXCIS UPPR JAW CYST W/REPAIR|| 80001|21050||993.25|0|993.25|0||REMOVAL OF JAW JOINT|| 80001|21060||957.65|0|957.65|0||REMOVE JAW JOINT CARTILAGE|| 80001|21070||728.26|0|728.26|0||REMOVE CORONOID PROCESS|| 80001|21073||456.3|0|300.07|0||MNPJ OF TMJ W/ANESTH|| 80001|21076||1186.52|0|1005.88|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21077||2979|0|2537.47|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21079||2001.72|0|1679.97|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21080||2240.94|0|1865.31|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21081||2072.32|0|1720.72|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21082||1960.38|0|1616.15|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21083||1865.1|0|1500.32|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21084||2135.82|0|1736.54|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21085||895.41|0|681.82|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21086||2213.03|0|1871.13|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21087||2213.03|0|1871.13|0||PREPARE FACE/ORAL PROSTHESIS|| 80001|21100||1306.26|0|605|0||MAXILLOFACIAL FIXATION|| 80001|21110||931.47|0|784.16|0||INTERDENTAL FIXATION|| 80001|21116||167.53|0|53.17|0||INJECTION - JAW JOINT X-RAY|| 80001|21120||690.7|0|557.35|0||RECONSTRUCTION OF CHIN|| 80001|21121||928.61|0|780.52|0||RECONSTRUCTION OF CHIN|| 80001|21122||752.12|0|752.12|0||RECONSTRUCTION OF CHIN|| 80001|21123||910.92|0|910.92|0||RECONSTRUCTION OF CHIN|| 80001|21125||3534.73|0|867.7|0||AUGMENTATION - LOWER JAW BONE|| 80001|21127||4879.72|0|1046.24|0||AUGMENTATION - LOWER JAW BONE|| 80001|21137||818.1|0|818.1|0||REDUCTION OF FOREHEAD|| 80001|21138||1037.01|0|1037.01|0||REDUCTION OF FOREHEAD|| 80001|21139||1320.01|0|1320.01|0||REDUCTION OF FOREHEAD|| 80001|21141||1597|0|1597|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21142||1705.17|0|1705.17|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21143||1722.9|0|1722.9|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21145||1936.39|0|1936.39|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21146||2016.45|0|2016.45|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21147||2132.02|0|2132.02|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21150||1993.21|0|1993.21|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21151||2425.82|0|2425.82|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21154||2609.84|0|2609.84|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21155||2782.98|0|2782.98|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21159||2877.66|0|2877.66|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21160||3124.07|0|3124.07|0||RECONSTRUCT MIDFACE - LEFORT|| 80001|21172||2096.4|0|2096.4|0||RECONSTRUCT ORBIT/FOREHEAD|| 80001|21175||2739.15|0|2739.15|0||RECONSTRUCT ORBIT/FOREHEAD|| 80001|21179||1559.28|0|1559.28|0||RECONSTRUCT ENTIRE FOREHEAD|| 80001|21180||1821.75|0|1821.75|0||RECONSTRUCT ENTIRE FOREHEAD|| 80001|21181||868.9|0|868.9|0||CONTOUR CRANIAL BONE LESION|| 80001|21182||2282.37|0|2282.37|0||RECONSTRUCT CRANIAL BONE|| 80001|21183||2642.04|0|2642.04|0||RECONSTRUCT CRANIAL BONE|| 80001|21184||2858.34|0|2858.34|0||RECONSTRUCT CRANIAL BONE|| 80001|21188||1849.47|0|1849.47|0||RECONSTRUCTION OF MIDFACE|| 80001|21193||1411|0|1411|0||RECONST LWR JAW W/O GRAFT|| 80001|21194||1772.02|0|1772.02|0||RECONST LWR JAW W/GRAFT|| 80001|21195||1584.34|0|1584.34|0||RECONST LWR JAW W/O FIXATION|| 80001|21196||1745.09|0|1745.09|0||RECONST LWR JAW W/FIXATION|| 80001|21198||1371.45|0|1371.45|0||RECONSTR LWR JAW SEGMENT|| 80001|21199||1196.41|0|1196.41|0||RECONSTR LWR JAW W/ADVANCE|| 80001|21206||1453.54|0|1453.54|0||RECONSTRUCT UPPER JAW BONE|| 80001|21208||2177.19|0|996.02|0||AUGMENTATION OF FACIAL BONES|| 80001|21209||935.21|0|722.77|0||REDUCTION OF FACIAL BONES|| 80001|21210||2613.7|0|1028.21|0||FACE BONE GRAFT|| 80001|21215||4629.15|0|1067.41|0||LOWER JAW BONE GRAFT|| 80001|21230||899.17|0|899.17|0||RIB CARTILAGE GRAFT|| 80001|21235||838.83|0|664.77|0||EAR CARTILAGE GRAFT|| 80001|21240||1328.11|0|1328.11|0||RECONSTRUCTION OF JAW JOINT|| 80001|21242||1216.17|0|1216.17|0||RECONSTRUCTION OF JAW JOINT|| 80001|21243||2017.29|0|2017.29|0||RECONSTRUCTION OF JAW JOINT|| 80001|21244||1253.74|0|1253.74|0||RECONSTRUCTION OF LOWER JAW|| 80001|21245||1289.12|0|1044.51|0||RECONSTRUCTION OF JAW|| 80001|21246||1062.3|0|1062.3|0||RECONSTRUCTION OF JAW|| 80001|21247||1811.41|0|1811.41|0||RECONSTRUCT LOWER JAW BONE|| 80001|21248||1303.01|0|1076.63|0||RECONSTRUCTION OF JAW|| 80001|21249||1794.68|0|1537.28|0||RECONSTRUCTION OF JAW|| 80001|21255||1552.5|0|1552.5|0||RECONSTRUCT LOWER JAW BONE|| 80001|21256||1407.6|0|1407.6|0||RECONSTRUCTION OF ORBIT|| 80001|21260||1355.54|0|1355.54|0||REVISE EYE SOCKETS|| 80001|21261||2415.48|0|2415.48|0||REVISE EYE SOCKETS|| 80001|21263||2230.38|0|2230.38|0||REVISE EYE SOCKETS|| 80001|21267||1843.78|0|1843.78|0||REVISE EYE SOCKETS|| 80001|21268||2178.73|0|2178.73|0||REVISE EYE SOCKETS|| 80001|21270||1116.77|0|851.61|0||AUGMENTATION - CHEEK BONE|| 80001|21275||983.56|0|983.56|0||REVISION - ORBITOFACIAL BONES|| 80001|21280||660.74|0|660.74|0||REVISION OF EYELID|| 80001|21282||438.92|0|438.92|0||REVISION OF EYELID|| 80001|21295||218.05|0|218.05|0||REVISION OF JAW MUSCLE/BONE|| 80001|21296||488.48|0|488.48|0||REVISION OF JAW MUSCLE/BONE|| 80001|21299||0|0|0|0||CRANIO/MAXILLOFACIAL SURGERY|| 80001|21310||147.91|0|32.39|0||TREATMENT OF NOSE FRACTURE|| 80001|21315||316.99|0|178.21|0||TREATMENT OF NOSE FRACTURE|| 80001|21320||292.79|0|159.43|0||TREATMENT OF NOSE FRACTURE|| 80001|21325||549.43|0|549.43|0||TREATMENT OF NOSE FRACTURE|| 80001|21330||663.5|0|663.5|0||TREATMENT OF NOSE FRACTURE|| 80001|21335||847.82|0|847.82|0||TREATMENT OF NOSE FRACTURE|| 80001|21336||747.25|0|747.25|0||TREAT NASAL SEPTAL FRACTURE|| 80001|21337||465.71|0|344.38|0||TREAT NASAL SEPTAL FRACTURE|| 80001|21338||867.49|0|867.49|0||TREAT NASOETHMOID FRACTURE|| 80001|21339||986.3|0|986.3|0||TREAT NASOETHMOID FRACTURE|| 80001|21340||939.88|0|939.88|0||TREATMENT OF NOSE FRACTURE|| 80001|21343||1417.34|0|1417.34|0||TREATMENT OF SINUS FRACTURE|| 80001|21344||1647.55|0|1647.55|0||TREATMENT OF SINUS FRACTURE|| 80001|21345||908.08|0|740.23|0||TREAT NOSE/JAW FRACTURE|| 80001|21346||1058.12|0|1058.12|0||TREAT NOSE/JAW FRACTURE|| 80001|21347||1327.81|0|1327.81|0||TREAT NOSE/JAW FRACTURE|| 80001|21348||1423.25|0|1423.25|0||TREAT NOSE/JAW FRACTURE|| 80001|21355||557.22|0|419.21|0||TREAT CHEEK BONE FRACTURE|| 80001|21356||579.81|0|443.35|0||TREAT CHEEK BONE FRACTURE|| 80001|21360||631.24|0|631.24|0||TREAT CHEEK BONE FRACTURE|| 80001|21365||1314.86|0|1314.86|0||TREAT CHEEK BONE FRACTURE|| 80001|21366||1376.05|0|1376.05|0||TREAT CHEEK BONE FRACTURE|| 80001|21385||802.16|0|802.16|0||TREAT EYE SOCKET FRACTURE|| 80001|21386||817.33|0|817.33|0||TREAT EYE SOCKET FRACTURE|| 80001|21387||837.87|0|837.87|0||TREAT EYE SOCKET FRACTURE|| 80001|21390||931.91|0|931.91|0||TREAT EYE SOCKET FRACTURE|| 80001|21395||1187.97|0|1187.97|0||TREAT EYE SOCKET FRACTURE|| 80001|21400||221.73|0|181.8|0||TREAT EYE SOCKET FRACTURE|| 80001|21401||563.14|0|358.07|0||TREAT EYE SOCKET FRACTURE|| 80001|21406||669.88|0|669.88|0||TREAT EYE SOCKET FRACTURE|| 80001|21407||757.08|0|757.08|0||TREAT EYE SOCKET FRACTURE|| 80001|21408||1057.81|0|1057.81|0||TREAT EYE SOCKET FRACTURE|| 80001|21421||965.33|0|803.68|0||TREAT MOUTH ROOF FRACTURE|| 80001|21422||791.91|0|791.91|0||TREAT MOUTH ROOF FRACTURE|| 80001|21423||931.1|0|931.1|0||TREAT MOUTH ROOF FRACTURE|| 80001|21431||913.88|0|913.88|0||TREAT CRANIOFACIAL FRACTURE|| 80001|21432||753.91|0|753.91|0||TREAT CRANIOFACIAL FRACTURE|| 80001|21433||2056.03|0|2056.03|0||TREAT CRANIOFACIAL FRACTURE|| 80001|21435||1497.6|0|1497.6|0||TREAT CRANIOFACIAL FRACTURE|| 80001|21436||2410.51|0|2410.51|0||TREAT CRANIOFACIAL FRACTURE|| 80001|21440||660.93|0|539.21|0||TREAT DENTAL RIDGE FRACTURE|| 80001|21445||893.5|0|732.63|0||TREAT DENTAL RIDGE FRACTURE|| 80001|21450||715.23|0|574.9|0||TREAT LOWER JAW FRACTURE|| 80001|21451||945.09|0|783.06|0||TREAT LOWER JAW FRACTURE|| 80001|21452||652.88|0|390.44|0||TREAT LOWER JAW FRACTURE|| 80001|21453||1054.88|0|908.35|0||TREAT LOWER JAW FRACTURE|| 80001|21454||675.04|0|675.04|0||TREAT LOWER JAW FRACTURE|| 80001|21461||2424.15|0|1092.95|0||TREAT LOWER JAW FRACTURE|| 80001|21462||2583.18|0|1220.59|0||TREAT LOWER JAW FRACTURE|| 80001|21465||1102.72|0|1102.72|0||TREAT LOWER JAW FRACTURE|| 80001|21470||1429.91|0|1429.91|0||TREAT LOWER JAW FRACTURE|| 80001|21480||111.99|0|38.34|0||RESET DISLOCATED JAW|| 80001|21485||810.2|0|680.73|0||RESET DISLOCATED JAW|| 80001|21490||1088.41|0|1088.41|0||REPAIR DISLOCATED JAW|| 80001|21495||741.79|0|741.79|0||TREAT HYOID BONE FRACTURE|| 80001|21497||844.91|0|704.97|0||INTERDENTAL WIRING|| 80001|21499||0|0|0|0||HEAD SURGERY PROCEDURE|| 80001|21501||519.51|0|374.53|0||DRAIN NECK/CHEST LESION|| 80001|21502||601.18|0|601.18|0||DRAIN CHEST LESION|| 80001|21510||519.25|0|519.25|0||DRAINAGE OF BONE LESION|| 80001|21550||299.61|0|185.25|0||BIOPSY OF NECK/CHEST|| 80001|21552||526.71|0|526.71|0||EXC NECK LES SC = 3 CM|| 80001|21554||866.14|0|866.14|0||EXC NECK TUM DEEP = 5 CM|| 80001|21555||477.95|0|358.16|0||REMOVE LESION - NECK/CHEST|| 80001|21556||624.85|0|624.85|0||REMOVE LESION - NECK/CHEST|| 80001|21557||1135.55|0|1135.55|0||REMOVE TUMOR - NECK/CHEST|| 80001|21558||1597.85|0|1597.85|0||RESECT NECK TUM = 5 CM|| 80001|21600||654.52|0|654.52|0||PARTIAL REMOVAL OF RIB|| 80001|21610||1445.76|0|1445.76|0||PARTIAL REMOVAL OF RIB|| 80001|21615||746.12|0|746.12|0||REMOVAL OF RIB|| 80001|21616||875.41|0|875.41|0||REMOVAL OF RIB AND NERVES|| 80001|21620||596.08|0|596.08|0||PARTIAL REMOVAL OF STERNUM|| 80001|21627||638.42|0|638.42|0||STERNAL DEBRIDEMENT|| 80001|21630||1427.82|0|1427.82|0||EXTENSIVE STERNUM SURGERY|| 80001|21632||1435.74|0|1435.74|0||EXTENSIVE STERNUM SURGERY|| 80001|21685||1177.57|0|1177.57|0||HYOID MYOTOMY & SUSPENSION|| 80001|21700||439.88|0|439.88|0||REVISION OF NECK MUSCLE|| 80001|21705||658.13|0|658.13|0||REVISION OF NECK MUSCLE/RIB|| 80001|21720||561.59|0|561.59|0||REVISION OF NECK MUSCLE|| 80001|21725||635.21|0|635.21|0||REVISION OF NECK MUSCLE|| 80001|21740||1234.56|0|1234.56|0||RECONSTRUCTION OF STERNUM|| 80001|21742||0|0|0|0||REPAIR STERN/NUSS W/O SCOPE|| 80001|21743||0|0|0|0||REPAIR STERNUM/NUSS W/SCOPE|| 80001|21750||817.37|0|817.37|0||REPAIR OF STERNUM SEPARATION|| 80001|21811||725.5|0|725.5|0||OPTX OF RIB FX W/FIXJ SCOPE|| 80001|21812||870.13|0|870.13|0||TREATMENT OF RIB FRACTURE|| 80001|21813||1183.87|0|1183.87|0||TREATMENT OF RIB FRACTURE|| 80001|21820||163.75|0|167.63|0||TREAT STERNUM FRACTURE|| 80001|21825||638.91|0|638.91|0||TREAT STERNUM FRACTURE|| 80001|21899||0|0|0|0||NECK/CHEST SURGERY PROCEDURE|| 80001|21920||292.24|0|187.19|0||BIOPSY SOFT TISSUE OF BACK|| 80001|21925||516.18|0|416.16|0||BIOPSY SOFT TISSUE OF BACK|| 80001|21930||545.07|0|427.22|0||REMOVE LESION - BACK OR FLANK|| 80001|21931||554.4|0|554.4|0||EXC BACK LES SC = 3 CM|| 80001|21932||781.33|0|781.33|0||EXC BACK TUM DEEP < 5 CM|| 80001|21933||874.32|0|874.32|0||EXC BACK TUM DEEP = 5 CM|| 80001|21935||1214.31|0|1214.31|0||REMOVE TUMOR - BACK|| 80001|21936||1677.78|0|1677.78|0||RESECT BACK TUM = 5 CM|| 80001|22010||1125.84|0|1125.84|0||I&D - P-SPINE - C/T/CERV-THOR|| 80001|22015||1071.4|0|1071.4|0||I&D - P-SPINE - L/S/LS|| 80001|22100||1103.33|0|1103.33|0||REMOVE PART OF NECK VERTEBRA|| 80001|22101||970.98|0|970.98|0||REMOVE PART - THORAX VERTEBRA|| 80001|22102||941.94|0|941.94|0||REMOVE PART - LUMBAR VERTEBRA|| 80001|22103||169.26|0|169.26|0||REMOVE EXTRA SPINE SEGMENT|| 80001|22110||1241.15|0|1241.15|0||REMOVE PART OF NECK VERTEBRA|| 80001|22112||1342.6|0|1342.6|0||REMOVE PART - THORAX VERTEBRA|| 80001|22114||1176.41|0|1176.41|0||REMOVE PART - LUMBAR VERTEBRA|| 80001|22116||170.74|0|170.74|0||REMOVE EXTRA SPINE SEGMENT|| 80001|22206||2928.2|0|2928.2|0||CUT SPINE 3 COL - THOR|| 80001|22207||2866.93|0|2866.93|0||CUT SPINE 3 COL - LUMB|| 80001|22208||691.89|0|691.89|0||CUT SPINE 3 COL - ADDL SEG|| 80001|22210||2134.62|0|2134.62|0||REVISION OF NECK SPINE|| 80001|22212||1767.3|0|1767.3|0||REVISION OF THORAX SPINE|| 80001|22214||1765.47|0|1765.47|0||REVISION OF LUMBAR SPINE|| 80001|22216||439.47|0|439.47|0||REVISE - EXTRA SPINE SEGMENT|| 80001|22220||1901.16|0|1901.16|0||REVISION OF NECK SPINE|| 80001|22222||1856.11|0|1856.11|0||REVISION OF THORAX SPINE|| 80001|22224||1880.72|0|1880.72|0||REVISION OF LUMBAR SPINE|| 80001|22226||437.13|0|437.13|0||REVISE - EXTRA SPINE SEGMENT|| 80001|22305||221.41|0|201.64|0||TREAT SPINE PROCESS FRACTURE|| 80001|22310||359.03|0|332.28|0||TREAT SPINE FRACTURE|| 80001|22315||1035.44|0|911.78|0||TREAT SPINE FRACTURE|| 80001|22318||1964.68|0|1964.68|0||TREAT ODONTOID FX W/O GRAFT|| 80001|22319||2211.01|0|2211.01|0||TREAT ODONTOID FX W/GRAFT|| 80001|22325||1704.73|0|1704.73|0||TREAT SPINE FRACTURE|| 80001|22326||1787.91|0|1787.91|0||TREAT NECK SPINE FRACTURE|| 80001|22327||1792.92|0|1792.92|0||TREAT THORAX SPINE FRACTURE|| 80001|22328||343.27|0|343.27|0||TREAT EACH ADD SPINE FX|| 80001|22505||156.7|0|156.7|0||MANIPULATION OF SPINE|| 80001|22510||1978.24|0|544.32|0||PERQ CERVICOTHORACIC INJECT|| 80001|22511||1957.91|0|510.81|0||PERQ LUMBOSACRAL INJECTION|| 80001|22512||1097.94|0|254.8|0||VERTEBROPLASTY ADDL INJECT|| 80001|22513||8125.93|0|646.6|0||PERQ VERTEBRAL AUGMENTATION|| 80001|22514||8080.38|0|602.21|0||PERQ VERTEBRAL AUGMENTATION|| 80001|22515||4898.13|0|273.84|0||PERQ VERTEBRAL AUGMENTATION|| 80001|22526||2638.26|0|402.29|0||IDET - SINGLE LEVEL|| 80001|22527||2186.8|0|183.81|0||IDET - 1 OR MORE LEVELS|| 80001|22532||2126.03|0|2126.03|0||LAT THORAX SPINE FUSION|| 80001|22533||1967.65|0|1967.65|0||LAT LUMBAR SPINE FUSION|| 80001|22534||435.41|0|435.41|0||LAT THOR/LUMB - ADD'L SEG|| 80001|22548||2374.93|0|2374.93|0||NECK SPINE FUSION|| 80001|22551||2057.47|0|2057.47|0||NECK SPINE FUSE&REMOVE ADDL|| 80001|22552||485.04|0|485.04|0||ADDL NECK SPINE FUSION|| 80001|22554||1501.71|0|1501.71|0||NECK SPINE FUSION|| 80001|22556||2003.25|0|2003.25|0||THORAX SPINE FUSION|| 80001|22558||1842.81|0|1842.81|0||LUMBAR SPINE FUSION|| 80001|22585||399.24|0|399.24|0||ADDITIONAL SPINAL FUSION|| 80001|22586||2416.08|0|2416.08|0||PRESCRL FUSE W/ INSTR L5/S1|| 80001|22590||1889.75|0|1889.75|0||SPINE & SKULL SPINAL FUSION|| 80001|22595||1806.09|0|1806.09|0||NECK SPINAL FUSION|| 80001|22600||1539.67|0|1539.67|0||NECK SPINE FUSION|| 80001|22610||1506.09|0|1506.09|0||THORAX SPINE FUSION|| 80001|22612||1898.72|0|1898.72|0||LUMBAR SPINE FUSION|| 80001|22614||475.78|0|475.78|0||SPINE FUSION - EXTRA SEGMENT|| 80001|22630||1877.14|0|1877.14|0||LUMBAR SPINE FUSION|| 80001|22632||389.82|0|389.82|0||SPINE FUSION - EXTRA SEGMENT|| 80001|22633||2223.34|0|2223.34|0||LUMBAR SPINE FUSION COMBINED|| 80001|22634||602.05|0|602.05|0||SPINE FUSION EXTRA SEGMENT|| 80001|22800||1611.45|0|1611.45|0||FUSION OF SPINE|| 80001|22802||2510.14|0|2510.14|0||FUSION OF SPINE|| 80001|22804||2911.18|0|2911.18|0||FUSION OF SPINE|| 80001|22808||2210.63|0|2210.63|0||FUSION OF SPINE|| 80001|22810||2422.68|0|2422.68|0||FUSION OF SPINE|| 80001|22812||2639.04|0|2639.04|0||FUSION OF SPINE|| 80001|22818||2595.98|0|2595.98|0||KYPHECTOMY - 1-2 SEGMENTS|| 80001|22819||3335.27|0|3335.27|0||KYPHECTOMY - 3 OR MORE|| 80001|22830||966.34|0|966.34|0||EXPLORATION OF SPINAL FUSION|| 80001|22840||922.52|0|922.52|0||INSERT SPINE FIXATION DEVICE|| 80001|22841||0|0|0|0||INSERT SPINE FIXATION DEVICE|| 80001|22842||925.02|0|925.02|0||INSERT SPINE FIXATION DEVICE|| 80001|22843||989.77|0|989.77|0||INSERT SPINE FIXATION DEVICE|| 80001|22844||1194.33|0|1194.33|0||INSERT SPINE FIXATION DEVICE|| 80001|22845||888.62|0|888.62|0||INSERT SPINE FIXATION DEVICE|| 80001|22846||922.44|0|922.44|0||INSERT SPINE FIXATION DEVICE|| 80001|22847||966.19|0|966.19|0||INSERT SPINE FIXATION DEVICE|| 80001|22848||435.79|0|435.79|0||INSERT PELV FIXATION DEVICE|| 80001|22849||1557.38|0|1557.38|0||REINSERT SPINAL FIXATION|| 80001|22850||860.16|0|860.16|0||REMOVE SPINE FIXATION DEVICE|| 80001|22851||494.03|0|494.03|0||APPLY SPINE PROSTH DEVICE|| 80001|22852||824.05|0|824.05|0||REMOVE SPINE FIXATION DEVICE|| 80001|22853||329.03|0|329.03|0||INSJ BIOMECHANICAL DEVICE|| 80001|22854||425.93|0|425.93|0||INSJ BIOMECHANICAL DEVICE|| 80001|22855||1324.58|0|1324.58|0||REMOVE SPINE FIXATION DEVICE|| 80001|22856||1907.31|0|1907.31|0||CERV ARTIFIC DISKECTOMY|| 80001|22857||2117.72|0|2117.72|0||LUMBAR ARTIF DISKECTOMY|| 80001|22858||599.99|0|599.99|0||SECOND LEVEL CER DISKECTOMY|| 80001|22859||425.93|0|425.93|0||INSJ BIOMECHANICAL DEVICE|| 80001|22861||2314.92|0|2314.92|0||REVISE CERV ARTIFIC DISC|| 80001|22862||2108.37|0|2108.37|0||REVISE LUMBAR ARTIF DISC|| 80001|22864||2518.68|0|2518.68|0||REMOVE CERV ARTIF DISC|| 80001|22865||2445.85|0|2445.85|0||REMOVE LUMB ARTIF DISC|| 80001|22867||1229.55|0|1229.55|0||INSJ STABLJ DEV W/DCMPRN|| 80001|22868||307.49|0|307.49|0||INSJ STABLJ DEV W/DCMPRN|| 80001|22869||676.14|0|676.14|0||INSJ STABLJ DEV W/O DCMPRN|| 80001|22870||179.16|0|179.16|0||INSJ STABLJ DEV W/O DCMPRN|| 80001|22899||0|0|0|0||SPINE SURGERY PROCEDURE|| 80001|22900||665.8|0|665.8|0||REMOVE ABDOMINAL WALL LESION|| 80001|22901||786.88|0|786.88|0||EXC BACK TUM DEEP = 5 CM|| 80001|22902||505.58|0|387.73|0||EXC ABD LES SC < 3 CM|| 80001|22903||518.14|0|518.14|0||EXC ABD LES SC > 3 CM|| 80001|22904||1249.62|0|1249.62|0||RESECT ABD TUM < 5 CM|| 80001|22905||1580.1|0|1580.1|0||RESECT ABD TUM > 5 CM|| 80001|22999||0|0|0|0||ABDOMEN SURGERY PROCEDURE|| 80001|23000||670.97|0|434.89|0||REMOVAL OF CALCIUM DEPOSITS|| 80001|23020||809.88|0|809.88|0||RELEASE SHOULDER JOINT|| 80001|23030||504.48|0|300.58|0||DRAIN SHOULDER LESION|| 80001|23031||485.59|0|257.65|0||DRAIN SHOULDER BURSA|| 80001|23035||799.7|0|799.7|0||DRAIN SHOULDER BONE LESION|| 80001|23040||845.33|0|845.33|0||EXPLORATORY SHOULDER SURGERY|| 80001|23044||671.47|0|671.47|0||EXPLORATORY SHOULDER SURGERY|| 80001|23065||248.89|0|195.78|0||BIOPSY SHOULDER TISSUES|| 80001|23066||635.68|0|416.27|0||BIOPSY SHOULDER TISSUES|| 80001|23071||493.14|0|493.14|0||EXC SHOULDER LES SC > 3 CM|| 80001|23073||818.34|0|818.34|0||EXC SHOULDER TUM DEEP > 5 CM|| 80001|23075||537.21|0|381.76|0||REMOVAL OF SHOULDER LESION|| 80001|23076||633.48|0|633.48|0||REMOVAL OF SHOULDER LESION|| 80001|23077||1351.16|0|1351.16|0||REMOVE TUMOR OF SHOULDER|| 80001|23078||1697.13|0|1697.13|0||RESECT SHOULDER TUM > 5 CM|| 80001|23100||585.11|0|585.11|0||BIOPSY OF SHOULDER JOINT|| 80001|23101||525.63|0|525.63|0||SHOULDER JOINT SURGERY|| 80001|23105||747.47|0|747.47|0||REMOVE SHOULDER JOINT LINING|| 80001|23106||580.54|0|580.54|0||INCISION OF COLLARBONE JOINT|| 80001|23107||774.38|0|774.38|0||EXPLORE TREAT SHOULDER JOINT|| 80001|23120||683.76|0|683.76|0||PARTIAL REMOVAL - COLLAR BONE|| 80001|23125||834.78|0|834.78|0||REMOVAL OF COLLAR BONE|| 80001|23130||714.52|0|714.52|0||REMOVE SHOULDER BONE - PART|| 80001|23140||619.79|0|619.79|0||REMOVAL OF BONE LESION|| 80001|23145||818.22|0|818.22|0||REMOVAL OF BONE LESION|| 80001|23146||729.06|0|729.06|0||REMOVAL OF BONE LESION|| 80001|23150||778.46|0|778.46|0||REMOVAL OF HUMERUS LESION|| 80001|23155||934.35|0|934.35|0||REMOVAL OF HUMERUS LESION|| 80001|23156||797.56|0|797.56|0||REMOVAL OF HUMERUS LESION|| 80001|23170||657.01|0|657.01|0||REMOVE COLLAR BONE LESION|| 80001|23172||663.65|0|663.65|0||REMOVE SHOULDER BLADE LESION|| 80001|23174||890.85|0|890.85|0||REMOVE HUMERUS LESION|| 80001|23180||784.63|0|784.63|0||REMOVE COLLAR BONE LESION|| 80001|23182||773.26|0|773.26|0||REMOVE SHOULDER BLADE LESION|| 80001|23184||863.82|0|863.82|0||REMOVE HUMERUS LESION|| 80001|23190||670.55|0|670.55|0||PARTIAL REMOVAL OF SCAPULA|| 80001|23195||889.89|0|889.89|0||REMOVAL OF HEAD OF HUMERUS|| 80001|23200||1800.56|0|1800.56|0||REMOVAL OF COLLAR BONE|| 80001|23210||2118.85|0|2118.85|0||REMOVAL OF SHOULDER BLADE|| 80001|23220||2324.32|0|2324.32|0||PARTIAL REMOVAL OF HUMERUS|| 80001|23330||275.06|0|178.93|0||REMOVE SHOULDER FOREIGN BODY|| 80001|23333||533.43|0|533.43|0||REMOVE SHOULDER FB DEEP|| 80001|23334||1265.22|0|1265.22|0||SHOULDER PROSTHESIS REMOVAL|| 80001|23335||1509.32|0|1509.32|0||SHOULDER PROSTHESIS REMOVAL|| 80001|23350||148.97|0|61.75|0||INJECTION FOR SHOULDER X-RAY|| 80001|23395||1515.83|0|1515.83|0||MUSCLE TRANSFER - SHOULDER/ARM|| 80001|23397||1352.22|0|1352.22|0||MUSCLE TRANSFERS|| 80001|23400||1146.84|0|1146.84|0||FIXATION OF SHOULDER BLADE|| 80001|23405||734.16|0|734.16|0||INCISION OF TENDON & MUSCLE|| 80001|23406||908.22|0|908.22|0||INCISE TENDON(S) & MUSCLE(S)|| 80001|23410||967.67|0|967.67|0||REPAIR ROTATOR CUFF - ACUTE|| 80001|23412||1003.37|0|1003.37|0||REPAIR ROTATOR CUFF - CHRONIC|| 80001|23415||819.4|0|819.4|0||RELEASE OF SHOULDER LIGAMENT|| 80001|23420||1140.71|0|1140.71|0||REPAIR OF SHOULDER|| 80001|23430||877.78|0|877.78|0||REPAIR BICEPS TENDON|| 80001|23440||890.32|0|890.32|0||REMOVE/TRANSPLANT TENDON|| 80001|23450||1121.67|0|1121.67|0||REPAIR SHOULDER CAPSULE|| 80001|23455||1183.28|0|1183.28|0||REPAIR SHOULDER CAPSULE|| 80001|23460||1289.55|0|1289.55|0||REPAIR SHOULDER CAPSULE|| 80001|23462||1260.81|0|1260.81|0||REPAIR SHOULDER CAPSULE|| 80001|23465||1326.17|0|1326.17|0||REPAIR SHOULDER CAPSULE|| 80001|23466||1325.13|0|1325.13|0||REPAIR SHOULDER CAPSULE|| 80001|23470||1423.82|0|1423.82|0||RECONSTRUCT SHOULDER JOINT|| 80001|23472||1727.38|0|1727.38|0||RECONSTRUCT SHOULDER JOINT|| 80001|23473||1930.73|0|1930.73|0||REVIS RECONST SHOULDER JOINT|| 80001|23474||2088.92|0|2088.92|0||REVIS RECONST SHOULDER JOINT|| 80001|23480||968.74|0|968.74|0||REVISION OF COLLAR BONE|| 80001|23485||1126.84|0|1126.84|0||REVISION OF COLLAR BONE|| 80001|23490||1017.6|0|1017.6|0||REINFORCE CLAVICLE|| 80001|23491||1196.31|0|1196.31|0||REINFORCE SHOULDER BONES|| 80001|23500||250.05|0|253.93|0||TREAT CLAVICLE FRACTURE|| 80001|23505||407.2|0|385.11|0||TREAT CLAVICLE FRACTURE|| 80001|23515||845.44|0|845.44|0||TREAT CLAVICLE FRACTURE|| 80001|23520||266.31|0|269.8|0||TREAT CLAVICLE DISLOCATION|| 80001|23525||443.48|0|411.69|0||TREAT CLAVICLE DISLOCATION|| 80001|23530||672.15|0|672.15|0||TREAT CLAVICLE DISLOCATION|| 80001|23532||732.69|0|732.69|0||TREAT CLAVICLE DISLOCATION|| 80001|23540||258.85|0|262.73|0||TREAT CLAVICLE DISLOCATION|| 80001|23545||391.08|0|356.58|0||TREAT CLAVICLE DISLOCATION|| 80001|23550||664.85|0|664.85|0||TREAT CLAVICLE DISLOCATION|| 80001|23552||766.01|0|766.01|0||TREAT CLAVICLE DISLOCATION|| 80001|23570||266.61|0|274.37|0||TREAT SHOULDER BLADE FX|| 80001|23575||463.25|0|435.34|0||TREAT SHOULDER BLADE FX|| 80001|23585||1156.92|0|1156.92|0||TREAT SCAPULA FRACTURE|| 80001|23600||372.92|0|351.99|0||TREAT HUMERUS FRACTURE|| 80001|23605||535.89|0|492.86|0||TREAT HUMERUS FRACTURE|| 80001|23615||1041.05|0|1041.05|0||TREAT HUMERUS FRACTURE|| 80001|23616||1468.97|0|1468.97|0||TREAT HUMERUS FRACTURE|| 80001|23620||309.31|0|294.97|0||TREAT HUMERUS FRACTURE|| 80001|23625||439.02|0|410.33|0||TREAT HUMERUS FRACTURE|| 80001|23630||917.93|0|917.93|0||TREAT HUMERUS FRACTURE|| 80001|23650||361.28|0|332.59|0||TREAT SHOULDER DISLOCATION|| 80001|23655||466.34|0|466.34|0||TREAT SHOULDER DISLOCATION|| 80001|23660||679.51|0|679.51|0||TREAT SHOULDER DISLOCATION|| 80001|23665||490.32|0|458.14|0||TREAT DISLOCATION/FRACTURE|| 80001|23670||1034|0|1034|0||TREAT DISLOCATION/FRACTURE|| 80001|23675||640.84|0|586.18|0||TREAT DISLOCATION/FRACTURE|| 80001|23680||1095.97|0|1095.97|0||TREAT DISLOCATION/FRACTURE|| 80001|23700||230.72|0|230.72|0||FIXATION OF SHOULDER|| 80001|23800||1212.65|0|1212.65|0||FUSION OF SHOULDER JOINT|| 80001|23802||1519.63|0|1519.63|0||FUSION OF SHOULDER JOINT|| 80001|23900||1647.59|0|1647.59|0||AMPUTATION OF ARM & GIRDLE|| 80001|23920||1333.61|0|1333.61|0||AMPUTATION AT SHOULDER JOINT|| 80001|23921||536.43|0|536.43|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|23929||0|0|0|0||SHOULDER SURGERY PROCEDURE|| 80001|23930||401.58|0|253.11|0||DRAINAGE OF ARM LESION|| 80001|23931||324.8|0|186.02|0||DRAINAGE OF ARM BURSA|| 80001|23935||590.93|0|590.93|0||DRAIN ARM/ELBOW BONE LESION|| 80001|24000||558.21|0|558.21|0||EXPLORATORY ELBOW SURGERY|| 80001|24006||835.56|0|835.56|0||RELEASE ELBOW JOINT|| 80001|24065||291.56|0|195.81|0||BIOPSY ARM/ELBOW SOFT TISSUE|| 80001|24066||716.29|0|486.8|0||BIOPSY ARM/ELBOW SOFT TISSUE|| 80001|24071||476.71|0|476.71|0||EXC ARM/ELBOW LES SC = 3 CM|| 80001|24073||819.49|0|819.49|0||EX ARM/ELBOW TUM DEEP > 5 CM|| 80001|24075||560.98|0|384.6|0||REMOVE ARM/ELBOW LESION|| 80001|24076||635.79|0|635.79|0||REMOVE ARM/ELBOW LESION|| 80001|24077||1222.84|0|1222.84|0||REMOVE TUMOR OF ARM/ELBOW|| 80001|24079||1571.91|0|1571.91|0||RESECT ARM/ELBOW TUM > 5 CM|| 80001|24100||487.49|0|487.49|0||BIOPSY ELBOW JOINT LINING|| 80001|24101||583.98|0|583.98|0||EXPLORE/TREAT ELBOW JOINT|| 80001|24102||720.91|0|720.91|0||REMOVE ELBOW JOINT LINING|| 80001|24105||405.83|0|405.83|0||REMOVAL OF ELBOW BURSA|| 80001|24110||688.87|0|688.87|0||REMOVE HUMERUS LESION|| 80001|24115||868.68|0|868.68|0||REMOVE/GRAFT BONE LESION|| 80001|24116||1017.9|0|1017.9|0||REMOVE/GRAFT BONE LESION|| 80001|24120||616.5|0|616.5|0||REMOVE ELBOW LESION|| 80001|24125||728.55|0|728.55|0||REMOVE/GRAFT BONE LESION|| 80001|24126||762.06|0|762.06|0||REMOVE/GRAFT BONE LESION|| 80001|24130||592.27|0|592.27|0||REMOVAL OF HEAD OF RADIUS|| 80001|24134||880.36|0|880.36|0||REMOVAL OF ARM BONE LESION|| 80001|24136||682.45|0|682.45|0||REMOVE RADIUS BONE LESION|| 80001|24138||790.61|0|790.61|0||REMOVE ELBOW BONE LESION|| 80001|24140||826.61|0|826.61|0||PARTIAL REMOVAL OF ARM BONE|| 80001|24145||694.92|0|694.92|0||PARTIAL REMOVAL OF RADIUS|| 80001|24147||728.77|0|728.77|0||PARTIAL REMOVAL OF ELBOW|| 80001|24149||1379.23|0|1379.23|0||RADICAL RESECTION OF ELBOW|| 80001|24150||1849.21|0|1849.21|0||EXTENSIVE HUMERUS SURGERY|| 80001|24152||1603.68|0|1603.68|0||EXTENSIVE RADIUS SURGERY|| 80001|24155||1007.21|0|1007.21|0||REMOVAL OF ELBOW JOINT|| 80001|24160||1489.47|0|1489.47|0||REMOVE ELBOW JOINT IMPLANT|| 80001|24164||855.72|0|855.72|0||REMOVE RADIUS HEAD IMPLANT|| 80001|24200||237.05|0|164.17|0||REMOVAL OF ARM FOREIGN BODY|| 80001|24201||638.99|0|428.88|0||REMOVAL OF ARM FOREIGN BODY|| 80001|24220||182.89|0|82.88|0||INJECTION FOR ELBOW X-RAY|| 80001|24300||481|0|481|0||MANIPULATE ELBOW W/ANESTH|| 80001|24301||875.96|0|875.96|0||MUSCLE/TENDON TRANSFER|| 80001|24305||672.71|0|672.71|0||ARM TENDON LENGTHENING|| 80001|24310||552.16|0|552.16|0||REVISION OF ARM TENDON|| 80001|24320||920.78|0|920.78|0||REPAIR OF ARM TENDON|| 80001|24330||845.13|0|845.13|0||REVISION OF ARM MUSCLES|| 80001|24331||926.99|0|926.99|0||REVISION OF ARM MUSCLES|| 80001|24332||718.23|0|718.23|0||TENOLYSIS - TRICEPS|| 80001|24340||717.02|0|717.02|0||REPAIR OF BICEPS TENDON|| 80001|24341||872.47|0|872.47|0||REPAIR ARM TENDON/MUSCLE|| 80001|24342||912.6|0|912.6|0||REPAIR OF RUPTURED TENDON|| 80001|24343||826.43|0|826.43|0||REPR ELBOW LAT LIGMNT W/TISS|| 80001|24344||1295.39|0|1295.39|0||RECONSTRUCT ELBOW LAT LIGMNT|| 80001|24345||830.73|0|830.73|0||REPR ELBW MED LIGMNT W/TISSU|| 80001|24346||1295.39|0|1295.39|0||RECONSTRUCT ELBOW MED LIGMNT|| 80001|24357||503.8|0|503.8|0||REPAIR ELBOW - PERC|| 80001|24358||610.37|0|610.37|0||REPAIR ELBOW W/DEB - OPEN|| 80001|24359||772.13|0|772.13|0||REPAIR ELBOW DEB/ATTCH OPEN|| 80001|24360||1061.71|0|1061.71|0||RECONSTRUCT ELBOW JOINT|| 80001|24361||1188.76|0|1188.76|0||RECONSTRUCT ELBOW JOINT|| 80001|24362||1253.24|0|1253.24|0||RECONSTRUCT ELBOW JOINT|| 80001|24363||1724.08|0|1724.08|0||REPLACE ELBOW JOINT|| 80001|24365||751.59|0|751.59|0||RECONSTRUCT HEAD OF RADIUS|| 80001|24366||799.79|0|799.79|0||RECONSTRUCT HEAD OF RADIUS|| 80001|24370||1839.44|0|1839.44|0||REVISE RECONST ELBOW JOINT|| 80001|24371||2132.53|0|2132.53|0||REVISE RECONST ELBOW JOINT|| 80001|24400||962.75|0|962.75|0||REVISION OF HUMERUS|| 80001|24410||1249.21|0|1249.21|0||REVISION OF HUMERUS|| 80001|24420||1170.26|0|1170.26|0||REVISION OF HUMERUS|| 80001|24430||1247.46|0|1247.46|0||REPAIR OF HUMERUS|| 80001|24435||1268.8|0|1268.8|0||REPAIR HUMERUS WITH GRAFT|| 80001|24470||788.62|0|788.62|0||REVISION OF ELBOW JOINT|| 80001|24495||635.98|0|635.98|0||DECOMPRESSION OF FOREARM|| 80001|24498||1024.33|0|1024.33|0||REINFORCE HUMERUS|| 80001|24500||411.17|0|375.5|0||TREAT HUMERUS FRACTURE|| 80001|24505||576.88|0|524.55|0||TREAT HUMERUS FRACTURE|| 80001|24515||1030.57|0|1030.57|0||TREAT HUMERUS FRACTURE|| 80001|24516||1013.83|0|1013.83|0||TREAT HUMERUS FRACTURE|| 80001|24530||436.05|0|396.51|0||TREAT HUMERUS FRACTURE|| 80001|24535||711.2|0|659.26|0||TREAT HUMERUS FRACTURE|| 80001|24538||872.95|0|872.95|0||TREAT HUMERUS FRACTURE|| 80001|24545||1095.58|0|1095.58|0||TREAT HUMERUS FRACTURE|| 80001|24546||1225.42|0|1225.42|0||TREAT HUMERUS FRACTURE|| 80001|24560||366.24|0|329.02|0||TREAT HUMERUS FRACTURE|| 80001|24565||617.38|0|568.92|0||TREAT HUMERUS FRACTURE|| 80001|24566||839.98|0|839.98|0||TREAT HUMERUS FRACTURE|| 80001|24575||861.04|0|861.04|0||TREAT HUMERUS FRACTURE|| 80001|24576||389.47|0|351.09|0||TREAT HUMERUS FRACTURE|| 80001|24577||636.61|0|585.83|0||TREAT HUMERUS FRACTURE|| 80001|24579||981.83|0|981.83|0||TREAT HUMERUS FRACTURE|| 80001|24582||945.91|0|945.91|0||TREAT HUMERUS FRACTURE|| 80001|24586||1279.64|0|1279.64|0||TREAT ELBOW FRACTURE|| 80001|24587||1287.09|0|1287.09|0||TREAT ELBOW FRACTURE|| 80001|24600||421.18|0|387.07|0||TREAT ELBOW DISLOCATION|| 80001|24605||547.36|0|547.36|0||TREAT ELBOW DISLOCATION|| 80001|24615||834.42|0|834.42|0||TREAT ELBOW DISLOCATION|| 80001|24620||637.24|0|637.24|0||TREAT ELBOW FRACTURE|| 80001|24635||788.03|0|788.03|0||TREAT ELBOW FRACTURE|| 80001|24640||159.78|0|110.16|0||TREAT ELBOW DISLOCATION|| 80001|24650||298.17|0|274.53|0||TREAT RADIUS FRACTURE|| 80001|24655||500.6|0|457.57|0||TREAT RADIUS FRACTURE|| 80001|24665||762.44|0|762.44|0||TREAT RADIUS FRACTURE|| 80001|24666||860.53|0|860.53|0||TREAT RADIUS FRACTURE|| 80001|24670||333.18|0|301.4|0||TREAT ULNAR FRACTURE|| 80001|24675||525.92|0|482.12|0||TREAT ULNAR FRACTURE|| 80001|24685||765.21|0|765.21|0||TREAT ULNAR FRACTURE|| 80001|24800||976.69|0|976.69|0||FUSION OF ELBOW JOINT|| 80001|24802||1182.93|0|1182.93|0||FUSION/GRAFT OF ELBOW JOINT|| 80001|24900||852.27|0|852.27|0||AMPUTATION OF UPPER ARM|| 80001|24920||863.29|0|863.29|0||AMPUTATION OF UPPER ARM|| 80001|24925||600.81|0|600.81|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|24930||913.67|0|913.67|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|24931||916.22|0|916.22|0||AMPUTATE UPPER ARM & IMPLANT|| 80001|24935||1083.09|0|1083.09|0||REVISION OF AMPUTATION|| 80001|24940||0|0|0|0||REVISION OF UPPER ARM|| 80001|24999||0|0|0|0||UPPER ARM/ELBOW SURGERY|| 80001|25000||388.14|0|388.14|0||INCISION OF TENDON SHEATH|| 80001|25001||397.72|0|397.72|0||INCISE FLEXOR CARPI RADIALIS|| 80001|25020||662.39|0|662.39|0||DECOMPRESS FOREARM 1 SPACE|| 80001|25023||1284.62|0|1284.62|0||DECOMPRESS FOREARM 1 SPACE|| 80001|25024||913.85|0|913.85|0||DECOMPRESS FOREARM 2 SPACES|| 80001|25025||1452.39|0|1452.39|0||DECOMPRESS FOREARM 2 SPACES|| 80001|25028||604.41|0|604.41|0||DRAINAGE OF FOREARM LESION|| 80001|25031||423.84|0|423.84|0||DRAINAGE OF FOREARM BURSA|| 80001|25035||681.01|0|681.01|0||TREAT FOREARM BONE LESION|| 80001|25040||657.85|0|657.85|0||EXPLORE/TREAT WRIST JOINT|| 80001|25065||289.61|0|191.15|0||BIOPSY FOREARM SOFT TISSUES|| 80001|25066||418.06|0|418.06|0||BIOPSY FOREARM SOFT TISSUES|| 80001|25071||499.33|0|499.33|0||EXC FOREARM LES SC > 3 CM|| 80001|25073||623.69|0|623.69|0||EXC FOREARM TUM DEEP = 3 CM|| 80001|25075||545.01|0|367.85|0||REMOVAL FOREARM LESION SUBCU|| 80001|25076||603.36|0|603.36|0||REMOVAL FOREARM LESION DEEP|| 80001|25077||1044.24|0|1044.24|0||REMOVE TUMOR - FOREARM/WRIST|| 80001|25078||1377.24|0|1377.24|0||RESECT FOREARM/WRIST TUM=3CM|| 80001|25085||526.83|0|526.83|0||INCISION OF WRIST CAPSULE|| 80001|25100||402.24|0|402.24|0||BIOPSY OF WRIST JOINT|| 80001|25101||468.97|0|468.97|0||EXPLORE/TREAT WRIST JOINT|| 80001|25105||559.86|0|559.86|0||REMOVE WRIST JOINT LINING|| 80001|25107||719.21|0|719.21|0||REMOVE WRIST JOINT CARTILAGE|| 80001|25109||626.69|0|626.69|0||EXCISE TENDON FOREARM/WRIST|| 80001|25110||395.72|0|395.72|0||REMOVE WRIST TENDON LESION|| 80001|25111||370.22|0|370.22|0||REMOVE WRIST TENDON LESION|| 80001|25112||447.33|0|447.33|0||REREMOVE WRIST TENDON LESION|| 80001|25115||886.32|0|886.32|0||REMOVE WRIST/FOREARM LESION|| 80001|25116||697.65|0|697.65|0||REMOVE WRIST/FOREARM LESION|| 80001|25118||441.58|0|441.58|0||EXCISE WRIST TENDON SHEATH|| 80001|25119||581.67|0|581.67|0||PARTIAL REMOVAL OF ULNA|| 80001|25120||579.19|0|579.19|0||REMOVAL OF FOREARM LESION|| 80001|25125||700.9|0|700.9|0||REMOVE/GRAFT FOREARM LESION|| 80001|25126||700.04|0|700.04|0||REMOVE/GRAFT FOREARM LESION|| 80001|25130||517.72|0|517.72|0||REMOVAL OF WRIST LESION|| 80001|25135||653.33|0|653.33|0||REMOVE & GRAFT WRIST LESION|| 80001|25136||576.32|0|576.32|0||REMOVE & GRAFT WRIST LESION|| 80001|25145||604.44|0|604.44|0||REMOVE FOREARM BONE LESION|| 80001|25150||664.73|0|664.73|0||PARTIAL REMOVAL OF ULNA|| 80001|25151||688.15|0|688.15|0||PARTIAL REMOVAL OF RADIUS|| 80001|25170||1756.1|0|1756.1|0||EXTENSIVE FOREARM SURGERY|| 80001|25210||566.49|0|566.49|0||REMOVAL OF WRIST BONE|| 80001|25215||721.52|0|721.52|0||REMOVAL OF WRIST BONES|| 80001|25230||503.51|0|503.51|0||PARTIAL REMOVAL OF RADIUS|| 80001|25240||496.65|0|496.65|0||PARTIAL REMOVAL OF ULNA|| 80001|25246||185.44|0|90.86|0||INJECTION FOR WRIST X-RAY|| 80001|25248||483.51|0|483.51|0||REMOVE FOREARM FOREIGN BODY|| 80001|25250||620.57|0|620.57|0||REMOVAL OF WRIST PROSTHESIS|| 80001|25251||830.83|0|830.83|0||REMOVAL OF WRIST PROSTHESIS|| 80001|25259||479.06|0|479.06|0||MANIPULATE WRIST W/ANESTHES|| 80001|25260||735.05|0|735.05|0||REPAIR FOREARM TENDON/MUSCLE|| 80001|25263||734.31|0|734.31|0||REPAIR FOREARM TENDON/MUSCLE|| 80001|25265||880.61|0|880.61|0||REPAIR FOREARM TENDON/MUSCLE|| 80001|25270||569.82|0|569.82|0||REPAIR FOREARM TENDON/MUSCLE|| 80001|25272||649.64|0|649.64|0||REPAIR FOREARM TENDON/MUSCLE|| 80001|25274||787.89|0|787.89|0||REPAIR FOREARM TENDON/MUSCLE|| 80001|25275||784.05|0|784.05|0||REPAIR FOREARM TENDON SHEATH|| 80001|25280||656.19|0|656.19|0||REVISE WRIST/FOREARM TENDON|| 80001|25290||507.26|0|507.26|0||INCISE WRIST/FOREARM TENDON|| 80001|25295||609.07|0|609.07|0||RELEASE WRIST/FOREARM TENDON|| 80001|25300||803.75|0|803.75|0||FUSION OF TENDONS AT WRIST|| 80001|25301||751.81|0|751.81|0||FUSION OF TENDONS AT WRIST|| 80001|25310||722.81|0|722.81|0||TRANSPLANT FOREARM TENDON|| 80001|25312||841.33|0|841.33|0||TRANSPLANT FOREARM TENDON|| 80001|25315||908.75|0|908.75|0||REVISE PALSY HAND TENDON(S)|| 80001|25316||1077.45|0|1077.45|0||REVISE PALSY HAND TENDON(S)|| 80001|25320||1151.92|0|1151.92|0||REPAIR/REVISE WRIST JOINT|| 80001|25332||985.04|0|985.04|0||REVISE WRIST JOINT|| 80001|25335||1112.56|0|1112.56|0||REALIGNMENT OF HAND|| 80001|25337||1038.12|0|1038.12|0||RECONSTRUCT ULNA/RADIOULNAR|| 80001|25350||788.88|0|788.88|0||REVISION OF RADIUS|| 80001|25355||902.27|0|902.27|0||REVISION OF RADIUS|| 80001|25360||766.05|0|766.05|0||REVISION OF ULNA|| 80001|25365||1078.65|0|1078.65|0||REVISE RADIUS & ULNA|| 80001|25370||1186.23|0|1186.23|0||REVISE RADIUS OR ULNA|| 80001|25375||1124.11|0|1124.11|0||REVISE RADIUS & ULNA|| 80001|25390||902.18|0|902.18|0||SHORTEN RADIUS OR ULNA|| 80001|25391||1176.17|0|1176.17|0||LENGTHEN RADIUS OR ULNA|| 80001|25392||1186.24|0|1186.24|0||SHORTEN RADIUS & ULNA|| 80001|25393||1326.34|0|1326.34|0||LENGTHEN RADIUS & ULNA|| 80001|25394||935.46|0|935.46|0||REPAIR CARPAL BONE - SHORTEN|| 80001|25400||943.12|0|943.12|0||REPAIR RADIUS OR ULNA|| 80001|25405||1218.47|0|1218.47|0||REPAIR/GRAFT RADIUS OR ULNA|| 80001|25415||1142.27|0|1142.27|0||REPAIR RADIUS & ULNA|| 80001|25420||1382.14|0|1382.14|0||REPAIR/GRAFT RADIUS & ULNA|| 80001|25425||1136.1|0|1136.1|0||REPAIR/GRAFT RADIUS OR ULNA|| 80001|25426||1329.92|0|1329.92|0||REPAIR/GRAFT RADIUS & ULNA|| 80001|25430||859.51|0|859.51|0||VASC GRAFT INTO CARPAL BONE|| 80001|25431||917.68|0|917.68|0||REPAIR NONUNION CARPAL BONE|| 80001|25440||900.93|0|900.93|0||REPAIR/GRAFT WRIST BONE|| 80001|25441||1093.35|0|1093.35|0||RECONSTRUCT WRIST JOINT|| 80001|25442||933.81|0|933.81|0||RECONSTRUCT WRIST JOINT|| 80001|25443||919.51|0|919.51|0||RECONSTRUCT WRIST JOINT|| 80001|25444||972.47|0|972.47|0||RECONSTRUCT WRIST JOINT|| 80001|25445||845.87|0|845.87|0||RECONSTRUCT WRIST JOINT|| 80001|25446||1378.52|0|1378.52|0||WRIST REPLACEMENT|| 80001|25447||968.07|0|968.07|0||REPAIR WRIST JOINT(S)|| 80001|25449||1211.52|0|1211.52|0||REMOVE WRIST JOINT IMPLANT|| 80001|25450||589.17|0|589.17|0||REVISION OF WRIST JOINT|| 80001|25455||698.73|0|698.73|0||REVISION OF WRIST JOINT|| 80001|25490||782.84|0|782.84|0||REINFORCE RADIUS|| 80001|25491||871.13|0|871.13|0||REINFORCE ULNA|| 80001|25492||1065.54|0|1065.54|0||REINFORCE RADIUS AND ULNA|| 80001|25500||311.85|0|287.04|0||TREAT FRACTURE OF RADIUS|| 80001|25505||579.06|0|532.93|0||TREAT FRACTURE OF RADIUS|| 80001|25515||784.93|0|784.93|0||TREAT FRACTURE OF RADIUS|| 80001|25520||659.31|0|627.13|0||TREAT FRACTURE OF RADIUS|| 80001|25525||920.93|0|920.93|0||TREAT FRACTURE OF RADIUS|| 80001|25526||1126.23|0|1126.23|0||TREAT FRACTURE OF RADIUS|| 80001|25530||299.03|0|271.12|0||TREAT FRACTURE OF ULNA|| 80001|25535||565.89|0|525.58|0||TREAT FRACTURE OF ULNA|| 80001|25545||728.42|0|728.42|0||TREAT FRACTURE OF ULNA|| 80001|25560||317.23|0|287.77|0||TREAT FRACTURE RADIUS & ULNA|| 80001|25565||600.6|0|546.71|0||TREAT FRACTURE RADIUS & ULNA|| 80001|25574||789.58|0|789.58|0||TREAT FRACTURE RADIUS & ULNA|| 80001|25575||1057.29|0|1057.29|0||TREAT FRACTURE RADIUS/ULNA|| 80001|25600||373.89|0|354.12|0||TREAT FRACTURE RADIUS/ULNA|| 80001|25605||631.43|0|595.38|0||TREAT FRACTURE RADIUS/ULNA|| 80001|25606||775.03|0|775.03|0||TREAT FX DISTAL RADIAL|| 80001|25607||859.2|0|859.2|0||TREAT FX RAD EXTRA-ARTICUL|| 80001|25608||965.86|0|965.86|0||TREAT FX RAD INTRA-ARTICUL|| 80001|25609||1228.89|0|1228.89|0||TREAT FX RADIAL 3+ FRAG|| 80001|25622||346.8|0|316.95|0||TREAT WRIST BONE FRACTURE|| 80001|25624||551.68|0|504.39|0||TREAT WRIST BONE FRACTURE|| 80001|25628||843.39|0|843.39|0||TREAT WRIST BONE FRACTURE|| 80001|25630||349.79|0|322.27|0||TREAT WRIST BONE FRACTURE|| 80001|25635||514.15|0|460.27|0||TREAT WRIST BONE FRACTURE|| 80001|25645||668.01|0|668.01|0||TREAT WRIST BONE FRACTURE|| 80001|25650||366.17|0|344.46|0||TREAT WRIST BONE FRACTURE|| 80001|25651||562.47|0|562.47|0||PIN ULNAR STYLOID FRACTURE|| 80001|25652||729.34|0|729.34|0||TREAT FRACTURE ULNAR STYLOID|| 80001|25660||475.03|0|475.03|0||TREAT WRIST DISLOCATION|| 80001|25670||707.74|0|707.74|0||TREAT WRIST DISLOCATION|| 80001|25671||618.43|0|618.43|0||PIN RADIOULNAR DISLOCATION|| 80001|25675||504.1|0|461.45|0||TREAT WRIST DISLOCATION|| 80001|25676||737.35|0|737.35|0||TREAT WRIST DISLOCATION|| 80001|25680||545.64|0|545.64|0||TREAT WRIST FRACTURE|| 80001|25685||866.61|0|866.61|0||TREAT WRIST FRACTURE|| 80001|25690||560.13|0|560.13|0||TREAT WRIST DISLOCATION|| 80001|25695||744.13|0|744.13|0||TREAT WRIST DISLOCATION|| 80001|25800||857.54|0|857.54|0||FUSION OF WRIST JOINT|| 80001|25805||995.16|0|995.16|0||FUSION/GRAFT OF WRIST JOINT|| 80001|25810||1016.21|0|1016.21|0||FUSION/GRAFT OF WRIST JOINT|| 80001|25820||715.84|0|715.84|0||FUSION OF HAND BONES|| 80001|25825||882.23|0|882.23|0||FUSE HAND BONES WITH GRAFT|| 80001|25830||1108.1|0|1108.1|0||FUSION - RADIOULNAR JNT/ULNA|| 80001|25900||827.25|0|827.25|0||AMPUTATION OF FOREARM|| 80001|25905||825.64|0|825.64|0||AMPUTATION OF FOREARM|| 80001|25907||719.42|0|719.42|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|25909||806.19|0|806.19|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|25915||1161.21|0|1161.21|0||AMPUTATION OF FOREARM|| 80001|25920||816.97|0|816.97|0||AMPUTATE HAND AT WRIST|| 80001|25922||715.15|0|715.15|0||AMPUTATE HAND AT WRIST|| 80001|25924||797.4|0|797.4|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|25927||942.45|0|942.45|0||AMPUTATION OF HAND|| 80001|25929||643.46|0|643.46|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|25931||863.4|0|863.4|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|25999||0|0|0|0||FOREARM OR WRIST SURGERY|| 80001|26010||297.33|0|159.32|0||DRAINAGE OF FINGER ABSCESS|| 80001|26011||438.97|0|215.3|0||DRAINAGE OF FINGER ABSCESS|| 80001|26020||503.02|0|503.02|0||DRAIN HAND TENDON SHEATH|| 80001|26025||491|0|491|0||DRAINAGE OF PALM BURSA|| 80001|26030||572.89|0|572.89|0||DRAINAGE OF PALM BURSA(S)|| 80001|26034||626.91|0|626.91|0||TREAT HAND BONE LESION|| 80001|26035||1006.75|0|1006.75|0||DECOMPRESS FINGERS/HAND|| 80001|26037||660.1|0|660.1|0||DECOMPRESS FINGERS/HAND|| 80001|26040||359.44|0|359.44|0||RELEASE PALM CONTRACTURE|| 80001|26045||544.65|0|544.65|0||RELEASE PALM CONTRACTURE|| 80001|26055||628.49|0|356.74|0||INCISE FINGER TENDON SHEATH|| 80001|26060||303.14|0|303.14|0||INCISION OF FINGER TENDON|| 80001|26070||366.78|0|366.78|0||EXPLORE/TREAT HAND JOINT|| 80001|26075||386.61|0|386.61|0||EXPLORE/TREAT FINGER JOINT|| 80001|26080||451.1|0|451.1|0||EXPLORE/TREAT FINGER JOINT|| 80001|26100||389.21|0|389.21|0||BIOPSY HAND JOINT LINING|| 80001|26105||391.71|0|391.71|0||BIOPSY FINGER JOINT LINING|| 80001|26110||371.52|0|371.52|0||BIOPSY FINGER JOINT LINING|| 80001|26111||488.23|0|488.23|0||EXC HAND LES SC > 1.5 CM|| 80001|26113||639.17|0|639.17|0||EXC HAND TUM DEEP > 1.5 CM|| 80001|26115||573.68|0|386.06|0||REMOVAL HAND LESION SUBCUT|| 80001|26116||614.2|0|614.2|0||REMOVAL HAND LESION - DEEP|| 80001|26117||872.93|0|872.93|0||REMOVE TUMOR - HAND/FINGER|| 80001|26118||1241.62|0|1241.62|0||EXC HAND TUM RA > 3 CM|| 80001|26121||696.86|0|696.86|0||RELEASE PALM CONTRACTURE|| 80001|26123||972.75|0|972.75|0||RELEASE PALM CONTRACTURE|| 80001|26125||326.85|0|326.85|0||RELEASE PALM CONTRACTURE|| 80001|26130||539.4|0|539.4|0||REMOVE WRIST JOINT LINING|| 80001|26135||639.55|0|639.55|0||REVISE FINGER JOINT - EACH|| 80001|26140||586.08|0|586.08|0||REVISE FINGER JOINT - EACH|| 80001|26145||596.44|0|596.44|0||TENDON EXCISION - PALM/FINGER|| 80001|26160||647.95|0|384.74|0||REMOVE TENDON SHEATH LESION|| 80001|26170||471.24|0|471.24|0||REMOVAL OF PALM TENDON - EACH|| 80001|26180||514.26|0|514.26|0||REMOVAL OF FINGER TENDON|| 80001|26185||629.08|0|629.08|0||REMOVE FINGER BONE|| 80001|26200||521.8|0|521.8|0||REMOVE HAND BONE LESION|| 80001|26205||706.3|0|706.3|0||REMOVE/GRAFT BONE LESION|| 80001|26210||512.59|0|512.59|0||REMOVAL OF FINGER LESION|| 80001|26215||659.6|0|659.6|0||REMOVE/GRAFT FINGER LESION|| 80001|26230||581.6|0|581.6|0||PARTIAL REMOVAL OF HAND BONE|| 80001|26235||574.4|0|574.4|0||PARTIAL REMOVAL - FINGER BONE|| 80001|26236||511.66|0|511.66|0||PARTIAL REMOVAL - FINGER BONE|| 80001|26250||1264.24|0|1264.24|0||EXTENSIVE HAND SURGERY|| 80001|26260||947.29|0|947.29|0||EXTENSIVE FINGER SURGERY|| 80001|26262||743.94|0|743.94|0||PARTIAL REMOVAL OF FINGER|| 80001|26320||401.4|0|401.4|0||REMOVAL OF IMPLANT FROM HAND|| 80001|26340||380.18|0|380.18|0||MANIPULATE FINGER W/ANESTH|| 80001|26341||113.32|0|87.34|0||MANIPULAT PALM CORD POST INJ|| 80001|26350||803.37|0|803.37|0||REPAIR FINGER/HAND TENDON|| 80001|26352||921.96|0|921.96|0||REPAIR/GRAFT HAND TENDON|| 80001|26356||1244.13|0|1244.13|0||REPAIR FINGER/HAND TENDON|| 80001|26357||995.7|0|995.7|0||REPAIR FINGER/HAND TENDON|| 80001|26358||1023.77|0|1023.77|0||REPAIR/GRAFT HAND TENDON|| 80001|26370||860.4|0|860.4|0||REPAIR FINGER/HAND TENDON|| 80001|26372||1012.65|0|1012.65|0||REPAIR/GRAFT HAND TENDON|| 80001|26373||943.62|0|943.62|0||REPAIR FINGER/HAND TENDON|| 80001|26390||962.17|0|962.17|0||REVISE HAND/FINGER TENDON|| 80001|26392||1118.06|0|1118.06|0||REPAIR/GRAFT HAND TENDON|| 80001|26410||635.78|0|635.78|0||REPAIR HAND TENDON|| 80001|26412||787.53|0|787.53|0||REPAIR/GRAFT HAND TENDON|| 80001|26415||783.41|0|783.41|0||EXCISION - HAND/FINGER TENDON|| 80001|26416||1017.01|0|1017.01|0||GRAFT HAND OR FINGER TENDON|| 80001|26418||648.42|0|648.42|0||REPAIR FINGER TENDON|| 80001|26420||802.31|0|802.31|0||REPAIR/GRAFT FINGER TENDON|| 80001|26426||582.89|0|582.89|0||REPAIR FINGER/HAND TENDON|| 80001|26428||839.17|0|839.17|0||REPAIR/GRAFT FINGER TENDON|| 80001|26432||563.32|0|563.32|0||REPAIR FINGER TENDON|| 80001|26433||599.42|0|599.42|0||REPAIR FINGER TENDON|| 80001|26434||737.33|0|737.33|0||REPAIR/GRAFT FINGER TENDON|| 80001|26437||705.88|0|705.88|0||REALIGNMENT OF TENDONS|| 80001|26440||696.8|0|696.8|0||RELEASE PALM/FINGER TENDON|| 80001|26442||1096.87|0|1096.87|0||RELEASE PALM & FINGER TENDON|| 80001|26445||645.61|0|645.61|0||RELEASE HAND/FINGER TENDON|| 80001|26449||808.39|0|808.39|0||RELEASE FOREARM/HAND TENDON|| 80001|26450||460.12|0|460.12|0||INCISION OF PALM TENDON|| 80001|26455||457.28|0|457.28|0||INCISION OF FINGER TENDON|| 80001|26460||443.31|0|443.31|0||INCISE HAND/FINGER TENDON|| 80001|26471||694.22|0|694.22|0||FUSION OF FINGER TENDONS|| 80001|26474||683.16|0|683.16|0||FUSION OF FINGER TENDONS|| 80001|26476||663.55|0|663.55|0||TENDON LENGTHENING|| 80001|26477||650.95|0|650.95|0||TENDON SHORTENING|| 80001|26478||699.19|0|699.19|0||LENGTHENING OF HAND TENDON|| 80001|26479||692.31|0|692.31|0||SHORTENING OF HAND TENDON|| 80001|26480||848.24|0|848.24|0||TRANSPLANT HAND TENDON|| 80001|26483||956|0|956|0||TRANSPLANT/GRAFT HAND TENDON|| 80001|26485||914.63|0|914.63|0||TRANSPLANT PALM TENDON|| 80001|26489||1072.6|0|1072.6|0||TRANSPLANT/GRAFT PALM TENDON|| 80001|26490||913.16|0|913.16|0||REVISE THUMB TENDON|| 80001|26492||1014.36|0|1014.36|0||TENDON TRANSFER WITH GRAFT|| 80001|26494||890.48|0|890.48|0||HAND TENDON/MUSCLE TRANSFER|| 80001|26496||975.61|0|975.61|0||REVISE THUMB TENDON|| 80001|26497||995.4|0|995.4|0||FINGER TENDON TRANSFER|| 80001|26498||1332.08|0|1332.08|0||FINGER TENDON TRANSFER|| 80001|26499||932.23|0|932.23|0||REVISION OF FINGER|| 80001|26500||706.1|0|706.1|0||HAND TENDON RECONSTRUCTION|| 80001|26502||811.73|0|811.73|0||HAND TENDON RECONSTRUCTION|| 80001|26508||716.44|0|716.44|0||RELEASE THUMB CONTRACTURE|| 80001|26510||671.58|0|671.58|0||THUMB TENDON TRANSFER|| 80001|26516||794.26|0|794.26|0||FUSION OF KNUCKLE JOINT|| 80001|26517||947.83|0|947.83|0||FUSION OF KNUCKLE JOINTS|| 80001|26518||940.03|0|940.03|0||FUSION OF KNUCKLE JOINTS|| 80001|26520||732.66|0|732.66|0||RELEASE KNUCKLE CONTRACTURE|| 80001|26525||733.18|0|733.18|0||RELEASE FINGER CONTRACTURE|| 80001|26530||626.05|0|626.05|0||REVISE KNUCKLE JOINT|| 80001|26531||727.29|0|727.29|0||REVISE KNUCKLE WITH IMPLANT|| 80001|26535||490.09|0|490.09|0||REVISE FINGER JOINT|| 80001|26536||803.72|0|803.72|0||REVISE/IMPLANT FINGER JOINT|| 80001|26540||744.6|0|744.6|0||REPAIR HAND JOINT|| 80001|26541||914.03|0|914.03|0||REPAIR HAND JOINT WITH GRAFT|| 80001|26542||771.33|0|771.33|0||REPAIR HAND JOINT WITH GRAFT|| 80001|26545||808.14|0|808.14|0||RECONSTRUCT FINGER JOINT|| 80001|26546||1136.89|0|1136.89|0||REPAIR NONUNION HAND|| 80001|26548||864.91|0|864.91|0||RECONSTRUCT FINGER JOINT|| 80001|26550||1917.75|0|1917.75|0||CONSTRUCT THUMB REPLACEMENT|| 80001|26551||3890.19|0|3890.19|0||GREAT TOE-HAND TRANSFER|| 80001|26553||3221.39|0|3221.39|0||SINGLE TRANSFER - TOE-HAND|| 80001|26554||3772.11|0|3772.11|0||DOUBLE TRANSFER - TOE-HAND|| 80001|26555||1591.26|0|1591.26|0||POSITIONAL CHANGE OF FINGER|| 80001|26556||3364.32|0|3364.32|0||TOE JOINT TRANSFER|| 80001|26560||671.66|0|671.66|0||REPAIR OF WEB FINGER|| 80001|26561||1066.71|0|1066.71|0||REPAIR OF WEB FINGER|| 80001|26562||1533.14|0|1533.14|0||REPAIR OF WEB FINGER|| 80001|26565||774.7|0|774.7|0||CORRECT METACARPAL FLAW|| 80001|26567||771.12|0|771.12|0||CORRECT FINGER DEFORMITY|| 80001|26568||1030.85|0|1030.85|0||LENGTHEN METACARPAL/FINGER|| 80001|26580||1761.17|0|1761.17|0||REPAIR HAND DEFORMITY|| 80001|26587||1130.71|0|1130.71|0||RECONSTRUCT EXTRA FINGER|| 80001|26590||1640.9|0|1640.9|0||REPAIR FINGER DEFORMITY|| 80001|26591||487|0|487|0||REPAIR MUSCLES OF HAND|| 80001|26593||677.74|0|677.74|0||RELEASE MUSCLES OF HAND|| 80001|26596||865.03|0|865.03|0||EXCISION CONSTRICTING TISSUE|| 80001|26600||335.11|0|316.11|0||TREAT METACARPAL FRACTURE|| 80001|26605||368.4|0|336.62|0||TREAT METACARPAL FRACTURE|| 80001|26607||532.32|0|532.32|0||TREAT METACARPAL FRACTURE|| 80001|26608||551.6|0|551.6|0||TREAT METACARPAL FRACTURE|| 80001|26615||670.7|0|670.7|0||TREAT METACARPAL FRACTURE|| 80001|26641||434.47|0|397.26|0||TREAT THUMB DISLOCATION|| 80001|26645||494.64|0|455.87|0||TREAT THUMB FRACTURE|| 80001|26650||554.22|0|554.22|0||TREAT THUMB FRACTURE|| 80001|26665||733.84|0|733.84|0||TREAT THUMB FRACTURE|| 80001|26670||388.18|0|354.46|0||TREAT HAND DISLOCATION|| 80001|26675||525.59|0|485.27|0||TREAT HAND DISLOCATION|| 80001|26676||579.57|0|579.57|0||PIN HAND DISLOCATION|| 80001|26685||671.09|0|671.09|0||TREAT HAND DISLOCATION|| 80001|26686||731.4|0|731.4|0||TREAT HAND DISLOCATION|| 80001|26700||371.12|0|349.02|0||TREAT KNUCKLE DISLOCATION|| 80001|26705||480.19|0|441.82|0||TREAT KNUCKLE DISLOCATION|| 80001|26706||505.54|0|505.54|0||PIN KNUCKLE DISLOCATION|| 80001|26715||665.09|0|665.09|0||TREAT KNUCKLE DISLOCATION|| 80001|26720||225.59|0|210.47|0||TREAT FINGER FRACTURE - EACH|| 80001|26725||386.66|0|350.22|0||TREAT FINGER FRACTURE - EACH|| 80001|26727||543.28|0|543.28|0||TREAT FINGER FRACTURE - EACH|| 80001|26735||694.72|0|694.72|0||TREAT FINGER FRACTURE - EACH|| 80001|26740||261.45|0|245.95|0||TREAT FINGER FRACTURE - EACH|| 80001|26742||421.46|0|383.86|0||TREAT FINGER FRACTURE - EACH|| 80001|26746||866.05|0|866.05|0||TREAT FINGER FRACTURE - EACH|| 80001|26750||210.25|0|210.64|0||TREAT FINGER FRACTURE - EACH|| 80001|26755||359.97|0|314.61|0||TREAT FINGER FRACTURE - EACH|| 80001|26756||481.04|0|481.04|0||PIN FINGER FRACTURE - EACH|| 80001|26765||580.87|0|580.87|0||TREAT FINGER FRACTURE - EACH|| 80001|26770||316.57|0|294.09|0||TREAT FINGER DISLOCATION|| 80001|26775||439.67|0|399.74|0||TREAT FINGER DISLOCATION|| 80001|26776||511.93|0|511.93|0||PIN FINGER DISLOCATION|| 80001|26785||634.91|0|634.91|0||TREAT FINGER DISLOCATION|| 80001|26820||902.81|0|902.81|0||THUMB FUSION WITH GRAFT|| 80001|26841||824.65|0|824.65|0||FUSION OF THUMB|| 80001|26842||895.19|0|895.19|0||THUMB FUSION WITH GRAFT|| 80001|26843||845.2|0|845.2|0||FUSION OF HAND JOINT|| 80001|26844||920.92|0|920.92|0||FUSION/GRAFT OF HAND JOINT|| 80001|26850||784.96|0|784.96|0||FUSION OF KNUCKLE|| 80001|26852||905.83|0|905.83|0||FUSION OF KNUCKLE WITH GRAFT|| 80001|26860||636.26|0|636.26|0||FUSION OF FINGER JOINT|| 80001|26861||123.55|0|123.55|0||FUSION OF FINGER JNT - ADD-ON|| 80001|26862||824.8|0|824.8|0||FUSION/GRAFT OF FINGER JOINT|| 80001|26863||273.31|0|273.31|0||FUSE/GRAFT ADDED JOINT|| 80001|26910||817.3|0|817.3|0||AMPUTATE METACARPAL BONE|| 80001|26951||739.06|0|739.06|0||AMPUTATION OF FINGER/THUMB|| 80001|26952||731.67|0|731.67|0||AMPUTATION OF FINGER/THUMB|| 80001|26989||0|0|0|0||HAND/FINGER SURGERY|| 80001|26990||732.37|0|732.37|0||DRAINAGE OF PELVIS LESION|| 80001|26991||809.83|0|610.58|0||DRAINAGE OF PELVIS BURSA|| 80001|26992||1125.67|0|1125.67|0||DRAINAGE OF BONE LESION|| 80001|27000||488.07|0|488.07|0||INCISION OF HIP TENDON|| 80001|27001||633.04|0|633.04|0||INCISION OF HIP TENDON|| 80001|27003||699.58|0|699.58|0||INCISION OF HIP TENDON|| 80001|27005||853.31|0|853.31|0||INCISION OF HIP TENDON|| 80001|27006||865.12|0|865.12|0||INCISION OF HIP TENDONS|| 80001|27025||1072.7|0|1072.7|0||INCISION OF HIP/THIGH FASCIA|| 80001|27027||1048.17|0|1048.17|0||BUTTOCK FASCIOTOMY|| 80001|27030||1107.47|0|1107.47|0||DRAINAGE OF HIP JOINT|| 80001|27033||1147.49|0|1147.49|0||EXPLORATION OF HIP JOINT|| 80001|27035||1271.07|0|1271.07|0||DENERVATION OF HIP JOINT|| 80001|27036||1193.25|0|1193.25|0||EXCISION OF HIP JOINT/MUSCLE|| 80001|27040||393.88|0|235.72|0||BIOPSY OF SOFT TISSUES|| 80001|27041||810.75|0|810.75|0||BIOPSY OF SOFT TISSUES|| 80001|27043||554.02|0|554.02|0||EXC HIP PELVIS LES SC > 3 CM|| 80001|27045||885.53|0|885.53|0||EXC HIP/PELV TUM DEEP > 5 CM|| 80001|27047||542.75|0|426.84|0||REMOVE HIP/PELVIS LESION|| 80001|27048||718.9|0|718.9|0||REMOVE HIP/PELVIS LESION|| 80001|27049||1590.37|0|1590.37|0||REMOVE TUMOR - HIP/PELVIS|| 80001|27050||468.21|0|468.21|0||BIOPSY OF SACROILIAC JOINT|| 80001|27052||679.25|0|679.25|0||BIOPSY OF HIP JOINT|| 80001|27054||803.4|0|803.4|0||REMOVAL OF HIP JOINT LINING|| 80001|27057||1201.04|0|1201.04|0||BUTTOCK FASCIOTOMY W/DBRDMT|| 80001|27059||2166.61|0|2166.61|0||RESECT HIP/PELV TUM > 5 CM|| 80001|27060||544.12|0|544.12|0||REMOVAL OF ISCHIAL BURSA|| 80001|27062||534.29|0|534.29|0||REMOVE FEMUR LESION/BURSA|| 80001|27065||606.02|0|606.02|0||REMOVAL OF HIP BONE LESION|| 80001|27066||956.76|0|956.76|0||REMOVAL OF HIP BONE LESION|| 80001|27067||1222.3|0|1222.3|0||REMOVE/GRAFT HIP BONE LESION|| 80001|27070||997.1|0|997.1|0||PARTIAL REMOVAL OF HIP BONE|| 80001|27071||1074.41|0|1074.41|0||PARTIAL REMOVAL OF HIP BONE|| 80001|27075||2504.34|0|2504.34|0||EXTENSIVE HIP SURGERY|| 80001|27076||3035.47|0|3035.47|0||EXTENSIVE HIP SURGERY|| 80001|27077||3390.08|0|3390.08|0||EXTENSIVE HIP SURGERY|| 80001|27078||2469.58|0|2469.58|0||EXTENSIVE HIP SURGERY|| 80001|27080||603.29|0|603.29|0||REMOVAL OF TAIL BONE|| 80001|27086||335.24|0|196.07|0||REMOVE HIP FOREIGN BODY|| 80001|27087||735.83|0|735.83|0||REMOVE HIP FOREIGN BODY|| 80001|27090||974.02|0|974.02|0||REMOVAL OF HIP PROSTHESIS|| 80001|27091||1895.72|0|1895.72|0||REMOVAL OF HIP PROSTHESIS|| 80001|27093||212.31|0|84.39|0||INJECTION FOR HIP X-RAY|| 80001|27095||272.89|0|99.22|0||INJECTION FOR HIP X-RAY|| 80001|27096||183.24|0|100.28|0||INJECT SACROILIAC JOINT|| 80001|27097||802.52|0|802.52|0||REVISION OF HIP TENDON|| 80001|27098||816.7|0|816.7|0||TRANSFER TENDON TO PELVIS|| 80001|27100||972.55|0|972.55|0||TRANSFER OF ABDOMINAL MUSCLE|| 80001|27105||1021.33|0|1021.33|0||TRANSFER OF SPINAL MUSCLE|| 80001|27110||1143.69|0|1143.69|0||TRANSFER OF ILIOPSOAS MUSCLE|| 80001|27111||1061.4|0|1061.4|0||TRANSFER OF ILIOPSOAS MUSCLE|| 80001|27120||1542.27|0|1542.27|0||RECONSTRUCTION OF HIP SOCKET|| 80001|27122||1298.46|0|1298.46|0||RECONSTRUCTION OF HIP SOCKET|| 80001|27125||1341.59|0|1341.59|0||PARTIAL HIP REPLACEMENT|| 80001|27130||1609.94|0|1609.94|0||TOTAL HIP ARTHROPLASTY|| 80001|27132||1989.21|0|1989.21|0||TOTAL HIP ARTHROPLASTY|| 80001|27134||2280.36|0|2280.36|0||REVISE HIP JOINT REPLACEMENT|| 80001|27137||1750.06|0|1750.06|0||REVISE HIP JOINT REPLACEMENT|| 80001|27138||1818.42|0|1818.42|0||REVISE HIP JOINT REPLACEMENT|| 80001|27140||1059.48|0|1059.48|0||TRANSPLANT FEMUR RIDGE|| 80001|27146||1519.5|0|1519.5|0||INCISION OF HIP BONE|| 80001|27147||1746.96|0|1746.96|0||REVISION OF HIP BONE|| 80001|27151||1892.04|0|1892.04|0||INCISION OF HIP BONES|| 80001|27156||2041.27|0|2041.27|0||REVISION OF HIP BONES|| 80001|27158||1665.67|0|1665.67|0||REVISION OF PELVIS|| 80001|27161||1439.35|0|1439.35|0||INCISION OF NECK OF FEMUR|| 80001|27165||1623.93|0|1623.93|0||INCISION/FIXATION OF FEMUR|| 80001|27170||1395.86|0|1395.86|0||REPAIR/GRAFT FEMUR HEAD/NECK|| 80001|27175||787.5|0|787.5|0||TREAT SLIPPED EPIPHYSIS|| 80001|27176||1083.74|0|1083.74|0||TREAT SLIPPED EPIPHYSIS|| 80001|27177||1318.26|0|1318.26|0||TREAT SLIPPED EPIPHYSIS|| 80001|27178||1083.74|0|1083.74|0||TREAT SLIPPED EPIPHYSIS|| 80001|27179||1153.87|0|1153.87|0||REVISE HEAD/NECK OF FEMUR|| 80001|27181||1329.12|0|1329.12|0||TREAT SLIPPED EPIPHYSIS|| 80001|27185||694.42|0|694.42|0||REVISION OF FEMUR EPIPHYSIS|| 80001|27187||1171.28|0|1171.28|0||REINFORCE HIP BONES|| 80001|27193||550.5|0|557.48|0||TREAT PELVIC RING FRACTURE|| 80001|27194||840.29|0|840.29|0||TREAT PELVIC RING FRACTURE|| 80001|27197||144.27|0|144.27|0||CLSD TX PELVIC RING FX|| 80001|27198||367.79|0|367.79|0||CLSD TX PELVIC RING FX|| 80001|27200||208.46|0|216.99|0||TREAT TAIL BONE FRACTURE|| 80001|27202||627.21|0|627.21|0||TREAT TAIL BONE FRACTURE|| 80001|27215||713.2|0|713.2|0||TREAT PELVIC FRACTURE(S)|| 80001|27216||1058.8|0|1058.8|0||TREAT PELVIC RING FRACTURE|| 80001|27217||993.22|0|993.22|0||TREAT PELVIC RING FRACTURE|| 80001|27218||1373.04|0|1373.04|0||TREAT PELVIC RING FRACTURE|| 80001|27220||620.43|0|615.01|0||TREAT HIP SOCKET FRACTURE|| 80001|27222||1155.25|0|1155.25|0||TREAT HIP SOCKET FRACTURE|| 80001|27226||1252.77|0|1252.77|0||TREAT HIP WALL FRACTURE|| 80001|27227||1972.11|0|1972.11|0||TREAT HIP FRACTURE(S)|| 80001|27228||2250.25|0|2250.25|0||TREAT HIP FRACTURE(S)|| 80001|27230||553.14|0|549.27|0||TREAT THIGH FRACTURE|| 80001|27232||894.28|0|894.28|0||TREAT THIGH FRACTURE|| 80001|27235||1074.39|0|1074.39|0||TREAT THIGH FRACTURE|| 80001|27236||1416.4|0|1416.4|0||TREAT THIGH FRACTURE|| 80001|27238||537.37|0|537.37|0||TREAT THIGH FRACTURE|| 80001|27240||1130.66|0|1130.66|0||TREAT THIGH FRACTURE|| 80001|27244||1458.46|0|1458.46|0||TREAT THIGH FRACTURE|| 80001|27245||1458.07|0|1458.07|0||TREAT THIGH FRACTURE|| 80001|27246||449.6|0|451.15|0||TREAT THIGH FRACTURE|| 80001|27248||878.54|0|878.54|0||TREAT THIGH FRACTURE|| 80001|27250||219.51|0|219.51|0||TREAT HIP DISLOCATION|| 80001|27252||897.86|0|897.86|0||TREAT HIP DISLOCATION|| 80001|27253||1111.43|0|1111.43|0||TREAT HIP DISLOCATION|| 80001|27254||1508.73|0|1508.73|0||TREAT HIP DISLOCATION|| 80001|27256||354.12|0|281.62|0||TREAT HIP DISLOCATION|| 80001|27257||405.48|0|405.48|0||TREAT HIP DISLOCATION|| 80001|27258||1314.39|0|1314.39|0||TREAT HIP DISLOCATION|| 80001|27259||1844.84|0|1844.84|0||TREAT HIP DISLOCATION|| 80001|27265||464.15|0|464.15|0||TREAT HIP DISLOCATION|| 80001|27266||683.16|0|683.16|0||TREAT HIP DISLOCATION|| 80001|27267||506.04|0|506.04|0||CLTX THIGH FX|| 80001|27268||632.58|0|632.58|0||CLTX THIGH FX W/MNPJ|| 80001|27269||1476.7|0|1476.7|0||OPTX THIGH FX|| 80001|27275||213.72|0|213.72|0||MANIPULATION OF HIP JOINT|| 80001|27279||661.75|0|661.75|0||ARTHRODESIS SACROILIAC JOINT|| 80001|27280||1272.2|0|1272.2|0||FUSION OF SACROILIAC JOINT|| 80001|27282||885.59|0|885.59|0||FUSION OF PUBIC BONES|| 80001|27284||1822.91|0|1822.91|0||FUSION OF HIP JOINT|| 80001|27286||1966.44|0|1966.44|0||FUSION OF HIP JOINT|| 80001|27290||1931.15|0|1931.15|0||AMPUTATION OF LEG AT HIP|| 80001|27295||1495.23|0|1495.23|0||AMPUTATION OF LEG AT HIP|| 80001|27299||0|0|0|0||PELVIS/HIP JOINT SURGERY|| 80001|27301||763.65|0|581.84|0||DRAIN THIGH/KNEE LESION|| 80001|27303||748.14|0|748.14|0||DRAINAGE OF BONE LESION|| 80001|27305||563.29|0|563.29|0||INCISE THIGH TENDON & FASCIA|| 80001|27306||420.46|0|420.46|0||INCISION OF THIGH TENDON|| 80001|27307||561.62|0|561.62|0||INCISION OF THIGH TENDONS|| 80001|27310||859.6|0|859.6|0||EXPLORATION OF KNEE JOINT|| 80001|27323||307.95|0|207.55|0||BIOPSY - THIGH SOFT TISSUES|| 80001|27324||463.73|0|463.73|0||BIOPSY - THIGH SOFT TISSUES|| 80001|27325||600.02|0|600.02|0||NEURECTOMY - HAMSTRING|| 80001|27326||601.03|0|601.03|0||NEURECTOMY - POPLITEAL|| 80001|27327||526.03|0|366.31|0||REMOVAL OF THIGH LESION|| 80001|27328||732.08|0|732.08|0||REMOVAL OF THIGH LESION|| 80001|27329||1225.54|0|1225.54|0||REMOVE TUMOR - THIGH/KNEE|| 80001|27330||484.95|0|484.95|0||BIOPSY - KNEE JOINT LINING|| 80001|27331||556.4|0|556.4|0||EXPLORE/TREAT KNEE JOINT|| 80001|27332||754.77|0|754.77|0||REMOVAL OF KNEE CARTILAGE|| 80001|27333||686.8|0|686.8|0||REMOVAL OF KNEE CARTILAGE|| 80001|27334||803.32|0|803.32|0||REMOVE KNEE JOINT LINING|| 80001|27335||898.46|0|898.46|0||REMOVE KNEE JOINT LINING|| 80001|27337||491.59|0|491.59|0||EXC THIGH/KNEE LES SC > 3 CM|| 80001|27339||890.19|0|890.19|0||EXC THIGH/KNEE TUM DEEP >5CM|| 80001|27340||432.24|0|432.24|0||REMOVAL OF KNEECAP BURSA|| 80001|27345||562.52|0|562.52|0||REMOVAL OF KNEE CYST|| 80001|27347||618.83|0|618.83|0||REMOVE KNEE CYST|| 80001|27350||764.16|0|764.16|0||REMOVAL OF KNEECAP|| 80001|27355||708.15|0|708.15|0||REMOVE FEMUR LESION|| 80001|27356||869.32|0|869.32|0||REMOVE FEMUR LESION/GRAFT|| 80001|27357||956.98|0|956.98|0||REMOVE FEMUR LESION/GRAFT|| 80001|27358||335.2|0|335.2|0||REMOVE FEMUR LESION/FIXATION|| 80001|27360||1000.15|0|1000.15|0||PARTIAL REMOVAL - LEG BONE(S)|| 80001|27364||1859.56|0|1859.56|0||RESECT THIGH/KNEE TUM >5 CM|| 80001|27365||2458.29|0|2458.29|0||EXTENSIVE LEG SURGERY|| 80001|27370||174.77|0|60.8|0||INJECTION FOR KNEE X-RAY|| 80001|27372||696.65|0|473.36|0||REMOVAL OF FOREIGN BODY|| 80001|27380||694.1|0|694.1|0||REPAIR OF KNEECAP TENDON|| 80001|27381||934.65|0|934.65|0||REPAIR/GRAFT KNEECAP TENDON|| 80001|27385||670.1|0|670.1|0||REPAIR OF THIGH MUSCLE|| 80001|27386||972.72|0|972.72|0||REPAIR/GRAFT OF THIGH MUSCLE|| 80001|27390||524.02|0|524.02|0||INCISION OF THIGH TENDON|| 80001|27391||676.85|0|676.85|0||INCISION OF THIGH TENDONS|| 80001|27392||838.22|0|838.22|0||INCISION OF THIGH TENDONS|| 80001|27393||597.68|0|597.68|0||LENGTHENING OF THIGH TENDON|| 80001|27394||764.34|0|764.34|0||LENGTHENING OF THIGH TENDONS|| 80001|27395||1035.78|0|1035.78|0||LENGTHENING OF THIGH TENDONS|| 80001|27396||723.17|0|723.17|0||TRANSPLANT OF THIGH TENDON|| 80001|27397||1080.27|0|1080.27|0||TRANSPLANTS OF THIGH TENDONS|| 80001|27400||817.52|0|817.52|0||REVISE THIGH MUSCLES/TENDONS|| 80001|27403||752.75|0|752.75|0||REPAIR OF KNEE CARTILAGE|| 80001|27405||794.69|0|794.69|0||REPAIR OF KNEE LIGAMENT|| 80001|27407||933.14|0|933.14|0||REPAIR OF KNEE LIGAMENT|| 80001|27409||1139.55|0|1139.55|0||REPAIR OF KNEE LIGAMENTS|| 80001|27412||1963.77|0|1963.77|0||AUTOCHONDROCYTE IMPLANT KNEE|| 80001|27415||1629.3|0|1629.3|0||OSTEOCHONDRAL KNEE ALLOGRAFT|| 80001|27416||1159.36|0|1159.36|0||OSTEOCHONDRAL KNEE AUTOGRAFT|| 80001|27418||974.01|0|974.01|0||REPAIR DEGENERATED KNEECAP|| 80001|27420||870.43|0|870.43|0||REVISION OF UNSTABLE KNEECAP|| 80001|27422||873.7|0|873.7|0||REVISION OF UNSTABLE KNEECAP|| 80001|27424||881.22|0|881.22|0||REVISION/REMOVAL OF KNEECAP|| 80001|27425||523.01|0|523.01|0||LAT RETINACULAR RELEASE OPEN|| 80001|27427||839.68|0|839.68|0||RECONSTRUCTION - KNEE|| 80001|27428||1315.24|0|1315.24|0||RECONSTRUCTION - KNEE|| 80001|27429||1477.76|0|1477.76|0||RECONSTRUCTION - KNEE|| 80001|27430||866.49|0|866.49|0||REVISION OF THIGH MUSCLES|| 80001|27435||946.81|0|946.81|0||INCISION OF KNEE JOINT|| 80001|27437||777.77|0|777.77|0||REVISE KNEECAP|| 80001|27438||990.79|0|990.79|0||REVISE KNEECAP WITH IMPLANT|| 80001|27440||940.78|0|940.78|0||REVISION OF KNEE JOINT|| 80001|27441||972.61|0|972.61|0||REVISION OF KNEE JOINT|| 80001|27442||1025.47|0|1025.47|0||REVISION OF KNEE JOINT|| 80001|27443||963.12|0|963.12|0||REVISION OF KNEE JOINT|| 80001|27445||1483.83|0|1483.83|0||REVISION OF KNEE JOINT|| 80001|27446||1374.73|0|1374.73|0||REVISION OF KNEE JOINT|| 80001|27447||1609.55|0|1609.55|0||TOTAL KNEE ARTHROPLASTY|| 80001|27448||904.92|0|904.92|0||INCISION OF THIGH|| 80001|27450||1191.93|0|1191.93|0||INCISION OF THIGH|| 80001|27454||1541.53|0|1541.53|0||REALIGNMENT OF THIGH BONE|| 80001|27455||1113.2|0|1113.2|0||REALIGNMENT OF KNEE|| 80001|27457||1136.3|0|1136.3|0||REALIGNMENT OF KNEE|| 80001|27465||1480.88|0|1480.88|0||SHORTENING OF THIGH BONE|| 80001|27466||1402.97|0|1402.97|0||LENGTHENING OF THIGH BONE|| 80001|27468||1593.51|0|1593.51|0||SHORTEN/LENGTHEN THIGHS|| 80001|27470||1390.3|0|1390.3|0||REPAIR OF THIGH|| 80001|27472||1497.66|0|1497.66|0||REPAIR/GRAFT OF THIGH|| 80001|27475||778.54|0|778.54|0||SURGERY TO STOP LEG GROWTH|| 80001|27477||864.11|0|864.11|0||SURGERY TO STOP LEG GROWTH|| 80001|27479||1088.29|0|1088.29|0||SURGERY TO STOP LEG GROWTH|| 80001|27485||789.5|0|789.5|0||SURGERY TO STOP LEG GROWTH|| 80001|27486||1667.13|0|1667.13|0||REVISE/REPLACE KNEE JOINT|| 80001|27487||2087.71|0|2087.71|0||REVISE/REPLACE KNEE JOINT|| 80001|27488||1421.01|0|1421.01|0||REMOVAL OF KNEE PROSTHESIS|| 80001|27495||1334.17|0|1334.17|0||REINFORCE THIGH|| 80001|27496||636.9|0|636.9|0||DECOMPRESSION OF THIGH/KNEE|| 80001|27497||693.72|0|693.72|0||DECOMPRESSION OF THIGH/KNEE|| 80001|27498||769.6|0|769.6|0||DECOMPRESSION OF THIGH/KNEE|| 80001|27499||824.16|0|824.16|0||DECOMPRESSION OF THIGH/KNEE|| 80001|27500||606.08|0|563.44|0||TREATMENT OF THIGH FRACTURE|| 80001|27501||588.53|0|583.49|0||TREATMENT OF THIGH FRACTURE|| 80001|27502||904.71|0|904.71|0||TREATMENT OF THIGH FRACTURE|| 80001|27503||945.05|0|945.05|0||TREATMENT OF THIGH FRACTURE|| 80001|27506||1583.93|0|1583.93|0||TREATMENT OF THIGH FRACTURE|| 80001|27507||1151.44|0|1151.44|0||TREATMENT OF THIGH FRACTURE|| 80001|27508||610.67|0|576.17|0||TREATMENT OF THIGH FRACTURE|| 80001|27509||752.95|0|752.95|0||TREATMENT OF THIGH FRACTURE|| 80001|27510||805.98|0|805.98|0||TREATMENT OF THIGH FRACTURE|| 80001|27511||1182.51|0|1182.51|0||TREATMENT OF THIGH FRACTURE|| 80001|27513||1474.79|0|1474.79|0||TREATMENT OF THIGH FRACTURE|| 80001|27514||1146.54|0|1146.54|0||TREATMENT OF THIGH FRACTURE|| 80001|27516||590.57|0|556.07|0||TREAT THIGH FX GROWTH PLATE|| 80001|27517||806.52|0|806.52|0||TREAT THIGH FX GROWTH PLATE|| 80001|27519||1057.67|0|1057.67|0||TREAT THIGH FX GROWTH PLATE|| 80001|27520||370.77|0|339.37|0||TREAT KNEECAP FRACTURE|| 80001|27524||886.82|0|886.82|0||TREAT KNEECAP FRACTURE|| 80001|27530||345.81|0|321.38|0||TREAT KNEE FRACTURE|| 80001|27532||720.52|0|678.66|0||TREAT KNEE FRACTURE|| 80001|27535||1062.61|0|1062.61|0||TREAT KNEE FRACTURE|| 80001|27536||1408.47|0|1408.47|0||TREAT KNEE FRACTURE|| 80001|27538||548.81|0|515.47|0||TREAT KNEE FRACTURE(S)|| 80001|27540||956.03|0|956.03|0||TREAT KNEE FRACTURE|| 80001|27550||584.89|0|544.57|0||TREAT KNEE DISLOCATION|| 80001|27552||733.36|0|733.36|0||TREAT KNEE DISLOCATION|| 80001|27556||1039.12|0|1039.12|0||TREAT KNEE DISLOCATION|| 80001|27557||1244.55|0|1244.55|0||TREAT KNEE DISLOCATION|| 80001|27558||1421.42|0|1421.42|0||TREAT KNEE DISLOCATION|| 80001|27560||415.64|0|384.63|0||TREAT KNEECAP DISLOCATION|| 80001|27562||565.54|0|565.54|0||TREAT KNEECAP DISLOCATION|| 80001|27566||1055.29|0|1055.29|0||TREAT KNEECAP DISLOCATION|| 80001|27570||176.5|0|176.5|0||FIXATION OF KNEE JOINT|| 80001|27580||1698.07|0|1698.07|0||FUSION OF KNEE|| 80001|27590||967.21|0|967.21|0||AMPUTATE LEG AT THIGH|| 80001|27591||1142.89|0|1142.89|0||AMPUTATE LEG AT THIGH|| 80001|27592||819.77|0|819.77|0||AMPUTATE LEG AT THIGH|| 80001|27594||600.4|0|600.4|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|27596||860.68|0|860.68|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|27598||858.82|0|858.82|0||AMPUTATE LOWER LEG AT KNEE|| 80001|27599||0|0|0|0||LEG SURGERY PROCEDURE|| 80001|27600||490.17|0|490.17|0||DECOMPRESSION OF LOWER LEG|| 80001|27601||526.69|0|526.69|0||DECOMPRESSION OF LOWER LEG|| 80001|27602||586.84|0|586.84|0||DECOMPRESSION OF LOWER LEG|| 80001|27603||610.68|0|455.62|0||DRAIN LOWER LEG LESION|| 80001|27604||564.03|0|402.77|0||DRAIN LOWER LEG BURSA|| 80001|27605||389.58|0|218.24|0||INCISION OF ACHILLES TENDON|| 80001|27606||337.01|0|337.01|0||INCISION OF ACHILLES TENDON|| 80001|27607||719.77|0|719.77|0||TREAT LOWER LEG BONE LESION|| 80001|27610||767.74|0|767.74|0||EXPLORE/TREAT ANKLE JOINT|| 80001|27612||665.69|0|665.69|0||EXPLORATION OF ANKLE JOINT|| 80001|27613||286.52|0|189.99|0||BIOPSY LOWER LEG SOFT TISSUE|| 80001|27614||660.82|0|472.81|0||BIOPSY LOWER LEG SOFT TISSUE|| 80001|27615||1208.84|0|1208.84|0||REMOVE TUMOR - LOWER LEG|| 80001|27616||1504.4|0|1504.4|0||RESECT LEG/ANKLE TUM > 5 CM|| 80001|27618||516.71|0|359.71|0||REMOVE LOWER LEG LESION|| 80001|27619||557.16|0|557.16|0||REMOVE LOWER LEG LESION|| 80001|27620||538.32|0|538.32|0||EXPLORE/TREAT ANKLE JOINT|| 80001|27625||688.52|0|688.52|0||REMOVE ANKLE JOINT LINING|| 80001|27626||728.02|0|728.02|0||REMOVE ANKLE JOINT LINING|| 80001|27630||644.25|0|428.33|0||REMOVAL OF TENDON LESION|| 80001|27632||488.08|0|488.08|0||EXC LEG/ANKLE LES SC > 3 CM|| 80001|27634||809.78|0|809.78|0||EXC LEG/ANKLE TUM DEEP >5 CM|| 80001|27635||691.2|0|691.2|0||REMOVE LOWER LEG BONE LESION|| 80001|27637||899.36|0|899.36|0||REMOVE/GRAFT LEG BONE LESION|| 80001|27638||916.7|0|916.7|0||REMOVE/GRAFT LEG BONE LESION|| 80001|27640||988.82|0|988.82|0||PARTIAL REMOVAL OF TIBIA|| 80001|27641||789.84|0|789.84|0||PARTIAL REMOVAL OF FIBULA|| 80001|27645||2118.85|0|2118.85|0||EXTENSIVE LOWER LEG SURGERY|| 80001|27646||1836.09|0|1836.09|0||EXTENSIVE LOWER LEG SURGERY|| 80001|27647||1232.51|0|1232.51|0||EXTENSIVE ANKLE/HEEL SURGERY|| 80001|27648||183.3|0|62.35|0||INJECTION FOR ANKLE X-RAY|| 80001|27650||775.41|0|775.41|0||REPAIR ACHILLES TENDON|| 80001|27652||813.27|0|813.27|0||REPAIR/GRAFT ACHILLES TENDON|| 80001|27654||835.44|0|835.44|0||REPAIR OF ACHILLES TENDON|| 80001|27656||727.03|0|462.65|0||REPAIR LEG FASCIA DEFECT|| 80001|27658||439.19|0|439.19|0||REPAIR OF LEG TENDON - EACH|| 80001|27659||565.7|0|565.7|0||REPAIR OF LEG TENDON - EACH|| 80001|27664||425.85|0|425.85|0||REPAIR OF LEG TENDON - EACH|| 80001|27665||480.31|0|480.31|0||REPAIR OF LEG TENDON - EACH|| 80001|27675||569.5|0|569.5|0||REPAIR LOWER LEG TENDONS|| 80001|27676||698.86|0|698.86|0||REPAIR LOWER LEG TENDONS|| 80001|27680||506.12|0|506.12|0||RELEASE OF LOWER LEG TENDON|| 80001|27681||641.57|0|641.57|0||RELEASE OF LOWER LEG TENDONS|| 80001|27685||766.25|0|545.29|0||REVISION OF LOWER LEG TENDON|| 80001|27686||662.83|0|662.83|0||REVISE LOWER LEG TENDONS|| 80001|27687||535.95|0|535.95|0||REVISION OF CALF TENDON|| 80001|27690||741.47|0|741.47|0||REVISE LOWER LEG TENDON|| 80001|27691||883.79|0|883.79|0||REVISE LOWER LEG TENDON|| 80001|27692||124.9|0|124.9|0||REVISE ADDITIONAL LEG TENDON|| 80001|27695||560.48|0|560.48|0||REPAIR OF ANKLE LIGAMENT|| 80001|27696||651.64|0|651.64|0||REPAIR OF ANKLE LIGAMENTS|| 80001|27698||755.06|0|755.06|0||REPAIR OF ANKLE LIGAMENT|| 80001|27700||691.93|0|691.93|0||REVISION OF ANKLE JOINT|| 80001|27702||1148.02|0|1148.02|0||RECONSTRUCT ANKLE JOINT|| 80001|27703||1318.02|0|1318.02|0||RECONSTRUCTION - ANKLE JOINT|| 80001|27704||677.44|0|677.44|0||REMOVAL OF ANKLE IMPLANT|| 80001|27705||886.99|0|886.99|0||INCISION OF TIBIA|| 80001|27707||469.92|0|469.92|0||INCISION OF FIBULA|| 80001|27709||1389.85|0|1389.85|0||INCISION OF TIBIA & FIBULA|| 80001|27712||1307.99|0|1307.99|0||REALIGNMENT OF LOWER LEG|| 80001|27715||1243.95|0|1243.95|0||REVISION OF LOWER LEG|| 80001|27720||1032.4|0|1032.4|0||REPAIR OF TIBIA|| 80001|27722||1051.05|0|1051.05|0||REPAIR/GRAFT OF TIBIA|| 80001|27724||1503.35|0|1503.35|0||REPAIR/GRAFT OF TIBIA|| 80001|27725||1443.85|0|1443.85|0||REPAIR OF LOWER LEG|| 80001|27726||1143.84|0|1143.84|0||REPAIR FIBULA NONUNION|| 80001|27727||1016.53|0|1016.53|0||REPAIR OF LOWER LEG|| 80001|27730||688.24|0|688.24|0||REPAIR OF TIBIA EPIPHYSIS|| 80001|27732||522.54|0|522.54|0||REPAIR OF FIBULA EPIPHYSIS|| 80001|27734||771.51|0|771.51|0||REPAIR LOWER LEG EPIPHYSES|| 80001|27740||834.26|0|834.26|0||REPAIR OF LEG EPIPHYSES|| 80001|27742||916.66|0|916.66|0||REPAIR OF LEG EPIPHYSES|| 80001|27745||893.93|0|893.93|0||REINFORCE TIBIA|| 80001|27750||398.59|0|367.19|0||TREATMENT OF TIBIA FRACTURE|| 80001|27752||624.17|0|578.43|0||TREATMENT OF TIBIA FRACTURE|| 80001|27756||676.65|0|676.65|0||TREATMENT OF TIBIA FRACTURE|| 80001|27758||1051.42|0|1051.42|0||TREATMENT OF TIBIA FRACTURE|| 80001|27759||1180|0|1180|0||TREATMENT OF TIBIA FRACTURE|| 80001|27760||382.75|0|350.19|0||TREATMENT OF ANKLE FRACTURE|| 80001|27762||549.3|0|502.78|0||TREATMENT OF ANKLE FRACTURE|| 80001|27766||718.13|0|718.13|0||TREATMENT OF ANKLE FRACTURE|| 80001|27767||323.27|0|324.82|0||CLTX POST ANKLE FX|| 80001|27768||513.39|0|513.39|0||CLTX POST ANKLE FX W/MNPJ|| 80001|27769||855.2|0|855.2|0||OPTX POST ANKLE FX|| 80001|27780||350.46|0|319.45|0||TREATMENT OF FIBULA FRACTURE|| 80001|27781||489.62|0|455.51|0||TREATMENT OF FIBULA FRACTURE|| 80001|27784||843.42|0|843.42|0||TREATMENT OF FIBULA FRACTURE|| 80001|27786||363.31|0|329.59|0||TREATMENT OF ANKLE FRACTURE|| 80001|27788||486.73|0|446.8|0||TREATMENT OF ANKLE FRACTURE|| 80001|27792||768.42|0|768.42|0||TREATMENT OF ANKLE FRACTURE|| 80001|27808||382.74|0|345.53|0||TREATMENT OF ANKLE FRACTURE|| 80001|27810||541.67|0|493.98|0||TREATMENT OF ANKLE FRACTURE|| 80001|27814||909.61|0|909.61|0||TREATMENT OF ANKLE FRACTURE|| 80001|27816||368.57|0|331.75|0||TREATMENT OF ANKLE FRACTURE|| 80001|27818||560.73|0|505.68|0||TREATMENT OF ANKLE FRACTURE|| 80001|27822||987.02|0|987.02|0||TREATMENT OF ANKLE FRACTURE|| 80001|27823||1126.24|0|1126.24|0||TREATMENT OF ANKLE FRACTURE|| 80001|27824||360.33|0|350.25|0||TREAT LOWER LEG FRACTURE|| 80001|27825||635.7|0|579.88|0||TREAT LOWER LEG FRACTURE|| 80001|27826||977.62|0|977.62|0||TREAT LOWER LEG FRACTURE|| 80001|27827||1273.35|0|1273.35|0||TREAT LOWER LEG FRACTURE|| 80001|27828||1529.32|0|1529.32|0||TREAT LOWER LEG FRACTURE|| 80001|27829||802.36|0|802.36|0||TREAT LOWER LEG JOINT|| 80001|27830||434.89|0|406.21|0||TREAT LOWER LEG DISLOCATION|| 80001|27831||466.22|0|466.22|0||TREAT LOWER LEG DISLOCATION|| 80001|27832||890.22|0|890.22|0||TREAT LOWER LEG DISLOCATION|| 80001|27840||428.36|0|428.36|0||TREAT ANKLE DISLOCATION|| 80001|27842||581.97|0|581.97|0||TREAT ANKLE DISLOCATION|| 80001|27846||863.92|0|863.92|0||TREAT ANKLE DISLOCATION|| 80001|27848||961.16|0|961.16|0||TREAT ANKLE DISLOCATION|| 80001|27860||203.93|0|203.93|0||FIXATION OF ANKLE JOINT|| 80001|27870||1221.36|0|1221.36|0||FUSION OF ANKLE JOINT - OPEN|| 80001|27871||806.77|0|806.77|0||FUSION OF TIBIOFIBULAR JOINT|| 80001|27880||1107.36|0|1107.36|0||AMPUTATION OF LOWER LEG|| 80001|27881||1034.62|0|1034.62|0||AMPUTATION OF LOWER LEG|| 80001|27882||721.89|0|721.89|0||AMPUTATION OF LOWER LEG|| 80001|27884||689.05|0|689.05|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|27886||788.41|0|788.41|0||AMPUTATION FOLLOW-UP SURGERY|| 80001|27888||817.8|0|817.8|0||AMPUTATION OF FOOT AT ANKLE|| 80001|27889||779.32|0|779.32|0||AMPUTATION OF FOOT AT ANKLE|| 80001|27892||646.63|0|646.63|0||DECOMPRESSION OF LEG|| 80001|27893||715.48|0|715.48|0||DECOMPRESSION OF LEG|| 80001|27894||1022.55|0|1022.55|0||DECOMPRESSION OF LEG|| 80001|27899||0|0|0|0||LEG/ANKLE SURGERY PROCEDURE|| 80001|28001||325|0|204.44|0||DRAINAGE OF BURSA OF FOOT|| 80001|28002||516.46|0|378.07|0||TREATMENT OF FOOT INFECTION|| 80001|28003||829.32|0|670.77|0||TREATMENT OF FOOT INFECTION|| 80001|28005||687.92|0|687.92|0||TREAT FOOT BONE LESION|| 80001|28008||504.25|0|347.64|0||INCISION OF FOOT FASCIA|| 80001|28010||271.55|0|246.36|0||INCISION OF TOE TENDON|| 80001|28011||378.47|0|339.71|0||INCISION OF TOE TENDONS|| 80001|28020||633.52|0|429.23|0||EXPLORATION OF FOOT JOINT|| 80001|28022||569.59|0|384.29|0||EXPLORATION OF FOOT JOINT|| 80001|28024||538.07|0|360.92|0||EXPLORATION OF TOE JOINT|| 80001|28035||613.69|0|419.48|0||DECOMPRESSION OF TIBIA NERVE|| 80001|28039||592.82|0|414.11|0||EXC FOOT/TOE TUM SC > 1.5 CM|| 80001|28041||542.54|0|542.54|0||EXC FOOT/TOE TUM DEEP >1.5CM|| 80001|28043||464.29|0|309.61|0||EXCISION OF FOOT LESION|| 80001|28045||577.02|0|410.33|0||EXCISION OF FOOT LESION|| 80001|28046||869.85|0|869.85|0||RESECTION OF TUMOR - FOOT|| 80001|28047||1279.52|0|1279.52|0||RESECT FOOT/TOE TUMOR > 3 CM|| 80001|28050||557.25|0|363.81|0||BIOPSY OF FOOT JOINT LINING|| 80001|28052||509.68|0|327.87|0||BIOPSY OF FOOT JOINT LINING|| 80001|28054||435.82|0|278.82|0||BIOPSY OF TOE JOINT LINING|| 80001|28055||449.66|0|449.66|0||NEURECTOMY - FOOT|| 80001|28060||602.78|0|420.2|0||PARTIAL REMOVAL - FOOT FASCIA|| 80001|28062||681.29|0|480.87|0||REMOVAL OF FOOT FASCIA|| 80001|28070||614.89|0|416.81|0||REMOVAL OF FOOT JOINT LINING|| 80001|28072||598.29|0|396.32|0||REMOVAL OF FOOT JOINT LINING|| 80001|28080||610.89|0|431.79|0||REMOVAL OF FOOT LESION|| 80001|28086||639.5|0|427.07|0||EXCISE FOOT TENDON SHEATH|| 80001|28088||508.16|0|323.25|0||EXCISE FOOT TENDON SHEATH|| 80001|28090||547.9|0|363.76|0||REMOVAL OF FOOT LESION|| 80001|28092||490.25|0|315.81|0||REMOVAL OF TOE LESIONS|| 80001|28100||709.76|0|488.8|0||REMOVAL OF ANKLE/HEEL LESION|| 80001|28102||712.46|0|712.46|0||REMOVE/GRAFT FOOT LESION|| 80001|28103||465.26|0|465.26|0||REMOVE/GRAFT FOOT LESION|| 80001|28104||619.64|0|420.38|0||REMOVAL OF FOOT LESION|| 80001|28106||509.71|0|509.71|0||REMOVE/GRAFT FOOT LESION|| 80001|28107||603.03|0|413.86|0||REMOVE/GRAFT FOOT LESION|| 80001|28108||515.39|0|341.73|0||REMOVAL OF TOE LESIONS|| 80001|28110||538.31|0|341.38|0||PART REMOVAL OF METATARSAL|| 80001|28111||577.67|0|387.72|0||PART REMOVAL OF METATARSAL|| 80001|28112||570.74|0|370.32|0||PART REMOVAL OF METATARSAL|| 80001|28113||692.73|0|503.55|0||PART REMOVAL OF METATARSAL|| 80001|28114||1262.47|0|993.06|0||REMOVAL OF METATARSAL HEADS|| 80001|28116||885.09|0|676.15|0||REVISION OF FOOT|| 80001|28118||691.68|0|487.78|0||REMOVAL OF HEEL BONE|| 80001|28119||612.78|0|426.32|0||REMOVAL OF HEEL SPUR|| 80001|28120||789.9|0|587.55|0||PART REMOVAL OF ANKLE/HEEL|| 80001|28122||700.23|0|520.75|0||PARTIAL REMOVAL OF FOOT BONE|| 80001|28124||555.66|0|389.36|0||PARTIAL REMOVAL OF TOE|| 80001|28126||459.01|0|292.71|0||PARTIAL REMOVAL OF TOE|| 80001|28130||722.24|0|722.24|0||REMOVAL OF ANKLE BONE|| 80001|28140||698.05|0|521.28|0||REMOVAL OF METATARSAL|| 80001|28150||497.65|0|332.51|0||REMOVAL OF TOE|| 80001|28153||478.7|0|311.24|0||PARTIAL REMOVAL OF TOE|| 80001|28160||489.91|0|318.57|0||PARTIAL REMOVAL OF TOE|| 80001|28171||1018.76|0|1018.76|0||EXTENSIVE FOOT SURGERY|| 80001|28173||912.45|0|912.45|0||EXTENSIVE FOOT SURGERY|| 80001|28175||582.44|0|582.44|0||EXTENSIVE FOOT SURGERY|| 80001|28190||295.65|0|158.04|0||REMOVAL OF FOOT FOREIGN BODY|| 80001|28192||546.96|0|370.58|0||REMOVAL OF FOOT FOREIGN BODY|| 80001|28193||623.18|0|438.66|0||REMOVAL OF FOOT FOREIGN BODY|| 80001|28200||568.5|0|378.17|0||REPAIR OF FOOT TENDON|| 80001|28202||694.58|0|503.08|0||REPAIR/GRAFT OF FOOT TENDON|| 80001|28208||551.99|0|367.86|0||REPAIR OF FOOT TENDON|| 80001|28210||680.91|0|487.86|0||REPAIR/GRAFT OF FOOT TENDON|| 80001|28220||525.92|0|357.3|0||RELEASE OF FOOT TENDON|| 80001|28222||588.44|0|411.67|0||RELEASE OF FOOT TENDONS|| 80001|28225||473.19|0|304.17|0||RELEASE OF FOOT TENDON|| 80001|28226||513.89|0|346.43|0||RELEASE OF FOOT TENDONS|| 80001|28230||509.07|0|336.56|0||INCISION OF FOOT TENDON(S)|| 80001|28232||449.52|0|286.71|0||INCISION OF TOE TENDON|| 80001|28234||474.86|0|310.1|0||INCISION OF FOOT TENDON|| 80001|28238||793.1|0|582.99|0||REVISION OF FOOT TENDON|| 80001|28240||513.85|0|342.9|0||RELEASE OF BIG TOE|| 80001|28250||677.43|0|478.56|0||REVISION OF FOOT FASCIA|| 80001|28260||805.36|0|606.5|0||RELEASE OF MIDFOOT JOINT|| 80001|28261||1175.02|0|938.55|0||REVISION OF FOOT TENDON|| 80001|28262||1724.8|0|1402.27|0||REVISION OF FOOT AND ANKLE|| 80001|28264||991.64|0|766.03|0||RELEASE OF MIDFOOT JOINT|| 80001|28270||573.2|0|393.72|0||RELEASE OF FOOT CONTRACTURE|| 80001|28272||459.84|0|301.67|0||RELEASE OF TOE JOINT - EACH|| 80001|28280||599.38|0|410.59|0||FUSION OF TOES|| 80001|28285||623.51|0|445.19|0||REPAIR OF HAMMERTOE|| 80001|28286||524.1|0|352.76|0||REPAIR OF HAMMERTOE|| 80001|28288||701.64|0|504.33|0||PARTIAL REMOVAL OF FOOT BONE|| 80001|28289||857.83|0|647.73|0||REPAIR HALLUX RIGIDUS|| 80001|28290||688.82|0|469.02|0||CORRECTION OF BUNION|| 80001|28291||910.42|0|596.04|0||CORRJ HALUX RIGDUS W/IMPLT|| 80001|28292||923.83|0|711.4|0||CORRECTION OF BUNION|| 80001|28293||1218.57|0|841|0||CORRECTION OF BUNION|| 80001|28294||894.18|0|639.88|0||CORRECTION OF BUNION|| 80001|28295||1167.1|0|664.08|0||CORRECTION HALLUX VALGUS|| 80001|28296||835.09|0|618.39|0||CORRECTION OF BUNION|| 80001|28297||949.57|0|690.62|0||CORRECTION OF BUNION|| 80001|28298||841.52|0|598.85|0||CORRECTION OF BUNION|| 80001|28299||1056.2|0|808.11|0||CORRECTION OF BUNION|| 80001|28300||772.65|0|772.65|0||INCISION OF HEEL BONE|| 80001|28302||842.97|0|842.97|0||INCISION OF ANKLE BONE|| 80001|28304||970.07|0|721.2|0||INCISION OF MIDFOOT BONES|| 80001|28305||775.08|0|775.08|0||INCISE/GRAFT MIDFOOT BONES|| 80001|28306||714.38|0|477.14|0||INCISION OF METATARSAL|| 80001|28307||824.45|0|555.81|0||INCISION OF METATARSAL|| 80001|28308||656.64|0|443.43|0||INCISION OF METATARSAL|| 80001|28309||1080.89|0|1080.89|0||INCISION OF METATARSALS|| 80001|28310||638.42|0|424.05|0||REVISION OF BIG TOE|| 80001|28312||601.24|0|381.83|0||REVISION OF TOE|| 80001|28313||616.07|0|423.02|0||REPAIR DEFORMITY OF TOE|| 80001|28315||563.04|0|385.5|0||REMOVAL OF SESAMOID BONE|| 80001|28320||719.48|0|719.48|0||REPAIR OF FOOT BONES|| 80001|28322||922.05|0|683.64|0||REPAIR OF METATARSALS|| 80001|28340||679.4|0|491.78|0||RESECT ENLARGED TOE TISSUE|| 80001|28341||789.77|0|587.03|0||RESECT ENLARGED TOE|| 80001|28344||639.99|0|422.13|0||REPAIR EXTRA TOE(S)|| 80001|28345||611.97|0|433.27|0||REPAIR WEBBED TOE(S)|| 80001|28360||978.52|0|978.52|0||RECONSTRUCT CLEFT FOOT|| 80001|28400||286.15|0|262.5|0||TREATMENT OF HEEL FRACTURE|| 80001|28405||463.11|0|422.41|0||TREATMENT OF HEEL FRACTURE|| 80001|28406||616.51|0|616.51|0||TREATMENT OF HEEL FRACTURE|| 80001|28415||1308.11|0|1308.11|0||TREAT HEEL FRACTURE|| 80001|28420||1482.33|0|1482.33|0||TREAT/GRAFT HEEL FRACTURE|| 80001|28430||272.96|0|243.5|0||TREATMENT OF ANKLE FRACTURE|| 80001|28435||375.32|0|338.1|0||TREATMENT OF ANKLE FRACTURE|| 80001|28436||522.79|0|522.79|0||TREATMENT OF ANKLE FRACTURE|| 80001|28445||1263.6|0|1263.6|0||TREAT ANKLE FRACTURE|| 80001|28446||1450.21|0|1450.21|0||OSTEOCHONDRAL TALUS AUTOGRFT|| 80001|28450||248.47|0|222.5|0||TREAT MIDFOOT FRACTURE - EACH|| 80001|28455||334.78|0|302.22|0||TREAT MIDFOOT FRACTURE - EACH|| 80001|28456||368.45|0|368.45|0||TREAT MIDFOOT FRACTURE|| 80001|28465||727.46|0|727.46|0||TREAT MIDFOOT FRACTURE - EACH|| 80001|28470||252.35|0|236.07|0||TREAT METATARSAL FRACTURE|| 80001|28475||298.11|0|266.32|0||TREAT METATARSAL FRACTURE|| 80001|28476||406.95|0|406.95|0||TREAT METATARSAL FRACTURE|| 80001|28485||619.9|0|619.9|0||TREAT METATARSAL FRACTURE|| 80001|28490||167.17|0|144.68|0||TREAT BIG TOE FRACTURE|| 80001|28495||207.39|0|175.99|0||TREAT BIG TOE FRACTURE|| 80001|28496||506.33|0|276.45|0||TREAT BIG TOE FRACTURE|| 80001|28505||788.53|0|596.64|0||TREAT BIG TOE FRACTURE|| 80001|28510||143.13|0|139.64|0||TREATMENT OF TOE FRACTURE|| 80001|28515||187.86|0|166.54|0||TREATMENT OF TOE FRACTURE|| 80001|28525||649.89|0|463.04|0||TREAT TOE FRACTURE|| 80001|28530||133.17|0|118.83|0||TREAT SESAMOID BONE FRACTURE|| 80001|28531||394.23|0|214.36|0||TREAT SESAMOID BONE FRACTURE|| 80001|28540||223.56|0|203.01|0||TREAT FOOT DISLOCATION|| 80001|28545||340.94|0|302.95|0||TREAT FOOT DISLOCATION|| 80001|28546||661.18|0|393.7|0||TREAT FOOT DISLOCATION|| 80001|28555||1030.1|0|791.31|0||REPAIR FOOT DISLOCATION|| 80001|28570||198.08|0|172.11|0||TREAT FOOT DISLOCATION|| 80001|28575||419.29|0|380.52|0||TREAT FOOT DISLOCATION|| 80001|28576||462.16|0|462.16|0||TREAT FOOT DISLOCATION|| 80001|28585||1003.11|0|795.71|0||REPAIR FOOT DISLOCATION|| 80001|28600||249.98|0|217.03|0||TREAT FOOT DISLOCATION|| 80001|28605||377.5|0|340.67|0||TREAT FOOT DISLOCATION|| 80001|28606||461.56|0|461.56|0||TREAT FOOT DISLOCATION|| 80001|28615||927.34|0|927.34|0||REPAIR FOOT DISLOCATION|| 80001|28630||181.72|0|129.39|0||TREAT TOE DISLOCATION|| 80001|28635||199.69|0|152.78|0||TREAT TOE DISLOCATION|| 80001|28636||403.72|0|263|0||TREAT TOE DISLOCATION|| 80001|28645||765.63|0|572.58|0||REPAIR TOE DISLOCATION|| 80001|28660||135.47|0|104.46|0||TREAT TOE DISLOCATION|| 80001|28665||181.13|0|155.55|0||TREAT TOE DISLOCATION|| 80001|28666||226.07|0|226.07|0||TREAT TOE DISLOCATION|| 80001|28675||686.36|0|489.05|0||REPAIR OF TOE DISLOCATION|| 80001|28705||1495.63|0|1495.63|0||FUSION OF FOOT BONES|| 80001|28715||1108.71|0|1108.71|0||FUSION OF FOOT BONES|| 80001|28725||918.37|0|918.37|0||FUSION OF FOOT BONES|| 80001|28730||863.73|0|863.73|0||FUSION OF FOOT BONES|| 80001|28735||927.01|0|927.01|0||FUSION OF FOOT BONES|| 80001|28737||821.69|0|821.69|0||REVISION OF FOOT BONES|| 80001|28740||988.93|0|736.96|0||FUSION OF FOOT BONES|| 80001|28750||951.28|0|699.69|0||FUSION OF BIG TOE JOINT|| 80001|28755||590.44|0|389.25|0||FUSION OF BIG TOE JOINT|| 80001|28760||926.2|0|686.24|0||FUSION OF BIG TOE JOINT|| 80001|28800||648.31|0|648.31|0||AMPUTATION OF MIDFOOT|| 80001|28805||877.19|0|877.19|0||AMPUTATION THRU METATARSAL|| 80001|28810||513.34|0|513.34|0||AMPUTATION TOE & METATARSAL|| 80001|28820||660.1|0|468.99|0||AMPUTATION OF TOE|| 80001|28825||629.44|0|439.1|0||PARTIAL AMPUTATION OF TOE|| 80001|28890||376.77|0|266.29|0||HIGH ENERGY ESWT - PLANTAR F|| 80001|28899||0|0|0|0||FOOT/TOES SURGERY PROCEDURE|| 80001|29000||348.04|0|219.34|0||APPLICATION OF BODY CAST|| 80001|29010||254.46|0|166.46|0||APPLICATION OF BODY CAST|| 80001|29015||317.24|0|207.14|0||APPLICATION OF BODY CAST|| 80001|29035||255.88|0|156.65|0||APPLICATION OF BODY CAST|| 80001|29040||253.53|0|166.7|0||APPLICATION OF BODY CAST|| 80001|29044||296.11|0|183.69|0||APPLICATION OF BODY CAST|| 80001|29046||273.36|0|181.1|0||APPLICATION OF BODY CAST|| 80001|29049||85.32|0|67.49|0||APPLICATION OF FIGURE EIGHT|| 80001|29055||255.15|0|163.28|0||APPLICATION OF SHOULDER CAST|| 80001|29058||144.54|0|112.37|0||APPLICATION OF SHOULDER CAST|| 80001|29065||110.82|0|80.19|0||APPLICATION OF LONG ARM CAST|| 80001|29075||99.91|0|73.16|0||APPLICATION OF FOREARM CAST|| 80001|29085||110.04|0|79.41|0||APPLY HAND/WRIST CAST|| 80001|29086||88.38|0|58.53|0||APPLY FINGER CAST|| 80001|29105||101.89|0|70.5|0||APPLY LONG ARM SPLINT|| 80001|29125||73.13|0|45.61|0||APPLY FOREARM SPLINT|| 80001|29126||88.65|0|57.25|0||APPLY FOREARM SPLINT|| 80001|29130||47.16|0|33.59|0||APPLICATION OF FINGER SPLINT|| 80001|29131||59.01|0|39.24|0||APPLICATION OF FINGER SPLINT|| 80001|29200||34.65|0|21.86|0||STRAPPING OF CHEST|| 80001|29240||33.49|0|22.25|0||STRAPPING OF SHOULDER|| 80001|29260||33.49|0|23.03|0||STRAPPING OF ELBOW OR WRIST|| 80001|29280||33.88|0|23.41|0||STRAPPING OF HAND OR FINGER|| 80001|29305||284.17|0|188.03|0||APPLICATION OF HIP CAST|| 80001|29325||314.9|0|211.01|0||APPLICATION OF HIP CASTS|| 80001|29345||158.11|0|119.35|0||APPLICATION OF LONG LEG CAST|| 80001|29355||163.33|0|125.73|0||APPLICATION OF LONG LEG CAST|| 80001|29358||185.39|0|122.98|0||APPLY LONG LEG CAST BRACE|| 80001|29365||141.64|0|102.87|0||APPLICATION OF LONG LEG CAST|| 80001|29405||94.22|0|70.57|0||APPLY SHORT LEG CAST|| 80001|29425||90.34|0|66.69|0||APPLY SHORT LEG CAST|| 80001|29435||136.6|0|98.61|0||APPLY SHORT LEG CAST|| 80001|29440||50.95|0|34.67|0||ADDITION OF WALKER TO CAST|| 80001|29445||158.6|0|124.87|0||APPLY RIGID LEG CAST|| 80001|29450||168.81|0|134.7|0||APPLICATION OF LEG CAST|| 80001|29505||95.29|0|58.46|0||APPLICATION - LONG LEG SPLINT|| 80001|29515||82.67|0|58.25|0||APPLICATION LOWER LEG SPLINT|| 80001|29520||35.82|0|22.25|0||STRAPPING OF HIP|| 80001|29530||32.71|0|21.86|0||STRAPPING OF KNEE|| 80001|29540||30|0|21.47|0||STRAPPING OF ANKLE AND/OR FT|| 80001|29550||22.03|0|13.89|0||STRAPPING OF TOES|| 80001|29580||60.17|0|41.56|0||APPLICATION OF PASTE BOOT|| 80001|29581||69.71|0|15.83|0||APPLY MULTLAY COMPRS LWR LEG|| 80001|29582||79.45|0|19.75|0||APPLY MULTLAY COMPRS UPR LEG|| 80001|29583||49.94|0|14.28|0||APPLY MULTLAY COMPRS UPR ARM|| 80001|29584||79.45|0|19.75|0||APPL MULTLAY COMPRS ARM/HAND|| 80001|29700||70.34|0|39.72|0||REMOVAL/REVISION OF CAST|| 80001|29705||78.16|0|56.45|0||REMOVAL/REVISION OF CAST|| 80001|29710||144.29|0|100.49|0||REMOVAL/REVISION OF CAST|| 80001|29720||97.97|0|53|0||REPAIR OF BODY CAST|| 80001|29730||74.23|0|52.91|0||WINDOWING OF CAST|| 80001|29740||115.8|0|84.01|0||WEDGING OF CAST|| 80001|29750||111.75|0|87.33|0||WEDGING OF CLUBFOOT CAST|| 80001|29799||0|0|0|0||CASTING/STRAPPING PROCEDURE|| 80001|29800||608.41|0|608.41|0||JAW ARTHROSCOPY/SURGERY|| 80001|29804||755.72|0|755.72|0||JAW ARTHROSCOPY/SURGERY|| 80001|29805||553.74|0|553.74|0||SHOULDER ARTHROSCOPY - DX|| 80001|29806||1253.99|0|1253.99|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29807||1224.01|0|1224.01|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29819||689.79|0|689.79|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29820||627.49|0|627.49|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29821||684.35|0|684.35|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29822||664.47|0|664.47|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29823||724.39|0|724.39|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29824||781.77|0|781.77|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29825||677.7|0|677.7|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29826||210.89|0|210.89|0||SHOULDER ARTHROSCOPY/SURGERY|| 80001|29827||1244.18|0|1244.18|0||ARTHROSCOP ROTATOR CUFF REPR|| 80001|29828||1071.1|0|1071.1|0||ARTHROSCOPY BICEPS TENODESIS|| 80001|29830||536.02|0|536.02|0||ELBOW ARTHROSCOPY|| 80001|29834||568.58|0|568.58|0||ELBOW ARTHROSCOPY/SURGERY|| 80001|29835||591.22|0|591.22|0||ELBOW ARTHROSCOPY/SURGERY|| 80001|29836||679.02|0|679.02|0||ELBOW ARTHROSCOPY/SURGERY|| 80001|29837||614.59|0|614.59|0||ELBOW ARTHROSCOPY/SURGERY|| 80001|29838||687.82|0|687.82|0||ELBOW ARTHROSCOPY/SURGERY|| 80001|29840||530.1|0|530.1|0||WRIST ARTHROSCOPY|| 80001|29843||567.83|0|567.83|0||WRIST ARTHROSCOPY/SURGERY|| 80001|29844||577.88|0|577.88|0||WRIST ARTHROSCOPY/SURGERY|| 80001|29845||674.17|0|674.17|0||WRIST ARTHROSCOPY/SURGERY|| 80001|29846||608.25|0|608.25|0||WRIST ARTHROSCOPY/SURGERY|| 80001|29847||639.61|0|639.61|0||WRIST ARTHROSCOPY/SURGERY|| 80001|29848||596|0|596|0||WRIST ENDOSCOPY/SURGERY|| 80001|29850||734.55|0|734.55|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29851||1103.07|0|1103.07|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29855||924.97|0|924.97|0||TIBIAL ARTHROSCOPY/SURGERY|| 80001|29856||1179.66|0|1179.66|0||TIBIAL ARTHROSCOPY/SURGERY|| 80001|29860||786.22|0|786.22|0||HIP ARTHROSCOPY - DX|| 80001|29861||842.92|0|842.92|0||HIP ARTHROSCOPY/SURGERY|| 80001|29862||948.01|0|948.01|0||HIP ARTHROSCOPY/SURGERY|| 80001|29863||945.68|0|945.68|0||HIP ARTHROSCOPY/SURGERY|| 80001|29866||1240.69|0|1240.69|0||AUTGRFT IMPLNT - KNEE W/SCOPE|| 80001|29867||1515.62|0|1515.62|0||ALLGRFT IMPLNT - KNEE W/SCOPE|| 80001|29868||1990.17|0|1990.17|0||MENISCAL TRNSPL - KNEE W/SCPE|| 80001|29870||673.31|0|483.36|0||KNEE ARTHROSCOPY - DX|| 80001|29871||603.93|0|603.93|0||KNEE ARTHROSCOPY/DRAINAGE|| 80001|29873||613.2|0|613.2|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29874||632.09|0|632.09|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29875||581.55|0|581.55|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29876||775.18|0|775.18|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29877||731.56|0|731.56|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29879||780.34|0|780.34|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29880||660.88|0|660.88|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29881||635.26|0|635.26|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29882||825.68|0|825.68|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29883||995.32|0|995.32|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29884||721.35|0|721.35|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29885||887.68|0|887.68|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29886||750.25|0|750.25|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29887||878.91|0|878.91|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29888||1164.2|0|1164.2|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29889||1448.12|0|1448.12|0||KNEE ARTHROSCOPY/SURGERY|| 80001|29891||801.87|0|801.87|0||ANKLE ARTHROSCOPY/SURGERY|| 80001|29892||742.66|0|742.66|0||ANKLE ARTHROSCOPY/SURGERY|| 80001|29893||711.45|0|504.83|0||SCOPE - PLANTAR FASCIOTOMY|| 80001|29894||592.42|0|592.42|0||ANKLE ARTHROSCOPY/SURGERY|| 80001|29895||571.28|0|571.28|0||ANKLE ARTHROSCOPY/SURGERY|| 80001|29897||598.89|0|598.89|0||ANKLE ARTHROSCOPY/SURGERY|| 80001|29898||669.9|0|669.9|0||ANKLE ARTHROSCOPY/SURGERY|| 80001|29899||1236.9|0|1236.9|0||ANKLE ARTHROSCOPY/SURGERY|| 80001|29900||491.26|0|491.26|0||MCP JOINT ARTHROSCOPY - DX|| 80001|29901||613.5|0|613.5|0||MCP JOINT ARTHROSCOPY - SURG|| 80001|29902||571.78|0|571.78|0||MCP JOINT ARTHROSCOPY - SURG|| 80001|29904||752.89|0|752.89|0||SUBTALAR ARTHRO W/FB RMVL|| 80001|29905||765.03|0|765.03|0||SUBTALAR ARTHRO W/EXC|| 80001|29906||833.27|0|833.27|0||SUBTALAR ARTHRO W/DEB|| 80001|29907||1035.13|0|1035.13|0||SUBTALAR ARTHRO W/FUSION|| 80001|29914||1171.15|0|1171.15|0||HIP ARTHRO W/FEMOROPLASTY|| 80001|29915||1193.14|0|1193.14|0||HIP ARTHRO ACETABULOPLASTY|| 80001|29916||1196.24|0|1196.24|0||HIP ARTHRO W/LABRAL REPAIR|| 80001|29999||0|0|0|0||ARTHROSCOPY OF JOINT|| 80001|30000||260.79|0|137.91|0||DRAINAGE OF NOSE LESION|| 80001|30020||263.89|0|139.07|0||DRAINAGE OF NOSE LESION|| 80001|30100||160.73|0|81.27|0||INTRANASAL BIOPSY|| 80001|30110||262.45|0|152.74|0||REMOVAL OF NOSE POLYP(S)|| 80001|30115||497.45|0|497.45|0||REMOVAL OF NOSE POLYP(S)|| 80001|30117||983.04|0|391.1|0||REMOVAL OF INTRANASAL LESION|| 80001|30118||891.7|0|891.7|0||REMOVAL OF INTRANASAL LESION|| 80001|30120||596.99|0|507.05|0||REVISION OF NOSE|| 80001|30124||329.2|0|329.2|0||REMOVAL OF NOSE LESION|| 80001|30125||704.21|0|704.21|0||REMOVAL OF NOSE LESION|| 80001|30130||436.21|0|436.21|0||EXCISE INFERIOR TURBINATE|| 80001|30140||502.55|0|502.55|0||RESECT INFERIOR TURBINATE|| 80001|30150||892.42|0|892.42|0||PARTIAL REMOVAL OF NOSE|| 80001|30160||899.37|0|899.37|0||REMOVAL OF NOSE|| 80001|30200||129.02|0|69.71|0||INJECTION TREATMENT OF NOSE|| 80001|30210||171.26|0|115.44|0||NASAL SINUS THERAPY|| 80001|30220||341.13|0|145.75|0||INSERT NASAL SEPTAL BUTTON|| 80001|30300||259.46|0|144.72|0||REMOVE NASAL FOREIGN BODY|| 80001|30310||235.59|0|235.59|0||REMOVE NASAL FOREIGN BODY|| 80001|30320||520.43|0|520.43|0||REMOVE NASAL FOREIGN BODY|| 80001|30400||1159.42|0|1159.42|0||RECONSTRUCTION OF NOSE|| 80001|30410||1366.63|0|1366.63|0||RECONSTRUCTION OF NOSE|| 80001|30420||1592.96|0|1592.96|0||RECONSTRUCTION OF NOSE|| 80001|30430||992.9|0|992.9|0||REVISION OF NOSE|| 80001|30435||1434.39|0|1434.39|0||REVISION OF NOSE|| 80001|30450||1740.35|0|1740.35|0||REVISION OF NOSE|| 80001|30460||945.44|0|945.44|0||REVISION OF NOSE|| 80001|30462||1655.17|0|1655.17|0||REVISION OF NOSE|| 80001|30465||1139.26|0|1139.26|0||REPAIR NASAL STENOSIS|| 80001|30520||719.99|0|719.99|0||REPAIR OF NASAL SEPTUM|| 80001|30540||794.93|0|794.93|0||REPAIR NASAL DEFECT|| 80001|30545||995.87|0|995.87|0||REPAIR NASAL DEFECT|| 80001|30560||302.69|0|158.09|0||RELEASE OF NASAL ADHESIONS|| 80001|30580||755.5|0|599.28|0||REPAIR UPPER JAW FISTULA|| 80001|30600||658.5|0|501.12|0||REPAIR MOUTH/NOSE FISTULA|| 80001|30620||717.04|0|717.04|0||INTRANASAL RECONSTRUCTION|| 80001|30630||724.33|0|724.33|0||REPAIR NASAL SEPTUM DEFECT|| 80001|30801||257.75|0|156.57|0||ABLATE INF TURBINATE - SUPERF|| 80001|30802||330.49|0|220.4|0||CAUTERIZATION - INNER NOSE|| 80001|30901||110.27|0|68.01|0||CONTROL OF NOSEBLEED|| 80001|30903||234.31|0|95.14|0||CONTROL OF NOSEBLEED|| 80001|30905||293.18|0|120.29|0||CONTROL OF NOSEBLEED|| 80001|30906||320.87|0|156.89|0||REPEAT CONTROL OF NOSEBLEED|| 80001|30915||669.94|0|669.94|0||LIGATION - NASAL SINUS ARTERY|| 80001|30920||972.64|0|972.64|0||LIGATION - UPPER JAW ARTERY|| 80001|30930||142.2|0|142.2|0||THER FX - NASAL INF TURBINATE|| 80001|30999||0|0|0|0||NASAL SURGERY PROCEDURE|| 80001|31000||208.39|0|123.11|0||IRRIGATION - MAXILLARY SINUS|| 80001|31002||222.19|0|222.19|0||IRRIGATION - SPHENOID SINUS|| 80001|31020||551.92|0|412.75|0||EXPLORATION - MAXILLARY SINUS|| 80001|31030||793.54|0|613.67|0||EXPLORATION - MAXILLARY SINUS|| 80001|31032||665.1|0|665.1|0||EXPLORE SINUS - REMOVE POLYPS|| 80001|31040||892.97|0|892.97|0||EXPLORATION BEHIND UPPER JAW|| 80001|31050||559.29|0|559.29|0||EXPLORATION - SPHENOID SINUS|| 80001|31051||744.69|0|744.69|0||SPHENOID SINUS SURGERY|| 80001|31070||504.25|0|504.25|0||EXPLORATION OF FRONTAL SINUS|| 80001|31075||904.63|0|904.63|0||EXPLORATION OF FRONTAL SINUS|| 80001|31080||1194.81|0|1194.81|0||REMOVAL OF FRONTAL SINUS|| 80001|31081||1754.43|0|1754.43|0||REMOVAL OF FRONTAL SINUS|| 80001|31084||1339.79|0|1339.79|0||REMOVAL OF FRONTAL SINUS|| 80001|31085||1695.97|0|1695.97|0||REMOVAL OF FRONTAL SINUS|| 80001|31086||1301.93|0|1301.93|0||REMOVAL OF FRONTAL SINUS|| 80001|31087||1260.21|0|1260.21|0||REMOVAL OF FRONTAL SINUS|| 80001|31090||1179.78|0|1179.78|0||EXPLORATION OF SINUSES|| 80001|31200||649.7|0|649.7|0||REMOVAL OF ETHMOID SINUS|| 80001|31201||856.05|0|856.05|0||REMOVAL OF ETHMOID SINUS|| 80001|31205||1033.24|0|1033.24|0||REMOVAL OF ETHMOID SINUS|| 80001|31225||2196.89|0|2196.89|0||REMOVAL OF UPPER JAW|| 80001|31230||2436.68|0|2436.68|0||REMOVAL OF UPPER JAW|| 80001|31231||236.25|0|77.7|0||NASAL ENDOSCOPY - DX|| 80001|31233||299.91|0|162.3|0||NASAL/SINUS ENDOSCOPY - DX|| 80001|31235||342.24|0|192.22|0||NASAL/SINUS ENDOSCOPY - DX|| 80001|31237||297.1|0|191.27|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31238||297.33|0|200.81|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31239||720.3|0|720.3|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31240||190.93|0|190.93|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31241||542.35|0|542.35|0||NSL/SINS NDSC W/ARTERY LIG|| 80001|31253||607.51|0|607.51|0||NSL/SINS NDSC TOTAL|| 80001|31254||325.44|0|325.44|0||REVISION OF ETHMOID SINUS|| 80001|31255||477.45|0|477.45|0||REMOVAL OF ETHMOID SINUS|| 80001|31256||235.78|0|235.78|0||EXPLORATION MAXILLARY SINUS|| 80001|31257||540.58|0|540.58|0||NSL/SINS NDSC TOT W/SPHENDT|| 80001|31259||573.18|0|573.18|0||NSL/SINS NDSC SPHN TISS RMVL|| 80001|31267||379|0|379|0||ENDOSCOPY - MAXILLARY SINUS|| 80001|31276||602.04|0|602.04|0||SINUS ENDOSCOPY - SURGICAL|| 80001|31287||276.49|0|276.49|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31288||320.87|0|320.87|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31290||1373.74|0|1373.74|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31291||1463.67|0|1463.67|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31292||1181.92|0|1181.92|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31293||1283.39|0|1283.39|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31294||1470.68|0|1470.68|0||NASAL/SINUS ENDOSCOPY - SURG|| 80001|31295||2274.56|0|198.69|0||SINUS ENDO W/BALLOON DIL|| 80001|31296||2308.94|0|237.33|0||SINUS ENDO W/BALLOON DIL|| 80001|31297||2264.6|0|194.16|0||SINUS ENDO W/BALLOON DIL|| 80001|31298||4290.23|0|309.12|0||NSL/SINS NDSC W/SINS DILAT|| 80001|31299||0|0|0|0||SINUS SURGERY PROCEDURE|| 80001|31300||1471.56|0|1471.56|0||REMOVAL OF LARYNX LESION|| 80001|31320||751.21|0|751.21|0||DIAGNOSTIC INCISION - LARYNX|| 80001|31360||2441.61|0|2441.61|0||REMOVAL OF LARYNX|| 80001|31365||3029.96|0|3029.96|0||REMOVAL OF LARYNX|| 80001|31367||2581.72|0|2581.72|0||PARTIAL REMOVAL OF LARYNX|| 80001|31368||2863.54|0|2863.54|0||PARTIAL REMOVAL OF LARYNX|| 80001|31370||2420.88|0|2420.88|0||PARTIAL REMOVAL OF LARYNX|| 80001|31375||2298|0|2298|0||PARTIAL REMOVAL OF LARYNX|| 80001|31380||2264.02|0|2264.02|0||PARTIAL REMOVAL OF LARYNX|| 80001|31382||2485.73|0|2485.73|0||PARTIAL REMOVAL OF LARYNX|| 80001|31390||3356.69|0|3356.69|0||REMOVAL OF LARYNX & PHARYNX|| 80001|31395||3528.65|0|3528.65|0||RECONSTRUCT LARYNX & PHARYNX|| 80001|31400||1158.4|0|1158.4|0||REVISION OF LARYNX|| 80001|31420||975.85|0|975.85|0||REMOVAL OF EPIGLOTTIS|| 80001|31500||133.1|0|133.1|0||INSERT EMERGENCY AIRWAY|| 80001|31502||41.61|0|41.61|0||CHANGE OF WINDPIPE AIRWAY|| 80001|31505||94.16|0|56.94|0||DIAGNOSTIC LARYNGOSCOPY|| 80001|31510||243.34|0|145.65|0||LARYNGOSCOPY WITH BIOPSY|| 80001|31511||243.62|0|154.46|0||REMOVE FOREIGN BODY - LARYNX|| 80001|31512||238.57|0|155.23|0||REMOVAL OF LARYNX LESION|| 80001|31513||157.68|0|157.68|0||INJECTION INTO VOCAL CORD|| 80001|31515||237.38|0|132.33|0||LARYNGOSCOPY FOR ASPIRATION|| 80001|31520||187.22|0|187.22|0||DX LARYNGOSCOPY - NEWBORN|| 80001|31525||291.81|0|191.02|0||DX LARYNGOSCOPY EXCL NB|| 80001|31526||187.65|0|187.65|0||DX LARYNGOSCOPY W/OPER SCOPE|| 80001|31527||234.53|0|234.53|0||LARYNGOSCOPY FOR TREATMENT|| 80001|31528||172.82|0|172.82|0||LARYNGOSCOPY AND DILATION|| 80001|31529||193.95|0|193.95|0||LARYNGOSCOPY AND DILATION|| 80001|31530||235.78|0|235.78|0||LARYNGOSCOPY W/FB REMOVAL|| 80001|31531||254.88|0|254.88|0||LARYNGOSCOPY W/FB & OP SCOPE|| 80001|31535||227.46|0|227.46|0||LARYNGOSCOPY W/BIOPSY|| 80001|31536||252.82|0|252.82|0||LARYNGOSCOPY W/BX & OP SCOPE|| 80001|31540||290.6|0|290.6|0||LARYNGOSCOPY W/EXC OF TUMOR|| 80001|31541||317.55|0|317.55|0||LARYNSCOP W/TUMR EXC + SCOPE|| 80001|31545||435.06|0|435.06|0||REMOVE VC LESION W/SCOPE|| 80001|31546||662.54|0|662.54|0||REMOVE VC LESION SCOPE/GRAFT|| 80001|31551||2036.61|0|2036.61|0||LARYNGOPLASTY LARYNGEAL STEN|| 80001|31552||609.39|0|224.38|0||LARYNGOPLASTY LARYNGEAL STEN|| 80001|31553||324.29|0|185.19|0||LARYNGOPLASTY LARYNGEAL STEN|| 80001|31554||1255.82|0|185.19|0||LARYNGOPLASTY LARYNGEAL STEN|| 80001|31560||377.06|0|377.06|0||LARYNGOSCOP W/ARYTENOIDECTOM|| 80001|31561||412.38|0|412.38|0||LARYNSCOP - REMVE CART + SCOP|| 80001|31570||394.13|0|275.9|0||LARYNGOSCOPE W/VC INJ|| 80001|31571||300.12|0|300.12|0||LARYNGOSCOP W/VC INJ + SCOPE|| 80001|31572||1754.53|0|1754.53|0||LARGSC W/LASER DSTRJ LES|| 80001|31573||1773.91|0|1773.91|0||LARGSC W/THER INJECTION|| 80001|31574||1934.11|0|1934.11|0||LARGSC W/NJX AUGMENTATION|| 80001|31575||131.59|0|90.5|0||DIAGNOSTIC LARYNGOSCOPY|| 80001|31576||256.35|0|147.42|0||LARYNGOSCOPY WITH BIOPSY|| 80001|31577||279.09|0|179.46|0||REMOVE FOREIGN BODY - LARYNX|| 80001|31578||320.64|0|205.12|0||REMOVAL OF LARYNX LESION|| 80001|31579||243.28|0|168.08|0||DIAGNOSTIC LARYNGOSCOPY|| 80001|31580||1419.92|0|1419.92|0||REVISION OF LARYNX|| 80001|31582||2207.19|0|2207.19|0||REVISION OF LARYNX|| 80001|31584||1767.94|0|1767.94|0||TREAT LARYNX FRACTURE|| 80001|31587||1181.1|0|1181.1|0||REVISION OF LARYNX|| 80001|31588||1331.82|0|1331.82|0||REVISION OF LARYNX|| 80001|31590||1021.01|0|1021.01|0||REINNERVATE LARYNX|| 80001|31591||1285.53|0|1285.53|0||LARYNGOPLASTY MEDIALIZATION|| 80001|31592||2080.11|0|2080.11|0||CRICOTRACHEAL RESECTION|| 80001|31595||886.96|0|886.96|0||LARYNX NERVE SURGERY|| 80001|31599||0|0|0|0||LARYNX SURGERY PROCEDURE|| 80001|31600||476.93|0|476.93|0||INCISION OF WINDPIPE|| 80001|31601||326.2|0|326.2|0||INCISION OF WINDPIPE|| 80001|31603||268.61|0|268.61|0||INCISION OF WINDPIPE|| 80001|31605||221.92|0|221.92|0||INCISION OF WINDPIPE|| 80001|31610||837.02|0|837.02|0||INCISION OF WINDPIPE|| 80001|31611||626.02|0|626.02|0||SURGERY/SPEECH PROSTHESIS|| 80001|31612||99.76|0|60.61|0||PUNCTURE/CLEAR WINDPIPE|| 80001|31613||525.02|0|525.02|0||REPAIR WINDPIPE OPENING|| 80001|31614||878.68|0|878.68|0||REPAIR WINDPIPE OPENING|| 80001|31615||210.74|0|152.98|0||VISUALIZATION OF WINDPIPE|| 80001|31622||357.96|0|174.99|0||DX BRONCHOSCOPE/WASH|| 80001|31623||378.15|0|176.58|0||DX BRONCHOSCOPE/BRUSH|| 80001|31624||358.77|0|178.13|0||DX BRONCHOSCOPE/LAVAGE|| 80001|31625||382.58|0|205.42|0||BRONCHOSCOPY W/BIOPSY(S)|| 80001|31626||512.86|0|256.24|0||BRONCHOSCOPY W/MARKERS|| 80001|31627||1564.4|0|117.69|0||NAVIGATIONAL BRONCHOSCOPY|| 80001|31628||427.53|0|229.05|0||BRONCHOSCOPY/LUNG BX - EACH|| 80001|31629||668.37|0|246.99|0||BRONCHOSCOPY/NEEDLE BX - EACH|| 80001|31630||241.14|0|241.14|0||BRONCHOSCOPY DILATE/FX REPR|| 80001|31631||278.86|0|278.86|0||BRONCHOSCOPY - DILATE W/STENT|| 80001|31632||83.19|0|59.16|0||BRONCHOSCOPY/LUNG BX - ADD'L|| 80001|31633||103.07|0|76.71|0||BRONCHOSCOPY/NEEDLE BX ADD'L|| 80001|31634||2091.46|0|249.73|0||BRONCH W/BALLOON OCCLUSION|| 80001|31635||402.56|0|227.34|0||BRONCHOSCOPY W/FB REMOVAL|| 80001|31636||267.33|0|267.33|0||BRONCHOSCOPY - BRONCH STENTS|| 80001|31637||89.86|0|89.86|0||BRONCHOSCOPY - STENT ADD-ON|| 80001|31638||305.93|0|305.93|0||BRONCHOSCOPY - REVISE STENT|| 80001|31640||306.92|0|306.92|0||BRONCHOSCOPY W/TUMOR EXCISE|| 80001|31641||310.4|0|310.4|0||BRONCHOSCOPY - TREAT BLOCKAGE|| 80001|31643||212.97|0|212.97|0||DIAG BRONCHOSCOPE/CATHETER|| 80001|31645||371.24|0|194.47|0||BRONCHOSCOPY - CLEAR AIRWAYS|| 80001|31646||333.26|0|168.51|0||BRONCHOSCOPY - RECLEAR AIRWAY|| 80001|31647||268.92|0|268.92|0||BRONCHIAL VALVE INIT INSERT|| 80001|31648||245.52|0|245.52|0||BRONCHIAL VALVE REMOV INIT|| 80001|31649||82.27|0|82.27|0||BRONCHIAL VALVE REMOV ADDL|| 80001|31651||89.86|0|89.86|0||BRONCHIAL VALVE ADDL INSERT|| 80001|31652||1013.6|0|281.25|0||BRONCH EBUS SAMPLNG 1/2 NODE|| 80001|31653||1078.35|0|310.47|0||BRONCH EBUS SAMPLNG 3/> NODE|| 80001|31654||164.47|0|81.42|0||BRONCH EBUS IVNTJ PERPH LES|| 80001|31660||251.95|0|251.95|0||BRONCH THERMOPLSTY 1 LOBE|| 80001|31661||263.89|0|263.89|0||BRONCH THERMOPLSTY 2/> LOBES|| 80001|31717||297.68|0|130.21|0||BRONCHIAL BRUSH BIOPSY|| 80001|31720||61.62|0|61.62|0||CLEARANCE OF AIRWAYS|| 80001|31725||108.2|0|108.2|0||CLEARANCE OF AIRWAYS|| 80001|31730||1365.04|0|179.21|0||INTRO - WINDPIPE WIRE/TUBE|| 80001|31750||1597.65|0|1597.65|0||REPAIR OF WINDPIPE|| 80001|31755||1988.06|0|1988.06|0||REPAIR OF WINDPIPE|| 80001|31760||1654.07|0|1654.07|0||REPAIR OF WINDPIPE|| 80001|31766||2034.4|0|2034.4|0||RECONSTRUCTION OF WINDPIPE|| 80001|31770||1610.92|0|1610.92|0||REPAIR/GRAFT OF BRONCHUS|| 80001|31775||1487.53|0|1487.53|0||RECONSTRUCT BRONCHUS|| 80001|31780||1413.73|0|1413.73|0||RECONSTRUCT WINDPIPE|| 80001|31781||1676.39|0|1676.39|0||RECONSTRUCT WINDPIPE|| 80001|31785||1280.28|0|1280.28|0||REMOVE WINDPIPE LESION|| 80001|31786||1889.01|0|1889.01|0||REMOVE WINDPIPE LESION|| 80001|31800||827.08|0|827.08|0||REPAIR OF WINDPIPE INJURY|| 80001|31805||979.81|0|979.81|0||REPAIR OF WINDPIPE INJURY|| 80001|31820||501.44|0|384.75|0||CLOSURE OF WINDPIPE LESION|| 80001|31825||700.1|0|565.98|0||REPAIR OF WINDPIPE DEFECT|| 80001|31830||511.83|0|401.74|0||REVISE WINDPIPE SCAR|| 80001|31899||0|0|0|0||AIRWAYS SURGICAL PROCEDURE|| 80001|32035||864.59|0|864.59|0||EXPLORATION OF CHEST|| 80001|32036||928.72|0|928.72|0||EXPLORATION OF CHEST|| 80001|32096||966.5|0|966.5|0||OPEN WEDGE/BX LUNG INFILTR|| 80001|32097||966.5|0|966.5|0||OPEN WEDGE/BX LUNG NODULE|| 80001|32098||915.5|0|915.5|0||OPEN BIOPSY OF LUNG PLEURA|| 80001|32100||971.16|0|971.16|0||EXPLORATION/BIOPSY OF CHEST|| 80001|32110||1756.92|0|1756.92|0||EXPLORE/REPAIR CHEST|| 80001|32120||1041.42|0|1041.42|0||RE-EXPLORATION OF CHEST|| 80001|32124||1112|0|1112|0||EXPLORE CHEST FREE ADHESIONS|| 80001|32140||1196.05|0|1196.05|0||REMOVAL OF LUNG LESION(S)|| 80001|32141||1835.84|0|1835.84|0||REMOVE/TREAT LUNG LESIONS|| 80001|32150||1206.81|0|1206.81|0||REMOVAL OF LUNG LESION(S)|| 80001|32151||1213.56|0|1213.56|0||REMOVE LUNG FOREIGN BODY|| 80001|32160||943.85|0|943.85|0||OPEN CHEST HEART MASSAGE|| 80001|32200||1371.64|0|1371.64|0||DRAIN - OPEN - LUNG LESION|| 80001|32215||958.79|0|958.79|0||TREAT CHEST LINING|| 80001|32220||1899.02|0|1899.02|0||RELEASE OF LUNG|| 80001|32225||1190.98|0|1190.98|0||PARTIAL RELEASE OF LUNG|| 80001|32310||1082.9|0|1082.9|0||REMOVAL OF CHEST LINING|| 80001|32320||1918.72|0|1918.72|0||FREE/REMOVE CHEST LINING|| 80001|32400||175.94|0|106.17|0||NEEDLE BIOPSY CHEST LINING|| 80001|32405||504.64|0|125.52|0||BIOPSY - LUNG OR MEDIASTINUM|| 80001|32440||1881.26|0|1881.26|0||REMOVAL OF LUNG|| 80001|32442||3721.42|0|3721.42|0||SLEEVE PNEUMONECTOMY|| 80001|32445||4285.36|0|4285.36|0||REMOVAL OF LUNG|| 80001|32480||1777.52|0|1777.52|0||PARTIAL REMOVAL OF LUNG|| 80001|32482||1905.23|0|1905.23|0||BILOBECTOMY|| 80001|32484||1731.41|0|1731.41|0||SEGMENTECTOMY|| 80001|32486||2841.98|0|2841.98|0||SLEEVE LOBECTOMY|| 80001|32488||2913.07|0|2913.07|0||COMPLETION PNEUMONECTOMY|| 80001|32491||1776.57|0|1776.57|0||LUNG VOLUME REDUCTION|| 80001|32501||297.4|0|297.4|0||REPAIR BRONCHUS ADD-ON|| 80001|32503||2181.23|0|2181.23|0||RESECT APICAL LUNG TUMOR|| 80001|32504||2503.21|0|2503.21|0||RESECT APICAL LUNG TUM/CHEST|| 80001|32505||1118.75|0|1118.75|0||WEDGE RESECT OF LUNG INITIAL|| 80001|32506||190.76|0|190.76|0||WEDGE RESECT OF LUNG ADD-ON|| 80001|32507||190.37|0|190.37|0||WEDGE RESECT OF LUNG DIAG|| 80001|32540||2085.52|0|2085.52|0||REMOVAL OF LUNG LESION|| 80001|32550||882.76|0|269.11|0||INSERT PLEURAL CATH|| 80001|32551||205.56|0|205.56|0||INSERTION OF CHEST TUBE|| 80001|32552||218.11|0|190.59|0||REMOVE LUNG CATHETER|| 80001|32553||669.43|0|235.26|0||INS MARK THOR FOR RT PERQ|| 80001|32554||229.32|0|107.98|0||ASPIRATE PLEURA W/O IMAGING|| 80001|32555||328.19|0|136.69|0||ASPIRATE PLEURA W/ IMAGING|| 80001|32556||621.89|0|149.34|0||INSERT CATH PLEURA W/O IMAGE|| 80001|32557||576.52|0|186.93|0||INSERT CATH PLEURA W/ IMAGE|| 80001|32560||275.79|0|94.76|0||TREAT LUNG LINING CHEMICALLY|| 80001|32561||109.21|0|83.23|0||LYSE CHEST FIBRIN INIT DAY|| 80001|32562||98.86|0|75.22|0||LYSE CHEST FIBRIN SUBQ DAY|| 80001|32601||371.55|0|371.55|0||THORACOSCOPY - DIAGNOSTIC|| 80001|32604||584.46|0|584.46|0||THORACOSCOPY - DIAGNOSTIC|| 80001|32606||557.17|0|557.17|0||THORACOSCOPY - DIAGNOSTIC|| 80001|32607||372.33|0|372.33|0||THORACOSCOPY W/BX INFILTRATE|| 80001|32608||457.32|0|457.32|0||THORACOSCOPY W/BX NODULE|| 80001|32609||312.45|0|312.45|0||THORACOSCOPY W/BX PLEURA|| 80001|32650||795.86|0|795.86|0||THORACOSCOPY - SURGICAL|| 80001|32651||1317.78|0|1317.78|0||THORACOSCOPY - SURGICAL|| 80001|32652||1999.51|0|1999.51|0||THORACOSCOPY - SURGICAL|| 80001|32653||1272.05|0|1272.05|0||THORACOSCOPY - SURGICAL|| 80001|32654||1377.6|0|1377.6|0||THORACOSCOPY - SURGICAL|| 80001|32655||1146.57|0|1146.57|0||THORACOSCOPY - SURGICAL|| 80001|32656||962.03|0|962.03|0||THORACOSCOPY - SURGICAL|| 80001|32658||858.69|0|858.69|0||THORACOSCOPY - SURGICAL|| 80001|32659||877.13|0|877.13|0||THORACOSCOPY - SURGICAL|| 80001|32661||961.58|0|961.58|0||THORACOSCOPY - SURGICAL|| 80001|32662||1072.76|0|1072.76|0||THORACOSCOPY - SURGICAL|| 80001|32663||1687.05|0|1687.05|0||THORACOSCOPY - SURGICAL|| 80001|32664||1021.97|0|1021.97|0||THORACOSCOPY - SURGICAL|| 80001|32665||1491.19|0|1491.19|0||THORACOSCOPY - SURGICAL|| 80001|32666||1044.63|0|1044.63|0||THORACOSCOPY W/WEDGE RESECT|| 80001|32667||191.15|0|191.15|0||THORACOSCOPY W/W RESECT ADDL|| 80001|32668||190.76|0|190.76|0||THORACOSCOPY W/W RESECT DIAG|| 80001|32669||1619.37|0|1619.37|0||THORACOSCOPY REMOVE SEGMENT|| 80001|32670||1934.4|0|1934.4|0||THORACOSCOPY BILOBECTOMY|| 80001|32671||2155.28|0|2155.28|0||THORACOSCOPY PNEUMONECTOMY|| 80001|32672||1832.72|0|1832.72|0||THORACOSCOPY FOR LVRS|| 80001|32673||1465.74|0|1465.74|0||THORACOSCOPY W/THYMUS RESECT|| 80001|32674||262.37|0|262.37|0||THORACOSCOPY LYMPH NODE EXC|| 80001|32701||259.89|0|259.89|0||THORAX STEREO RAD TARGETW/TX|| 80001|32800||1144.18|0|1144.18|0||REPAIR LUNG HERNIA|| 80001|32810||1085.79|0|1085.79|0||CLOSE CHEST AFTER DRAINAGE|| 80001|32815||3380.9|0|3380.9|0||CLOSE BRONCHIAL FISTULA|| 80001|32820||1679.65|0|1679.65|0||RECONSTRUCT INJURED CHEST|| 80001|32850||0|0|0|0||DONOR PNEUMONECTOMY|| 80001|32851||3977.61|0|3977.61|0||LUNG TRANSPLANT - SINGLE|| 80001|32852||4360.52|0|4360.52|0||LUNG TRANSPLANT WITH BYPASS|| 80001|32853||5565.19|0|5565.19|0||LUNG TRANSPLANT - DOUBLE|| 80001|32854||5908.51|0|5908.51|0||LUNG TRANSPLANT WITH BYPASS|| 80001|32855||0|0|0|0||PREPARE DONOR LUNG - SINGLE|| 80001|32856||0|0|0|0||PREPARE DONOR LUNG - DOUBLE|| 80001|32900||1712.12|0|1712.12|0||REMOVAL OF RIB(S)|| 80001|32905||1615.63|0|1615.63|0||REVISE & REPAIR CHEST WALL|| 80001|32906||1997.98|0|1997.98|0||REVISE & REPAIR CHEST WALL|| 80001|32940||1492.3|0|1492.3|0||REVISION OF LUNG|| 80001|32960||147.99|0|110.38|0||THERAPEUTIC PNEUMOTHORAX|| 80001|32994||6851.54|0|593.06|0||ABLATE PULM TUMOR PERQ CRYBL|| 80001|32997||414.57|0|414.57|0||TOTAL LUNG LAVAGE|| 80001|32998||3282.29|0|347|0||PERQ RF ABLATE TX - PUL TUMOR|| 80001|32999||0|0|0|0||CHEST SURGERY PROCEDURE|| 80001|33010||145.15|0|145.15|0||DRAINAGE OF HEART SAC|| 80001|33011||146.32|0|146.32|0||REPEAT DRAINAGE OF HEART SAC|| 80001|33015||608.87|0|608.87|0||INCISION OF HEART SAC|| 80001|33020||1058.63|0|1058.63|0||INCISION OF HEART SAC|| 80001|33025||959.69|0|959.69|0||INCISION OF HEART SAC|| 80001|33030||2417.02|0|2417.02|0||PARTIAL REMOVAL OF HEART SAC|| 80001|33031||2978.41|0|2978.41|0||PARTIAL REMOVAL OF HEART SAC|| 80001|33050||1208.66|0|1208.66|0||REMOVAL OF HEART SAC LESION|| 80001|33120||2536.33|0|2536.33|0||REMOVAL OF HEART LESION|| 80001|33130||1671.84|0|1671.84|0||REMOVAL OF HEART LESION|| 80001|33140||1913.5|0|1913.5|0||HEART REVASCULARIZE (TMR)|| 80001|33141||159.27|0|159.27|0||HEART TMR W/OTHER PROCEDURE|| 80001|33202||932.31|0|932.31|0||INSERT EPICARD ELTRD - OPEN|| 80001|33203||969.43|0|969.43|0||INSERT EPICARD ELTRD - ENDO|| 80001|33206||551.22|0|551.22|0||INSERTION OF HEART PACEMAKER|| 80001|33207||587.86|0|587.86|0||INSERTION OF HEART PACEMAKER|| 80001|33208||636.39|0|636.39|0||INSERTION OF HEART PACEMAKER|| 80001|33210||215.72|0|215.72|0||INSERTION OF HEART ELECTRODE|| 80001|33211||219.99|0|219.99|0||INSERTION OF HEART ELECTRODE|| 80001|33212||396.86|0|396.86|0||INSERTION OF PULSE GENERATOR|| 80001|33213||414.72|0|414.72|0||INSERTION OF PULSE GENERATOR|| 80001|33214||582.27|0|582.27|0||UPGRADE OF PACEMAKER SYSTEM|| 80001|33215||369.39|0|369.39|0||REPOSITION PACING-DEFIB LEAD|| 80001|33216||454.59|0|454.59|0||INSERT LEAD PACE-DEFIB - ONE|| 80001|33217||446.32|0|446.32|0||INSERT LEAD PACE-DEFIB - DUAL|| 80001|33218||476.02|0|476.02|0||REPAIR LEAD PACE-DEFIB - ONE|| 80001|33220||476.76|0|476.76|0||REPAIR LEAD PACE-DEFIB - DUAL|| 80001|33221||443.04|0|443.04|0||INSERT PULSE GEN MULT LEADS|| 80001|33222||412.83|0|412.83|0||REVISE POCKET - PACEMAKER|| 80001|33223||499.85|0|499.85|0||REVISE POCKET - PACING-DEFIB|| 80001|33224||618.58|0|618.58|0||INSERT PACING LEAD & CONNECT|| 80001|33225||562.34|0|562.34|0||L VENTRIC PACING LEAD ADD-ON|| 80001|33226||594.12|0|594.12|0||REPOSITION L VENTRIC LEAD|| 80001|33227||417.69|0|417.69|0||REMOVE&REPLACE PM GEN SINGL|| 80001|33228||435.16|0|435.16|0||REMV PERM PACEMKR GEN & REPLAC|| 80001|33229||456.5|0|456.5|0||REMV&REPLC PM GEN MULT LEADS|| 80001|33230||470.15|0|470.15|0||INSRT PULSE GEN W/DUAL LEADS|| 80001|33231||495.37|0|495.37|0||INSRT PULSE GEN W/MULT LEADS|| 80001|33233||287.06|0|287.06|0||REMOVAL OF PACEMAKER SYSTEM|| 80001|33234||592.67|0|592.67|0||REMOVAL OF PACEMAKER SYSTEM|| 80001|33235||770.39|0|770.39|0||REMOVAL PACEMAKER ELECTRODE|| 80001|33236||937.61|0|937.61|0||REMOVE ELECTRODE/THORACOTOMY|| 80001|33237||1008.01|0|1008.01|0||REMOVE ELECTRODE/THORACOTOMY|| 80001|33238||1121.83|0|1121.83|0||REMOVE ELECTRODE/THORACOTOMY|| 80001|33240||449.96|0|449.96|0||INSERT PULSE GENERATOR|| 80001|33241||270.73|0|270.73|0||REMOVE PULSE GENERATOR|| 80001|33243||1647.46|0|1647.46|0||REMOVE ELTRD/THORACOTOMY|| 80001|33244||1037.72|0|1037.72|0||REMOVE ELTRD - TRANSVEN|| 80001|33249||1107.27|0|1107.27|0||ELTRD/INSERT PACE-DEFIB|| 80001|33250||1781.42|0|1781.42|0||ABLATE HEART DYSRHYTHM FOCUS|| 80001|33251||1957.53|0|1957.53|0||ABLATE HEART DYSRHYTHM FOCUS|| 80001|33254||1639.96|0|1639.96|0||ABLATE ATRIA - LMTD|| 80001|33255||1977.06|0|1977.06|0||ABLATE ATRIA W/O BYPASS - EXT|| 80001|33256||2353.7|0|2353.7|0||ABLATE ATRIA W/BYPASS - EXTEN|| 80001|33257||697.93|0|697.93|0||ABLATE ATRIA - LMTD - ADD-ON|| 80001|33258||789.66|0|789.66|0||ABLATE ATRIA - X10SV - ADD-ON|| 80001|33259||1012.4|0|1012.4|0||ABLATE ATRIA W/BYPASS ADD-ON|| 80001|33261||1957.53|0|1957.53|0||ABLATE HEART DYSRHYTHM FOCUS|| 80001|33262||457.76|0|457.76|0||REMV&REPLC CVD GEN SING LEAD|| 80001|33263||476.78|0|476.78|0||REMV&REPLC CVD GEN DUAL LEAD|| 80001|33264||496.58|0|496.58|0||REMV&REPLC CVD GEN MULT LEAD|| 80001|33265||1635.25|0|1635.25|0||ABLATE ATRIA W/BYPASS - ENDO|| 80001|33266||2232.27|0|2232.27|0||ABLATE ATRIA W/O BYPASS ENDO|| 80001|33270||701.41|0|701.41|0||INS/REP SUBQ DEFIBRILLATOR|| 80001|33271||589.31|0|589.31|0||INSJ SUBQ IMPLTBL DFB ELCTRD|| 80001|33272||433.23|0|433.23|0||RMVL OF SUBQ DEFIBRILLATOR|| 80001|33273||479.08|0|479.08|0||REPOS PREV IMPLTBL SUBQ DFB|| 80001|33282||282.89|0|282.89|0||IMPLANT PAT-ACTIVE HT RECORD|| 80001|33284||250.46|0|250.46|0||REMOVE PAT-ACTIVE HT RECORD|| 80001|33300||2958.91|0|2958.91|0||REPAIR OF HEART WOUND|| 80001|33305||4969.3|0|4969.3|0||REPAIR OF HEART WOUND|| 80001|33310||1440.98|0|1440.98|0||EXPLORATORY HEART SURGERY|| 80001|33315||2316.47|0|2316.47|0||EXPLORATORY HEART SURGERY|| 80001|33320||1283.03|0|1283.03|0||REPAIR MAJOR BLOOD VESSEL(S)|| 80001|33321||1450.41|0|1450.41|0||REPAIR MAJOR VESSEL|| 80001|33322||1670.57|0|1670.57|0||REPAIR MAJOR BLOOD VESSEL(S)|| 80001|33330||1728.72|0|1728.72|0||INSERT MAJOR VESSEL GRAFT|| 80001|33335||2283.45|0|2283.45|0||INSERT MAJOR VESSEL GRAFT|| 80001|33340||1000|0|1000|0||PERQ CLSR TCAT L ATR APNDGE|| 80001|33361||1643.45|0|1643.45|0||REPLACE AORTIC VALVE PERQ|| 80001|33362||1797.05|0|1797.05|0||REPLACE AORTIC VALVE OPEN|| 80001|33363||1885.49|0|1885.49|0||REPLACE AORTIC VALVE OPEN|| 80001|33364||1956.46|0|1956.46|0||REPLACE AORTIC VALVE OPEN|| 80001|33365||2154.29|0|2154.29|0||REPLACE AORTIC VALVE OPEN|| 80001|33366||2332|0|2332|0||TRCATH REPLACE AORTIC VALVE|| 80001|33367||756.7|0|756.7|0||REPLACE AORTIC VALVE W/BYP|| 80001|33368||909.26|0|909.26|0||REPLACE AORTIC VALVE W/BYP|| 80001|33369||1200.15|0|1200.15|0||REPLACE AORTIC VALVE W/BYP|| 80001|33390||2384.59|0|2384.59|0||VALVULOPLASTY AORTIC VALVE|| 80001|33391||2825.59|0|2825.59|0||VALVULOPLASTY AORTIC VALVE|| 80001|33400||2752.89|0|2752.89|0||REPAIR OF AORTIC VALVE|| 80001|33401||1739.38|0|1739.38|0||VALVULOPLASTY - OPEN|| 80001|33403||1785.56|0|1785.56|0||VALVULOPLASTY - W/CP BYPASS|| 80001|33404||2141.22|0|2141.22|0||PREPARE HEART-AORTA CONDUIT|| 80001|33405||2740.46|0|2740.46|0||REPLACEMENT OF AORTIC VALVE|| 80001|33406||3474.33|0|3474.33|0||REPLACEMENT OF AORTIC VALVE|| 80001|33410||3066.77|0|3066.77|0||REPLACEMENT OF AORTIC VALVE|| 80001|33411||4057.98|0|4057.98|0||REPLACEMENT OF AORTIC VALVE|| 80001|33412||3848.07|0|3848.07|0||REPLACEMENT OF AORTIC VALVE|| 80001|33413||3963.95|0|3963.95|0||REPLACEMENT OF AORTIC VALVE|| 80001|33414||2597.07|0|2597.07|0||REPAIR OF AORTIC VALVE|| 80001|33415||2456.65|0|2456.65|0||REVISION - SUBVALVULAR TISSUE|| 80001|33416||2452.03|0|2452.03|0||REVISE VENTRICLE MUSCLE|| 80001|33417||2001.17|0|2001.17|0||REPAIR OF AORTIC VALVE|| 80001|33418||2235.29|0|2235.29|0||REPAIR TCAT MITRAL VALVE|| 80001|33419||526.84|0|526.84|0||REPAIR TCAT MITRAL VALVE|| 80001|33420||1737.71|0|1737.71|0||REVISION OF MITRAL VALVE|| 80001|33422||2021.57|0|2021.57|0||REVISION OF MITRAL VALVE|| 80001|33425||3299.53|0|3299.53|0||REPAIR OF MITRAL VALVE|| 80001|33426||2874.69|0|2874.69|0||REPAIR OF MITRAL VALVE|| 80001|33427||2953.22|0|2953.22|0||REPAIR OF MITRAL VALVE|| 80001|33430||3378.21|0|3378.21|0||REPLACEMENT OF MITRAL VALVE|| 80001|33460||2953.94|0|2953.94|0||REVISION OF TRICUSPID VALVE|| 80001|33463||3741|0|3741|0||VALVULOPLASTY - TRICUSPID|| 80001|33464||2949.18|0|2949.18|0||VALVULOPLASTY - TRICUSPID|| 80001|33465||3333.1|0|3333.1|0||REPLACE TRICUSPID VALVE|| 80001|33468||2962.81|0|2962.81|0||REVISION OF TRICUSPID VALVE|| 80001|33470||1488.13|0|1488.13|0||REVISION OF PULMONARY VALVE|| 80001|33471||1669.25|0|1669.25|0||VALVOTOMY - PULMONARY VALVE|| 80001|33474||2627.44|0|2627.44|0||REVISION OF PULMONARY VALVE|| 80001|33475||2835.26|0|2835.26|0||REPLACEMENT - PULMONARY VALVE|| 80001|33476||1838.61|0|1838.61|0||REVISION OF HEART CHAMBER|| 80001|33477||1560.46|0|1560.46|0||IMPLANT TCAT PULM VLV PERQ|| 80001|33478||1890.98|0|1890.98|0||REVISION OF HEART CHAMBER|| 80001|33496||2023.22|0|2023.22|0||REPAIR - PROSTH VALVE CLOT|| 80001|33500||1895.45|0|1895.45|0||REPAIR HEART VESSEL FISTULA|| 80001|33501||1352.81|0|1352.81|0||REPAIR HEART VESSEL FISTULA|| 80001|33502||1534.07|0|1534.07|0||CORONARY ARTERY CORRECTION|| 80001|33503||1590.87|0|1590.87|0||CORONARY ARTERY GRAFT|| 80001|33504||1761.25|0|1761.25|0||CORONARY ARTERY GRAFT|| 80001|33505||2495.5|0|2495.5|0||REPAIR ARTERY W/TUNNEL|| 80001|33506||2609.77|0|2609.77|0||REPAIR ARTERY - TRANSLOCATION|| 80001|33507||2080.88|0|2080.88|0||REPAIR ART - INTRAMURAL|| 80001|33508||19.19|0|19.19|0||ENDOSCOPIC VEIN HARVEST|| 80001|33510||2331.47|0|2331.47|0||CABG - VEIN - SINGLE|| 80001|33511||2562.29|0|2562.29|0||CABG - VEIN - TWO|| 80001|33512||2915.37|0|2915.37|0||CABG - VEIN - THREE|| 80001|33513||3001.37|0|3001.37|0||CABG - VEIN - FOUR|| 80001|33514||3173.03|0|3173.03|0||CABG - VEIN - FIVE|| 80001|33516||3320.87|0|3320.87|0||CABG - VEIN - SIX OR MORE|| 80001|33517||227.55|0|227.55|0||CABG - ARTERY-VEIN - SINGLE|| 80001|33518||500.1|0|500.1|0||CABG - ARTERY-VEIN - TWO|| 80001|33519||661.01|0|661.01|0||CABG - ARTERY-VEIN - THREE|| 80001|33521||792.37|0|792.37|0||CABG - ARTERY-VEIN - FOUR|| 80001|33522||890.29|0|890.29|0||CABG - ARTERY-VEIN - FIVE|| 80001|33523||1017.5|0|1017.5|0||CABG - ART-VEIN - SIX OR MORE|| 80001|33530||639.66|0|639.66|0||CORONARY ARTERY - BYPASS/REOP|| 80001|33533||2255.12|0|2255.12|0||CABG - ARTERIAL - SINGLE|| 80001|33534||2654.26|0|2654.26|0||CABG - ARTERIAL - TWO|| 80001|33535||2962.55|0|2962.55|0||CABG - ARTERIAL - THREE|| 80001|33536||3197.41|0|3197.41|0||CABG - ARTERIAL - FOUR OR MORE|| 80001|33542||3171.65|0|3171.65|0||REMOVAL OF HEART LESION|| 80001|33545||3746.49|0|3746.49|0||REPAIR OF HEART DAMAGE|| 80001|33548||3579.95|0|3579.95|0||RESTORE/REMODEL - VENTRICLE|| 80001|33572||280.05|0|280.05|0||OPEN CORONARY ENDARTERECTOMY|| 80001|33600||2085.39|0|2085.39|0||CLOSURE OF VALVE|| 80001|33602||2022.18|0|2022.18|0||CLOSURE OF VALVE|| 80001|33606||2255.95|0|2255.95|0||ANASTOMOSIS/ARTERY-AORTA|| 80001|33608||2167.5|0|2167.5|0||REPAIR ANOMALY W/CONDUIT|| 80001|33610||2154.93|0|2154.93|0||REPAIR BY ENLARGEMENT|| 80001|33611||2493.94|0|2493.94|0||REPAIR DOUBLE VENTRICLE|| 80001|33612||2420.37|0|2420.37|0||REPAIR DOUBLE VENTRICLE|| 80001|33615||2427.07|0|2427.07|0||REPAIR - MODIFIED FONTAN|| 80001|33617||2609.79|0|2609.79|0||REPAIR SINGLE VENTRICLE|| 80001|33619||3466.16|0|3466.16|0||REPAIR SINGLE VENTRICLE|| 80001|33620||1837.85|0|1837.85|0||APPLY R&L PULM ART BANDS|| 80001|33621||1126.48|0|1126.48|0||TRANSTHOR CATH FOR STENT|| 80001|33622||4116.26|0|4116.26|0||REDO COMPL CARDIAC ANOMALY|| 80001|33641||1973.55|0|1973.55|0||REPAIR HEART SEPTUM DEFECT|| 80001|33645||2088.19|0|2088.19|0||REVISION OF HEART VEINS|| 80001|33647||2193.75|0|2193.75|0||REPAIR HEART SEPTUM DEFECTS|| 80001|33660||2138.61|0|2138.61|0||REPAIR OF HEART DEFECTS|| 80001|33665||2311.61|0|2311.61|0||REPAIR OF HEART DEFECTS|| 80001|33670||2404.36|0|2404.36|0||REPAIR OF HEART CHAMBERS|| 80001|33675||2400.98|0|2400.98|0||CLOSE MULT VSD|| 80001|33676||2588.02|0|2588.02|0||CLOSE MULT VSD W/RESECTION|| 80001|33677||2674.79|0|2674.79|0||CL MULT VSD W/REM PUL BAND|| 80001|33681||2219.92|0|2219.92|0||REPAIR HEART SEPTUM DEFECT|| 80001|33684||2299.43|0|2299.43|0||REPAIR HEART SEPTUM DEFECT|| 80001|33688||2278.22|0|2278.22|0||REPAIR HEART SEPTUM DEFECT|| 80001|33690||1451.14|0|1451.14|0||REINFORCE PULMONARY ARTERY|| 80001|33692||2510.07|0|2510.07|0||REPAIR OF HEART DEFECTS|| 80001|33694||2357.04|0|2357.04|0||REPAIR OF HEART DEFECTS|| 80001|33697||2536.42|0|2536.42|0||REPAIR OF HEART DEFECTS|| 80001|33702||1861.36|0|1861.36|0||REPAIR OF HEART DEFECTS|| 80001|33710||2533.4|0|2533.4|0||REPAIR OF HEART DEFECTS|| 80001|33720||1876.96|0|1876.96|0||REPAIR OF HEART DEFECT|| 80001|33722||1973.53|0|1973.53|0||REPAIR OF HEART DEFECT|| 80001|33724||1856.49|0|1856.49|0||REPAIR VENOUS ANOMALY|| 80001|33726||2475.91|0|2475.91|0||REPAIR PUL VENOUS STENOSIS|| 80001|33730||2437.48|0|2437.48|0||REPAIR HEART-VEIN DEFECT(S)|| 80001|33732||1999.58|0|1999.58|0||REPAIR HEART-VEIN DEFECT|| 80001|33735||1568.96|0|1568.96|0||REVISION OF HEART CHAMBER|| 80001|33736||1689.17|0|1689.17|0||REVISION OF HEART CHAMBER|| 80001|33737||1636.47|0|1636.47|0||REVISION OF HEART CHAMBER|| 80001|33750||1598.9|0|1598.9|0||MAJOR VESSEL SHUNT|| 80001|33755||1653.69|0|1653.69|0||MAJOR VESSEL SHUNT|| 80001|33762||1623.48|0|1623.48|0||MAJOR VESSEL SHUNT|| 80001|33764||1657.2|0|1657.2|0||MAJOR VESSEL SHUNT & GRAFT|| 80001|33766||1688.19|0|1688.19|0||MAJOR VESSEL SHUNT|| 80001|33767||1712.87|0|1712.87|0||MAJOR VESSEL SHUNT|| 80001|33768||539.98|0|539.98|0||CAVOPULMONARY SHUNTING|| 80001|33770||2714.44|0|2714.44|0||REPAIR GREAT VESSELS DEFECT|| 80001|33771||2800.78|0|2800.78|0||REPAIR GREAT VESSELS DEFECT|| 80001|33774||2183.9|0|2183.9|0||REPAIR GREAT VESSELS DEFECT|| 80001|33775||2354.26|0|2354.26|0||REPAIR GREAT VESSELS DEFECT|| 80001|33776||2486.06|0|2486.06|0||REPAIR GREAT VESSELS DEFECT|| 80001|33777||2411.4|0|2411.4|0||REPAIR GREAT VESSELS DEFECT|| 80001|33778||3000.46|0|3000.46|0||REPAIR GREAT VESSELS DEFECT|| 80001|33779||2987.85|0|2987.85|0||REPAIR GREAT VESSELS DEFECT|| 80001|33780||3040.42|0|3040.42|0||REPAIR GREAT VESSELS DEFECT|| 80001|33781||2974.19|0|2974.19|0||REPAIR GREAT VESSELS DEFECT|| 80001|33782||3934.24|0|3934.24|0||NIKAIDOH PROC|| 80001|33783||4486.3|0|4486.3|0||NIKAIDOH PROC W/OSTIA IMPLT|| 80001|33786||2915.18|0|2915.18|0||REPAIR ARTERIAL TRUNK|| 80001|33788||1862.16|0|1862.16|0||REVISION OF PULMONARY ARTERY|| 80001|33800||1251.5|0|1251.5|0||AORTIC SUSPENSION|| 80001|33802||1371.82|0|1371.82|0||REPAIR VESSEL DEFECT|| 80001|33803||1457.55|0|1457.55|0||REPAIR VESSEL DEFECT|| 80001|33813||1561.41|0|1561.41|0||REPAIR SEPTAL DEFECT|| 80001|33814||1846.78|0|1846.78|0||REPAIR SEPTAL DEFECT|| 80001|33820||1164.39|0|1164.39|0||REVISE MAJOR VESSEL|| 80001|33822||1290.25|0|1290.25|0||REVISE MAJOR VESSEL|| 80001|33824||1416.46|0|1416.46|0||REVISE MAJOR VESSEL|| 80001|33840||1559.77|0|1559.77|0||REMOVE AORTA CONSTRICTION|| 80001|33845||1602.02|0|1602.02|0||REMOVE AORTA CONSTRICTION|| 80001|33851||1603.69|0|1603.69|0||REMOVE AORTA CONSTRICTION|| 80001|33852||1681.42|0|1681.42|0||REPAIR SEPTAL DEFECT|| 80001|33853||2207.1|0|2207.1|0||REPAIR SEPTAL DEFECT|| 80001|33860||3884.85|0|3884.85|0||ASCENDING AORTIC GRAFT|| 80001|33863||3814.45|0|3814.45|0||ASCENDING AORTIC GRAFT|| 80001|33864||3908.93|0|3908.93|0||ASCENDING AORTIC GRAFT|| 80001|33870||3047.46|0|3047.46|0||TRANSVERSE AORTIC ARCH GRAFT|| 80001|33875||3326.58|0|3326.58|0||THORACIC AORTIC GRAFT|| 80001|33877||4429.9|0|4429.9|0||THORACOABDOMINAL GRAFT|| 80001|33880||2205.67|0|2205.67|0||ENDOVASC TAA REPR INCL SUBCL|| 80001|33881||1894.86|0|1894.86|0||ENDOVASC TAA REPR W/O SUBCL|| 80001|33883||1370.95|0|1370.95|0||INSERT ENDOVASC PROSTH - TAA|| 80001|33884||508.68|0|508.68|0||ENDOVASC PROSTH - TAA - ADD-ON|| 80001|33886||1182.93|0|1182.93|0||ENDOVASC PROSTH - DELAYED|| 80001|33889||974.92|0|974.92|0||ARTERY TRANSPOSE/ENDOVAS TAA|| 80001|33891||1198.35|0|1198.35|0||CAR-CAR BP GRFT/ENDOVAS TAA|| 80001|33910||3185.6|0|3185.6|0||REMOVE LUNG ARTERY EMBOLI|| 80001|33915||1558.59|0|1558.59|0||REMOVE LUNG ARTERY EMBOLI|| 80001|33916||5106.39|0|5106.39|0||SURGERY OF GREAT VESSEL|| 80001|33917||1765.59|0|1765.59|0||REPAIR PULMONARY ARTERY|| 80001|33920||2199.2|0|2199.2|0||REPAIR PULMONARY ATRESIA|| 80001|33922||1669.73|0|1669.73|0||TRANSECT PULMONARY ARTERY|| 80001|33924||347.1|0|347.1|0||REMOVE PULMONARY SHUNT|| 80001|33925||2090.91|0|2090.91|0||RPR PUL ART UNIFOCAL W/O CPB|| 80001|33926||3068.04|0|3068.04|0||REPR PUL ART - UNIFOCAL W/CPB|| 80001|33927||3166.62|0|3166.62|0||IMPLTJ TOT RPLCMT HRT SYS|| 80001|33930||0|0|0|0||REMOVAL OF DONOR HEART/LUNG|| 80001|33933||0|0|0|0||PREPARE DONOR HEART/LUNG|| 80001|33935||6017.21|0|6017.21|0||TRANSPLANTATION - HEART/LUNG|| 80001|33940||0|0|0|0||REMOVAL OF DONOR HEART|| 80001|33944||0|0|0|0||PREPARE DONOR HEART|| 80001|33945||5882.24|0|5882.24|0||TRANSPLANTATION OF HEART|| 80001|33946||374.87|0|374.87|0||ECMO/ECLS INITIATION VENOUS|| 80001|33947||414.08|0|414.08|0||ECMO/ECLS INITIATION ARTERY|| 80001|33948||296.01|0|296.01|0||ECMO/ECLS DAILY MGMT-VENOUS|| 80001|33949||288.08|0|288.08|0||ECMO/ECLS DAILY MGMT ARTERY|| 80001|33951||535.99|0|535.99|0||ECMO/ECLS INSJ PRPH CANNULA|| 80001|33952||522.02|0|522.02|0||ECMO/ECLS INSJ PRPH CANNULA|| 80001|33953||597.97|0|597.97|0||ECMO/ECLS INSJ PRPH CANNULA|| 80001|33954||583.23|0|583.23|0||ECMO/ECLS INSJ PRPH CANNULA|| 80001|33955||1077.62|0|1077.62|0||ECMO/ECLS INSJ CTR CANNULA|| 80001|33956||1023.35|0|1023.35|0||ECMO/ECLS INSJ CTR CANNULA|| 80001|33957||239.14|0|239.14|0||ECMO/ECLS REPOS PERPH CNULA|| 80001|33958||231.77|0|231.77|0||ECMO/ECLS REPOS PERPH CNULA|| 80001|33959||303.84|0|303.84|0||ECMO/ECLS REPOS PERPH CNULA|| 80001|33962||286.4|0|286.4|0||ECMO/ECLS REPOS PERPH CNULA|| 80001|33963||607.18|0|607.18|0||ECMO/ECLS REPOS PERPH CNULA|| 80001|33964||622.95|0|622.95|0||ECMO/ECLS REPOS PERPH CNULA|| 80001|33965||239.14|0|239.14|0||ECMO/ECLS RMVL PERPH CANNULA|| 80001|33966||288.47|0|288.47|0||ECMO/ECLS RMVL PRPH CANNULA|| 80001|33967||313.99|0|313.99|0||INSERT IA PERCUT DEVICE|| 80001|33968||40.42|0|40.42|0||REMOVE AORTIC ASSIST DEVICE|| 80001|33969||352.49|0|352.49|0||ECMO/ECLS RMVL PERPH CANNULA|| 80001|33970||430.9|0|430.9|0||AORTIC CIRCULATION ASSIST|| 80001|33971||854.47|0|854.47|0||AORTIC CIRCULATION ASSIST|| 80001|33973||625.57|0|625.57|0||INSERT BALLOON DEVICE|| 80001|33974||1074.51|0|1074.51|0||REMOVE INTRA-AORTIC BALLOON|| 80001|33975||1593.66|0|1593.66|0||IMPLANT VENTRICULAR DEVICE|| 80001|33976||1943.5|0|1943.5|0||IMPLANT VENTRICULAR DEVICE|| 80001|33977||1370.74|0|1370.74|0||REMOVE VENTRICULAR DEVICE|| 80001|33978||1627.43|0|1627.43|0||REMOVE VENTRICULAR DEVICE|| 80001|33979||2377.13|0|2377.13|0||INSERT INTRACORPOREAL DEVICE|| 80001|33980||2163.73|0|2163.73|0||REMOVE INTRACORPOREAL DEVICE|| 80001|33981||1018.02|0|1018.02|0||REPLACE VAD PUMP EXT|| 80001|33982||2392.33|0|2392.33|0||REPLACE VAD INTRA W/O BP|| 80001|33983||2824.11|0|2824.11|0||REPLACE VAD INTRA W/BP|| 80001|33984||347.35|0|347.35|0||ECMO/ECLS RMVL PRPH CANNULA|| 80001|33985||664.19|0|664.19|0||ECMO/ECLS RMVL CTR CANNULA|| 80001|33986||633.67|0|633.67|0||ECMO/ECLS RMVL CTR CANNULA|| 80001|33987||254.26|0|254.26|0||ARTERY EXPOS/GRAFT ARTERY|| 80001|33988||945.25|0|945.25|0||INSERTION OF LEFT HEART VENT|| 80001|33989||600.83|0|600.83|0||REMOVAL OF LEFT HEART VENT|| 80001|33990||531.7|0|531.7|0||INSERT VAD ARTERY ACCESS|| 80001|33991||770.27|0|770.27|0||INSERT VAD ART&VEIN ACCESS|| 80001|33992||259.13|0|259.13|0||REMOVE VAD DIFFERENT SESSION|| 80001|33993||228.28|0|228.28|0||REPOSITION VAD DIFF SESSION|| 80001|33999||0|0|0|0||CARDIAC SURGERY PROCEDURE|| 80001|34001||1208.01|0|1208.01|0||REMOVAL OF ARTERY CLOT|| 80001|34051||1096.71|0|1096.71|0||REMOVAL OF ARTERY CLOT|| 80001|34101||737.39|0|737.39|0||REMOVAL OF ARTERY CLOT|| 80001|34111||733.9|0|733.9|0||REMOVAL OF ARM ARTERY CLOT|| 80001|34151||1724.02|0|1724.02|0||REMOVAL OF ARTERY CLOT|| 80001|34201||1269.32|0|1269.32|0||REMOVAL OF ARTERY CLOT|| 80001|34203||1171.47|0|1171.47|0||REMOVAL OF LEG ARTERY CLOT|| 80001|34401||1785.7|0|1785.7|0||REMOVAL OF VEIN CLOT|| 80001|34421||892.73|0|892.73|0||REMOVAL OF VEIN CLOT|| 80001|34451||2006.95|0|2006.95|0||REMOVAL OF VEIN CLOT|| 80001|34471||1332.33|0|1332.33|0||REMOVAL OF VEIN CLOT|| 80001|34490||746.61|0|746.61|0||REMOVAL OF VEIN CLOT|| 80001|34501||1099.97|0|1099.97|0||REPAIR VALVE - FEMORAL VEIN|| 80001|34502||1867.62|0|1867.62|0||RECONSTRUCT VENA CAVA|| 80001|34510||1437.54|0|1437.54|0||TRANSPOSITION OF VEIN VALVE|| 80001|34520||1220.32|0|1220.32|0||CROSS-OVER VEIN GRAFT|| 80001|34530||1332.68|0|1332.68|0||LEG VEIN FUSION|| 80001|34701||1527.59|0|1527.59|0||EVASC RPR A-AO NDGFT|| 80001|34702||2283.88|0|2283.88|0||EVASC RPR A-AO NDGFT RPT|| 80001|34703||1723.6|0|1723.6|0||EVASC RPR A-UNILAC NDGFT|| 80001|34704||2869.5|0|2869.5|0||EVASC RPR A-UNILAC NDGFT RPT|| 80001|34705||1897.67|0|1897.67|0||EVAC RPR A-BIILIAC NDGFT|| 80001|34706||2858.94|0|2858.94|0||EVASC RPR A-BIILIAC RPT|| 80001|34707||1425.5|0|1425.5|0||EVASC RPR ILIO-ILIAC NDGFT|| 80001|34708||2297.05|0|2297.05|0||EVASC RPR ILIO-ILIAC RPT|| 80001|34709||403.09|0|403.09|0||PLMT XTN PROSTH EVASC RPR|| 80001|34710||992.22|0|992.22|0||DLYD PLMT XTN PROSTH 1ST VSL|| 80001|34711||372.2|0|372.2|0||DLYD PLMT XTN PROSTH EA ADDL|| 80001|34712||841.93|0|841.93|0||TCAT DLVR ENHNCD FIXJ DEV|| 80001|34713||159.99|0|159.99|0||PERQ ACCESS & CLSR FEM ART|| 80001|34714||335.51|0|335.51|0||OPN FEM ART EXPOS CNDT CRTJ|| 80001|34715||375.19|0|375.19|0||OPN AX/SUBCLA ART EXPOS|| 80001|34716||464.82|0|464.82|0||OPN AX/SUBCLA ART EXPOS CNDT|| 80001|34800||1386.9|0|1386.9|0||ENDOVAS AAA REPR W/SM TUBE|| 80001|34802||1533.64|0|1533.64|0||ENDOVAS AAA REPR W/2-P PART|| 80001|34803||1584.31|0|1584.31|0||ENDOVAS AAA REPR W/3-P PART|| 80001|34804||1531.32|0|1531.32|0||ENDOVAS AAA REPR W/1-P PART|| 80001|34805||1475.28|0|1475.28|0||ENDOVAS AAA REPR W/LONG TUBE|| 80001|34806||123.82|0|123.82|0||ANEURYSM PRESS SENSOR ADD-ON|| 80001|34808||257.34|0|257.34|0||ENDOVAS ILIAC A DEVICE ADDON|| 80001|34812||416.57|0|416.57|0||XPOSE FOR ENDOPROSTH - FEMORL|| 80001|34813||292.85|0|292.85|0||FEMORAL ENDOVAS GRAFT ADD-ON|| 80001|34820||605.39|0|605.39|0||XPOSE FOR ENDOPROSTH - ILIAC|| 80001|34825||852.2|0|852.2|0||ENDOVASC EXTEND PROSTH - INIT|| 80001|34826||253.84|0|253.84|0||ENDOVASC EXTEN PROSTH - ADD'L|| 80001|34830||2183.03|0|2183.03|0||OPEN AORTIC TUBE PROSTH REPR|| 80001|34831||2347.88|0|2347.88|0||OPEN AORTOILIAC PROSTH REPR|| 80001|34832||2347.88|0|2347.88|0||OPEN AORTOFEMOR PROSTH REPR|| 80001|34833||753.66|0|753.66|0||XPOSE FOR ENDOPROSTH - ILIAC|| 80001|34834||335.58|0|335.58|0||XPOSE - ENDOPROSTH - BRACHIAL|| 80001|34839||0|0|0|0||PLNNING PT SPEC FENEST GRAFT|| 80001|34841||0|0|0|0||ENDOVASC VISC AORTA 1 GRAFT|| 80001|34842||0|0|0|0||ENDOVASC VISC AORTA 2 GRAFT|| 80001|34843||0|0|0|0||ENDOVASC VISC AORTA 3 GRAFT|| 80001|34844||0|0|0|0||ENDOVASC VISC AORTA 4 GRAFT|| 80001|34845||0|0|0|0||VISC & INFRAREN ABD 1 PROSTH|| 80001|34846||0|0|0|0||VISC & INFRAREN ABD 2 PROSTH|| 80001|34847||0|0|0|0||VISC & INFRAREN ABD 3 PROSTH|| 80001|34848||0|0|0|0||VISC & INFRAREN ABD 4+ PROST|| 80001|34900||1098.37|0|1098.37|0||ENDOVASC ILIAC REPR W/GRAFT|| 80001|35001||1387.22|0|1387.22|0||REPAIR DEFECT OF ARTERY|| 80001|35002||1402.78|0|1402.78|0||REPAIR ARTERY RUPTURE - NECK|| 80001|35005||1400.69|0|1400.69|0||REPAIR DEFECT OF ARTERY|| 80001|35011||1229.69|0|1229.69|0||REPAIR DEFECT OF ARTERY|| 80001|35013||1529.67|0|1529.67|0||REPAIR ARTERY RUPTURE - ARM|| 80001|35021||1536.27|0|1536.27|0||REPAIR DEFECT OF ARTERY|| 80001|35022||1760.77|0|1760.77|0||REPAIR ARTERY RUPTURE - CHEST|| 80001|35045||1216.3|0|1216.3|0||REPAIR DEFECT OF ARM ARTERY|| 80001|35081||2152.25|0|2152.25|0||REPAIR DEFECT OF ARTERY|| 80001|35082||2702.44|0|2702.44|0||REPAIR ARTERY RUPTURE - AORTA|| 80001|35091||2215.72|0|2215.72|0||REPAIR DEFECT OF ARTERY|| 80001|35092||3222.26|0|3222.26|0||REPAIR ARTERY RUPTURE - AORTA|| 80001|35102||2331.39|0|2331.39|0||REPAIR DEFECT OF ARTERY|| 80001|35103||2777.79|0|2777.79|0||REPAIR ARTERY RUPTURE - GROIN|| 80001|35111||1642.75|0|1642.75|0||REPAIR DEFECT OF ARTERY|| 80001|35112||2281.81|0|2281.81|0||REPAIR ARTERY RUPTURE - SPLEEN|| 80001|35121||2025.58|0|2025.58|0||REPAIR DEFECT OF ARTERY|| 80001|35122||2634.37|0|2634.37|0||REPAIR ARTERY RUPTURE - BELLY|| 80001|35131||1710.71|0|1710.71|0||REPAIR DEFECT OF ARTERY|| 80001|35132||2023.61|0|2023.61|0||REPAIR ARTERY RUPTURE - GROIN|| 80001|35141||1363.99|0|1363.99|0||REPAIR DEFECT OF ARTERY|| 80001|35142||1625.39|0|1625.39|0||REPAIR ARTERY RUPTURE - THIGH|| 80001|35151||1531.43|0|1531.43|0||REPAIR DEFECT OF ARTERY|| 80001|35152||1728.68|0|1728.68|0||REPAIR ARTERY RUPTURE - KNEE|| 80001|35180||1090.41|0|1090.41|0||REPAIR BLOOD VESSEL LESION|| 80001|35182||1995.79|0|1995.79|0||REPAIR BLOOD VESSEL LESION|| 80001|35184||1355.59|0|1355.59|0||REPAIR BLOOD VESSEL LESION|| 80001|35188||1291.89|0|1291.89|0||REPAIR BLOOD VESSEL LESION|| 80001|35189||1868|0|1868|0||REPAIR BLOOD VESSEL LESION|| 80001|35190||927.85|0|927.85|0||REPAIR BLOOD VESSEL LESION|| 80001|35201||1166.18|0|1166.18|0||REPAIR BLOOD VESSEL LESION|| 80001|35206||945.18|0|945.18|0||REPAIR BLOOD VESSEL LESION|| 80001|35207||891.6|0|891.6|0||REPAIR BLOOD VESSEL LESION|| 80001|35211||1666.98|0|1666.98|0||REPAIR BLOOD VESSEL LESION|| 80001|35216||2482.52|0|2482.52|0||REPAIR BLOOD VESSEL LESION|| 80001|35221||1771.37|0|1771.37|0||REPAIR BLOOD VESSEL LESION|| 80001|35226||1019.08|0|1019.08|0||REPAIR BLOOD VESSEL LESION|| 80001|35231||1485.85|0|1485.85|0||REPAIR BLOOD VESSEL LESION|| 80001|35236||1200.83|0|1200.83|0||REPAIR BLOOD VESSEL LESION|| 80001|35241||1745.89|0|1745.89|0||REPAIR BLOOD VESSEL LESION|| 80001|35246||1916.51|0|1916.51|0||REPAIR BLOOD VESSEL LESION|| 80001|35251||2090.07|0|2090.07|0||REPAIR BLOOD VESSEL LESION|| 80001|35256||1250.02|0|1250.02|0||REPAIR BLOOD VESSEL LESION|| 80001|35261||1309.29|0|1309.29|0||REPAIR BLOOD VESSEL LESION|| 80001|35266||1059.79|0|1059.79|0||REPAIR BLOOD VESSEL LESION|| 80001|35271||1675.97|0|1675.97|0||REPAIR BLOOD VESSEL LESION|| 80001|35276||1777.22|0|1777.22|0||REPAIR BLOOD VESSEL LESION|| 80001|35281||1988.13|0|1988.13|0||REPAIR BLOOD VESSEL LESION|| 80001|35286||1144.87|0|1144.87|0||REPAIR BLOOD VESSEL LESION|| 80001|35301||1391.47|0|1391.47|0||RECHANNELING OF ARTERY|| 80001|35302||1387.25|0|1387.25|0||RECHANNELING OF ARTERY|| 80001|35303||1528.96|0|1528.96|0||RECHANNELING OF ARTERY|| 80001|35304||1582.6|0|1582.6|0||RECHANNELING OF ARTERY|| 80001|35305||1508.81|0|1508.81|0||RECHANNELING OF ARTERY|| 80001|35306||554.39|0|554.39|0||RECHANNELING OF ARTERY|| 80001|35311||1907.66|0|1907.66|0||RECHANNELING OF ARTERY|| 80001|35321||1091.83|0|1091.83|0||RECHANNELING OF ARTERY|| 80001|35331||1792.11|0|1792.11|0||RECHANNELING OF ARTERY|| 80001|35341||1676.54|0|1676.54|0||RECHANNELING OF ARTERY|| 80001|35351||1577.6|0|1577.6|0||RECHANNELING OF ARTERY|| 80001|35355||1276.03|0|1276.03|0||RECHANNELING OF ARTERY|| 80001|35361||1883.48|0|1883.48|0||RECHANNELING OF ARTERY|| 80001|35363||2153.67|0|2153.67|0||RECHANNELING OF ARTERY|| 80001|35371||1007.88|0|1007.88|0||RECHANNELING OF ARTERY|| 80001|35372||1208.75|0|1208.75|0||RECHANNELING OF ARTERY|| 80001|35390||197.41|0|197.41|0||REOPERATION - CAROTID ADD-ON|| 80001|35400||184.56|0|184.56|0||ANGIOSCOPY|| 80001|35450||619.93|0|619.93|0||REPAIR ARTERIAL BLOCKAGE|| 80001|35452||422.32|0|422.32|0||REPAIR ARTERIAL BLOCKAGE|| 80001|35458||603.47|0|603.47|0||REPAIR ARTERIAL BLOCKAGE|| 80001|35460||385.53|0|385.53|0||REPAIR VENOUS BLOCKAGE|| 80001|35471||2868.25|0|638.09|0||REPAIR ARTERIAL BLOCKAGE|| 80001|35472||2097.72|0|437.8|0||REPAIR ARTERIAL BLOCKAGE|| 80001|35475||1750.51|0|408.08|0||REPAIR ARTERIAL BLOCKAGE|| 80001|35476||1596.24|0|329.01|0||REPAIR VENOUS BLOCKAGE|| 80001|35500||395.09|0|395.09|0||HARVEST VEIN FOR BYPASS|| 80001|35501||1855.13|0|1855.13|0||ARTERY BYPASS GRAFT|| 80001|35506||1578.09|0|1578.09|0||ARTERY BYPASS GRAFT|| 80001|35508||1643.07|0|1643.07|0||ARTERY BYPASS GRAFT|| 80001|35509||1751.12|0|1751.12|0||ARTERY BYPASS GRAFT|| 80001|35510||1522.78|0|1522.78|0||ARTERY BYPASS GRAFT|| 80001|35511||1387.14|0|1387.14|0||ARTERY BYPASS GRAFT|| 80001|35512||1686.49|0|1686.49|0||ARTERY BYPASS GRAFT|| 80001|35515||1864.03|0|1864.03|0||ARTERY BYPASS GRAFT|| 80001|35516||1510.74|0|1510.74|0||ARTERY BYPASS GRAFT|| 80001|35518||1413.93|0|1413.93|0||ARTERY BYPASS GRAFT|| 80001|35521||1516.98|0|1516.98|0||ARTERY BYPASS GRAFT|| 80001|35522||1497.55|0|1497.55|0||ARTERY BYPASS GRAFT|| 80001|35523||1590.21|0|1590.21|0||ARTERY BYPASS GRAFT|| 80001|35525||1415.1|0|1415.1|0||ARTERY BYPASS GRAFT|| 80001|35526||2122.64|0|2122.64|0||ARTERY BYPASS GRAFT|| 80001|35531||2494.74|0|2494.74|0||ARTERY BYPASS GRAFT|| 80001|35533||1864.63|0|1864.63|0||ARTERY BYPASS GRAFT|| 80001|35535||2357.84|0|2357.84|0||ARTERY BYPASS GRAFT|| 80001|35536||2093.07|0|2093.07|0||ARTERY BYPASS GRAFT|| 80001|35537||2903.54|0|2903.54|0||ARTERY BYPASS GRAFT|| 80001|35538||2893.25|0|2893.25|0||ARTERY BYPASS GRAFT|| 80001|35539||2717.57|0|2717.57|0||ARTERY BYPASS GRAFT|| 80001|35540||3165.41|0|3165.41|0||ARTERY BYPASS GRAFT|| 80001|35556||1726.97|0|1726.97|0||ARTERY BYPASS GRAFT|| 80001|35558||1511.75|0|1511.75|0||ARTERY BYPASS GRAFT|| 80001|35560||2111.07|0|2111.07|0||ARTERY BYPASS GRAFT|| 80001|35563||1854.5|0|1854.5|0||ARTERY BYPASS GRAFT|| 80001|35565||1636.49|0|1636.49|0||ARTERY BYPASS GRAFT|| 80001|35566||2063.31|0|2063.31|0||ARTERY BYPASS GRAFT|| 80001|35570||1873.64|0|1873.64|0||ARTERY BYPASS GRAFT|| 80001|35571||1640.93|0|1640.93|0||ARTERY BYPASS GRAFT|| 80001|35572||426.18|0|426.18|0||HARVEST FEMOROPOPLITEAL VEIN|| 80001|35583||1791.46|0|1791.46|0||VEIN BYPASS GRAFT|| 80001|35585||2073.78|0|2073.78|0||VEIN BYPASS GRAFT|| 80001|35587||1692.42|0|1692.42|0||VEIN BYPASS GRAFT|| 80001|35600||311.33|0|311.33|0||HARVEST ARTERY FOR CABG|| 80001|35601||1731.58|0|1731.58|0||ARTERY BYPASS GRAFT|| 80001|35606||1452.23|0|1452.23|0||ARTERY BYPASS GRAFT|| 80001|35612||1290.61|0|1290.61|0||ARTERY BYPASS GRAFT|| 80001|35616||1364.15|0|1364.15|0||ARTERY BYPASS GRAFT|| 80001|35621||1358.32|0|1358.32|0||ARTERY BYPASS GRAFT|| 80001|35623||1624.88|0|1624.88|0||BYPASS GRAFT - NOT VEIN|| 80001|35626||1928.62|0|1928.62|0||ARTERY BYPASS GRAFT|| 80001|35631||2286.93|0|2286.93|0||ARTERY BYPASS GRAFT|| 80001|35632||2238.55|0|2238.55|0||ARTERY BYPASS GRAFT|| 80001|35633||2487.76|0|2487.76|0||ARTERY BYPASS GRAFT|| 80001|35634||2261.39|0|2261.39|0||ARTERY BYPASS GRAFT|| 80001|35636||1974.26|0|1974.26|0||ARTERY BYPASS GRAFT|| 80001|35637||2146.29|0|2146.29|0||ARTERY BYPASS GRAFT|| 80001|35638||2175.44|0|2175.44|0||ARTERY BYPASS GRAFT|| 80001|35642||1397.99|0|1397.99|0||ARTERY BYPASS GRAFT|| 80001|35645||1168.57|0|1168.57|0||ARTERY BYPASS GRAFT|| 80001|35646||2119.2|0|2119.2|0||ARTERY BYPASS GRAFT|| 80001|35647||1912.21|0|1912.21|0||ARTERY BYPASS GRAFT|| 80001|35650||1340.55|0|1340.55|0||ARTERY BYPASS GRAFT|| 80001|35654||1693.9|0|1693.9|0||ARTERY BYPASS GRAFT|| 80001|35656||1336.47|0|1336.47|0||ARTERY BYPASS GRAFT|| 80001|35661||1337.1|0|1337.1|0||ARTERY BYPASS GRAFT|| 80001|35663||1557.19|0|1557.19|0||ARTERY BYPASS GRAFT|| 80001|35665||1445.92|0|1445.92|0||ARTERY BYPASS GRAFT|| 80001|35666||1557.53|0|1557.53|0||ARTERY BYPASS GRAFT|| 80001|35671||1375.77|0|1375.77|0||ARTERY BYPASS GRAFT|| 80001|35681||98.92|0|98.92|0||COMPOSITE BYPASS GRAFT|| 80001|35682||437.93|0|437.93|0||COMPOSITE BYPASS GRAFT|| 80001|35683||509.18|0|509.18|0||COMPOSITE BYPASS GRAFT|| 80001|35685||246.51|0|246.51|0||BYPASS GRAFT PATENCY/PATCH|| 80001|35686||200.4|0|200.4|0||BYPASS GRAFT/AV FIST PATENCY|| 80001|35691||1167.31|0|1167.31|0||ARTERIAL TRANSPOSITION|| 80001|35693||1027.58|0|1027.58|0||ARTERIAL TRANSPOSITION|| 80001|35694||1219.6|0|1219.6|0||ARTERIAL TRANSPOSITION|| 80001|35695||1266.85|0|1266.85|0||ARTERIAL TRANSPOSITION|| 80001|35697||183.01|0|183.01|0||REIMPLANT ARTERY EACH|| 80001|35700||189.17|0|189.17|0||REOPERATION - BYPASS GRAFT|| 80001|35701||683.14|0|683.14|0||EXPLORATION - CAROTID ARTERY|| 80001|35721||555.78|0|555.78|0||EXPLORATION - FEMORAL ARTERY|| 80001|35741||622.46|0|622.46|0||EXPLORATION POPLITEAL ARTERY|| 80001|35761||471.13|0|471.13|0||EXPLORATION OF ARTERY/VEIN|| 80001|35800||862.99|0|862.99|0||EXPLORE NECK VESSELS|| 80001|35820||2432.15|0|2432.15|0||EXPLORE CHEST VESSELS|| 80001|35840||1433.05|0|1433.05|0||EXPLORE ABDOMINAL VESSELS|| 80001|35860||1027|0|1027|0||EXPLORE LIMB VESSELS|| 80001|35870||1538.77|0|1538.77|0||REPAIR VESSEL GRAFT DEFECT|| 80001|35875||728.72|0|728.72|0||REMOVAL OF CLOT IN GRAFT|| 80001|35876||1162.75|0|1162.75|0||REMOVAL OF CLOT IN GRAFT|| 80001|35879||1135.76|0|1135.76|0||REVISE GRAFT W/VEIN|| 80001|35881||1254.38|0|1254.38|0||REVISE GRAFT W/VEIN|| 80001|35883||1491.32|0|1491.32|0||REVISE GRAFT W/NONAUTO GRAFT|| 80001|35884||1535.94|0|1535.94|0||REVISE GRAFT W/VEIN|| 80001|35901||601.73|0|601.73|0||EXCISION - GRAFT - NECK|| 80001|35903||688.97|0|688.97|0||EXCISION - GRAFT - EXTREMITY|| 80001|35905||2166.58|0|2166.58|0||EXCISION - GRAFT - THORAX|| 80001|35907||2359.86|0|2359.86|0||EXCISION - GRAFT - ABDOMEN|| 80001|36000||28.7|0|10.86|0||PLACE NEEDLE IN VEIN|| 80001|36002||189.63|0|129.55|0||PSEUDOANEURYSM INJECTION TRT|| 80001|36005||360.03|0|58.83|0||INJECTION EXT VENOGRAPHY|| 80001|36010||563.85|0|149.45|0||PLACE CATHETER IN VEIN|| 80001|36011||934.84|0|192.49|0||PLACE CATHETER IN VEIN|| 80001|36012||967.08|0|212.71|0||PLACE CATHETER IN VEIN|| 80001|36013||872.02|0|152.15|0||PLACE CATHETER IN ARTERY|| 80001|36014||909.87|0|184.19|0||PLACE CATHETER IN ARTERY|| 80001|36015||966.67|0|208.42|0||PLACE CATHETER IN ARTERY|| 80001|36100||555.62|0|188.13|0||ESTABLISH ACCESS TO ARTERY|| 80001|36120||472.47|0|122.81|0||ESTABLISH ACCESS TO ARTERY|| 80001|36140||491.08|0|125.14|0||ESTABLISH ACCESS TO ARTERY|| 80001|36147||937.76|0|227.2|0||ACCESS AV DIAL GRFT FOR EVAL|| 80001|36148||293.19|0|60.21|0||ACCESS AV DIAL GRFT FOR PROC|| 80001|36160||557.63|0|151.37|0||ESTABLISH ACCESS TO AORTA|| 80001|36200||703.31|0|187.74|0||PLACE CATHETER IN AORTA|| 80001|36215||1262.92|0|287.59|0||PLACE CATHETER IN ARTERY|| 80001|36216||1315.99|0|333.3|0||PLACE CATHETER IN ARTERY|| 80001|36217||2117.1|0|395.54|0||PLACE CATHETER IN ARTERY|| 80001|36218||207.96|0|63.75|0||PLACE CATHETER IN ARTERY|| 80001|36221||1225.49|0|262.18|0||PLACE CATH THORACIC AORTA|| 80001|36222||1422.6|0|358.89|0||PLACE CATH CAROTID/INOM ART|| 80001|36223||1704.55|0|392.36|0||PLACE CATH CAROTID/INOM ART|| 80001|36224||2121.96|0|442.27|0||PLACE CATH CAROTD ART|| 80001|36225||1646.03|0|391.59|0||PLACE CATH SUBCLAVIAN ART|| 80001|36226||2073.11|0|439.94|0||PLACE CATH VERTEBRAL ART|| 80001|36227||298.79|0|140.63|0||PLACE CATH XTRNL CAROTID|| 80001|36228||1410.4|0|285.82|0||PLACE CATH INTRACRANIAL ART|| 80001|36245||1531.42|0|307.61|0||PLACE CATHETER IN ARTERY|| 80001|36246||1008.58|0|328.64|0||PLACE CATHETER IN ARTERY|| 80001|36247||1768.19|0|388.93|0||PLACE CATHETER IN ARTERY|| 80001|36248||173.05|0|60.25|0||PLACE CATHETER IN ARTERY|| 80001|36251||1593.52|0|342.96|0||INS CATH REN ART 1ST UNILAT|| 80001|36252||1736.05|0|455.25|0||INS CATH REN ART 1ST BILAT|| 80001|36253||2533.44|0|460.67|0||INS CATH REN ART 2ND+ UNILAT|| 80001|36254||2468.39|0|528.58|0||INS CATH REN ART 2ND+ BILAT|| 80001|36260||768.96|0|768.96|0||INSERTION OF INFUSION PUMP|| 80001|36261||431.45|0|431.45|0||REVISION OF INFUSION PUMP|| 80001|36262||360.79|0|360.79|0||REMOVAL OF INFUSION PUMP|| 80001|36299||0|0|0|0||VESSEL INJECTION PROCEDURE|| 80001|36400||32.67|0|22.98|0||BL DRAW < 3 YRS FEM/JUGULAR|| 80001|36405||30.43|0|19.19|0||BL DRAW < 3 YRS SCALP VEIN|| 80001|36406||23.27|0|12.03|0||BL DRAW < 3 YRS OTHER VEIN|| 80001|36410||19.4|0|11.25|0||NON-ROUTINE BL DRAW > 3 YRS|| 80001|36415||3.6|0|3.6|0||ROUTINE VENIPUNCTURE|| 80001|36416||3.6|0|3.6|||CAPILLARY BLOOD DRAW|| 80001|36420||61.01|0|61.01|0||VEIN ACCESS CUTDOWN < 1 YR|| 80001|36425||47.91|0|47.91|0||VEIN ACCESS CUTDOWN > 1 YR|| 80001|36430||37.99|0|37.99|0||BLOOD TRANSFUSION SERVICE|| 80001|36440||67.34|0|67.34|0||BL PUSH TRANSFUSE - 2 YR OR <|| 80001|36450||142.36|0|142.36|0||BL EXCHANGE/TRANSFUSE - NB|| 80001|36455||154.91|0|154.91|0||BL EXCHANGE/TRANSFUSE NON-NB|| 80001|36456||133.08|0|133.08|0||PRTL EXCHANGE TRANSFUSE NB|| 80001|36460||416.1|0|416.1|0||TRANSFUSION SERVICE - FETAL|| 80001|36465||1766.16|0|148.24|0||NJX NONCMPND SCLRSNT 1 VEIN|| 80001|36466||1848.35|0|188.48|0||NJX NONCMPND SCLRSNT MLT VN|| 80001|36468||0|0|0|0||INJECTION(S) - SPIDER VEINS|| 80001|36470||170.36|0|99.04|0||INJECTION THERAPY OF VEIN|| 80001|36471||200.69|0|120.06|0||INJECTION THERAPY OF VEINS|| 80001|36473||1826.88|0|215.76|0||ENDOVENOUS MCHNCHEM 1ST VEIN|| 80001|36474||334.63|0|108.1|0||ENDOVENOUS MCHNCHEM ADD-ON|| 80001|36475||1715.8|0|341.97|0||ENDOVENOUS RF - 1ST VEIN|| 80001|36476||339.22|0|165.17|0||ENDOVENOUS RF - VEIN ADD-ON|| 80001|36478||1347.91|0|340.02|0||ENDOVENOUS LASER - 1ST VEIN|| 80001|36479||352.01|0|165.94|0||ENDOVENOUS LASER VEIN ADDON|| 80001|36481||2304.52|0|428.68|0||INSERTION OF CATHETER - VEIN|| 80001|36482||2353.05|0|219.76|0||ENDOVEN THER CHEM ADHES 1ST|| 80001|36483||168.64|0|109.61|0||ENDOVEN THER CHEM ADHES SBSQ|| 80001|36500||219.7|0|219.7|0||INSERTION OF CATHETER - VEIN|| 80001|36510||107.12|0|69.52|0||INSERTION OF CATHETER - VEIN|| 80001|36511||110.34|0|110.34|0||APHERESIS WBC|| 80001|36512||113.05|0|113.05|0||APHERESIS RBC|| 80001|36513||115.79|0|115.79|0||APHERESIS PLATELETS|| 80001|36514||595.3|0|111.12|0||APHERESIS PLASMA|| 80001|36515||2265.3|0|109.18|0||APHERESIS - ADSORP/REINFUSE|| 80001|36516||2284.77|0|83.69|0||APHERESIS - SELECTIVE|| 80001|36522||1536.58|0|120.11|0||PHOTOPHERESIS|| 80001|36555||291.99|0|142.75|0||INSERT NON-TUNNEL CV CATH|| 80001|36556||268.74|0|146.63|0||INSERT NON-TUNNEL CV CATH|| 80001|36557||1152.26|0|393.63|0||INSERT TUNNELED CV CATH|| 80001|36558||886.08|0|334.06|0||INSERT TUNNELED CV CATH|| 80001|36560||1211.02|0|425.26|0||INSERT TUNNELED CV CATH|| 80001|36561||1325.55|0|425.04|0||INSERT TUNNELED CV CATH|| 80001|36563||1504.04|0|457|0||INSERT TUNNELED CV CATH|| 80001|36565||1094.18|0|419.67|0||INSERT TUNNELED CV CATH|| 80001|36566||6132.71|0|464.1|0||INSERT TUNNELED CV CATH|| 80001|36568||343.33|0|119.66|0||INSERT PICC CATH|| 80001|36569||283.97|0|111.08|0||INSERT PICC CATH|| 80001|36570||1336.01|0|366.49|0||INSERT PICVAD CATH|| 80001|36571||1467.87|0|387.87|0||INSERT PICVAD CATH|| 80001|36575||186.3|0|42.48|0||REPAIR TUNNELED CV CATH|| 80001|36576||444.54|0|237.53|0||REPAIR TUNNELED CV CATH|| 80001|36578||592.36|0|260.14|0||REPLACE TUNNELED CV CATH|| 80001|36580||243.37|0|81.33|0||REPLACE CVAD CATH|| 80001|36581||863.05|0|236.99|0||REPLACE TUNNELED CV CATH|| 80001|36582||1235.21|0|368.42|0||REPLACE TUNNELED CV CATH|| 80001|36583||1532.44|0|403.99|0||REPLACE TUNNELED CV CATH|| 80001|36584||230.86|0|80.07|0||REPLACE PICC CATH|| 80001|36585||1300.88|0|341.44|0||REPLACE PICVAD CATH|| 80001|36589||193.75|0|165.45|0||REMOVAL TUNNELED CV CATH|| 80001|36590||340.35|0|245.77|0||REMOVAL TUNNELED CV CATH|| 80001|36591||25.59|0|25.59|0||DRAW BLOOD OFF VENOUS DEVICE|| 80001|36592||28.69|0|28.69|0||COLLECT BLOOD FROM PICC|| 80001|36593||33.73|0|33.73|0||DECLOT VASCULAR DEVICE|| 80001|36595||661.94|0|223.9|0||MECH REMOV TUNNELED CV CATH|| 80001|36596||150.6|0|53.68|0||MECH REMOV TUNNELED CV CATH|| 80001|36597||147.18|0|75.08|0||REPOSITION VENOUS CATHETER|| 80001|36598||124.57|0|44.33|0||INJ W/FLUOR - EVAL CV DEVICE|| 80001|36600||36.29|0|18.45|0||WITHDRAWAL OF ARTERIAL BLOOD|| 80001|36620||62.01|0|62.01|0||INSERTION CATHETER - ARTERY|| 80001|36625||124.78|0|124.78|0||INSERTION CATHETER - ARTERY|| 80001|36640||142.53|0|142.53|0||INSERTION CATHETER - ARTERY|| 80001|36660||73.96|0|73.96|0||INSERTION CATHETER - ARTERY|| 80001|36680||71.17|0|71.17|0||INSERT NEEDLE - BONE CAVITY|| 80001|36800||149.44|0|149.44|0||INSERTION OF CANNULA|| 80001|36810||259.29|0|259.29|0||INSERTION OF CANNULA|| 80001|36815||168.15|0|168.15|0||INSERTION OF CANNULA|| 80001|36818||846.94|0|846.94|0||AV FUSE - UPPR ARM - CEPHALIC|| 80001|36819||898.59|0|898.59|0||AV FUSE - UPPR ARM - BASILIC|| 80001|36820||891.81|0|891.81|0||AV FUSION/FOREARM VEIN|| 80001|36821||812.99|0|812.99|0||AV FUSION DIRECT ANY SITE|| 80001|36823||1665.05|0|1665.05|0||INSERTION OF CANNULA(S)|| 80001|36825||979.61|0|979.61|0||ARTERY-VEIN AUTOGRAFT|| 80001|36830||817.83|0|817.83|0||ARTERY-VEIN NONAUTOGRAFT|| 80001|36831||755.92|0|755.92|0||OPEN THROMBECT AV FISTULA|| 80001|36832||926.65|0|926.65|0||AV FISTULA REVISION - OPEN|| 80001|36833||991.52|0|991.52|0||AV FISTULA REVISION|| 80001|36835||601.78|0|601.78|0||ARTERY TO VEIN SHUNT|| 80001|36838||1407.36|0|1407.36|0||DIST REVAS LIGATION - HEMO|| 80001|36860||238.28|0|132.45|0||EXTERNAL CANNULA DECLOTTING|| 80001|36861||160.34|0|160.34|0||CANNULA DECLOTTING|| 80001|36870||2045.18|0|362.77|0||PERCUT THROMBECT AV FISTULA|| 80001|36901||696.81|0|181.31|0||INTRO CATH DIALYSIS CIRCUIT|| 80001|36902||1481.92|0|270.03|0||INTRO CATH DIALYSIS CIRCUIT|| 80001|36903||6795.88|0|369.51|0||INTRO CATH DIALYSIS CIRCUIT|| 80001|36904||2160.64|0|425.5|0||THRMBC/NFS DIALYSIS CIRCUIT|| 80001|36905||2764.87|0|534.02|0||THRMBC/NFS DIALYSIS CIRCUIT|| 80001|36906||8240.76|0|623.17|0||THRMBC/NFS DIALYSIS CIRCUIT|| 80001|36907||886.74|0|155.47|0||BALO ANGIOP CTR DIALYSIS SEG|| 80001|36908||3266.16|0|232.99|0||STENT PLMT CTR DIALYSIS SEG|| 80001|36909||2382.44|0|221.36|0||DIALYSIS CIRCUIT EMBOLJ|| 80001|37140||2781.29|0|2781.29|0||REVISION OF CIRCULATION|| 80001|37145||2578.5|0|2578.5|0||REVISION OF CIRCULATION|| 80001|37160||2648.42|0|2648.42|0||REVISION OF CIRCULATION|| 80001|37180||2548|0|2548|0||REVISION OF CIRCULATION|| 80001|37181||2781.29|0|2781.29|0||SPLICE SPLEEN/KIDNEY VEINS|| 80001|37182||1020.91|0|1020.91|0||INSERT HEPATIC SHUNT (TIPS)|| 80001|37183||6551.37|0|481.54|0||REMOVE HEPATIC SHUNT (TIPS)|| 80001|37184||2549.7|0|562.6|0||PRIM ART MECH THROMBECTOMY|| 80001|37185||809.12|0|205.16|0||PRIM ART M-THROMBECT ADD-ON|| 80001|37186||1543.95|0|304.63|0||SEC ART M-THROMBECT ADD-ON|| 80001|37187||2315.42|0|498.12|0||VENOUS MECH THROMBECTOMY|| 80001|37188||1971.07|0|358.05|0||VENOUS M-THROMBECTOMY ADD-ON|| 80001|37191||2927.27|0|292.02|0||INS ENDOVAS VENA CAVA FILTR|| 80001|37192||1886.69|0|456.26|0||REDO ENDOVAS VENA CAVA FILTR|| 80001|37193||1802.65|0|448.19|0||REM ENDOVAS VENA CAVA FILTER|| 80001|37195||0|0|0|0||THROMBOLYTIC THERAPY - STROKE|| 80001|37197||1707.69|0|387.74|0||REMOVE INTRVAS FOREIGN BODY|| 80001|37200||269.95|0|269.95|0||TRANSCATHETER BIOPSY|| 80001|37202||365.32|0|365.32|0||TRANSCATHETER THERAPY INFUSE|| 80001|37211||489.87|0|489.87|0||THROMBOLYTIC ART THERAPY|| 80001|37212||429.51|0|429.51|0||THROMBOLYTIC VENOUS THERAPY|| 80001|37213||302.98|0|302.98|0||THROMBLYTIC ART/VEN THERAPY|| 80001|37214||166.7|0|166.7|0||CESSJ THERAPY CATH REMOVAL|| 80001|37215||1323.3|0|1323.3|0||TRANSCATH STENT - CCA W/EPS|| 80001|37216||0|0|0|0||TRANSCATH STENT - CCA W/O EPS|| 80001|37217||1366.73|0|1366.73|0||STENT PLACEMT RETRO CAROTID|| 80001|37218||998.69|0|998.69|0||STENT PLACEMT ANTE CAROTID|| 80001|37220||3521.63|0|509.97|0||ILIAC REVASC|| 80001|37221||5183.87|0|626.26|0||ILIAC REVASC W/STENT|| 80001|37222||994.46|0|230.01|0||ILIAC REVASC ADD-ON|| 80001|37223||2882.67|0|264.09|0||ILIAC REVASC W/STENT ADD-ON|| 80001|37224||4268.87|0|562.15|0||FEM/POPL REVAS W/TLA|| 80001|37225||12217.3|0|758.74|0||FEM/POPL REVAS W/ATHER|| 80001|37226||10049.89|0|659.83|0||FEM/POPL REVASC W/STENT|| 80001|37227||16490.91|0|912.79|0||FEM/POPL REVASC STNT & ATHER|| 80001|37228||6062.81|0|686.1|0||TIB/PER REVASC W/TLA|| 80001|37229||12063.12|0|885.6|0||TIB/PER REVASC W/ATHER|| 80001|37230||9237.21|0|873.27|0||TIB/PER REVASC W/STENT|| 80001|37231||14809.16|0|949.1|0||TIB/PER REVASC STENT & ATHER|| 80001|37232||1359.65|0|249.03|0||TIB/PER REVASC ADD-ON|| 80001|37233||1652.09|0|404.63|0||TIBPER REVASC W/ATHER ADD-ON|| 80001|37234||4303.88|0|349.46|0||REVSC OPN/PRQ TIB/PERO STENT|| 80001|37235||4630.69|0|481.28|0||TIB/PER REVASC STNT & ATHER|| 80001|37236||4616.15|0|557.06|0||OPEN/PERQ PLACE STENT 1ST|| 80001|37237||2762.11|0|264.48|0||OPEN/PERQ PLACE STENT EA ADD|| 80001|37238||4563.93|0|390.09|0||OPEN/PERQ PLACE STENT SAME|| 80001|37239||2251.75|0|184.8|0||OPEN/PERQ PLACE STENT EA ADD|| 80001|37241||5106.04|0|542.61|0||VASC EMBOLIZE/OCCLUDE VENOUS|| 80001|37242||8583.99|0|604.98|0||VASC EMBOLIZE/OCCLUDE ARTERY|| 80001|37243||10833.11|0|720.86|0||VASC EMBOLIZE/OCCLUDE ORGAN|| 80001|37244||7605.81|0|841.31|0||VASC EMBOLIZE/OCCLUDE BLEED|| 80001|37246||2609.83|0|443.15|0||TRLUML BALO ANGIOP 1ST ART|| 80001|37247||1055.99|0|219.64|0||TRLUML BALO ANGIOP ADDL ART|| 80001|37248||1807.93|0|381.14|0||TRLUML BALO ANGIOP 1ST VEIN|| 80001|37249||774.77|0|186.91|0||TRLUML BALO ANGIOP ADDL VEIN|| 80001|37252||1545.97|0|112.19|0||INTRVASC US NONCORONARY 1ST|| 80001|37253||245.41|0|89.75|0||INTRVASC US NONCORONARY ADDL|| 80001|37500||783.31|0|783.31|0||ENDOSCOPY LIGATE PERF VEINS|| 80001|37501||0|0|0|0||VASCULAR ENDOSCOPY PROCEDURE|| 80001|37565||881.27|0|881.27|0||LIGATION OF NECK VEIN|| 80001|37600||874.99|0|874.99|0||LIGATION OF NECK ARTERY|| 80001|37605||964.21|0|964.21|0||LIGATION OF NECK ARTERY|| 80001|37606||589.67|0|589.67|0||LIGATION OF NECK ARTERY|| 80001|37607||456.66|0|456.66|0||LIGATION OF A-V FISTULA|| 80001|37609||358.82|0|247.17|0||TEMPORAL ARTERY PROCEDURE|| 80001|37615||604.45|0|604.45|0||LIGATION OF NECK ARTERY|| 80001|37616||1335.32|0|1335.32|0||LIGATION OF CHEST ARTERY|| 80001|37617||1624.73|0|1624.73|0||LIGATION OF ABDOMEN ARTERY|| 80001|37618||459.56|0|459.56|0||LIGATION OF EXTREMITY ARTERY|| 80001|37619||1981.2|0|1981.2|0||LIGATION OF INF VENA CAVA|| 80001|37650||565.39|0|565.39|0||REVISION OF MAJOR VEIN|| 80001|37660||1574.74|0|1574.74|0||REVISION OF MAJOR VEIN|| 80001|37700||300.58|0|300.58|0||REVISE LEG VEIN|| 80001|37718||528.76|0|528.76|0||LIGATE/STRIP SHORT LEG VEIN|| 80001|37722||580.21|0|580.21|0||LIGATE/STRIP LONG LEG VEIN|| 80001|37735||716.34|0|716.34|0||REMOVAL OF LEG VEINS/LESION|| 80001|37760||746.03|0|746.03|0||LIGATION - LEG VEINS - OPEN|| 80001|37761||672.46|0|672.46|0||LIGATE LEG VEINS OPEN|| 80001|37765||766.59|0|545.24|0||PHLEB VEINS - EXTREM - TO 20|| 80001|37766||912.39|0|667.01|0||PHLEB VEINS - EXTREM 20+|| 80001|37780||310.77|0|310.77|0||REVISION OF LEG VEIN|| 80001|37785||419.3|0|316.96|0||LIGATE/DIVIDE/EXCISE VEIN|| 80001|37788||1507.78|0|1507.78|0||REVASCULARIZATION - PENIS|| 80001|37790||578.46|0|578.46|0||PENILE VENOUS OCCLUSION|| 80001|37799||0|0|0|0||VASCULAR SURGERY PROCEDURE|| 80001|38100||1379.7|0|1379.7|0||REMOVAL OF SPLEEN - TOTAL|| 80001|38101||1394.09|0|1394.09|0||REMOVAL OF SPLEEN - PARTIAL|| 80001|38102||315.71|0|315.71|0||REMOVAL OF SPLEEN - TOTAL|| 80001|38115||1528.33|0|1528.33|0||REPAIR OF RUPTURED SPLEEN|| 80001|38120||1255.6|0|1255.6|0||LAPAROSCOPY - SPLENECTOMY|| 80001|38129||0|0|0|0||LAPAROSCOPE PROC - SPLEEN|| 80001|38200||162.74|0|162.74|0||INJECTION FOR SPLEEN X-RAY|| 80001|38204||121.55|0|121.55|0||BL DONOR SEARCH MANAGEMENT|| 80001|38205||98.04|0|98.04|0||HARVEST ALLOGENIC STEM CELLS|| 80001|38206||98.82|0|98.82|0||HARVEST AUTO STEM CELLS|| 80001|38207||53.51|0|53.51|0||CRYOPRESERVE STEM CELLS|| 80001|38208||33.46|0|33.46|0||THAW PRESERVED STEM CELLS|| 80001|38209||14.23|0|14.23|0||WASH HARVEST STEM CELLS|| 80001|38210||95.25|0|95.25|0||T-CELL DEPLETION OF HARVEST|| 80001|38211||86.06|0|86.06|0||TUMOR CELL DEPLETE OF HARVST|| 80001|38212||56.83|0|56.83|0||RBC DEPLETION OF HARVEST|| 80001|38213||14.23|0|14.23|0||PLATELET DEPLETE OF HARVEST|| 80001|38214||48.89|0|48.89|0||VOLUME DEPLETE OF HARVEST|| 80001|38215||56.83|0|56.83|0||HARVEST STEM CELL CONCENTRTE|| 80001|38220||185.77|0|73.35|0||BONE MARROW ASPIRATION|| 80001|38221||190.51|0|89.72|0||BONE MARROW BIOPSY|| 80001|38222||195|0|94.03|0||DX BONE MARROW BX & ASPIR|| 80001|38230||236.3|0|236.3|0||BONE MARROW COLLECTION|| 80001|38232||242.56|0|242.56|0||BONE MARROW HARVEST AUTOLOG|| 80001|38240||266.35|0|266.35|0||BONE MARROW/STEM TRANSPLANT|| 80001|38241||200.34|0|200.34|0||BONE MARROW/STEM TRANSPLANT|| 80001|38242||141.8|0|141.8|0||LYMPHOCYTE INFUSE TRANSPLANT|| 80001|38243||141.88|0|141.88|0||TRANSPLJ HEMATOPOIETIC BOOST|| 80001|38300||314.69|0|216.22|0||DRAINAGE - LYMPH NODE LESION|| 80001|38305||546.56|0|546.56|0||DRAINAGE - LYMPH NODE LESION|| 80001|38308||526.18|0|526.18|0||INCISION OF LYMPH CHANNELS|| 80001|38380||662.78|0|662.78|0||THORACIC DUCT PROCEDURE|| 80001|38381||961.78|0|961.78|0||THORACIC DUCT PROCEDURE|| 80001|38382||807.89|0|807.89|0||THORACIC DUCT PROCEDURE|| 80001|38500||384.57|0|301.23|0||BIOPSY/REMOVAL - LYMPH NODES|| 80001|38505||145.71|0|85.23|0||NEEDLE BIOPSY - LYMPH NODES|| 80001|38510||608.01|0|499.86|0||BIOPSY/REMOVAL - LYMPH NODES|| 80001|38520||549.61|0|549.61|0||BIOPSY/REMOVAL - LYMPH NODES|| 80001|38525||516|0|516|0||BIOPSY/REMOVAL - LYMPH NODES|| 80001|38530||648.04|0|648.04|0||BIOPSY/REMOVAL - LYMPH NODES|| 80001|38542||613.69|0|613.69|0||EXPLORE DEEP NODE(S) - NECK|| 80001|38550||599.24|0|599.24|0||REMOVAL - NECK/ARMPIT LESION|| 80001|38555||1195.6|0|1195.6|0||REMOVAL - NECK/ARMPIT LESION|| 80001|38562||836.35|0|836.35|0||REMOVAL - PELVIC LYMPH NODES|| 80001|38564||838.58|0|838.58|0||REMOVAL - ABDOMEN LYMPH NODES|| 80001|38570||642.27|0|642.27|0||LAPAROSCOPY - LYMPH NODE BIOP|| 80001|38571||956.29|0|956.29|0||LAPAROSCOPY - LYMPHADENECTOMY|| 80001|38572||1177.37|0|1177.37|0||LAPAROSCOPY - LYMPHADENECTOMY|| 80001|38573||1417.86|0|1417.86|0||LAPS PELVIC LYMPHADEC|| 80001|38589||0|0|0|0||LAPAROSCOPE PROC - LYMPHATIC|| 80001|38700||958.67|0|958.67|0||REMOVAL OF LYMPH NODES - NECK|| 80001|38720||1600.86|0|1600.86|0||REMOVAL OF LYMPH NODES - NECK|| 80001|38724||1733.24|0|1733.24|0||REMOVAL OF LYMPH NODES - NECK|| 80001|38740||823.61|0|823.61|0||REMOVE ARMPIT LYMPH NODES|| 80001|38745||1040.7|0|1040.7|0||REMOVE ARMPIT LYMPH NODES|| 80001|38746||261.59|0|261.59|0||REMOVE THORACIC LYMPH NODES|| 80001|38747||321.92|0|321.92|0||REMOVE ABDOMINAL LYMPH NODES|| 80001|38760||1001.95|0|1001.95|0||REMOVE GROIN LYMPH NODES|| 80001|38765||1543.51|0|1543.51|0||REMOVE GROIN LYMPH NODES|| 80001|38770||963.37|0|963.37|0||REMOVE PELVIS LYMPH NODES|| 80001|38780||1225.13|0|1225.13|0||REMOVE ABDOMEN LYMPH NODES|| 80001|38790||99.48|0|99.48|0||INJECT FOR LYMPHATIC X-RAY|| 80001|38792||46.47|0|46.47|0||IDENTIFY SENTINEL NODE|| 80001|38794||357.48|0|357.48|0||ACCESS THORACIC LYMPH DUCT|| 80001|38900||165.69|0|165.69|0||IO MAP OF SENT LYMPH NODE|| 80001|38999||0|0|0|0||BLOOD/LYMPH SYSTEM PROCEDURE|| 80001|39000||591.94|0|591.94|0||EXPLORATION OF CHEST|| 80001|39010||945.43|0|945.43|0||EXPLORATION OF CHEST|| 80001|39200||1057.72|0|1057.72|0||REMOVAL CHEST LESION|| 80001|39220||1369.6|0|1369.6|0||REMOVAL CHEST LESION|| 80001|39401||373.45|0|373.45|0||MEDIASTINOSCPY W/MEDSTNL BX|| 80001|39402||488.39|0|488.39|0||MEDIASTINOSCPY W/LMPH NOD BX|| 80001|39499||0|0|0|0||CHEST PROCEDURE|| 80001|39501||1015.19|0|1015.19|0||REPAIR DIAPHRAGM LACERATION|| 80001|39503||7396.41|0|7396.41|0||REPAIR OF DIAPHRAGM HERNIA|| 80001|39540||1039.52|0|1039.52|0||REPAIR OF DIAPHRAGM HERNIA|| 80001|39541||1132.72|0|1132.72|0||REPAIR OF DIAPHRAGM HERNIA|| 80001|39545||1069.03|0|1069.03|0||REVISION OF DIAPHRAGM|| 80001|39560||952.61|0|952.61|0||RESECT DIAPHRAGM - SIMPLE|| 80001|39561||1478.95|0|1478.95|0||RESECT DIAPHRAGM - COMPLEX|| 80001|39599||0|0|0|0||DIAPHRAGM SURGERY PROCEDURE|| 80001|40490||148|0|87.14|0||BIOPSY OF LIP|| 80001|40500||584.03|0|427.42|0||PARTIAL EXCISION OF LIP|| 80001|40510||562.71|0|421.6|0||PARTIAL EXCISION OF LIP|| 80001|40520||568.39|0|424.18|0||PARTIAL EXCISION OF LIP|| 80001|40525||651.41|0|651.41|0||RECONSTRUCT LIP WITH FLAP|| 80001|40527||733.61|0|733.61|0||RECONSTRUCT LIP WITH FLAP|| 80001|40530||627.11|0|476.71|0||PARTIAL REMOVAL OF LIP|| 80001|40650||504.64|0|350.74|0||REPAIR LIP|| 80001|40652||569.13|0|417.56|0||REPAIR LIP|| 80001|40654||658.64|0|500.09|0||REPAIR LIP|| 80001|40700||1189.13|0|1189.13|0||REPAIR CLEFT LIP/NASAL|| 80001|40701||1169.64|0|1169.64|0||REPAIR CLEFT LIP/NASAL|| 80001|40702||1115.26|0|1115.26|0||REPAIR CLEFT LIP/NASAL|| 80001|40720||1216.35|0|1216.35|0||REPAIR CLEFT LIP/NASAL|| 80001|40761||1163.44|0|1163.44|0||REPAIR CLEFT LIP/NASAL|| 80001|40799||0|0|0|0||LIP SURGERY PROCEDURE|| 80001|40800||244.58|0|155.42|0||DRAINAGE OF MOUTH LESION|| 80001|40801||369.74|0|265.07|0||DRAINAGE OF MOUTH LESION|| 80001|40804||244.88|0|154.56|0||REMOVAL - FOREIGN BODY - MOUTH|| 80001|40805||377.81|0|278.18|0||REMOVAL - FOREIGN BODY - MOUTH|| 80001|40806||122.7|0|38.96|0||INCISION OF LIP FOLD|| 80001|40808||215.32|0|128.09|0||BIOPSY OF MOUTH LESION|| 80001|40810||238.95|0|151.73|0||EXCISION OF MOUTH LESION|| 80001|40812||336.81|0|235.63|0||EXCISE/REPAIR MOUTH LESION|| 80001|40814||452.33|0|362.79|0||EXCISE/REPAIR MOUTH LESION|| 80001|40816||471.65|0|376.68|0||EXCISION OF MOUTH LESION|| 80001|40818||418.66|0|322.14|0||EXCISE ORAL MUCOSA FOR GRAFT|| 80001|40819||366.5|0|282.38|0||EXCISE LIP OR CHEEK FOLD|| 80001|40820||305.92|0|201.25|0||TREATMENT OF MOUTH LESION|| 80001|40830||308.03|0|196.77|0||REPAIR MOUTH LACERATION|| 80001|40831||391.56|0|265.58|0||REPAIR MOUTH LACERATION|| 80001|40840||954.99|0|749.93|0||RECONSTRUCTION OF MOUTH|| 80001|40842||963.57|0|778.66|0||RECONSTRUCTION OF MOUTH|| 80001|40843||1282.3|0|1029.94|0||RECONSTRUCTION OF MOUTH|| 80001|40844||1527|0|1258.36|0||RECONSTRUCTION OF MOUTH|| 80001|40845||1733.63|0|1472.36|0||RECONSTRUCTION OF MOUTH|| 80001|40899||0|0|0|0||MOUTH SURGERY PROCEDURE|| 80001|41000||189.67|0|133.85|0||DRAINAGE OF MOUTH LESION|| 80001|41005||261.21|0|147.63|0||DRAINAGE OF MOUTH LESION|| 80001|41006||448.06|0|318.58|0||DRAINAGE OF MOUTH LESION|| 80001|41007||440.47|0|309.05|0||DRAINAGE OF MOUTH LESION|| 80001|41008||444.7|0|321.82|0||DRAINAGE OF MOUTH LESION|| 80001|41009||471.78|0|349.28|0||DRAINAGE OF MOUTH LESION|| 80001|41010||232.42|0|127.37|0||INCISION OF TONGUE FOLD|| 80001|41015||530.78|0|416.81|0||DRAINAGE OF MOUTH LESION|| 80001|41016||516.91|0|418.45|0||DRAINAGE OF MOUTH LESION|| 80001|41017||524.28|0|421.56|0||DRAINAGE OF MOUTH LESION|| 80001|41018||594.7|0|491.59|0||DRAINAGE OF MOUTH LESION|| 80001|41019||556.94|0|556.94|0||PLACE NEEDLES H&N FOR RT|| 80001|41100||195.79|0|128.73|0||BIOPSY OF TONGUE|| 80001|41105||199.11|0|133.21|0||BIOPSY OF TONGUE|| 80001|41108||171.9|0|107.55|0||BIOPSY OF FLOOR OF MOUTH|| 80001|41110||245.64|0|156.48|0||EXCISION OF TONGUE LESION|| 80001|41112||391.16|0|300.06|0||EXCISION OF TONGUE LESION|| 80001|41113||429.23|0|333.09|0||EXCISION OF TONGUE LESION|| 80001|41114||758.19|0|758.19|0||EXCISION OF TONGUE LESION|| 80001|41115||285.8|0|172.99|0||EXCISION OF TONGUE FOLD|| 80001|41116||384.36|0|260.32|0||EXCISION OF MOUTH LESION|| 80001|41120||1229.27|0|1229.27|0||PARTIAL REMOVAL OF TONGUE|| 80001|41130||1530.11|0|1530.11|0||PARTIAL REMOVAL OF TONGUE|| 80001|41135||2557.77|0|2557.77|0||TONGUE AND NECK SURGERY|| 80001|41140||2565.03|0|2565.03|0||REMOVAL OF TONGUE|| 80001|41145||3250.54|0|3250.54|0||TONGUE REMOVAL - NECK SURGERY|| 80001|41150||2579.79|0|2579.79|0||TONGUE - MOUTH - JAW SURGERY|| 80001|41153||2820.99|0|2820.99|0||TONGUE - MOUTH - NECK SURGERY|| 80001|41155||3559.57|0|3559.57|0||TONGUE - JAW - & NECK SURGERY|| 80001|41250||311.35|0|183.04|0||REPAIR TONGUE LACERATION|| 80001|41251||339.69|0|218.36|0||REPAIR TONGUE LACERATION|| 80001|41252||368.73|0|250.89|0||REPAIR TONGUE LACERATION|| 80001|41500||531.08|0|531.08|0||FIXATION OF TONGUE|| 80001|41510||464.63|0|464.63|0||TONGUE TO LIP SURGERY|| 80001|41512||746.08|0|746.08|0||TONGUE SUSPENSION|| 80001|41520||413.65|0|306.66|0||RECONSTRUCTION - TONGUE FOLD|| 80001|41530||3603.23|0|487.29|0||TONGUE BASE VOL REDUCTION|| 80001|41599||0|0|0|0||TONGUE AND MOUTH SURGERY|| 80001|41800||308.32|0|171.09|0||DRAINAGE OF GUM LESION|| 80001|41805||286.93|0|200.87|0||REMOVAL FOREIGN BODY - GUM|| 80001|41806||415.02|0|309.19|0||REMOVAL FOREIGN BODY - JAWBONE|| 80001|41820||0|0|0|0||EXCISION - GUM - EACH QUADRANT|| 80001|41821||0|0|0|0||EXCISION OF GUM FLAP|| 80001|41822||361.79|0|219.91|0||EXCISION OF GUM LESION|| 80001|41823||530.58|0|393.35|0||EXCISION OF GUM LESION|| 80001|41825||245.37|0|145.74|0||EXCISION OF GUM LESION|| 80001|41826||368|0|253.25|0||EXCISION OF GUM LESION|| 80001|41827||518.82|0|368.41|0||EXCISION OF GUM LESION|| 80001|41828||362.67|0|259.17|0||EXCISION OF GUM LESION|| 80001|41830||462.5|0|340.39|0||REMOVAL OF GUM TISSUE|| 80001|41850||0|0|0|0||TREATMENT OF GUM LESION|| 80001|41870||0|0|0|0||GUM GRAFT|| 80001|41872||436.53|0|310.93|0||REPAIR GUM|| 80001|41874||442.36|0|305.91|0||REPAIR TOOTH SOCKET|| 80001|41899||0|0|0|0||DENTAL SURGERY PROCEDURE|| 80001|42000||183.16|0|122.68|0||DRAINAGE MOUTH ROOF LESION|| 80001|42100||175.76|0|130.4|0||BIOPSY ROOF OF MOUTH|| 80001|42104||250.48|0|165.58|0||EXCISION LESION - MOUTH ROOF|| 80001|42106||318.78|0|212.95|0||EXCISION LESION - MOUTH ROOF|| 80001|42107||539.46|0|411.54|0||EXCISION LESION - MOUTH ROOF|| 80001|42120||1171.95|0|1171.95|0||REMOVE PALATE/LESION|| 80001|42140||291.61|0|183.07|0||EXCISION OF UVULA|| 80001|42145||836.43|0|836.43|0||REPAIR PALATE - PHARYNX/UVULA|| 80001|42160||269.78|0|175.19|0||TREATMENT MOUTH ROOF LESION|| 80001|42180||284.48|0|218.58|0||REPAIR PALATE|| 80001|42182||375.94|0|305.39|0||REPAIR PALATE|| 80001|42200||1010.14|0|1010.14|0||RECONSTRUCT CLEFT PALATE|| 80001|42205||1057.35|0|1057.35|0||RECONSTRUCT CLEFT PALATE|| 80001|42210||1278.57|0|1278.57|0||RECONSTRUCT CLEFT PALATE|| 80001|42215||848.12|0|848.12|0||RECONSTRUCT CLEFT PALATE|| 80001|42220||633.85|0|633.85|0||RECONSTRUCT CLEFT PALATE|| 80001|42225||1031.37|0|1031.37|0||RECONSTRUCT CLEFT PALATE|| 80001|42226||1050.97|0|1050.97|0||LENGTHENING OF PALATE|| 80001|42227||986.2|0|986.2|0||LENGTHENING OF PALATE|| 80001|42235||861.22|0|861.22|0||REPAIR PALATE|| 80001|42260||1015.17|0|857.78|0||REPAIR NOSE TO LIP FISTULA|| 80001|42280||193.06|0|133.36|0||PREPARATION - PALATE MOLD|| 80001|42281||238.56|0|179.25|0||INSERTION - PALATE PROSTHESIS|| 80001|42299||0|0|0|0||PALATE/UVULA SURGERY|| 80001|42300||243.6|0|181.19|0||DRAINAGE OF SALIVARY GLAND|| 80001|42305||512.25|0|512.25|0||DRAINAGE OF SALIVARY GLAND|| 80001|42310||188.48|0|147.39|0||DRAINAGE OF SALIVARY GLAND|| 80001|42320||290.41|0|208.62|0||DRAINAGE OF SALIVARY GLAND|| 80001|42330||270.8|0|196.76|0||REMOVAL OF SALIVARY STONE|| 80001|42335||435.95|0|304.92|0||REMOVAL OF SALIVARY STONE|| 80001|42340||545.2|0|401.38|0||REMOVAL OF SALIVARY STONE|| 80001|42400||122.43|0|65.44|0||BIOPSY OF SALIVARY GLAND|| 80001|42405||349.19|0|269.73|0||BIOPSY OF SALIVARY GLAND|| 80001|42408||528.27|0|387.16|0||EXCISION OF SALIVARY CYST|| 80001|42409||386.85|0|263.19|0||DRAINAGE OF SALIVARY CYST|| 80001|42410||739.78|0|739.78|0||EXCISE PAROTID GLAND/LESION|| 80001|42415||1261.5|0|1261.5|0||EXCISE PAROTID GLAND/LESION|| 80001|42420||1418.43|0|1418.43|0||EXCISE PAROTID GLAND/LESION|| 80001|42425||997.38|0|997.38|0||EXCISE PAROTID GLAND/LESION|| 80001|42426||1617.08|0|1617.08|0||EXCISE PAROTID GLAND/LESION|| 80001|42440||490.18|0|490.18|0||EXCISE SUBMAXILLARY GLAND|| 80001|42450||530.17|0|425.5|0||EXCISE SUBLINGUAL GLAND|| 80001|42500||507.06|0|405.5|0||REPAIR SALIVARY DUCT|| 80001|42505||652.23|0|538.26|0||REPAIR SALIVARY DUCT|| 80001|42507||603.85|0|603.85|0||PAROTID DUCT DIVERSION|| 80001|42509||1000.94|0|1000.94|0||PAROTID DUCT DIVERSION|| 80001|42510||742.93|0|742.93|0||PAROTID DUCT DIVERSION|| 80001|42550||155.88|0|76.8|0||INJECTION FOR SALIVARY X-RAY|| 80001|42600||559.34|0|412.81|0||CLOSURE OF SALIVARY FISTULA|| 80001|42650||97.19|0|69.67|0||DILATION OF SALIVARY DUCT|| 80001|42660||147.65|0|105.78|0||DILATION OF SALIVARY DUCT|| 80001|42665||360.81|0|243.35|0||LIGATION OF SALIVARY DUCT|| 80001|42699||0|0|0|0||SALIVARY SURGERY PROCEDURE|| 80001|42700||220.54|0|160.84|0||DRAINAGE OF TONSIL ABSCESS|| 80001|42720||537.05|0|468.44|0||DRAINAGE OF THROAT ABSCESS|| 80001|42725||974.73|0|974.73|0||DRAINAGE OF THROAT ABSCESS|| 80001|42800||184.64|0|132.69|0||BIOPSY OF THROAT|| 80001|42804||224.29|0|133.2|0||BIOPSY OF UPPER NOSE/THROAT|| 80001|42806||252.53|0|155.62|0||BIOPSY OF UPPER NOSE/THROAT|| 80001|42808||264.22|0|192.89|0||EXCISE PHARYNX LESION|| 80001|42809||202.76|0|158.18|0||REMOVE PHARYNX FOREIGN BODY|| 80001|42810||450.55|0|340.07|0||EXCISION OF NECK CYST|| 80001|42815||662.01|0|662.01|0||EXCISION OF NECK CYST|| 80001|42820||344.14|0|344.14|0||REMOVE TONSILS AND ADENOIDS|| 80001|42821||357.16|0|357.16|0||REMOVE TONSILS AND ADENOIDS|| 80001|42825||309.24|0|309.24|0||REMOVAL OF TONSILS|| 80001|42826||297.34|0|297.34|0||REMOVAL OF TONSILS|| 80001|42830||244.99|0|244.99|0||REMOVAL OF ADENOIDS|| 80001|42831||263.14|0|263.14|0||REMOVAL OF ADENOIDS|| 80001|42835||227.53|0|227.53|0||REMOVAL OF ADENOIDS|| 80001|42836||284.88|0|284.88|0||REMOVAL OF ADENOIDS|| 80001|42842||1172.42|0|1172.42|0||EXTENSIVE SURGERY OF THROAT|| 80001|42844||1616.58|0|1616.58|0||EXTENSIVE SURGERY OF THROAT|| 80001|42845||2631.16|0|2631.16|0||EXTENSIVE SURGERY OF THROAT|| 80001|42860||222.14|0|222.14|0||EXCISION OF TONSIL TAGS|| 80001|42870||674.3|0|674.3|0||EXCISION OF LINGUAL TONSIL|| 80001|42890||1667.47|0|1667.47|0||PARTIAL REMOVAL OF PHARYNX|| 80001|42892||2220.29|0|2220.29|0||REVISION OF PHARYNGEAL WALLS|| 80001|42894||2788.66|0|2788.66|0||REVISION OF PHARYNGEAL WALLS|| 80001|42900||403.88|0|403.88|0||REPAIR THROAT WOUND|| 80001|42950||927.1|0|927.1|0||RECONSTRUCTION OF THROAT|| 80001|42953||1113.71|0|1113.71|0||REPAIR THROAT - ESOPHAGUS|| 80001|42955||879.44|0|879.44|0||SURGICAL OPENING OF THROAT|| 80001|42960||202.33|0|202.33|0||CONTROL THROAT BLEEDING|| 80001|42961||500.96|0|500.96|0||CONTROL THROAT BLEEDING|| 80001|42962||615.88|0|615.88|0||CONTROL THROAT BLEEDING|| 80001|42970||491.1|0|491.1|0||CONTROL NOSE/THROAT BLEEDING|| 80001|42971||542.98|0|542.98|0||CONTROL NOSE/THROAT BLEEDING|| 80001|42972||608.57|0|608.57|0||CONTROL NOSE/THROAT BLEEDING|| 80001|42999||0|0|0|0||THROAT SURGERY PROCEDURE|| 80001|43020||671.24|0|671.24|0||INCISION OF ESOPHAGUS|| 80001|43030||618.1|0|618.1|0||THROAT MUSCLE SURGERY|| 80001|43045||1569.1|0|1569.1|0||INCISION OF ESOPHAGUS|| 80001|43100||746.74|0|746.74|0||EXCISION OF ESOPHAGUS LESION|| 80001|43101||1271.13|0|1271.13|0||EXCISION OF ESOPHAGUS LESION|| 80001|43107||3079.94|0|3079.94|0||REMOVAL OF ESOPHAGUS|| 80001|43108||5653.13|0|5653.13|0||REMOVAL OF ESOPHAGUS|| 80001|43112||3251.1|0|3251.1|0||REMOVAL OF ESOPHAGUS|| 80001|43113||5292.23|0|5292.23|0||REMOVAL OF ESOPHAGUS|| 80001|43116||6284.33|0|6284.33|0||PARTIAL REMOVAL OF ESOPHAGUS|| 80001|43117||2974.87|0|2974.87|0||PARTIAL REMOVAL OF ESOPHAGUS|| 80001|43118||4606.24|0|4606.24|0||PARTIAL REMOVAL OF ESOPHAGUS|| 80001|43121||3468.94|0|3468.94|0||PARTIAL REMOVAL OF ESOPHAGUS|| 80001|43122||3077.59|0|3077.59|0||PARTIAL REMOVAL OF ESOPHAGUS|| 80001|43123||5722.85|0|5722.85|0||PARTIAL REMOVAL OF ESOPHAGUS|| 80001|43124||4625.98|0|4625.98|0||REMOVAL OF ESOPHAGUS|| 80001|43130||939.27|0|939.27|0||REMOVAL OF ESOPHAGUS POUCH|| 80001|43135||1798.5|0|1798.5|0||REMOVAL OF ESOPHAGUS POUCH|| 80001|43180||666.88|0|666.88|0||ESOPHAGOSCOPY RIGID TRNSO|| 80001|43191||183.42|0|183.42|0||ESOPHAGOSCOPY RIGID TRNSO DX|| 80001|43192||203.74|0|203.74|0||ESOPHAGOSCP RIG TRNSO INJECT|| 80001|43193||203.35|0|203.35|0||ESOPHAGOSCP RIG TRNSO BIOPSY|| 80001|43194||230.93|0|230.93|0||ESOPHAGOSCP RIG TRNSO REM FB|| 80001|43195||222.41|0|222.41|0||ESOPHAGOSCOPY RIGID BALLOON|| 80001|43196||235.86|0|235.86|0||ESOPHAGOSCP GUIDE WIRE DILAT|| 80001|43197||215.61|0|99.7|0||ESOPHAGOSCOPY FLEX DX BRUSH|| 80001|43198||242.9|0|119.63|0||ESOPHAGOSC FLEX TRNSN BIOPSY|| 80001|43200||307.1|0|112.89|0||ESOPHAGUS ENDOSCOPY|| 80001|43201||315.01|0|132.81|0||ESOPH SCOPE W/SUBMUCOUS INJ|| 80001|43202||411.15|0|133.2|0||ESOPHAGUS ENDOSCOPY - BIOPSY|| 80001|43204||174.25|0|174.25|0||ESOPH SCOPE W/SCLEROSIS INJ|| 80001|43205||179.77|0|179.77|0||ESOPHAGUS ENDOSCOPY/LIGATION|| 80001|43206||377.21|0|169.81|0||ESOPH OPTICAL ENDOMICROSCOPY|| 80001|43210||512.8|0|512.8|0||EGD ESOPHAGOGASTRC FNDOPLSTY|| 80001|43211||300.69|0|300.69|0||ESOPHAGOSCOP MUCOSAL RESECT|| 80001|43212||239.83|0|239.83|0||ESOPHAGOSCOP STENT PLACEMENT|| 80001|43213||1390.71|0|325.06|0||ESOPHAGOSCOPY RETRO BALLOON|| 80001|43214||242.51|0|242.51|0||ESOPHAGOSC DILATE BALLOON 30|| 80001|43215||465.87|0|180.17|0||ESOPHAGUS ENDOSCOPY|| 80001|43216||477.26|0|172.57|0||ESOPHAGUS ENDOSCOPY/LESION|| 80001|43217||510.09|0|204.23|0||ESOPHAGUS ENDOSCOPY|| 80001|43220||1268.69|0|151.48|0||ESOPH ENDOSCOPY - DILATION|| 80001|43226||433.2|0|166.88|0||ESOPH ENDOSCOPY - DILATION|| 80001|43227||452.33|0|210.44|0||ESOPH ENDOSCOPY - REPAIR|| 80001|43229||825.17|0|250.67|0||ESOPHAGOSCOPY LESION ABLATE|| 80001|43231||461.62|0|204.22|0||ESOPH ENDOSCOPY W/US EXAM|| 80001|43232||549.58|0|250.7|0||ESOPH ENDOSCOPY W/US FN BX|| 80001|43233||286.15|0|286.15|0||EGD BALLOON DIL ESOPH30 MM/>|| 80001|43235||358.11|0|157.69|0||UPPR GI ENDOSCOPY - DIAGNOSIS|| 80001|43236||445.09|0|177.61|0||UPPR GI SCOPE W/SUBMUC INJ|| 80001|43237||248.25|0|248.25|0||ENDOSCOPIC US EXAM - ESOPH|| 80001|43238||295.47|0|295.47|0||UPPR GI ENDOSCOPY W/US FN BX|| 80001|43239||455.94|0|177.22|0||UPPER GI ENDOSCOPY - BIOPSY|| 80001|43240||492.72|0|492.72|0||ESOPH ENDOSCOPE W/DRAIN CYST|| 80001|43241||181.93|0|181.93|0||UPPER GI ENDOSCOPY WITH TUBE|| 80001|43242||333.24|0|333.24|0||UPPR GI ENDOSCOPY W/US FN BX|| 80001|43243||300.22|0|300.22|0||UPPER GI ENDOSCOPY & INJECT|| 80001|43244||311.25|0|311.25|0||UPPER GI ENDOSCOPY/LIGATION|| 80001|43245||699.71|0|222.9|0||UPPR GI SCOPE DILATE STRICTR|| 80001|43246||252.92|0|252.92|0||PLACE GASTROSTOMY TUBE|| 80001|43247||468.02|0|225.36|0||OPERATIVE UPPER GI ENDOSCOPY|| 80001|43248||471.79|0|212.46|0||UPPR GI ENDOSCOPY/GUIDE WIRE|| 80001|43249||1215.03|0|196.29|0||ESOPH ENDOSCOPY - DILATION|| 80001|43250||522.46|0|215.83|0||UPPER GI ENDOSCOPY/TUMOR|| 80001|43251||574.65|0|249.03|0||OPERATIVE UPPER GI ENDOSCOPY|| 80001|43252||423.95|0|215.4|0||UPPR GI OPTICL ENDOMICRSCOPY|| 80001|43253||333.24|0|333.24|0||EGD US TRANSMURAL INJXN/MARK|| 80001|43254||341.61|0|341.61|0||EGD ENDO MUCOSAL RESECTION|| 80001|43255||496.74|0|255.23|0||OPERATIVE UPPER GI ENDOSCOPY|| 80001|43257||294.27|0|294.27|0||UPPR GI SCOPE W/THRML TXMNT|| 80001|43259||286.8|0|286.8|0||ENDOSCOPIC ULTRASOUND EXAM|| 80001|43260||406.77|0|406.77|0||ENDO CHOLANGIOPANCREATOGRAPH|| 80001|43261||425.91|0|425.91|0||ENDO CHOLANGIOPANCREATOGRAPH|| 80001|43262||449.55|0|449.55|0||ENDO CHOLANGIOPANCREATOGRAPH|| 80001|43263||450.71|0|450.71|0||ENDO CHOLANGIOPANCREATOGRAPH|| 80001|43264||458.26|0|458.26|0||ENDO CHOLANGIOPANCREATOGRAPH|| 80001|43265||543.82|0|543.82|0||ENDO CHOLANGIOPANCREATOGRAPH|| 80001|43266||286.55|0|286.55|0||EGD ENDOSCOPIC STENT PLACE|| 80001|43270||861.83|0|295.08|0||EGD LESION ABLATION|| 80001|43273||148.6|0|148.6|0||ENDOSCOPIC PANCREATOSCOPY|| 80001|43274||580.34|0|580.34|0||ERCP DUCT STENT PLACEMENT|| 80001|43275||473.22|0|473.22|0||ERCP REMOVE FORGN BODY DUCT|| 80001|43276||604.02|0|604.02|0||ERCP STENT EXCHANGE W/DILATE|| 80001|43277||475.72|0|475.72|0||ERCP EA DUCT/AMPULLA DILATE|| 80001|43278||543.38|0|543.38|0||ERCP LESION ABLATE W/DILATE|| 80001|43279||1550.28|0|1550.28|0||LAP MYOTOMY - HELLER|| 80001|43280||1293.47|0|1293.47|0||LAPAROSCOPY - FUNDOPLASTY|| 80001|43281||1851.53|0|1851.53|0||LAP PARAESOPHAG HERN REPAIR|| 80001|43282||2082.87|0|2082.87|0||LAP PARAESOPH HER RPR W/MESH|| 80001|43283||192.09|0|192.09|0||LAP ESOPH LENGTHENING|| 80001|43284||809.22|0|809.22|0||LAPS ESOPHGL SPHNCTR AGMNTJ|| 80001|43285||818.69|0|818.69|0||RMVL ESOPHGL SPHNCTR DEV|| 80001|43286||3857.14|0|3857.14|0||ESPHG TOT W/LAPS MOBLJ|| 80001|43287||4410.45|0|4410.45|0||ESPHG DSTL 2/3 W/LAPS MOBLJ|| 80001|43288||4599.62|0|4599.62|0||ESPHG THRSC MOBLJ|| 80001|43289||0|0|0|0||LAPAROSCOPE PROC - ESOPH|| 80001|43300||731.72|0|731.72|0||REPAIR OF ESOPHAGUS|| 80001|43305||1305.54|0|1305.54|0||REPAIR ESOPHAGUS AND FISTULA|| 80001|43310||1782.61|0|1782.61|0||REPAIR OF ESOPHAGUS|| 80001|43312||1940|0|1940|0||REPAIR ESOPHAGUS AND FISTULA|| 80001|43313||3129.19|0|3129.19|0||ESOPHAGOPLASTY CONGENITAL|| 80001|43314||3381.99|0|3381.99|0||TRACHEO-ESOPHAGOPLASTY CONG|| 80001|43320||1671.16|0|1671.16|0||FUSE ESOPHAGUS & STOMACH|| 80001|43325||1610.63|0|1610.63|0||REVISE ESOPHAGUS & STOMACH|| 80001|43327||975.61|0|975.61|0||ESOPH FUNDOPLASTY LAP|| 80001|43328||1367.37|0|1367.37|0||ESOPH FUNDOPLASTY THOR|| 80001|43330||1596.05|0|1596.05|0||REPAIR OF ESOPHAGUS|| 80001|43331||1620.82|0|1620.82|0||REPAIR OF ESOPHAGUS|| 80001|43332||1391.27|0|1391.27|0||TRANSAB ESOPH HIAT HERN RPR|| 80001|43333||1514.89|0|1514.89|0||TRANSAB ESOPH HIAT HERN RPR|| 80001|43334||1511.6|0|1511.6|0||TRANSTHOR DIAPHRAG HERN RPR|| 80001|43335||1625.22|0|1625.22|0||TRANSTHOR DIAPHRAG HERN RPR|| 80001|43336||1825.22|0|1825.22|0||THORABD DIAPHR HERN REPAIR|| 80001|43337||1961.25|0|1961.25|0||THORABD DIAPHR HERN REPAIR|| 80001|43338||140.76|0|140.76|0||ESOPH LENGTHENING|| 80001|43340||1649.2|0|1649.2|0||FUSE ESOPHAGUS & INTESTINE|| 80001|43341||1771.73|0|1771.73|0||FUSE ESOPHAGUS & INTESTINE|| 80001|43351||1662.11|0|1662.11|0||SURGICAL OPENING - ESOPHAGUS|| 80001|43352||1287.57|0|1287.57|0||SURGICAL OPENING - ESOPHAGUS|| 80001|43360||2855.42|0|2855.42|0||GASTROINTESTINAL REPAIR|| 80001|43361||3091.23|0|3091.23|0||GASTROINTESTINAL REPAIR|| 80001|43400||1822.35|0|1822.35|0||LIGATE ESOPHAGUS VEINS|| 80001|43401||1881.32|0|1881.32|0||ESOPHAGUS SURGERY FOR VEINS|| 80001|43405||1840.62|0|1840.62|0||LIGATE/STAPLE ESOPHAGUS|| 80001|43410||1255.04|0|1255.04|0||REPAIR ESOPHAGUS WOUND|| 80001|43415||3089.95|0|3089.95|0||REPAIR ESOPHAGUS WOUND|| 80001|43420||1217.18|0|1217.18|0||REPAIR ESOPHAGUS OPENING|| 80001|43425||1746.62|0|1746.62|0||REPAIR ESOPHAGUS OPENING|| 80001|43450||243.3|0|104.52|0||DILATE ESOPHAGUS|| 80001|43453||1088.94|0|112.45|0||DILATE ESOPHAGUS|| 80001|43460||263.95|0|263.95|0||PRESSURE TREATMENT ESOPHAGUS|| 80001|43496||0|0|0|0||FREE JEJUNUM FLAP - MICROVASC|| 80001|43499||0|0|0|0||ESOPHAGUS SURGERY PROCEDURE|| 80001|43500||935.51|0|935.51|0||SURGICAL OPENING OF STOMACH|| 80001|43501||1611.4|0|1611.4|0||SURGICAL REPAIR OF STOMACH|| 80001|43502||1826.24|0|1826.24|0||SURGICAL REPAIR OF STOMACH|| 80001|43510||1127.72|0|1127.72|0||SURGICAL OPENING OF STOMACH|| 80001|43520||819.61|0|819.61|0||INCISION OF PYLORIC MUSCLE|| 80001|43605||997|0|997|0||BIOPSY OF STOMACH|| 80001|43610||1172.91|0|1172.91|0||EXCISION OF STOMACH LESION|| 80001|43611||1459.34|0|1459.34|0||EXCISION OF STOMACH LESION|| 80001|43620||2360.74|0|2360.74|0||REMOVAL OF STOMACH|| 80001|43621||2723.74|0|2723.74|0||REMOVAL OF STOMACH|| 80001|43622||2776.77|0|2776.77|0||REMOVAL OF STOMACH|| 80001|43631||1735.73|0|1735.73|0||REMOVAL OF STOMACH - PARTIAL|| 80001|43632||2435.75|0|2435.75|0||REMOVAL OF STOMACH - PARTIAL|| 80001|43633||2301.72|0|2301.72|0||REMOVAL OF STOMACH - PARTIAL|| 80001|43634||2551.72|0|2551.72|0||REMOVAL OF STOMACH - PARTIAL|| 80001|43635||135.84|0|135.84|0||REMOVAL OF STOMACH - PARTIAL|| 80001|43640||1406.89|0|1406.89|0||VAGOTOMY & PYLORUS REPAIR|| 80001|43641||1436.71|0|1436.71|0||VAGOTOMY & PYLORUS REPAIR|| 80001|43644||2073.19|0|2073.19|0||LAP GASTRIC BYPASS/ROUX-EN-Y|| 80001|43645||2215.93|0|2215.93|0||LAP GASTR BYPASS INCL SMLL I|| 80001|43647||0|0|0|0||LAP IMPL ELECTRODE - ANTRUM|| 80001|43648||0|0|0|0||LAP REVISE/REMV ELTRD ANTRUM|| 80001|43651||778.85|0|778.85|0||LAPAROSCOPY - VAGUS NERVE|| 80001|43652||911.33|0|911.33|0||LAPAROSCOPY - VAGUS NERVE|| 80001|43653||678.54|0|678.54|0||LAPAROSCOPY - GASTROSTOMY|| 80001|43659||0|0|0|0||LAPAROSCOPE PROC - STOM|| 80001|43752||49.68|0|49.68|0||NASAL/OROGASTRIC W/STENT|| 80001|43753||26|0|26|0||TX GASTRO INTUB W/ASP|| 80001|43754||146.57|0|42.68|0||DX GASTR INTUB W/ASP SPEC|| 80001|43755||158.43|0|73.92|0||DX GASTR INTUB W/ASP SPECS|| 80001|43756||231.7|0|61.91|0||DX DUOD INTUB W/ASP SPEC|| 80001|43757||331.93|0|94.69|0||DX DUOD INTUB W/ASP SPECS|| 80001|43760||545.89|0|57.45|0||CHANGE GASTROSTOMY TUBE|| 80001|43761||139.05|0|124.71|0||REPOSITION GASTROSTOMY TUBE|| 80001|43770||1333.35|0|1333.35|0||LAP - PLACE GASTR ADJUST BAND|| 80001|43771||1516.2|0|1516.2|0||LAP - REVISE ADJUST GAST BAND|| 80001|43772||1135.97|0|1135.97|0||LAP - REMOVE ADJUST GAST BAND|| 80001|43773||1527.47|0|1527.47|0||LAP - CHANGE ADJUST GAST BAND|| 80001|43774||1145.15|0|1145.15|0||LAP REMOV ADJ GAST BAND/PORT|| 80001|43775||0|0|0|0||LAP SLEEVE GASTRECTOMY|| 80001|43800||1110.37|0|1110.37|0||RECONSTRUCTION OF PYLORUS|| 80001|43810||1217.96|0|1217.96|0||FUSION OF STOMACH AND BOWEL|| 80001|43820||1603.34|0|1603.34|0||FUSION OF STOMACH AND BOWEL|| 80001|43825||1565.86|0|1565.86|0||FUSION OF STOMACH AND BOWEL|| 80001|43830||830.84|0|830.84|0||PLACE GASTROSTOMY TUBE|| 80001|43831||703.78|0|703.78|0||PLACE GASTROSTOMY TUBE|| 80001|43832||1243.98|0|1243.98|0||PLACE GASTROSTOMY TUBE|| 80001|43840||1624.04|0|1624.04|0||REPAIR OF STOMACH LESION|| 80001|43842||1372.32|0|1372.32|0||V-BAND GASTROPLASTY|| 80001|43843||1531.66|0|1531.66|0||GASTROPLASTY W/O V-BAND|| 80001|43845||2350.51|0|2350.51|0||GASTROPLASTY DUODENAL SWITCH|| 80001|43846||1930.3|0|1930.3|0||GASTRIC BYPASS FOR OBESITY|| 80001|43847||2158.53|0|2158.53|0||GASTRIC BYPASS INCL SMALL I|| 80001|43848||2304.26|0|2304.26|0||REVISION GASTROPLASTY|| 80001|43850||1951.25|0|1951.25|0||REVISE STOMACH-BOWEL FUSION|| 80001|43855||2025.14|0|2025.14|0||REVISE STOMACH-BOWEL FUSION|| 80001|43860||1960.32|0|1960.32|0||REVISE STOMACH-BOWEL FUSION|| 80001|43865||2048.83|0|2048.83|0||REVISE STOMACH-BOWEL FUSION|| 80001|43870||849.72|0|849.72|0||REPAIR STOMACH OPENING|| 80001|43880||1908.73|0|1908.73|0||REPAIR STOMACH-BOWEL FISTULA|| 80001|43881||0|0|0|0||IMPL/REDO ELECTRD - ANTRUM|| 80001|43882||0|0|0|0||REVISE/REMOVE ELECTRD ANTRUM|| 80001|43886||425.54|0|425.54|0||REVISE GASTRIC PORT - OPEN|| 80001|43887||384.59|0|384.59|0||REMOVE GASTRIC PORT - OPEN|| 80001|43888||542.79|0|542.79|0||CHANGE GASTRIC PORT - OPEN|| 80001|43999||0|0|0|0||STOMACH SURGERY PROCEDURE|| 80001|44005||1307.83|0|1307.83|0||FREEING OF BOWEL ADHESION|| 80001|44010||1035.38|0|1035.38|0||INCISION OF SMALL BOWEL|| 80001|44015||172.03|0|172.03|0||INSERT NEEDLE CATH BOWEL|| 80001|44020||1164.62|0|1164.62|0||EXPLORE SMALL INTESTINE|| 80001|44021||1166.16|0|1166.16|0||DECOMPRESS SMALL BOWEL|| 80001|44025||1179.43|0|1179.43|0||INCISION OF LARGE BOWEL|| 80001|44050||1116.96|0|1116.96|0||REDUCE BOWEL OBSTRUCTION|| 80001|44055||1782.86|0|1782.86|0||CORRECT MALROTATION OF BOWEL|| 80001|44100||134.03|0|134.03|0||BIOPSY OF BOWEL|| 80001|44110||1017.39|0|1017.39|0||EXCISE INTESTINE LESION(S)|| 80001|44111||1175.6|0|1175.6|0||EXCISION OF BOWEL LESION(S)|| 80001|44120||1463.59|0|1463.59|0||REMOVAL OF SMALL INTESTINE|| 80001|44121||292.07|0|292.07|0||REMOVAL OF SMALL INTESTINE|| 80001|44125||1412.4|0|1412.4|0||REMOVAL OF SMALL INTESTINE|| 80001|44126||2958.58|0|2958.58|0||ENTERECTOMY W/O TAPER - CONG|| 80001|44127||3423.51|0|3423.51|0||ENTERECTOMY W/TAPER - CONG|| 80001|44128||294.41|0|294.41|0||ENTERECTOMY CONG - ADD-ON|| 80001|44130||1569.65|0|1569.65|0||BOWEL TO BOWEL FUSION|| 80001|44132||0|0|0|0||ENTERECTOMY - CADAVER DONOR|| 80001|44133||0|0|0|0||ENTERECTOMY - LIVE DONOR|| 80001|44135||0|0|0|0||INTESTINE TRANSPLNT - CADAVER|| 80001|44136||0|0|0|0||INTESTINE TRANSPLANT - LIVE|| 80001|44137||0|0|0|0||REMOVE INTESTINAL ALLOGRAFT|| 80001|44139||146.27|0|146.27|0||MOBILIZATION OF COLON|| 80001|44140||1604.73|0|1604.73|0||PARTIAL REMOVAL OF COLON|| 80001|44141||2179.66|0|2179.66|0||PARTIAL REMOVAL OF COLON|| 80001|44143||1990.46|0|1990.46|0||PARTIAL REMOVAL OF COLON|| 80001|44144||2118.42|0|2118.42|0||PARTIAL REMOVAL OF COLON|| 80001|44145||1986.49|0|1986.49|0||PARTIAL REMOVAL OF COLON|| 80001|44146||2538.23|0|2538.23|0||PARTIAL REMOVAL OF COLON|| 80001|44147||2331.19|0|2331.19|0||PARTIAL REMOVAL OF COLON|| 80001|44150||2232.75|0|2232.75|0||REMOVAL OF COLON|| 80001|44151||2570.11|0|2570.11|0||REMOVAL OF COLON/ILEOSTOMY|| 80001|44155||2486.18|0|2486.18|0||REMOVAL OF COLON/ILEOSTOMY|| 80001|44156||2764.1|0|2764.1|0||REMOVAL OF COLON/ILEOSTOMY|| 80001|44157||2608.44|0|2608.44|0||COLECTOMY W/ILEOANAL ANAST|| 80001|44158||2536.42|0|2536.42|0||COLECTOMY W/NEO-RECTUM POUCH|| 80001|44160||1484.8|0|1484.8|0||REMOVAL OF COLON|| 80001|44180||1097.62|0|1097.62|0||LAP - ENTEROLYSIS|| 80001|44186||777.23|0|777.23|0||LAP - JEJUNOSTOMY|| 80001|44187||1319.34|0|1319.34|0||LAP - ILEO/JEJUNO-STOMY|| 80001|44188||1459.37|0|1459.37|0||LAP - COLOSTOMY|| 80001|44202||1657.48|0|1657.48|0||LAP - ENTERECTOMY|| 80001|44203||294.41|0|294.41|0||LAP RESECT S/INTESTINE - ADDL|| 80001|44204||1842.85|0|1842.85|0||LAPARO PARTIAL COLECTOMY|| 80001|44205||1603.12|0|1603.12|0||LAP COLECTOMY PART W/ILEUM|| 80001|44206||2099.99|0|2099.99|0||LAP PART COLECTOMY W/STOMA|| 80001|44207||2186.4|0|2186.4|0||L COLECTOMY/COLOPROCTOSTOMY|| 80001|44208||2384.69|0|2384.69|0||L COLECTOMY/COLOPROCTOSTOMY|| 80001|44210||2132.15|0|2132.15|0||LAPARO TOTAL PROCTOCOLECTOMY|| 80001|44211||2604.66|0|2604.66|0||LAPARO TOTAL PROCTOCOLECTOMY|| 80001|44212||2455.35|0|2455.35|0||LAPARO TOTAL PROCTOCOLECTOMY|| 80001|44213||227.83|0|227.83|0||LAP - MOBIL SPLENIC FL ADD-ON|| 80001|44227||1999.89|0|1999.89|0||LAP - CLOSE ENTEROSTOMY|| 80001|44238||0|0|0|0||LAPAROSCOPE PROC - INTESTINE|| 80001|44300||1003.33|0|1003.33|0||OPEN BOWEL TO SKIN|| 80001|44310||1248.49|0|1248.49|0||ILEOSTOMY/JEJUNOSTOMY|| 80001|44312||702.78|0|702.78|0||REVISION OF ILEOSTOMY|| 80001|44314||1199.34|0|1199.34|0||REVISION OF ILEOSTOMY|| 80001|44316||1692.16|0|1692.16|0||DEVISE BOWEL POUCH|| 80001|44320||1435.12|0|1435.12|0||COLOSTOMY|| 80001|44322||1179.78|0|1179.78|0||COLOSTOMY WITH BIOPSIES|| 80001|44340||740.56|0|740.56|0||REVISION OF COLOSTOMY|| 80001|44345||1255.41|0|1255.41|0||REVISION OF COLOSTOMY|| 80001|44346||1412.92|0|1412.92|0||REVISION OF COLOSTOMY|| 80001|44360||183.86|0|183.86|0||SMALL BOWEL ENDOSCOPY|| 80001|44361||202.92|0|202.92|0||SMALL BOWEL ENDOSCOPY/BIOPSY|| 80001|44363||243.25|0|243.25|0||SMALL BOWEL ENDOSCOPY|| 80001|44364||259.41|0|259.41|0||SMALL BOWEL ENDOSCOPY|| 80001|44365||226.15|0|226.15|0||SMALL BOWEL ENDOSCOPY|| 80001|44366||304.61|0|304.61|0||SMALL BOWEL ENDOSCOPY|| 80001|44369||311.68|0|311.68|0||SMALL BOWEL ENDOSCOPY|| 80001|44370||336.56|0|336.56|0||SMALL BOWEL ENDOSCOPY/STENT|| 80001|44372||303.45|0|303.45|0||SMALL BOWEL ENDOSCOPY|| 80001|44373||243.25|0|243.25|0||SMALL BOWEL ENDOSCOPY|| 80001|44376||357.18|0|357.18|0||SMALL BOWEL ENDOSCOPY|| 80001|44377||378.14|0|378.14|0||SMALL BOWEL ENDOSCOPY/BIOPSY|| 80001|44378||484|0|484|0||SMALL BOWEL ENDOSCOPY|| 80001|44379||514.96|0|514.96|0||S BOWEL ENDOSCOPE W/STENT|| 80001|44380||80.58|0|80.58|0||SMALL BOWEL ENDOSCOPY|| 80001|44381||0|0|0|0||SMALL BOWEL ENDOSCOPY BR/WA|| 80001|44382||95.89|0|95.89|0||SMALL BOWEL ENDOSCOPY|| 80001|44384||0|0|0|0||SMALL BOWEL ENDOSCOPY|| 80001|44385||301.82|0|128.15|0||ENDOSCOPY OF BOWEL POUCH|| 80001|44386||400.83|0|151.18|0||ENDOSCOPY - BOWEL POUCH/BIOP|| 80001|44388||402.36|0|198.46|0||COLONOSCOPY|| 80001|44389||450.62|0|219.19|0||COLONOSCOPY WITH BIOPSY|| 80001|44390||528.84|0|266.79|0||COLONOSCOPY FOR FOREIGN BODY|| 80001|44391||569.37|0|298.02|0||COLONOSCOPY FOR BLEEDING|| 80001|44392||502.05|0|260.16|0||COLONOSCOPY & POLYPECTOMY|| 80001|44394||567.92|0|304.32|0||COLONOSCOPY W/SNARE|| 80001|44401||0|0|0|0||COLONOSCOPY WITH ABLATION|| 80001|44402||0|0|0|0||COLONOSCOPY W/STENT PLCMT|| 80001|44403||0|0|0|0||COLONOSCOPY W/RESECTION|| 80001|44404||0|0|0|0||COLONOSCOPY W/INJECTION|| 80001|44405||0|0|0|0||COLONOSCOPY W/DILATION|| 80001|44406||0|0|0|0||COLONOSCOPY W/ULTRASOUND|| 80001|44407||0|0|0|0||COLONOSCOPY W/NDL ASPIR/BX|| 80001|44408||0|0|0|0||COLONOSCOPY W/DECOMPRESSION|| 80001|44500||29.67|0|29.67|0||INTRO - GASTROINTESTINAL TUBE|| 80001|44602||1692.03|0|1692.03|0||SUTURE - SMALL INTESTINE|| 80001|44603||1943.25|0|1943.25|0||SUTURE - SMALL INTESTINE|| 80001|44604||1268.12|0|1268.12|0||SUTURE - LARGE INTESTINE|| 80001|44605||1562.54|0|1562.54|0||REPAIR OF BOWEL LESION|| 80001|44615||1282.44|0|1282.44|0||INTESTINAL STRICTUROPLASTY|| 80001|44620||1038.05|0|1038.05|0||REPAIR BOWEL OPENING|| 80001|44625||1218.8|0|1218.8|0||REPAIR BOWEL OPENING|| 80001|44626||1921.91|0|1921.91|0||REPAIR BOWEL OPENING|| 80001|44640||1679.61|0|1679.61|0||REPAIR BOWEL-SKIN FISTULA|| 80001|44650||1741.05|0|1741.05|0||REPAIR BOWEL FISTULA|| 80001|44660||1602.92|0|1602.92|0||REPAIR BOWEL-BLADDER FISTULA|| 80001|44661||1861.23|0|1861.23|0||REPAIR BOWEL-BLADDER FISTULA|| 80001|44680||1275.76|0|1275.76|0||SURGICAL REVISION - INTESTINE|| 80001|44700||1221.56|0|1221.56|0||SUSPEND BOWEL W/PROSTHESIS|| 80001|44701||202.82|0|202.82|0||INTRAOP COLON LAVAGE ADD-ON|| 80001|44705||0|0|0|0||PREPARE FECAL MICROBIOTA|| 80001|44715||0|0|0|0||PREPARE DONOR INTESTINE|| 80001|44720||331.77|0|331.77|0||PREP DONOR INTESTINE/VENOUS|| 80001|44721||463.85|0|463.85|0||PREP DONOR INTESTINE/ARTERY|| 80001|44799||0|0|0|0||UNLISTED PROCEDURE INTESTINE|| 80001|44800||911.32|0|911.32|0||EXCISION OF BOWEL POUCH|| 80001|44820||1012.19|0|1012.19|0||EXCISION OF MESENTERY LESION|| 80001|44850||896.09|0|896.09|0||REPAIR OF MESENTERY|| 80001|44899||0|0|0|0||BOWEL SURGERY PROCEDURE|| 80001|44900||924.51|0|924.51|0||DRAIN APP ABSCESS - OPEN|| 80001|44950||766.17|0|766.17|0||APPENDECTOMY|| 80001|44955||100.93|0|100.93|0||APPENDECTOMY ADD-ON|| 80001|44960||1043.08|0|1043.08|0||APPENDECTOMY|| 80001|44970||714.2|0|714.2|0||LAPAROSCOPY - APPENDECTOMY|| 80001|44979||0|0|0|0||LAPAROSCOPE PROC - APP|| 80001|45000||498.68|0|498.68|0||DRAINAGE OF PELVIC ABSCESS|| 80001|45005||310.1|0|188.76|0||DRAINAGE OF RECTAL ABSCESS|| 80001|45020||674.95|0|674.95|0||DRAINAGE OF RECTAL ABSCESS|| 80001|45100||353.08|0|353.08|0||BIOPSY OF RECTUM|| 80001|45108||435.41|0|435.41|0||REMOVAL OF ANORECTAL LESION|| 80001|45110||2209.57|0|2209.57|0||REMOVAL OF RECTUM|| 80001|45111||1299.17|0|1299.17|0||PARTIAL REMOVAL OF RECTUM|| 80001|45112||2258.49|0|2258.49|0||REMOVAL OF RECTUM|| 80001|45113||2264.15|0|2264.15|0||PARTIAL PROCTECTOMY|| 80001|45114||2178.22|0|2178.22|0||PARTIAL REMOVAL OF RECTUM|| 80001|45116||1859.75|0|1859.75|0||PARTIAL REMOVAL OF RECTUM|| 80001|45119||2336.93|0|2336.93|0||REMOVE RECTUM W/RESERVOIR|| 80001|45120||1903.02|0|1903.02|0||REMOVAL OF RECTUM|| 80001|45121||1973.48|0|1973.48|0||REMOVAL OF RECTUM AND COLON|| 80001|45123||1340.77|0|1340.77|0||PARTIAL PROCTECTOMY|| 80001|45126||3260.64|0|3260.64|0||PELVIC EXENTERATION|| 80001|45130||1301.95|0|1301.95|0||EXCISION OF RECTAL PROLAPSE|| 80001|45135||1644.49|0|1644.49|0||EXCISION OF RECTAL PROLAPSE|| 80001|45136||2157.49|0|2157.49|0||EXCISE ILEOANAL RESERVIOR|| 80001|45150||426.45|0|426.45|0||EXCISION OF RECTAL STRICTURE|| 80001|45160||1219.8|0|1219.8|0||EXCISION OF RECTAL LESION|| 80001|45171||707.93|0|707.93|0||EXC RECT TUM TRANSANAL PART|| 80001|45172||960.39|0|960.39|0||EXC RECT TUM TRANSANAL FULL|| 80001|45190||822.62|0|822.62|0||DESTRUCTION - RECTAL TUMOR|| 80001|45300||140.35|0|63.98|0||PROCTOSIGMOIDOSCOPY DX|| 80001|45303||1075.74|0|110.87|0||PROCTOSIGMOIDOSCOPY DILATE|| 80001|45305||221.8|0|94.26|0||PROCTOSIGMOIDOSCOPY W/BX|| 80001|45307||255.17|0|122.6|0||PROCTOSIGMOIDOSCOPY FB|| 80001|45308||249.61|0|106.57|0||PROCTOSIGMOIDOSCOPY REMOVAL|| 80001|45309||251.57|0|107.75|0||PROCTOSIGMOIDOSCOPY REMOVAL|| 80001|45315||283.17|0|133.92|0||PROCTOSIGMOIDOSCOPY REMOVAL|| 80001|45317||277.42|0|140.58|0||PROCTOSIGMOIDOSCOPY BLEED|| 80001|45320||279.59|0|132.28|0||PROCTOSIGMOIDOSCOPY ABLATE|| 80001|45321||127.86|0|127.86|0||PROCTOSIGMOIDOSCOPY VOLVUL|| 80001|45327||146|0|146|0||PROCTOSIGMOIDOSCOPY W/STENT|| 80001|45330||155.78|0|75.15|0||DIAGNOSTIC SIGMOIDOSCOPY|| 80001|45331||184.91|0|88.78|0||SIGMOIDOSCOPY AND BIOPSY|| 80001|45332||330.38|0|131.13|0||SIGMOIDOSCOPY W/FB REMOVAL|| 80001|45333||335.81|0|130.74|0||SIGMOIDOSCOPY & POLYPECTOMY|| 80001|45334||193.4|0|193.4|0||SIGMOIDOSCOPY FOR BLEEDING|| 80001|45335||309.94|0|109.14|0||SIGMOIDOSCOPY W/SUBMUC INJ|| 80001|45337||168.91|0|168.91|0||SIGMOIDOSCOPY & DECOMPRESS|| 80001|45338||362.25|0|166.88|0||SIGMOIDOSCOPY W/TUMR REMOVE|| 80001|45340||545.58|0|137.38|0||SIG W/BALLOON DILATION|| 80001|45341||184.3|0|184.3|0||SIGMOIDOSCOPY W/ULTRASOUND|| 80001|45342||280.2|0|280.2|0||SIGMOIDOSCOPY W/US GUIDE BX|| 80001|45346||0|0|0|0||SIGMOIDOSCOPY W/ABLATION|| 80001|45347||0|0|0|0||SIGMOIDOSCOPY W/PLCMT STENT|| 80001|45349||0|0|0|0||SIGMOIDOSCOPY W/RESECTION|| 80001|45350||0|0|0|0||SGMDSC W/BAND LIGATION|| 80001|45378||444.93|0|256.15|0||DIAGNOSTIC COLONOSCOPY|| 80001|45378|53|155.78|0|75.15|0||DIAGNOSTIC COLONOSCOPY|| 80001|45379||572.94|0|322.13|0||COLONOSCOPY W/FB REMOVAL|| 80001|45380||530.36|0|306.3|0||COLONOSCOPY AND BIOPSY|| 80001|45381||531.63|0|290.12|0||COLONOSCOPY - SUBMUCOUS INJ|| 80001|45382||688.57|0|388.92|0||COLONOSCOPY/CONTROL BLEEDING|| 80001|45384||532.67|0|321.4|0||LESION REMOVE COLONOSCOPY|| 80001|45385||600.08|0|363.61|0||LESION REMOVAL COLONOSCOPY|| 80001|45386||755.04|0|314.67|0||COLONOSCOPY DILATE STRICTURE|| 80001|45388||0|0|0|0||COLONOSCOPY W/ABLATION|| 80001|45389||0|0|0|0||COLONOSCOPY W/STENT PLCMT|| 80001|45390||0|0|0|0||COLONOSCOPY W/RESECTION|| 80001|45391||349.11|0|349.11|0||COLONOSCOPY W/ENDOSCOPE US|| 80001|45392||444.63|0|444.63|0||COLONOSCOPY W/ENDOSCOPIC FNB|| 80001|45393||0|0|0|0||COLONOSCOPY W/DECOMPRESSION|| 80001|45395||2368.18|0|2368.18|0||LAP - REMOVAL OF RECTUM|| 80001|45397||2581.19|0|2581.19|0||LAP - REMOVE RECTUM W/POUCH|| 80001|45398||0|0|0|0||COLONOSCOPY W/BAND LIGATION|| 80001|45398||759.58|0|759.58|||COLONOSCOPY W/BAND LIGATION|| 80001|45399||0|0|0|0||UNLISTED PROCEDURE COLON|| 80001|45400||1362.68|0|1362.68|0||LAPAROSCOPIC PROCTOPEXY|| 80001|45402||1822.9|0|1822.9|0||LAP PROCTOPEXY W/SIG RESECT|| 80001|45499||0|0|0|0||LAPAROSCOPE PROC - RECTUM|| 80001|45500||620.79|0|620.79|0||REPAIR OF RECTUM|| 80001|45505||701.96|0|701.96|0||REPAIR OF RECTUM|| 80001|45520||178.01|0|47.38|0||TREATMENT OF RECTAL PROLAPSE|| 80001|45540||1268.92|0|1268.92|0||CORRECT RECTAL PROLAPSE|| 80001|45541||1117.4|0|1117.4|0||CORRECT RECTAL PROLAPSE|| 80001|45550||1746.77|0|1746.77|0||REPAIR RECTUM/REMOVE SIGMOID|| 80001|45560||820.68|0|820.68|0||REPAIR OF RECTOCELE|| 80001|45562||1363.14|0|1363.14|0||EXPLORATION/REPAIR OF RECTUM|| 80001|45563||1966.9|0|1966.9|0||EXPLORATION/REPAIR OF RECTUM|| 80001|45800||1478.45|0|1478.45|0||REPAIR RECT/BLADDER FISTULA|| 80001|45805||1648.96|0|1648.96|0||REPAIR FISTULA W/COLOSTOMY|| 80001|45820||1345.58|0|1345.58|0||REPAIR RECTOURETHRAL FISTULA|| 80001|45825||1726.34|0|1726.34|0||REPAIR FISTULA W/COLOSTOMY|| 80001|45900||241.87|0|241.87|0||REDUCTION OF RECTAL PROLAPSE|| 80001|45905||199.89|0|199.89|0||DILATION OF ANAL SPHINCTER|| 80001|45910||230.38|0|230.38|0||DILATION OF RECTAL NARROWING|| 80001|45915||381.88|0|267.91|0||REMOVE RECTAL OBSTRUCTION|| 80001|45990||128.86|0|128.86|0||SURG DX EXAM - ANORECTAL|| 80001|45999||0|0|0|0||RECTUM SURGERY PROCEDURE|| 80001|46020||320.2|0|274.85|0||PLACEMENT OF SETON|| 80001|46030||160.21|0|106.71|0||REMOVAL OF RECTAL MARKER|| 80001|46040||618.67|0|486.09|0||INCISION OF RECTAL ABSCESS|| 80001|46045||511.16|0|511.16|0||INCISION OF RECTAL ABSCESS|| 80001|46050||228.74|0|114.38|0||INCISION OF ANAL ABSCESS|| 80001|46060||559.86|0|559.86|0||INCISION OF RECTAL ABSCESS|| 80001|46070||257.57|0|257.57|0||INCISION OF ANAL SEPTUM|| 80001|46080||285.54|0|189.01|0||INCISION OF ANAL SPHINCTER|| 80001|46083||200.97|0|124.99|0||INCISE EXTERNAL HEMORRHOID|| 80001|46200||511.58|0|379.01|0||REMOVAL OF ANAL FISSURE|| 80001|46220||235.79|0|140.04|0||REMOVAL OF ANAL TAG|| 80001|46221||310.01|0|224.73|0||LIGATION OF HEMORRHOID(S)|| 80001|46230||314.27|0|204.95|0||REMOVAL OF ANAL TAGS|| 80001|46250||533.1|0|369.9|0||HEMORRHOIDECTOMY|| 80001|46255||585.46|0|416.83|0||HEMORRHOIDECTOMY|| 80001|46257||495.15|0|495.15|0||REMOVE HEMORRHOIDS & FISSURE|| 80001|46258||548.86|0|548.86|0||REMOVE HEMORRHOIDS & FISTULA|| 80001|46260||561.07|0|561.07|0||HEMORRHOIDECTOMY|| 80001|46261||615.95|0|615.95|0||REMOVE HEMORRHOIDS & FISSURE|| 80001|46262||653.45|0|653.45|0||REMOVE HEMORRHOIDS & FISTULA|| 80001|46270||586.45|0|458.91|0||REMOVAL OF ANAL FISTULA|| 80001|46275||622.73|0|485.89|0||REMOVAL OF ANAL FISTULA|| 80001|46280||552.56|0|552.56|0||REMOVAL OF ANAL FISTULA|| 80001|46285||616.91|0|483.94|0||REMOVAL OF ANAL FISTULA|| 80001|46288||649.12|0|649.12|0||REPAIR ANAL FISTULA|| 80001|46320||210.72|0|131.26|0||REMOVAL OF HEMORRHOID CLOT|| 80001|46500||272.96|0|152.01|0||INJECTION INTO HEMORRHOID(S)|| 80001|46505||329.9|0|279.9|0||CHEMODENERVATION ANAL MUSC|| 80001|46600||100.1|0|47.77|0||DIAGNOSTIC ANOSCOPY|| 80001|46601||0|0|0|0||DIAGNOSTIC ANOSCOPY|| 80001|46604||696.86|0|78.95|0||ANOSCOPY AND DILATION|| 80001|46606||254.53|0|90.55|0||ANOSCOPY AND BIOPSY|| 80001|46607||0|0|0|0||DIAGNOSTIC ANOSCOPY & BIOPSY|| 80001|46608||268.94|0|100.32|0||ANOSCOPY - REMOVE FOR BODY|| 80001|46610||256.06|0|97.12|0||ANOSCOPY - REMOVE LESION|| 80001|46611||199.15|0|97.19|0||ANOSCOPY|| 80001|46612||310.92|0|113.6|0||ANOSCOPY - REMOVE LESIONS|| 80001|46614||147.04|0|76.88|0||ANOSCOPY - CONTROL BLEEDING|| 80001|46615||166.69|0|110.87|0||ANOSCOPY|| 80001|46700||774.18|0|774.18|0||REPAIR OF ANAL STRICTURE|| 80001|46705||571.69|0|571.69|0||REPAIR OF ANAL STRICTURE|| 80001|46706||207.29|0|207.29|0||REPR OF ANAL FISTULA W/GLUE|| 80001|46707||557.25|0|557.25|0||REPAIR ANORECTAL FIST W/PLUG|| 80001|46710||1247.01|0|1247.01|0||REPR PER/VAG POUCH SNGL PROC|| 80001|46712||2400.68|0|2400.68|0||REPR PER/VAG POUCH DBL PROC|| 80001|46715||638.7|0|638.7|0||REP PERF ANOPER FISTU|| 80001|46716||1269.84|0|1269.84|0||REP PERF ANOPER/VESTIB FISTU|| 80001|46730||2333.43|0|2333.43|0||CONSTRUCTION OF ABSENT ANUS|| 80001|46735||2424.92|0|2424.92|0||CONSTRUCTION OF ABSENT ANUS|| 80001|46740||2552.82|0|2552.82|0||CONSTRUCTION OF ABSENT ANUS|| 80001|46742||2667.62|0|2667.62|0||REPAIR OF IMPERFORATED ANUS|| 80001|46744||4211.45|0|4211.45|0||REPAIR OF CLOACAL ANOMALY|| 80001|46746||4180.91|0|4180.91|0||REPAIR OF CLOACAL ANOMALY|| 80001|46748||4567.74|0|4567.74|0||REPAIR OF CLOACAL ANOMALY|| 80001|46750||896.05|0|896.05|0||REPAIR OF ANAL SPHINCTER|| 80001|46751||682.2|0|682.2|0||REPAIR OF ANAL SPHINCTER|| 80001|46753||684.41|0|684.41|0||RECONSTRUCTION OF ANUS|| 80001|46754||341.88|0|267.07|0||REMOVAL OF SUTURE FROM ANUS|| 80001|46760||1299.93|0|1299.93|0||REPAIR OF ANAL SPHINCTER|| 80001|46761||1100.92|0|1100.92|0||REPAIR OF ANAL SPHINCTER|| 80001|46762||1097.67|0|1097.67|0||IMPLANT ARTIFICIAL SPHINCTER|| 80001|46900||277.8|0|162.28|0||DESTRUCTION - ANAL LESION(S)|| 80001|46910||291.76|0|157.63|0||DESTRUCTION - ANAL LESION(S)|| 80001|46916||261.12|0|167.69|0||CRYOSURGERY - ANAL LESION(S)|| 80001|46917||506.9|0|156.46|0||LASER SURGERY - ANAL LESIONS|| 80001|46922||304.17|0|159.97|0||EXCISION OF ANAL LESION(S)|| 80001|46924||606.22|0|218.57|0||DESTRUCTION - ANAL LESION(S)|| 80001|46930||236.16|0|172.59|0||DESTROY INTERNAL HEMORRHOIDS|| 80001|46940||265|0|174.29|0||TREATMENT OF ANAL FISSURE|| 80001|46942||250.2|0|156.78|0||TREATMENT OF ANAL FISSURE|| 80001|46945||352.4|0|261.3|0||LIGATION OF HEMORRHOIDS|| 80001|46946||361.61|0|264.31|0||LIGATION OF HEMORRHOIDS|| 80001|46947||450.54|0|450.54|0||HEMORRHOIDOPEXY BY STAPLING|| 80001|46999||0|0|0|0||ANUS SURGERY PROCEDURE|| 80001|47000||409.53|0|124.61|0||NEEDLE BIOPSY OF LIVER|| 80001|47001||125.44|0|125.44|0||NEEDLE BIOPSY - LIVER ADD-ON|| 80001|47010||1435.24|0|1435.24|0||OPEN DRAINAGE - LIVER LESION|| 80001|47015||1385.58|0|1385.58|0||INJECT/ASPIRATE LIVER CYST|| 80001|47100||1004.29|0|1004.29|0||WEDGE BIOPSY OF LIVER|| 80001|47120||2785.41|0|2785.41|0||PARTIAL REMOVAL OF LIVER|| 80001|47122||4114.55|0|4114.55|0||EXTENSIVE REMOVAL OF LIVER|| 80001|47125||3681.84|0|3681.84|0||PARTIAL REMOVAL OF LIVER|| 80001|47130||3957.55|0|3957.55|0||PARTIAL REMOVAL OF LIVER|| 80001|47133||0|0|0|0||REMOVAL OF DONOR LIVER|| 80001|47135||5852.58|0|5852.58|0||TRANSPLANTATION OF LIVER|| 80001|47140||3856.98|0|3856.98|0||PARTIAL REMOVAL - DONOR LIVER|| 80001|47141||5104.13|0|5104.13|0||PARTIAL REMOVAL - DONOR LIVER|| 80001|47142||5630.27|0|5630.27|0||PARTIAL REMOVAL - DONOR LIVER|| 80001|47143||0|0|0|0||PREP DONOR LIVER - WHOLE|| 80001|47144||0|0|0|0||PREP DONOR LIVER - 3-SEGMENT|| 80001|47145||0|0|0|0||PREP DONOR LIVER - LOBE SPLIT|| 80001|47146||398.2|0|398.2|0||PREP DONOR LIVER/VENOUS|| 80001|47147||461.9|0|461.9|0||PREP DONOR LIVER/ARTERIAL|| 80001|47300||1352.19|0|1352.19|0||SURGERY FOR LIVER LESION|| 80001|47350||1635.71|0|1635.71|0||REPAIR LIVER WOUND|| 80001|47360||2235.94|0|2235.94|0||REPAIR LIVER WOUND|| 80001|47361||3634.08|0|3634.08|0||REPAIR LIVER WOUND|| 80001|47362||1731.48|0|1731.48|0||REPAIR LIVER WOUND|| 80001|47370||1489.89|0|1489.89|0||LAPARO ABLATE LIVER TUMOR RF|| 80001|47371||1501.55|0|1501.55|0||LAPARO ABLATE LIVER CRYOSURG|| 80001|47379||0|0|0|0||LAPAROSCOPE PROCEDURE - LIVER|| 80001|47380||1723.49|0|1723.49|0||OPEN ABLATE LIVER TUMOR RF|| 80001|47381||1617.62|0|1617.62|0||OPEN ABLATE LIVER TUMOR CRYO|| 80001|47382||5587.92|0|937.66|0||PERCUT ABLATE LIVER RF|| 80001|47383||8394.22|0|577.63|0||PERQ ABLTJ LVR CRYOABLATION|| 80001|47399||0|0|0|0||LIVER SURGERY PROCEDURE|| 80001|47400||2581.11|0|2581.11|0||INCISION OF LIVER DUCT|| 80001|47420||1601.92|0|1601.92|0||INCISION OF BILE DUCT|| 80001|47425||1632.25|0|1632.25|0||INCISION OF BILE DUCT|| 80001|47460||1513.49|0|1513.49|0||INCISE BILE DUCT SPHINCTER|| 80001|47480||1039.9|0|1039.9|0||INCISION OF GALLBLADDER|| 80001|47490||393.75|0|393.75|0||INCISION OF GALLBLADDER|| 80001|47531||416.89|0|115.23|0||INJECTION FOR CHOLANGIOGRAM|| 80001|47532||918.9|0|260.72|0||INJECTION FOR CHOLANGIOGRAM|| 80001|47533||1495.12|0|369.19|0||PLMT BILIARY DRAINAGE CATH|| 80001|47534||1845.43|0|490.06|0||PLMT BILIARY DRAINAGE CATH|| 80001|47535||1234.04|0|281.53|0||CONVERSION EXT BIL DRG CATH|| 80001|47536||908.67|0|177.87|0||EXCHANGE BILIARY DRG CATH|| 80001|47537||451.03|0|119.62|0||REMOVAL BILIARY DRG CATH|| 80001|47538||4974.01|0|397.64|0||PERQ PLMT BILE DUCT STENT|| 80001|47539||5443.34|0|537.88|0||PERQ PLMT BILE DUCT STENT|| 80001|47540||5665.34|0|642.07|0||PERQ PLMT BILE DUCT STENT|| 80001|47541||1321.52|0|341.59|0||PLMT ACCESS BIL TREE SM BWL|| 80001|47542||578.77|0|160.84|0||DILATE BILIARY DUCT/AMPULLA|| 80001|47544||915.24|0|260.15|0||REMOVAL DUCT GLBLDR CALCULI|| 80001|47550||199.77|0|199.77|0||BILE DUCT ENDOSCOPY ADD-ON|| 80001|47552||380.32|0|380.32|0||BILIARY ENDOSCOPY THRU SKIN|| 80001|47553||378.96|0|378.96|0||BILIARY ENDOSCOPY THRU SKIN|| 80001|47554||581.63|0|581.63|0||BILIARY ENDOSCOPY THRU SKIN|| 80001|47555||450.16|0|450.16|0||BILIARY ENDOSCOPY THRU SKIN|| 80001|47556||511.13|0|511.13|0||BILIARY ENDOSCOPY THRU SKIN|| 80001|47562||782.66|0|782.66|0||LAPAROSCOPIC CHOLECYSTECTOMY|| 80001|47563||850.25|0|850.25|0||LAPARO CHOLECYSTECTOMY/GRAPH|| 80001|47564||1325.21|0|1325.21|0||LAPARO CHOLECYSTECTOMY/EXPLR|| 80001|47570||925.24|0|925.24|0||LAPARO CHOLECYSTOENTEROSTOMY|| 80001|47579||0|0|0|0||LAPAROSCOPE PROC - BILIARY|| 80001|47600||1273.29|0|1273.29|0||REMOVAL OF GALLBLADDER|| 80001|47605||1340.12|0|1340.12|0||REMOVAL OF GALLBLADDER|| 80001|47610||1499.34|0|1499.34|0||REMOVAL OF GALLBLADDER|| 80001|47612||1517.67|0|1517.67|0||REMOVAL OF GALLBLADDER|| 80001|47620||1649.55|0|1649.55|0||REMOVAL OF GALLBLADDER|| 80001|47700||1252.72|0|1252.72|0||EXPLORATION OF BILE DUCTS|| 80001|47701||2074.94|0|2074.94|0||BILE DUCT REVISION|| 80001|47711||1855.04|0|1855.04|0||EXCISION OF BILE DUCT TUMOR|| 80001|47712||2393.87|0|2393.87|0||EXCISION OF BILE DUCT TUMOR|| 80001|47715||1587.81|0|1587.81|0||EXCISION OF BILE DUCT CYST|| 80001|47720||1375.57|0|1375.57|0||FUSE GALLBLADDER & BOWEL|| 80001|47721||1616.88|0|1616.88|0||FUSE UPPER GI STRUCTURES|| 80001|47740||1567.02|0|1567.02|0||FUSE GALLBLADDER & BOWEL|| 80001|47741||1763.89|0|1763.89|0||FUSE GALLBLADDER & BOWEL|| 80001|47760||2701.74|0|2701.74|0||FUSE BILE DUCTS AND BOWEL|| 80001|47765||3645.97|0|3645.97|0||FUSE LIVER DUCTS & BOWEL|| 80001|47780||2959.32|0|2959.32|0||FUSE BILE DUCTS AND BOWEL|| 80001|47785||3893.42|0|3893.42|0||FUSE BILE DUCTS AND BOWEL|| 80001|47800||1888.81|0|1888.81|0||RECONSTRUCTION OF BILE DUCTS|| 80001|47801||1201.76|0|1201.76|0||PLACEMENT - BILE DUCT SUPPORT|| 80001|47802||1823.28|0|1823.28|0||FUSE LIVER DUCT & INTESTINE|| 80001|47900||1640.17|0|1640.17|0||SUTURE BILE DUCT INJURY|| 80001|47999||0|0|0|0||BILE TRACT SURGERY PROCEDURE|| 80001|48000||2252.33|0|2252.33|0||DRAINAGE OF ABDOMEN|| 80001|48001||2770.62|0|2770.62|0||PLACEMENT OF DRAIN - PANCREAS|| 80001|48020||1405.63|0|1405.63|0||REMOVAL OF PANCREATIC STONE|| 80001|48100||1051.8|0|1051.8|0||BIOPSY OF PANCREAS - OPEN|| 80001|48102||611.74|0|294.64|0||NEEDLE BIOPSY - PANCREAS|| 80001|48105||3413.95|0|3413.95|0||RESECT/DEBRIDE PANCREAS|| 80001|48120||1322.35|0|1322.35|0||REMOVAL OF PANCREAS LESION|| 80001|48140||1869.3|0|1869.3|0||PARTIAL REMOVAL OF PANCREAS|| 80001|48145||1955.06|0|1955.06|0||PARTIAL REMOVAL OF PANCREAS|| 80001|48146||2244.44|0|2244.44|0||PANCREATECTOMY|| 80001|48148||1491.21|0|1491.21|0||REMOVAL OF PANCREATIC DUCT|| 80001|48150||3724.78|0|3724.78|0||PARTIAL REMOVAL OF PANCREAS|| 80001|48152||3457.09|0|3457.09|0||PANCREATECTOMY|| 80001|48153||3705.93|0|3705.93|0||PANCREATECTOMY|| 80001|48154||3472.83|0|3472.83|0||PANCREATECTOMY|| 80001|48155||2164.93|0|2164.93|0||REMOVAL OF PANCREAS|| 80001|48160||0|0|0|0||PANCREAS REMOVAL/TRANSPLANT|| 80001|48400||129.54|0|129.54|0||INJECTION - INTRAOP ADD-ON|| 80001|48500||1371.29|0|1371.29|0||SURGERY OF PANCREATIC CYST|| 80001|48510||1306.93|0|1306.93|0||DRAIN PANCREATIC PSEUDOCYST|| 80001|48520||1306.85|0|1306.85|0||FUSE PANCREAS CYST AND BOWEL|| 80001|48540||1568.6|0|1568.6|0||FUSE PANCREAS CYST AND BOWEL|| 80001|48545||1607.86|0|1607.86|0||PANCREATORRHAPHY|| 80001|48547||2148.89|0|2148.89|0||DUODENAL EXCLUSION|| 80001|48548||1996.13|0|1996.13|0||FUSE PANCREAS AND BOWEL|| 80001|48550||0|0|0|0||DONOR PANCREATECTOMY|| 80001|48551||0|0|0|0||PREP DONOR PANCREAS|| 80001|48552||285.27|0|285.27|0||PREP DONOR PANCREAS/VENOUS|| 80001|48554||3033.2|0|3033.2|0||TRANSPL ALLOGRAFT PANCREAS|| 80001|48556||1514.68|0|1514.68|0||REMOVAL - ALLOGRAFT PANCREAS|| 80001|48999||0|0|0|0||PANCREAS SURGERY PROCEDURE|| 80001|49000||918.52|0|918.52|0||EXPLORATION OF ABDOMEN|| 80001|49002||1251.05|0|1251.05|0||REOPENING OF ABDOMEN|| 80001|49010||1115.8|0|1115.8|0||EXPLORATION BEHIND ABDOMEN|| 80001|49020||1904.13|0|1904.13|0||DRAIN ABDOMINAL ABSCESS|| 80001|49040||1194.61|0|1194.61|0||DRAIN - OPEN - ABDOM ABSCESS|| 80001|49060||1313.91|0|1313.91|0||DRAIN - OPEN - RETROP ABSCESS|| 80001|49062||883.76|0|883.76|0||DRAIN TO PERITONEAL CAVITY|| 80001|49082||219.03|0|89.56|0||ABD PARACENTESIS|| 80001|49083||332.05|0|131.25|0||ABD PARACENTESIS W/IMAGING|| 80001|49084||131.3|0|131.3|0||PERITONEAL LAVAGE|| 80001|49180||188.99|0|104.48|0||BIOPSY - ABDOMINAL MASS|| 80001|49185||1102.2|0|148.14|0||SCLEROTX FLUID COLLECTION|| 80001|49203||1431.81|0|1431.81|0||EXC ABD TUM 5 CM OR LESS|| 80001|49204||1832.3|0|1832.3|0||EXC ABD TUM OVER 5 CM|| 80001|49205||2102.69|0|2102.69|0||EXC ABD TUM OVER 10 CM|| 80001|49215||2632.13|0|2632.13|0||EXCISE SACRAL SPINE TUMOR|| 80001|49220||1159.27|0|1159.27|0||MULTIPLE SURGERY - ABDOMEN|| 80001|49250||694.03|0|694.03|0||EXCISION OF UMBILICUS|| 80001|49255||939.51|0|939.51|0||REMOVAL OF OMENTUM|| 80001|49320||386.22|0|386.22|0||DIAG LAPARO SEPARATE PROC|| 80001|49321||409.26|0|409.26|0||LAPAROSCOPY - BIOPSY|| 80001|49322||437.72|0|437.72|0||LAPAROSCOPY - ASPIRATION|| 80001|49323||760.22|0|760.22|0||LAPARO DRAIN LYMPHOCELE|| 80001|49324||465.1|0|465.1|0||LAP INSERTION PERM IP CATH|| 80001|49325||496.38|0|496.38|0||LAP REVISION PERM IP CATH|| 80001|49326||228.63|0|228.63|0||LAP W/OMENTOPEXY ADD-ON|| 80001|49327||157.41|0|157.41|0||LAP INS DEVICE FOR RT|| 80001|49329||0|0|0|0||LAPARO PROC - ABDM/PER/OMENT|| 80001|49400||160.2|0|114.84|0||AIR INJECTION INTO ABDOMEN|| 80001|49402||1020.71|0|1020.71|0||REMOVE FOREIGN BODY - ADBOMEN|| 80001|49405||983.08|0|258.56|0||IMAGE CATH FLUID COLXN VISC|| 80001|49406||984.24|0|258.95|0||IMAGE CATH FLUID PERI/RETRO|| 80001|49407||827.56|0|274.77|0||IMAGE CATH FLUID TRNS/VGNL|| 80001|49411||622.23|0|239.23|0||INS MARK ABD/PEL FOR RT PERQ|| 80001|49412||99.25|0|99.25|0||INS DEVICE FOR RT GUIDE OPEN|| 80001|49418||1597.73|0|264.98|0||INSERT TUN IP CATH PERC|| 80001|49419||530.04|0|530.04|0||INSRT ABDOM CATH FOR CHEMOTX|| 80001|49421||277.88|0|277.88|0||INSERT ABDOM DRAIN - PERM|| 80001|49422||453.33|0|453.33|0||REMOVE PERM CANNULA/CATHETER|| 80001|49423||611.9|0|88.19|0||EXCHANGE DRAINAGE CATHETER|| 80001|49424||164.59|0|46.35|0||ASSESS CYST - CONTRAST INJECT|| 80001|49425||870.51|0|870.51|0||INSERT ABDOMEN-VENOUS DRAIN|| 80001|49426||730.43|0|730.43|0||REVISE ABDOMEN-VENOUS SHUNT|| 80001|49427||54.68|0|54.68|0||INJECTION - ABDOMINAL SHUNT|| 80001|49428||629.47|0|629.47|0||LIGATION OF SHUNT|| 80001|49429||547.2|0|547.2|0||REMOVAL OF SHUNT|| 80001|49435||144.42|0|144.42|0||INSERT SUBQ EXTEN TO IP CATH|| 80001|49436||221.31|0|221.31|0||EMBEDDED IP CATH EXIT-SITE|| 80001|49440||1165.75|0|269.5|0||PLACE GASTROSTOMY TUBE PERC|| 80001|49441||1305.58|0|310.48|0||PLACE DUOD/JEJ TUBE PERC|| 80001|49442||1085.09|0|268.31|0||PLACE CECOSTOMY TUBE PERC|| 80001|49446||1117.35|0|198.62|0||CHANGE G-TUBE TO G-J PERC|| 80001|49450||741.33|0|81.93|0||REPLACE G/C TUBE PERC|| 80001|49451||810.1|0|110.78|0||REPLACE DUOD/JEJ TUBE PERC|| 80001|49452||1004.9|0|171.45|0||REPLACE G-J TUBE PERC|| 80001|49460||812.45|0|58.47|0||FIX G/COLON TUBE W/DEVICE|| 80001|49465||181.81|0|37.6|0||FLUORO EXAM OF G/COLON TUBE|| 80001|49491||891.77|0|891.77|0||RPR HERN PREEMIE REDUC|| 80001|49492||1026.87|0|1026.87|0||RPR ING HERN PREMIE - BLOCKED|| 80001|49495||442.64|0|442.64|0||RPR ING HERNIA BABY - REDUC|| 80001|49496||652.11|0|652.11|0||RPR ING HERNIA BABY - BLOCKED|| 80001|49500||485.1|0|485.1|0||RPR ING HERNIA - INIT - REDUCE|| 80001|49501||719.64|0|719.64|0||RPR ING HERNIA - INIT BLOCKED|| 80001|49505||616.93|0|616.93|0||PRP I/HERN INIT REDUC >5 YR|| 80001|49507||694.79|0|694.79|0||PRP I/HERN INIT BLOCK >5 YR|| 80001|49520||751.08|0|751.08|0||REREPAIR ING HERNIA - REDUCE|| 80001|49521||851.85|0|851.85|0||REREPAIR ING HERNIA - BLOCKED|| 80001|49525||679.73|0|679.73|0||REPAIR ING HERNIA - SLIDING|| 80001|49540||800.52|0|800.52|0||REPAIR LUMBAR HERNIA|| 80001|49550||683.49|0|683.49|0||RPR REM HERNIA - INIT - REDUCE|| 80001|49553||750|0|750|0||RPR FEM HERNIA - INIT BLOCKED|| 80001|49555||708.12|0|708.12|0||REREPAIR FEM HERNIA - REDUCE|| 80001|49557||860.99|0|860.99|0||REREPAIR FEM HERNIA - BLOCKED|| 80001|49560||877.42|0|877.42|0||RPR VENTRAL HERN INIT - REDUC|| 80001|49561||1110.14|0|1110.14|0||RPR VENTRAL HERN INIT - BLOCK|| 80001|49565||914.29|0|914.29|0||REREPAIR VENTRL HERN - REDUCE|| 80001|49566||1119.72|0|1119.72|0||REREPAIR VENTRL HERN - BLOCK|| 80001|49568||322.31|0|322.31|0||HERNIA REPAIR W/MESH|| 80001|49570||490.28|0|490.28|0||RPR EPIGASTRIC HERN - REDUCE|| 80001|49572||611.5|0|611.5|0||RPR EPIGASTRIC HERN - BLOCKED|| 80001|49580||391.07|0|391.07|0||RPR UMBIL HERN - REDUC < 5 YR|| 80001|49582||571.03|0|571.03|0||RPR UMBIL HERN - BLOCK < 5 YR|| 80001|49585||526|0|526|0||RPR UMBIL HERN - REDUC > 5 YR|| 80001|49587||562.27|0|562.27|0||RPR UMBIL HERN - BLOCK > 5 YR|| 80001|49590||679.61|0|679.61|0||REPAIR SPIGELIAN HERNIA|| 80001|49600||828.9|0|828.9|0||REPAIR UMBILICAL LESION|| 80001|49605||5933.01|0|5933.01|0||REPAIR UMBILICAL LESION|| 80001|49606||1355.22|0|1355.22|0||REPAIR UMBILICAL LESION|| 80001|49610||818.34|0|818.34|0||REPAIR UMBILICAL LESION|| 80001|49611||644|0|644|0||REPAIR UMBILICAL LESION|| 80001|49650||506.38|0|506.38|0||LAPARO HERNIA REPAIR INITIAL|| 80001|49651||659.1|0|659.1|0||LAPARO HERNIA REPAIR RECUR|| 80001|49652||885.57|0|885.57|0||LAP VENT/ABD HERNIA REPAIR|| 80001|49653||1105.49|0|1105.49|0||LAP VENT/ABD HERN PROC COMP|| 80001|49654||1007.64|0|1007.64|0||LAP INC HERNIA REPAIR|| 80001|49655||1231.32|0|1231.32|0||LAP INC HERN REPAIR COMP|| 80001|49656||1095.65|0|1095.65|0||LAP INC HERNIA REPAIR RECUR|| 80001|49657||1577.06|0|1577.06|0||LAP INC HERN RECUR COMP|| 80001|49659||0|0|0|0||LAPARO PROC - HERNIA REPAIR|| 80001|49900||967.18|0|967.18|0||REPAIR OF ABDOMINAL WALL|| 80001|49904||1691.98|0|1691.98|0||OMENTAL FLAP - EXTRA-ABDOM|| 80001|49905||425.34|0|425.34|0||OMENTAL FLAP - INTRA-ABDOM|| 80001|49906||0|0|0|0||FREE OMENTAL FLAP - MICROVASC|| 80001|49999||0|0|0|0||ABDOMEN SURGERY PROCEDURE|| 80001|50010||884.29|0|884.29|0||EXPLORATION OF KIDNEY|| 80001|50020||1204.91|0|1204.91|0||RENAL ABSCESS - OPEN DRAIN|| 80001|50040||1104.2|0|1104.2|0||DRAINAGE OF KIDNEY|| 80001|50045||1110.62|0|1110.62|0||EXPLORATION OF KIDNEY|| 80001|50060||1360.14|0|1360.14|0||REMOVAL OF KIDNEY STONE|| 80001|50065||1443.28|0|1443.28|0||INCISION OF KIDNEY|| 80001|50070||1414.47|0|1414.47|0||INCISION OF KIDNEY|| 80001|50075||1740.56|0|1740.56|0||REMOVAL OF KIDNEY STONE|| 80001|50080||1036.51|0|1036.51|0||REMOVAL OF KIDNEY STONE|| 80001|50081||1523.65|0|1523.65|0||REMOVAL OF KIDNEY STONE|| 80001|50100||1285.98|0|1285.98|0||REVISE KIDNEY BLOOD VESSELS|| 80001|50120||1131.71|0|1131.71|0||EXPLORATION OF KIDNEY|| 80001|50125||1171.6|0|1171.6|0||EXPLORE AND DRAIN KIDNEY|| 80001|50130||1232.19|0|1232.19|0||REMOVAL OF KIDNEY STONE|| 80001|50135||1339.57|0|1339.57|0||EXPLORATION OF KIDNEY|| 80001|50200||689.52|0|172.39|0||BIOPSY OF KIDNEY|| 80001|50205||895.69|0|895.69|0||BIOPSY OF KIDNEY|| 80001|50220||1246.79|0|1246.79|0||REMOVE KIDNEY - OPEN|| 80001|50225||1432.11|0|1432.11|0||REMOVAL KIDNEY OPEN - COMPLEX|| 80001|50230||1531.25|0|1531.25|0||REMOVAL KIDNEY OPEN - RADICAL|| 80001|50234||1552.44|0|1552.44|0||REMOVAL OF KIDNEY & URETER|| 80001|50236||1750.38|0|1750.38|0||REMOVAL OF KIDNEY & URETER|| 80001|50240||1578.72|0|1578.72|0||PARTIAL REMOVAL OF KIDNEY|| 80001|50250||1450.59|0|1450.59|0||CRYOABLATE RENAL MASS OPEN|| 80001|50280||1137.82|0|1137.82|0||REMOVAL OF KIDNEY LESION|| 80001|50290||1069.7|0|1069.7|0||REMOVAL OF KIDNEY LESION|| 80001|50300||0|0|0|0||REMOVE CADAVER DONOR KIDNEY|| 80001|50320||1781.25|0|1781.25|0||REMOVE KIDNEY - LIVING DONOR|| 80001|50323||0|0|0|0||PREP CADAVER RENAL ALLOGRAFT|| 80001|50325||0|0|0|0||PREP DONOR RENAL GRAFT|| 80001|50327||261.44|0|261.44|0||PREP RENAL GRAFT/VENOUS|| 80001|50328||229|0|229|0||PREP RENAL GRAFT/ARTERIAL|| 80001|50329||220.56|0|220.56|0||PREP RENAL GRAFT/URETERAL|| 80001|50340||1122.48|0|1122.48|0||REMOVAL OF KIDNEY|| 80001|50360||2885.7|0|2885.7|0||TRANSPLANTATION OF KIDNEY|| 80001|50365||3379.46|0|3379.46|0||TRANSPLANTATION OF KIDNEY|| 80001|50370||1424.78|0|1424.78|0||REMOVE TRANSPLANTED KIDNEY|| 80001|50380||2375.25|0|2375.25|0||REIMPLANTATION OF KIDNEY|| 80001|50382||1332.78|0|330.32|0||CHANGE URETER STENT - PERCUT|| 80001|50384||1063.5|0|299.05|0||REMOVE URETER STENT - PERCUT|| 80001|50385||1277.75|0|281.1|0||CHANGE STENT VIA TRANSURETH|| 80001|50386||832.78|0|212.15|0||REMOVE STENT VIA TRANSURETH|| 80001|50387||608.06|0|118.84|0||CHANGE EXT/INT URETER STENT|| 80001|50389||331.99|0|66.06|0||REMOVE RENAL TUBE W/FLUORO|| 80001|50390||117.51|0|117.51|0||DRAINAGE OF KIDNEY LESION|| 80001|50391||144.26|0|119.06|0||INSTLL RX AGNT INTO RNAL TUB|| 80001|50395||215.94|0|215.94|0||CREATE PASSAGE TO KIDNEY|| 80001|50396||142.5|0|142.5|0||MEASURE KIDNEY PRESSURE|| 80001|50400||1379.75|0|1379.75|0||REVISION OF KIDNEY/URETER|| 80001|50405||1668.11|0|1668.11|0||REVISION OF KIDNEY/URETER|| 80001|50430||586.16|0|200.68|0||NJX PX NFROSGRM &/URTRGRM|| 80001|50431||182.86|0|78.96|0||NJX PX NFROSGRM &/URTRGRM|| 80001|50432||946.7|0|265.73|0||PLMT NEPHROSTOMY CATHETER|| 80001|50433||1272.25|0|327.86|0||PLMT NEPHROURETERAL CATHETER|| 80001|50434||1005.87|0|251.12|0||CONVERT NEPHROSTOMY CATHETER|| 80001|50435||526.68|0|121.49|0||EXCHANGE NEPHROSTOMY CATH|| 80001|50500||1376.44|0|1376.44|0||REPAIR OF KIDNEY WOUND|| 80001|50520||1235.55|0|1235.55|0||CLOSE KIDNEY-SKIN FISTULA|| 80001|50525||1803.94|0|1803.94|0||REPAIR RENAL-ABDOMEN FISTULA|| 80001|50526||1702.02|0|1702.02|0||REPAIR RENAL-ABDOMEN FISTULA|| 80001|50540||1369.32|0|1369.32|0||REVISION OF HORSESHOE KIDNEY|| 80001|50541||1096.07|0|1096.07|0||LAPARO ABLATE RENAL CYST|| 80001|50542||1390.62|0|1390.62|0||LAPARO ABLATE RENAL MASS|| 80001|50543||1774.91|0|1774.91|0||LAPARO PARTIAL NEPHRECTOMY|| 80001|50544||1488.19|0|1488.19|0||LAPAROSCOPY - PYELOPLASTY|| 80001|50545||1601.04|0|1601.04|0||LAPARO RADICAL NEPHRECTOMY|| 80001|50546||1434.37|0|1434.37|0||LAPAROSCOPIC NEPHRECTOMY|| 80001|50547||1912.64|0|1912.64|0||LAPARO REMOVAL DONOR KIDNEY|| 80001|50548||1610.88|0|1610.88|0||LAPARO REMOVE W/URETER|| 80001|50549||0|0|0|0||LAPAROSCOPE PROC - RENAL|| 80001|50551||422.98|0|353.59|0||KIDNEY ENDOSCOPY|| 80001|50553||452.6|0|376.62|0||KIDNEY ENDOSCOPY|| 80001|50555||485.59|0|410.39|0||KIDNEY ENDOSCOPY & BIOPSY|| 80001|50557||493.74|0|415.43|0||KIDNEY ENDOSCOPY & TREATMENT|| 80001|50561||559.23|0|472.79|0||KIDNEY ENDOSCOPY & TREATMENT|| 80001|50562||695.11|0|695.11|0||RENAL SCOPE W/TUMOR RESECT|| 80001|50570||589.87|0|589.87|0||KIDNEY ENDOSCOPY|| 80001|50572||638.34|0|638.34|0||KIDNEY ENDOSCOPY|| 80001|50574||678.49|0|678.49|0||KIDNEY ENDOSCOPY & BIOPSY|| 80001|50575||857.75|0|857.75|0||KIDNEY ENDOSCOPY|| 80001|50576||676.81|0|676.81|0||KIDNEY ENDOSCOPY & TREATMENT|| 80001|50580||729.46|0|729.46|0||KIDNEY ENDOSCOPY & TREATMENT|| 80001|50590||837.86|0|673.88|0||FRAGMENTING OF KIDNEY STONE|| 80001|50592||3493.42|0|439.51|0||PERC RF ABLATE RENAL TUMOR|| 80001|50593||5144.16|0|581.9|0||PERC CRYO ABLATE RENAL TUM|| 80001|50600||1120.3|0|1120.3|0||EXPLORATION OF URETER|| 80001|50605||1172.4|0|1172.4|0||INSERT URETERAL SUPPORT|| 80001|50606||593.95|0|189.92|0||ENDOLUMINAL BX URTR RNL PLVS|| 80001|50610||1127.62|0|1127.62|0||REMOVAL OF URETER STONE|| 80001|50620||1078.29|0|1078.29|0||REMOVAL OF URETER STONE|| 80001|50630||1064.53|0|1064.53|0||REMOVAL OF URETER STONE|| 80001|50650||1234.13|0|1234.13|0||REMOVAL OF URETER|| 80001|50660||1364.32|0|1364.32|0||REMOVAL OF URETER|| 80001|50684||120.01|0|59.15|0||INJECTION FOR URETER X-RAY|| 80001|50686||181.06|0|111.67|0||MEASURE URETER PRESSURE|| 80001|50688||94.41|0|94.41|0||CHANGE OF URETER TUBE/STENT|| 80001|50690||114.01|0|84.16|0||INJECTION FOR URETER X-RAY|| 80001|50693||1180.98|0|262.85|0||PLMT URETERAL STENT PRQ|| 80001|50694||1304.41|0|339.93|0||PLMT URETERAL STENT PRQ|| 80001|50700||1103.08|0|1103.08|0||REVISION OF URETER|| 80001|50705||1889.39|0|243.16|0||URETERAL EMBOLIZATION/OCCL|| 80001|50706||856.29|0|226.3|0||BALLOON DILATE URTRL STRIX|| 80001|50715||1454.09|0|1454.09|0||RELEASE OF URETER|| 80001|50722||1227.27|0|1227.27|0||RELEASE OF URETER|| 80001|50725||1325.9|0|1325.9|0||RELEASE/REVISE URETER|| 80001|50727||601.09|0|601.09|0||REVISE URETER|| 80001|50728||829.41|0|829.41|0||REVISE URETER|| 80001|50740||1460.34|0|1460.34|0||FUSION OF URETER & KIDNEY|| 80001|50750||1376.44|0|1376.44|0||FUSION OF URETER & KIDNEY|| 80001|50760||1346.75|0|1346.75|0||FUSION OF URETERS|| 80001|50770||1376.44|0|1376.44|0||SPLICING OF URETERS|| 80001|50780||1323.28|0|1323.28|0||REIMPLANT URETER IN BLADDER|| 80001|50782||1333.94|0|1333.94|0||REIMPLANT URETER IN BLADDER|| 80001|50783||1345.47|0|1345.47|0||REIMPLANT URETER IN BLADDER|| 80001|50785||1447.96|0|1447.96|0||REIMPLANT URETER IN BLADDER|| 80001|50800||1103.05|0|1103.05|0||IMPLANT URETER IN BOWEL|| 80001|50810||1666.13|0|1666.13|0||FUSION OF URETER & BOWEL|| 80001|50815||1457.75|0|1457.75|0||URINE SHUNT TO INTESTINE|| 80001|50820||1571.94|0|1571.94|0||CONSTRUCT BOWEL BLADDER|| 80001|50825||1976.47|0|1976.47|0||CONSTRUCT BOWEL BLADDER|| 80001|50830||2153.97|0|2153.97|0||REVISE URINE FLOW|| 80001|50840||1465.29|0|1465.29|0||REPLACE URETER BY BOWEL|| 80001|50845||1487.31|0|1487.31|0||APPENDICO-VESICOSTOMY|| 80001|50860||1126.88|0|1126.88|0||TRANSPLANT URETER TO SKIN|| 80001|50900||1010.95|0|1010.95|0||REPAIR OF URETER|| 80001|50920||1049.6|0|1049.6|0||CLOSURE URETER/SKIN FISTULA|| 80001|50930||1315.33|0|1315.33|0||CLOSURE URETER/BOWEL FISTULA|| 80001|50940||1056.72|0|1056.72|0||RELEASE OF URETER|| 80001|50945||1162.18|0|1162.18|0||LAPAROSCOPY URETEROLITHOTOMY|| 80001|50947||1658.86|0|1658.86|0||LAPARO NEW URETER/BLADDER|| 80001|50948||1523.89|0|1523.89|0||LAPARO NEW URETER/BLADDER|| 80001|50949||0|0|0|0||LAPAROSCOPE PROC - URETER|| 80001|50951||441.87|0|368.6|0||ENDOSCOPY OF URETER|| 80001|50953||468.43|0|392.45|0||ENDOSCOPY OF URETER|| 80001|50955||500.9|0|423.76|0||URETER ENDOSCOPY & BIOPSY|| 80001|50957||505.73|0|426.26|0||URETER ENDOSCOPY & TREATMENT|| 80001|50961||455.19|0|381.54|0||URETER ENDOSCOPY & TREATMENT|| 80001|50970||445.62|0|445.62|0||URETER ENDOSCOPY|| 80001|50972||430.57|0|430.57|0||URETER ENDOSCOPY & CATHETER|| 80001|50974||567.71|0|567.71|0||URETER ENDOSCOPY & BIOPSY|| 80001|50976||559.77|0|559.77|0||URETER ENDOSCOPY & TREATMENT|| 80001|50980||428.46|0|428.46|0||URETER ENDOSCOPY & TREATMENT|| 80001|51020||553.13|0|553.13|0||INCISE & TREAT BLADDER|| 80001|51030||556.36|0|556.36|0||INCISE & TREAT BLADDER|| 80001|51040||340.25|0|340.25|0||INCISE & DRAIN BLADDER|| 80001|51045||579.69|0|579.69|0||INCISE BLADDER/DRAIN URETER|| 80001|51050||559|0|559|0||REMOVAL OF BLADDER STONE|| 80001|51060||689.01|0|689.01|0||REMOVAL OF URETER STONE|| 80001|51065||686.3|0|686.3|0||REMOVE URETER CALCULUS|| 80001|51080||482.55|0|482.55|0||DRAINAGE OF BLADDER ABSCESS|| 80001|51100||72.03|0|47.22|0||DRAIN BLADDER BY NEEDLE|| 80001|51101||142.08|0|62.62|0||DRAIN BLADDER BY TROCAR/CATH|| 80001|51102||262.25|0|173.86|0||DRAIN BL W/CATH INSERTION|| 80001|51500||755.46|0|755.46|0||REMOVAL OF BLADDER CYST|| 80001|51520||704.88|0|704.88|0||REMOVAL OF BLADDER LESION|| 80001|51525||1023.48|0|1023.48|0||REMOVAL OF BLADDER LESION|| 80001|51530||931.09|0|931.09|0||REMOVAL OF BLADDER LESION|| 80001|51535||927.66|0|927.66|0||REPAIR OF URETER LESION|| 80001|51550||1148.92|0|1148.92|0||PARTIAL REMOVAL OF BLADDER|| 80001|51555||1514.17|0|1514.17|0||PARTIAL REMOVAL OF BLADDER|| 80001|51565||1552.02|0|1552.02|0||REVISE BLADDER & URETER(S)|| 80001|51570||1767.41|0|1767.41|0||REMOVAL OF BLADDER|| 80001|51575||2177.49|0|2177.49|0||REMOVAL OF BLADDER & NODES|| 80001|51580||2265.26|0|2265.26|0||REMOVE BLADDER/REVISE TRACT|| 80001|51585||2523.53|0|2523.53|0||REMOVAL OF BLADDER & NODES|| 80001|51590||2311.35|0|2311.35|0||REMOVE BLADDER/REVISE TRACT|| 80001|51595||2617.73|0|2617.73|0||REMOVE BLADDER/REVISE TRACT|| 80001|51596||2810.08|0|2810.08|0||REMOVE BLADDER/CREATE POUCH|| 80001|51597||2742.76|0|2742.76|0||REMOVAL OF PELVIC STRUCTURES|| 80001|51600||205.43|0|53.86|0||INJECTION FOR BLADDER X-RAY|| 80001|51605||45.05|0|45.05|0||PREPARATION FOR BLADDER XRAY|| 80001|51610||122.44|0|76.7|0||INJECTION FOR BLADDER X-RAY|| 80001|51700||95.34|0|53.86|0||IRRIGATION OF BLADDER|| 80001|51701||61.89|0|32.81|0||INSERT BLADDER CATHETER|| 80001|51702||78.94|0|35.53|0||INSERT TEMP BLADDER CATH|| 80001|51703||149.09|0|97.15|0||INSERT BLADDER CATH - COMPLEX|| 80001|51705||103.96|0|61.7|0||CHANGE OF BLADDER TUBE|| 80001|51710||147.4|0|95.07|0||CHANGE OF BLADDER TUBE|| 80001|51715||336.93|0|240.01|0||ENDOSCOPIC INJECTION/IMPLANT|| 80001|51720||126.74|0|95.73|0||TREATMENT OF BLADDER LESION|| 80001|51725||212.45|0|212.45|0||SIMPLE CYSTOMETROGRAM|| 80001|51725|26|91.89|0|91.89|0||SIMPLE CYSTOMETROGRAM|| 80001|51725|TC|120.56|0|120.56|0||SIMPLE CYSTOMETROGRAM|| 80001|51726||295.51|0|295.51|0||COMPLEX CYSTOMETROGRAM|| 80001|51726|26|102.84|0|102.84|0||COMPLEX CYSTOMETROGRAM|| 80001|51726|TC|192.66|0|192.66|0||COMPLEX CYSTOMETROGRAM|| 80001|51727||350.36|0|350.36|0||CYSTOMETROGRAM W/UP|| 80001|51727|26|128.63|0|128.63|0||CYSTOMETROGRAM W/UP|| 80001|51727|TC|221.74|0|221.74|0||CYSTOMETROGRAM W/UP|| 80001|51728||353.07|0|353.07|0||CYSTOMETROGRAM W/VP|| 80001|51728|26|125.52|0|125.52|0||CYSTOMETROGRAM W/VP|| 80001|51728|TC|227.55|0|227.55|0||CYSTOMETROGRAM W/VP|| 80001|51729||383.52|0|383.52|0||CYSTOMETROGRAM W/VP&UP|| 80001|51729|26|152.08|0|152.08|0||CYSTOMETROGRAM W/VP&UP|| 80001|51729|TC|231.43|0|231.43|0||CYSTOMETROGRAM W/VP&UP|| 80001|51736||17.8|0|17.8|0||URINE FLOW MEASUREMENT|| 80001|51736|26|10.05|0|10.05|0||URINE FLOW MEASUREMENT|| 80001|51736|TC|7.76|0|7.76|0||URINE FLOW MEASUREMENT|| 80001|51741||18.19|0|18.19|0||ELECTRO-UROFLOWMETRY - FIRST|| 80001|51741|26|10.05|0|10.05|0||ELECTRO-UROFLOWMETRY - FIRST|| 80001|51741|TC|8.14|0|8.14|0||ELECTRO-UROFLOWMETRY - FIRST|| 80001|51784||217.58|0|217.58|0||ANAL/URINARY MUSCLE STUDY|| 80001|51784|26|92.36|0|92.36|0||ANAL/URINARY MUSCLE STUDY|| 80001|51784|TC|125.21|0|125.21|0||ANAL/URINARY MUSCLE STUDY|| 80001|51785||283.51|0|283.51|0||ANAL/URINARY MUSCLE STUDY|| 80001|51785|26|100.14|0|100.14|0||ANAL/URINARY MUSCLE STUDY|| 80001|51785|TC|183.36|0|183.36|0||ANAL/URINARY MUSCLE STUDY|| 80001|51792||235.85|0|235.85|0||URINARY REFLEX STUDY|| 80001|51792|26|66.06|0|66.06|0||URINARY REFLEX STUDY|| 80001|51792|TC|169.8|0|169.8|0||URINARY REFLEX STUDY|| 80001|51797||126|0|126|0||INTRAABDOMINAL PRESSURE TEST|| 80001|51797|26|47.69|0|47.69|0||INTRAABDOMINAL PRESSURE TEST|| 80001|51797|TC|78.31|0|78.31|0||INTRAABDOMINAL PRESSURE TEST|| 80001|51798||20.55|0|20.55|0||US URINE CAPACITY MEASURE|| 80001|51800||1244.14|0|1244.14|0||REVISION OF BLADDER/URETHRA|| 80001|51820||1445.43|0|1445.43|0||REVISION OF URINARY TRACT|| 80001|51840||778.93|0|778.93|0||ATTACH BLADDER/URETHRA|| 80001|51841||920.88|0|920.88|0||ATTACH BLADDER/URETHRA|| 80001|51845||695.7|0|695.7|0||REPAIR BLADDER NECK|| 80001|51860||885.24|0|885.24|0||REPAIR OF BLADDER WOUND|| 80001|51865||1068.24|0|1068.24|0||REPAIR OF BLADDER WOUND|| 80001|51880||555.5|0|555.5|0||REPAIR OF BLADDER OPENING|| 80001|51900||990.55|0|990.55|0||REPAIR BLADDER/VAGINA LESION|| 80001|51920||907.29|0|907.29|0||CLOSE BLADDER-UTERUS FISTULA|| 80001|51925||1329.75|0|1329.75|0||HYSTERECTOMY/BLADDER REPAIR|| 80001|51940||1961.26|0|1961.26|0||CORRECTION OF BLADDER DEFECT|| 80001|51960||1656.43|0|1656.43|0||REVISION OF BLADDER & BOWEL|| 80001|51980||847.4|0|847.4|0||CONSTRUCT BLADDER OPENING|| 80001|51990||894.29|0|894.29|0||LAPARO URETHRAL SUSPENSION|| 80001|51992||1002.5|0|1002.5|0||LAPARO SLING OPERATION|| 80001|51999||0|0|0|0||LAPAROSCOPE PROC - BLADDER|| 80001|52000||234.61|0|150.49|0||CYSTOSCOPY|| 80001|52001||433.57|0|344.8|0||CYSTOSCOPY - REMOVAL OF CLOTS|| 80001|52005||301.51|0|158.85|0||CYSTOSCOPY & URETER CATHETER|| 80001|52007||498.95|0|198.14|0||CYSTOSCOPY AND BIOPSY|| 80001|52010||414.83|0|197.75|0||CYSTOSCOPY & DUCT CATHETER|| 80001|52204||415.66|0|169.89|0||CYSTOSCOPY|| 80001|52214||736.36|0|211.48|0||CYSTOSCOPY AND TREATMENT|| 80001|52224||773.27|0|245.68|0||CYSTOSCOPY AND TREATMENT|| 80001|52234||294.69|0|294.69|0||CYSTOSCOPY AND TREATMENT|| 80001|52235||345.96|0|345.96|0||CYSTOSCOPY AND TREATMENT|| 80001|52240||470.5|0|470.5|0||CYSTOSCOPY AND TREATMENT|| 80001|52250||287.14|0|287.14|0||CYSTOSCOPY AND RADIOTRACER|| 80001|52260||252.43|0|252.43|0||CYSTOSCOPY AND TREATMENT|| 80001|52265||414.1|0|194.3|0||CYSTOSCOPY AND TREATMENT|| 80001|52270||404.69|0|217.45|0||CYSTOSCOPY & REVISE URETHRA|| 80001|52275||546.58|0|298.1|0||CYSTOSCOPY & REVISE URETHRA|| 80001|52276||317.24|0|317.24|0||CYSTOSCOPY AND TREATMENT|| 80001|52277||388.27|0|388.27|0||CYSTOSCOPY AND TREATMENT|| 80001|52281||310.53|0|181.83|0||CYSTOSCOPY AND TREATMENT|| 80001|52282||404.4|0|404.4|0||CYSTOSCOPY - IMPLANT STENT|| 80001|52283||320.25|0|240.78|0||CYSTOSCOPY AND TREATMENT|| 80001|52285||322.79|0|234.4|0||CYSTOSCOPY AND TREATMENT|| 80001|52287||355.53|0|202.8|0||CYSTOSCOPY CHEMODENERVATION|| 80001|52290||292.57|0|292.57|0||CYSTOSCOPY AND TREATMENT|| 80001|52300||336.43|0|336.43|0||CYSTOSCOPY AND TREATMENT|| 80001|52301||348.55|0|348.55|0||CYSTOSCOPY AND TREATMENT|| 80001|52305||334.11|0|334.11|0||CYSTOSCOPY AND TREATMENT|| 80001|52310||279.4|0|181.32|0||CYSTOSCOPY AND TREATMENT|| 80001|52315||477.49|0|329.4|0||CYSTOSCOPY AND TREATMENT|| 80001|52317||910.52|0|417.81|0||REMOVE BLADDER STONE|| 80001|52318||568.96|0|568.96|0||REMOVE BLADDER STONE|| 80001|52320||295.77|0|295.77|0||CYSTOSCOPY AND TREATMENT|| 80001|52325||385.12|0|385.12|0||CYSTOSCOPY - STONE REMOVAL|| 80001|52327||315.36|0|315.36|0||CYSTOSCOPY - INJECT MATERIAL|| 80001|52330||563.19|0|316.25|0||CYSTOSCOPY AND TREATMENT|| 80001|52332||546.92|0|186.02|0||CYSTOSCOPY AND TREATMENT|| 80001|52334||306.8|0|306.8|0||CREATE PASSAGE TO KIDNEY|| 80001|52341||340.14|0|340.14|0||CYSTO W/URETER STRICTURE TX|| 80001|52342||371.02|0|371.02|0||CYSTO W/UP STRICTURE TX|| 80001|52343||413.23|0|413.23|0||CYSTO W/RENAL STRICTURE TX|| 80001|52344||443.72|0|443.72|0||CYSTO/URETERO - STRICTURE TX|| 80001|52345||473.43|0|473.43|0||CYSTO/URETERO W/UP STRICTURE|| 80001|52346||536.87|0|536.87|0||CYSTOURETERO W/RENAL STRICT|| 80001|52351||363.21|0|363.21|0||CYSTOURETERO & OR PYELOSCOPE|| 80001|52352||425.74|0|425.74|0||CYSTOURETERO W/STONE REMOVE|| 80001|52353||470.5|0|470.5|0||CYSTOURETERO W/LITHOTRIPSY|| 80001|52354||500.21|0|500.21|0||CYSTOURETERO W/BIOPSY|| 80001|52355||560.41|0|560.41|0||CYSTOURETERO W/EXCISE TUMOR|| 80001|52356||499.05|0|499.05|0||CYSTO/URETERO W/LITHOTRIPSY|| 80001|52400||569.91|0|569.91|0||CYSTOURETERO W/CONGEN REPR|| 80001|52402||320.79|0|320.79|0||CYSTOURETHRO CUT EJACUL DUCT|| 80001|52441||1372.61|0|273.23|0||CYSTOURETHRO W/IMPLANT|| 80001|52442||1039.9|0|73.1|0||CYSTOURETHRO W/ADDL IMPLANT|| 80001|52450||555.46|0|555.46|0||INCISION OF PROSTATE|| 80001|52500||577.97|0|577.97|0||REVISION OF BLADDER NECK|| 80001|52601||1007.27|0|1007.27|0||PROSTATECTOMY (TURP)|| 80001|52630||472.54|0|472.54|0||REMOVE PROSTATE REGROWTH|| 80001|52640||370.25|0|370.25|0||RELIEVE BLADDER CONTRACTURE|| 80001|52647||1997.04|0|768.96|0||LASER SURGERY OF PROSTATE|| 80001|52648||2057.75|0|820.37|0||LASER SURGERY OF PROSTATE|| 80001|52649||979|0|979|0||PROSTATE LASER ENUCLEATION|| 80001|52700||522.01|0|522.01|0||DRAINAGE OF PROSTATE ABSCESS|| 80001|53000||175.34|0|175.34|0||INCISION OF URETHRA|| 80001|53010||346.28|0|346.28|0||INCISION OF URETHRA|| 80001|53020||115.52|0|115.52|0||INCISION OF URETHRA|| 80001|53025||80.93|0|80.93|0||INCISION OF URETHRA|| 80001|53040||464.4|0|464.4|0||DRAINAGE OF URETHRA ABSCESS|| 80001|53060||215.65|0|195.49|0||DRAINAGE OF URETHRA ABSCESS|| 80001|53080||504.34|0|504.34|0||DRAINAGE OF URINARY LEAKAGE|| 80001|53085||770.38|0|770.38|0||DRAINAGE OF URINARY LEAKAGE|| 80001|53200||185.02|0|170.29|0||BIOPSY OF URETHRA|| 80001|53210||919.12|0|919.12|0||REMOVAL OF URETHRA|| 80001|53215||1106.49|0|1106.49|0||REMOVAL OF URETHRA|| 80001|53220||539.7|0|539.7|0||TREATMENT OF URETHRA LESION|| 80001|53230||719.85|0|719.85|0||REMOVAL OF URETHRA LESION|| 80001|53235||750.94|0|750.94|0||REMOVAL OF URETHRA LESION|| 80001|53240||502.39|0|502.39|0||SURGERY FOR URETHRA POUCH|| 80001|53250||467.76|0|467.76|0||REMOVAL OF URETHRA GLAND|| 80001|53260||235.78|0|213.3|0||TREATMENT OF URETHRA LESION|| 80001|53265||255|0|220.89|0||TREATMENT OF URETHRA LESION|| 80001|53270||241.3|0|218.04|0||REMOVAL OF URETHRA GLAND|| 80001|53275||312.3|0|312.3|0||REPAIR OF URETHRA DEFECT|| 80001|53400||952.7|0|952.7|0||REVISE URETHRA - STAGE 1|| 80001|53405||1040.42|0|1040.42|0||REVISE URETHRA - STAGE 2|| 80001|53410||1167.11|0|1167.11|0||RECONSTRUCTION OF URETHRA|| 80001|53415||1348.19|0|1348.19|0||RECONSTRUCTION OF URETHRA|| 80001|53420||1001.44|0|1001.44|0||RECONSTRUCT URETHRA - STAGE 1|| 80001|53425||1116.37|0|1116.37|0||RECONSTRUCT URETHRA - STAGE 2|| 80001|53430||1148.59|0|1148.59|0||RECONSTRUCTION OF URETHRA|| 80001|53431||1377.04|0|1377.04|0||RECONSTRUCT URETHRA/BLADDER|| 80001|53440||895.83|0|895.83|0||MALE SLING PROCEDURE|| 80001|53442||929.35|0|929.35|0||REMOVE/REVISE MALE SLING|| 80001|53444||944.05|0|944.05|0||INSERT TANDEM CUFF|| 80001|53445||894.26|0|894.26|0||INSERT URO/VES NCK SPHINCTER|| 80001|53446||761.54|0|761.54|0||REMOVE URO SPHINCTER|| 80001|53447||961.5|0|961.5|0||REMOVE/REPLACE UR SPHINCTER|| 80001|53448||1526.88|0|1526.88|0||REMOV/REPLC UR SPHINCTR COMP|| 80001|53449||725.8|0|725.8|0||REPAIR URO SPHINCTER|| 80001|53450||483.98|0|483.98|0||REVISION OF URETHRA|| 80001|53460||542.15|0|542.15|0||REVISION OF URETHRA|| 80001|53500||889.62|0|889.62|0||URETHRLYS - TRANSVAG W/ SCOPE|| 80001|53502||576.95|0|576.95|0||REPAIR OF URETHRA INJURY|| 80001|53505||576.17|0|576.17|0||REPAIR OF URETHRA INJURY|| 80001|53510||749.26|0|749.26|0||REPAIR OF URETHRA INJURY|| 80001|53515||947.28|0|947.28|0||REPAIR OF URETHRA INJURY|| 80001|53520||659.43|0|659.43|0||REPAIR OF URETHRA DEFECT|| 80001|53600||97.17|0|76.63|0||DILATE URETHRA STRICTURE|| 80001|53601||93.45|0|63.99|0||DILATE URETHRA STRICTURE|| 80001|53605||77.71|0|77.71|0||DILATE URETHRA STRICTURE|| 80001|53620||135.02|0|104.39|0||DILATE URETHRA STRICTURE|| 80001|53621||126.47|0|86.16|0||DILATE URETHRA STRICTURE|| 80001|53660||80.25|0|49.24|0||DILATION OF URETHRA|| 80001|53661||78.74|0|47.73|0||DILATION OF URETHRA|| 80001|53665||46.75|0|46.75|0||DILATION OF URETHRA|| 80001|53850||2309.96|0|718.66|0||PROSTATIC MICROWAVE THERMOTX|| 80001|53852||2136.48|0|739.38|0||PROSTATIC RF THERMOTX|| 80001|53855||854.2|0|99.05|0||INSERT PROST URETHRAL STENT|| 80001|53860||1728.48|0|268.2|0||TRANSURETHRAL RF TREATMENT|| 80001|53899||0|0|0|0||UROLOGY SURGERY PROCEDURE|| 80001|54000||170.16|0|127.14|0||SLITTING OF PREPUCE|| 80001|54001||213.33|0|164.1|0||SLITTING OF PREPUCE|| 80001|54015||363.83|0|363.83|0||DRAIN PENIS LESION|| 80001|54050||151.41|0|122.72|0||DESTRUCTION - PENIS LESION(S)|| 80001|54055||136.5|0|108.59|0||DESTRUCTION - PENIS LESION(S)|| 80001|54056||161.88|0|128.54|0||CRYOSURGERY - PENIS LESION(S)|| 80001|54057||154.51|0|110.7|0||LASER SURG - PENIS LESION(S)|| 80001|54060||205.99|0|153.27|0||EXCISION OF PENIS LESION(S)|| 80001|54065||251.17|0|202.71|0||DESTRUCTION - PENIS LESION(S)|| 80001|54100||226.57|0|148.27|0||BIOPSY OF PENIS|| 80001|54105||307.02|0|252.75|0||BIOPSY OF PENIS|| 80001|54110||741.33|0|741.33|0||TREATMENT OF PENIS LESION|| 80001|54111||953.97|0|953.97|0||TREAT PENIS LESION - GRAFT|| 80001|54112||1117.53|0|1117.53|0||TREAT PENIS LESION - GRAFT|| 80001|54115||530.89|0|501.43|0||TREATMENT OF PENIS LESION|| 80001|54120||751.03|0|751.03|0||PARTIAL REMOVAL OF PENIS|| 80001|54125||966.99|0|966.99|0||REMOVAL OF PENIS|| 80001|54130||1422.96|0|1422.96|0||REMOVE PENIS & NODES|| 80001|54135||1806.15|0|1806.15|0||REMOVE PENIS & NODES|| 80001|54150||178.5|0|117.25|0||CIRCUMCISION|| 80001|54160||252.98|0|171.57|0||CIRCUMCISION|| 80001|54161||233.17|0|233.17|0||CIRCUMCISION|| 80001|54162||297.14|0|235.89|0||LYSIS PENIL CIRCUMIC LESION|| 80001|54163||257.21|0|257.21|0||REPAIR OF CIRCUMCISION|| 80001|54164||227.11|0|227.11|0||FRENULOTOMY OF PENIS|| 80001|54200||122.71|0|97.9|0||TREATMENT OF PENIS LESION|| 80001|54205||630.45|0|630.45|0||TREATMENT OF PENIS LESION|| 80001|54220||236.22|0|160.63|0||TREATMENT OF PENIS LESION|| 80001|54230||112.86|0|95.03|0||PREPARE PENIS STUDY|| 80001|54231||163.99|0|138.8|0||DYNAMIC CAVERNOSOMETRY|| 80001|54235||105.23|0|87.39|0||PENILE INJECTION|| 80001|54240||115.43|0|115.43|0||PENIS STUDY|| 80001|54240|26|77.05|0|77.05|0||PENIS STUDY|| 80001|54240|TC|38.38|0|38.38|0||PENIS STUDY|| 80001|54250||143.84|0|143.84|0||PENIS STUDY|| 80001|54250|26|131.82|0|131.82|0||PENIS STUDY|| 80001|54250|TC|12.02|0|12.02|0||PENIS STUDY|| 80001|54300||762.33|0|762.33|0||REVISION OF PENIS|| 80001|54304||892.38|0|892.38|0||REVISION OF PENIS|| 80001|54308||849.95|0|849.95|0||RECONSTRUCTION OF URETHRA|| 80001|54312||973.36|0|973.36|0||RECONSTRUCTION OF URETHRA|| 80001|54316||1189.66|0|1189.66|0||RECONSTRUCTION OF URETHRA|| 80001|54318||854.04|0|854.04|0||RECONSTRUCTION OF URETHRA|| 80001|54322||929.56|0|929.56|0||RECONSTRUCTION OF URETHRA|| 80001|54324||1155.3|0|1155.3|0||RECONSTRUCTION OF URETHRA|| 80001|54326||1127|0|1127|0||RECONSTRUCTION OF URETHRA|| 80001|54328||1119.46|0|1119.46|0||REVISE PENIS/URETHRA|| 80001|54332||1208.89|0|1208.89|0||REVISE PENIS/URETHRA|| 80001|54336||1418.12|0|1418.12|0||REVISE PENIS/URETHRA|| 80001|54340||675.94|0|675.94|0||SECONDARY URETHRAL SURGERY|| 80001|54344||1129.12|0|1129.12|0||SECONDARY URETHRAL SURGERY|| 80001|54348||1218.59|0|1218.59|0||SECONDARY URETHRAL SURGERY|| 80001|54352||1691|0|1691|0||RECONSTRUCT URETHRA/PENIS|| 80001|54360||857.63|0|857.63|0||PENIS PLASTIC SURGERY|| 80001|54380||950.98|0|950.98|0||REPAIR PENIS|| 80001|54385||1230.17|0|1230.17|0||REPAIR PENIS|| 80001|54390||1491.17|0|1491.17|0||REPAIR PENIS AND BLADDER|| 80001|54400||628.61|0|628.61|0||INSERT SEMI-RIGID PROSTHESIS|| 80001|54401||773.34|0|773.34|0||INSERT SELF-CONTD PROSTHESIS|| 80001|54405||962.55|0|962.55|0||INSERT MULTI-COMP PENIS PROS|| 80001|54406||868.97|0|868.97|0||REMOVE MUTI-COMP PENIS PROS|| 80001|54408||939.72|0|939.72|0||REPAIR MULTI-COMP PENIS PROS|| 80001|54410||1022.03|0|1022.03|0||REMOVE/REPLACE PENIS PROSTH|| 80001|54411||1221.99|0|1221.99|0||REMOV/REPLC PENIS PROS - COMP|| 80001|54415||626.96|0|626.96|0||REMOVE SELF-CONTD PENIS PROS|| 80001|54416||841.38|0|841.38|0||REMV/REPL PENIS CONTAIN PROS|| 80001|54417||1070.25|0|1070.25|0||REMV/REPLC PENIS PROS - COMPL|| 80001|54420||837.31|0|837.31|0||REVISION OF PENIS|| 80001|54430||759.77|0|759.77|0||REVISION OF PENIS|| 80001|54435||492.29|0|492.29|0||REVISION OF PENIS|| 80001|54437||806.5|0|806.5|0||REPAIR CORPOREAL TEAR|| 80001|54438||1631.59|0|1631.59|0||REPLANTATION OF PENIS|| 80001|54440||0|0|0|0||REPAIR OF PENIS|| 80001|54450||82.05|0|68.87|0||PREPUTIAL STRETCHING|| 80001|54500||89.08|0|89.08|0||BIOPSY OF TESTIS|| 80001|54505||248.3|0|248.3|0||BIOPSY OF TESTIS|| 80001|54512||642.9|0|642.9|0||EXCISE LESION TESTIS|| 80001|54520||386.07|0|386.07|0||REMOVAL OF TESTIS|| 80001|54522||700.79|0|700.79|0||ORCHIECTOMY - PARTIAL|| 80001|54530||597.98|0|597.98|0||REMOVAL OF TESTIS|| 80001|54535||885.79|0|885.79|0||EXTENSIVE TESTIS SURGERY|| 80001|54550||583.8|0|583.8|0||EXPLORATION FOR TESTIS|| 80001|54560||807.93|0|807.93|0||EXPLORATION FOR TESTIS|| 80001|54600||536.24|0|536.24|0||REDUCE TESTIS TORSION|| 80001|54620||356.58|0|356.58|0||SUSPENSION OF TESTIS|| 80001|54640||566.9|0|566.9|0||SUSPENSION OF TESTIS|| 80001|54650||845.06|0|845.06|0||ORCHIOPEXY (FOWLER-STEPHENS)|| 80001|54660||421.7|0|421.7|0||REVISION OF TESTIS|| 80001|54670||478.8|0|478.8|0||REPAIR TESTIS INJURY|| 80001|54680||936.8|0|936.8|0||RELOCATION OF TESTIS(ES)|| 80001|54690||782.34|0|782.34|0||LAPAROSCOPY - ORCHIECTOMY|| 80001|54692||904.86|0|904.86|0||LAPAROSCOPY - ORCHIOPEXY|| 80001|54699||0|0|0|0||LAPAROSCOPE PROC - TESTIS|| 80001|54700||254.39|0|254.39|0||DRAINAGE OF SCROTUM|| 80001|54800||150.92|0|150.92|0||BIOPSY OF EPIDIDYMIS|| 80001|54830||439.95|0|439.95|0||REMOVE EPIDIDYMIS LESION|| 80001|54840||379.33|0|379.33|0||REMOVE EPIDIDYMIS LESION|| 80001|54860||495.62|0|495.62|0||REMOVAL OF EPIDIDYMIS|| 80001|54861||671.64|0|671.64|0||REMOVAL OF EPIDIDYMIS|| 80001|54865||423.38|0|423.38|0||EXPLORE EPIDIDYMIS|| 80001|54900||961.79|0|961.79|0||FUSION OF SPERMATIC DUCTS|| 80001|54901||1268.9|0|1268.9|0||FUSION OF SPERMATIC DUCTS|| 80001|55000||135.74|0|101.24|0||DRAINAGE OF HYDROCELE|| 80001|55040||399.9|0|399.9|0||REMOVAL OF HYDROCELE|| 80001|55041||604.54|0|604.54|0||REMOVAL OF HYDROCELES|| 80001|55060||449.87|0|449.87|0||REPAIR OF HYDROCELE|| 80001|55100||248.37|0|196.04|0||DRAINAGE OF SCROTUM ABSCESS|| 80001|55110||458.02|0|458.02|0||EXPLORE SCROTUM|| 80001|55120||422.39|0|422.39|0||REMOVAL OF SCROTUM LESION|| 80001|55150||583.8|0|583.8|0||REMOVAL OF SCROTUM|| 80001|55175||428.48|0|428.48|0||REVISION OF SCROTUM|| 80001|55180||817.98|0|817.98|0||REVISION OF SCROTUM|| 80001|55200||499.06|0|329.66|0||INCISION OF SPERM DUCT|| 80001|55250||436.52|0|267.12|0||REMOVAL OF SPERM DUCT(S)|| 80001|55300||223.88|0|223.88|0||PREPARE - SPERM DUCT X-RAY|| 80001|55400||591.66|0|591.66|0||REPAIR OF SPERM DUCT|| 80001|55450||414.41|0|305.87|0||LIGATION OF SPERM DUCT|| 80001|55500||467.66|0|467.66|0||REMOVAL OF HYDROCELE|| 80001|55520||535.21|0|535.21|0||REMOVAL OF SPERM CORD LESION|| 80001|55530||417.11|0|417.11|0||REVISE SPERMATIC CORD VEINS|| 80001|55535||509.46|0|509.46|0||REVISE SPERMATIC CORD VEINS|| 80001|55540||654.88|0|654.88|0||REVISE HERNIA & SPERM VEINS|| 80001|55550||507.18|0|507.18|0||LAPARO LIGATE SPERMATIC VEIN|| 80001|55559||0|0|0|0||LAPARO PROC - SPERMATIC CORD|| 80001|55600||498.59|0|498.59|0||INCISE SPERM DUCT POUCH|| 80001|55605||625.96|0|625.96|0||INCISE SPERM DUCT POUCH|| 80001|55650||852.01|0|852.01|0||REMOVE SPERM DUCT POUCH|| 80001|55680||414.75|0|414.75|0||REMOVE SPERM POUCH LESION|| 80001|55700||250.87|0|166.75|0||BIOPSY OF PROSTATE|| 80001|55705||316.74|0|316.74|0||BIOPSY OF PROSTATE|| 80001|55706||441.51|0|441.51|0||PROSTATE SATURATION SAMPLING|| 80001|55720||535.47|0|535.47|0||DRAINAGE OF PROSTATE ABSCESS|| 80001|55725||749.53|0|749.53|0||DRAINAGE OF PROSTATE ABSCESS|| 80001|55801||1302.38|0|1302.38|0||REMOVAL OF PROSTATE|| 80001|55810||1572.89|0|1572.89|0||EXTENSIVE PROSTATE SURGERY|| 80001|55812||1921.84|0|1921.84|0||EXTENSIVE PROSTATE SURGERY|| 80001|55815||2106.97|0|2106.97|0||EXTENSIVE PROSTATE SURGERY|| 80001|55821||1040.86|0|1040.86|0||REMOVAL OF PROSTATE|| 80001|55831||1127.36|0|1127.36|0||REMOVAL OF PROSTATE|| 80001|55840||1397.21|0|1397.21|0||EXTENSIVE PROSTATE SURGERY|| 80001|55842||1396.04|0|1396.04|0||EXTENSIVE PROSTATE SURGERY|| 80001|55845||1627.92|0|1627.92|0||EXTENSIVE PROSTATE SURGERY|| 80001|55860||1042.76|0|1042.76|0||SURGICAL EXPOSURE - PROSTATE|| 80001|55862||1317.98|0|1317.98|0||EXTENSIVE PROSTATE SURGERY|| 80001|55865||1592.69|0|1592.69|0||EXTENSIVE PROSTATE SURGERY|| 80001|55866||2069.73|0|2069.73|0||LAPARO RADICAL PROSTATECTOMY|| 80001|55870||205.51|0|169.85|0||ELECTROEJACULATION|| 80001|55873||7830.81|0|913.96|0||CRYOABLATE PROSTATE|| 80001|55874||4112.61|0|202.95|0||TPRNL PLMT BIODEGRDABL MATRL|| 80001|55875||906.72|0|906.72|0||TRANSPERI NEEDLE PLACE - PROS|| 80001|55876||156.82|0|119.6|0||PLACE RT DEVICE/MARKER - PROS|| 80001|55899||0|0|0|0||GENITAL SURGERY PROCEDURE|| 80001|55920||531.79|0|531.79|0||PLACE NEEDLES PELVIC FOR RT|| 80001|55970||0|0|0|0||SEX TRANSFORMATION - M TO F|| 80001|55980||0|0|0|0||SEX TRANSFORMATION - F TO M|| 80001|56405||127.48|0|126.71|0||I & D OF VULVA/PERINEUM|| 80001|56420||140.44|0|107.1|0||DRAINAGE OF GLAND ABSCESS|| 80001|56440||213.86|0|213.86|0||SURGERY FOR VULVA LESION|| 80001|56441||168.96|0|163.14|0||LYSIS OF LABIAL LESION(S)|| 80001|56442||55.31|0|55.31|0||HYMENOTOMY|| 80001|56501||151.13|0|133.69|0||DESTROY - VULVA LESIONS - SIM|| 80001|56515||263.55|0|236.41|0||DESTROY VULVA LESION/S COMPL|| 80001|56605||95.53|0|71.89|0||BIOPSY OF VULVA/PERINEUM|| 80001|56606||43.89|0|34.97|0||BIOPSY OF VULVA/PERINEUM|| 80001|56620||609.14|0|609.14|0||PARTIAL REMOVAL OF VULVA|| 80001|56625||742.28|0|742.28|0||COMPLETE REMOVAL OF VULVA|| 80001|56630||1096.26|0|1096.26|0||EXTENSIVE VULVA SURGERY|| 80001|56631||1393.81|0|1393.81|0||EXTENSIVE VULVA SURGERY|| 80001|56632||1632.86|0|1632.86|0||EXTENSIVE VULVA SURGERY|| 80001|56633||1436.14|0|1436.14|0||EXTENSIVE VULVA SURGERY|| 80001|56634||1546.67|0|1546.67|0||EXTENSIVE VULVA SURGERY|| 80001|56637||1795.23|0|1795.23|0||EXTENSIVE VULVA SURGERY|| 80001|56640||1814.48|0|1814.48|0||EXTENSIVE VULVA SURGERY|| 80001|56700||218.29|0|218.29|0||PARTIAL REMOVAL OF HYMEN|| 80001|56740||354.01|0|354.01|0||REMOVE VAGINA GLAND LESION|| 80001|56800||283.54|0|283.54|0||REPAIR OF VAGINA|| 80001|56805||1346.59|0|1346.59|0||REPAIR CLITORIS|| 80001|56810||305.67|0|305.67|0||REPAIR OF PERINEUM|| 80001|56820||130.24|0|102.72|0||EXAM OF VULVA W/SCOPE|| 80001|56821||172.2|0|137.31|0||EXAM/BIOPSY OF VULVA W/SCOPE|| 80001|57000||216.75|0|216.75|0||EXPLORATION OF VAGINA|| 80001|57010||506.78|0|506.78|0||DRAINAGE OF PELVIC ABSCESS|| 80001|57020||108.52|0|95.73|0||DRAINAGE OF PELVIC FLUID|| 80001|57022||197.26|0|197.26|0||I & D VAGINAL HEMATOMA - PP|| 80001|57023||365.39|0|365.39|0||I & D VAG HEMATOMA - NON-OB|| 80001|57061||131.3|0|114.63|0||DESTROY VAG LESIONS - SIMPLE|| 80001|57065||227.99|0|205.5|0||DESTROY VAG LESIONS - COMPLEX|| 80001|57100||103.73|0|79.7|0||BIOPSY OF VAGINA|| 80001|57105||158.04|0|147.58|0||BIOPSY OF VAGINA|| 80001|57106||579.52|0|579.52|0||REMOVE VAGINA WALL - PARTIAL|| 80001|57107||1725.62|0|1725.62|0||REMOVE VAGINA TISSUE - PART|| 80001|57109||2075.42|0|2075.42|0||VAGINECTOMY PARTIAL W/NODES|| 80001|57110||1053.63|0|1053.63|0||REMOVE VAGINA WALL - COMPLETE|| 80001|57111||1889.42|0|1889.42|0||REMOVE VAGINA TISSUE - COMPL|| 80001|57112||2221.99|0|2221.99|0||VAGINECTOMY W/NODES - COMPL|| 80001|57120||597.22|0|597.22|0||CLOSURE OF VAGINA|| 80001|57130||205.77|0|186.39|0||REMOVE VAGINA LESION|| 80001|57135||223.11|0|202.95|0||REMOVE VAGINA LESION|| 80001|57150||52.03|0|34.2|0||TREAT VAGINA INFECTION|| 80001|57155||493.85|0|343.82|0||INSERT UTERI TANDEMS/OVOIDS|| 80001|57156||228.07|0|173.03|0||INS VAG BRACHYTX DEVICE|| 80001|57160||88.02|0|56.23|0||INSERT PESSARY/OTHER DEVICE|| 80001|57170||70.66|0|57.48|0||FITTING OF DIAPHRAGM/CAP|| 80001|57180||162.21|0|124.22|0||TREAT VAGINAL BLEEDING|| 80001|57200||353.16|0|353.16|0||REPAIR OF VAGINA|| 80001|57210||430.52|0|430.52|0||REPAIR VAGINA/PERINEUM|| 80001|57220||372.47|0|372.47|0||REVISION OF URETHRA|| 80001|57230||461.78|0|461.78|0||REPAIR OF URETHRAL LESION|| 80001|57240||790.8|0|790.8|0||REPAIR BLADDER & VAGINA|| 80001|57250||796.24|0|796.24|0||REPAIR RECTUM & VAGINA|| 80001|57260||982.4|0|982.4|0||REPAIR OF VAGINA|| 80001|57265||1076.19|0|1076.19|0||EXTENSIVE REPAIR OF VAGINA|| 80001|57267||304.75|0|304.75|0||INSERT MESH/PELVIC FLR ADDON|| 80001|57268||565.81|0|565.81|0||REPAIR OF BOWEL BULGE|| 80001|57270||939.5|0|939.5|0||REPAIR OF BOWEL POUCH|| 80001|57280||1126.13|0|1126.13|0||SUSPENSION OF VAGINA|| 80001|57282||586.16|0|586.16|0||COLPOPEXY - EXTRAPERITONEAL|| 80001|57283||811.29|0|811.29|0||COLPOPEXY - INTRAPERITONEAL|| 80001|57284||962.92|0|962.92|0||REPAIR PARAVAGINAL DEFECT|| 80001|57285||792.4|0|792.4|0||REPAIR PARAVAG DEFECT - VAG|| 80001|57287||799.72|0|799.72|0||REVISE/REMOVE SLING REPAIR|| 80001|57288||843.17|0|843.17|0||REPAIR BLADDER DEFECT|| 80001|57289||866.63|0|866.63|0||REPAIR BLADDER & VAGINA|| 80001|57291||620.89|0|620.89|0||CONSTRUCTION OF VAGINA|| 80001|57292||960.35|0|960.35|0||CONSTRUCT VAGINA WITH GRAFT|| 80001|57295||560.31|0|560.31|0||CHANGE VAGINAL GRAFT|| 80001|57296||1103.33|0|1103.33|0||REVISE VAG GRAFT - OPEN ABD|| 80001|57300||666.63|0|666.63|0||REPAIR RECTUM-VAGINA FISTULA|| 80001|57305||1109.89|0|1109.89|0||REPAIR RECTUM-VAGINA FISTULA|| 80001|57307||1275.83|0|1275.83|0||FISTULA REPAIR & COLOSTOMY|| 80001|57308||749.99|0|749.99|0||FISTULA REPAIR - TRANSPERINE|| 80001|57310||544.42|0|544.42|0||REPAIR URETHROVAGINAL LESION|| 80001|57311||620.88|0|620.88|0||REPAIR URETHROVAGINAL LESION|| 80001|57320||624.64|0|624.64|0||REPAIR BLADDER-VAGINA LESION|| 80001|57330||880.06|0|880.06|0||REPAIR BLADDER-VAGINA LESION|| 80001|57335||1322.54|0|1322.54|0||REPAIR VAGINA|| 80001|57400||156.87|0|156.87|0||DILATION OF VAGINA|| 80001|57410||127.46|0|127.46|0||PELVIC EXAMINATION|| 80001|57415||187.68|0|187.68|0||REMOVE VAGINAL FOREIGN BODY|| 80001|57420||137.66|0|109.75|0||EXAM OF VAGINA W/SCOPE|| 80001|57421||183.71|0|147.66|0||EXAM/BIOPSY OF VAG W/SCOPE|| 80001|57423||1078.75|0|1078.75|0||REPAIR PARAVAG DEFECT - LAP|| 80001|57425||1143.77|0|1143.77|0||LAPAROSCOPY - SURG - COLPOPEXY|| 80001|57426||993.41|0|993.41|0||REVISE PROSTH VAG GRAFT LAP|| 80001|57452||126.75|0|108.92|0||EXAM OF CERVIX W/SCOPE|| 80001|57454||178.84|0|161.01|0||BX/CURETT OF CERVIX W/SCOPE|| 80001|57455||166.5|0|131.61|0||BIOPSY OF CERVIX W/SCOPE|| 80001|57456||156.58|0|122.47|0||ENDOCERV CURETTAGE W/SCOPE|| 80001|57460||322.52|0|192.27|0||BX OF CERVIX W/SCOPE - LEEP|| 80001|57461||366.25|0|223.21|0||CONZ OF CERVIX W/SCOPE - LEEP|| 80001|57500||145.98|0|89.38|0||BIOPSY OF CERVIX|| 80001|57505||117.25|0|106.78|0||ENDOCERVICAL CURETTAGE|| 80001|57510||152.53|0|135.86|0||CAUTERIZATION OF CERVIX|| 80001|57511||168.65|0|154.69|0||CRYOCAUTERY OF CERVIX|| 80001|57513||168.65|0|157.03|0||LASER SURGERY OF CERVIX|| 80001|57520||355.67|0|321.95|0||CONIZATION OF CERVIX|| 80001|57522||305.66|0|285.12|0||CONIZATION OF CERVIX|| 80001|57530||407.67|0|407.67|0||REMOVAL OF CERVIX|| 80001|57531||2190.41|0|2190.41|0||REMOVAL OF CERVIX - RADICAL|| 80001|57540||944.02|0|944.02|0||REMOVAL OF RESIDUAL CERVIX|| 80001|57545||966.18|0|966.18|0||REMOVE CERVIX/REPAIR PELVIS|| 80001|57550||475.13|0|475.13|0||REMOVAL OF RESIDUAL CERVIX|| 80001|57555||704.89|0|704.89|0||REMOVE CERVIX/REPAIR VAGINA|| 80001|57556||666.29|0|666.29|0||REMOVE CERVIX - REPAIR BOWEL|| 80001|57558||145.15|0|132.75|0||D&C OF CERVICAL STUMP|| 80001|57700||360.19|0|360.19|0||REVISION OF CERVIX|| 80001|57720||357.45|0|357.45|0||REVISION OF CERVIX|| 80001|57800||70.44|0|57.65|0||DILATION OF CERVICAL CANAL|| 80001|58100||126.49|0|103.23|0||BIOPSY OF UTERUS LINING|| 80001|58110||56.48|0|49.12|0||BX DONE W/COLPOSCOPY ADD-ON|| 80001|58120||300.28|0|258.02|0||DILATION AND CURETTAGE|| 80001|58140||1087.62|0|1087.62|0||MYOMECTOMY ABDOM METHOD|| 80001|58145||643.42|0|643.42|0||MYOMECTOMY VAG METHOD|| 80001|58146||1357.52|0|1357.52|0||MYOMECTOMY ABDOM COMPLEX|| 80001|58150||1197.83|0|1197.83|0||TOTAL HYSTERECTOMY|| 80001|58152||1479.38|0|1479.38|0||TOTAL HYSTERECTOMY|| 80001|58180||1137.68|0|1137.68|0||PARTIAL HYSTERECTOMY|| 80001|58200||1622.71|0|1622.71|0||EXTENSIVE HYSTERECTOMY|| 80001|58210||2186.27|0|2186.27|0||EXTENSIVE HYSTERECTOMY|| 80001|58240||3459.26|0|3459.26|0||REMOVAL OF PELVIS CONTENTS|| 80001|58260||972.6|0|972.6|0||VAGINAL HYSTERECTOMY|| 80001|58262||1086.67|0|1086.67|0||VAG HYST INCLUDING T/O|| 80001|58263||1165.19|0|1165.19|0||VAG HYST W/T/O & VAG REPAIR|| 80001|58267||1243.82|0|1243.82|0||VAG HYST W/URINARY REPAIR|| 80001|58270||1038.9|0|1038.9|0||VAG HYST W/ENTEROCELE REPAIR|| 80001|58275||1163.18|0|1163.18|0||HYSTERECTOMY/REVISE VAGINA|| 80001|58280||1237.85|0|1237.85|0||HYSTERECTOMY/REVISE VAGINA|| 80001|58285||1696.28|0|1696.28|0||EXTENSIVE HYSTERECTOMY|| 80001|58290||1353.73|0|1353.73|0||VAG HYST COMPLEX|| 80001|58291||1466.63|0|1466.63|0||VAG HYST INCL T/O - COMPLEX|| 80001|58292||1547.48|0|1547.48|0||VAG HYST T/O & REPAIR - COMPL|| 80001|58293||1609.15|0|1609.15|0||VAG HYST W/URO REPAIR - COMPL|| 80001|58294||1433.77|0|1433.77|0||VAG HYST W/ENTEROCELE - COMPL|| 80001|58300||81.17|0|61.01|0||INSERT INTRAUTERINE DEVICE|| 80001|58301||109.84|0|80.38|0||REMOVE INTRAUTERINE DEVICE|| 80001|58321||87.76|0|57.91|0||ARTIFICIAL INSEMINATION|| 80001|58322||99.02|0|69.56|0||ARTIFICIAL INSEMINATION|| 80001|58323||18.06|0|14.58|0||SPERM WASHING|| 80001|58340||134.1|0|68.2|0||CATHETER FOR HYSTEROGRAPHY|| 80001|58345||327.61|0|327.61|0||REOPEN FALLOPIAN TUBE|| 80001|58346||521.1|0|521.1|0||INSERT HEYMAN UTERI CAPSULE|| 80001|58350||110.86|0|91.48|0||REOPEN FALLOPIAN TUBE|| 80001|58353||1114.38|0|257.28|0||ENDOMETR ABLATE - THERMAL|| 80001|58356||2080.31|0|409.15|0||ENDOMETRIAL CRYOABLATION|| 80001|58400||514.69|0|514.69|0||SUSPENSION OF UTERUS|| 80001|58410||944.7|0|944.7|0||SUSPENSION OF UTERUS|| 80001|58520||941.75|0|941.75|0||REPAIR OF RUPTURED UTERUS|| 80001|58540||1068.59|0|1068.59|0||REVISION OF UTERUS|| 80001|58541||843.89|0|843.89|0||LSH - UTERUS 250 G OR LESS|| 80001|58542||964.9|0|964.9|0||LSH W/T/O UT 250 G OR LESS|| 80001|58543||976.36|0|976.36|0||LSH UTERUS ABOVE 250 G|| 80001|58544||1065.83|0|1065.83|0||LSH W/T/O UTERUS ABOVE 250 G|| 80001|58545||1068.36|0|1068.36|0||LAPAROSCOPIC MYOMECTOMY|| 80001|58546||1324.76|0|1324.76|0||LAPARO-MYOMECTOMY - COMPLEX|| 80001|58548||2251.87|0|2251.87|0||LAP RADICAL HYST|| 80001|58550||1038.41|0|1038.41|0||LAPARO-ASST VAG HYSTERECTOMY|| 80001|58552||1165.8|0|1165.8|0||LAPARO-VAG HYST INCL T/O|| 80001|58553||1336.55|0|1336.55|0||LAPARO-VAG HYST - COMPLEX|| 80001|58554||1565.14|0|1565.14|0||LAPARO-VAG HYST W/T/O - COMPL|| 80001|58555||347.59|0|224.31|0||HYSTEROSCOPY - DX - SEP PROC|| 80001|58558||456.5|0|315.39|0||HYSTEROSCOPY - BIOPSY|| 80001|58559||403.4|0|403.4|0||HYSTEROSCOPY - LYSIS|| 80001|58560||456.27|0|456.27|0||HYSTEROSCOPY - RESECT SEPTUM|| 80001|58561||646.58|0|646.58|0||HYSTEROSCOPY - REMOVE MYOMA|| 80001|58562||474.79|0|343.38|0||HYSTEROSCOPY - REMOVE FB|| 80001|58563||1843.14|0|404.18|0||HYSTEROSCOPY - ABLATION|| 80001|58565||2072.95|0|506.85|0||HYSTEROSCOPY - STERILIZATION|| 80001|58570||917.99|0|917.99|0||TLH - UTERUS 250 G OR LESS|| 80001|58571||1059.83|0|1059.83|0||TLH W/T/O 250 G OR LESS|| 80001|58572||1201.07|0|1201.07|0||TLH - UTERUS OVER 250 G|| 80001|58573||1433.73|0|1433.73|0||TLH W/T/O UTERUS OVER 250 G|| 80001|58575||2262.38|0|2262.38|0||LAPS TOT HYST RESJ MAL|| 80001|58578||0|0|0|0||LAPARO PROC - UTERUS|| 80001|58579||0|0|0|0||HYSTEROSCOPE PROCEDURE|| 80001|58600||425.95|0|425.95|0||DIVISION OF FALLOPIAN TUBE|| 80001|58605||385.59|0|385.59|0||DIVISION OF FALLOPIAN TUBE|| 80001|58611||91.64|0|91.64|0||LIGATE OVIDUCT(S) ADD-ON|| 80001|58615||285.52|0|285.52|0||OCCLUDE FALLOPIAN TUBE(S)|| 80001|58660||794.73|0|794.73|0||LAPAROSCOPY - LYSIS|| 80001|58661||766.94|0|766.94|0||LAPAROSCOPY - REMOVE ADNEXA|| 80001|58662||836.73|0|836.73|0||LAPAROSCOPY - EXCISE LESIONS|| 80001|58670||427.12|0|427.12|0||LAPAROSCOPY - TUBAL CAUTERY|| 80001|58671||426.34|0|426.34|0||LAPAROSCOPY - TUBAL BLOCK|| 80001|58672||865.21|0|865.21|0||LAPAROSCOPY - FIMBRIOPLASTY|| 80001|58673||941.1|0|941.1|0||LAPAROSCOPY - SALPINGOSTOMY|| 80001|58674||1000.43|0|1000.43|0||LAPS ABLTJ UTERINE FIBROIDS|| 80001|58679||0|0|0|0||LAPARO PROC - OVIDUCT-OVARY|| 80001|58700||921.71|0|921.71|0||REMOVAL OF FALLOPIAN TUBE|| 80001|58720||867.47|0|867.47|0||REMOVAL OF OVARY/TUBE(S)|| 80001|58740||1042.66|0|1042.66|0||REVISE FALLOPIAN TUBE(S)|| 80001|58750||1073.33|0|1073.33|0||REPAIR OVIDUCT|| 80001|58752||1027.78|0|1027.78|0||REVISE OVARIAN TUBE(S)|| 80001|58760||951.87|0|951.87|0||REMOVE TUBAL OBSTRUCTION|| 80001|58770||1002.45|0|1002.45|0||CREATE NEW TUBAL OPENING|| 80001|58800||369.52|0|348.2|0||DRAINAGE OF OVARIAN CYST(S)|| 80001|58805||472.38|0|472.38|0||DRAINAGE OF OVARIAN CYST(S)|| 80001|58820||363.28|0|363.28|0||DRAIN OVARY ABSCESS - OPEN|| 80001|58822||821.63|0|821.63|0||DRAIN OVARY ABSCESS - PERCUT|| 80001|58825||894.28|0|894.28|0||TRANSPOSITION - OVARY(S)|| 80001|58900||482.82|0|482.82|0||BIOPSY OF OVARY(S)|| 80001|58920||838.91|0|838.91|0||PARTIAL REMOVAL OF OVARY(S)|| 80001|58925||881.04|0|881.04|0||REMOVAL OF OVARIAN CYST(S)|| 80001|58940||618.37|0|618.37|0||REMOVAL OF OVARY(S)|| 80001|58943||1389.91|0|1389.91|0||REMOVAL OF OVARY(S)|| 80001|58950||1337.2|0|1337.2|0||RESECT OVARIAN MALIGNANCY|| 80001|58951||1719.34|0|1719.34|0||RESECT OVARIAN MALIGNANCY|| 80001|58952||1949.01|0|1949.01|0||RESECT OVARIAN MALIGNANCY|| 80001|58953||2410.16|0|2410.16|0||TAH - RAD DISSECT FOR DEBULK|| 80001|58954||2614.08|0|2614.08|0||TAH RAD DEBULK/LYMPH REMOVE|| 80001|58956||1638.11|0|1638.11|0||BSO - OMENTECTOMY W/TAH|| 80001|58957||1883.85|0|1883.85|0||RESECT RECURRENT GYN MAL|| 80001|58958||2070.28|0|2070.28|0||RESECT RECUR GYN MAL W/LYM|| 80001|58960||1154.92|0|1154.92|0||EXPLORATION OF ABDOMEN|| 80001|58970||260.42|0|237.16|0||RETRIEVAL OF OOCYTE|| 80001|58974||0|0|0|0||TRANSFER OF EMBRYO|| 80001|58976||285.72|0|248.12|0||TRANSFER OF EMBRYO|| 80001|58999||0|0|0|0||GENITAL SURGERY PROCEDURE|| 80001|59000||145.68|0|96.83|0||AMNIOCENTESIS - DIAGNOSTIC|| 80001|59001||216.37|0|216.37|0||AMNIOCENTESIS - THERAPEUTIC|| 80001|59012||244.28|0|244.28|0||FETAL CORD PUNCTURE - PRENATAL|| 80001|59015||184.15|0|158.95|0||CHORION BIOPSY|| 80001|59020||81.99|0|81.99|0||FETAL CONTRACT STRESS TEST|| 80001|59020|26|44.78|0|44.78|0||FETAL CONTRACT STRESS TEST|| 80001|59020|TC|37.22|0|37.22|0||FETAL CONTRACT STRESS TEST|| 80001|59025||55.83|0|55.83|0||FETAL NON-STRESS TEST|| 80001|59025|26|35.67|0|35.67|0||FETAL NON-STRESS TEST|| 80001|59025|TC|20.16|0|20.16|0||FETAL NON-STRESS TEST|| 80001|59030||120.73|0|120.73|0||FETAL SCALP BLOOD SAMPLE|| 80001|59050||61.3|0|61.3|0||FETAL MONITOR W/REPORT|| 80001|59051||50.56|0|50.56|0||FETAL MONITOR/INTERPRET ONLY|| 80001|59070||480.93|0|373.55|0||TRANSABDOM AMNIOINFUS W/US|| 80001|59072||560.68|0|560.68|0||UMBILICAL CORD OCCLUD W/US|| 80001|59074||462.33|0|373.94|0||FETAL FLUID DRAINAGE W/US|| 80001|59076||560.68|0|560.68|0||FETAL SHUNT PLACEMENT - W/US|| 80001|59100||996.72|0|996.72|0||REMOVE UTERUS LESION|| 80001|59120||948.27|0|948.27|0||TREAT ECTOPIC PREGNANCY|| 80001|59121||949.36|0|949.36|0||TREAT ECTOPIC PREGNANCY|| 80001|59130||1001.3|0|1001.3|0||TREAT ECTOPIC PREGNANCY|| 80001|59135||988.97|0|988.97|0||TREAT ECTOPIC PREGNANCY|| 80001|59136||1050.61|0|1050.61|0||TREAT ECTOPIC PREGNANCY|| 80001|59140||475.88|0|475.88|0||TREAT ECTOPIC PREGNANCY|| 80001|59150||919.46|0|919.46|0||TREAT ECTOPIC PREGNANCY|| 80001|59151||893.85|0|893.85|0||TREAT ECTOPIC PREGNANCY|| 80001|59160||240.12|0|207.17|0||D & C AFTER DELIVERY|| 80001|59200||83.73|0|54.27|0||INSERT CERVICAL DILATOR|| 80001|59300||226.94|0|178.49|0||EPISIOTOMY OR VAGINAL REPAIR|| 80001|59320||183.06|0|183.06|0||REVISION OF CERVIX|| 80001|59325||291.59|0|291.59|0||REVISION OF CERVIX|| 80001|59350||339.67|0|339.67|0||REPAIR OF UTERUS|| 80001|59400||2491.78|0|2491.78|0||OBSTETRICAL CARE|| 80001|59409||984.04|0|984.04|0||OBSTETRICAL CARE|| 80001|59410||1254.01|0|1254.01|0||OBSTETRICAL CARE|| 80001|59412||124.62|0|124.62|0||ANTEPARTUM MANIPULATION|| 80001|59414||110.61|0|110.61|0||DELIVER PLACENTA|| 80001|59425||537.58|0|430.98|0||ANTEPARTUM CARE ONLY|| 80001|59426||962.11|0|759.76|0||ANTEPARTUM CARE ONLY|| 80001|59430||218.28|0|168.66|0||CARE AFTER DELIVERY|| 80001|59510||2753.32|0|2753.32|0||CESAREAN DELIVERY|| 80001|59514||1105.39|0|1105.39|0||CESAREAN DELIVERY ONLY|| 80001|59515||1515.45|0|1515.45|0||CESAREAN DELIVERY|| 80001|59525||585.78|0|585.78|0||REMOVE UTERUS AFTER CESAREAN|| 80001|59610||2611.41|0|2611.41|0||VBAC DELIVERY|| 80001|59612||1104.47|0|1104.47|0||VBAC DELIVERY ONLY|| 80001|59614||1372.89|0|1372.89|0||VBAC CARE AFTER DELIVERY|| 80001|59618||2791.69|0|2791.69|0||ATTEMPTED VBAC DELIVERY|| 80001|59620||1143.81|0|1143.81|0||ATTEMPTED VBAC DELIVERY ONLY|| 80001|59622||1555.79|0|1555.79|0||ATTEMPTED VBAC AFTER CARE|| 80001|59812||375.06|0|351.42|0||TREATMENT OF MISCARRIAGE|| 80001|59820||445.06|0|419.86|0||CARE OF MISCARRIAGE|| 80001|59821||449.26|0|421.74|0||TREATMENT OF MISCARRIAGE|| 80001|59830||518.68|0|518.68|0||TREAT UTERUS INFECTION|| 80001|59840||256.73|0|247.03|0||ABORTION|| 80001|59841||453.28|0|430.02|0||ABORTION|| 80001|59850||412.27|0|412.27|0||ABORTION|| 80001|59851||472.3|0|472.3|0||ABORTION|| 80001|59852||594.96|0|594.96|0||ABORTION|| 80001|59855||493.94|0|493.94|0||ABORTION|| 80001|59856||581.73|0|581.73|0||ABORTION|| 80001|59857||616.05|0|616.05|0||ABORTION|| 80001|59866||258.56|0|258.56|0||ABORTION (MPR)|| 80001|59870||556.58|0|556.58|0||EVACUATE MOLE OF UTERUS|| 80001|59871||159.8|0|159.8|0||REMOVE CERCLAGE SUTURE|| 80001|59897||0|0|0|0||FETAL INVAS PX W/US|| 80001|59898||0|0|0|0||LAPARO PROC - OB CARE/DELIVER|| 80001|59899||0|0|0|0||MATERNITY CARE PROCEDURE|| 80001|60000||184.71|0|167.65|0||DRAIN THYROID/TONGUE CYST|| 80001|60100||132.43|0|95.99|0||BIOPSY OF THYROID|| 80001|60200||781.35|0|781.35|0||REMOVE THYROID LESION|| 80001|60210||839.8|0|839.8|0||PARTIAL THYROID EXCISION|| 80001|60212||1201.07|0|1201.07|0||PARTIAL THYROID EXCISION|| 80001|60220||839.6|0|839.6|0||PARTIAL REMOVAL OF THYROID|| 80001|60225||1108.2|0|1108.2|0||PARTIAL REMOVAL OF THYROID|| 80001|60240||1094.57|0|1094.57|0||REMOVAL OF THYROID|| 80001|60252||1574.11|0|1574.11|0||REMOVAL OF THYROID|| 80001|60254||2001.51|0|2001.51|0||EXTENSIVE THYROID SURGERY|| 80001|60260||1303.3|0|1303.3|0||REPEAT THYROID SURGERY|| 80001|60270||1635.57|0|1635.57|0||REMOVAL OF THYROID|| 80001|60271||1260.95|0|1260.95|0||REMOVAL OF THYROID|| 80001|60280||522.07|0|522.07|0||REMOVE THYROID DUCT LESION|| 80001|60281||695.76|0|695.76|0||REMOVE THYROID DUCT LESION|| 80001|60300||135.66|0|60.46|0||ASPIR/INJ THYROID CYST|| 80001|60500||1148.24|0|1148.24|0||EXPLORE PARATHYROID GLANDS|| 80001|60502||1534.74|0|1534.74|0||RE-EXPLORE PARATHYROIDS|| 80001|60505||1655.85|0|1655.85|0||EXPLORE PARATHYROID GLANDS|| 80001|60512||293.6|0|293.6|0||AUTOTRANSPLANT PARATHYROID|| 80001|60520||1248.21|0|1248.21|0||REMOVAL OF THYMUS GLAND|| 80001|60521||1348.22|0|1348.22|0||REMOVAL OF THYMUS GLAND|| 80001|60522||1634.64|0|1634.64|0||REMOVAL OF THYMUS GLAND|| 80001|60540||1261.53|0|1261.53|0||EXPLORE ADRENAL GLAND|| 80001|60545||1453.84|0|1453.84|0||EXPLORE ADRENAL GLAND|| 80001|60600||1685.52|0|1685.52|0||REMOVE CAROTID BODY LESION|| 80001|60605||2385.7|0|2385.7|0||REMOVE CAROTID BODY LESION|| 80001|60650||1424.29|0|1424.29|0||LAPAROSCOPY ADRENALECTOMY|| 80001|60659||0|0|0|0||LAPARO PROC - ENDOCRINE|| 80001|60699||0|0|0|0||ENDOCRINE SURGERY PROCEDURE|| 80001|61000||129.14|0|129.14|0||REMOVE CRANIAL CAVITY FLUID|| 80001|61001||97.61|0|97.61|0||REMOVE CRANIAL CAVITY FLUID|| 80001|61020||125.7|0|125.7|0||REMOVE BRAIN CAVITY FLUID|| 80001|61026||123.33|0|123.33|0||INJECTION INTO BRAIN CANAL|| 80001|61050||102.36|0|102.36|0||REMOVE BRAIN CANAL FLUID|| 80001|61055||145.68|0|145.68|0||INJECTION INTO BRAIN CANAL|| 80001|61070||68.65|0|68.65|0||BRAIN CANAL SHUNT PROCEDURE|| 80001|61105||555.32|0|555.32|0||TWIST DRILL HOLE|| 80001|61107||384.62|0|384.62|0||DRILL SKULL FOR IMPLANTATION|| 80001|61108||1095.3|0|1095.3|0||DRILL SKULL FOR DRAINAGE|| 80001|61120||900.95|0|900.95|0||BURR HOLE FOR PUNCTURE|| 80001|61140||1521.34|0|1521.34|0||PIERCE SKULL FOR BIOPSY|| 80001|61150||1644.74|0|1644.74|0||PIERCE SKULL FOR DRAINAGE|| 80001|61151||1203.95|0|1203.95|0||PIERCE SKULL FOR DRAINAGE|| 80001|61154||1529.55|0|1529.55|0||PIERCE SKULL & REMOVE CLOT|| 80001|61156||1512.3|0|1512.3|0||PIERCE SKULL FOR DRAINAGE|| 80001|61210||452.33|0|452.33|0||PIERCE SKULL - IMPLANT DEVICE|| 80001|61215||601.28|0|601.28|0||INSERT BRAIN-FLUID DEVICE|| 80001|61250||1048.53|0|1048.53|0||PIERCE SKULL & EXPLORE|| 80001|61253||1122.55|0|1122.55|0||PIERCE SKULL & EXPLORE|| 80001|61304||1981.38|0|1981.38|0||OPEN SKULL FOR EXPLORATION|| 80001|61305||2443.59|0|2443.59|0||OPEN SKULL FOR EXPLORATION|| 80001|61312||2520.85|0|2520.85|0||OPEN SKULL FOR DRAINAGE|| 80001|61313||2397.62|0|2397.62|0||OPEN SKULL FOR DRAINAGE|| 80001|61314||2205.68|0|2205.68|0||OPEN SKULL FOR DRAINAGE|| 80001|61315||2504.98|0|2504.98|0||OPEN SKULL FOR DRAINAGE|| 80001|61316||107.74|0|107.74|0||IMPLT CRAN BONE FLAP TO ABDO|| 80001|61320||2295.37|0|2295.37|0||OPEN SKULL FOR DRAINAGE|| 80001|61321||2591.16|0|2591.16|0||OPEN SKULL FOR DRAINAGE|| 80001|61322||2879.79|0|2879.79|0||DECOMPRESSIVE CRANIOTOMY|| 80001|61323||2909.76|0|2909.76|0||DECOMPRESSIVE LOBECTOMY|| 80001|61330||1830.59|0|1830.59|0||DECOMPRESS EYE SOCKET|| 80001|61332||2114.04|0|2114.04|0||EXPLORE/BIOPSY EYE SOCKET|| 80001|61333||2160.77|0|2160.77|0||EXPLORE ORBIT/REMOVE LESION|| 80001|61340||1754.4|0|1754.4|0||SUBTEMPORAL DECOMPRESSION|| 80001|61343||2660.52|0|2660.52|0||INCISE SKULL (PRESS RELIEF)|| 80001|61345||2482.65|0|2482.65|0||RELIEVE CRANIAL PRESSURE|| 80001|61450||2341.29|0|2341.29|0||INCISE SKULL FOR SURGERY|| 80001|61458||2430.82|0|2430.82|0||INCISE SKULL FOR BRAIN WOUND|| 80001|61460||2561.19|0|2561.19|0||INCISE SKULL FOR SURGERY|| 80001|61480||2363.05|0|2363.05|0||INCISE SKULL FOR SURGERY|| 80001|61500||1585.47|0|1585.47|0||REMOVAL OF SKULL LESION|| 80001|61501||1390|0|1390|0||REMOVE INFECTED SKULL BONE|| 80001|61510||2641.62|0|2641.62|0||REMOVAL OF BRAIN LESION|| 80001|61512||3087.93|0|3087.93|0||REMOVE BRAIN LINING LESION|| 80001|61514||2311.27|0|2311.27|0||REMOVAL OF BRAIN ABSCESS|| 80001|61516||2252.51|0|2252.51|0||REMOVAL OF BRAIN LESION|| 80001|61517||107.7|0|107.7|0||IMPLT BRAIN CHEMOTX ADD-ON|| 80001|61518||3336.22|0|3336.22|0||REMOVAL OF BRAIN LESION|| 80001|61519||3575.65|0|3575.65|0||REMOVE BRAIN LINING LESION|| 80001|61520||4556.6|0|4556.6|0||REMOVAL OF BRAIN LESION|| 80001|61521||3838.36|0|3838.36|0||REMOVAL OF BRAIN LESION|| 80001|61522||2662.72|0|2662.72|0||REMOVAL OF BRAIN ABSCESS|| 80001|61524||2533.65|0|2533.65|0||REMOVAL OF BRAIN LESION|| 80001|61526||4455.45|0|4455.45|0||REMOVAL OF BRAIN LESION|| 80001|61530||3755.45|0|3755.45|0||REMOVAL OF BRAIN LESION|| 80001|61531||1478.21|0|1478.21|0||IMPLANT BRAIN ELECTRODES|| 80001|61533||1846.07|0|1846.07|0||IMPLANT BRAIN ELECTRODES|| 80001|61534||1997.17|0|1997.17|0||REMOVAL OF BRAIN LESION|| 80001|61535||1207.09|0|1207.09|0||REMOVE BRAIN ELECTRODES|| 80001|61536||3144.14|0|3144.14|0||REMOVAL OF BRAIN LESION|| 80001|61537||2982.9|0|2982.9|0||REMOVAL OF BRAIN TISSUE|| 80001|61538||3257.28|0|3257.28|0||REMOVAL OF BRAIN TISSUE|| 80001|61539||2876.09|0|2876.09|0||REMOVAL OF BRAIN TISSUE|| 80001|61540||2657.19|0|2657.19|0||REMOVAL OF BRAIN TISSUE|| 80001|61541||2615.86|0|2615.86|0||INCISION OF BRAIN TISSUE|| 80001|61543||2644.64|0|2644.64|0||REMOVAL OF BRAIN TISSUE|| 80001|61544||2315.01|0|2315.01|0||REMOVE & TREAT BRAIN LESION|| 80001|61545||3880.26|0|3880.26|0||EXCISION OF BRAIN TUMOR|| 80001|61546||2811.11|0|2811.11|0||REMOVAL OF PITUITARY GLAND|| 80001|61548||1897.61|0|1897.61|0||REMOVAL OF PITUITARY GLAND|| 80001|61550||1160.48|0|1160.48|0||RELEASE OF SKULL SEAMS|| 80001|61552||1335.84|0|1335.84|0||RELEASE OF SKULL SEAMS|| 80001|61556||2070.59|0|2070.59|0||INCISE SKULL/SUTURES|| 80001|61557||2038.82|0|2038.82|0||INCISE SKULL/SUTURES|| 80001|61558||2035.57|0|2035.57|0||EXCISION OF SKULL/SUTURES|| 80001|61559||2907.11|0|2907.11|0||EXCISION OF SKULL/SUTURES|| 80001|61563||2409.36|0|2409.36|0||EXCISION OF SKULL TUMOR|| 80001|61564||2929.7|0|2929.7|0||EXCISION OF SKULL TUMOR|| 80001|61566||2737.71|0|2737.71|0||REMOVAL OF BRAIN TISSUE|| 80001|61567||2872.3|0|2872.3|0||INCISION OF BRAIN TISSUE|| 80001|61570||2270.53|0|2270.53|0||REMOVE FOREIGN BODY - BRAIN|| 80001|61571||2418.96|0|2418.96|0||INCISE SKULL FOR BRAIN WOUND|| 80001|61575||3053.7|0|3053.7|0||SKULL BASE/BRAINSTEM SURGERY|| 80001|61576||4075.72|0|4075.72|0||SKULL BASE/BRAINSTEM SURGERY|| 80001|61580||2969.21|0|2969.21|0||CRANIOFACIAL APPROACH - SKULL|| 80001|61581||3128.27|0|3128.27|0||CRANIOFACIAL APPROACH - SKULL|| 80001|61582||3595.91|0|3595.91|0||CRANIOFACIAL APPROACH - SKULL|| 80001|61583||3476.9|0|3476.9|0||CRANIOFACIAL APPROACH - SKULL|| 80001|61584||3427.62|0|3427.62|0||ORBITOCRANIAL APPROACH/SKULL|| 80001|61585||3881.32|0|3881.32|0||ORBITOCRANIAL APPROACH/SKULL|| 80001|61586||2881.9|0|2881.9|0||RESECT NASOPHARYNX - SKULL|| 80001|61590||3625.54|0|3625.54|0||INFRATEMPORAL APPROACH/SKULL|| 80001|61591||3718.16|0|3718.16|0||INFRATEMPORAL APPROACH/SKULL|| 80001|61592||3828.25|0|3828.25|0||ORBITOCRANIAL APPROACH/SKULL|| 80001|61595||2814.62|0|2814.62|0||TRANSTEMPORAL APPROACH/SKULL|| 80001|61596||2915.6|0|2915.6|0||TRANSCOCHLEAR APPROACH/SKULL|| 80001|61597||3494.02|0|3494.02|0||TRANSCONDYLAR APPROACH/SKULL|| 80001|61598||3419.9|0|3419.9|0||TRANSPETROSAL APPROACH/SKULL|| 80001|61600||2530.59|0|2530.59|0||RESECT/EXCISE CRANIAL LESION|| 80001|61601||2884.36|0|2884.36|0||RESECT/EXCISE CRANIAL LESION|| 80001|61605||2582.12|0|2582.12|0||RESECT/EXCISE CRANIAL LESION|| 80001|61606||3672.77|0|3672.77|0||RESECT/EXCISE CRANIAL LESION|| 80001|61607||3211.52|0|3211.52|0||RESECT/EXCISE CRANIAL LESION|| 80001|61608||3931.82|0|3931.82|0||RESECT/EXCISE CRANIAL LESION|| 80001|61610||2283.24|0|2283.24|0||TRANSECT ARTERY - SINUS|| 80001|61611||449.49|0|449.49|0||TRANSECT ARTERY - SINUS|| 80001|61612||1686.61|0|1686.61|0||TRANSECT ARTERY - SINUS|| 80001|61613||3979.87|0|3979.87|0||REMOVE ANEURYSM - SINUS|| 80001|61615||3249.05|0|3249.05|0||RESECT/EXCISE LESION - SKULL|| 80001|61616||3992.59|0|3992.59|0||RESECT/EXCISE LESION - SKULL|| 80001|61618||1558.98|0|1558.98|0||REPAIR DURA|| 80001|61619||1731.14|0|1731.14|0||REPAIR DURA|| 80001|61623||681.17|0|681.17|0||ENDOVASC TEMPORY VESSEL OCCL|| 80001|61624||1380.03|0|1380.03|0||TRANSCATH OCCLUSION - CNS|| 80001|61626||1044.32|0|1044.32|0||TRANSCATH OCCLUSION - NON-CNS|| 80001|61630||1590.6|0|1590.6|0||INTRACRANIAL ANGIOPLASTY|| 80001|61635||1683.88|0|1683.88|0||INTRACRAN ANGIOPLSTY W/STENT|| 80001|61640||745.79|0|745.79|0||DILATE IC VASOSPASM - INIT|| 80001|61641||262.75|0|262.75|0||DILATE IC VASOSPASM ADD-ON|| 80001|61642||524.74|0|524.74|0||DILATE IC VASOSPASM ADD-ON|| 80001|61645||938.3|0|938.3|0||PERQ ART M-THROMBECT &/NFS|| 80001|61650||625.87|0|625.87|0||EVASC PRLNG ADMN RX AGNT 1ST|| 80001|61651||265.81|0|265.81|0||EVASC PRLNG ADMN RX AGNT ADD|| 80001|61680||2725.22|0|2725.22|0||INTRACRANIAL VESSEL SURGERY|| 80001|61682||5085.63|0|5085.63|0||INTRACRANIAL VESSEL SURGERY|| 80001|61684||3468.21|0|3468.21|0||INTRACRANIAL VESSEL SURGERY|| 80001|61686||5501.71|0|5501.71|0||INTRACRANIAL VESSEL SURGERY|| 80001|61690||2660.28|0|2660.28|0||INTRACRANIAL VESSEL SURGERY|| 80001|61692||4472.45|0|4472.45|0||INTRACRANIAL VESSEL SURGERY|| 80001|61697||5139.44|0|5139.44|0||BRAIN ANEURYSM REPR - COMPLX|| 80001|61698||5667.79|0|5667.79|0||BRAIN ANEURYSM REPR - COMPLX|| 80001|61700||4143.35|0|4143.35|0||BRAIN ANEURYSM REPR - SIMPLE|| 80001|61702||4920.39|0|4920.39|0||INNER SKULL VESSEL SURGERY|| 80001|61703||1648.17|0|1648.17|0||CLAMP NECK ARTERY|| 80001|61705||3174.13|0|3174.13|0||REVISE CIRCULATION TO HEAD|| 80001|61708||3103.45|0|3103.45|0||REVISE CIRCULATION TO HEAD|| 80001|61710||2621.68|0|2621.68|0||REVISE CIRCULATION TO HEAD|| 80001|61711||3148.21|0|3148.21|0||FUSION OF SKULL ARTERIES|| 80001|61720||1540.97|0|1540.97|0||INCISE SKULL/BRAIN SURGERY|| 80001|61735||1931.44|0|1931.44|0||INCISE SKULL/BRAIN SURGERY|| 80001|61750||1700.01|0|1700.01|0||INCISE SKULL/BRAIN BIOPSY|| 80001|61751||1665.94|0|1665.94|0||BRAIN BIOPSY W/CT/MR GUIDE|| 80001|61760||1921.54|0|1921.54|0||IMPLANT BRAIN ELECTRODES|| 80001|61770||1975.49|0|1975.49|0||INCISE SKULL FOR TREATMENT|| 80001|61781||288.4|0|288.4|0||SCAN PROC CRANIAL INTRA|| 80001|61782||211.66|0|211.66|0||SCAN PROC CRANIAL EXTRA|| 80001|61783||284.5|0|284.5|0||SCAN PROC SPINAL|| 80001|61790||1058.3|0|1058.3|0||TREAT TRIGEMINAL NERVE|| 80001|61791||1362.13|0|1362.13|0||TREAT TRIGEMINAL TRACT|| 80001|61796||1226.82|0|1226.82|0||SRS - CRANIAL LESION SIMPLE|| 80001|61797||271.33|0|271.33|0||SRS - CRAN LES SIMPLE - ADDL|| 80001|61798||1678.75|0|1678.75|0||SRS - CRANIAL LESION COMPLEX|| 80001|61799||373.76|0|373.76|0||SRS - CRAN LES COMPLEX - ADDL|| 80001|61800||188.32|0|188.32|0||APPLY SRS HEADFRAME ADD-ON|| 80001|61850||1188.94|0|1188.94|0||IMPLANT NEUROELECTRODES|| 80001|61860||1903.13|0|1903.13|0||IMPLANT NEUROELECTRODES|| 80001|61863||1819.84|0|1819.84|0||IMPLANT NEUROELECTRODE|| 80001|61864||350.25|0|350.25|0||IMPLANT NEUROELECTRDE - ADDL|| 80001|61867||2763.84|0|2763.84|0||IMPLANT NEUROELECTRODE|| 80001|61868||612.37|0|612.37|0||IMPLANT NEUROELECTRDE - ADD'L|| 80001|61870||1434.88|0|1434.88|0||IMPLANT NEUROELECTRODES|| 80001|61880||679.8|0|679.8|0||REVISE/REMOVE NEUROELECTRODE|| 80001|61885||612.2|0|612.2|0||INSRT/REDO NEUROSTIM 1 ARRAY|| 80001|61886||1007.05|0|1007.05|0||IMPLANT NEUROSTIM ARRAYS|| 80001|61888||473.68|0|473.68|0||REVISE/REMOVE NEURORECEIVER|| 80001|62000||1246.61|0|1246.61|0||TREAT SKULL FRACTURE|| 80001|62005||1541.79|0|1541.79|0||TREAT SKULL FRACTURE|| 80001|62010||1859.51|0|1859.51|0||TREATMENT OF HEAD INJURY|| 80001|62100||1937.56|0|1937.56|0||REPAIR BRAIN FLUID LEAKAGE|| 80001|62115||1644.13|0|1644.13|0||REDUCTION OF SKULL DEFECT|| 80001|62117||2389.19|0|2389.19|0||REDUCTION OF SKULL DEFECT|| 80001|62120||1969.76|0|1969.76|0||REPAIR SKULL CAVITY LESION|| 80001|62121||1924|0|1924|0||INCISE SKULL REPAIR|| 80001|62140||1245.31|0|1245.31|0||REPAIR OF SKULL DEFECT|| 80001|62141||1377.69|0|1377.69|0||REPAIR OF SKULL DEFECT|| 80001|62142||1063.91|0|1063.91|0||REMOVE SKULL PLATE/FLAP|| 80001|62143||1257.23|0|1257.23|0||REPLACE SKULL PLATE/FLAP|| 80001|62145||1706.11|0|1706.11|0||REPAIR OF SKULL & BRAIN|| 80001|62146||1488.29|0|1488.29|0||REPAIR OF SKULL WITH GRAFT|| 80001|62147||1771.62|0|1771.62|0||REPAIR OF SKULL WITH GRAFT|| 80001|62148||155.81|0|155.81|0||RETR BONE FLAP TO FIX SKULL|| 80001|62160||233.91|0|233.91|0||NEUROENDOSCOPY ADD-ON|| 80001|62161||1844.28|0|1844.28|0||DISSECT BRAIN W/SCOPE|| 80001|62162||2296.62|0|2296.62|0||REMOVE COLLOID CYST W/SCOPE|| 80001|62163||1482.24|0|1482.24|0||NEUROENDOSCOPY W/FB REMOVAL|| 80001|62164||2537.81|0|2537.81|0||REMOVE BRAIN TUMOR W/SCOPE|| 80001|62165||1859.19|0|1859.19|0||REMOVE PITUIT TUMOR W/SCOPE|| 80001|62180||1944.87|0|1944.87|0||ESTABLISH BRAIN CAVITY SHUNT|| 80001|62190||710.67|0|710.67|0||ESTABLISH BRAIN CAVITY SHUNT|| 80001|62192||1177.66|0|1177.66|0||ESTABLISH BRAIN CAVITY SHUNT|| 80001|62194||583.15|0|583.15|0||REPLACE/IRRIGATE CATHETER|| 80001|62200||1671.28|0|1671.28|0||ESTABLISH BRAIN CAVITY SHUNT|| 80001|62201||1452.53|0|1452.53|0||BRAIN CAVITY SHUNT W/SCOPE|| 80001|62220||1236.05|0|1236.05|0||ESTABLISH BRAIN CAVITY SHUNT|| 80001|62223||1260.22|0|1260.22|0||ESTABLISH BRAIN CAVITY SHUNT|| 80001|62225||627.6|0|627.6|0||REPLACE/IRRIGATE CATHETER|| 80001|62230||1015.24|0|1015.24|0||REPLACE/REVISE BRAIN SHUNT|| 80001|62252||98.64|0|98.64|0||CSF SHUNT REPROGRAM|| 80001|62252|26|55.61|0|55.61|0||CSF SHUNT REPROGRAM|| 80001|62252|TC|43.03|0|43.03|0||CSF SHUNT REPROGRAM|| 80001|62256||719.33|0|719.33|0||REMOVE BRAIN CAVITY SHUNT|| 80001|62258||1354.92|0|1354.92|0||REPLACE BRAIN CAVITY SHUNT|| 80001|62263||720.02|0|393.62|0||EPIDURAL LYSIS MULT SESSIONS|| 80001|62264||481.8|0|284.48|0||EPIDURAL LYSIS ON SINGLE DAY|| 80001|62267||289.91|0|193.39|0||INTERDISCAL PERQ ASPIR - DX|| 80001|62268||315.32|0|315.32|0||DRAIN SPINAL CORD CYST|| 80001|62269||324.29|0|324.29|0||NEEDLE BIOPSY - SPINAL CORD|| 80001|62270||182.78|0|94.01|0||SPINAL FLUID TAP - DIAGNOSTIC|| 80001|62272||228.85|0|100.53|0||DRAIN CEREBRO SPINAL FLUID|| 80001|62273||200.9|0|136.55|0||INJECT EPIDURAL PATCH|| 80001|62280||342.58|0|188.29|0||TREAT SPINAL CORD LESION|| 80001|62281||269.83|0|183|0||TREAT SPINAL CORD LESION|| 80001|62282||335.45|0|173.8|0||TREAT SPINAL CANAL LESION|| 80001|62284||208.71|0|103.66|0||INJECTION FOR MYELOGRAM|| 80001|62287||679.2|0|679.2|0||PERCUTANEOUS DISKECTOMY|| 80001|62290||382.17|0|205.79|0||INJECT FOR SPINE DISK X-RAY|| 80001|62291||385.26|0|205|0||INJECT FOR SPINE DISK X-RAY|| 80001|62292||691.28|0|691.28|0||INJECTION INTO DISK LESION|| 80001|62294||941.33|0|941.33|0||INJECTION INTO SPINAL ARTERY|| 80001|62302||279.45|0|149.97|0||MYELOGRAPHY LUMBAR INJECTION|| 80001|62303||289.92|0|151.91|0||MYELOGRAPHY LUMBAR INJECTION|| 80001|62304||275.79|0|147.47|0||MYELOGRAPHY LUMBAR INJECTION|| 80001|62305||300.65|0|154.5|0||MYELOGRAPHY LUMBAR INJECTION|| 80001|62310||273.12|0|129.69|0||INJECT SPINE C/T|| 80001|62311||250.57|0|106.75|0||INJECT SPINE L/S (CD)|| 80001|62318||261.67|0|119.79|0||INJECT SPINE W/CATH - C/T|| 80001|62319||193.09|0|115.17|0||INJECT SPINE W/CATH L/S (CD)|| 80001|62320||204.57|0|126.62|0||NJX INTERLAMINAR CRV/THRC|| 80001|62321||304.05|0|136.52|0||NJX INTERLAMINAR CRV/THRC|| 80001|62322||190.78|0|108.96|0||NJX INTERLAMINAR LMBR/SAC|| 80001|62323||298.45|0|124.46|0||NJX INTERLAMINAR LMBR/SAC|| 80001|62323||298.45|0|124.46|0||NJX INTERLAMINAR LMBR/SAC|| 80001|62324||178.73|0|115.42|0||NJX INTERLAMINAR CRV/THRC|| 80001|62325||269.6|0|132.64|0||NJX INTERLAMINAR CRV/THRC|| 80001|62326||187.77|0|113.26|0||NJX INTERLAMINAR LMBR/SAC|| 80001|62327||274.76|0|120.59|0||NJX INTERLAMINAR LMBR/SAC|| 80001|62350||476.66|0|476.66|0||IMPLANT SPINAL CANAL CATH|| 80001|62351||1026.88|0|1026.88|0||IMPLANT SPINAL CANAL CATH|| 80001|62355||319.16|0|319.16|0||REMOVE SPINAL CANAL CATHETER|| 80001|62360||360.96|0|360.96|0||INSERT SPINE INFUSION DEVICE|| 80001|62361||511.06|0|511.06|0||IMPLANT SPINE INFUSION PUMP|| 80001|62362||459.6|0|459.6|0||IMPLANT SPINE INFUSION PUMP|| 80001|62365||352.64|0|352.64|0||REMOVE SPINE INFUSION DEVICE|| 80001|62367||47.07|0|30.01|0||ANALYZE SPINE INFUSION PUMP|| 80001|62368||65.34|0|42.08|0||ANALYZE SPINE INFUSION PUMP|| 80001|62369||135.9|0|42.47|0||ANAL SP INF PMP W/REPRG&FILL|| 80001|62370||144.27|0|56.27|0||ANL SP INF PMP W/MDREPRG&FIL|| 80001|63001||1494.2|0|1494.2|0||REMOVAL OF SPINAL LAMINA|| 80001|63003||1488.5|0|1488.5|0||REMOVAL OF SPINAL LAMINA|| 80001|63005||1416.01|0|1416.01|0||REMOVAL OF SPINAL LAMINA|| 80001|63011||1317.36|0|1317.36|0||REMOVAL OF SPINAL LAMINA|| 80001|63012||1424.39|0|1424.39|0||REMOVAL OF SPINAL LAMINA|| 80001|63015||1785.38|0|1785.38|0||REMOVAL OF SPINAL LAMINA|| 80001|63016||1828.09|0|1828.09|0||REMOVAL OF SPINAL LAMINA|| 80001|63017||1503.4|0|1503.4|0||REMOVAL OF SPINAL LAMINA|| 80001|63020||1395.17|0|1395.17|0||NECK SPINE DISK SURGERY|| 80001|63030||1154.96|0|1154.96|0||LOW BACK DISK SURGERY|| 80001|63035||232.56|0|232.56|0||SPINAL DISK SURGERY ADD-ON|| 80001|63040||1671.48|0|1671.48|0||LAMINOTOMY - SINGLE CERVICAL|| 80001|63042||1549.37|0|1549.37|0||LAMINOTOMY - SINGLE LUMBAR|| 80001|63043||0|0|0|0||LAMINOTOMY - ADD'L CERVICAL|| 80001|63044||0|0|0|0||LAMINOTOMY - ADD'L LUMBAR|| 80001|63045||1529.38|0|1529.38|0||REMOVAL OF SPINAL LAMINA|| 80001|63046||1446.28|0|1446.28|0||REMOVAL OF SPINAL LAMINA|| 80001|63047||1318.16|0|1318.16|0||REMOVAL OF SPINAL LAMINA|| 80001|63048||257.24|0|257.24|0||REMOVE SPINAL LAMINA ADD-ON|| 80001|63050||1782.78|0|1782.78|0||CERVICAL LAMINOPLASTY|| 80001|63051||2054.92|0|2054.92|0||C-LAMINOPLASTY W/GRAFT/PLATE|| 80001|63055||1964.4|0|1964.4|0||DECOMPRESS SPINAL CORD|| 80001|63056||1779.87|0|1779.87|0||DECOMPRESS SPINAL CORD|| 80001|63057||387.99|0|387.99|0||DECOMPRESS SPINE CORD ADD-ON|| 80001|63064||2131.51|0|2131.51|0||DECOMPRESS SPINAL CORD|| 80001|63066||253.68|0|253.68|0||DECOMPRESS SPINE CORD ADD-ON|| 80001|63075||1623.37|0|1623.37|0||NECK SPINE DISK SURGERY|| 80001|63076||299.7|0|299.7|0||NECK SPINE DISK SURGERY|| 80001|63077||1804.06|0|1804.06|0||SPINE DISK SURGERY - THORAX|| 80001|63078||229.97|0|229.97|0||SPINE DISK SURGERY - THORAX|| 80001|63081||2109.92|0|2109.92|0||REMOVAL OF VERTEBRAL BODY|| 80001|63082||323.59|0|323.59|0||REMOVE VERTEBRAL BODY ADD-ON|| 80001|63085||2303.1|0|2303.1|0||REMOVAL OF VERTEBRAL BODY|| 80001|63086||231.57|0|231.57|0||REMOVE VERTEBRAL BODY ADD-ON|| 80001|63087||2901.57|0|2901.57|0||REMOVAL OF VERTEBRAL BODY|| 80001|63088||317.99|0|317.99|0||REMOVE VERTEBRAL BODY ADD-ON|| 80001|63090||2338.53|0|2338.53|0||REMOVAL OF VERTEBRAL BODY|| 80001|63091||214.15|0|214.15|0||REMOVE VERTEBRAL BODY ADD-ON|| 80001|63101||2794.87|0|2794.87|0||REMOVAL OF VERTEBRAL BODY|| 80001|63102||2733.3|0|2733.3|0||REMOVAL OF VERTEBRAL BODY|| 80001|63103||357.41|0|357.41|0||REMOVE VERTEBRAL BODY ADD-ON|| 80001|63170||1933.53|0|1933.53|0||INCISE SPINAL CORD TRACT(S)|| 80001|63172||1721.06|0|1721.06|0||DRAINAGE OF SPINAL CYST|| 80001|63173||2096.77|0|2096.77|0||DRAINAGE OF SPINAL CYST|| 80001|63180||1802.79|0|1802.79|0||REVISE SPINAL CORD LIGAMENTS|| 80001|63182||1980.44|0|1980.44|0||REVISE SPINAL CORD LIGAMENTS|| 80001|63185||1366.03|0|1366.03|0||INCISE SPINAL COLUMN/NERVES|| 80001|63190||1505.95|0|1505.95|0||INCISE SPINAL COLUMN/NERVES|| 80001|63191||1670.41|0|1670.41|0||INCISE SPINAL COLUMN/NERVES|| 80001|63194||1937.69|0|1937.69|0||INCISE SPINAL COLUMN & CORD|| 80001|63195||1399.4|0|1399.4|0||INCISE SPINAL COLUMN & CORD|| 80001|63196||1626.92|0|1626.92|0||INCISE SPINAL COLUMN & CORD|| 80001|63197||2078.69|0|2078.69|0||INCISE SPINAL COLUMN & CORD|| 80001|63198||1916.96|0|1916.96|0||INCISE SPINAL COLUMN & CORD|| 80001|63199||2011.43|0|2011.43|0||INCISE SPINAL COLUMN & CORD|| 80001|63200||1847.79|0|1847.79|0||RELEASE OF SPINAL CORD|| 80001|63250||3623.06|0|3623.06|0||REVISE SPINAL CORD VESSELS|| 80001|63251||3702.12|0|3702.12|0||REVISE SPINAL CORD VESSELS|| 80001|63252||3701.69|0|3701.69|0||REVISE SPINAL CORD VESSELS|| 80001|63265||2010.23|0|2010.23|0||EXCISE INTRASPINAL LESION|| 80001|63266||2073.35|0|2073.35|0||EXCISE INTRASPINAL LESION|| 80001|63267||1645.3|0|1645.3|0||EXCISE INTRASPINAL LESION|| 80001|63268||1745.86|0|1745.86|0||EXCISE INTRASPINAL LESION|| 80001|63270||2526.67|0|2526.67|0||EXCISE INTRASPINAL LESION|| 80001|63271||2510.4|0|2510.4|0||EXCISE INTRASPINAL LESION|| 80001|63272||2280.04|0|2280.04|0||EXCISE INTRASPINAL LESION|| 80001|63273||2267.64|0|2267.64|0||EXCISE INTRASPINAL LESION|| 80001|63275||2177.89|0|2177.89|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63276||2157.72|0|2157.72|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63277||1868.05|0|1868.05|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63278||1928.09|0|1928.09|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63280||2568.7|0|2568.7|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63281||2531.25|0|2531.25|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63282||2380.77|0|2380.77|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63283||2307.69|0|2307.69|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63285||3188.25|0|3188.25|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63286||3152.61|0|3152.61|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63287||3346.91|0|3346.91|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63290||3404.47|0|3404.47|0||BIOPSY/EXCISE SPINAL TUMOR|| 80001|63295||410.23|0|410.23|0||REPAIR OF LAMINECTOMY DEFECT|| 80001|63300||2218.38|0|2218.38|0||REMOVAL OF VERTEBRAL BODY|| 80001|63301||2623.31|0|2623.31|0||REMOVAL OF VERTEBRAL BODY|| 80001|63302||2650.52|0|2650.52|0||REMOVAL OF VERTEBRAL BODY|| 80001|63303||2819.74|0|2819.74|0||REMOVAL OF VERTEBRAL BODY|| 80001|63304||2861.39|0|2861.39|0||REMOVAL OF VERTEBRAL BODY|| 80001|63305||3047.24|0|3047.24|0||REMOVAL OF VERTEBRAL BODY|| 80001|63306||2408.47|0|2408.47|0||REMOVAL OF VERTEBRAL BODY|| 80001|63307||2627.82|0|2627.82|0||REMOVAL OF VERTEBRAL BODY|| 80001|63308||394.21|0|394.21|0||REMOVE VERTEBRAL BODY ADD-ON|| 80001|63600||1081.81|0|1081.81|0||REMOVE SPINAL CORD LESION|| 80001|63610||474.23|0|474.23|0||STIMULATION OF SPINAL CORD|| 80001|63615||1279.07|0|1279.07|0||REMOVE LESION OF SPINAL CORD|| 80001|63620||1348.19|0|1348.19|0||SRS - SPINAL LESION|| 80001|63621||310.07|0|310.07|0||SRS - SPINAL LESION - ADDL|| 80001|63650||1494.67|0|492.2|0||IMPLANT NEUROELECTRODES|| 80001|63655||986.09|0|986.09|0||IMPLANT NEUROELECTRODES|| 80001|63661||663.07|0|382.03|0||REMOVE SPINE ELTRD PERQ ARAY|| 80001|63662||998.86|0|998.86|0||REMOVE SPINE ELTRD PLATE|| 80001|63663||905.01|0|539.06|0||REVISE SPINE ELTRD PERQ ARAY|| 80001|63664||1022.83|0|1022.83|0||REVISE SPINE ELTRD PLATE|| 80001|63685||435.31|0|435.31|0||INSRT/REDO SPINE N GENERATOR|| 80001|63688||439.67|0|439.67|0||REVISE/REMOVE NEURORECEIVER|| 80001|63700||1390.23|0|1390.23|0||REPAIR OF SPINAL HERNIATION|| 80001|63702||1693.53|0|1693.53|0||REPAIR OF SPINAL HERNIATION|| 80001|63704||1770.25|0|1770.25|0||REPAIR OF SPINAL HERNIATION|| 80001|63706||2007.93|0|2007.93|0||REPAIR OF SPINAL HERNIATION|| 80001|63707||1095.63|0|1095.63|0||REPAIR SPINAL FLUID LEAKAGE|| 80001|63709||1316.29|0|1316.29|0||REPAIR SPINAL FLUID LEAKAGE|| 80001|63710||1292.67|0|1292.67|0||GRAFT REPAIR OF SPINE DEFECT|| 80001|63740||1152.06|0|1152.06|0||INSTALL SPINAL SHUNT|| 80001|63741||812.61|0|812.61|0||INSTALL SPINAL SHUNT|| 80001|63744||812.65|0|812.65|0||REVISION OF SPINAL SHUNT|| 80001|63746||720.29|0|720.29|0||REMOVAL OF SPINAL SHUNT|| 80001|64400||145.6|0|83.96|0||N BLOCK INJ - TRIGEMINAL|| 80001|64402||149.32|0|92.72|0||N BLOCK INJ - FACIAL|| 80001|64405||115.78|0|74.69|0||N BLOCK INJ - OCCIPITAL|| 80001|64408||134.87|0|101.92|0||N BLOCK INJ - VAGUS|| 80001|64410||138.83|0|82.62|0||N BLOCK INJ - PHRENIC|| 80001|64413||148.8|0|98.02|0||N BLOCK INJ - CERVICAL PLEXUS|| 80001|64415||135.95|0|78.57|0||N BLOCK INJ - BRACHIAL PLEXUS|| 80001|64416||95.91|0|95.91|0||N BLOCK CONT INFUSE - B PLEX|| 80001|64417||148.57|0|84.6|0||N BLOCK INJ - AXILLARY|| 80001|64418||167.43|0|91.45|0||N BLOCK INJ - SUPRASCAPULAR|| 80001|64420||129.21|0|80.75|0||N BLOCK INJ - INTERCOST - SNG|| 80001|64421||172.49|0|109.3|0||N BLOCK INJ - INTERCOST - MLT|| 80001|64425||152.64|0|111.16|0||N BLOCK INJ - ILIO-ING/HYPOGI|| 80001|64430||160.68|0|99.04|0||N BLOCK INJ - PUDENDAL|| 80001|64435||155.6|0|99.39|0||N BLOCK INJ - PARACERVICAL|| 80001|64445||155.34|0|86.72|0||N BLOCK INJ - SCIATIC - SNG|| 80001|64446||96.3|0|96.3|0||N BLK INJ - SCIATIC - CONT INF|| 80001|64447||137.97|0|79.82|0||N BLOCK INJ FEM - SINGLE|| 80001|64448||85.82|0|85.82|0||N BLOCK INJ FEM - CONT INF|| 80001|64449||100.96|0|100.96|0||N BLOCK INJ - LUMBAR PLEXUS|| 80001|64450||91.67|0|54.06|0||N BLOCK - OTHER PERIPHERAL|| 80001|64455||55.61|0|41.65|0||N BLOCK INJ - PLANTAR DIGIT|| 80001|64461||170.63|0|103.81|0||PVB THORACIC SINGLE INJ SITE|| 80001|64462||97.11|0|65.44|0||PVB THORACIC 2ND+ INJ SITE|| 80001|64463||185.18|0|100.97|0||PVB THORACIC CONT INFUSION|| 80001|64479||269.74|0|158.1|0||INJ FORAMEN EPIDURAL C/T|| 80001|64480||129.69|0|75.8|0||INJ FORAMEN EPIDURAL ADD-ON|| 80001|64483||249.43|0|134.3|0||INJ FORAMEN EPIDURAL L/S|| 80001|64484||100.51|0|62.13|0||INJ FORAMEN EPIDURAL ADD-ON|| 80001|64486||142.39|0|75.72|0||TAP BLOCK UNIL BY INJECTION|| 80001|64487||173.55|0|87.1|0||TAP BLOCK UNI BY INFUSION|| 80001|64488||175.23|0|94.99|0||TAP BLOCK BI INJECTION|| 80001|64489||241.62|0|106.72|0||TAP BLOCK BI BY INFUSION|| 80001|64490||217.68|0|127.36|0||INJ PARAVERT F JNT C/T 1 LEV|| 80001|64491||108.96|0|72.52|0||INJ PARAVERT F JNT C/T 2 LEV|| 80001|64492||109.35|0|73.3|0||INJ PARAVERT F JNT C/T 3 LEV|| 80001|64493||196.6|0|108.6|0||INJ PARAVERT F JNT L/S 1 LEV|| 80001|64494||100.12|0|62.52|0||INJ PARAVERT F JNT L/S 2 LEV|| 80001|64495||100.51|0|63.3|0||INJ PARAVERT F JNT L/S 3 LEV|| 80001|64505||121.48|0|102.48|0||N BLOCK - SPENOPALATINE GANGL|| 80001|64508||74.71|0|86.73|0||N BLOCK - CAROTID SINUS S/P|| 80001|64510||145.66|0|87.52|0||N BLOCK - STELLATE GANGLION|| 80001|64517||208.87|0|146.07|0||N BLOCK INJ - HYPOGAS PLXS|| 80001|64520||210.58|0|96.23|0||N BLOCK - LUMBAR/THORACIC|| 80001|64530||217.02|0|110.03|0||N BLOCK INJ - CELIAC PELUS|| 80001|64550||18.23|0|10.48|0||APPLY NEUROSTIMULATOR|| 80001|64553||246.4|0|188.64|0||IMPLANT NEUROELECTRODES|| 80001|64555||243.91|0|181.88|0||IMPLANT NEUROELECTRODES|| 80001|64561||923.18|0|361.08|0||IMPLANT NEUROELECTRODES|| 80001|64565||217.26|0|155.63|0||IMPLANT NEUROELECTRODES|| 80001|64566||135.98|0|36.35|0||NEUROELTRD STIM POST TIBIAL|| 80001|64568||788|0|788|0||INC FOR VAGUS N ELECT IMPL|| 80001|64569||939.51|0|939.51|0||REVISE/REPL VAGUS N ELTRD|| 80001|64570||796.18|0|796.18|0||REMOVE VAGUS N ELTRD|| 80001|64575||376.09|0|376.09|0||IMPLANT NEUROELECTRODES|| 80001|64580||354.55|0|354.55|0||IMPLANT NEUROELECTRODES|| 80001|64581||792.7|0|792.7|0||IMPLANT NEUROELECTRODES|| 80001|64585||279.83|0|169.35|0||REVISE/REMOVE NEUROELECTRODE|| 80001|64590||303.03|0|190.22|0||INSRT/REDO PERPH N GENERATOR|| 80001|64595||278.77|0|148.91|0||REVISE/REMOVE NEURORECEIVER|| 80001|64600||438.26|0|259.94|0||INJECTION TREATMENT OF NERVE|| 80001|64605||672.59|0|420.62|0||INJECTION TREATMENT OF NERVE|| 80001|64610||841.29|0|580.79|0||INJECTION TREATMENT OF NERVE|| 80001|64611||134.43|0|118.54|0||CHEMODENERV SALIV GLANDS|| 80001|64612||151.19|0|136.46|0||DESTROY NERVE - FACE MUSCLE|| 80001|64615||171.4|0|149.7|0||CHEMODENERV MUSC MIGRAINE|| 80001|64616||145.16|0|127.72|0||CHEMODENERV MUSC NECK DYSTON|| 80001|64617||218.44|0|136.65|0||CHEMODENER MUSCLE LARYNX EMG|| 80001|64620||240.19|0|204.91|0||INJECTION TREATMENT OF NERVE|| 80001|64630||271.56|0|228.91|0||INJECTION TREATMENT OF NERVE|| 80001|64632||99.96|0|82.13|0||N BLOCK INJ - COMMON DIGIT|| 80001|64633||476.16|0|269.93|0||DESTROY CERV/THOR FACET JNT|| 80001|64634||210.84|0|81.75|0||DESTROY C/TH FACET JNT ADDL|| 80001|64635||472.02|0|266.56|0||DESTROY LUMB/SAC FACET JNT|| 80001|64636||192.69|0|72.13|0||DESTROY L/S FACET JNT ADDL|| 80001|64640||152.3|0|108.88|0||INJECTION TREATMENT OF NERVE|| 80001|64642||163.88|0|128.6|0||CHEMODENERV 1 EXTREMITY 1-4|| 80001|64643||109.27|0|87.95|0||CHEMODENERV 1 EXTREM 1-4 EA|| 80001|64644||188.28|0|141.37|0||CHEMODENERV 1 EXTREM 5/> MUS|| 80001|64645||132.5|0|99.55|0||CHEMODENERV 1 EXTREM 5/> EA|| 80001|64646||178.11|0|140.12|0||CHEMODENERV TRUNK MUSC 1-5|| 80001|64647||205.84|0|162.03|0||CHEMODENERV TRUNK MUSC 6/>|| 80001|64650||89.13|0|49.59|0||CHEMODENERV ECCRINE GLANDS|| 80001|64653||108.94|0|63.97|0||CHEMODENERV ECCRINE GLANDS|| 80001|64680||357.86|0|199.7|0||INJECTION TREATMENT OF NERVE|| 80001|64681||462.33|0|273.54|0||INJECTION TREATMENT OF NERVE|| 80001|64702||583|0|583|0||REVISE FINGER/TOE NERVE|| 80001|64704||372.13|0|372.13|0||REVISE HAND/FOOT NERVE|| 80001|64708||583.85|0|583.85|0||REVISE ARM/LEG NERVE|| 80001|64712||673.16|0|673.16|0||REVISION OF SCIATIC NERVE|| 80001|64713||855.64|0|855.64|0||REVISION OF ARM NERVE(S)|| 80001|64714||768.46|0|768.46|0||REVISE LOW BACK NERVE(S)|| 80001|64716||625.73|0|625.73|0||REVISION OF CRANIAL NERVE|| 80001|64718||690.94|0|690.94|0||REVISE ULNAR NERVE AT ELBOW|| 80001|64719||466.49|0|466.49|0||REVISE ULNAR NERVE AT WRIST|| 80001|64721||499.84|0|496.35|0||CARPAL TUNNEL SURGERY|| 80001|64722||435.21|0|435.21|0||RELIEVE PRESSURE ON NERVE(S)|| 80001|64726||325.32|0|325.32|0||RELEASE FOOT/TOE NERVE|| 80001|64727||221.04|0|221.04|0||INTERNAL NERVE REVISION|| 80001|64732||444.4|0|444.4|0||INCISION OF BROW NERVE|| 80001|64734||593.37|0|593.37|0||INCISION OF CHEEK NERVE|| 80001|64736||466.82|0|466.82|0||INCISION OF CHIN NERVE|| 80001|64738||541.57|0|541.57|0||INCISION OF JAW NERVE|| 80001|64740||535.88|0|535.88|0||INCISION OF TONGUE NERVE|| 80001|64742||539.81|0|539.81|0||INCISION OF FACIAL NERVE|| 80001|64744||588.7|0|588.7|0||INCISE NERVE - BACK OF HEAD|| 80001|64746||513.47|0|513.47|0||INCISE DIAPHRAGM NERVE|| 80001|64755||1097.09|0|1097.09|0||INCISION OF STOMACH NERVES|| 80001|64760||608.33|0|608.33|0||INCISION OF VAGUS NERVE|| 80001|64763||602.78|0|602.78|0||INCISE HIP/THIGH NERVE|| 80001|64766||675.31|0|675.31|0||INCISE HIP/THIGH NERVE|| 80001|64771||700.22|0|700.22|0||SEVER CRANIAL NERVE|| 80001|64772||670.27|0|670.27|0||INCISION OF SPINAL NERVE|| 80001|64774||489.91|0|489.91|0||REMOVE SKIN NERVE LESION|| 80001|64776||457.18|0|457.18|0||REMOVE DIGIT NERVE LESION|| 80001|64778||172.53|0|172.53|0||DIGIT NERVE SURGERY ADD-ON|| 80001|64782||531.69|0|531.69|0||REMOVE LIMB NERVE LESION|| 80001|64783||262.44|0|262.44|0||LIMB NERVE SURGERY ADD-ON|| 80001|64784||859.17|0|859.17|0||REMOVE NERVE LESION|| 80001|64786||1284.46|0|1284.46|0||REMOVE SCIATIC NERVE LESION|| 80001|64787||293.28|0|293.28|0||IMPLANT NERVE END|| 80001|64788||479.35|0|479.35|0||REMOVE SKIN NERVE LESION|| 80001|64790||997.3|0|997.3|0||REMOVAL OF NERVE LESION|| 80001|64792||1276.81|0|1276.81|0||REMOVAL OF NERVE LESION|| 80001|64795||229.2|0|229.2|0||BIOPSY OF NERVE|| 80001|64802||787.69|0|787.69|0||REMOVE SYMPATHETIC NERVES|| 80001|64804||1121.42|0|1121.42|0||REMOVE SYMPATHETIC NERVES|| 80001|64809||1313.66|0|1313.66|0||REMOVE SYMPATHETIC NERVES|| 80001|64818||666.33|0|666.33|0||REMOVE SYMPATHETIC NERVES|| 80001|64820||858.11|0|858.11|0||REMOVE SYMPATHETIC NERVES|| 80001|64821||805.78|0|805.78|0||REMOVE SYMPATHETIC NERVES|| 80001|64822||805.78|0|805.78|0||REMOVE SYMPATHETIC NERVES|| 80001|64823||929.66|0|929.66|0||REMOVE SYMPATHETIC NERVES|| 80001|64831||803.14|0|803.14|0||REPAIR OF DIGIT NERVE|| 80001|64832||403.17|0|403.17|0||REPAIR NERVE ADD-ON|| 80001|64834||869.68|0|869.68|0||REPAIR OF HAND OR FOOT NERVE|| 80001|64835||964.53|0|964.53|0||REPAIR OF HAND OR FOOT NERVE|| 80001|64836||965.98|0|965.98|0||REPAIR OF HAND OR FOOT NERVE|| 80001|64837||452.7|0|452.7|0||REPAIR NERVE ADD-ON|| 80001|64840||1142.72|0|1142.72|0||REPAIR OF LEG NERVE|| 80001|64856||1198.2|0|1198.2|0||REPAIR/TRANSPOSE NERVE|| 80001|64857||1242.96|0|1242.96|0||REPAIR ARM/LEG NERVE|| 80001|64858||1400.3|0|1400.3|0||REPAIR SCIATIC NERVE|| 80001|64859||302.03|0|302.03|0||NERVE SURGERY|| 80001|64861||1510.15|0|1510.15|0||REPAIR OF ARM NERVES|| 80001|64862||1376.45|0|1376.45|0||REPAIR OF LOW BACK NERVES|| 80001|64864||1031.83|0|1031.83|0||REPAIR OF FACIAL NERVE|| 80001|64865||1310.29|0|1310.29|0||REPAIR OF FACIAL NERVE|| 80001|64866||1359.67|0|1359.67|0||FUSION OF FACIAL/OTHER NERVE|| 80001|64868||1200.4|0|1200.4|0||FUSION OF FACIAL/OTHER NERVE|| 80001|64872||141.72|0|141.72|0||SUBSEQUENT REPAIR OF NERVE|| 80001|64874||197.99|0|197.99|0||REPAIR & REVISE NERVE ADD-ON|| 80001|64876||204.29|0|204.29|0||REPAIR NERVE/SHORTEN BONE|| 80001|64885||1328.16|0|1328.16|0||NERVE GRAFT - HEAD OR NECK|| 80001|64886||1541.92|0|1541.92|0||NERVE GRAFT - HEAD OR NECK|| 80001|64890||1292.41|0|1292.41|0||NERVE GRAFT - HAND OR FOOT|| 80001|64891||1377.15|0|1377.15|0||NERVE GRAFT - HAND OR FOOT|| 80001|64892||1248.11|0|1248.11|0||NERVE GRAFT - ARM OR LEG|| 80001|64893||1342.09|0|1342.09|0||NERVE GRAFT - ARM OR LEG|| 80001|64895||1598.28|0|1598.28|0||NERVE GRAFT - HAND OR FOOT|| 80001|64896||1918.46|0|1918.46|0||NERVE GRAFT - HAND OR FOOT|| 80001|64897||1501.14|0|1501.14|0||NERVE GRAFT - ARM OR LEG|| 80001|64898||1629.51|0|1629.51|0||NERVE GRAFT - ARM OR LEG|| 80001|64901||673.52|0|673.52|0||NERVE GRAFT ADD-ON|| 80001|64902||779.82|0|779.82|0||NERVE GRAFT ADD-ON|| 80001|64905||1210.7|0|1210.7|0||NERVE PEDICLE TRANSFER|| 80001|64907||1743.96|0|1743.96|0||NERVE PEDICLE TRANSFER|| 80001|64910||970.33|0|970.33|0||NERVE REPAIR W/ALLOGRAFT|| 80001|64911||1195.91|0|1195.91|0||NEURORRAPHY W/VEIN AUTOGRAFT|| 80001|64912||935.13|0|935.13|0||NRV RPR W/NRV ALGRFT 1ST|| 80001|64913||192.86|0|192.86|0||NRV RPR W/NRV ALGRFT EA ADDL|| 80001|64999||0|0|0|0||NERVOUS SYSTEM SURGERY|| 80001|65091||726.01|0|726.01|0||REVISE EYE|| 80001|65093||717.3|0|717.3|0||REVISE EYE WITH IMPLANT|| 80001|65101||843.76|0|843.76|0||REMOVAL OF EYE|| 80001|65103||879.84|0|879.84|0||REMOVE EYE/INSERT IMPLANT|| 80001|65105||972.6|0|972.6|0||REMOVE EYE/ATTACH IMPLANT|| 80001|65110||1405.63|0|1405.63|0||REMOVAL OF EYE|| 80001|65112||1631.5|0|1631.5|0||REMOVE EYE/REVISE SOCKET|| 80001|65114||1712.08|0|1712.08|0||REMOVE EYE/REVISE SOCKET|| 80001|65125||513.97|0|334.49|0||REVISE OCULAR IMPLANT|| 80001|65130||837.3|0|837.3|0||INSERT OCULAR IMPLANT|| 80001|65135||849.72|0|849.72|0||INSERT OCULAR IMPLANT|| 80001|65140||924.8|0|924.8|0||ATTACH OCULAR IMPLANT|| 80001|65150||659.59|0|659.59|0||REVISE OCULAR IMPLANT|| 80001|65155||969.47|0|969.47|0||REINSERT OCULAR IMPLANT|| 80001|65175||751.05|0|751.05|0||REMOVAL OF OCULAR IMPLANT|| 80001|65205||64.35|0|51.56|0||REMOVE FOREIGN BODY FROM EYE|| 80001|65210||78.87|0|62.2|0||REMOVE FOREIGN BODY FROM EYE|| 80001|65220||66.29|0|49.24|0||REMOVE FOREIGN BODY FROM EYE|| 80001|65222||76.94|0|61.04|0||REMOVE FOREIGN BODY FROM EYE|| 80001|65235||819.72|0|819.72|0||REMOVE FOREIGN BODY FROM EYE|| 80001|65260||1104.57|0|1104.57|0||REMOVE FOREIGN BODY FROM EYE|| 80001|65265||1245.01|0|1245.01|0||REMOVE FOREIGN BODY FROM EYE|| 80001|65270||300.43|0|163.2|0||REPAIR OF EYE WOUND|| 80001|65272||569.88|0|404.74|0||REPAIR OF EYE WOUND|| 80001|65273||439.66|0|439.66|0||REPAIR OF EYE WOUND|| 80001|65275||660.53|0|534.54|0||REPAIR OF EYE WOUND|| 80001|65280||777.09|0|777.09|0||REPAIR OF EYE WOUND|| 80001|65285||1282.81|0|1282.81|0||REPAIR OF EYE WOUND|| 80001|65286||799.63|0|572.85|0||REPAIR OF EYE WOUND|| 80001|65290||566.21|0|566.21|0||REPAIR OF EYE SOCKET WOUND|| 80001|65400||776.68|0|694.5|0||REMOVAL OF EYE LESION|| 80001|65410||163.03|0|121.17|0||BIOPSY OF CORNEA|| 80001|65420||583.86|0|432.68|0||REMOVAL OF EYE LESION|| 80001|65426||740.5|0|551.71|0||REMOVAL OF EYE LESION|| 80001|65430||132.02|0|120.01|0||CORNEAL SMEAR|| 80001|65435||90.85|0|80|0||CURETTE/TREAT CORNEA|| 80001|65436||445.54|0|428.49|0||CURETTE/TREAT CORNEA|| 80001|65450||371.42|0|367.54|0||TREATMENT OF CORNEAL LESION|| 80001|65600||450.2|0|395.54|0||REVISION OF CORNEA|| 80001|65710||1275.73|0|1275.73|0||CORNEAL TRANSPLANT|| 80001|65730||1416.61|0|1416.61|0||CORNEAL TRANSPLANT|| 80001|65750||1426.38|0|1426.38|0||CORNEAL TRANSPLANT|| 80001|65755||1418.53|0|1418.53|0||CORNEAL TRANSPLANT|| 80001|65756||1373.01|0|1373.01|0||CORNEAL TRNSPL - ENDOTHELIAL|| 80001|65757||0|0|0|0||PREP CORNEAL ENDO ALLOGRAFT|| 80001|65760||0|0|0|0||REVISION OF CORNEA|| 80001|65765||0|0|0|0||REVISION OF CORNEA|| 80001|65767||0|0|0|0||CORNEAL TISSUE TRANSPLANT|| 80001|65770||1628.74|0|1628.74|0||REVISE CORNEA WITH IMPLANT|| 80001|65771||0|0|0|0||RADIAL KERATOTOMY|| 80001|65772||516.11|0|467.66|0||CORRECTION OF ASTIGMATISM|| 80001|65775||634.94|0|634.94|0||CORRECTION OF ASTIGMATISM|| 80001|65778||1513.93|0|82.34|0||COVER EYE W/MEMBRANE|| 80001|65779||1357.63|0|328.03|0||COVER EYE W/MEMBRANE STENT|| 80001|65780||1021.45|0|1021.45|0||OCULAR RECONST - TRANSPLANT|| 80001|65781||1541.12|0|1541.12|0||OCULAR RECONST - TRANSPLANT|| 80001|65782||1328.86|0|1328.86|0||OCULAR RECONST - TRANSPLANT|| 80001|65785||2336.07|0|449.59|0||IMPLTJ NTRSTRML CRNL RNG SEG|| 80001|65800||137.33|0|107.48|0||DRAINAGE OF EYE|| 80001|65810||535.98|0|535.98|0||DRAINAGE OF EYE|| 80001|65815||724.38|0|549.94|0||DRAINAGE OF EYE|| 80001|65820||858.44|0|858.44|0||RELIEVE INNER EYE PRESSURE|| 80001|65850||969.68|0|969.68|0||INCISION OF EYE|| 80001|65855||387.65|0|343.45|0||LASER SURGERY OF EYE|| 80001|65860||354.11|0|293.64|0||INCISE INNER EYE ADHESIONS|| 80001|65865||543.9|0|543.9|0||INCISE INNER EYE ADHESIONS|| 80001|65870||680.06|0|680.06|0||INCISE INNER EYE ADHESIONS|| 80001|65875||724.15|0|724.15|0||INCISE INNER EYE ADHESIONS|| 80001|65880||763.39|0|763.39|0||INCISE INNER EYE ADHESIONS|| 80001|65900||1111.03|0|1111.03|0||REMOVE EYE LESION|| 80001|65920||907.74|0|907.74|0||REMOVE IMPLANT OF EYE|| 80001|65930||735.99|0|735.99|0||REMOVE BLOOD CLOT FROM EYE|| 80001|66020||210.68|0|151.37|0||INJECTION TREATMENT OF EYE|| 80001|66030||187.1|0|127.41|0||INJECTION TREATMENT OF EYE|| 80001|66130||795.95|0|658.34|0||REMOVE EYE LESION|| 80001|66150||1001.2|0|1001.2|0||GLAUCOMA SURGERY|| 80001|66155||1005.8|0|1005.8|0||GLAUCOMA SURGERY|| 80001|66160||1136.47|0|1136.47|0||GLAUCOMA SURGERY|| 80001|66170||1381.34|0|1381.34|0||GLAUCOMA SURGERY|| 80001|66172||1741.58|0|1741.58|0||INCISION OF EYE|| 80001|66174||1095.07|0|1095.07|0||TRANSLUM DIL EYE CANAL|| 80001|66175||1147.58|0|1147.58|0||TRNSLUM DIL EYE CANAL W/STNT|| 80001|66179||1242.75|0|1242.75|0||AQUEOUS SHUNT EYE W/O GRAFT|| 80001|66180||1312.64|0|1312.64|0||IMPLANT EYE SHUNT|| 80001|66183||1186.92|0|1186.92|0||INSERT ANT DRAINAGE DEVICE|| 80001|66184||902.07|0|902.07|0||REVISION OF AQUEOUS SHUNT|| 80001|66185||972.34|0|972.34|0||REVISE EYE SHUNT|| 80001|66220||855.1|0|855.1|0||REPAIR EYE LESION|| 80001|66225||1076.66|0|1076.66|0||REPAIR/GRAFT EYE LESION|| 80001|66250||850.52|0|641.97|0||FOLLOW-UP SURGERY OF EYE|| 80001|66500||404.39|0|404.39|0||INCISION OF IRIS|| 80001|66505||443.31|0|443.31|0||INCISION OF IRIS|| 80001|66600||955.99|0|955.99|0||REMOVE IRIS AND LESION|| 80001|66605||1220.45|0|1220.45|0||REMOVAL OF IRIS|| 80001|66625||493.38|0|493.38|0||REMOVAL OF IRIS|| 80001|66630||655.93|0|655.93|0||REMOVAL OF IRIS|| 80001|66635||662.53|0|662.53|0||REMOVAL OF IRIS|| 80001|66680||595.45|0|595.45|0||REPAIR IRIS & CILIARY BODY|| 80001|66682||730.2|0|730.2|0||REPAIR IRIS & CILIARY BODY|| 80001|66700||515.56|0|453.53|0||DESTRUCTION - CILIARY BODY|| 80001|66710||504.31|0|453.53|0||CILIARY TRANSSLERAL THERAPY|| 80001|66711||737.86|0|737.86|0||CILIARY ENDOSCOPIC ABLATION|| 80001|66720||542.08|0|486.65|0||DESTRUCTION - CILIARY BODY|| 80001|66740||501.21|0|453.15|0||DESTRUCTION - CILIARY BODY|| 80001|66761||337.19|0|271.68|0||REVISION OF IRIS|| 80001|66762||543.35|0|490.24|0||REVISION OF IRIS|| 80001|66770||605.56|0|557.49|0||REMOVAL OF INNER EYE LESION|| 80001|66820||448.21|0|448.21|0||INCISION - SECONDARY CATARACT|| 80001|66821||376.24|0|356.08|0||AFTER CATARACT LASER SURGERY|| 80001|66825||871.67|0|871.67|0||REPOSITION INTRAOCULAR LENS|| 80001|66830||822.12|0|822.12|0||REMOVAL OF LENS LESION|| 80001|66840||804.19|0|804.19|0||REMOVAL OF LENS MATERIAL|| 80001|66850||914.84|0|914.84|0||REMOVAL OF LENS MATERIAL|| 80001|66852||975.58|0|975.58|0||REMOVAL OF LENS MATERIAL|| 80001|66920||871.14|0|871.14|0||EXTRACTION OF LENS|| 80001|66930||989.63|0|989.63|0||EXTRACTION OF LENS|| 80001|66940||902.81|0|902.81|0||EXTRACTION OF LENS|| 80001|66982||920.25|0|920.25|0||CATARACT SURGERY - COMPLEX|| 80001|66983||849.93|0|849.93|0||CATARACT SURG W/IOL - 1 STAGE|| 80001|66984||738.88|0|738.88|0||CATARACT SURG W/IOL - 1 STAGE|| 80001|66985||887.53|0|887.53|0||INSERT LENS PROSTHESIS|| 80001|66986||1049.07|0|1049.07|0||EXCHANGE LENS PROSTHESIS|| 80001|66990||106.23|0|106.23|0||OPHTHALMIC ENDOSCOPE ADD-ON|| 80001|66999||0|0|0|0||EYE SURGERY PROCEDURE|| 80001|67005||543.65|0|543.65|0||PARTIAL REMOVAL OF EYE FLUID|| 80001|67010||625.9|0|625.9|0||PARTIAL REMOVAL OF EYE FLUID|| 80001|67015||667.34|0|667.34|0||RELEASE OF EYE FLUID|| 80001|67025||830.91|0|729.73|0||REPLACE EYE FLUID|| 80001|67027||984.64|0|984.64|0||IMPLANT EYE DRUG SYSTEM|| 80001|67028||117.94|0|116|0||INJECTION EYE DRUG|| 80001|67030||610.12|0|610.12|0||INCISE INNER EYE STRANDS|| 80001|67031||444.79|0|409.9|0||LASER SURGERY - EYE STRANDS|| 80001|67036||1040.75|0|1040.75|0||REMOVAL OF INNER EYE FLUID|| 80001|67039||1116.37|0|1116.37|0||LASER TREATMENT OF RETINA|| 80001|67040||1207.33|0|1207.33|0||LASER TREATMENT OF RETINA|| 80001|67041||1336.28|0|1336.28|0||VIT FOR MACULAR PUCKER|| 80001|67042||1336.28|0|1336.28|0||VIT FOR MACULAR HOLE|| 80001|67043||1410.73|0|1410.73|0||VIT FOR MEMBRANE DISSECT|| 80001|67101||896.72|0|777.33|0||REPAIR DETACHED RETINA|| 80001|67105||824.99|0|743.97|0||REPAIR DETACHED RETINA|| 80001|67107||1405|0|1405|0||REPAIR DETACHED RETINA|| 80001|67108||1859.59|0|1859.59|0||REPAIR DETACHED RETINA|| 80001|67110||996.48|0|893.75|0||REPAIR DETACHED RETINA|| 80001|67113||2023.47|0|2023.47|0||REPAIR RETINAL DETACH - CPLX|| 80001|67115||574.46|0|574.46|0||RELEASE ENCIRCLING MATERIAL|| 80001|67120||750.51|0|643.13|0||REMOVE EYE IMPLANT MATERIAL|| 80001|67121||1049.41|0|1049.41|0||REMOVE EYE IMPLANT MATERIAL|| 80001|67141||600.99|0|561.84|0||TREATMENT OF RETINA|| 80001|67145||605.22|0|573.44|0||TREATMENT OF RETINA|| 80001|67208||689.73|0|666.47|0||TREATMENT OF RETINAL LESION|| 80001|67210||596.1|0|576.71|0||TREATMENT OF RETINAL LESION|| 80001|67218||1604.71|0|1604.71|0||TREATMENT OF RETINAL LESION|| 80001|67220||613.93|0|576.71|0||TREATMENT OF CHOROID LESION|| 80001|67221||329.47|0|250.39|0||OCULAR PHOTODYNAMIC THER|| 80001|67225||34.62|0|32.68|0||EYE PHOTODYNAMIC THER ADD-ON|| 80001|67227||702.38|0|658.97|0||TREATMENT OF RETINAL LESION|| 80001|67228||1156.68|0|1098.92|0||TREATMENT OF RETINAL LESION|| 80001|67229||1350.1|0|1350.1|0||TR RETINAL LES PRETERM INF|| 80001|67250||897.16|0|897.16|0||REINFORCE EYE WALL|| 80001|67255||785.57|0|785.57|0||REINFORCE/GRAFT EYE WALL|| 80001|67299||0|0|0|0||EYE SURGERY PROCEDURE|| 80001|67311||689.86|0|689.86|0||REVISE EYE MUSCLE|| 80001|67312||822.56|0|822.56|0||REVISE TWO EYE MUSCLES|| 80001|67314||776.51|0|776.51|0||REVISE EYE MUSCLE|| 80001|67316||926.97|0|926.97|0||REVISE TWO EYE MUSCLES|| 80001|67318||812.45|0|812.45|0||REVISE EYE MUSCLE(S)|| 80001|67320||377.91|0|377.91|0||REVISE EYE MUSCLE(S) ADD-ON|| 80001|67331||358.51|0|358.51|0||EYE SURGERY FOLLOW-UP ADD-ON|| 80001|67332||389.08|0|389.08|0||REREVISE EYE MUSCLES ADD-ON|| 80001|67334||353.51|0|353.51|0||REVISE EYE MUSCLE W/SUTURE|| 80001|67335||174.86|0|174.86|0||EYE SUTURE DURING SURGERY|| 80001|67340||420.47|0|420.47|0||REVISE EYE MUSCLE ADD-ON|| 80001|67343||753.4|0|753.4|0||RELEASE EYE TISSUE|| 80001|67345||279.9|0|253.93|0||DESTROY NERVE OF EYE MUSCLE|| 80001|67346||226.14|0|226.14|0||BIOPSY - EYE MUSCLE|| 80001|67399||0|0|0|0||EYE MUSCLE SURGERY PROCEDURE|| 80001|67400||1067.32|0|1067.32|0||EXPLORE/BIOPSY EYE SOCKET|| 80001|67405||908.96|0|908.96|0||EXPLORE/DRAIN EYE SOCKET|| 80001|67412||977.33|0|977.33|0||EXPLORE/TREAT EYE SOCKET|| 80001|67413||980.55|0|980.55|0||EXPLORE/TREAT EYE SOCKET|| 80001|67414||1530.56|0|1530.56|0||EXPLR/DECOMPRESS EYE SOCKET|| 80001|67415||122.82|0|122.82|0||ASPIRATION - ORBITAL CONTENTS|| 80001|67420||1870.33|0|1870.33|0||EXPLORE/TREAT EYE SOCKET|| 80001|67430||1431.75|0|1431.75|0||EXPLORE/TREAT EYE SOCKET|| 80001|67440||1385.59|0|1385.59|0||EXPLORE/DRAIN EYE SOCKET|| 80001|67445||1620.24|0|1620.24|0||EXPLR/DECOMPRESS EYE SOCKET|| 80001|67450||1440.83|0|1440.83|0||EXPLORE/BIOPSY EYE SOCKET|| 80001|67500||92.35|0|85.76|0||INJECT/TREAT EYE SOCKET|| 80001|67505||103.24|0|95.1|0||INJECT/TREAT EYE SOCKET|| 80001|67515||112.34|0|104.19|0||INJECT/TREAT EYE SOCKET|| 80001|67550||1107.42|0|1107.42|0||INSERT EYE SOCKET IMPLANT|| 80001|67560||1135.96|0|1135.96|0||REVISE EYE SOCKET IMPLANT|| 80001|67570||1329.54|0|1329.54|0||DECOMPRESS OPTIC NERVE|| 80001|67599||0|0|0|0||ORBIT SURGERY PROCEDURE|| 80001|67700||298.41|0|133.66|0||DRAINAGE OF EYELID ABSCESS|| 80001|67710||248.12|0|111.28|0||INCISION OF EYELID|| 80001|67715||265.28|0|124.56|0||INCISION OF EYELID FOLD|| 80001|67800||145.33|0|119.74|0||REMOVE EYELID LESION|| 80001|67801||185.89|0|155.27|0||REMOVE EYELID LESIONS|| 80001|67805||230.5|0|191.34|0||REMOVE EYELID LESIONS|| 80001|67808||424.04|0|424.04|0||REMOVE EYELID LESION(S)|| 80001|67810||192.79|0|84.25|0||BIOPSY OF EYELID|| 80001|67820||57.76|0|61.64|0||REVISE EYELASHES|| 80001|67825||147.35|0|139.99|0||REVISE EYELASHES|| 80001|67830||298.39|0|159.61|0||REVISE EYELASHES|| 80001|67835||505.99|0|505.99|0||REVISE EYELASHES|| 80001|67840||309.57|0|183.19|0||REMOVE EYELID LESION|| 80001|67850||241.76|0|157.25|0||TREAT EYELID LESION|| 80001|67875||192.75|0|112.89|0||CLOSURE OF EYELID BY SUTURE|| 80001|67880||521.34|0|423.65|0||REVISION OF EYELID|| 80001|67882||643.07|0|544.22|0||REVISION OF EYELID|| 80001|67900||730.31|0|588.43|0||REPAIR BROW DEFECT|| 80001|67901||860.43|0|666.22|0||REPAIR EYELID DEFECT|| 80001|67902||836.85|0|836.85|0||REPAIR EYELID DEFECT|| 80001|67903||677|0|558.38|0||REPAIR EYELID DEFECT|| 80001|67904||836.12|0|690.36|0||REPAIR EYELID DEFECT|| 80001|67906||587.73|0|587.73|0||REPAIR EYELID DEFECT|| 80001|67908||562.77|0|487.96|0||REPAIR EYELID DEFECT|| 80001|67909||611.65|0|505.82|0||REVISE EYELID DEFECT|| 80001|67911||649.15|0|649.15|0||REVISE EYELID DEFECT|| 80001|67912||991.92|0|566.67|0||CORRECTION EYELID W/IMPLANT|| 80001|67914||530.42|0|375.75|0||REPAIR EYELID DEFECT|| 80001|67915||327.91|0|225.57|0||REPAIR EYELID DEFECT|| 80001|67916||671.34|0|496.89|0||REPAIR EYELID DEFECT|| 80001|67917||684.93|0|528.32|0||REPAIR EYELID DEFECT|| 80001|67921||517.95|0|355.14|0||REPAIR EYELID DEFECT|| 80001|67922||324.81|0|224.79|0||REPAIR EYELID DEFECT|| 80001|67923||670.17|0|496.11|0||REPAIR EYELID DEFECT|| 80001|67924||715.17|0|528.32|0||REPAIR EYELID DEFECT|| 80001|67930||414.46|0|280.72|0||REPAIR EYELID WOUND|| 80001|67935||678.29|0|513.54|0||REPAIR EYELID WOUND|| 80001|67938||268.85|0|132.01|0||REMOVE EYELID FOREIGN BODY|| 80001|67950||652.25|0|534.4|0||REVISION OF EYELID|| 80001|67961||654.78|0|524.91|0||REVISION OF EYELID|| 80001|67966||880.42|0|761.41|0||REVISION OF EYELID|| 80001|67971||837.67|0|837.67|0||RECONSTRUCTION OF EYELID|| 80001|67973||1078.86|0|1078.86|0||RECONSTRUCTION OF EYELID|| 80001|67974||1076.4|0|1076.4|0||RECONSTRUCTION OF EYELID|| 80001|67975||792.92|0|792.92|0||RECONSTRUCTION OF EYELID|| 80001|67999||0|0|0|0||REVISION OF EYELID|| 80001|68020||137.23|0|127.54|0||INCISE/DRAIN EYELID LINING|| 80001|68040||71.94|0|59.53|0||TREATMENT OF EYELID LESIONS|| 80001|68100||191.2|0|112.89|0||BIOPSY OF EYELID LINING|| 80001|68110||254.11|0|171.93|0||REMOVE EYELID LINING LESION|| 80001|68115||350.11|0|212.5|0||REMOVE EYELID LINING LESION|| 80001|68130||610.74|0|473.51|0||REMOVE EYELID LINING LESION|| 80001|68135||179.99|0|174.56|0||REMOVE EYELID LINING LESION|| 80001|68200||47.11|0|40.13|0||TREAT EYELID BY INJECTION|| 80001|68320||820.99|0|620.19|0||REVISE/GRAFT EYELID LINING|| 80001|68325||761.86|0|761.86|0||REVISE/GRAFT EYELID LINING|| 80001|68326||745.43|0|745.43|0||REVISE/GRAFT EYELID LINING|| 80001|68328||817.78|0|817.78|0||REVISE/GRAFT EYELID LINING|| 80001|68330||685.82|0|531.15|0||REVISE EYELID LINING|| 80001|68335||747.93|0|747.93|0||REVISE/GRAFT EYELID LINING|| 80001|68340||617.15|0|459.38|0||SEPARATE EYELID ADHESIONS|| 80001|68360||602.52|0|473.43|0||REVISE EYELID LINING|| 80001|68362||758.28|0|758.28|0||REVISE EYELID LINING|| 80001|68371||474.63|0|474.63|0||HARVEST EYE TISSUE - ALOGRAFT|| 80001|68399||0|0|0|0||EYELID LINING SURGERY|| 80001|68400||318.11|0|152.97|0||INCISE/DRAIN TEAR GLAND|| 80001|68420||360.71|0|195.57|0||INCISE/DRAIN TEAR SAC|| 80001|68440||115.97|0|112.87|0||INCISE TEAR DUCT OPENING|| 80001|68500||1124.96|0|1124.96|0||REMOVAL OF TEAR GLAND|| 80001|68505||1119.57|0|1119.57|0||PARTIAL REMOVAL - TEAR GLAND|| 80001|68510||508.16|0|341.47|0||BIOPSY OF TEAR GLAND|| 80001|68520||791.2|0|791.2|0||REMOVAL OF TEAR SAC|| 80001|68525||309.67|0|309.67|0||BIOPSY OF TEAR SAC|| 80001|68530||483.68|0|298.77|0||CLEARANCE OF TEAR DUCT|| 80001|68540||1071.59|0|1071.59|0||REMOVE TEAR GLAND LESION|| 80001|68550||1248.37|0|1248.37|0||REMOVE TEAR GLAND LESION|| 80001|68700||696.89|0|696.89|0||REPAIR TEAR DUCTS|| 80001|68705||267.4|0|192.19|0||REVISE TEAR DUCT OPENING|| 80001|68720||872.34|0|872.34|0||CREATE TEAR SAC DRAIN|| 80001|68745||875.94|0|875.94|0||CREATE TEAR DUCT DRAIN|| 80001|68750||905.9|0|905.9|0||CREATE TEAR DUCT DRAIN|| 80001|68760||227.19|0|168.27|0||CLOSE TEAR DUCT OPENING|| 80001|68761||167.81|0|136.8|0||CLOSE TEAR DUCT OPENING|| 80001|68770||726.64|0|726.64|0||CLOSE TEAR SYSTEM FISTULA|| 80001|68801||140.43|0|122.21|0||DILATE TEAR DUCT OPENING|| 80001|68810||273.39|0|215.24|0||PROBE NASOLACRIMAL DUCT|| 80001|68811||236.71|0|236.71|0||PROBE NASOLACRIMAL DUCT|| 80001|68815||505.58|0|296.64|0||PROBE NASOLACRIMAL DUCT|| 80001|68816||823.57|0|287.83|0||PROBE NL DUCT W/BALLOON|| 80001|68840||145.62|0|133.99|0||EXPLORE/IRRIGATE TEAR DUCTS|| 80001|68850||70.56|0|65.14|0||INJECTION FOR TEAR SAC X-RAY|| 80001|68899||0|0|0|0||TEAR DUCT SYSTEM SURGERY|| 80001|69000||212.8|0|138.76|0||DRAIN EXTERNAL EAR LESION|| 80001|69005||247.11|0|185.08|0||DRAIN EXTERNAL EAR LESION|| 80001|69020||263.72|0|165.26|0||DRAIN OUTER EAR CANAL LESION|| 80001|69090||0|0|0|0||PIERCE EARLOBES|| 80001|69100||114.03|0|57.82|0||BIOPSY OF EXTERNAL EAR|| 80001|69105||159.18|0|74.67|0||BIOPSY OF EXTERNAL EAR CANAL|| 80001|69110||522.54|0|375.23|0||REMOVE EXTERNAL EAR - PARTIAL|| 80001|69120||465.89|0|465.89|0||REMOVAL OF EXTERNAL EAR|| 80001|69140||1012.98|0|1012.98|0||REMOVE EAR CANAL LESION(S)|| 80001|69145||452.22|0|289.4|0||REMOVE EAR CANAL LESION(S)|| 80001|69150||1228.88|0|1228.88|0||EXTENSIVE EAR CANAL SURGERY|| 80001|69155||1961.61|0|1961.61|0||EXTENSIVE EAR/NECK SURGERY|| 80001|69200||139.05|0|67.73|0||CLEAR OUTER EAR CANAL|| 80001|69205||118.5|0|118.5|0||CLEAR OUTER EAR CANAL|| 80001|69209||13.91|0|13.91|||REMOVE IMPACTED EAR WAX UNI|| 80001|69209||13.91|0|13.91|0||REMOVE IMPACTED EAR WAX UNI|| 80001|69210||56.94|0|39.11|0||REMOVE IMPACTED EAR WAX|| 80001|69220||155.21|0|72.64|0||CLEAN OUT MASTOID CAVITY|| 80001|69222||249.42|0|159.1|0||CLEAN OUT MASTOID CAVITY|| 80001|69300||840.7|0|559.27|0||REVISE EXTERNAL EAR|| 80001|69310||1263.03|0|1263.03|0||REBUILD OUTER EAR CANAL|| 80001|69320||1779.86|0|1779.86|0||REBUILD OUTER EAR CANAL|| 80001|69399||0|0|0|0||OUTER EAR SURGERY PROCEDURE|| 80001|69420||218.1|0|140.96|0||INCISION OF EARDRUM|| 80001|69421||174.5|0|174.5|0||INCISION OF EARDRUM|| 80001|69424||145.22|0|72.73|0||REMOVE VENTILATING TUBE|| 80001|69433||230.95|0|154.58|0||CREATE EARDRUM OPENING|| 80001|69436||188.3|0|188.3|0||CREATE EARDRUM OPENING|| 80001|69440||801.76|0|801.76|0||EXPLORATION OF MIDDLE EAR|| 80001|69450||632.02|0|632.02|0||EARDRUM REVISION|| 80001|69501||856.79|0|856.79|0||MASTOIDECTOMY|| 80001|69502||1141.69|0|1141.69|0||MASTOIDECTOMY|| 80001|69505||1400.6|0|1400.6|0||REMOVE MASTOID STRUCTURES|| 80001|69511||1435.48|0|1435.48|0||EXTENSIVE MASTOID SURGERY|| 80001|69530||1934.23|0|1934.23|0||EXTENSIVE MASTOID SURGERY|| 80001|69535||3157.29|0|3157.29|0||REMOVE PART OF TEMPORAL BONE|| 80001|69540||236.13|0|146.98|0||REMOVE EAR LESION|| 80001|69550||1210.31|0|1210.31|0||REMOVE EAR LESION|| 80001|69552||1839.08|0|1839.08|0||REMOVE EAR LESION|| 80001|69554||2974.07|0|2974.07|0||REMOVE EAR LESION|| 80001|69601||1227.38|0|1227.38|0||MASTOID SURGERY REVISION|| 80001|69602||1275.26|0|1275.26|0||MASTOID SURGERY REVISION|| 80001|69603||1468.69|0|1468.69|0||MASTOID SURGERY REVISION|| 80001|69604||1303.55|0|1303.55|0||MASTOID SURGERY REVISION|| 80001|69605||1823.32|0|1823.32|0||MASTOID SURGERY REVISION|| 80001|69610||446.41|0|344.85|0||REPAIR OF EARDRUM|| 80001|69620||797.1|0|571.88|0||REPAIR OF EARDRUM|| 80001|69631||1031.05|0|1031.05|0||REPAIR EARDRUM STRUCTURES|| 80001|69632||1259.35|0|1259.35|0||REBUILD EARDRUM STRUCTURES|| 80001|69633||1218.12|0|1218.12|0||REBUILD EARDRUM STRUCTURES|| 80001|69635||1434.28|0|1434.28|0||REPAIR EARDRUM STRUCTURES|| 80001|69636||1607.83|0|1607.83|0||REBUILD EARDRUM STRUCTURES|| 80001|69637||1633.39|0|1633.39|0||REBUILD EARDRUM STRUCTURES|| 80001|69641||1218.72|0|1218.72|0||REVISE MIDDLE EAR & MASTOID|| 80001|69642||1568.46|0|1568.46|0||REVISE MIDDLE EAR & MASTOID|| 80001|69643||1436.03|0|1436.03|0||REVISE MIDDLE EAR & MASTOID|| 80001|69644||1729.31|0|1729.31|0||REVISE MIDDLE EAR & MASTOID|| 80001|69645||1697.96|0|1697.96|0||REVISE MIDDLE EAR & MASTOID|| 80001|69646||1803.31|0|1803.31|0||REVISE MIDDLE EAR & MASTOID|| 80001|69650||940.02|0|940.02|0||RELEASE MIDDLE EAR BONE|| 80001|69660||1090.13|0|1090.13|0||REVISE MIDDLE EAR BONE|| 80001|69661||1418.48|0|1418.48|0||REVISE MIDDLE EAR BONE|| 80001|69662||1365.14|0|1365.14|0||REVISE MIDDLE EAR BONE|| 80001|69666||948.16|0|948.16|0||REPAIR MIDDLE EAR STRUCTURES|| 80001|69667||947.43|0|947.43|0||REPAIR MIDDLE EAR STRUCTURES|| 80001|69670||1104.32|0|1104.32|0||REMOVE MASTOID AIR CELLS|| 80001|69676||970.16|0|970.16|0||REMOVE MIDDLE EAR NERVE|| 80001|69700||801.16|0|801.16|0||CLOSE MASTOID FISTULA|| 80001|69710||0|0|0|0||IMPLANT/REPLACE HEARING AID|| 80001|69711||1008.74|0|1008.74|0||REMOVE/REPAIR HEARING AID|| 80001|69714||1268.22|0|1268.22|0||IMPLANT TEMPLE BONE W/STIMUL|| 80001|69715||1567.88|0|1567.88|0||TEMPLE BNE IMPLNT W/STIMULAT|| 80001|69717||1329.88|0|1329.88|0||TEMPLE BONE IMPLANT REVISION|| 80001|69718||1584.09|0|1584.09|0||REVISE TEMPLE BONE IMPLANT|| 80001|69720||1403.09|0|1403.09|0||RELEASE FACIAL NERVE|| 80001|69725||2223.1|0|2223.1|0||RELEASE FACIAL NERVE|| 80001|69740||1375.82|0|1375.82|0||REPAIR FACIAL NERVE|| 80001|69745||1461.68|0|1461.68|0||REPAIR FACIAL NERVE|| 80001|69799||0|0|0|0||MIDDLE EAR SURGERY PROCEDURE|| 80001|69801||226.51|0|150.14|0||INCISE INNER EAR|| 80001|69805||1241.82|0|1241.82|0||EXPLORE INNER EAR|| 80001|69806||1111.36|0|1111.36|0||EXPLORE INNER EAR|| 80001|69820||1002.09|0|1002.09|0||ESTABLISH INNER EAR WINDOW|| 80001|69840||1062.05|0|1062.05|0||REVISE INNER EAR WINDOW|| 80001|69905||1073.18|0|1073.18|0||REMOVE INNER EAR|| 80001|69910||1196.84|0|1196.84|0||REMOVE INNER EAR & MASTOID|| 80001|69915||1819.12|0|1819.12|0||INCISE INNER EAR NERVE|| 80001|69930||1446.96|0|1446.96|0||IMPLANT COCHLEAR DEVICE|| 80001|69949||0|0|0|0||INNER EAR SURGERY PROCEDURE|| 80001|69950||2115.28|0|2115.28|0||INCISE INNER EAR NERVE|| 80001|69955||2341.38|0|2341.38|0||RELEASE FACIAL NERVE|| 80001|69960||2282.46|0|2282.46|0||RELEASE INNER EAR CANAL|| 80001|69970||2538.24|0|2538.24|0||REMOVE INNER EAR LESION|| 80001|69979||0|0|0|0||TEMPORAL BONE SURGERY|| 80001|69990||267.74|0|267.74|0||MICROSURGERY ADD-ON|| 80001|70010||84.71|0|84.71|0||CONTRAST X-RAY OF BRAIN|| 80001|70015||173.44|0|173.44|0||CONTRAST X-RAY OF BRAIN|| 80001|70015|26|71.49|0|71.49|0||CONTRAST X-RAY OF BRAIN|| 80001|70015|TC|101.95|0|101.95|0||CONTRAST X-RAY OF BRAIN|| 80001|70030||30.59|0|30.59|0||X-RAY EYE FOR FOREIGN BODY|| 80001|70030|26|10.05|0|10.05|0||X-RAY EYE FOR FOREIGN BODY|| 80001|70030|TC|20.55|0|20.55|0||X-RAY EYE FOR FOREIGN BODY|| 80001|70100||36.45|0|36.45|0||X-RAY EXAM OF JAW|| 80001|70100|26|10.86|0|10.86|0||X-RAY EXAM OF JAW|| 80001|70100|TC|25.59|0|25.59|0||X-RAY EXAM OF JAW|| 80001|70110||42.18|0|42.18|0||X-RAY EXAM OF JAW|| 80001|70110|26|15.05|0|15.05|0||X-RAY EXAM OF JAW|| 80001|70110|TC|27.14|0|27.14|0||X-RAY EXAM OF JAW|| 80001|70120||37.62|0|37.62|0||X-RAY EXAM OF MASTOIDS|| 80001|70120|26|10.86|0|10.86|0||X-RAY EXAM OF MASTOIDS|| 80001|70120|TC|26.75|0|26.75|0||X-RAY EXAM OF MASTOIDS|| 80001|70130||60.8|0|60.8|0||X-RAY EXAM OF MASTOIDS|| 80001|70130|26|20.48|0|20.48|0||X-RAY EXAM OF MASTOIDS|| 80001|70130|TC|40.32|0|40.32|0||X-RAY EXAM OF MASTOIDS|| 80001|70134||57.31|0|57.31|0||X-RAY EXAM OF MIDDLE EAR|| 80001|70134|26|20.87|0|20.87|0||X-RAY EXAM OF MIDDLE EAR|| 80001|70134|TC|36.44|0|36.44|0||X-RAY EXAM OF MIDDLE EAR|| 80001|70140||33.01|0|33.01|0||X-RAY EXAM OF FACIAL BONES|| 80001|70140|26|12.46|0|12.46|0||X-RAY EXAM OF FACIAL BONES|| 80001|70140|TC|20.55|0|20.55|0||X-RAY EXAM OF FACIAL BONES|| 80001|70150||46.1|0|46.1|0||X-RAY EXAM OF FACIAL BONES|| 80001|70150|26|15.87|0|15.87|0||X-RAY EXAM OF FACIAL BONES|| 80001|70150|TC|30.24|0|30.24|0||X-RAY EXAM OF FACIAL BONES|| 80001|70160||36.02|0|36.02|0||X-RAY EXAM OF NASAL BONES|| 80001|70160|26|10.43|0|10.43|0||X-RAY EXAM OF NASAL BONES|| 80001|70160|TC|25.59|0|25.59|0||X-RAY EXAM OF NASAL BONES|| 80001|70170||0|0|0|0||X-RAY EXAM OF TEAR DUCT|| 80001|70170|26|18.37|0|18.37|0||X-RAY EXAM OF TEAR DUCT|| 80001|70170|TC|0|0|0|0||X-RAY EXAM OF TEAR DUCT|| 80001|70190||38.91|0|38.91|0||X-RAY EXAM OF EYE SOCKETS|| 80001|70190|26|13.32|0|13.32|0||X-RAY EXAM OF EYE SOCKETS|| 80001|70190|TC|25.59|0|25.59|0||X-RAY EXAM OF EYE SOCKETS|| 80001|70200||46.97|0|46.97|0||X-RAY EXAM OF EYE SOCKETS|| 80001|70200|26|16.73|0|16.73|0||X-RAY EXAM OF EYE SOCKETS|| 80001|70200|TC|30.24|0|30.24|0||X-RAY EXAM OF EYE SOCKETS|| 80001|70210||32.92|0|32.92|0||X-RAY EXAM OF SINUSES|| 80001|70210|26|10.43|0|10.43|0||X-RAY EXAM OF SINUSES|| 80001|70210|TC|22.49|0|22.49|0||X-RAY EXAM OF SINUSES|| 80001|70220||41.41|0|41.41|0||X-RAY EXAM OF SINUSES|| 80001|70220|26|15.05|0|15.05|0||X-RAY EXAM OF SINUSES|| 80001|70220|TC|26.36|0|26.36|0||X-RAY EXAM OF SINUSES|| 80001|70240||33.4|0|33.4|0||X-RAY EXAM - PITUITARY SADDLE|| 80001|70240|26|12.07|0|12.07|0||X-RAY EXAM - PITUITARY SADDLE|| 80001|70240|TC|21.32|0|21.32|0||X-RAY EXAM - PITUITARY SADDLE|| 80001|70250||39.81|0|39.81|0||X-RAY EXAM OF SKULL|| 80001|70250|26|15|0|15|0||X-RAY EXAM OF SKULL|| 80001|70250|TC|24.81|0|24.81|0||X-RAY EXAM OF SKULL|| 80001|70260||50.33|0|50.33|0||X-RAY EXAM OF SKULL|| 80001|70260|26|20.48|0|20.48|0||X-RAY EXAM OF SKULL|| 80001|70260|TC|29.85|0|29.85|0||X-RAY EXAM OF SKULL|| 80001|70300||16.72|0|16.72|0||X-RAY EXAM OF TEETH|| 80001|70300|26|7.03|0|7.03|0||X-RAY EXAM OF TEETH|| 80001|70300|TC|9.69|0|9.69|0||X-RAY EXAM OF TEETH|| 80001|70310||42.57|0|42.57|0||X-RAY EXAM OF TEETH|| 80001|70310|26|10|0|10|0||X-RAY EXAM OF TEETH|| 80001|70310|TC|32.56|0|32.56|0||X-RAY EXAM OF TEETH|| 80001|70320||59.11|0|59.11|0||FULL MOUTH X-RAY OF TEETH|| 80001|70320|26|14.92|0|14.92|0||FULL MOUTH X-RAY OF TEETH|| 80001|70320|TC|44.19|0|44.19|0||FULL MOUTH X-RAY OF TEETH|| 80001|70328||34.51|0|34.51|0||X-RAY EXAM OF JAW JOINT|| 80001|70328|26|11.25|0|11.25|0||X-RAY EXAM OF JAW JOINT|| 80001|70328|TC|23.26|0|23.26|0||X-RAY EXAM OF JAW JOINT|| 80001|70330||52.22|0|52.22|0||X-RAY EXAM OF JAW JOINTS|| 80001|70330|26|15.39|0|15.39|0||X-RAY EXAM OF JAW JOINTS|| 80001|70330|TC|36.83|0|36.83|0||X-RAY EXAM OF JAW JOINTS|| 80001|70332||91.53|0|91.53|0||X-RAY EXAM OF JAW JOINT|| 80001|70332|26|37.64|0|37.64|0||X-RAY EXAM OF JAW JOINT|| 80001|70332|TC|53.89|0|53.89|0||X-RAY EXAM OF JAW JOINT|| 80001|70336||354.19|0|354.19|0||MAGNETIC IMAGE - JAW JOINT|| 80001|70336|26|87.48|0|87.48|0||MAGNETIC IMAGE - JAW JOINT|| 80001|70336|TC|266.71|0|266.71|0||MAGNETIC IMAGE - JAW JOINT|| 80001|70350||22.07|0|22.07|0||X-RAY HEAD FOR ORTHODONTIA|| 80001|70350|26|11.99|0|11.99|0||X-RAY HEAD FOR ORTHODONTIA|| 80001|70350|TC|10.08|0|10.08|0||X-RAY HEAD FOR ORTHODONTIA|| 80001|70355||22.97|0|22.97|0||PANORAMIC X-RAY OF JAWS|| 80001|70355|26|13.28|0|13.28|0||PANORAMIC X-RAY OF JAWS|| 80001|70355|TC|9.69|0|9.69|0||PANORAMIC X-RAY OF JAWS|| 80001|70360||30.98|0|30.98|0||X-RAY EXAM OF NECK|| 80001|70360|26|10.05|0|10.05|0||X-RAY EXAM OF NECK|| 80001|70360|TC|20.94|0|20.94|0||X-RAY EXAM OF NECK|| 80001|70370||89.01|0|89.01|0||THROAT X-RAY & FLUOROSCOPY|| 80001|70370|26|19.23|0|19.23|0||THROAT X-RAY & FLUOROSCOPY|| 80001|70370|TC|69.78|0|69.78|0||THROAT X-RAY & FLUOROSCOPY|| 80001|70371||101.74|0|101.74|0||SPEECH EVALUATION - COMPLEX|| 80001|70371|26|50.18|0|50.18|0||SPEECH EVALUATION - COMPLEX|| 80001|70371|TC|51.56|0|51.56|0||SPEECH EVALUATION - COMPLEX|| 80001|70380||39.9|0|39.9|0||X-RAY EXAM OF SALIVARY GLAND|| 80001|70380|26|11.21|0|11.21|0||X-RAY EXAM OF SALIVARY GLAND|| 80001|70380|TC|28.69|0|28.69|0||X-RAY EXAM OF SALIVARY GLAND|| 80001|70390||103.61|0|103.61|0||X-RAY EXAM OF SALIVARY DUCT|| 80001|70390|26|22.59|0|22.59|0||X-RAY EXAM OF SALIVARY DUCT|| 80001|70390|TC|81.02|0|81.02|0||X-RAY EXAM OF SALIVARY DUCT|| 80001|70450||129.7|0|129.7|0||CT HEAD/BRAIN W/O DYE|| 80001|70450|26|50.62|0|50.62|0||CT HEAD/BRAIN W/O DYE|| 80001|70450|TC|79.08|0|79.08|0||CT HEAD/BRAIN W/O DYE|| 80001|70460||180.93|0|180.93|0||CT HEAD/BRAIN W/DYE|| 80001|70460|26|67.35|0|67.35|0||CT HEAD/BRAIN W/DYE|| 80001|70460|TC|113.58|0|113.58|0||CT HEAD/BRAIN W/DYE|| 80001|70470||213.71|0|213.71|0||CT HEAD/BRAIN W/O & W/DYE|| 80001|70470|26|75.71|0|75.71|0||CT HEAD/BRAIN W/O & W/DYE|| 80001|70470|TC|138.01|0|138.01|0||CT HEAD/BRAIN W/O & W/DYE|| 80001|70480||205.62|0|0|0||CT ORBIT/EAR/FOSSA W/O DYE|| 80001|70480|26|76.14|0|76.14|0||CT ORBIT/EAR/FOSSA W/O DYE|| 80001|70480|TC|129.48|0|0|0||CT ORBIT/EAR/FOSSA W/O DYE|| 80001|70481||305.29|0|305.29|0||CT ORBIT/EAR/FOSSA W/DYE|| 80001|70481|26|82|0|82|0||CT ORBIT/EAR/FOSSA W/DYE|| 80001|70481|TC|223.29|0|223.29|0||CT ORBIT/EAR/FOSSA W/DYE|| 80001|70482||333.9|0|333.9|0||CT ORBIT/EAR/FOSSA W/O&W/DYE|| 80001|70482|26|86.19|0|86.19|0||CT ORBIT/EAR/FOSSA W/O&W/DYE|| 80001|70482|TC|247.71|0|247.71|0||CT ORBIT/EAR/FOSSA W/O&W/DYE|| 80001|70486||155.67|0|155.67|0||CT MAXILLOFACIAL W/O DYE|| 80001|70486|26|50.62|0|50.62|0||CT MAXILLOFACIAL W/O DYE|| 80001|70486|TC|105.06|0|105.06|0||CT MAXILLOFACIAL W/O DYE|| 80001|70487||187.91|0|187.91|0||CT MAXILLOFACIAL W/DYE|| 80001|70487|26|67.35|0|67.35|0||CT MAXILLOFACIAL W/DYE|| 80001|70487|TC|120.56|0|120.56|0||CT MAXILLOFACIAL W/DYE|| 80001|70488||228.06|0|228.06|0||CT MAXILLOFACIAL W/O & W/DYE|| 80001|70488|26|75.32|0|75.32|0||CT MAXILLOFACIAL W/O & W/DYE|| 80001|70488|TC|152.74|0|152.74|0||CT MAXILLOFACIAL W/O & W/DYE|| 80001|70490||205.62|0|0|0||CT SOFT TISSUE NECK W/O DYE|| 80001|70490|26|76.14|0|76.14|0||CT SOFT TISSUE NECK W/O DYE|| 80001|70490|TC|129.48|0|0|0||CT SOFT TISSUE NECK W/O DYE|| 80001|70491||261.88|0|261.88|0||CT SOFT TISSUE NECK W/DYE|| 80001|70491|26|82.39|0|82.39|0||CT SOFT TISSUE NECK W/DYE|| 80001|70491|TC|179.48|0|179.48|0||CT SOFT TISSUE NECK W/DYE|| 80001|70492||307.92|0|307.92|0||CT SFT TSUE NCK W/O & W/DYE|| 80001|70492|26|86.19|0|86.19|0||CT SFT TSUE NCK W/O & W/DYE|| 80001|70492|TC|221.74|0|221.74|0||CT SFT TSUE NCK W/O & W/DYE|| 80001|70496||328.62|0|328.62|0||CT ANGIOGRAPHY - HEAD|| 80001|70496|26|104.56|0|104.56|0||CT ANGIOGRAPHY - HEAD|| 80001|70496|TC|224.07|0|224.07|0||CT ANGIOGRAPHY - HEAD|| 80001|70498||326.68|0|326.68|0||CT ANGIOGRAPHY - NECK|| 80001|70498|26|104.17|0|104.17|0||CT ANGIOGRAPHY - NECK|| 80001|70498|TC|222.52|0|222.52|0||CT ANGIOGRAPHY - NECK|| 80001|70540||388.51|0|0|0||MRI ORBIT/FACE/NECK W/O DYE|| 80001|70540|26|79.55|0|79.55|0||MRI ORBIT/FACE/NECK W/O DYE|| 80001|70540|TC|308.96|0|0|0||MRI ORBIT/FACE/NECK W/O DYE|| 80001|70542||444.74|0|444.74|0||MRI ORBIT/FACE/NECK W/DYE|| 80001|70542|26|96.62|0|96.62|0||MRI ORBIT/FACE/NECK W/DYE|| 80001|70542|TC|348.11|0|348.11|0||MRI ORBIT/FACE/NECK W/DYE|| 80001|70543||543.96|0|543.96|0||MRI ORBT/FAC/NCK W/O & W/DYE|| 80001|70543|26|127.62|0|127.62|0||MRI ORBT/FAC/NCK W/O & W/DYE|| 80001|70543|TC|416.34|0|416.34|0||MRI ORBT/FAC/NCK W/O & W/DYE|| 80001|70544||380.48|0|0|0||MR ANGIOGRAPHY HEAD W/O DYE|| 80001|70544|26|71.53|0|71.53|0||MR ANGIOGRAPHY HEAD W/O DYE|| 80001|70544|TC|308.96|0|0|0||MR ANGIOGRAPHY HEAD W/O DYE|| 80001|70545||424.68|0|424.68|0||MR ANGIOGRAPHY HEAD W/DYE|| 80001|70545|26|71.14|0|71.14|0||MR ANGIOGRAPHY HEAD W/DYE|| 80001|70545|TC|353.54|0|353.54|0||MR ANGIOGRAPHY HEAD W/DYE|| 80001|70546||628.49|0|0|0||MR ANGIOGRAPH HEAD W/O&W/DYE|| 80001|70546|26|107.49|0|107.49|0||MR ANGIOGRAPH HEAD W/O&W/DYE|| 80001|70546|TC|521|0|0|0||MR ANGIOGRAPH HEAD W/O&W/DYE|| 80001|70547||380.1|0|0|0||MR ANGIOGRAPHY NECK W/O DYE|| 80001|70547|26|71.14|0|71.14|0||MR ANGIOGRAPHY NECK W/O DYE|| 80001|70547|TC|308.96|0|0|0||MR ANGIOGRAPHY NECK W/O DYE|| 80001|70548||454.53|0|454.53|0||MR ANGIOGRAPHY NECK W/DYE|| 80001|70548|26|71.53|0|71.53|0||MR ANGIOGRAPHY NECK W/DYE|| 80001|70548|TC|383|0|383|0||MR ANGIOGRAPHY NECK W/DYE|| 80001|70549||628.49|0|0|0||MR ANGIOGRAPH NECK W/O&W/DYE|| 80001|70549|26|107.49|0|107.49|0||MR ANGIOGRAPH NECK W/O&W/DYE|| 80001|70549|TC|521|0|0|0||MR ANGIOGRAPH NECK W/O&W/DYE|| 80001|70551||256.11|0|256.11|0||MRI BRAIN W/O DYE|| 80001|70551|26|87.87|0|87.87|0||MRI BRAIN W/O DYE|| 80001|70551|TC|168.24|0|168.24|0||MRI BRAIN W/O DYE|| 80001|70552||355.5|0|355.5|0||MRI BRAIN W/DYE|| 80001|70552|26|106.62|0|106.62|0||MRI BRAIN W/DYE|| 80001|70552|TC|248.88|0|248.88|0||MRI BRAIN W/DYE|| 80001|70553||420.14|0|420.14|0||MRI BRAIN W/O & W/DYE|| 80001|70553|26|136.37|0|136.37|0||MRI BRAIN W/O & W/DYE|| 80001|70553|TC|283.76|0|283.76|0||MRI BRAIN W/O & W/DYE|| 80001|70554||499.6|0|499.6|0||FMRI BRAIN BY TECH|| 80001|70554|26|127.84|0|127.84|0||FMRI BRAIN BY TECH|| 80001|70554|TC|371.76|0|371.76|0||FMRI BRAIN BY TECH|| 80001|70555||0|0|0|0||FMRI BRAIN BY PHYS/PSYCH|| 80001|70555|26|155.32|0|155.32|0||FMRI BRAIN BY PHYS/PSYCH|| 80001|70555|TC|0|0|0|0||FMRI BRAIN BY PHYS/PSYCH|| 80001|70557||0|0|0|0||MRI BRAIN W/O DYE|| 80001|70557|26|178.61|0|178.61|0||MRI BRAIN W/O DYE|| 80001|70557|TC|0|0|0|0||MRI BRAIN W/O DYE|| 80001|70558||0|0|0|0||MRI BRAIN W/DYE|| 80001|70558|26|197.36|0|197.36|0||MRI BRAIN W/DYE|| 80001|70558|TC|0|0|0|0||MRI BRAIN W/DYE|| 80001|70559||0|0|0|0||MRI BRAIN W/O & W/DYE|| 80001|70559|26|197.75|0|197.75|0||MRI BRAIN W/O & W/DYE|| 80001|70559|TC|0|0|0|0||MRI BRAIN W/O & W/DYE|| 80001|71010||25.21|0|25.21|0||CHEST X-RAY|| 80001|71010|26|10.86|0|10.86|0||CHEST X-RAY|| 80001|71010|TC|14.35|0|14.35|0||CHEST X-RAY|| 80001|71015||30.77|0|30.77|0||CHEST X-RAY|| 80001|71015|26|12.93|0|12.93|0||CHEST X-RAY|| 80001|71015|TC|17.83|0|17.83|0||CHEST X-RAY|| 80001|71020||31.2|0|31.2|0||CHEST X-RAY|| 80001|71020|26|12.98|0|12.98|0||CHEST X-RAY|| 80001|71020|TC|18.22|0|18.22|0||CHEST X-RAY|| 80001|71021||38.01|0|38.01|0||CHEST X-RAY|| 80001|71021|26|16.3|0|16.3|0||CHEST X-RAY|| 80001|71021|TC|21.71|0|21.71|0||CHEST X-RAY|| 80001|71022||46.71|0|46.71|0||CHEST X-RAY|| 80001|71022|26|19.57|0|19.57|0||CHEST X-RAY|| 80001|71022|TC|27.14|0|27.14|0||CHEST X-RAY|| 80001|71023||70.67|0|70.67|0||CHEST X-RAY AND FLUOROSCOPY|| 80001|71023|26|22.98|0|22.98|0||CHEST X-RAY AND FLUOROSCOPY|| 80001|71023|TC|47.68|0|47.68|0||CHEST X-RAY AND FLUOROSCOPY|| 80001|71030||46.32|0|46.32|0||CHEST X-RAY|| 80001|71030|26|18.41|0|18.41|0||CHEST X-RAY|| 80001|71030|TC|27.91|0|27.91|0||CHEST X-RAY|| 80001|71034||93.5|0|93.5|0||CHEST X-RAY AND FLUOROSCOPY|| 80001|71034|26|27.59|0|27.59|0||CHEST X-RAY AND FLUOROSCOPY|| 80001|71034|TC|65.9|0|65.9|0||CHEST X-RAY AND FLUOROSCOPY|| 80001|71035||36.06|0|36.06|0||CHEST X-RAY|| 80001|71035|26|10.86|0|10.86|0||CHEST X-RAY|| 80001|71035|TC|25.2|0|25.2|0||CHEST X-RAY|| 80001|71045||22.68|0|22.68|0||X-RAY EXAM CHEST 1 VIEW|| 80001|71045|26|10.96|0|10.96|0||X-RAY EXAM CHEST 1 VIEW|| 80001|71045|TC|11.73|0|11.73|0||X-RAY EXAM CHEST 1 VIEW|| 80001|71046||34.32|0|34.32|||X-RAY EXAM CHEST 2 VIEWS|| 80001|71046|26|12.88|0|12.88|||X-RAY EXAM CHEST 2 VIEWS|| 80001|71046|TC|21.44|0|21.44|||X-RAY EXAM CHEST 2 VIEWS|| 80001|71047||44.05|0|44.05|0||X-RAY EXAM CHEST 3 VIEWS|| 80001|71047|26|16.79|0|16.79|0||X-RAY EXAM CHEST 3 VIEWS|| 80001|71047|TC|27.26|0|27.26|0||X-RAY EXAM CHEST 3 VIEWS|| 80001|71048||47.33|0|47.33|0||X-RAY EXAM CHEST 4+ VIEWS|| 80001|71048|26|19.29|0|19.29|0||X-RAY EXAM CHEST 4+ VIEWS|| 80001|71048|TC|28.04|0|28.04|0||X-RAY EXAM CHEST 4+ VIEWS|| 80001|71100||33.91|0|33.91|0||X-RAY EXAM OF RIBS|| 80001|71100|26|13.37|0|13.37|0||X-RAY EXAM OF RIBS|| 80001|71100|TC|20.55|0|20.55|0||X-RAY EXAM OF RIBS|| 80001|71101||40.33|0|40.33|0||X-RAY EXAM OF RIBS/CHEST|| 80001|71101|26|15.91|0|15.91|0||X-RAY EXAM OF RIBS/CHEST|| 80001|71101|TC|24.42|0|24.42|0||X-RAY EXAM OF RIBS/CHEST|| 80001|71110||41.5|0|41.5|0||X-RAY EXAM OF RIBS|| 80001|71110|26|16.3|0|16.3|0||X-RAY EXAM OF RIBS|| 80001|71110|TC|25.2|0|25.2|0||X-RAY EXAM OF RIBS|| 80001|71111||52.57|0|52.57|0||X-RAY EXAM OF RIBS/CHEST|| 80001|71111|26|19.23|0|19.23|0||X-RAY EXAM OF RIBS/CHEST|| 80001|71111|TC|33.34|0|33.34|0||X-RAY EXAM OF RIBS/CHEST|| 80001|71120||32.66|0|32.66|0||X-RAY EXAM OF BREASTBONE|| 80001|71120|26|12.12|0|12.12|0||X-RAY EXAM OF BREASTBONE|| 80001|71120|TC|20.55|0|20.55|0||X-RAY EXAM OF BREASTBONE|| 80001|71130||40.12|0|40.12|0||X-RAY EXAM OF BREASTBONE|| 80001|71130|26|13.75|0|13.75|0||X-RAY EXAM OF BREASTBONE|| 80001|71130|TC|26.36|0|26.36|0||X-RAY EXAM OF BREASTBONE|| 80001|71250||190.14|0|0|0||CT THORAX W/O DYE|| 80001|71250|26|60.66|0|60.66|0||CT THORAX W/O DYE|| 80001|71250|TC|129.48|0|0|0||CT THORAX W/O DYE|| 80001|71260||254.29|0|254.29|0||CT THORAX W/DYE|| 80001|71260|26|74.03|0|74.03|0||CT THORAX W/DYE|| 80001|71260|TC|180.26|0|180.26|0||CT THORAX W/DYE|| 80001|71270||304.52|0|304.52|0||CT THORAX W/O & W/DYE|| 80001|71270|26|82|0|82|0||CT THORAX W/O & W/DYE|| 80001|71270|TC|222.51|0|222.51|0||CT THORAX W/O & W/DYE|| 80001|71275||333.97|0|333.97|0||CT ANGIOGRAPHY - CHEST|| 80001|71275|26|108.74|0|108.74|0||CT ANGIOGRAPHY - CHEST|| 80001|71275|TC|225.23|0|225.23|0||CT ANGIOGRAPHY - CHEST|| 80001|71550||395.58|0|0|0||MRI CHEST W/O DYE|| 80001|71550|26|86.62|0|86.62|0||MRI CHEST W/O DYE|| 80001|71550|TC|308.96|0|0|0||MRI CHEST W/O DYE|| 80001|71551||504.92|0|504.92|0||MRI CHEST W/DYE|| 80001|71551|26|103.31|0|103.31|0||MRI CHEST W/DYE|| 80001|71551|TC|401.61|0|401.61|0||MRI CHEST W/DYE|| 80001|71552||640.2|0|640.2|0||MRI CHEST W/O & W/DYE|| 80001|71552|26|135.47|0|135.47|0||MRI CHEST W/O & W/DYE|| 80001|71552|TC|504.73|0|504.73|0||MRI CHEST W/O & W/DYE|| 80001|71555||440.53|0|440.53|0||MRI ANGIO CHEST W OR W/O DYE|| 80001|71555|26|107.14|0|107.14|0||MRI ANGIO CHEST W OR W/O DYE|| 80001|71555|TC|333.38|0|333.38|0||MRI ANGIO CHEST W OR W/O DYE|| 80001|72020||24.3|0|24.3|0||X-RAY EXAM OF SPINE|| 80001|72020|26|9.18|0|9.18|0||X-RAY EXAM OF SPINE|| 80001|72020|TC|15.12|0|15.12|0||X-RAY EXAM OF SPINE|| 80001|72040||37.02|0|37.02|0||X-RAY EXAM OF NECK SPINE|| 80001|72040|26|13.75|0|13.75|0||X-RAY EXAM OF NECK SPINE|| 80001|72040|TC|23.26|0|23.26|0||X-RAY EXAM OF NECK SPINE|| 80001|72050||49.81|0|49.81|0||X-RAY EXAM OF NECK SPINE|| 80001|72050|26|18.8|0|18.8|0||X-RAY EXAM OF NECK SPINE|| 80001|72050|TC|31.01|0|31.01|0||X-RAY EXAM OF NECK SPINE|| 80001|72052||62.44|0|62.44|0||X-RAY EXAM OF NECK SPINE|| 80001|72052|26|22.12|0|22.12|0||X-RAY EXAM OF NECK SPINE|| 80001|72052|TC|40.32|0|40.32|0||X-RAY EXAM OF NECK SPINE|| 80001|72070||35.08|0|35.08|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72070|26|13.75|0|13.75|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72070|TC|21.32|0|21.32|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72072||38.18|0|38.18|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72072|26|12.98|0|12.98|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72072|TC|25.2|0|25.2|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72074||43.22|0|43.22|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72074|26|12.98|0|12.98|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72074|TC|30.24|0|30.24|0||X-RAY EXAM OF THORACIC SPINE|| 80001|72080||37.41|0|37.41|0||X-RAY EXAM OF TRUNK SPINE|| 80001|72080|26|14.14|0|14.14|0||X-RAY EXAM OF TRUNK SPINE|| 80001|72080|TC|23.26|0|23.26|0||X-RAY EXAM OF TRUNK SPINE|| 80001|72081||43.24|0|43.24|0||X-RAY EXAM ENTIRE SPI 1 VW|| 80001|72081|26|15.81|0|15.81|0||X-RAY EXAM ENTIRE SPI 1 VW|| 80001|72081|TC|27.43|0|27.43|0||X-RAY EXAM ENTIRE SPI 1 VW|| 80001|72082||68.95|0|68.95|0||X-RAY EXAM ENTIRE SPI 2/3 VW|| 80001|72082|26|19.12|0|19.12|0||X-RAY EXAM ENTIRE SPI 2/3 VW|| 80001|72082|TC|49.83|0|49.83|0||X-RAY EXAM ENTIRE SPI 2/3 VW|| 80001|72083||74.91|0|74.91|0||X-RAY EXAM ENTIRE SPI 4/5 VW|| 80001|72083|26|20.84|0|20.84|0||X-RAY EXAM ENTIRE SPI 4/5 VW|| 80001|72083|TC|54.08|0|54.08|0||X-RAY EXAM ENTIRE SPI 4/5 VW|| 80001|72084||89.47|0|89.47|0||X-RAY EXAM ENTIRE SPI 6/> VW|| 80001|72084|26|24.19|0|24.19|0||X-RAY EXAM ENTIRE SPI 6/> VW|| 80001|72084|TC|65.28|0|65.28|0||X-RAY EXAM ENTIRE SPI 6/> VW|| 80001|72100||38.95|0|38.95|0||X-RAY EXAM OF LOWER SPINE|| 80001|72100|26|13.75|0|13.75|0||X-RAY EXAM OF LOWER SPINE|| 80001|72100|TC|25.2|0|25.2|0||X-RAY EXAM OF LOWER SPINE|| 80001|72110||54.47|0|54.47|0||X-RAY EXAM OF LOWER SPINE|| 80001|72110|26|19.19|0|19.19|0||X-RAY EXAM OF LOWER SPINE|| 80001|72110|TC|35.28|0|35.28|0||X-RAY EXAM OF LOWER SPINE|| 80001|72114||69.24|0|69.24|0||X-RAY EXAM OF LOWER SPINE|| 80001|72114|26|20.01|0|20.01|0||X-RAY EXAM OF LOWER SPINE|| 80001|72114|TC|49.23|0|49.23|0||X-RAY EXAM OF LOWER SPINE|| 80001|72120||44.77|0|44.77|0||X-RAY EXAM OF LOWER SPINE|| 80001|72120|26|14.14|0|14.14|0||X-RAY EXAM OF LOWER SPINE|| 80001|72120|TC|30.63|0|30.63|0||X-RAY EXAM OF LOWER SPINE|| 80001|72125||193.07|0|0|0||CT NECK SPINE W/O DYE|| 80001|72125|26|63.59|0|63.59|0||CT NECK SPINE W/O DYE|| 80001|72125|TC|129.48|0|0|0||CT NECK SPINE W/O DYE|| 80001|72126||254.2|0|254.2|0||CT NECK SPINE W/DYE|| 80001|72126|26|72.78|0|72.78|0||CT NECK SPINE W/DYE|| 80001|72126|TC|181.42|0|181.42|0||CT NECK SPINE W/DYE|| 80001|72127||299|0|299|0||CT NECK SPINE W/O & W/DYE|| 80001|72127|26|75.32|0|75.32|0||CT NECK SPINE W/O & W/DYE|| 80001|72127|TC|223.68|0|223.68|0||CT NECK SPINE W/O & W/DYE|| 80001|72128||188.89|0|0|0||CT CHEST SPINE W/O DYE|| 80001|72128|26|59.41|0|59.41|0||CT CHEST SPINE W/O DYE|| 80001|72128|TC|129.48|0|0|0||CT CHEST SPINE W/O DYE|| 80001|72129||254.2|0|254.2|0||CT CHEST SPINE W/DYE|| 80001|72129|26|72.39|0|72.39|0||CT CHEST SPINE W/DYE|| 80001|72129|TC|181.81|0|181.81|0||CT CHEST SPINE W/DYE|| 80001|72130||299.39|0|299.39|0||CT CHEST SPINE W/O & W/DYE|| 80001|72130|26|75.32|0|75.32|0||CT CHEST SPINE W/O & W/DYE|| 80001|72130|TC|224.06|0|224.06|0||CT CHEST SPINE W/O & W/DYE|| 80001|72131||188.89|0|0|0||CT LUMBAR SPINE W/O DYE|| 80001|72131|26|59.41|0|59.41|0||CT LUMBAR SPINE W/O DYE|| 80001|72131|TC|129.48|0|0|0||CT LUMBAR SPINE W/O DYE|| 80001|72132||253.43|0|253.43|0||CT LUMBAR SPINE W/DYE|| 80001|72132|26|72.78|0|72.78|0||CT LUMBAR SPINE W/DYE|| 80001|72132|TC|180.65|0|180.65|0||CT LUMBAR SPINE W/DYE|| 80001|72133||299.39|0|299.39|0||CT LUMBAR SPINE W/O & W/DYE|| 80001|72133|26|75.71|0|75.71|0||CT LUMBAR SPINE W/O & W/DYE|| 80001|72133|TC|223.68|0|223.68|0||CT LUMBAR SPINE W/O & W/DYE|| 80001|72141||248.74|0|248.74|0||MRI NECK SPINE W/O DYE|| 80001|72141|26|87.87|0|87.87|0||MRI NECK SPINE W/O DYE|| 80001|72141|TC|160.88|0|160.88|0||MRI NECK SPINE W/O DYE|| 80001|72142||359.37|0|359.37|0||MRI NECK SPINE W/DYE|| 80001|72142|26|106.62|0|106.62|0||MRI NECK SPINE W/DYE|| 80001|72142|TC|252.75|0|252.75|0||MRI NECK SPINE W/DYE|| 80001|72146||248.74|0|248.74|0||MRI CHEST SPINE W/O DYE|| 80001|72146|26|87.87|0|87.87|0||MRI CHEST SPINE W/O DYE|| 80001|72146|TC|160.88|0|160.88|0||MRI CHEST SPINE W/O DYE|| 80001|72147||357.05|0|357.05|0||MRI CHEST SPINE W/DYE|| 80001|72147|26|106.62|0|106.62|0||MRI CHEST SPINE W/DYE|| 80001|72147|TC|250.42|0|250.42|0||MRI CHEST SPINE W/DYE|| 80001|72148||247.58|0|247.58|0||MRI LUMBAR SPINE W/O DYE|| 80001|72148|26|88.25|0|88.25|0||MRI LUMBAR SPINE W/O DYE|| 80001|72148|TC|159.33|0|159.33|0||MRI LUMBAR SPINE W/O DYE|| 80001|72149||355.11|0|355.11|0||MRI LUMBAR SPINE W/DYE|| 80001|72149|26|106.62|0|106.62|0||MRI LUMBAR SPINE W/DYE|| 80001|72149|TC|248.49|0|248.49|0||MRI LUMBAR SPINE W/DYE|| 80001|72156||422.46|0|422.46|0||MRI NECK SPINE W/O & W/DYE|| 80001|72156|26|136.37|0|136.37|0||MRI NECK SPINE W/O & W/DYE|| 80001|72156|TC|286.09|0|286.09|0||MRI NECK SPINE W/O & W/DYE|| 80001|72157||423.63|0|423.63|0||MRI CHEST SPINE W/O & W/DYE|| 80001|72157|26|137.15|0|137.15|0||MRI CHEST SPINE W/O & W/DYE|| 80001|72157|TC|286.48|0|286.48|0||MRI CHEST SPINE W/O & W/DYE|| 80001|72158||421.31|0|421.31|0||MRI LUMBAR SPINE W/O & W/DYE|| 80001|72158|26|137.15|0|137.15|0||MRI LUMBAR SPINE W/O & W/DYE|| 80001|72158|TC|284.15|0|284.15|0||MRI LUMBAR SPINE W/O & W/DYE|| 80001|72159||461.81|0|461.81|0||MR ANGIO SPINE W/O&W/DYE|| 80001|72159|26|108.65|0|108.65|0||MR ANGIO SPINE W/O&W/DYE|| 80001|72159|TC|353.15|0|353.15|0||MR ANGIO SPINE W/O&W/DYE|| 80001|72170||30.6|0|30.6|0||X-RAY EXAM OF PELVIS|| 80001|72170|26|10.82|0|10.82|0||X-RAY EXAM OF PELVIS|| 80001|72170|TC|19.77|0|19.77|0||X-RAY EXAM OF PELVIS|| 80001|72190||42.4|0|42.4|0||X-RAY EXAM OF PELVIS|| 80001|72190|26|13.32|0|13.32|0||X-RAY EXAM OF PELVIS|| 80001|72190|TC|29.08|0|29.08|0||X-RAY EXAM OF PELVIS|| 80001|72191||338.57|0|338.57|0||CT ANGIOGRAPH PELV W/O&W/DYE|| 80001|72191|26|107.53|0|107.53|0||CT ANGIOGRAPH PELV W/O&W/DYE|| 80001|72191|TC|231.04|0|231.04|0||CT ANGIOGRAPH PELV W/O&W/DYE|| 80001|72192||163.7|0|163.7|0||CT PELVIS W/O DYE|| 80001|72192|26|64.84|0|64.84|0||CT PELVIS W/O DYE|| 80001|72192|TC|98.85|0|98.85|0||CT PELVIS W/O DYE|| 80001|72193||250.06|0|250.06|0||CT PELVIS W/DYE|| 80001|72193|26|69.03|0|69.03|0||CT PELVIS W/DYE|| 80001|72193|TC|181.03|0|181.03|0||CT PELVIS W/DYE|| 80001|72194||287.93|0|287.93|0||CT PELVIS W/O & W/DYE|| 80001|72194|26|72.39|0|72.39|0||CT PELVIS W/O & W/DYE|| 80001|72194|TC|215.54|0|215.54|0||CT PELVIS W/O & W/DYE|| 80001|72195||395.96|0|0|0||MRI PELVIS W/O DYE|| 80001|72195|26|87|0|87|0||MRI PELVIS W/O DYE|| 80001|72195|TC|308.96|0|0|0||MRI PELVIS W/O DYE|| 80001|72196||454.52|0|454.52|0||MRI PELVIS W/DYE|| 80001|72196|26|103.69|0|103.69|0||MRI PELVIS W/DYE|| 80001|72196|TC|350.83|0|350.83|0||MRI PELVIS W/DYE|| 80001|72197||559.95|0|559.95|0||MRI PELVIS W/O & W/DYE|| 80001|72197|26|135.47|0|135.47|0||MRI PELVIS W/O & W/DYE|| 80001|72197|TC|424.48|0|424.48|0||MRI PELVIS W/O & W/DYE|| 80001|72198||444.75|0|444.75|0||MR ANGIO PELVIS W/O & W/DYE|| 80001|72198|26|106.71|0|106.71|0||MR ANGIO PELVIS W/O & W/DYE|| 80001|72198|TC|338.04|0|338.04|0||MR ANGIO PELVIS W/O & W/DYE|| 80001|72200||31.37|0|31.37|0||X-RAY EXAM SACROILIAC JOINTS|| 80001|72200|26|10.43|0|10.43|0||X-RAY EXAM SACROILIAC JOINTS|| 80001|72200|TC|20.94|0|20.94|0||X-RAY EXAM SACROILIAC JOINTS|| 80001|72202||36.5|0|36.5|0||X-RAY EXAM SACROILIAC JOINTS|| 80001|72202|26|11.3|0|11.3|0||X-RAY EXAM SACROILIAC JOINTS|| 80001|72202|TC|25.2|0|25.2|0||X-RAY EXAM SACROILIAC JOINTS|| 80001|72220||30.98|0|30.98|0||X-RAY EXAM OF TAILBONE|| 80001|72220|26|10.43|0|10.43|0||X-RAY EXAM OF TAILBONE|| 80001|72220|TC|20.55|0|20.55|0||X-RAY EXAM OF TAILBONE|| 80001|72240||110.97|0|110.97|0||CONTRAST X-RAY OF NECK SPINE|| 80001|72240|26|54.76|0|54.76|0||CONTRAST X-RAY OF NECK SPINE|| 80001|72240|TC|56.21|0|56.21|0||CONTRAST X-RAY OF NECK SPINE|| 80001|72255||110.19|0|110.19|0||CONTRAST X-RAY - THORAX SPINE|| 80001|72255|26|54.76|0|54.76|0||CONTRAST X-RAY - THORAX SPINE|| 80001|72255|TC|55.44|0|55.44|0||CONTRAST X-RAY - THORAX SPINE|| 80001|72265||103.64|0|103.64|0||CONTRAST X-RAY - LOWER SPINE|| 80001|72265|26|49.76|0|49.76|0||CONTRAST X-RAY - LOWER SPINE|| 80001|72265|TC|53.89|0|53.89|0||CONTRAST X-RAY - LOWER SPINE|| 80001|72270||144.2|0|144.2|0||CONTRAST X-RAY - SPINE|| 80001|72270|26|79.46|0|79.46|0||CONTRAST X-RAY - SPINE|| 80001|72270|TC|64.74|0|64.74|0||CONTRAST X-RAY - SPINE|| 80001|72275||128.92|0|128.92|0||EPIDUROGRAPHY|| 80001|72275|26|46.74|0|46.74|0||EPIDUROGRAPHY|| 80001|72275|TC|82.18|0|82.18|0||EPIDUROGRAPHY|| 80001|72285||129.51|0|129.51|0||X-RAY C/T SPINE DISK|| 80001|72285|26|72.52|0|72.52|0||X-RAY C/T SPINE DISK|| 80001|72285|TC|56.99|0|56.99|0||X-RAY C/T SPINE DISK|| 80001|72295||110.23|0|110.23|0||X-RAY OF LOWER SPINE DISK|| 80001|72295|26|50.92|0|50.92|0||X-RAY OF LOWER SPINE DISK|| 80001|72295|TC|59.31|0|59.31|0||X-RAY OF LOWER SPINE DISK|| 80001|73000||30.94|0|30.94|0||X-RAY EXAM OF COLLAR BONE|| 80001|73000|26|10.39|0|10.39|0||X-RAY EXAM OF COLLAR BONE|| 80001|73000|TC|20.55|0|20.55|0||X-RAY EXAM OF COLLAR BONE|| 80001|73010||33.31|0|33.31|0||X-RAY EXAM OF SHOULDER BLADE|| 80001|73010|26|11.21|0|11.21|0||X-RAY EXAM OF SHOULDER BLADE|| 80001|73010|TC|22.1|0|22.1|0||X-RAY EXAM OF SHOULDER BLADE|| 80001|73020||25.86|0|25.86|0||X-RAY EXAM OF SHOULDER|| 80001|73020|26|9.57|0|9.57|0||X-RAY EXAM OF SHOULDER|| 80001|73020|TC|16.28|0|16.28|0||X-RAY EXAM OF SHOULDER|| 80001|73030||32.19|0|32.19|0||X-RAY EXAM OF SHOULDER|| 80001|73030|26|11.64|0|11.64|0||X-RAY EXAM OF SHOULDER|| 80001|73030|TC|20.55|0|20.55|0||X-RAY EXAM OF SHOULDER|| 80001|73040||111.68|0|111.68|0||CONTRAST X-RAY OF SHOULDER|| 80001|73040|26|32.98|0|32.98|0||CONTRAST X-RAY OF SHOULDER|| 80001|73040|TC|78.7|0|78.7|0||CONTRAST X-RAY OF SHOULDER|| 80001|73050||39.64|0|39.64|0||X-RAY EXAM OF SHOULDERS|| 80001|73050|26|12.89|0|12.89|0||X-RAY EXAM OF SHOULDERS|| 80001|73050|TC|26.75|0|26.75|0||X-RAY EXAM OF SHOULDERS|| 80001|73060||29.82|0|29.82|0||X-RAY EXAM OF HUMERUS|| 80001|73060|26|10.82|0|10.82|0||X-RAY EXAM OF HUMERUS|| 80001|73060|TC|19|0|19|0||X-RAY EXAM OF HUMERUS|| 80001|73070||30.51|0|30.51|0||X-RAY EXAM OF ELBOW|| 80001|73070|26|9.96|0|9.96|0||X-RAY EXAM OF ELBOW|| 80001|73070|TC|20.55|0|20.55|0||X-RAY EXAM OF ELBOW|| 80001|73080||34.86|0|34.86|0||X-RAY EXAM OF ELBOW|| 80001|73080|26|10.82|0|10.82|0||X-RAY EXAM OF ELBOW|| 80001|73080|TC|24.04|0|24.04|0||X-RAY EXAM OF ELBOW|| 80001|73085||109.35|0|109.35|0||CONTRAST X-RAY OF ELBOW|| 80001|73085|26|33.76|0|33.76|0||CONTRAST X-RAY OF ELBOW|| 80001|73085|TC|75.59|0|75.59|0||CONTRAST X-RAY OF ELBOW|| 80001|73090||28.61|0|28.61|0||X-RAY EXAM OF FOREARM|| 80001|73090|26|10|0|10|0||X-RAY EXAM OF FOREARM|| 80001|73090|TC|18.61|0|18.61|0||X-RAY EXAM OF FOREARM|| 80001|73092||30.16|0|30.16|0||X-RAY EXAM OF ARM - INFANT|| 80001|73092|26|9.61|0|9.61|0||X-RAY EXAM OF ARM - INFANT|| 80001|73092|TC|20.55|0|20.55|0||X-RAY EXAM OF ARM - INFANT|| 80001|73100||32.49|0|32.49|0||X-RAY EXAM OF WRIST|| 80001|73100|26|10.39|0|10.39|0||X-RAY EXAM OF WRIST|| 80001|73100|TC|22.1|0|22.1|0||X-RAY EXAM OF WRIST|| 80001|73110||39.12|0|39.12|0||X-RAY EXAM OF WRIST|| 80001|73110|26|10.82|0|10.82|0||X-RAY EXAM OF WRIST|| 80001|73110|TC|28.3|0|28.3|0||X-RAY EXAM OF WRIST|| 80001|73115||118.66|0|118.66|0||CONTRAST X-RAY OF WRIST|| 80001|73115|26|33.76|0|33.76|0||CONTRAST X-RAY OF WRIST|| 80001|73115|TC|84.9|0|84.9|0||CONTRAST X-RAY OF WRIST|| 80001|73120||29|0|29|0||X-RAY EXAM OF HAND|| 80001|73120|26|10|0|10|0||X-RAY EXAM OF HAND|| 80001|73120|TC|19|0|19|0||X-RAY EXAM OF HAND|| 80001|73130||33.69|0|33.69|0||X-RAY EXAM OF HAND|| 80001|73130|26|10.43|0|10.43|0||X-RAY EXAM OF HAND|| 80001|73130|TC|23.26|0|23.26|0||X-RAY EXAM OF HAND|| 80001|73140||34.3|0|34.3|0||X-RAY EXAM OF FINGER(S)|| 80001|73140|26|8.32|0|8.32|0||X-RAY EXAM OF FINGER(S)|| 80001|73140|TC|25.97|0|25.97|0||X-RAY EXAM OF FINGER(S)|| 80001|73200||188.89|0|0|0||CT UPPER EXTREMITY W/O DYE|| 80001|73200|26|59.41|0|59.41|0||CT UPPER EXTREMITY W/O DYE|| 80001|73200|TC|129.48|0|0|0||CT UPPER EXTREMITY W/O DYE|| 80001|73201||246.57|0|246.57|0||CT UPPER EXTREMITY W/DYE|| 80001|73201|26|69.03|0|69.03|0||CT UPPER EXTREMITY W/DYE|| 80001|73201|TC|177.55|0|177.55|0||CT UPPER EXTREMITY W/DYE|| 80001|73202||306.92|0|306.92|0||CT UPPR EXTREMITY W/O&W/DYE|| 80001|73202|26|72.39|0|72.39|0||CT UPPR EXTREMITY W/O&W/DYE|| 80001|73202|TC|234.53|0|234.53|0||CT UPPR EXTREMITY W/O&W/DYE|| 80001|73206||362.61|0|362.61|0||CT ANGIO UPR EXTRM W/O&W/DYE|| 80001|73206|26|107.14|0|107.14|0||CT ANGIO UPR EXTRM W/O&W/DYE|| 80001|73206|TC|255.47|0|255.47|0||CT ANGIO UPR EXTRM W/O&W/DYE|| 80001|73218||388.9|0|0|0||MRI UPPER EXTREMITY W/O DYE|| 80001|73218|26|79.93|0|79.93|0||MRI UPPER EXTREMITY W/O DYE|| 80001|73218|TC|308.96|0|0|0||MRI UPPER EXTREMITY W/O DYE|| 80001|73219||445.9|0|445.9|0||MRI UPPER EXTREMITY W/DYE|| 80001|73219|26|97.4|0|97.4|0||MRI UPPER EXTREMITY W/DYE|| 80001|73219|TC|348.5|0|348.5|0||MRI UPPER EXTREMITY W/DYE|| 80001|73220||552.1|0|552.1|0||MRI UPPR EXTREMITY W/O&W/DYE|| 80001|73220|26|128.4|0|128.4|0||MRI UPPR EXTREMITY W/O&W/DYE|| 80001|73220|TC|423.71|0|423.71|0||MRI UPPR EXTREMITY W/O&W/DYE|| 80001|73221||261.75|0|261.75|0||MRI JOINT UPR EXTREM W/O DYE|| 80001|73221|26|81.1|0|81.1|0||MRI JOINT UPR EXTREM W/O DYE|| 80001|73221|TC|180.65|0|180.65|0||MRI JOINT UPR EXTREM W/O DYE|| 80001|73222||418.37|0|418.37|0||MRI JOINT UPR EXTREM W/DYE|| 80001|73222|26|97.01|0|97.01|0||MRI JOINT UPR EXTREM W/DYE|| 80001|73222|TC|321.36|0|321.36|0||MRI JOINT UPR EXTREM W/DYE|| 80001|73223||519.15|0|519.15|0||MRI JOINT UPR EXTR W/O&W/DYE|| 80001|73223|26|128.4|0|128.4|0||MRI JOINT UPR EXTR W/O&W/DYE|| 80001|73223|TC|390.76|0|390.76|0||MRI JOINT UPR EXTR W/O&W/DYE|| 80001|73225||446.38|0|446.38|0||MR ANGIO UPR EXTR W/O&W/DYE|| 80001|73225|26|101.76|0|101.76|0||MR ANGIO UPR EXTR W/O&W/DYE|| 80001|73225|TC|344.63|0|344.63|0||MR ANGIO UPR EXTR W/O&W/DYE|| 80001|73501||32.84|0|32.84|0||X-RAY EXAM HIP UNI 1 VIEW|| 80001|73501|26|11.21|0|11.21|0||X-RAY EXAM HIP UNI 1 VIEW|| 80001|73501|TC|21.63|0|21.63|0||X-RAY EXAM HIP UNI 1 VIEW|| 80001|73502||45.76|0|45.76|0||X-RAY EXAM HIP UNI 2-3 VIEWS|| 80001|73502|26|13.32|0|13.32|0||X-RAY EXAM HIP UNI 2-3 VIEWS|| 80001|73502|TC|32.45|0|32.45|0||X-RAY EXAM HIP UNI 2-3 VIEWS|| 80001|73503||57.19|0|57.19|0||X-RAY EXAM HIP UNI 4/> VIEWS|| 80001|73503|26|17.01|0|17.01|0||X-RAY EXAM HIP UNI 4/> VIEWS|| 80001|73503|TC|40.17|0|40.17|0||X-RAY EXAM HIP UNI 4/> VIEWS|| 80001|73521||43.83|0|43.83|0||X-RAY EXAM HIPS BI 2 VIEWS|| 80001|73521|26|13.7|0|13.7|0||X-RAY EXAM HIPS BI 2 VIEWS|| 80001|73521|TC|30.13|0|30.13|0||X-RAY EXAM HIPS BI 2 VIEWS|| 80001|73522||54.18|0|54.18|0||X-RAY EXAM HIPS BI 3-4 VIEWS|| 80001|73522|26|17.87|0|17.87|0||X-RAY EXAM HIPS BI 3-4 VIEWS|| 80001|73522|TC|36.31|0|36.31|0||X-RAY EXAM HIPS BI 3-4 VIEWS|| 80001|73523||62.77|0|62.77|0||X-RAY EXAM HIPS BI 5/> VIEWS|| 80001|73523|26|19.12|0|19.12|0||X-RAY EXAM HIPS BI 5/> VIEWS|| 80001|73523|TC|43.65|0|43.65|0||X-RAY EXAM HIPS BI 5/> VIEWS|| 80001|73525||112.84|0|112.84|0||CONTRAST X-RAY OF HIP|| 80001|73525|26|34.15|0|34.15|0||CONTRAST X-RAY OF HIP|| 80001|73525|TC|78.7|0|78.7|0||CONTRAST X-RAY OF HIP|| 80001|73551||30.83|0|30.83|0||X-RAY EXAM OF FEMUR 1|| 80001|73551|26|9.97|0|9.97|0||X-RAY EXAM OF FEMUR 1|| 80001|73551|TC|20.86|0|20.86|0||X-RAY EXAM OF FEMUR 1|| 80001|73552||35.93|0|35.93|0||X-RAY EXAM OF FEMUR 2/>|| 80001|73552|26|11.21|0|11.21|0||X-RAY EXAM OF FEMUR 2/>|| 80001|73552|TC|24.72|0|24.72|0||X-RAY EXAM OF FEMUR 2/>|| 80001|73560||32.53|0|32.53|0||X-RAY EXAM OF KNEE - 1 OR 2|| 80001|73560|26|11.21|0|11.21|0||X-RAY EXAM OF KNEE - 1 OR 2|| 80001|73560|TC|21.32|0|21.32|0||X-RAY EXAM OF KNEE - 1 OR 2|| 80001|73562||38|0|38|0||X-RAY EXAM OF KNEE - 3|| 80001|73562|26|11.64|0|11.64|0||X-RAY EXAM OF KNEE - 3|| 80001|73562|TC|26.36|0|26.36|0||X-RAY EXAM OF KNEE - 3|| 80001|73564||44.38|0|44.38|0||X-RAY EXAM - KNEE - 4 OR MORE|| 80001|73564|26|14.14|0|14.14|0||X-RAY EXAM - KNEE - 4 OR MORE|| 80001|73564|TC|30.24|0|30.24|0||X-RAY EXAM - KNEE - 4 OR MORE|| 80001|73565||36.41|0|36.41|0||X-RAY EXAM OF KNEES|| 80001|73565|26|11.21|0|11.21|0||X-RAY EXAM OF KNEES|| 80001|73565|TC|25.2|0|25.2|0||X-RAY EXAM OF KNEES|| 80001|73580||127.18|0|127.18|0||CONTRAST X-RAY OF KNEE JOINT|| 80001|73580|26|33.37|0|33.37|0||CONTRAST X-RAY OF KNEE JOINT|| 80001|73580|TC|93.81|0|93.81|0||CONTRAST X-RAY OF KNEE JOINT|| 80001|73590||29.43|0|29.43|0||X-RAY EXAM OF LOWER LEG|| 80001|73590|26|10.43|0|10.43|0||X-RAY EXAM OF LOWER LEG|| 80001|73590|TC|19|0|19|0||X-RAY EXAM OF LOWER LEG|| 80001|73592||30.16|0|30.16|0||X-RAY EXAM OF LEG - INFANT|| 80001|73592|26|9.61|0|9.61|0||X-RAY EXAM OF LEG - INFANT|| 80001|73592|TC|20.55|0|20.55|0||X-RAY EXAM OF LEG - INFANT|| 80001|73600||30.16|0|30.16|0||X-RAY EXAM OF ANKLE|| 80001|73600|26|10|0|10|0||X-RAY EXAM OF ANKLE|| 80001|73600|TC|20.16|0|20.16|0||X-RAY EXAM OF ANKLE|| 80001|73610||34.86|0|34.86|0||X-RAY EXAM OF ANKLE|| 80001|73610|26|10.82|0|10.82|0||X-RAY EXAM OF ANKLE|| 80001|73610|TC|24.04|0|24.04|0||X-RAY EXAM OF ANKLE|| 80001|73615||109.74|0|109.74|0||CONTRAST X-RAY OF ANKLE|| 80001|73615|26|34.54|0|34.54|0||CONTRAST X-RAY OF ANKLE|| 80001|73615|TC|75.21|0|75.21|0||CONTRAST X-RAY OF ANKLE|| 80001|73620||28.61|0|28.61|0||X-RAY EXAM OF FOOT|| 80001|73620|26|9.23|0|9.23|0||X-RAY EXAM OF FOOT|| 80001|73620|TC|19.38|0|19.38|0||X-RAY EXAM OF FOOT|| 80001|73630||32.14|0|32.14|0||X-RAY EXAM OF FOOT|| 80001|73630|26|10.05|0|10.05|0||X-RAY EXAM OF FOOT|| 80001|73630|TC|22.1|0|22.1|0||X-RAY EXAM OF FOOT|| 80001|73650||29.77|0|29.77|0||X-RAY EXAM OF HEEL|| 80001|73650|26|9.61|0|9.61|0||X-RAY EXAM OF HEEL|| 80001|73650|TC|20.16|0|20.16|0||X-RAY EXAM OF HEEL|| 80001|73660||30.81|0|30.81|0||X-RAY EXAM OF TOE(S)|| 80001|73660|26|7.93|0|7.93|0||X-RAY EXAM OF TOE(S)|| 80001|73660|TC|22.87|0|22.87|0||X-RAY EXAM OF TOE(S)|| 80001|73700||188.89|0|0|0||CT LOWER EXTREMITY W/O DYE|| 80001|73700|26|59.41|0|59.41|0||CT LOWER EXTREMITY W/O DYE|| 80001|73700|TC|129.48|0|0|0||CT LOWER EXTREMITY W/O DYE|| 80001|73701||250.06|0|250.06|0||CT LOWER EXTREMITY W/DYE|| 80001|73701|26|69.03|0|69.03|0||CT LOWER EXTREMITY W/DYE|| 80001|73701|TC|181.03|0|181.03|0||CT LOWER EXTREMITY W/DYE|| 80001|73702||301.88|0|301.88|0||CT LWR EXTREMITY W/O&W/DYE|| 80001|73702|26|71.61|0|71.61|0||CT LWR EXTREMITY W/O&W/DYE|| 80001|73702|TC|230.27|0|230.27|0||CT LWR EXTREMITY W/O&W/DYE|| 80001|73706||389.75|0|389.75|0||CT ANGIO LWR EXTR W/O&W/DYE|| 80001|73706|26|112.18|0|112.18|0||CT ANGIO LWR EXTR W/O&W/DYE|| 80001|73706|TC|277.56|0|277.56|0||CT ANGIO LWR EXTR W/O&W/DYE|| 80001|73718||388.9|0|0|0||MRI LOWER EXTREMITY W/O DYE|| 80001|73718|26|79.93|0|79.93|0||MRI LOWER EXTREMITY W/O DYE|| 80001|73718|TC|308.96|0|0|0||MRI LOWER EXTREMITY W/O DYE|| 80001|73719||446.67|0|446.67|0||MRI LOWER EXTREMITY W/DYE|| 80001|73719|26|96.62|0|96.62|0||MRI LOWER EXTREMITY W/DYE|| 80001|73719|TC|350.05|0|350.05|0||MRI LOWER EXTREMITY W/DYE|| 80001|73720||555.59|0|555.59|0||MRI LWR EXTREMITY W/O&W/DYE|| 80001|73720|26|128.4|0|128.4|0||MRI LWR EXTREMITY W/O&W/DYE|| 80001|73720|TC|427.2|0|427.2|0||MRI LWR EXTREMITY W/O&W/DYE|| 80001|73721||261.36|0|261.36|0||MRI JNT OF LWR EXTRE W/O DYE|| 80001|73721|26|80.71|0|80.71|0||MRI JNT OF LWR EXTRE W/O DYE|| 80001|73721|TC|180.65|0|180.65|0||MRI JNT OF LWR EXTRE W/O DYE|| 80001|73722||421.87|0|421.87|0||MRI JOINT OF LWR EXTR W/DYE|| 80001|73722|26|97.4|0|97.4|0||MRI JOINT OF LWR EXTR W/DYE|| 80001|73722|TC|324.47|0|324.47|0||MRI JOINT OF LWR EXTR W/DYE|| 80001|73723||521.48|0|521.48|0||MRI JOINT LWR EXTR W/O&W/DYE|| 80001|73723|26|128.4|0|128.4|0||MRI JOINT LWR EXTR W/O&W/DYE|| 80001|73723|TC|393.08|0|393.08|0||MRI JOINT LWR EXTR W/O&W/DYE|| 80001|73725||446|0|446|0||MR ANG LWR EXT W OR W/O DYE|| 80001|73725|26|107.57|0|107.57|0||MR ANG LWR EXT W OR W/O DYE|| 80001|73725|TC|338.42|0|338.42|0||MR ANG LWR EXT W OR W/O DYE|| 80001|74000||26.37|0|26.37|0||X-RAY EXAM OF ABDOMEN|| 80001|74000|26|10.86|0|10.86|0||X-RAY EXAM OF ABDOMEN|| 80001|74000|TC|15.51|0|15.51|0||X-RAY EXAM OF ABDOMEN|| 80001|74010||39|0|39|0||X-RAY EXAM OF ABDOMEN|| 80001|74010|26|13.8|0|13.8|0||X-RAY EXAM OF ABDOMEN|| 80001|74010|TC|25.2|0|25.2|0||X-RAY EXAM OF ABDOMEN|| 80001|74018||30.68|0|30.68|||X-RAY EXAM ABDOMEN 1 VIEW|| 80001|74018|26|10.8|0|10.8|||X-RAY EXAM ABDOMEN 1 VIEW|| 80001|74018|TC|19.88|0|19.88|||X-RAY EXAM ABDOMEN 1 VIEW|| 80001|74019||37.66|0|37.66|0||X-RAY EXAM ABDOMEN 2 VIEWS|| 80001|74019|26|13.89|0|13.89|0||X-RAY EXAM ABDOMEN 2 VIEWS|| 80001|74019|TC|23.77|0|23.77|0||X-RAY EXAM ABDOMEN 2 VIEWS|| 80001|74020||41.5|0|41.5|0||X-RAY EXAM OF ABDOMEN|| 80001|74020|26|15.91|0|15.91|0||X-RAY EXAM OF ABDOMEN|| 80001|74020|TC|25.59|0|25.59|0||X-RAY EXAM OF ABDOMEN|| 80001|74021||44.12|0|44.12|0||X-RAY EXAM ABDOMEN 3+ VIEWS|| 80001|74021|26|16.47|0|16.47|0||X-RAY EXAM ABDOMEN 3+ VIEWS|| 80001|74021|TC|27.65|0|27.65|0||X-RAY EXAM ABDOMEN 3+ VIEWS|| 80001|74022||49.08|0|49.08|0||X-RAY EXAM SERIES - ABDOMEN|| 80001|74022|26|18.84|0|18.84|0||X-RAY EXAM SERIES - ABDOMEN|| 80001|74022|TC|30.24|0|30.24|0||X-RAY EXAM SERIES - ABDOMEN|| 80001|74150||168.01|0|168.01|0||CT ABDOMEN W/O DYE|| 80001|74150|26|70.71|0|70.71|0||CT ABDOMEN W/O DYE|| 80001|74150|TC|97.3|0|97.3|0||CT ABDOMEN W/O DYE|| 80001|74160||255.97|0|255.97|0||CT ABDOMEN W/DYE|| 80001|74160|26|75.71|0|75.71|0||CT ABDOMEN W/DYE|| 80001|74160|TC|180.26|0|180.26|0||CT ABDOMEN W/DYE|| 80001|74170||291.04|0|291.04|0||CT ABDOMEN W/O & W/DYE|| 80001|74170|26|83.25|0|83.25|0||CT ABDOMEN W/O & W/DYE|| 80001|74170|TC|207.78|0|207.78|0||CT ABDOMEN W/O & W/DYE|| 80001|74174||432.54|0|432.54|0||CT ANGIO ABD&PELV W/O&W/DYE|| 80001|74174|26|131.34|0|131.34|0||CT ANGIO ABD&PELV W/O&W/DYE|| 80001|74174|TC|301.21|0|301.21|0||CT ANGIO ABD&PELV W/O&W/DYE|| 80001|74175||341.33|0|341.33|0||CT ANGIO ABDOM W/O & W/DYE|| 80001|74175|26|107.96|0|107.96|0||CT ANGIO ABDOM W/O & W/DYE|| 80001|74175|TC|233.37|0|233.37|0||CT ANGIO ABDOM W/O & W/DYE|| 80001|74176||225.46|0|225.46|0||CT ANGIO ABD & PELVIS|| 80001|74176|26|104.12|0|104.12|0||CT ANGIO ABD & PELVIS|| 80001|74176|TC|121.34|0|121.34|0||CT ANGIO ABD & PELVIS|| 80001|74177||346.76|0|346.76|0||CT ANGIO ABD&PELV W/CONTRAST|| 80001|74177|26|109.13|0|109.13|0||CT ANGIO ABD&PELV W/CONTRAST|| 80001|74177|TC|237.63|0|237.63|0||CT ANGIO ABD&PELV W/CONTRAST|| 80001|74178||392.17|0|392.17|0||CT ANGIO ABD & PELV 1+ REGNS|| 80001|74178|26|120.03|0|120.03|0||CT ANGIO ABD & PELV 1+ REGNS|| 80001|74178|TC|272.13|0|272.13|0||CT ANGIO ABD & PELV 1+ REGNS|| 80001|74181||367.67|0|367.67|0||MRI ABDOMEN W/O DYE|| 80001|74181|26|86.62|0|86.62|0||MRI ABDOMEN W/O DYE|| 80001|74181|TC|281.05|0|281.05|0||MRI ABDOMEN W/O DYE|| 80001|74182||501.81|0|501.81|0||MRI ABDOMEN W/DYE|| 80001|74182|26|103.31|0|103.31|0||MRI ABDOMEN W/DYE|| 80001|74182|TC|398.51|0|398.51|0||MRI ABDOMEN W/DYE|| 80001|74183||561.12|0|561.12|0||MRI ABDOMEN W/O & W/DYE|| 80001|74183|26|135.47|0|135.47|0||MRI ABDOMEN W/O & W/DYE|| 80001|74183|TC|425.64|0|425.64|0||MRI ABDOMEN W/O & W/DYE|| 80001|74185||445.91|0|445.91|0||MRI ANGIO - ABDOM W ORW/O DYE|| 80001|74185|26|106.71|0|106.71|0||MRI ANGIO - ABDOM W ORW/O DYE|| 80001|74185|TC|339.2|0|339.2|0||MRI ANGIO - ABDOM W ORW/O DYE|| 80001|74190||0|0|0|0||X-RAY EXAM OF PERITONEUM|| 80001|74190|26|28.46|0|28.46|0||X-RAY EXAM OF PERITONEUM|| 80001|74190|TC|0|0|0|0||X-RAY EXAM OF PERITONEUM|| 80001|74210||85.69|0|85.69|0||CONTRST X-RAY EXAM OF THROAT|| 80001|74210|26|21.34|0|21.34|0||CONTRST X-RAY EXAM OF THROAT|| 80001|74210|TC|64.35|0|64.35|0||CONTRST X-RAY EXAM OF THROAT|| 80001|74220||98.15|0|98.15|0||CONTRAST X-RAY - ESOPHAGUS|| 80001|74220|26|27.59|0|27.59|0||CONTRAST X-RAY - ESOPHAGUS|| 80001|74220|TC|70.55|0|70.55|0||CONTRAST X-RAY - ESOPHAGUS|| 80001|74230||141.48|0|0|0||CINE/VID X-RAY - THROAT/ESOPH|| 80001|74230|26|31.78|0|31.78|0||CINE/VID X-RAY - THROAT/ESOPH|| 80001|74230|TC|109.7|0|0|0||CINE/VID X-RAY - THROAT/ESOPH|| 80001|74235||0|0|0|0||REMOVE ESOPHAGUS OBSTRUCTION|| 80001|74235|26|74.97|0|74.97|0||REMOVE ESOPHAGUS OBSTRUCTION|| 80001|74235|TC|0|0|0|0||REMOVE ESOPHAGUS OBSTRUCTION|| 80001|74240||126.68|0|126.68|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74240|26|41.78|0|41.78|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74240|TC|84.9|0|84.9|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74241||130.55|0|130.55|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74241|26|41|0|41|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74241|TC|89.55|0|89.55|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74245||190.05|0|190.05|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74245|26|54.37|0|54.37|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74245|TC|135.68|0|135.68|0||X-RAY EXAM - UPPER GI TRACT|| 80001|74246||142.19|0|142.19|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74246|26|42.17|0|42.17|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74246|TC|100.02|0|100.02|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74247||156.14|0|156.14|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74247|26|41.39|0|41.39|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74247|TC|114.75|0|114.75|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74249||203.23|0|203.23|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74249|26|54.37|0|54.37|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74249|TC|148.86|0|148.86|0||CONTRST X-RAY UPPR GI TRACT|| 80001|74250||115.25|0|115.25|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74250|26|28.41|0|28.41|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74250|TC|86.84|0|86.84|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74251||204.6|0|0|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74251|26|41.39|0|41.39|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74251|TC|163.2|0|0|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74260||140.18|0|0|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74260|26|30.09|0|30.09|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74260|TC|110.1|0|0|0||X-RAY EXAM OF SMALL BOWEL|| 80001|74261||273.7|0|0|0||CT COLONOGRAPHY - W/O DYE|| 80001|74261|26|144.22|0|144.22|0||CT COLONOGRAPHY - W/O DYE|| 80001|74261|TC|129.48|0|0|0||CT COLONOGRAPHY - W/O DYE|| 80001|74262||409.81|0|0|0||CT COLONOGRAPHY - W/DYE|| 80001|74262|26|150.09|0|150.09|0||CT COLONOGRAPHY - W/DYE|| 80001|74262|TC|259.73|0|0|0||CT COLONOGRAPHY - W/DYE|| 80001|74263||830.61|0|830.61|0||CT COLONOGRAPHY - SCREEN|| 80001|74263|26|135.55|0|135.55|0||CT COLONOGRAPHY - SCREEN|| 80001|74263|TC|695.06|0|695.06|0||CT COLONOGRAPHY - SCREEN|| 80001|74270||165.83|0|165.83|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74270|26|41.39|0|41.39|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74270|TC|124.44|0|124.44|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74280||222.19|0|0|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74280|26|59.37|0|59.37|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74280|TC|162.82|0|0|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74283||234.45|0|234.45|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74283|26|123.97|0|123.97|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74283|TC|110.48|0|110.48|0||CONTRAST X-RAY EXAM OF COLON|| 80001|74290||77.38|0|77.38|0||CONTRAST X-RAY - GALLBLADDER|| 80001|74290|26|19.23|0|19.23|0||CONTRAST X-RAY - GALLBLADDER|| 80001|74290|TC|58.15|0|58.15|0||CONTRAST X-RAY - GALLBLADDER|| 80001|74300||0|0|0|0||X-RAY BILE DUCTS/PANCREAS|| 80001|74300|26|22.12|0|22.12|0||X-RAY BILE DUCTS/PANCREAS|| 80001|74300|TC|0|0|0|0||X-RAY BILE DUCTS/PANCREAS|| 80001|74301||0|0|0|0||X-RAYS AT SURGERY ADD-ON|| 80001|74301|26|12.94|0|12.94|0||X-RAYS AT SURGERY ADD-ON|| 80001|74301|TC|0|0|0|0||X-RAYS AT SURGERY ADD-ON|| 80001|74328||0|0|0|0||X-RAY BILE DUCT ENDOSCOPY|| 80001|74328|26|43.38|0|43.38|0||X-RAY BILE DUCT ENDOSCOPY|| 80001|74328|TC|0|0|0|0||X-RAY BILE DUCT ENDOSCOPY|| 80001|74329||0|0|0|0||X-RAY FOR PANCREAS ENDOSCOPY|| 80001|74329|26|42.99|0|42.99|0||X-RAY FOR PANCREAS ENDOSCOPY|| 80001|74329|TC|0|0|0|0||X-RAY FOR PANCREAS ENDOSCOPY|| 80001|74330||0|0|0|0||X-RAY BILE/PANC ENDOSCOPY|| 80001|74330|26|55.1|0|55.1|0||X-RAY BILE/PANC ENDOSCOPY|| 80001|74330|TC|0|0|0|0||X-RAY BILE/PANC ENDOSCOPY|| 80001|74340||0|0|0|0||X-RAY GUIDE FOR GI TUBE|| 80001|74340|26|32.6|0|32.6|0||X-RAY GUIDE FOR GI TUBE|| 80001|74340|TC|0|0|0|0||X-RAY GUIDE FOR GI TUBE|| 80001|74355||0|0|0|0||X-RAY GUIDE - INTESTINAL TUBE|| 80001|74355|26|46.74|0|46.74|0||X-RAY GUIDE - INTESTINAL TUBE|| 80001|74355|TC|0|0|0|0||X-RAY GUIDE - INTESTINAL TUBE|| 80001|74360||0|0|0|0||X-RAY GUIDE - GI DILATION|| 80001|74360|26|33.76|0|33.76|0||X-RAY GUIDE - GI DILATION|| 80001|74360|TC|0|0|0|0||X-RAY GUIDE - GI DILATION|| 80001|74363||0|0|0|0||X-RAY - BILE DUCT DILATION|| 80001|74363|26|52.7|0|52.7|0||X-RAY - BILE DUCT DILATION|| 80001|74363|TC|0|0|0|0||X-RAY - BILE DUCT DILATION|| 80001|74400||120.76|0|120.76|0||CONTRST X-RAY - URINARY TRACT|| 80001|74400|26|28.89|0|28.89|0||CONTRST X-RAY - URINARY TRACT|| 80001|74400|TC|91.88|0|91.88|0||CONTRST X-RAY - URINARY TRACT|| 80001|74410||117.66|0|117.66|0||CONTRST X-RAY - URINARY TRACT|| 80001|74410|26|28.11|0|28.11|0||CONTRST X-RAY - URINARY TRACT|| 80001|74410|TC|89.55|0|89.55|0||CONTRST X-RAY - URINARY TRACT|| 80001|74415||150.22|0|150.22|0||CONTRST X-RAY - URINARY TRACT|| 80001|74415|26|28.89|0|28.89|0||CONTRST X-RAY - URINARY TRACT|| 80001|74415|TC|121.34|0|121.34|0||CONTRST X-RAY - URINARY TRACT|| 80001|74420||0|0|0|0||CONTRST X-RAY - URINARY TRACT|| 80001|74420|26|21.34|0|21.34|0||CONTRST X-RAY - URINARY TRACT|| 80001|74420|TC|0|0|0|0||CONTRST X-RAY - URINARY TRACT|| 80001|74425||0|0|0|0||CONTRST X-RAY - URINARY TRACT|| 80001|74425|26|21.34|0|21.34|0||CONTRST X-RAY - URINARY TRACT|| 80001|74425|TC|0|0|0|0||CONTRST X-RAY - URINARY TRACT|| 80001|74430||41.71|0|41.71|0||CONTRAST X-RAY - BLADDER|| 80001|74430|26|18.84|0|18.84|0||CONTRAST X-RAY - BLADDER|| 80001|74430|TC|22.87|0|22.87|0||CONTRAST X-RAY - BLADDER|| 80001|74440||88.11|0|88.11|0||X-RAY - MALE GENITAL TRACT|| 80001|74440|26|21.81|0|21.81|0||X-RAY - MALE GENITAL TRACT|| 80001|74440|TC|66.29|0|66.29|0||X-RAY - MALE GENITAL TRACT|| 80001|74445||0|0|0|0||X-RAY EXAM OF PENIS|| 80001|74445|26|68.95|0|68.95|0||X-RAY EXAM OF PENIS|| 80001|74445|TC|0|0|0|0||X-RAY EXAM OF PENIS|| 80001|74450||0|0|0|0||X-RAY - URETHRA/BLADDER|| 80001|74450|26|19.66|0|19.66|0||X-RAY - URETHRA/BLADDER|| 80001|74450|TC|0|0|0|0||X-RAY - URETHRA/BLADDER|| 80001|74455||89.83|0|89.83|0||X-RAY - URETHRA/BLADDER|| 80001|74455|26|19.27|0|19.27|0||X-RAY - URETHRA/BLADDER|| 80001|74455|TC|70.55|0|70.55|0||X-RAY - URETHRA/BLADDER|| 80001|74470||0|0|0|0||X-RAY EXAM OF KIDNEY LESION|| 80001|74470|26|31.44|0|31.44|0||X-RAY EXAM OF KIDNEY LESION|| 80001|74470|TC|0|0|0|0||X-RAY EXAM OF KIDNEY LESION|| 80001|74485||101.98|0|101.98|0||X-RAY GUIDE - GU DILATION|| 80001|74485|26|30.65|0|30.65|0||X-RAY GUIDE - GU DILATION|| 80001|74485|TC|71.33|0|71.33|0||X-RAY GUIDE - GU DILATION|| 80001|74710||44.9|0|44.9|0||X-RAY MEASUREMENT OF PELVIS|| 80001|74710|26|20.87|0|20.87|0||X-RAY MEASUREMENT OF PELVIS|| 80001|74710|TC|24.04|0|24.04|0||X-RAY MEASUREMENT OF PELVIS|| 80001|74712||473.09|0|473.09|0||MRI FETAL SNGL/1ST GESTATION|| 80001|74712|26|294.34|0|294.34|0||MRI FETAL SNGL/1ST GESTATION|| 80001|74712|TC|178.76|0|178.76|0||MRI FETAL SNGL/1ST GESTATION|| 80001|74713||259.59|0|259.59|0||MRI FETAL EA ADDL GESTATION|| 80001|74713|26|106.24|0|106.24|0||MRI FETAL EA ADDL GESTATION|| 80001|74713|TC|153.35|0|153.35|0||MRI FETAL EA ADDL GESTATION|| 80001|74740||83.46|0|83.46|0||X-RAY - FEMALE GENITAL TRACT|| 80001|74740|26|22.98|0|22.98|0||X-RAY - FEMALE GENITAL TRACT|| 80001|74740|TC|60.48|0|60.48|0||X-RAY - FEMALE GENITAL TRACT|| 80001|74742||0|0|0|0||X-RAY - FALLOPIAN TUBE|| 80001|74742|26|37.17|0|37.17|0||X-RAY - FALLOPIAN TUBE|| 80001|74742|TC|0|0|0|0||X-RAY - FALLOPIAN TUBE|| 80001|74775||0|0|0|0||X-RAY EXAM OF PERINEUM|| 80001|74775|26|37.6|0|37.6|0||X-RAY EXAM OF PERINEUM|| 80001|74775|TC|0|0|0|0||X-RAY EXAM OF PERINEUM|| 80001|75557||356.05|0|356.05|0||CARDIAC MRI FOR MORPH|| 80001|75557|26|138.57|0|138.57|0||CARDIAC MRI FOR MORPH|| 80001|75557|TC|217.47|0|217.47|0||CARDIAC MRI FOR MORPH|| 80001|75559||479.22|0|0|0||CARDIAC MRI W/STRESS IMG|| 80001|75559|26|170.26|0|170.26|0||CARDIAC MRI W/STRESS IMG|| 80001|75559|TC|308.96|0|0|0||CARDIAC MRI W/STRESS IMG|| 80001|75561||472.66|0|472.66|0||CARDIAC MRI FOR MORPH W/DYE|| 80001|75561|26|153.23|0|153.23|0||CARDIAC MRI FOR MORPH W/DYE|| 80001|75561|TC|319.43|0|319.43|0||CARDIAC MRI FOR MORPH W/DYE|| 80001|75563||560.46|0|560.46|0||CARD MRI W/STRESS IMG & DYE|| 80001|75563|26|175.91|0|175.91|0||CARD MRI W/STRESS IMG & DYE|| 80001|75563|TC|384.55|0|384.55|0||CARD MRI W/STRESS IMG & DYE|| 80001|75565||61.18|0|61.18|0||CARD MRI VEL FLW MAP ADD-ON|| 80001|75565|26|14.66|0|14.66|0||CARD MRI VEL FLW MAP ADD-ON|| 80001|75565|TC|46.52|0|46.52|0||CARD MRI VEL FLW MAP ADD-ON|| 80001|75571||66.11|0|0|0||CT HRT W/O DYE W/CA TEST|| 80001|75571|26|34.32|0|34.32|0||CT HRT W/O DYE W/CA TEST|| 80001|75571|TC|31.79|0|0|0||CT HRT W/O DYE W/CA TEST|| 80001|75572||316.99|0|316.99|0||CT HRT W/3D IMAGE|| 80001|75572|26|103.39|0|103.39|0||CT HRT W/3D IMAGE|| 80001|75572|TC|213.6|0|213.6|0||CT HRT W/3D IMAGE|| 80001|75573||381.72|0|0|0||CT HRT W/3D IMAGE - CONGEN|| 80001|75573|26|148.74|0|148.74|0||CT HRT W/3D IMAGE - CONGEN|| 80001|75573|TC|232.98|0|0|0||CT HRT W/3D IMAGE - CONGEN|| 80001|75574||373.7|0|0|0||CT ANGIO HRT W/3D IMAGE|| 80001|75574|26|140.73|0|140.73|0||CT ANGIO HRT W/3D IMAGE|| 80001|75574|TC|232.98|0|0|0||CT ANGIO HRT W/3D IMAGE|| 80001|75600||220.02|0|220.02|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75600|26|30.84|0|30.84|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75600|TC|189.18|0|189.18|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75605||156.95|0|156.95|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75605|26|67.4|0|67.4|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75605|TC|89.55|0|89.55|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75625||156.96|0|156.96|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75625|26|67.8|0|67.8|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75625|TC|89.16|0|89.16|0||CONTRAST X-RAY EXAM OF AORTA|| 80001|75630||195.86|0|195.86|0||X-RAY AORTA - LEG ARTERIES|| 80001|75630|26|106.69|0|106.69|0||X-RAY AORTA - LEG ARTERIES|| 80001|75630|TC|89.16|0|89.16|0||X-RAY AORTA - LEG ARTERIES|| 80001|75635||423.34|0|423.34|0||CT ANGIO ABDOMINAL ARTERIES|| 80001|75635|26|142.28|0|142.28|0||CT ANGIO ABDOMINAL ARTERIES|| 80001|75635|TC|281.05|0|281.05|0||CT ANGIO ABDOMINAL ARTERIES|| 80001|75658||187.95|0|187.95|0||ARTERY X-RAYS - ARM|| 80001|75658|26|78.24|0|78.24|0||ARTERY X-RAYS - ARM|| 80001|75658|TC|109.71|0|109.71|0||ARTERY X-RAYS - ARM|| 80001|75705||266.92|0|266.92|0||ARTERY X-RAYS - SPINE|| 80001|75705|26|127.36|0|127.36|0||ARTERY X-RAYS - SPINE|| 80001|75705|TC|139.56|0|139.56|0||ARTERY X-RAYS - SPINE|| 80001|75710||180.59|0|180.59|0||ARTERY X-RAYS - ARM/LEG|| 80001|75710|26|64.68|0|64.68|0||ARTERY X-RAYS - ARM/LEG|| 80001|75710|TC|115.91|0|115.91|0||ARTERY X-RAYS - ARM/LEG|| 80001|75716||209.26|0|209.26|0||ARTERY X-RAYS - ARMS/LEGS|| 80001|75716|26|77.07|0|77.07|0||ARTERY X-RAYS - ARMS/LEGS|| 80001|75716|TC|132.19|0|132.19|0||ARTERY X-RAYS - ARMS/LEGS|| 80001|75726||168.97|0|168.97|0||ARTERY X-RAYS - ABDOMEN|| 80001|75726|26|67.4|0|67.4|0||ARTERY X-RAYS - ABDOMEN|| 80001|75726|TC|101.57|0|101.57|0||ARTERY X-RAYS - ABDOMEN|| 80001|75731||191.05|0|191.05|0||ARTERY X-RAYS - ADRENAL GLAND|| 80001|75731|26|67.39|0|67.39|0||ARTERY X-RAYS - ADRENAL GLAND|| 80001|75731|TC|123.66|0|123.66|0||ARTERY X-RAYS - ADRENAL GLAND|| 80001|75733||204.97|0|204.97|0||ARTERY X-RAYS - ADRENALS|| 80001|75733|26|75.88|0|75.88|0||ARTERY X-RAYS - ADRENALS|| 80001|75733|TC|129.09|0|129.09|0||ARTERY X-RAYS - ADRENALS|| 80001|75736||182.94|0|182.94|0||ARTERY X-RAYS - PELVIS|| 80001|75736|26|69.35|0|69.35|0||ARTERY X-RAYS - PELVIS|| 80001|75736|TC|113.59|0|113.59|0||ARTERY X-RAYS - PELVIS|| 80001|75741||171.64|0|171.64|0||ARTERY X-RAYS - LUNG|| 80001|75741|26|76.28|0|76.28|0||ARTERY X-RAYS - LUNG|| 80001|75741|TC|95.36|0|95.36|0||ARTERY X-RAYS - LUNG|| 80001|75743||192.94|0|192.94|0||ARTERY X-RAYS - LUNGS|| 80001|75743|26|96.41|0|96.41|0||ARTERY X-RAYS - LUNGS|| 80001|75743|TC|96.53|0|96.53|0||ARTERY X-RAYS - LUNGS|| 80001|75746||172.05|0|172.05|0||ARTERY X-RAYS - LUNG|| 80001|75746|26|66.22|0|66.22|0||ARTERY X-RAYS - LUNG|| 80001|75746|TC|105.83|0|105.83|0||ARTERY X-RAYS - LUNG|| 80001|75756||190.31|0|190.31|0||ARTERY X-RAYS - CHEST|| 80001|75756|26|69.75|0|69.75|0||ARTERY X-RAYS - CHEST|| 80001|75756|TC|120.56|0|120.56|0||ARTERY X-RAYS - CHEST|| 80001|75774||97.33|0|97.33|0||ARTERY X-RAY - EACH VESSEL|| 80001|75774|26|21.35|0|21.35|0||ARTERY X-RAY - EACH VESSEL|| 80001|75774|TC|75.98|0|75.98|0||ARTERY X-RAY - EACH VESSEL|| 80001|75791||356.36|0|356.36|0||AV DIALYSIS SHUNT IMAGING|| 80001|75791|26|98.18|0|98.18|0||AV DIALYSIS SHUNT IMAGING|| 80001|75791|TC|258.18|0|258.18|0||AV DIALYSIS SHUNT IMAGING|| 80001|75801||0|0|0|0||LYMPH VESSEL X-RAY - ARM/LEG|| 80001|75801|26|53.58|0|53.58|0||LYMPH VESSEL X-RAY - ARM/LEG|| 80001|75801|TC|0|0|0|0||LYMPH VESSEL X-RAY - ARM/LEG|| 80001|75803||0|0|0|0||LYMPH VESSEL X-RAY - ARMS/LEGS|| 80001|75803|26|71.8|0|71.8|0||LYMPH VESSEL X-RAY - ARMS/LEGS|| 80001|75803|TC|0|0|0|0||LYMPH VESSEL X-RAY - ARMS/LEGS|| 80001|75805||0|0|0|0||LYMPH VESSEL X-RAY - TRUNK|| 80001|75805|26|49.29|0|49.29|0||LYMPH VESSEL X-RAY - TRUNK|| 80001|75805|TC|0|0|0|0||LYMPH VESSEL X-RAY - TRUNK|| 80001|75807||0|0|0|0||LYMPH VESSEL X-RAY - TRUNK|| 80001|75807|26|71.8|0|71.8|0||LYMPH VESSEL X-RAY - TRUNK|| 80001|75807|TC|0|0|0|0||LYMPH VESSEL X-RAY - TRUNK|| 80001|75809||109.82|0|109.82|0||NONVASCULAR SHUNT - X-RAY|| 80001|75809|26|28.02|0|28.02|0||NONVASCULAR SHUNT - X-RAY|| 80001|75809|TC|81.8|0|81.8|0||NONVASCULAR SHUNT - X-RAY|| 80001|75810||0|0|0|0||VEIN X-RAY - SPLEEN/LIVER|| 80001|75810|26|70.11|0|70.11|0||VEIN X-RAY - SPLEEN/LIVER|| 80001|75810|TC|0|0|0|0||VEIN X-RAY - SPLEEN/LIVER|| 80001|75820||129.05|0|129.05|0||VEIN X-RAY - ARM/LEG|| 80001|75820|26|41.83|0|41.83|0||VEIN X-RAY - ARM/LEG|| 80001|75820|TC|87.22|0|87.22|0||VEIN X-RAY - ARM/LEG|| 80001|75822||154.66|0|154.66|0||VEIN X-RAY - ARMS/LEGS|| 80001|75822|26|62.4|0|62.4|0||VEIN X-RAY - ARMS/LEGS|| 80001|75822|TC|92.26|0|92.26|0||VEIN X-RAY - ARMS/LEGS|| 80001|75825||154.63|0|154.63|0||VEIN X-RAY - TRUNK|| 80001|75825|26|67.79|0|67.79|0||VEIN X-RAY - TRUNK|| 80001|75825|TC|86.84|0|86.84|0||VEIN X-RAY - TRUNK|| 80001|75827||155.79|0|155.79|0||VEIN X-RAY - CHEST|| 80001|75827|26|66.63|0|66.63|0||VEIN X-RAY - CHEST|| 80001|75827|TC|89.16|0|89.16|0||VEIN X-RAY - CHEST|| 80001|75831||158.49|0|158.49|0||VEIN X-RAY - KIDNEY|| 80001|75831|26|65.07|0|65.07|0||VEIN X-RAY - KIDNEY|| 80001|75831|TC|93.43|0|93.43|0||VEIN X-RAY - KIDNEY|| 80001|75833||190.69|0|190.69|0||VEIN X-RAY - KIDNEYS|| 80001|75833|26|91.45|0|91.45|0||VEIN X-RAY - KIDNEYS|| 80001|75833|TC|99.24|0|99.24|0||VEIN X-RAY - KIDNEYS|| 80001|75840||167.41|0|167.41|0||VEIN X-RAY - ADRENAL GLAND|| 80001|75840|26|68.55|0|68.55|0||VEIN X-RAY - ADRENAL GLAND|| 80001|75840|TC|98.85|0|98.85|0||VEIN X-RAY - ADRENAL GLAND|| 80001|75842||203.83|0|203.83|0||VEIN X-RAY - ADRENAL GLANDS|| 80001|75842|26|89.86|0|89.86|0||VEIN X-RAY - ADRENAL GLANDS|| 80001|75842|TC|113.97|0|113.97|0||VEIN X-RAY - ADRENAL GLANDS|| 80001|75860||162.38|0|162.38|0||VEIN X-RAY - NECK|| 80001|75860|26|67.4|0|67.4|0||VEIN X-RAY - NECK|| 80001|75860|TC|94.98|0|94.98|0||VEIN X-RAY - NECK|| 80001|75870||167.02|0|167.02|0||VEIN X-RAY - SKULL|| 80001|75870|26|68.55|0|68.55|0||VEIN X-RAY - SKULL|| 80001|75870|TC|98.47|0|98.47|0||VEIN X-RAY - SKULL|| 80001|75872||167.8|0|167.8|0||VEIN X-RAY - SKULL|| 80001|75872|26|68.55|0|68.55|0||VEIN X-RAY - SKULL|| 80001|75872|TC|99.24|0|99.24|0||VEIN X-RAY - SKULL|| 80001|75880||161.99|0|161.99|0||VEIN X-RAY - EYE SOCKET|| 80001|75880|26|42.59|0|42.59|0||VEIN X-RAY - EYE SOCKET|| 80001|75880|TC|119.4|0|119.4|0||VEIN X-RAY - EYE SOCKET|| 80001|75885||178.8|0|178.8|0||VEIN X-RAY - LIVER|| 80001|75885|26|83.05|0|83.05|0||VEIN X-RAY - LIVER|| 80001|75885|TC|95.75|0|95.75|0||VEIN X-RAY - LIVER|| 80001|75887||181.13|0|181.13|0||VEIN X-RAY - LIVER|| 80001|75887|26|84.21|0|84.21|0||VEIN X-RAY - LIVER|| 80001|75887|TC|96.91|0|96.91|0||VEIN X-RAY - LIVER|| 80001|75889||162.37|0|162.37|0||VEIN X-RAY - LIVER|| 80001|75889|26|65.84|0|65.84|0||VEIN X-RAY - LIVER|| 80001|75889|TC|96.53|0|96.53|0||VEIN X-RAY - LIVER|| 80001|75891||164.31|0|164.31|0||VEIN X-RAY - LIVER|| 80001|75891|26|67|0|67|0||VEIN X-RAY - LIVER|| 80001|75891|TC|97.3|0|97.3|0||VEIN X-RAY - LIVER|| 80001|75893||131.84|0|131.84|0||VENOUS SAMPLING BY CATHETER|| 80001|75893|26|32.21|0|32.21|0||VENOUS SAMPLING BY CATHETER|| 80001|75893|TC|99.63|0|99.63|0||VENOUS SAMPLING BY CATHETER|| 80001|75894||0|0|0|0||X-RAYS - TRANSCATH THERAPY|| 80001|75894|26|79.4|0|79.4|0||X-RAYS - TRANSCATH THERAPY|| 80001|75894|TC|0|0|0|0||X-RAYS - TRANSCATH THERAPY|| 80001|75898||0|0|0|0||FOLLOW-UP ANGIOGRAPHY|| 80001|75898|26|101.82|0|101.82|0||FOLLOW-UP ANGIOGRAPHY|| 80001|75898|TC|0|0|0|0||FOLLOW-UP ANGIOGRAPHY|| 80001|75901||192.48|0|192.48|0||REMOVE CVA DEVICE OBSTRUCT|| 80001|75901|26|27.72|0|27.72|0||REMOVE CVA DEVICE OBSTRUCT|| 80001|75901|TC|164.75|0|164.75|0||REMOVE CVA DEVICE OBSTRUCT|| 80001|75902||79.62|0|79.62|0||REMOVE CVA LUMEN OBSTRUCT|| 80001|75902|26|22.64|0|22.64|0||REMOVE CVA LUMEN OBSTRUCT|| 80001|75902|TC|56.99|0|56.99|0||REMOVE CVA LUMEN OBSTRUCT|| 80001|75952||0|0|0|0||ENDOVASC REPAIR ABDOM AORTA|| 80001|75952|26|274.05|0|274.05|0||ENDOVASC REPAIR ABDOM AORTA|| 80001|75952|TC|0|0|0|0||ENDOVASC REPAIR ABDOM AORTA|| 80001|75953||0|0|0|0||ABDOM ANEURYSM ENDOVAS RPR|| 80001|75953|26|83.13|0|83.13|0||ABDOM ANEURYSM ENDOVAS RPR|| 80001|75953|TC|0|0|0|0||ABDOM ANEURYSM ENDOVAS RPR|| 80001|75954||0|0|0|0||ILIAC ANEURYSM ENDOVAS RPR|| 80001|75954|26|138.6|0|138.6|0||ILIAC ANEURYSM ENDOVAS RPR|| 80001|75954|TC|0|0|0|0||ILIAC ANEURYSM ENDOVAS RPR|| 80001|75956||0|0|0|0||XRAY - ENDOVASC THOR AO REPR|| 80001|75956|26|426.99|0|426.99|0||XRAY - ENDOVASC THOR AO REPR|| 80001|75956|TC|0|0|0|0||XRAY - ENDOVASC THOR AO REPR|| 80001|75957||0|0|0|0||XRAY - ENDOVASC THOR AO REPR|| 80001|75957|26|365.99|0|365.99|0||XRAY - ENDOVASC THOR AO REPR|| 80001|75957|TC|0|0|0|0||XRAY - ENDOVASC THOR AO REPR|| 80001|75958||0|0|0|0||XRAY - PLACE PROX EXT THOR AO|| 80001|75958|26|243.6|0|243.6|0||XRAY - PLACE PROX EXT THOR AO|| 80001|75958|TC|0|0|0|0||XRAY - PLACE PROX EXT THOR AO|| 80001|75959||0|0|0|0||XRAY - PLACE DIST EXT THOR AO|| 80001|75959|26|210.02|0|210.02|0||XRAY - PLACE DIST EXT THOR AO|| 80001|75959|TC|0|0|0|0||XRAY - PLACE DIST EXT THOR AO|| 80001|75962||153.16|0|153.16|0||REPAIR ARTERIAL BLOCKAGE|| 80001|75962|26|30.66|0|30.66|0||REPAIR ARTERIAL BLOCKAGE|| 80001|75962|TC|122.5|0|122.5|0||REPAIR ARTERIAL BLOCKAGE|| 80001|75964||95.39|0|95.39|0||REPAIR ARTERY BLOCKAGE - EACH|| 80001|75964|26|20.57|0|20.57|0||REPAIR ARTERY BLOCKAGE - EACH|| 80001|75964|TC|74.82|0|74.82|0||REPAIR ARTERY BLOCKAGE - EACH|| 80001|75966||192.58|0|192.58|0||REPAIR ARTERIAL BLOCKAGE|| 80001|75966|26|76.28|0|76.28|0||REPAIR ARTERIAL BLOCKAGE|| 80001|75966|TC|116.3|0|116.3|0||REPAIR ARTERIAL BLOCKAGE|| 80001|75968||98.1|0|98.1|0||REPAIR ARTERY BLOCKAGE - EACH|| 80001|75968|26|20.95|0|20.95|0||REPAIR ARTERY BLOCKAGE - EACH|| 80001|75968|TC|77.14|0|77.14|0||REPAIR ARTERY BLOCKAGE - EACH|| 80001|75970||0|0|0|0||VASCULAR BIOPSY|| 80001|75970|26|48.6|0|48.6|0||VASCULAR BIOPSY|| 80001|75970|TC|0|0|0|0||VASCULAR BIOPSY|| 80001|75978||151.61|0|151.61|0||REPAIR VENOUS BLOCKAGE|| 80001|75978|26|30.66|0|30.66|0||REPAIR VENOUS BLOCKAGE|| 80001|75978|TC|120.95|0|120.95|0||REPAIR VENOUS BLOCKAGE|| 80001|75984||119.05|0|119.05|0||XRAY CONTROL CATHETER CHANGE|| 80001|75984|26|41.91|0|41.91|0||XRAY CONTROL CATHETER CHANGE|| 80001|75984|TC|77.14|0|77.14|0||XRAY CONTROL CATHETER CHANGE|| 80001|75989||137.39|0|137.39|0||ABSCESS DRAINAGE UNDER X-RAY|| 80001|75989|26|70.33|0|70.33|0||ABSCESS DRAINAGE UNDER X-RAY|| 80001|75989|TC|67.07|0|67.07|0||ABSCESS DRAINAGE UNDER X-RAY|| 80001|76000||51.92|0|51.92|0||FLUOROSCOPE EXAMINATION|| 80001|76000|26|10.44|0|10.44|0||FLUOROSCOPE EXAMINATION|| 80001|76000|TC|41.48|0|41.48|0||FLUOROSCOPE EXAMINATION|| 80001|76001||0|0|0|0||FLUOROSCOPE EXAM - EXTENSIVE|| 80001|76001|26|43.26|0|43.26|0||FLUOROSCOPE EXAM - EXTENSIVE|| 80001|76001|TC|0|0|0|0||FLUOROSCOPE EXAM - EXTENSIVE|| 80001|76010||29.09|0|29.09|0||X-RAY - NOSE TO RECTUM|| 80001|76010|26|10.86|0|10.86|0||X-RAY - NOSE TO RECTUM|| 80001|76010|TC|18.22|0|18.22|0||X-RAY - NOSE TO RECTUM|| 80001|76080||62.45|0|62.45|0||X-RAY EXAM OF FISTULA|| 80001|76080|26|31.43|0|31.43|0||X-RAY EXAM OF FISTULA|| 80001|76080|TC|31.01|0|31.01|0||X-RAY EXAM OF FISTULA|| 80001|76098||18.53|0|18.53|0||X-RAY EXAM - BREAST SPECIMEN|| 80001|76098|26|9.61|0|9.61|0||X-RAY EXAM - BREAST SPECIMEN|| 80001|76098|TC|8.92|0|8.92|0||X-RAY EXAM - BREAST SPECIMEN|| 80001|76100||103.33|0|103.33|0||X-RAY EXAM OF BODY SECTION|| 80001|76100|26|37.81|0|37.81|0||X-RAY EXAM OF BODY SECTION|| 80001|76100|TC|65.52|0|65.52|0||X-RAY EXAM OF BODY SECTION|| 80001|76101||146.75|0|146.75|0||COMPLEX BODY SECTION X-RAY|| 80001|76101|26|41.31|0|41.31|0||COMPLEX BODY SECTION X-RAY|| 80001|76101|TC|105.44|0|105.44|0||COMPLEX BODY SECTION X-RAY|| 80001|76102||192.11|0|192.11|0||COMPLEX BODY SECTION X-RAYS|| 80001|76102|26|41.31|0|41.31|0||COMPLEX BODY SECTION X-RAYS|| 80001|76102|TC|150.8|0|150.8|0||COMPLEX BODY SECTION X-RAYS|| 80001|76120||100.52|0|100.52|0||CINE/VIDEO X-RAYS|| 80001|76120|26|23.76|0|23.76|0||CINE/VIDEO X-RAYS|| 80001|76120|TC|76.76|0|76.76|0||CINE/VIDEO X-RAYS|| 80001|76125||0|0|0|0||CINE/VIDEO X-RAYS ADD-ON|| 80001|76125|26|17.47|0|17.47|0||CINE/VIDEO X-RAYS ADD-ON|| 80001|76125|TC|0|0|0|0||CINE/VIDEO X-RAYS ADD-ON|| 80001|76140||0|0|0|0||X-RAY CONSULTATION|| 80001|76376||25.68|0|25.68|0||3D RENDER W/O POSTPROCESS|| 80001|76376|26|11.73|0|11.73|0||3D RENDER W/O POSTPROCESS|| 80001|76376|TC|13.96|0|13.96|0||3D RENDER W/O POSTPROCESS|| 80001|76377||73.23|0|73.23|0||3D RENDERING W/POSTPROCESS|| 80001|76377|26|46.87|0|46.87|0||3D RENDERING W/POSTPROCESS|| 80001|76377|TC|26.36|0|26.36|0||3D RENDERING W/POSTPROCESS|| 80001|76380||122.52|0|0|0||CAT SCAN FOLLOW-UP STUDY|| 80001|76380|26|58.16|0|58.16|0||CAT SCAN FOLLOW-UP STUDY|| 80001|76380|TC|64.36|0|0|0||CAT SCAN FOLLOW-UP STUDY|| 80001|76390||490.29|0|490.29|0||MR SPECTROSCOPY|| 80001|76390|26|83.25|0|83.25|0||MR SPECTROSCOPY|| 80001|76390|TC|407.04|0|407.04|0||MR SPECTROSCOPY|| 80001|76496||0|0|0|0||FLUOROSCOPIC PROCEDURE|| 80001|76496|26|0|0|0|0||FLUOROSCOPIC PROCEDURE|| 80001|76496|TC|0|0|0|0||FLUOROSCOPIC PROCEDURE|| 80001|76497||0|0|0|0||CT PROCEDURE|| 80001|76497|26|0|0|0|0||CT PROCEDURE|| 80001|76497|TC|0|0|0|0||CT PROCEDURE|| 80001|76498||0|0|0|0||MRI PROCEDURE|| 80001|76498|26|0|0|0|0||MRI PROCEDURE|| 80001|76498|TC|0|0|0|0||MRI PROCEDURE|| 80001|76499||0|0|0|0||RADIOGRAPHIC PROCEDURE|| 80001|76499|26|0|0|0|0||RADIOGRAPHIC PROCEDURE|| 80001|76499|TC|0|0|0|0||RADIOGRAPHIC PROCEDURE|| 80001|76506||132.62|0|132.62|0||ECHO EXAM OF HEAD|| 80001|76506|26|38.03|0|38.03|0||ECHO EXAM OF HEAD|| 80001|76506|TC|94.59|0|94.59|0||ECHO EXAM OF HEAD|| 80001|76510||192.83|0|192.83|0||OPHTH US - B & QUANT A|| 80001|76510|26|104.05|0|104.05|0||OPHTH US - B & QUANT A|| 80001|76510|TC|88.77|0|88.77|0||OPHTH US - B & QUANT A|| 80001|76511||116.52|0|116.52|0||OPHTH US - QUANT A ONLY|| 80001|76511|26|62.63|0|62.63|0||OPHTH US - QUANT A ONLY|| 80001|76511|TC|53.89|0|53.89|0||OPHTH US - QUANT A ONLY|| 80001|76512||105.66|0|105.66|0||OPHTH US - B W/NON-QUANT A|| 80001|76512|26|62.24|0|62.24|0||OPHTH US - B W/NON-QUANT A|| 80001|76512|TC|43.42|0|43.42|0||OPHTH US - B W/NON-QUANT A|| 80001|76513||107.93|0|107.93|0||ECHO EXAM OF EYE - WATER BATH|| 80001|76513|26|42.42|0|42.42|0||ECHO EXAM OF EYE - WATER BATH|| 80001|76513|TC|65.52|0|65.52|0||ECHO EXAM OF EYE - WATER BATH|| 80001|76514||17.41|0|17.41|0||ECHO EXAM OF EYE - THICKNESS|| 80001|76514|26|11.6|0|11.6|0||ECHO EXAM OF EYE - THICKNESS|| 80001|76514|TC|5.82|0|5.82|0||ECHO EXAM OF EYE - THICKNESS|| 80001|76516||88.41|0|88.41|0||ECHO EXAM OF EYE|| 80001|76516|26|36.47|0|36.47|0||ECHO EXAM OF EYE|| 80001|76516|TC|51.95|0|51.95|0||ECHO EXAM OF EYE|| 80001|76519||94.62|0|94.62|0||ECHO EXAM OF EYE|| 80001|76519|26|36.47|0|36.47|0||ECHO EXAM OF EYE|| 80001|76519|TC|58.15|0|58.15|0||ECHO EXAM OF EYE|| 80001|76529||89.71|0|89.71|0||ECHO EXAM OF EYE|| 80001|76529|26|38.15|0|38.15|0||ECHO EXAM OF EYE|| 80001|76529|TC|51.56|0|51.56|0||ECHO EXAM OF EYE|| 80001|76536||129.59|0|129.59|0||US EXAM OF HEAD AND NECK|| 80001|76536|26|33.07|0|33.07|0||US EXAM OF HEAD AND NECK|| 80001|76536|TC|96.53|0|96.53|0||US EXAM OF HEAD AND NECK|| 80001|76604||98.93|0|98.93|0||US EXAM - CHEST - B-SCAN|| 80001|76604|26|32.64|0|32.64|0||US EXAM - CHEST - B-SCAN|| 80001|76604|TC|66.29|0|66.29|0||US EXAM - CHEST - B-SCAN|| 80001|76641||121.81|0|121.81|0||ULTRASOUND BREAST COMPLETE|| 80001|76641|26|43.89|0|43.89|0||ULTRASOUND BREAST COMPLETE|| 80001|76641|TC|77.92|0|77.92|0||ULTRASOUND BREAST COMPLETE|| 80001|76642||100.66|0|100.66|0||ULTRASOUND BREAST LIMITED|| 80001|76642|26|40.96|0|40.96|0||ULTRASOUND BREAST LIMITED|| 80001|76642|TC|59.7|0|59.7|0||ULTRASOUND BREAST LIMITED|| 80001|76700||138.05|0|138.05|0||US EXAM - ABDOM - COMPLETE|| 80001|76700|26|48.12|0|48.12|0||US EXAM - ABDOM - COMPLETE|| 80001|76700|TC|89.94|0|89.94|0||US EXAM - ABDOM - COMPLETE|| 80001|76705||102.98|0|102.98|0||ECHO EXAM OF ABDOMEN|| 80001|76705|26|35.14|0|35.14|0||ECHO EXAM OF ABDOMEN|| 80001|76705|TC|67.84|0|67.84|0||ECHO EXAM OF ABDOMEN|| 80001|76706||114.56|0|114.56|0||US ABDL AORTA SCREEN AAA|| 80001|76706|26|34.02|0|34.02|0||US ABDL AORTA SCREEN AAA|| 80001|76706|TC|80.53|0|80.53|0||US ABDL AORTA SCREEN AAA|| 80001|76770||126.89|0|126.89|0||US EXAM ABDO BACK WALL - COMP|| 80001|76770|26|43.54|0|43.54|0||US EXAM ABDO BACK WALL - COMP|| 80001|76770|TC|83.35|0|83.35|0||US EXAM ABDO BACK WALL - COMP|| 80001|76775||65.33|0|65.33|0||US EXAM ABDO BACK WALL - LIM|| 80001|76775|26|33.93|0|33.93|0||US EXAM ABDO BACK WALL - LIM|| 80001|76775|TC|31.4|0|31.4|0||US EXAM ABDO BACK WALL - LIM|| 80001|76776||174.66|0|174.66|0||US EXAM K TRANSPL W/DOPPLER|| 80001|76776|26|45.18|0|45.18|0||US EXAM K TRANSPL W/DOPPLER|| 80001|76776|TC|129.48|0|129.48|0||US EXAM K TRANSPL W/DOPPLER|| 80001|76800||155.73|0|155.73|0||US EXAM - SPINAL CANAL|| 80001|76800|26|67.34|0|67.34|0||US EXAM - SPINAL CANAL|| 80001|76800|TC|88.39|0|88.39|0||US EXAM - SPINAL CANAL|| 80001|76801||140.79|0|140.79|0||OB US < 14 WKS - SINGLE FETUS|| 80001|76801|26|60.93|0|60.93|0||OB US < 14 WKS - SINGLE FETUS|| 80001|76801|TC|79.86|0|79.86|0||OB US < 14 WKS - SINGLE FETUS|| 80001|76802||75.74|0|75.74|0||OB US < 14 WKS - ADD'L FETUS|| 80001|76802|26|50.92|0|50.92|0||OB US < 14 WKS - ADD'L FETUS|| 80001|76802|TC|24.81|0|24.81|0||OB US < 14 WKS - ADD'L FETUS|| 80001|76805||160.94|0|160.94|0||OB US >/= 14 WKS - SNGL FETUS|| 80001|76805|26|60.93|0|60.93|0||OB US >/= 14 WKS - SNGL FETUS|| 80001|76805|TC|100.02|0|100.02|0||OB US >/= 14 WKS - SNGL FETUS|| 80001|76810||108.57|0|108.57|0||OB US >/= 14 WKS - ADDL FETUS|| 80001|76810|26|60.5|0|60.5|0||OB US >/= 14 WKS - ADDL FETUS|| 80001|76810|TC|48.07|0|48.07|0||OB US >/= 14 WKS - ADDL FETUS|| 80001|76811||208.34|0|208.34|0||OB US - DETAILED - SNGL FETUS|| 80001|76811|26|117.24|0|117.24|0||OB US - DETAILED - SNGL FETUS|| 80001|76811|TC|91.1|0|91.1|0||OB US - DETAILED - SNGL FETUS|| 80001|76812||234.57|0|234.57|0||OB US - DETAILED - ADDL FETUS|| 80001|76812|26|110.52|0|110.52|0||OB US - DETAILED - ADDL FETUS|| 80001|76812|TC|124.05|0|124.05|0||OB US - DETAILED - ADDL FETUS|| 80001|76813||138.9|0|138.9|0||OB US NUCHAL MEAS - 1 GEST|| 80001|76813|26|73|0|73|0||OB US NUCHAL MEAS - 1 GEST|| 80001|76813|TC|65.9|0|65.9|0||OB US NUCHAL MEAS - 1 GEST|| 80001|76814||94.27|0|94.27|0||OB US NUCHAL MEAS - ADD-ON|| 80001|76814|26|61.32|0|61.32|0||OB US NUCHAL MEAS - ADD-ON|| 80001|76814|TC|32.95|0|32.95|0||OB US NUCHAL MEAS - ADD-ON|| 80001|76815||95.88|0|95.88|0||OB US - LIMITED - FETUS(S)|| 80001|76815|26|39.67|0|39.67|0||OB US - LIMITED - FETUS(S)|| 80001|76815|TC|56.21|0|56.21|0||OB US - LIMITED - FETUS(S)|| 80001|76816||130.09|0|130.09|0||OB US - FOLLOW-UP - PER FETUS|| 80001|76816|26|52.17|0|52.17|0||OB US - FOLLOW-UP - PER FETUS|| 80001|76816|TC|77.92|0|77.92|0||OB US - FOLLOW-UP - PER FETUS|| 80001|76817||110.27|0|110.27|0||TRANSVAGINAL US - OBSTETRIC|| 80001|76817|26|45.92|0|45.92|0||TRANSVAGINAL US - OBSTETRIC|| 80001|76817|TC|64.35|0|64.35|0||TRANSVAGINAL US - OBSTETRIC|| 80001|76818||138.34|0|138.34|0||FETAL BIOPHYS PROFILE W/NST|| 80001|76818|26|65.07|0|65.07|0||FETAL BIOPHYS PROFILE W/NST|| 80001|76818|TC|73.27|0|73.27|0||FETAL BIOPHYS PROFILE W/NST|| 80001|76819||101.06|0|101.06|0||FETAL BIOPHYS PROFIL W/O NST|| 80001|76819|26|47.17|0|47.17|0||FETAL BIOPHYS PROFIL W/O NST|| 80001|76819|TC|53.89|0|53.89|0||FETAL BIOPHYS PROFIL W/O NST|| 80001|76820||54.13|0|54.13|0||UMBILICAL ARTERY ECHO|| 80001|76820|26|30.48|0|30.48|0||UMBILICAL ARTERY ECHO|| 80001|76820|TC|23.65|0|23.65|0||UMBILICAL ARTERY ECHO|| 80001|76821||105.02|0|105.02|0||MIDDLE CEREBRAL ARTERY ECHO|| 80001|76821|26|42.99|0|42.99|0||MIDDLE CEREBRAL ARTERY ECHO|| 80001|76821|TC|62.03|0|62.03|0||MIDDLE CEREBRAL ARTERY ECHO|| 80001|76825||311.61|0|311.61|0||ECHO EXAM OF FETAL HEART|| 80001|76825|26|101.5|0|101.5|0||ECHO EXAM OF FETAL HEART|| 80001|76825|TC|210.11|0|210.11|0||ECHO EXAM OF FETAL HEART|| 80001|76826||183.89|0|183.89|0||ECHO EXAM OF FETAL HEART|| 80001|76826|26|50.15|0|50.15|0||ECHO EXAM OF FETAL HEART|| 80001|76826|TC|133.74|0|133.74|0||ECHO EXAM OF FETAL HEART|| 80001|76827||86.27|0|86.27|0||ECHO EXAM OF FETAL HEART|| 80001|76827|26|34.71|0|34.71|0||ECHO EXAM OF FETAL HEART|| 80001|76827|TC|51.56|0|51.56|0||ECHO EXAM OF FETAL HEART|| 80001|76828||61.37|0|61.37|0||ECHO EXAM OF FETAL HEART|| 80001|76828|26|33.85|0|33.85|0||ECHO EXAM OF FETAL HEART|| 80001|76828|TC|27.53|0|27.53|0||ECHO EXAM OF FETAL HEART|| 80001|76830||137.15|0|137.15|0||TRANSVAGINAL US - NON-OB|| 80001|76830|26|41.78|0|41.78|0||TRANSVAGINAL US - NON-OB|| 80001|76830|TC|95.36|0|95.36|0||TRANSVAGINAL US - NON-OB|| 80001|76831||133.4|0|133.4|0||ECHO EXAM - UTERUS|| 80001|76831|26|44.24|0|44.24|0||ECHO EXAM - UTERUS|| 80001|76831|TC|89.16|0|89.16|0||ECHO EXAM - UTERUS|| 80001|76856||123.19|0|123.19|0||US EXAM - PELVIC - COMPLETE|| 80001|76856|26|40.61|0|40.61|0||US EXAM - PELVIC - COMPLETE|| 80001|76856|TC|82.57|0|82.57|0||US EXAM - PELVIC - COMPLETE|| 80001|76857||53.74|0|53.74|0||US EXAM - PELVIC - LIMITED|| 80001|76857|26|28.93|0|28.93|0||US EXAM - PELVIC - LIMITED|| 80001|76857|TC|24.81|0|24.81|0||US EXAM - PELVIC - LIMITED|| 80001|76870||75.67|0|75.67|0||US EXAM - SCROTUM|| 80001|76870|26|37.29|0|37.29|0||US EXAM - SCROTUM|| 80001|76870|TC|38.38|0|38.38|0||US EXAM - SCROTUM|| 80001|76872||105.35|0|105.35|0||US - TRANSRECTAL|| 80001|76872|26|39.84|0|39.84|0||US - TRANSRECTAL|| 80001|76872|TC|65.52|0|65.52|0||US - TRANSRECTAL|| 80001|76873||188.57|0|188.57|0||ECHOGRAP TRANS R - PROS STUDY|| 80001|76873|26|91.66|0|91.66|0||ECHOGRAP TRANS R - PROS STUDY|| 80001|76873|TC|96.91|0|96.91|0||ECHOGRAP TRANS R - PROS STUDY|| 80001|76881||130.29|0|130.29|0||US XTR NON-VASC COMPLETE|| 80001|76881|26|37.64|0|37.64|0||US XTR NON-VASC COMPLETE|| 80001|76881|TC|92.65|0|92.65|0||US XTR NON-VASC COMPLETE|| 80001|76882||41.68|0|41.68|0||US XTR NON-VASC LMTD|| 80001|76882|26|29.28|0|29.28|0||US XTR NON-VASC LMTD|| 80001|76882|TC|12.41|0|12.41|0||US XTR NON-VASC LMTD|| 80001|76885||142.01|0|0|0||US EXAM INFANT HIPS - DYNAMIC|| 80001|76885|26|43.15|0|43.15|0||US EXAM INFANT HIPS - DYNAMIC|| 80001|76885|TC|98.86|0|0|0||US EXAM INFANT HIPS - DYNAMIC|| 80001|76886||119.39|0|119.39|0||US EXAM INFANT HIPS - STATIC|| 80001|76886|26|37.21|0|37.21|0||US EXAM INFANT HIPS - STATIC|| 80001|76886|TC|82.18|0|82.18|0||US EXAM INFANT HIPS - STATIC|| 80001|76930||0|0|0|0||ECHO GUIDE - CARDIOCENTESIS|| 80001|76930|26|39.76|0|39.76|0||ECHO GUIDE - CARDIOCENTESIS|| 80001|76930|TC|0|0|0|0||ECHO GUIDE - CARDIOCENTESIS|| 80001|76932||0|0|0|0||ECHO GUIDE FOR HEART BIOPSY|| 80001|76932|26|39.37|0|39.37|0||ECHO GUIDE FOR HEART BIOPSY|| 80001|76932|TC|0|0|0|0||ECHO GUIDE FOR HEART BIOPSY|| 80001|76936||308.78|0|308.78|0||ECHO GUIDE FOR ARTERY REPAIR|| 80001|76936|26|119.99|0|119.99|0||ECHO GUIDE FOR ARTERY REPAIR|| 80001|76936|TC|188.79|0|188.79|0||ECHO GUIDE FOR ARTERY REPAIR|| 80001|76937||36.59|0|36.59|0||US GUIDE - VASCULAR ACCESS|| 80001|76937|26|17.59|0|17.59|0||US GUIDE - VASCULAR ACCESS|| 80001|76937|TC|19|0|19|0||US GUIDE - VASCULAR ACCESS|| 80001|76940||258.38|0|258.38|||US GUIDE - TISSUE ABLATION|| 80001|76940|26|125.46|0|125.46|0||US GUIDE - TISSUE ABLATION|| 80001|76940|59|258.38|0|258.38|||US GUIDE - TISSUE ABLATION|| 80001|76940|TC|0|0|0|0||US GUIDE - TISSUE ABLATION|| 80001|76941||0|0|0|0||ECHO GUIDE FOR TRANSFUSION|| 80001|76941|26|81.85|0|81.85|0||ECHO GUIDE FOR TRANSFUSION|| 80001|76941|TC|0|0|0|0||ECHO GUIDE FOR TRANSFUSION|| 80001|76942||68.83|0|68.83|0||ECHO GUIDE FOR BIOPSY|| 80001|76942|26|39.37|0|39.37|0||ECHO GUIDE FOR BIOPSY|| 80001|76942|TC|29.46|0|29.46|0||ECHO GUIDE FOR BIOPSY|| 80001|76945||0|0|0|0||ECHO GUIDE - VILLUS SAMPLING|| 80001|76945|26|41.7|0|41.7|0||ECHO GUIDE - VILLUS SAMPLING|| 80001|76945|TC|0|0|0|0||ECHO GUIDE - VILLUS SAMPLING|| 80001|76946||37.72|0|37.72|0||ECHO GUIDE FOR AMNIOCENTESIS|| 80001|76946|26|23.37|0|23.37|0||ECHO GUIDE FOR AMNIOCENTESIS|| 80001|76946|TC|14.35|0|14.35|0||ECHO GUIDE FOR AMNIOCENTESIS|| 80001|76948||37.72|0|37.72|0||ECHO GUIDE - OVA ASPIRATION|| 80001|76948|26|23.37|0|23.37|0||ECHO GUIDE - OVA ASPIRATION|| 80001|76948|TC|14.35|0|14.35|0||ECHO GUIDE - OVA ASPIRATION|| 80001|76965||104.31|0|104.31|0||ECHO GUIDANCE RADIOTHERAPY|| 80001|76965|26|78.72|0|78.72|0||ECHO GUIDANCE RADIOTHERAPY|| 80001|76965|TC|25.59|0|25.59|0||ECHO GUIDANCE RADIOTHERAPY|| 80001|76970||103.71|0|103.71|0||ULTRASOUND EXAM FOLLOW-UP|| 80001|76970|26|24.24|0|24.24|0||ULTRASOUND EXAM FOLLOW-UP|| 80001|76970|TC|79.47|0|79.47|0||ULTRASOUND EXAM FOLLOW-UP|| 80001|76975||0|0|0|0||GI ENDOSCOPIC ULTRASOUND|| 80001|76975|26|52.01|0|52.01|0||GI ENDOSCOPIC ULTRASOUND|| 80001|76975|TC|0|0|0|0||GI ENDOSCOPIC ULTRASOUND|| 80001|76977||7.98|0|7.98|0||US BONE DENSITY MEASURE|| 80001|76977|26|3.32|0|3.32|0||US BONE DENSITY MEASURE|| 80001|76977|TC|4.65|0|4.65|0||US BONE DENSITY MEASURE|| 80001|76998||0|0|0|0||US GUIDE - INTRAOP|| 80001|76998|26|77|0|77|0||US GUIDE - INTRAOP|| 80001|76998|TC|0|0|0|0||US GUIDE - INTRAOP|| 80001|76999||0|0|0|0||ECHO EXAMINATION PROCEDURE|| 80001|76999|26|0|0|0|0||ECHO EXAMINATION PROCEDURE|| 80001|76999|TC|0|0|0|0||ECHO EXAMINATION PROCEDURE|| 80001|77001||78.03|0|78.03|0||FLUOROGUIDE FOR VEIN DEVICE|| 80001|77001|26|22.2|0|22.2|0||FLUOROGUIDE FOR VEIN DEVICE|| 80001|77001|TC|55.82|0|55.82|0||FLUOROGUIDE FOR VEIN DEVICE|| 80001|77002||102.76|0|102.76|0||NEEDLE LOCALIZATION BY XRAY|| 80001|77002|26|32.98|0|32.98|0||NEEDLE LOCALIZATION BY XRAY|| 80001|77002|TC|69.78|0|69.78|0||NEEDLE LOCALIZATION BY XRAY|| 80001|77003||95.66|0|95.66|0||FLUOROGUIDE FOR SPINE INJECT|| 80001|77003|26|35.96|0|35.96|0||FLUOROGUIDE FOR SPINE INJECT|| 80001|77003|TC|59.7|0|59.7|0||FLUOROGUIDE FOR SPINE INJECT|| 80001|77011||244.46|0|244.46|0||CT SCAN FOR LOCALIZATION|| 80001|77011|26|73.12|0|73.12|0||CT SCAN FOR LOCALIZATION|| 80001|77011|TC|171.34|0|171.34|0||CT SCAN FOR LOCALIZATION|| 80001|77012||140.74|0|140.74|0||CT SCAN FOR NEEDLE BIOPSY|| 80001|77012|26|68.25|0|68.25|0||CT SCAN FOR NEEDLE BIOPSY|| 80001|77012|TC|72.49|0|72.49|0||CT SCAN FOR NEEDLE BIOPSY|| 80001|77013||0|0|0|0||CT GUIDE FOR TISSUE ABLATION|| 80001|77013|26|239.2|0|239.2|0||CT GUIDE FOR TISSUE ABLATION|| 80001|77013|TC|0|0|0|0||CT GUIDE FOR TISSUE ABLATION|| 80001|77014||130.86|0|130.86|0||CT SCAN FOR THERAPY GUIDE|| 80001|77014|26|51.39|0|51.39|0||CT SCAN FOR THERAPY GUIDE|| 80001|77014|TC|79.47|0|79.47|0||CT SCAN FOR THERAPY GUIDE|| 80001|77021||454.29|0|454.29|0||MR GUIDANCE FOR NEEDLE PLACE|| 80001|77021|26|89.9|0|89.9|0||MR GUIDANCE FOR NEEDLE PLACE|| 80001|77021|TC|364.39|0|364.39|0||MR GUIDANCE FOR NEEDLE PLACE|| 80001|77022||0|0|0|0||MRI FOR TISSUE ABLATION|| 80001|77022|26|260.06|0|260.06|0||MRI FOR TISSUE ABLATION|| 80001|77022|TC|0|0|0|0||MRI FOR TISSUE ABLATION|| 80001|77051||9.96|0|9.96|0||MAMMOGRAPHY; COMPUTER AIDED|| 80001|77051|26|3.75|0|3.75|0||MAMMOGRAPHY; COMPUTER AIDED|| 80001|77051|TC|6.2|0|6.2|0||MAMMOGRAPHY; COMPUTER AIDED|| 80001|77052||9.96|0|9.96|0||COMPUTER AIDED DETECTION|| 80001|77052|26|3.75|0|3.75|0||COMPUTER AIDED DETECTION|| 80001|77052|TC|6.2|0|6.2|0||COMPUTER AIDED DETECTION|| 80001|77053||64.76|0|64.76|0||X-RAY OF MAMMARY DUCT|| 80001|77053|26|21.34|0|21.34|0||X-RAY OF MAMMARY DUCT|| 80001|77053|TC|43.42|0|43.42|0||X-RAY OF MAMMARY DUCT|| 80001|77054||84.93|0|84.93|0||X-RAY OF MAMMARY DUCTS|| 80001|77054|26|27.16|0|27.16|0||X-RAY OF MAMMARY DUCTS|| 80001|77054|TC|57.76|0|57.76|0||X-RAY OF MAMMARY DUCTS|| 80001|77055||100.75|0|100.75|0||MAMMOGRAPHY; UNILATERAL|| 80001|77055|26|41.82|0|41.82|0||MAMMOGRAPHY; UNILATERAL|| 80001|77055|TC|58.93|0|58.93|0||MAMMOGRAPHY; UNILATERAL|| 80001|77056||129.4|0|129.4|0||MAMMOGRAM - BOTH BREASTS|| 80001|77056|26|51.87|0|51.87|0||MAMMOGRAM - BOTH BREASTS|| 80001|77056|TC|77.53|0|77.53|0||MAMMOGRAM - BOTH BREASTS|| 80001|77057||92.61|0|92.61|0||SCREEN MAMMOGRAM - BILAT(2 VIEW)|| 80001|77057|26|41.82|0|41.82|0||SCREEN MAMMOGRAM - BILAT(2 VIEW)|| 80001|77057|TC|50.78|0|50.78|0||SCREEN MAMMOGRAM - BILAT(2 VIEW)|| 80001|77058||595.58|0|595.58|0||MRI - ONE BREAST|| 80001|77058|26|97.44|0|97.44|0||MRI - ONE BREAST|| 80001|77058|TC|498.14|0|498.14|0||MRI - ONE BREAST|| 80001|77059||589.38|0|589.38|0||MRI - BOTH BREASTS|| 80001|77059|26|97.44|0|97.44|0||MRI - BOTH BREASTS|| 80001|77059|TC|491.93|0|491.93|0||MRI - BOTH BREASTS|| 80001|77061||0|0|0|0||BREAST TOMOSYNTHESIS UNI|| 80001|77061|26|0|0|0|0||BREAST TOMOSYNTHESIS UNI|| 80001|77061|TC|0|0|0|0||BREAST TOMOSYNTHESIS UNI|| 80001|77062||0|0|0|0||BREAST TOMOSYNTHESIS BI|| 80001|77062|26|0|0|0|0||BREAST TOMOSYNTHESIS BI|| 80001|77062|TC|0|0|0|0||BREAST TOMOSYNTHESIS BI|| 80001|77063||63.48|0|63.48|0||BREAST TOMOSYNTHESIS BI|| 80001|77063|26|35.57|0|35.57|0||BREAST TOMOSYNTHESIS BI|| 80001|77063|TC|27.91|0|27.91|0||BREAST TOMOSYNTHESIS BI|| 80001|77065||161.94|0|161.94|0||DX MAMMO INCL CAD UNI|| 80001|77065|26|47.81|0|47.81|0||DX MAMMO INCL CAD UNI|| 80001|77065|TC|114.13|0|114.13|0||DX MAMMO INCL CAD UNI|| 80001|77066||205.43|0|205.43|0||DX MAMMO INCL CAD BI|| 80001|77066|26|59.44|0|59.44|0||DX MAMMO INCL CAD BI|| 80001|77066|TC|145.99|0|145.99|0||DX MAMMO INCL CAD BI|| 80001|77067||165.8|0|165.8|0||SCR MAMMO BI INCL CAD|| 80001|77067|26|45.22|0|45.22|0||SCR MAMMO BI INCL CAD|| 80001|77067|TC|120.59|0|120.59|0||SCR MAMMO BI INCL CAD|| 80001|77071||54.52|0|54.52|0||X-RAY STRESS VIEW|| 80001|77072||26.03|0|26.03|0||X-RAYS FOR BONE AGE|| 80001|77072|26|11.3|0|11.3|0||X-RAYS FOR BONE AGE|| 80001|77072|TC|14.73|0|14.73|0||X-RAYS FOR BONE AGE|| 80001|77073||40.72|0|40.72|0||X-RAYS - BONE LENGTH STUDIES|| 80001|77073|26|17.46|0|17.46|0||X-RAYS - BONE LENGTH STUDIES|| 80001|77073|TC|23.26|0|23.26|0||X-RAYS - BONE LENGTH STUDIES|| 80001|77074||71.36|0|71.36|0||X-RAYS - BONE SURVEY - LIMITED|| 80001|77074|26|26.77|0|26.77|0||X-RAYS - BONE SURVEY - LIMITED|| 80001|77074|TC|44.58|0|44.58|0||X-RAYS - BONE SURVEY - LIMITED|| 80001|77075||96.95|0|96.95|0||X-RAYS - BONE SURVEY COMPLETE|| 80001|77075|26|32.21|0|32.21|0||X-RAYS - BONE SURVEY COMPLETE|| 80001|77075|TC|64.74|0|64.74|0||X-RAYS - BONE SURVEY COMPLETE|| 80001|77076||106.56|0|106.56|0||X-RAYS - BONE SURVEY - INFANT|| 80001|77076|26|41.82|0|41.82|0||X-RAYS - BONE SURVEY - INFANT|| 80001|77076|TC|64.74|0|64.74|0||X-RAYS - BONE SURVEY - INFANT|| 80001|77077||42.45|0|42.45|0||JOINT SURVEY - SINGLE VIEW|| 80001|77077|26|19.97|0|19.97|0||JOINT SURVEY - SINGLE VIEW|| 80001|77077|TC|22.49|0|22.49|0||JOINT SURVEY - SINGLE VIEW|| 80001|77078||79.01|0|0|0||CT BONE DENSITY - AXIAL|| 80001|77078|26|14.66|0|14.66|0||CT BONE DENSITY - AXIAL|| 80001|77078|TC|64.36|0|0|0||CT BONE DENSITY - AXIAL|| 80001|77080||45.84|0|45.84|0||DXA BONE DENSITY - AXIAL|| 80001|77080|26|12.12|0|12.12|0||DXA BONE DENSITY - AXIAL|| 80001|77080|TC|33.73|0|33.73|0||DXA BONE DENSITY - AXIAL|| 80001|77081||31.59|0|31.59|0||DXA BONE DENSITY/PERIPHERAL|| 80001|77081|26|12.98|0|12.98|0||DXA BONE DENSITY/PERIPHERAL|| 80001|77081|TC|18.61|0|18.61|0||DXA BONE DENSITY/PERIPHERAL|| 80001|77084||405.5|0|0|0||MAGNETIC IMAGE - BONE MARROW|| 80001|77084|26|96.54|0|96.54|0||MAGNETIC IMAGE - BONE MARROW|| 80001|77084|TC|308.96|0|0|0||MAGNETIC IMAGE - BONE MARROW|| 80001|77085||62.56|0|62.56|0||DXA BONE DENSITY STUDY|| 80001|77085|26|17.98|0|17.98|0||DXA BONE DENSITY STUDY|| 80001|77085|TC|44.58|0|44.58|0||DXA BONE DENSITY STUDY|| 80001|77086||39.51|0|39.51|0||FRACTURE ASSESSMENT VIA DXA|| 80001|77086|26|10.43|0|10.43|0||FRACTURE ASSESSMENT VIA DXA|| 80001|77086|TC|29.08|0|29.08|0||FRACTURE ASSESSMENT VIA DXA|| 80001|77261||88.64|0|88.64|0||RADIATION THERAPY PLANNING|| 80001|77262||132.11|0|132.11|0||RADIATION THERAPY PLANNING|| 80001|77263||193.6|0|193.6|0||RADIATION THERAPY PLANNING|| 80001|77280||297.28|0|297.28|0||SET RADIATION THERAPY FIELD|| 80001|77280|26|42.21|0|42.21|0||SET RADIATION THERAPY FIELD|| 80001|77280|TC|255.08|0|255.08|0||SET RADIATION THERAPY FIELD|| 80001|77285||468.21|0|468.21|0||SET RADIATION THERAPY FIELD|| 80001|77285|26|63.5|0|63.5|0||SET RADIATION THERAPY FIELD|| 80001|77285|TC|404.71|0|404.71|0||SET RADIATION THERAPY FIELD|| 80001|77290||560.76|0|560.76|0||SET RADIATION THERAPY FIELD|| 80001|77290|26|94.03|0|94.03|0||SET RADIATION THERAPY FIELD|| 80001|77290|TC|466.73|0|466.73|0||SET RADIATION THERAPY FIELD|| 80001|77293||512.29|0|512.29|0||RESPIRATOR MOTION MGMT SIMUL|| 80001|77293|26|121.15|0|121.15|0||RESPIRATOR MOTION MGMT SIMUL|| 80001|77293|TC|391.14|0|391.14|0||RESPIRATOR MOTION MGMT SIMUL|| 80001|77295||549.05|0|549.05|0||SET RADIATION THERAPY FIELD|| 80001|77295|26|259.85|0|259.85|0||SET RADIATION THERAPY FIELD|| 80001|77295|TC|289.2|0|289.2|0||SET RADIATION THERAPY FIELD|| 80001|77299||0|0|0|0||RADIATION THERAPY PLANNING|| 80001|77299|26|0|0|0|0||RADIATION THERAPY PLANNING|| 80001|77299|TC|0|0|0|0||RADIATION THERAPY PLANNING|| 80001|77300||71.32|0|71.32|0||RADIATION THERAPY DOSE PLAN|| 80001|77300|26|37.6|0|37.6|0||RADIATION THERAPY DOSE PLAN|| 80001|77300|TC|33.73|0|33.73|0||RADIATION THERAPY DOSE PLAN|| 80001|77301||2139.49|0|2139.1|0||RADIOTHERAPY DOSE PLAN - IMRT|| 80001|77301|26|483.39|0|483|0||RADIOTHERAPY DOSE PLAN - IMRT|| 80001|77301|TC|1656.1|0|1656.1|0||RADIOTHERAPY DOSE PLAN - IMRT|| 80001|77306||163.89|0|163.89|0||TELETHX ISODOSE PLAN SIMPLE|| 80001|77306|26|84.42|0|84.42|0||TELETHX ISODOSE PLAN SIMPLE|| 80001|77306|TC|79.47|0|79.47|0||TELETHX ISODOSE PLAN SIMPLE|| 80001|77307||321.62|0|321.62|0||TELETHX ISODOSE PLAN CPLX|| 80001|77307|26|175.86|0|175.86|0||TELETHX ISODOSE PLAN CPLX|| 80001|77307|TC|145.76|0|145.76|0||TELETHX ISODOSE PLAN CPLX|| 80001|77316||208.47|0|208.47|0||BRACHYTX ISODOSE PLAN SIMPLE|| 80001|77316|26|84.42|0|84.42|0||BRACHYTX ISODOSE PLAN SIMPLE|| 80001|77316|TC|124.05|0|124.05|0||BRACHYTX ISODOSE PLAN SIMPLE|| 80001|77317||272.76|0|272.76|0||BRACHYTX ISODOSE INTERMED|| 80001|77317|26|111.1|0|111.1|0||BRACHYTX ISODOSE INTERMED|| 80001|77317|TC|161.66|0|161.66|0||BRACHYTX ISODOSE INTERMED|| 80001|77318||395.28|0|395.28|0||BRACHYTX ISODOSE COMPLEX|| 80001|77318|26|175.86|0|175.86|0||BRACHYTX ISODOSE COMPLEX|| 80001|77318|TC|219.42|0|219.42|0||BRACHYTX ISODOSE COMPLEX|| 80001|77321||104.16|0|104.16|0||SPECIAL TELETX PORT PLAN|| 80001|77321|26|57.25|0|57.25|0||SPECIAL TELETX PORT PLAN|| 80001|77321|TC|46.91|0|46.91|0||SPECIAL TELETX PORT PLAN|| 80001|77331||73.19|0|73.19|0||SPECIAL RADIATION DOSIMETRY|| 80001|77331|26|52.64|0|52.64|0||SPECIAL RADIATION DOSIMETRY|| 80001|77331|TC|20.55|0|20.55|0||SPECIAL RADIATION DOSIMETRY|| 80001|77332||91.91|0|91.91|0||RADIATION TREATMENT AID(S)|| 80001|77332|26|32.98|0|32.98|0||RADIATION TREATMENT AID(S)|| 80001|77332|TC|58.93|0|58.93|0||RADIATION TREATMENT AID(S)|| 80001|77333||61.04|0|61.04|0||RADIATION TREATMENT AID(S)|| 80001|77333|26|50.96|0|50.96|0||RADIATION TREATMENT AID(S)|| 80001|77333|TC|10.08|0|10.08|0||RADIATION TREATMENT AID(S)|| 80001|77334||170.55|0|170.55|0||RADIATION TREATMENT AID(S)|| 80001|77334|26|74.8|0|74.8|0||RADIATION TREATMENT AID(S)|| 80001|77334|TC|95.75|0|95.75|0||RADIATION TREATMENT AID(S)|| 80001|77336||83.35|0|83.35|0||RADIATION PHYSICS CONSULT|| 80001|77338||567.27|0|567.27|0||DESIGN MLC DEVICE FOR IMRT|| 80001|77338|26|259.85|0|259.85|0||DESIGN MLC DEVICE FOR IMRT|| 80001|77338|TC|307.42|0|307.42|0||DESIGN MLC DEVICE FOR IMRT|| 80001|77370||126.77|0|126.77|0||RADIATION PHYSICS CONSULT|| 80001|77371||0|0|0|0||SRS - MULTISOURCE|| 80001|77372||1152.5|0|1152.5|0||SRS - LINEAR BASED|| 80001|77373||1463.4|0|1463.4|0||SBRT DELIVERY|| 80001|77385||0|0|0|0||NTSTY MODUL RAD TX DLVR SMPL|| 80001|77386||0|0|0|0||NTSTY MODUL RAD TX DLVR CPLX|| 80001|77387||0|0|0|0||GUIDANCE FOR RADIAJ TX DLVR|| 80001|77399||0|0|0|0||EXTERNAL RADIATION DOSIMETRY|| 80001|77399|26|0|0|0|0||EXTERNAL RADIATION DOSIMETRY|| 80001|77399|TC|0|0|0|0||EXTERNAL RADIATION DOSIMETRY|| 80001|77401||22.49|0|22.49|0||RADIATION TREATMENT DELIVERY|| 80001|77402||0|0|0|0||RADIATION TREATMENT DELIVERY|| 80001|77407||0|0|0|0||RADIATION TREATMENT DELIVERY|| 80001|77412||0|0|0|0||RADIATION TREATMENT DELIVERY|| 80001|77417||11.63|0|11.63|0||RADIOLOGY PORT FILM(S)|| 80001|77422||36.44|0|36.44|0||NEUTRON BEAM TX - SIMPLE|| 80001|77423||70.94|0|70.94|0||NEUTRON BEAM TX - COMPLEX|| 80001|77424||0|0|0|0||IO RAD TX DELIVERY BY X-RAY|| 80001|77425||0|0|0|0||WEEKLY RADIATION THERAPY|| 80001|77427||217.09|0|217.09|0||RADIATION TX MANAGEMENT - X5|| 80001|77431||118.78|0|118.78|0||RADIATION THERAPY MANAGEMENT|| 80001|77432||488.57|0|488.18|0||STEREOTACTIC RADIATION TRMT|| 80001|77435||736.87|0|736.49|0||SBRT MANAGEMENT|| 80001|77469||374.4|0|374.4|0||IO RADIATION TX MANAGEMENT|| 80001|77470||178.14|0|178.14|0||SPECIAL RADIATION TREATMENT|| 80001|77470|26|126.58|0|126.58|0||SPECIAL RADIATION TREATMENT|| 80001|77470|TC|51.56|0|51.56|0||SPECIAL RADIATION TREATMENT|| 80001|77499||0|0|0|0||RADIATION THERAPY MANAGEMENT|| 80001|77499|26|0|0|0|0||RADIATION THERAPY MANAGEMENT|| 80001|77499|TC|0|0|0|0||RADIATION THERAPY MANAGEMENT|| 80001|77520||0|0|0|0||PROTON TRMT - SIMPLE W/O COMP|| 80001|77522||0|0|0|0||PROTON TRMT - SIMPLE W/COMP|| 80001|77523||0|0|0|0||PROTON TRMT - INTERMEDIATE|| 80001|77525||0|0|0|0||PROTON TREATMENT - COMPLEX|| 80001|77600||444.86|0|444.86|0||HYPERTHERMIA TREATMENT|| 80001|77600|26|94.42|0|94.42|0||HYPERTHERMIA TREATMENT|| 80001|77600|TC|350.44|0|350.44|0||HYPERTHERMIA TREATMENT|| 80001|77605||838.32|0|838.32|0||HYPERTHERMIA TREATMENT|| 80001|77605|26|125.81|0|125.81|0||HYPERTHERMIA TREATMENT|| 80001|77605|TC|712.51|0|712.51|0||HYPERTHERMIA TREATMENT|| 80001|77610||1125.19|0|1125.19|0||HYPERTHERMIA TREATMENT|| 80001|77610|26|91.7|0|91.7|0||HYPERTHERMIA TREATMENT|| 80001|77610|TC|1033.49|0|1033.49|0||HYPERTHERMIA TREATMENT|| 80001|77615||1108.13|0|1108.13|0||HYPERTHERMIA TREATMENT|| 80001|77615|26|126.58|0|126.58|0||HYPERTHERMIA TREATMENT|| 80001|77615|TC|981.55|0|981.55|0||HYPERTHERMIA TREATMENT|| 80001|77620||512.37|0|512.37|0||HYPERTHERMIA TREATMENT|| 80001|77620|26|102.61|0|102.61|0||HYPERTHERMIA TREATMENT|| 80001|77620|TC|409.76|0|409.76|0||HYPERTHERMIA TREATMENT|| 80001|77750||424.61|0|424.61|0||INFUSE RADIOACTIVE MATERIALS|| 80001|77750|26|302.87|0|302.87|0||INFUSE RADIOACTIVE MATERIALS|| 80001|77750|TC|121.73|0|121.73|0||INFUSE RADIOACTIVE MATERIALS|| 80001|77761||438.19|0|438.19|0||APPLY INTRCAV RADIAT SIMPLE|| 80001|77761|26|230.79|0|230.79|0||APPLY INTRCAV RADIAT SIMPLE|| 80001|77761|TC|207.4|0|207.4|0||APPLY INTRCAV RADIAT SIMPLE|| 80001|77762||620.79|0|620.79|0||APPLY INTRCAV RADIAT INTERM|| 80001|77762|26|381.98|0|381.98|0||APPLY INTRCAV RADIAT INTERM|| 80001|77762|TC|238.81|0|238.81|0||APPLY INTRCAV RADIAT INTERM|| 80001|77763||832.12|0|831.73|0||APPLY INTRCAV RADIAT COMPL|| 80001|77763|26|523.53|0|523.14|0||APPLY INTRCAV RADIAT COMPL|| 80001|77763|TC|308.59|0|308.59|0||APPLY INTRCAV RADIAT COMPL|| 80001|77767||249.85|0|249.85|0||HDR RDNCL SKN SURF BRACHYTX|| 80001|77767|26|64.05|0|64.05|0||HDR RDNCL SKN SURF BRACHYTX|| 80001|77767|TC|185.8|0|185.8|0||HDR RDNCL SKN SURF BRACHYTX|| 80001|77768||390.42|0|390.42|0||HDR RDNCL SKN SURF BRACHYTX|| 80001|77768|26|84.88|0|84.88|0||HDR RDNCL SKN SURF BRACHYTX|| 80001|77768|TC|305.54|0|305.54|0||HDR RDNCL SKN SURF BRACHYTX|| 80001|77770||358.44|0|358.44|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77770|26|118.56|0|118.56|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77770|TC|239.87|0|239.87|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77771||667.77|0|667.77|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77771|26|230.9|0|230.9|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77771|TC|436.87|0|436.87|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77772||1018.51|0|1018.51|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77772|26|327.85|0|327.85|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77772|TC|690.65|0|690.65|0||HDR RDNCL NTRSTL/ICAV BRCHTX|| 80001|77778||996.46|0|996.08|0||APPLY INTERSTIT RADIAT COMPL|| 80001|77778|26|682.84|0|682.45|0||APPLY INTERSTIT RADIAT COMPL|| 80001|77778|TC|313.63|0|313.63|0||APPLY INTERSTIT RADIAT COMPL|| 80001|77789||134.06|0|134.06|0||APPLY SURFACE RADIATION|| 80001|77789|26|68.94|0|68.94|0||APPLY SURFACE RADIATION|| 80001|77789|TC|65.13|0|65.13|0||APPLY SURFACE RADIATION|| 80001|77790||109.64|0|109.64|0||RADIATION HANDLING|| 80001|77790|26|62.73|0|62.73|0||RADIATION HANDLING|| 80001|77790|TC|46.91|0|46.91|0||RADIATION HANDLING|| 80001|77799||0|0|0|0||RADIUM/RADIOISOTOPE THERAPY|| 80001|77799|26|0|0|0|0||RADIUM/RADIOISOTOPE THERAPY|| 80001|77799|TC|0|0|0|0||RADIUM/RADIOISOTOPE THERAPY|| 80001|78012||90.38|0|90.38|0||THYROID UPTAKE MEASUREMENT|| 80001|78012|26|11.3|0|11.3|0||THYROID UPTAKE MEASUREMENT|| 80001|78012|TC|79.09|0|79.09|0||THYROID UPTAKE MEASUREMENT|| 80001|78013||215.21|0|215.21|0||THYROID IMAGING W/BLOOD FLOW|| 80001|78013|26|21.38|0|21.38|0||THYROID IMAGING W/BLOOD FLOW|| 80001|78013|TC|193.83|0|193.83|0||THYROID IMAGING W/BLOOD FLOW|| 80001|78014||273.16|0|273.16|0||THYROID IMAGING W/BLOOD FLOW|| 80001|78014|26|28.93|0|28.93|0||THYROID IMAGING W/BLOOD FLOW|| 80001|78014|TC|244.23|0|244.23|0||THYROID IMAGING W/BLOOD FLOW|| 80001|78015||250.64|0|250.64|0||THYROID MET IMAGING|| 80001|78015|26|38.59|0|38.59|0||THYROID MET IMAGING|| 80001|78015|TC|212.05|0|212.05|0||THYROID MET IMAGING|| 80001|78016||321.84|0|321.84|0||THYROID MET IMAGING/STUDIES|| 80001|78016|26|41.56|0|41.56|0||THYROID MET IMAGING/STUDIES|| 80001|78016|TC|280.28|0|280.28|0||THYROID MET IMAGING/STUDIES|| 80001|78018||354.19|0|354.19|0||THYROID MET IMAGING - BODY|| 80001|78018|26|49.11|0|49.11|0||THYROID MET IMAGING - BODY|| 80001|78018|TC|305.09|0|305.09|0||THYROID MET IMAGING - BODY|| 80001|78020||96.43|0|96.43|0||THYROID MET UPTAKE|| 80001|78020|26|33.24|0|33.24|0||THYROID MET UPTAKE|| 80001|78020|TC|63.19|0|63.19|0||THYROID MET UPTAKE|| 80001|78070||341.53|0|341.53|0||PARATHYROID NUCLEAR IMAGING|| 80001|78070|26|46.91|0|46.91|0||PARATHYROID NUCLEAR IMAGING|| 80001|78070|TC|294.62|0|294.62|0||PARATHYROID NUCLEAR IMAGING|| 80001|78071||408.01|0|408.01|0||PARATHYRD PLANAR W/WO SUBTRJ|| 80001|78071|26|69.98|0|69.98|0||PARATHYRD PLANAR W/WO SUBTRJ|| 80001|78071|TC|338.04|0|338.04|0||PARATHYRD PLANAR W/WO SUBTRJ|| 80001|78072||467.91|0|467.91|0||PARATHYRD PLANAR W/SPECT&CT|| 80001|78072|26|91.1|0|91.1|0||PARATHYRD PLANAR W/SPECT&CT|| 80001|78072|TC|376.81|0|376.81|0||PARATHYRD PLANAR W/SPECT&CT|| 80001|78075||512.23|0|512.23|0||ADRENAL NUCLEAR IMAGING|| 80001|78075|26|44.32|0|44.32|0||ADRENAL NUCLEAR IMAGING|| 80001|78075|TC|467.91|0|467.91|0||ADRENAL NUCLEAR IMAGING|| 80001|78099||0|0|0|0||ENDOCRINE NUCLEAR PROCEDURE|| 80001|78099|26|0|0|0|0||ENDOCRINE NUCLEAR PROCEDURE|| 80001|78099|TC|0|0|0|0||ENDOCRINE NUCLEAR PROCEDURE|| 80001|78102||193.13|0|193.13|0||BONE MARROW IMAGING - LTD|| 80001|78102|26|31.86|0|31.86|0||BONE MARROW IMAGING - LTD|| 80001|78102|TC|161.27|0|161.27|0||BONE MARROW IMAGING - LTD|| 80001|78103||251.37|0|251.37|0||BONE MARROW IMAGING - MULT|| 80001|78103|26|42.03|0|42.03|0||BONE MARROW IMAGING - MULT|| 80001|78103|TC|209.34|0|209.34|0||BONE MARROW IMAGING - MULT|| 80001|78104||278.72|0|278.72|0||BONE MARROW IMAGING - BODY|| 80001|78104|26|44.96|0|44.96|0||BONE MARROW IMAGING - BODY|| 80001|78104|TC|233.76|0|233.76|0||BONE MARROW IMAGING - BODY|| 80001|78110||116.35|0|116.35|0||PLASMA VOLUME - SINGLE|| 80001|78110|26|11.68|0|11.68|0||PLASMA VOLUME - SINGLE|| 80001|78110|TC|104.67|0|104.67|0||PLASMA VOLUME - SINGLE|| 80001|78111||109.12|0|109.12|0||PLASMA VOLUME - MULTIPLE|| 80001|78111|26|12.98|0|12.98|0||PLASMA VOLUME - MULTIPLE|| 80001|78111|TC|96.14|0|96.14|0||PLASMA VOLUME - MULTIPLE|| 80001|78120||106.45|0|106.45|0||RED CELL MASS - SINGLE|| 80001|78120|26|13.8|0|13.8|0||RED CELL MASS - SINGLE|| 80001|78120|TC|92.65|0|92.65|0||RED CELL MASS - SINGLE|| 80001|78121||119.63|0|119.63|0||RED CELL MASS - MULTIPLE|| 80001|78121|26|18.84|0|18.84|0||RED CELL MASS - MULTIPLE|| 80001|78121|TC|100.79|0|100.79|0||RED CELL MASS - MULTIPLE|| 80001|78122||109.73|0|109.73|0||BLOOD VOLUME|| 80001|78122|26|24.83|0|24.83|0||BLOOD VOLUME|| 80001|78122|TC|84.9|0|84.9|0||BLOOD VOLUME|| 80001|78130||179.44|0|179.44|0||RED CELL SURVIVAL STUDY|| 80001|78130|26|34.45|0|34.45|0||RED CELL SURVIVAL STUDY|| 80001|78130|TC|144.99|0|144.99|0||RED CELL SURVIVAL STUDY|| 80001|78135||397.43|0|397.43|0||RED CELL SURVIVAL KINETICS|| 80001|78135|26|38.46|0|38.46|0||RED CELL SURVIVAL KINETICS|| 80001|78135|TC|358.97|0|358.97|0||RED CELL SURVIVAL KINETICS|| 80001|78140||155.01|0|155.01|0||RED CELL SEQUESTRATION|| 80001|78140|26|35.61|0|35.61|0||RED CELL SEQUESTRATION|| 80001|78140|TC|119.4|0|119.4|0||RED CELL SEQUESTRATION|| 80001|78185||240.16|0|240.16|0||SPLEEN IMAGING|| 80001|78185|26|23.84|0|23.84|0||SPLEEN IMAGING|| 80001|78185|TC|216.32|0|216.32|0||SPLEEN IMAGING|| 80001|78190||366.83|0|0|0||PLATELET SURVIVAL - KINETICS|| 80001|78190|26|64.84|0|64.84|0||PLATELET SURVIVAL - KINETICS|| 80001|78190|TC|301.99|0|0|0||PLATELET SURVIVAL - KINETICS|| 80001|78191||189.91|0|189.91|0||PLATELET SURVIVAL|| 80001|78191|26|36.78|0|36.78|0||PLATELET SURVIVAL|| 80001|78191|TC|153.13|0|153.13|0||PLATELET SURVIVAL|| 80001|78195||405.69|0|405.69|0||LYMPH SYSTEM IMAGING|| 80001|78195|26|69.98|0|69.98|0||LYMPH SYSTEM IMAGING|| 80001|78195|TC|335.71|0|335.71|0||LYMPH SYSTEM IMAGING|| 80001|78199||0|0|0|0||BLOOD/LYMPH NUCLEAR EXAM|| 80001|78199|26|0|0|0|0||BLOOD/LYMPH NUCLEAR EXAM|| 80001|78199|TC|0|0|0|0||BLOOD/LYMPH NUCLEAR EXAM|| 80001|78201||213.59|0|213.59|0||LIVER IMAGING|| 80001|78201|26|25.57|0|25.57|0||LIVER IMAGING|| 80001|78201|TC|188.02|0|188.02|0||LIVER IMAGING|| 80001|78202||227.84|0|227.84|0||LIVER IMAGING WITH FLOW|| 80001|78202|26|28.2|0|28.2|0||LIVER IMAGING WITH FLOW|| 80001|78202|TC|199.65|0|199.65|0||LIVER IMAGING WITH FLOW|| 80001|78205||239.57|0|239.57|0||LIVER IMAGING (3D)|| 80001|78205|26|40.31|0|40.31|0||LIVER IMAGING (3D)|| 80001|78205|TC|199.26|0|199.26|0||LIVER IMAGING (3D)|| 80001|78206||390.69|0|390.69|0||LIVER IMAGE (3D) WITH FLOW|| 80001|78206|26|56.14|0|56.14|0||LIVER IMAGE (3D) WITH FLOW|| 80001|78206|TC|334.55|0|334.55|0||LIVER IMAGE (3D) WITH FLOW|| 80001|78215||220.39|0|220.39|0||LIVER AND SPLEEN IMAGING|| 80001|78215|26|28.5|0|28.5|0||LIVER AND SPLEEN IMAGING|| 80001|78215|TC|191.89|0|191.89|0||LIVER AND SPLEEN IMAGING|| 80001|78216||143.6|0|143.6|0||LIVER & SPLEEN IMAGE/FLOW|| 80001|78216|26|33.11|0|33.11|0||LIVER & SPLEEN IMAGE/FLOW|| 80001|78216|TC|110.49|0|110.49|0||LIVER & SPLEEN IMAGE/FLOW|| 80001|78226||376.16|0|376.16|0||HEPATOBILIARY SYSTEM IMAGING|| 80001|78226|26|43.55|0|43.55|0||HEPATOBILIARY SYSTEM IMAGING|| 80001|78226|TC|332.61|0|332.61|0||HEPATOBILIARY SYSTEM IMAGING|| 80001|78227||455.16|0|0|0||HEPATOBIL SYST IMAGE W/DRUG|| 80001|78227|26|52.77|0|52.77|0||HEPATOBIL SYST IMAGE W/DRUG|| 80001|78227|TC|402.38|0|0|0||HEPATOBIL SYST IMAGE W/DRUG|| 80001|78230||196.18|0|196.18|0||SALIVARY GLAND IMAGING|| 80001|78230|26|26.38|0|26.38|0||SALIVARY GLAND IMAGING|| 80001|78230|TC|169.8|0|169.8|0||SALIVARY GLAND IMAGING|| 80001|78231||147.64|0|147.64|0||SERIAL SALIVARY IMAGING|| 80001|78231|26|30.57|0|30.57|0||SERIAL SALIVARY IMAGING|| 80001|78231|TC|117.08|0|117.08|0||SERIAL SALIVARY IMAGING|| 80001|78232||112.93|0|112.93|0||SALIVARY GLAND FUNCTION EXAM|| 80001|78232|26|24.54|0|24.54|0||SALIVARY GLAND FUNCTION EXAM|| 80001|78232|TC|88.39|0|88.39|0||SALIVARY GLAND FUNCTION EXAM|| 80001|78258||250.55|0|250.55|0||ESOPHAGEAL MOTILITY STUDY|| 80001|78258|26|42.77|0|42.77|0||ESOPHAGEAL MOTILITY STUDY|| 80001|78258|TC|207.79|0|207.79|0||ESOPHAGEAL MOTILITY STUDY|| 80001|78261||287.56|0|287.56|0||GASTRIC MUCOSA IMAGING|| 80001|78261|26|41.39|0|41.39|0||GASTRIC MUCOSA IMAGING|| 80001|78261|TC|246.16|0|246.16|0||GASTRIC MUCOSA IMAGING|| 80001|78262||277.04|0|277.04|0||GASTROESOPHAGEAL REFLUX EXAM|| 80001|78262|26|39.4|0|39.4|0||GASTROESOPHAGEAL REFLUX EXAM|| 80001|78262|TC|237.64|0|237.64|0||GASTROESOPHAGEAL REFLUX EXAM|| 80001|78264||329.13|0|329.13|0||GASTRIC EMPTYING STUDY|| 80001|78264|26|46.91|0|46.91|0||GASTRIC EMPTYING STUDY|| 80001|78264|TC|282.22|0|282.22|0||GASTRIC EMPTYING STUDY|| 80001|78265||415.25|0|415.25|0||GASTRIC EMPTYING IMAG STUDY|| 80001|78265|26|358.07|0|358.07|0||GASTRIC EMPTYING IMAG STUDY|| 80001|78265|TC|57.18|0|57.18|0||GASTRIC EMPTYING IMAG STUDY|| 80001|78266||537.74|0|537.74|0||GASTRIC EMPTYING IMAG STUDY|| 80001|78266|26|63.41|0|63.41|0||GASTRIC EMPTYING IMAG STUDY|| 80001|78266|TC|474.33|0|474.33|0||GASTRIC EMPTYING IMAG STUDY|| 80001|78267||12.84|0|12.84|0||BREATH TST ATTAIN/ANAL C-14|| 80001|78268||22.08|0|22.08|0||BREATH TEST ANALYSIS - C-14|| 80001|78270||114.85|0|114.85|0||VIT B-12 ABSORPTION EXAM|| 80001|78270|26|12.5|0|12.5|0||VIT B-12 ABSORPTION EXAM|| 80001|78270|TC|102.34|0|102.34|0||VIT B-12 ABSORPTION EXAM|| 80001|78271||102.44|0|102.44|0||VIT B-12 ABSRP EXAM - INT FAC|| 80001|78271|26|12.12|0|12.12|0||VIT B-12 ABSRP EXAM - INT FAC|| 80001|78271|TC|90.33|0|90.33|0||VIT B-12 ABSRP EXAM - INT FAC|| 80001|78272||110.11|0|110.11|0||VIT B-12 ABSORP - COMBINED|| 80001|78272|26|15.91|0|15.91|0||VIT B-12 ABSORP - COMBINED|| 80001|78272|TC|94.2|0|94.2|0||VIT B-12 ABSORP - COMBINED|| 80001|78278||397.41|0|397.41|0||ACUTE GI BLOOD LOSS IMAGING|| 80001|78278|26|58.6|0|58.6|0||ACUTE GI BLOOD LOSS IMAGING|| 80001|78278|TC|338.82|0|338.82|0||ACUTE GI BLOOD LOSS IMAGING|| 80001|78282||0|0|0|0||GI PROTEIN LOSS EXAM|| 80001|78282|26|22.98|0|22.98|0||GI PROTEIN LOSS EXAM|| 80001|78282|TC|0|0|0|0||GI PROTEIN LOSS EXAM|| 80001|78290||377.45|0|377.45|0||MECKEL'S DIVERT EXAM|| 80001|78290|26|40.18|0|40.18|0||MECKEL'S DIVERT EXAM|| 80001|78290|TC|337.26|0|337.26|0||MECKEL'S DIVERT EXAM|| 80001|78291||283.73|0|283.73|0||LEVEEN/SHUNT PATENCY EXAM|| 80001|78291|26|50.36|0|50.36|0||LEVEEN/SHUNT PATENCY EXAM|| 80001|78291|TC|233.37|0|233.37|0||LEVEEN/SHUNT PATENCY EXAM|| 80001|78299||0|0|0|0||GI NUCLEAR PROCEDURE|| 80001|78299|26|0|0|0|0||GI NUCLEAR PROCEDURE|| 80001|78299|TC|0|0|0|0||GI NUCLEAR PROCEDURE|| 80001|78300||205.45|0|205.45|0||BONE IMAGING - LIMITED AREA|| 80001|78300|26|37.21|0|37.21|0||BONE IMAGING - LIMITED AREA|| 80001|78300|TC|168.24|0|168.24|0||BONE IMAGING - LIMITED AREA|| 80001|78305||262.97|0|262.97|0||BONE IMAGING - MULTIPLE AREAS|| 80001|78305|26|48.59|0|48.59|0||BONE IMAGING - MULTIPLE AREAS|| 80001|78305|TC|214.38|0|214.38|0||BONE IMAGING - MULTIPLE AREAS|| 80001|78306||287.13|0|287.13|0||BONE IMAGING - WHOLE BODY|| 80001|78306|26|50.27|0|50.27|0||BONE IMAGING - WHOLE BODY|| 80001|78306|TC|236.86|0|236.86|0||BONE IMAGING - WHOLE BODY|| 80001|78315||395.21|0|395.21|0||BONE IMAGING - 3 PHASE|| 80001|78315|26|59.89|0|59.89|0||BONE IMAGING - 3 PHASE|| 80001|78315|TC|335.33|0|335.33|0||BONE IMAGING - 3 PHASE|| 80001|78320||260.78|0|260.78|0||BONE IMAGING (3D)|| 80001|78320|26|59.97|0|59.97|0||BONE IMAGING (3D)|| 80001|78320|TC|200.81|0|200.81|0||BONE IMAGING (3D)|| 80001|78350||37.01|0|37.01|0||BONE MINERAL - SINGLE PHOTON|| 80001|78350|26|12.98|0|12.98|0||BONE MINERAL - SINGLE PHOTON|| 80001|78350|TC|24.04|0|24.04|0||BONE MINERAL - SINGLE PHOTON|| 80001|78351||17.98|0|17.98|0||BONE MINERAL - DUAL PHOTON|| 80001|78399||0|0|0|0||MUSCULOSKELETAL NUCLEAR EXAM|| 80001|78399|26|0|0|0|0||MUSCULOSKELETAL NUCLEAR EXAM|| 80001|78399|TC|0|0|0|0||MUSCULOSKELETAL NUCLEAR EXAM|| 80001|78414||0|0|0|0||NON-IMAGING HEART FUNCTION|| 80001|78414|26|26.78|0|26.78|0||NON-IMAGING HEART FUNCTION|| 80001|78414|TC|0|0|0|0||NON-IMAGING HEART FUNCTION|| 80001|78428||206.54|0|206.54|0||CARDIAC SHUNT IMAGING|| 80001|78428|26|44.88|0|44.88|0||CARDIAC SHUNT IMAGING|| 80001|78428|TC|161.66|0|161.66|0||CARDIAC SHUNT IMAGING|| 80001|78445||204.11|0|204.11|0||VASCULAR FLOW IMAGING|| 80001|78445|26|28.11|0|28.11|0||VASCULAR FLOW IMAGING|| 80001|78445|TC|176|0|176|0||VASCULAR FLOW IMAGING|| 80001|78451||389.8|0|389.8|0||HT MUSCLE IMAGE SPECT - SING|| 80001|78451|26|79.67|0|79.67|0||HT MUSCLE IMAGE SPECT - SING|| 80001|78451|TC|310.13|0|310.13|0||HT MUSCLE IMAGE SPECT - SING|| 80001|78452||538.55|0|538.55|0||HT MUSCLE IMAGE SPECT - MULT|| 80001|78452|26|93.9|0|93.9|0||HT MUSCLE IMAGE SPECT - MULT|| 80001|78452|TC|444.65|0|444.65|0||HT MUSCLE IMAGE SPECT - MULT|| 80001|78453||346.66|0|346.66|0||HT MUSCLE IMAGE - PLANAR - SING|| 80001|78453|26|58.25|0|58.25|0||HT MUSCLE IMAGE - PLANAR - SING|| 80001|78453|TC|288.42|0|288.42|0||HT MUSCLE IMAGE - PLANAR - SING|| 80001|78454||495.85|0|495.85|0||HT MUSC IMAGE - PLANAR - MULT|| 80001|78454|26|78.72|0|78.72|0||HT MUSC IMAGE - PLANAR - MULT|| 80001|78454|TC|417.12|0|417.12|0||HT MUSC IMAGE - PLANAR - MULT|| 80001|78456||364.89|0|364.89|0||ACUTE VENOUS THROMBUS IMAGE|| 80001|78456|26|57.86|0|57.86|0||ACUTE VENOUS THROMBUS IMAGE|| 80001|78456|TC|307.03|0|307.03|0||ACUTE VENOUS THROMBUS IMAGE|| 80001|78457||200.29|0|200.29|0||VENOUS THROMBOSIS IMAGING|| 80001|78457|26|44.45|0|44.45|0||VENOUS THROMBOSIS IMAGING|| 80001|78457|TC|155.84|0|155.84|0||VENOUS THROMBOSIS IMAGING|| 80001|78458||234.58|0|234.58|0||VEN THROMBOSIS IMAGES - BILAT|| 80001|78458|26|53.16|0|53.16|0||VEN THROMBOSIS IMAGES - BILAT|| 80001|78458|TC|181.43|0|181.43|0||VEN THROMBOSIS IMAGES - BILAT|| 80001|78459||0|0|0|0||HEART MUSCLE IMAGING (PET)|| 80001|78459|26|86.41|0|86.41|0||HEART MUSCLE IMAGING (PET)|| 80001|78459|TC|0|0|0|0||HEART MUSCLE IMAGING (PET)|| 80001|78466||222.04|0|222.04|0||HEART INFARCT IMAGE|| 80001|78466|26|41.39|0|41.39|0||HEART INFARCT IMAGE|| 80001|78466|TC|180.65|0|180.65|0||HEART INFARCT IMAGE|| 80001|78468||220.58|0|220.58|0||HEART INFARCT IMAGE (EF)|| 80001|78468|26|46.13|0|46.13|0||HEART INFARCT IMAGE (EF)|| 80001|78468|TC|174.45|0|174.45|0||HEART INFARCT IMAGE (EF)|| 80001|78469||259.87|0|259.87|0||HEART INFARCT IMAGE (3D)|| 80001|78469|26|54.02|0|54.02|0||HEART INFARCT IMAGE (3D)|| 80001|78469|TC|205.85|0|205.85|0||HEART INFARCT IMAGE (3D)|| 80001|78472||262.85|0|262.85|0||GATED HEART - PLANAR - SINGLE|| 80001|78472|26|57|0|57|0||GATED HEART - PLANAR - SINGLE|| 80001|78472|TC|205.85|0|205.85|0||GATED HEART - PLANAR - SINGLE|| 80001|78473||330.88|0|330.88|0||GATED HEART - MULTIPLE|| 80001|78473|26|84.33|0|84.33|0||GATED HEART - MULTIPLE|| 80001|78473|TC|246.55|0|246.55|0||GATED HEART - MULTIPLE|| 80001|78481||200.43|0|200.43|0||HEART FIRST PASS - SINGLE|| 80001|78481|26|56.61|0|56.61|0||HEART FIRST PASS - SINGLE|| 80001|78481|TC|143.82|0|143.82|0||HEART FIRST PASS - SINGLE|| 80001|78483||273.51|0|273.51|0||HEART FIRST PASS - MULTIPLE|| 80001|78483|26|84.72|0|84.72|0||HEART FIRST PASS - MULTIPLE|| 80001|78483|TC|188.79|0|188.79|0||HEART FIRST PASS - MULTIPLE|| 80001|78491||0|0|0|0||HEART IMAGE (PET) - SINGLE|| 80001|78491|26|86.8|0|86.8|0||HEART IMAGE (PET) - SINGLE|| 80001|78491|TC|0|0|0|0||HEART IMAGE (PET) - SINGLE|| 80001|78492||0|0|0|0||HEART IMAGE (PET) - MULTIPLE|| 80001|78492|26|108.96|0|108.96|0||HEART IMAGE (PET) - MULTIPLE|| 80001|78492|TC|0|0|0|0||HEART IMAGE (PET) - MULTIPLE|| 80001|78494||256.78|0|256.78|0||HEART IMAGE - SPECT|| 80001|78494|26|68.77|0|68.77|0||HEART IMAGE - SPECT|| 80001|78494|TC|188.02|0|188.02|0||HEART IMAGE - SPECT|| 80001|78496||51.8|0|51.8|0||HEART FIRST PASS ADD-ON|| 80001|78496|26|28.93|0|28.93|0||HEART FIRST PASS ADD-ON|| 80001|78496|TC|22.87|0|22.87|0||HEART FIRST PASS ADD-ON|| 80001|78499||0|0|0|0||CARDIOVASCULAR NUCLEAR EXAM|| 80001|78499|26|0|0|0|0||CARDIOVASCULAR NUCLEAR EXAM|| 80001|78499|TC|0|0|0|0||CARDIOVASCULAR NUCLEAR EXAM|| 80001|78579||209.53|0|209.53|0||LUNG VENTILATION IMAGING|| 80001|78579|26|27.72|0|27.72|0||LUNG VENTILATION IMAGING|| 80001|78579|TC|181.81|0|181.81|0||LUNG VENTILATION IMAGING|| 80001|78580||271.49|0|271.49|0||LUNG PERFUSION IMAGING|| 80001|78580|26|43.16|0|43.16|0||LUNG PERFUSION IMAGING|| 80001|78580|TC|228.33|0|228.33|0||LUNG PERFUSION IMAGING|| 80001|78582||381.47|0|381.47|0||LUNG VENTILAT&PERFUS IMAGING|| 80001|78582|26|62.82|0|62.82|0||LUNG VENTILAT&PERFUS IMAGING|| 80001|78582|TC|318.66|0|318.66|0||LUNG VENTILAT&PERFUS IMAGING|| 80001|78597||230.44|0|230.44|0||LUNG PERFUSION DIFFERENTIAL|| 80001|78597|26|42.82|0|42.82|0||LUNG PERFUSION DIFFERENTIAL|| 80001|78597|TC|187.63|0|187.63|0||LUNG PERFUSION DIFFERENTIAL|| 80001|78598||348.34|0|348.34|0||LUNG PERF&VENTILAT DIFERENTL|| 80001|78598|26|49.45|0|49.45|0||LUNG PERF&VENTILAT DIFERENTL|| 80001|78598|TC|298.89|0|298.89|0||LUNG PERF&VENTILAT DIFERENTL|| 80001|78599||0|0|0|0||RESPIRATORY NUCLEAR EXAM|| 80001|78599|26|0|0|0|0||RESPIRATORY NUCLEAR EXAM|| 80001|78599|TC|0|0|0|0||RESPIRATORY NUCLEAR EXAM|| 80001|78600||208.93|0|208.93|0||BRAIN IMAGING - LTD STATIC|| 80001|78600|26|25.95|0|25.95|0||BRAIN IMAGING - LTD STATIC|| 80001|78600|TC|182.98|0|182.98|0||BRAIN IMAGING - LTD STATIC|| 80001|78601||243.74|0|243.74|0||BRAIN IMAGING - LTD W/FLOW|| 80001|78601|26|29.75|0|29.75|0||BRAIN IMAGING - LTD W/FLOW|| 80001|78601|TC|213.99|0|213.99|0||BRAIN IMAGING - LTD W/FLOW|| 80001|78605||225.61|0|225.61|0||BRAIN IMAGING - COMPLETE|| 80001|78605|26|31.39|0|31.39|0||BRAIN IMAGING - COMPLETE|| 80001|78605|TC|194.22|0|194.22|0||BRAIN IMAGING - COMPLETE|| 80001|78606||377.27|0|377.27|0||BRAIN IMAGING - COMPL W/FLOW|| 80001|78606|26|37.29|0|37.29|0||BRAIN IMAGING - COMPL W/FLOW|| 80001|78606|TC|339.98|0|339.98|0||BRAIN IMAGING - COMPL W/FLOW|| 80001|78607||401.94|0|401.94|0||BRAIN IMAGING (3D)|| 80001|78607|26|70.49|0|70.49|0||BRAIN IMAGING (3D)|| 80001|78607|TC|331.45|0|331.45|0||BRAIN IMAGING (3D)|| 80001|78608||0|0|0|0||BRAIN IMAGING (PET)|| 80001|78608|26|87.58|0|87.58|0||BRAIN IMAGING (PET)|| 80001|78608|TC|0|0|0|0||BRAIN IMAGING (PET)|| 80001|78609||90.67|0|90.67|0||BRAIN IMAGING (PET)|| 80001|78609|26|90.67|0|90.67|0||BRAIN IMAGING (PET)|| 80001|78609|TC|0|0|0|0||BRAIN IMAGING (PET)|| 80001|78610||197.08|0|197.08|0||BRAIN FLOW IMAGING ONLY|| 80001|78610|26|17.59|0|17.59|0||BRAIN FLOW IMAGING ONLY|| 80001|78610|TC|179.49|0|179.49|0||BRAIN FLOW IMAGING ONLY|| 80001|78630||385.2|0|385.2|0||CEREBROSPINAL FLUID SCAN|| 80001|78630|26|40.18|0|40.18|0||CEREBROSPINAL FLUID SCAN|| 80001|78630|TC|345.02|0|345.02|0||CEREBROSPINAL FLUID SCAN|| 80001|78635||386.06|0|386.06|0||CSF VENTRICULOGRAPHY|| 80001|78635|26|36.78|0|36.78|0||CSF VENTRICULOGRAPHY|| 80001|78635|TC|349.28|0|349.28|0||CSF VENTRICULOGRAPHY|| 80001|78645||366.89|0|366.89|0||CSF SHUNT EVALUATION|| 80001|78645|26|33.11|0|33.11|0||CSF SHUNT EVALUATION|| 80001|78645|TC|333.78|0|333.78|0||CSF SHUNT EVALUATION|| 80001|78647||398.95|0|398.95|0||CEREBROSPINAL FLUID SCAN|| 80001|78647|26|52.38|0|52.38|0||CEREBROSPINAL FLUID SCAN|| 80001|78647|TC|346.57|0|346.57|0||CEREBROSPINAL FLUID SCAN|| 80001|78650||378.69|0|378.69|0||CSF LEAKAGE IMAGING|| 80001|78650|26|36|0|36|0||CSF LEAKAGE IMAGING|| 80001|78650|TC|342.69|0|342.69|0||CSF LEAKAGE IMAGING|| 80001|78660||200.4|0|200.4|0||NUCLEAR EXAM OF TEAR FLOW|| 80001|78660|26|30.61|0|30.61|0||NUCLEAR EXAM OF TEAR FLOW|| 80001|78660|TC|169.8|0|169.8|0||NUCLEAR EXAM OF TEAR FLOW|| 80001|78699||0|0|0|0||NERVOUS SYSTEM NUCLEAR EXAM|| 80001|78699|26|0|0|0|0||NERVOUS SYSTEM NUCLEAR EXAM|| 80001|78699|TC|0|0|0|0||NERVOUS SYSTEM NUCLEAR EXAM|| 80001|78700||194.63|0|194.63|0||KIDNEY IMAGING - STATIC|| 80001|78700|26|26|0|26|0||KIDNEY IMAGING - STATIC|| 80001|78700|TC|168.63|0|168.63|0||KIDNEY IMAGING - STATIC|| 80001|78701||238.61|0|238.61|0||KIDNEY IMAGING WITH FLOW|| 80001|78701|26|28.11|0|28.11|0||KIDNEY IMAGING WITH FLOW|| 80001|78701|TC|210.5|0|210.5|0||KIDNEY IMAGING WITH FLOW|| 80001|78707||265.08|0|265.08|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78707|26|55.36|0|55.36|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78707|TC|209.73|0|209.73|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78708||200.28|0|200.28|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78708|26|70.8|0|70.8|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78708|TC|129.48|0|129.48|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78709||412.42|0|412.42|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78709|26|80.58|0|80.58|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78709|TC|331.84|0|331.84|0||KIDNEY FLOW/FUNCTION IMAGE|| 80001|78710||225.01|0|225.01|0||KIDNEY IMAGING (3D)|| 80001|78710|26|35.44|0|35.44|0||KIDNEY IMAGING (3D)|| 80001|78710|TC|189.57|0|189.57|0||KIDNEY IMAGING (3D)|| 80001|78725||123|0|123|0||KIDNEY FUNCTION STUDY|| 80001|78725|26|21.43|0|21.43|0||KIDNEY FUNCTION STUDY|| 80001|78725|TC|101.57|0|101.57|0||KIDNEY FUNCTION STUDY|| 80001|78730||86.72|0|86.72|0||URINARY BLADDER RETENTION|| 80001|78730|26|9.18|0|9.18|0||URINARY BLADDER RETENTION|| 80001|78730|TC|77.53|0|77.53|0||URINARY BLADDER RETENTION|| 80001|78740||248.26|0|248.26|0||URETERAL REFLUX STUDY|| 80001|78740|26|33.11|0|33.11|0||URETERAL REFLUX STUDY|| 80001|78740|TC|215.15|0|215.15|0||URETERAL REFLUX STUDY|| 80001|78761||239.96|0|239.96|0||TESTICULAR IMAGING/FLOW|| 80001|78761|26|42.64|0|42.64|0||TESTICULAR IMAGING/FLOW|| 80001|78761|TC|197.32|0|197.32|0||TESTICULAR IMAGING/FLOW|| 80001|78799||0|0|0|0||GENITOURINARY NUCLEAR EXAM|| 80001|78799|26|0|0|0|0||GENITOURINARY NUCLEAR EXAM|| 80001|78799|TC|0|0|0|0||GENITOURINARY NUCLEAR EXAM|| 80001|78800||216.87|0|216.87|0||TUMOR IMAGING - LIMITED AREA|| 80001|78800|26|39.32|0|39.32|0||TUMOR IMAGING - LIMITED AREA|| 80001|78800|TC|177.55|0|177.55|0||TUMOR IMAGING - LIMITED AREA|| 80001|78801||296.13|0|296.13|0||TUMOR IMAGING - MULT AREAS|| 80001|78801|26|47.26|0|47.26|0||TUMOR IMAGING - MULT AREAS|| 80001|78801|TC|248.88|0|248.88|0||TUMOR IMAGING - MULT AREAS|| 80001|78802||368.93|0|368.93|0||TUMOR IMAGING - WHOLE BODY|| 80001|78802|26|50.27|0|50.27|0||TUMOR IMAGING - WHOLE BODY|| 80001|78802|TC|318.66|0|318.66|0||TUMOR IMAGING - WHOLE BODY|| 80001|78803||388.15|0|388.15|0||TUMOR IMAGING (3D)|| 80001|78803|26|62.13|0|62.13|0||TUMOR IMAGING (3D)|| 80001|78803|TC|326.02|0|326.02|0||TUMOR IMAGING (3D)|| 80001|78804||646.25|0|646.25|0||TUMOR IMAGING - WHOLE BODY|| 80001|78804|26|62.04|0|62.04|0||TUMOR IMAGING - WHOLE BODY|| 80001|78804|TC|584.2|0|584.2|0||TUMOR IMAGING - WHOLE BODY|| 80001|78805||207.48|0|207.48|0||ABSCESS IMAGING - LTD AREA|| 80001|78805|26|42.73|0|42.73|0||ABSCESS IMAGING - LTD AREA|| 80001|78805|TC|164.76|0|164.76|0||ABSCESS IMAGING - LTD AREA|| 80001|78806||379.01|0|379.01|0||ABSCESS IMAGING - WHOLE BODY|| 80001|78806|26|49.88|0|49.88|0||ABSCESS IMAGING - WHOLE BODY|| 80001|78806|TC|329.12|0|329.12|0||ABSCESS IMAGING - WHOLE BODY|| 80001|78807||388.54|0|388.54|0||NUCLEAR LOCALIZATION/ABSCESS|| 80001|78807|26|61.35|0|61.35|0||NUCLEAR LOCALIZATION/ABSCESS|| 80001|78807|TC|327.19|0|327.19|0||NUCLEAR LOCALIZATION/ABSCESS|| 80001|78808||50.02|0|50.02|0||IV INJ RA DRUG DX STUDY|| 80001|78811||0|0|0|0||TUMOR IMAGING (PET) - LIMITED|| 80001|78811|26|93.57|0|93.57|0||TUMOR IMAGING (PET) - LIMITED|| 80001|78811|TC|0|0|0|0||TUMOR IMAGING (PET) - LIMITED|| 80001|78812||0|0|0|0||TUMOR IMAGE (PET)/SKUL-THIGH|| 80001|78812|26|115.05|0|115.05|0||TUMOR IMAGE (PET)/SKUL-THIGH|| 80001|78812|TC|0|0|0|0||TUMOR IMAGE (PET)/SKUL-THIGH|| 80001|78813||0|0|0|0||TUMOR IMAGE (PET) FULL BODY|| 80001|78813|26|120|0|120|0||TUMOR IMAGE (PET) FULL BODY|| 80001|78813|TC|0|0|0|0||TUMOR IMAGE (PET) FULL BODY|| 80001|78814||0|0|0|0||TUMOR IMAGE PET/CT - LIMITED|| 80001|78814|26|133.29|0|133.29|0||TUMOR IMAGE PET/CT - LIMITED|| 80001|78814|TC|0|0|0|0||TUMOR IMAGE PET/CT - LIMITED|| 80001|78815||0|0|0|0||TUMORIMAGE PET/CT SKUL-THIGH|| 80001|78815|26|146.35|0|146.35|0||TUMORIMAGE PET/CT SKUL-THIGH|| 80001|78815|TC|0|0|0|0||TUMORIMAGE PET/CT SKUL-THIGH|| 80001|78816||0|0|0|0||TUMOR IMAGE PET/CT FULL BODY|| 80001|78816|26|147.39|0|147.39|0||TUMOR IMAGE PET/CT FULL BODY|| 80001|78816|TC|0|0|0|0||TUMOR IMAGE PET/CT FULL BODY|| 80001|78999||0|0|0|0||NUCLEAR DIAGNOSTIC EXAM|| 80001|78999|26|0|0|0|0||NUCLEAR DIAGNOSTIC EXAM|| 80001|78999|TC|0|0|0|0||NUCLEAR DIAGNOSTIC EXAM|| 80001|79005||157.49|0|157.49|0||NUCLEAR RX - ORAL ADMIN|| 80001|79005|26|103.99|0|103.99|0||NUCLEAR RX - ORAL ADMIN|| 80001|79005|TC|53.5|0|53.5|0||NUCLEAR RX - ORAL ADMIN|| 80001|79101||164.78|0|164.78|0||NUCLEAR RX - IV ADMIN|| 80001|79101|26|112.44|0|112.44|0||NUCLEAR RX - IV ADMIN|| 80001|79101|TC|52.33|0|52.33|0||NUCLEAR RX - IV ADMIN|| 80001|79200||157.54|0|157.54|0||NUCLEAR RX - INTRACAV ADMIN|| 80001|79200|26|100.93|0|100.93|0||NUCLEAR RX - INTRACAV ADMIN|| 80001|79200|TC|56.6|0|56.6|0||NUCLEAR RX - INTRACAV ADMIN|| 80001|79300||0|0|0|0||NUCLR RX - INTERSTIT COLLOID|| 80001|79300|26|86.45|0|86.45|0||NUCLR RX - INTERSTIT COLLOID|| 80001|79300|TC|0|0|0|0||NUCLR RX - INTERSTIT COLLOID|| 80001|79403||218.38|0|218.38|0||HEMATOPOIETIC NUCLEAR TX|| 80001|79403|26|130.38|0|130.38|0||HEMATOPOIETIC NUCLEAR TX|| 80001|79403|TC|88|0|88|0||HEMATOPOIETIC NUCLEAR TX|| 80001|79440||149.79|0|149.79|0||NUCLEAR RX - INTRA-ARTICULAR|| 80001|79440|26|105.99|0|105.99|0||NUCLEAR RX - INTRA-ARTICULAR|| 80001|79440|TC|43.81|0|43.81|0||NUCLEAR RX - INTRA-ARTICULAR|| 80001|79445||0|0|0|0||NUCLEAR RX - INTRA-ARTERIAL|| 80001|79445|26|141.14|0|141.14|0||NUCLEAR RX - INTRA-ARTERIAL|| 80001|79445|TC|0|0|0|0||NUCLEAR RX - INTRA-ARTERIAL|| 80001|79999||0|0|0|0||NUCLEAR MEDICINE THERAPY|| 80001|79999|26|0|0|0|0||NUCLEAR MEDICINE THERAPY|| 80001|79999|TC|0|0|0|0||NUCLEAR MEDICINE THERAPY|| 80001|80047||13.81|0|13.81|0||METABOLIC PANEL IONIZED CA|| 80001|80048||13.81|0|13.81|0||BASIC METABOLIC PANEL|| 80001|80050||61.25|0|61.25|||GENERAL HEALTH PANEL|| 80001|80051||11.46|0|11.46|0||ELECTROLYTE PANEL|| 80001|80053||17.24|0|17.24|0||COMPREHEN METABOLIC PANEL|| 80001|80061||21.86|0|21.86|0||LIPID PANEL|| 80001|80069||14.18|0|14.18|0||RENAL FUNCTION PANEL|| 80001|80074||77.8|0|77.8|0||ACUTE HEPATITIS PANEL|| 80001|80076||13.33|0|13.33|0||HEPATIC FUNCTION PANEL|| 80001|80081||122.36|0|122.36|0||OBSTETRIC PANEL|| 80001|80150||24.61|0|24.61|0||ASSAY OF AMIKACIN|| 80001|80155||23.1|0|23.1|0||DRUG SCREEN QUANT CAFFEINE|| 80001|80156||23.78|0|23.78|0||ASSAY - CARBAMAZEPINE - TOTAL|| 80001|80157||21.65|0|21.65|0||ASSAY - CARBAMAZEPINE - FREE|| 80001|80158||9.72|0|9.72|0||ASSAY OF CYCLOSPORINE|| 80001|80159||30.2|0|30.2|0||DRUG SCREEN QUANT CLOZAPINE|| 80001|80162||21.68|0|21.68|0||ASSAY OF DIGOXIN|| 80001|80163||21.68|0|21.68|0||ASSAY OF DIGOXIN FREE|| 80001|80164||18.54|0|18.54|0||ASSAY - DIPROPYLACETIC ACID|| 80001|80165||18.54|0|18.54|0||DIPROPYLACETIC ACID FREE|| 80001|80168||26.69|0|26.69|0||ASSAY OF ETHOSUXIMIDE|| 80001|80169||22.43|0|22.43|0||DRUG SCREEN QUANT EVEROLIMUS|| 80001|80170||26.76|0|26.76|0||ASSAY OF GENTAMICIN|| 80001|80171||21.65|0|21.65|0||DRUG SCREEN QUANT GABAPENTIN|| 80001|80173||23.78|0|23.78|0||ASSAY OF HALOPERIDOL|| 80001|80175||21.65|0|21.65|0||DRUG SCREEN QUAN LAMOTRIGINE|| 80001|80176||23.99|0|23.99|0||ASSAY OF LIDOCAINE|| 80001|80177||21.65|0|21.65|0||DRUG SCRN QUAN LEVETIRACETAM|| 80001|80178||10.8|0|10.8|0||ASSAY OF LITHIUM|| 80001|80180||9.72|0|9.72|0||DRUG SCRN QUAN MYCOPHENOLATE|| 80001|80183||21.65|0|21.65|0||DRUG SCRN QUANT OXCARBAZEPIN|| 80001|80184||18.7|0|18.7|0||ASSAY OF PHENOBARBITAL|| 80001|80185||21.65|0|21.65|0||ASSAY OF PHENYTOIN - TOTAL|| 80001|80186||22.48|0|22.48|0||ASSAY OF PHENYTOIN - FREE|| 80001|80188||27.1|0|27.1|0||ASSAY OF PRIMIDONE|| 80001|80190||27.36|0|27.36|0||ASSAY OF PROCAINAMIDE|| 80001|80192||27.36|0|27.36|0||ASSAY OF PROCAINAMIDE|| 80001|80194||23.84|0|23.84|0||ASSAY OF QUINIDINE|| 80001|80195||22.43|0|22.43|0||ASSAY OF SIROLIMUS|| 80001|80197||22.43|0|22.43|0||ASSAY OF TACROLIMUS|| 80001|80198||23.1|0|23.1|0||ASSAY OF THEOPHYLLINE|| 80001|80199||9.8|0|9.8|0||DRUG SCREEN QUANT TIAGABINE|| 80001|80200||24.46|0|24.46|0||ASSAY OF TOBRAMYCIN|| 80001|80201||19.48|0|19.48|0||ASSAY OF TOPIRAMATE|| 80001|80202||18.54|0|18.54|0||ASSAY OF VANCOMYCIN|| 80001|80203||21.65|0|21.65|0||DRUG SCREEN QUANT ZONISAMIDE|| 80001|80299||19.68|0|19.68|0||QUANTITATIVE ASSAY - DRUG|| 80001|80305||17.21|0|17.21|0||DRUG TEST PRSMV DIR OPT OBS|| 80001|80306||22.93|0|22.93|0||DRUG TEST PRSMV INSTRMNT|| 80001|80307||91.74|0|91.74|0||DRUG TEST PRSMV CHEM ANLYZR|| 80001|80400||53.27|0|53.27|0||ACTH STIMULATION PANEL|| 80001|80402||142|0|142|0||ACTH STIMULATION PANEL|| 80001|80406||127.79|0|127.79|0||ACTH STIMULATION PANEL|| 80001|80408||204.94|0|204.94|0||ALDOSTERONE SUPPRESSION EVAL|| 80001|80410||131.2|0|131.2|0||CALCITONIN STIMUL PANEL|| 80001|80412||538.28|0|538.28|0||CRH STIMULATION PANEL|| 80001|80414||84.32|0|84.32|0||TESTOSTERONE RESPONSE|| 80001|80415||91.26|0|91.26|0||ESTRADIOL RESPONSE PANEL|| 80001|80416||215.5|0|215.5|0||RENIN STIMULATION PANEL|| 80001|80417||71.83|0|71.83|0||RENIN STIMULATION PANEL|| 80001|80418||930.55|0|930.55|0||PITUITARY EVALUATION PANEL|| 80001|80420||117.65|0|117.65|0||DEXAMETHASONE PANEL|| 80001|80422||75.24|0|75.24|0||GLUCAGON TOLERANCE PANEL|| 80001|80424||82.46|0|82.46|0||GLUCAGON TOLERANCE PANEL|| 80001|80426||242.35|0|242.35|0||GONADOTROPIN HORMONE PANEL|| 80001|80428||92.98|0|92.98|0||GROWTH HORMONE PANEL|| 80001|80430||112.21|0|112.21|0||GROWTH HORMONE PANEL|| 80001|80432||180.48|0|180.48|0||INSULIN SUPPRESSION PANEL|| 80001|80434||165.22|0|165.22|0||INSULIN TOLERANCE PANEL|| 80001|80435||148.27|0|148.27|0||INSULIN TOLERANCE PANEL|| 80001|80436||148.87|0|148.87|0||METYRAPONE PANEL|| 80001|80438||82.32|0|82.32|0||TRH STIMULATION PANEL|| 80001|80439||109.76|0|109.76|0||TRH STIMULATION PANEL|| 80001|80500||23.32|0|23.32|0||LAB PATHOLOGY CONSULTATION|| 80001|80502||81.78|0|81.78|0||LAB PATHOLOGY CONSULTATION|| 80001|81000||5.17|0|5.17|0||URINALYSIS - NONAUTO W/SCOPE|| 80001|81001||5.17|0|5.17|0||URINALYSIS - AUTO W/SCOPE|| 80001|81002||4.18|0|4.18|0||URINALYSIS NONAUTO W/O SCOPE|| 80001|81003||3.67|0|3.67|0||URINALYSIS - AUTO - W/O SCOPE|| 80001|81005||3.54|0|3.54|0||URINALYSIS|| 80001|81007||4.19|0|4.19|0||URINE SCREEN FOR BACTERIA|| 80001|81015||4.97|0|4.97|0||MICROSCOPIC EXAM OF URINE|| 80001|81020||6.02|0|6.02|0||URINALYSIS - GLASS TEST|| 80001|81025||10.33|0|10.33|0||URINE PREGNANCY TEST|| 80001|81050||4.9|0|4.9|0||URINALYSIS - VOLUME MEASURE|| 80001|81105||181.07|0|181.07|0||HPA-1 GENOTYPING|| 80001|81106||181.07|0|181.07|0||HPA-2 GENOTYPING|| 80001|81107||181.07|0|181.07|0||HPA-3 GENOTYPING|| 80001|81108||181.07|0|181.07|0||HPA-4 GENOTYPING|| 80001|81109||181.07|0|181.07|0||HPA-5 GENOTYPING|| 80001|81110||181.07|0|181.07|0||HPA-6 GENOTYPING|| 80001|81111||181.07|0|181.07|0||HPA-9 GENOTYPING|| 80001|81112||181.07|0|181.07|0||HPA-15 GENOTYPING|| 80001|81120||231.9|0|231.9|0||IDH1 COMMON VARIANTS|| 80001|81121||354.95|0|354.95|0||IDH2 COMMON VARIANTS|| 80001|81162||146.27|0|146.27|0||BRCA1&2 SEQ & FULL DUP/DEL|| 80001|81170||2983.03|0|2983.03|0||ABL1 GENE|| 80001|81175||848.42|0|848.42|0||ASXL1 FULL GENE SEQUENCE|| 80001|81176||358.37|0|358.37|0||ASXL1 GENE TARGET SEQ ALYS|| 80001|81206||267.76|0|267.76|0||BCR/ABL1 GENE MAJOR BP|| 80001|81207||236.52|0|236.52|0||BCR/ABL1 GENE MINOR BP|| 80001|81208||262.66|0|262.66|0||BCR/ABL1 GENE OTHER BP|| 80001|81210||214.56|0|214.56|0||BRAF GENE|| 80001|81211||2613.65|0|2613.65|0||BRCA1&2 SEQ & COM DUP/DEL|| 80001|81212||211.51|0|211.51|0||BRCA1&2 185&5385&6174 VAR|| 80001|81213||697.51|0|697.51|0||BRCA1&2 UNCOM DUP/DEL VAR|| 80001|81214||1721.45|0|1721.45|0||BRCA1 FULL SEQ & COM DUP/DEL|| 80001|81215||111.61|0|111.61|0||BRCA1 GENE KNOWN FAM VARIANT|| 80001|81217||111.61|0|111.61|0||BRCA2 GENE KNOWN FAM VARIANT|| 80001|81218||146.27|0|146.27|0||CEBPA GENE FULL SEQUENCE|| 80001|81219||146.27|0|146.27|0||CALR GENE COM VARIANTS|| 80001|81225||349.28|0|349.28|0||CYP2C19 GENE COM VARIANTS|| 80001|81226||540.55|0|540.55|0||CYP2D6 GENE COM VARIANTS|| 80001|81227||209.57|0|209.57|0||CYP2C9 GENE COM VARIANTS|| 80001|81230||209.77|0|209.77|0||CYP3A4 GENE COMMON VARIANTS|| 80001|81231||209.77|0|209.77|0||CYP3A5 GENE COMMON VARIANTS|| 80001|81232||209.77|0|209.77|0||DPYD GENE COMMON VARIANTS|| 80001|81235||395.02|0|395.02|0||EGFR GENE COM VARIANTS|| 80001|81238||720|0|720|0||F9 FULL GENE SEQUENCE|| 80001|81240||80.35|0|80.35|0||F2 GENE|| 80001|81241||99.79|0|99.79|0||F5 GENE|| 80001|81245||198.61|0|198.61|0||FLT3 GENE|| 80001|81247||209.77|0|209.77|0||G6PD GENE ALYS CMN VARIANT|| 80001|81248||450.3|0|450.3|0||G6PD KNOWN FAMILIAL VARIANT|| 80001|81249||720|0|720|0||G6PD FULL GENE SEQUENCE|| 80001|81256||106.74|0|106.74|0||HFE GENE|| 80001|81258||450.3|0|450.3|0||HBA1/HBA2 GENE FAM VRNT|| 80001|81259||720|0|720|0||HBA1/HBA2 FULL GENE SEQUENCE|| 80001|81261||323.32|0|323.32|0||IGH GENE REARRANGE AMP METH|| 80001|81262||71.28|0|71.28|0||IGH GENE REARRANG DIR PROBE|| 80001|81263||480.95|0|480.95|0||IGH VARI REGIONAL MUTATION|| 80001|81264||243.85|0|243.85|0||IGK REARRANGEABN CLONAL POP|| 80001|81265||351.18|0|351.18|0||STR MARKERS SPECIMEN ANAL|| 80001|81266||338.78|0|338.78|0||STR MARKERS SPEC ANAL ADDL|| 80001|81267||425.87|0|425.87|0||CHIMERISM ANAL NO CELL SELEC|| 80001|81268||149.7|0|149.7|0||CHIMERISM ANAL W/CELL SELECT|| 80001|81269||242.88|0|242.88|0||HBA1/HBA2 GENE DUP/DEL VRNTS|| 80001|81270||236.39|0|236.39|0||JAK2 GENE|| 80001|81272||146.27|0|146.27|0||KIT GENE TARGETED SEQ ANALYS|| 80001|81273||107.04|0|107.04|0||KIT GENE ANALYS D816 VARIANT|| 80001|81276||236.63|0|236.63|0||KRAS GENE ADDL VARIANTS|| 80001|81283||90.53|0|90.53|0||IFNL3 GENE|| 80001|81291||71.28|0|71.28|0||MTHFR GENE|| 80001|81292||773.54|0|773.54|0||MLH1 GENE FULL SEQ|| 80001|81293||310.09|0|310.09|0||MLH1 GENE KNOWN VARIANTS|| 80001|81294||228.24|0|228.24|0||MLH1 GENE DUP/DELETE VARIANT|| 80001|81295||181.6|0|181.6|0||MSH2 GENE FULL SEQ|| 80001|81296||155.05|0|155.05|0||MSH2 GENE KNOWN VARIANTS|| 80001|81297||181.6|0|181.6|0||MSH2 GENE DUP/DELETE VARIANT|| 80001|81298||344.53|0|344.53|0||MSH6 GENE FULL SEQ|| 80001|81299||193.01|0|193.01|0||MSH6 GENE KNOWN VARIANTS|| 80001|81300||193.54|0|193.54|0||MSH6 GENE DUP/DELETE VARIANT|| 80001|81301||472.86|0|472.86|0||MICROSATELLITE INSTABILITY|| 80001|81310||295.82|0|295.82|0||NPM1 GENE|| 80001|81311||354.95|0|354.95|0||NRAS GENE VARIANTS EXON 2&3|| 80001|81314||146.27|0|146.27|0||PDGFRA GENE|| 80001|81315||338.54|0|338.54|0||PML/RARALPHA COM BREAKPOINTS|| 80001|81316||516.37|0|516.37|0||PML/RARALPHA 1 BREAKPOINT|| 80001|81317||935.21|0|935.21|0||PMS2 GENE FULL SEQ ANALYSIS|| 80001|81318||220.98|0|220.98|0||PMS2 KNOWN FAMILIAL VARIANTS|| 80001|81319||265.33|0|265.33|0||PMS2 GENE DUP/DELET VARIANTS|| 80001|81321||719.04|0|719.04|0||PTEN GENE FULL SEQUENCE|| 80001|81322||69.9|0|69.9|0||PTEN GENE KNOWN FAM VARIANT|| 80001|81323||104.86|0|104.86|0||PTEN GENE DUP/DELET VARIANT|| 80001|81327||100.4|0|100.4|0||SEPT9 METHYLATION ANALYSIS|| 80001|81328||209.77|0|209.77|0||SLCO1B1 GENE COM VARIANTS|| 80001|81332||71.28|0|71.28|0||SERPINA1 GENE|| 80001|81334||395.41|0|395.41|0||RUNX1 GENE TARGETED SEQ ALYS|| 80001|81335||209.77|0|209.77|0||TPMT GENE COM VARIANTS|| 80001|81340||341.17|0|341.17|0||TRB@ GENE REARRANGE AMPLIFY|| 80001|81341||80.98|0|80.98|0||TRB@ GENE REARRANGE DIRPROBE|| 80001|81342||329.05|0|329.05|0||TRG GENE REARRANGEMENT ANAL|| 80001|81346||209.77|0|209.77|0||TYMS GENE COM VARIANTS|| 80001|81361||209.77|0|209.77|0||HBB GENE COM VARIANTS|| 80001|81362||450.3|0|450.3|0||HBB GENE KNOWN FAM VARIANT|| 80001|81363||242.88|0|242.88|0||HBB GENE DUP/DEL VARIANTS|| 80001|81364||389.49|0|389.49|0||HBB FULL GENE SEQUENCE|| 80001|81370||656.68|0|656.68|0||HLA I & II TYPING LR|| 80001|81371||393.05|0|393.05|0||HLA I & II TYPE VERIFY LR|| 80001|81372||360.73|0|360.73|0||HLA I TYPING COMPLETE LR|| 80001|81373||181.86|0|181.86|0||HLA I TYPING 1 LOCUS LR|| 80001|81374||118.8|0|118.8|0||HLA I TYPING 1 ANTIGEN LR|| 80001|81375||360.48|0|360.48|0||HLA II TYPING AG EQUIV LR|| 80001|81376||199.58|0|199.58|0||HLA II TYPING 1 LOCUS LR|| 80001|81377||149.93|0|149.93|0||HLA II TYPE 1 AG EQUIV LR|| 80001|81378||564.31|0|564.31|0||HLA I & II TYPING HR|| 80001|81379||547.68|0|547.68|0||HLA I TYPING COMPLETE HR|| 80001|81380||289.45|0|289.45|0||HLA I TYPING 1 LOCUS HR|| 80001|81381||154.45|0|154.45|0||HLA I TYPING 1 ALLELE HR|| 80001|81382||201.97|0|201.97|0||HLA II TYPING 1 LOC HR|| 80001|81383||178.21|0|178.21|0||HLA II TYPING 1 ALLELE HR|| 80001|81412||0|0|0|0||ASHKENAZI JEWISH ASSOC DIS|| 80001|81413||962.8|0|962.8|0||CAR ION CHNNLPATH INC 10 GNS|| 80001|81414||962.8|0|962.8|0||CAR ION CHNNLPATH INC 2 GNS|| 80001|81422||962.8|0|962.8|0||FETAL CHRMOML MICRODELTJ|| 80001|81432||0|0|0|0||HRDTRY BRST CA-RLATD DSORDRS|| 80001|81433||0|0|0|0||HRDTRY BRST CA-RLATD DSORDRS|| 80001|81434||0|0|0|0||HEREDITARY RETINAL DISORDERS|| 80001|81437||0|0|0|0||HEREDTRY NURONDCRN TUM DSRDR|| 80001|81438||0|0|0|0||HEREDTRY NURONDCRN TUM DSRDR|| 80001|81439||962.8|0|962.8|0||INHERITED CARDMYPTHY 5 GNS|| 80001|81442||0|0|0|0||NOONAN SPECTRUM DISORDERS|| 80001|81448||866.52|0|866.52|0||HRDTRY PERPH NEURPHY PANEL|| 80001|81490||0|0|0|0||AUTOIMMUNE RHEUMATOID ARTHR|| 80001|81493||0|0|0|0||COR ARTERY DISEASE MRNA|| 80001|81520||3718.82|0|3718.82|0||ONC BREAST MRNA 58 GENES|| 80001|81521||4647.6|0|4647.6|0||ONC BREAST MRNA 70 GENES|| 80001|81525||0|0|0|0||ONCOLOGY COLON MRNA|| 80001|81528||460.87|0|460.87|0||ONCOLOGY COLORECTAL SCR|| 80001|81535||695.35|0|695.35|0||ONCOLOGY GYNECOLOGIC|| 80001|81536||180.7|0|180.7|0||ONCOLOGY GYNECOLOGIC|| 80001|81538||0|0|0|0||ONCOLOGY LUNG|| 80001|81539||722.52|0|722.52|0||ONCOLOGY PROSTATE PROB SCORE|| 80001|81540||0|0|0|0||ONCOLOGY TUM UNKNOWN ORIGIN|| 80001|81541||4647.6|0|4647.6|0||ONC PROSTATE MRNA 46 GENES|| 80001|81545||0|0|0|0||ONCOLOGY THYROID|| 80001|81595||0|0|0|0||CARDIOLOGY HRT TRNSPL MRNA|| 80001|82009||5.38|0|5.38|0||TEST FOR ACETONE/KETONES|| 80001|82010||13.34|0|13.34|0||ACETONE ASSAY|| 80001|82010|QW|13.34|0|13.34|0||ACETONE ASSAY|| 80001|82013||18.24|0|18.24|0||ACETYLCHOLINESTERASE ASSAY|| 80001|82016||22.64|0|22.64|0||ACYLCARNITINES - QUAL|| 80001|82017||27.54|0|27.54|0||ACYLCARNITINES - QUANT|| 80001|82024||63.07|0|63.07|0||ASSAY OF ACTH|| 80001|82030||42.13|0|42.13|0||ASSAY OF ADP & AMP|| 80001|82040||4.7|0|4.7|0||ASSAY OF SERUM ALBUMIN|| 80001|82040|QW|4.7|0|4.7|0||ASSAY OF SERUM ALBUMIN|| 80001|82042||8.45|0|8.45|0||ASSAY OF URINE ALBUMIN|| 80001|82042|QW|8.45|0|8.45|0||ASSAY OF URINE ALBUMIN|| 80001|82043||9.44|0|9.44|0||MICROALBUMIN - QUANTITATIVE|| 80001|82043|QW|9.44|0|9.44|0||MICROALBUMIN - QUANTITATIVE|| 80001|82044||7.46|0|7.46|0||MICROALBUMIN - SEMIQUANT|| 80001|82044|QW|7.46|0|7.46|0||MICROALBUMIN - SEMIQUANT|| 80001|82045||55.43|0|55.43|0||ALBUMIN - ISCHEMIA MODIFIED|| 80001|82075||19.68|0|19.68|0||ASSAY OF BREATH ETHANOL|| 80001|82085||15.85|0|15.85|0||ASSAY OF ALDOLASE|| 80001|82088||66.55|0|66.55|0||ASSAY OF ALDOSTERONE|| 80001|82103||21.95|0|21.95|0||ALPHA-1-ANTITRYPSIN - TOTAL|| 80001|82104||23.62|0|23.62|0||ALPHA-1-ANTITRYPSIN - PHENO|| 80001|82105||27.4|0|27.4|0||ALPHA-FETOPROTEIN - SERUM|| 80001|82106||27.4|0|27.4|0||ALPHA-FETOPROTEIN - AMNIOTIC|| 80001|82107||105.18|0|105.18|0||ALPHA-FETOPROTEIN L3|| 80001|82108||27.53|0|27.53|0||ASSAY OF ALUMINUM|| 80001|82120||3.95|0|3.95|0||AMINES - VAGINAL FLUID QUAL|| 80001|82120|QW|3.95|0|3.95|0||AMINES - VAGINAL FLUID QUAL|| 80001|82127||22.64|0|22.64|0||AMINO ACID - SINGLE QUAL|| 80001|82128||22.64|0|22.64|0||AMINO ACIDS - MULT QUAL|| 80001|82131||27.54|0|27.54|0||AMINO ACIDS - SINGLE QUANT|| 80001|82135||26.87|0|26.87|0||ASSAY - AMINOLEVULINIC ACID|| 80001|82136||27.54|0|27.54|0||AMINO ACIDS - QUANT - 2-5|| 80001|82139||27.54|0|27.54|0||AMINO ACIDS - QUAN - 6 OR MORE|| 80001|82140||16.16|0|16.16|0||ASSAY OF AMMONIA|| 80001|82143||11.22|0|11.22|0||AMNIOTIC FLUID SCAN|| 80001|82150||10.58|0|10.58|0||ASSAY OF AMYLASE|| 80001|82150|QW|10.58|0|10.58|0||ASSAY OF AMYLASE|| 80001|82154||47.09|0|47.09|0||ANDROSTANEDIOL GLUCURONIDE|| 80001|82157||47.81|0|47.81|0||ASSAY OF ANDROSTENEDIONE|| 80001|82160||40.84|0|40.84|0||ASSAY OF ANDROSTERONE|| 80001|82163||33.52|0|33.52|0||ASSAY OF ANGIOTENSIN II|| 80001|82164||23.84|0|23.84|0||ANGIOTENSIN I ENZYME TEST|| 80001|82172||25.31|0|25.31|0||ASSAY OF APOLIPOPROTEIN|| 80001|82175||30.98|0|30.98|0||ASSAY OF ARSENIC|| 80001|82180||14.42|0|14.42|0||ASSAY OF ASCORBIC ACID|| 80001|82190||24.34|0|24.34|0||ATOMIC ABSORPTION|| 80001|82232||26.42|0|26.42|0||ASSAY OF BETA-2 PROTEIN|| 80001|82239||27.97|0|27.97|0||BILE ACIDS - TOTAL|| 80001|82240||43.4|0|43.4|0||BILE ACIDS - CHOLYLGLYCINE|| 80001|82247||8.2|0|8.2|0||BILIRUBIN - TOTAL|| 80001|82247|QW|8.2|0|8.2|0||BILIRUBIN - TOTAL|| 80001|82248||8.2|0|8.2|0||BILIRUBIN - DIRECT|| 80001|82252||7.43|0|7.43|0||FECAL BILIRUBIN TEST|| 80001|82261||27.54|0|27.54|0||ASSAY OF BIOTINIDASE|| 80001|82270||5.26|0|5.26|0||OCCULT BLOOD - OTHER SOURCES|| 80001|82271||5.26|0|5.26|0||OCCULT BLOOD - FECES - SINGLE|| 80001|82271|QW|5.26|0|5.26|0||OCCULT BLOOD - FECES - SINGLE|| 80001|82272||5.26|0|5.26|0||BLOOD OCCULT PEROXIDASE|| 80001|82272|QW|5.26|0|5.26|0||BLOOD OCCULT PEROXIDASE|| 80001|82274||25.98|0|25.98|0||ASSAY TEST FOR BLOOD - FECAL|| 80001|82274|QW|25.98|0|25.98|0||ASSAY TEST FOR BLOOD - FECAL|| 80001|82286||11.26|0|11.26|0||ASSAY OF BRADYKININ|| 80001|82300||37.79|0|37.79|0||ASSAY OF CADMIUM|| 80001|82306||48.35|0|48.35|0||ASSAY OF VITAMIN D|| 80001|82308||43.74|0|43.74|0||ASSAY OF CALCITONIN|| 80001|82310||8.42|0|8.42|0||ASSAY OF CALCIUM|| 80001|82310|QW|8.42|0|8.42|0||ASSAY OF CALCIUM|| 80001|82330||22.32|0|22.32|0||ASSAY OF CALCIUM|| 80001|82330|QW|22.32|0|22.32|0||ASSAY OF CALCIUM|| 80001|82331||8.45|0|8.45|0||CALCIUM INFUSION TEST|| 80001|82340||9.85|0|9.85|0||ASSAY OF CALCIUM IN URINE|| 80001|82355||18.9|0|18.9|0||CALCULUS ANALYSIS - QUAL|| 80001|82360||21.02|0|21.02|0||CALCULUS ASSAY - QUANT|| 80001|82365||21.06|0|21.06|0||CALCULUS SPECTROSCOPY|| 80001|82370||20.46|0|20.46|0||X-RAY ASSAY - CALCULUS|| 80001|82373||9.8|0|9.8|0||ASSAY - C-D TRANSFER MEASURE|| 80001|82374||7.98|0|7.98|0||ASSAY - BLOOD CARBON DIOXIDE|| 80001|82374|QW|7.98|0|7.98|0||ASSAY - BLOOD CARBON DIOXIDE|| 80001|82375||4.7|0|4.7|0||ASSAY - BLOOD CARBON MONOXIDE|| 80001|82376||9.78|0|9.78|0||TEST FOR CARBON MONOXIDE|| 80001|82378||30.97|0|30.97|0||CARCINOEMBRYONIC ANTIGEN|| 80001|82379||27.54|0|27.54|0||ASSAY OF CARNITINE|| 80001|82380||15.06|0|15.06|0||ASSAY OF CAROTENE|| 80001|82382||28.08|0|28.08|0||ASSAY - URINE CATECHOLAMINES|| 80001|82383||40.92|0|40.92|0||ASSAY - BLOOD CATECHOLAMINES|| 80001|82384||41.23|0|41.23|0||ASSAY - THREE CATECHOLAMINES|| 80001|82387||33.98|0|33.98|0||ASSAY OF CATHEPSIN-D|| 80001|82390||17.54|0|17.54|0||ASSAY OF CERULOPLASMIN|| 80001|82397||23.06|0|23.06|0||CHEMILUMINESCENT ASSAY|| 80001|82415||20.69|0|20.69|0||ASSAY OF CHLORAMPHENICOL|| 80001|82435||7.51|0|7.51|0||ASSAY OF BLOOD CHLORIDE|| 80001|82435|QW|7.51|0|7.51|0||ASSAY OF BLOOD CHLORIDE|| 80001|82436||8.22|0|8.22|0||ASSAY OF URINE CHLORIDE|| 80001|82438||7.98|0|7.98|0||ASSAY - OTHER FLUID CHLORIDES|| 80001|82441||9.8|0|9.8|0||TEST FOR CHLOROHYDROCARBONS|| 80001|82465||7.1|0|7.1|0||ASSAY - BLD/SERUM CHOLESTEROL|| 80001|82465|QW|7.1|0|7.1|0||ASSAY - BLD/SERUM CHOLESTEROL|| 80001|82480||12.86|0|12.86|0||ASSAY - SERUM CHOLINESTERASE|| 80001|82482||12.54|0|12.54|0||ASSAY - RBC CHOLINESTERASE|| 80001|82485||33.72|0|33.72|0||ASSAY - CHONDROITIN SULFATE|| 80001|82495||33.12|0|33.12|0||ASSAY OF CHROMIUM|| 80001|82507||45.41|0|45.41|0||ASSAY OF CITRATE|| 80001|82523||30.52|0|30.52|0||COLLAGEN CROSSLINKS|| 80001|82523|QW|30.52|0|30.52|0||COLLAGEN CROSSLINKS|| 80001|82525||20.27|0|20.27|0||ASSAY OF COPPER|| 80001|82528||36.77|0|36.77|0||ASSAY OF CORTICOSTERONE|| 80001|82530||27.29|0|27.29|0||CORTISOL - FREE|| 80001|82533||26.63|0|26.63|0||TOTAL CORTISOL|| 80001|82540||7.57|0|7.57|0||ASSAY OF CREATINE|| 80001|82542||9.8|0|9.8|0||COLUMN CHROMOTOGRAPHY - QUANT|| 80001|82550||10.63|0|10.63|0||ASSAY OF CK (CPK)|| 80001|82550|QW|10.63|0|10.63|0||ASSAY OF CK (CPK)|| 80001|82552||21.88|0|21.88|0||ASSAY OF CPK IN BLOOD|| 80001|82553||18.86|0|18.86|0||CREATINE - MB FRACTION|| 80001|82554||19.38|0|19.38|0||CREATINE - ISOFORMS|| 80001|82565||8.36|0|8.36|0||ASSAY OF CREATININE|| 80001|82565|QW|8.36|0|8.36|0||ASSAY OF CREATININE|| 80001|82570||8.45|0|8.45|0||ASSAY OF URINE CREATININE|| 80001|82570|QW|8.45|0|8.45|0||ASSAY OF URINE CREATININE|| 80001|82575||15.43|0|15.43|0||CREATININE CLEARANCE TEST|| 80001|82585||14.02|0|14.02|0||ASSAY OF CRYOFIBRINOGEN|| 80001|82595||10.57|0|10.57|0||ASSAY OF CRYOGLOBULIN|| 80001|82600||31.68|0|31.68|0||ASSAY OF CYANIDE|| 80001|82607||24.61|0|24.61|0||VITAMIN B-12|| 80001|82608||23.38|0|23.38|0||B-12 BINDING CAPACITY|| 80001|82610||22.2|0|22.2|0||CYSTATIN C|| 80001|82615||13.33|0|13.33|0||TEST FOR URINE CYSTINES|| 80001|82626||41.27|0|41.27|0||DEHYDROEPIANDROSTERONE|| 80001|82627||36.31|0|36.31|0||DEHYDROEPIANDROSTERONE|| 80001|82633||50.59|0|50.59|0||DESOXYCORTICOSTERONE|| 80001|82634||47.81|0|47.81|0||DEOXYCORTISOL|| 80001|82638||19.99|0|19.99|0||ASSAY OF DIBUCAINE NUMBER|| 80001|82652||62.87|0|62.87|0||ASSAY OF DIHYDROXYVITAMIN D|| 80001|82656||17.45|0|17.45|0||PANCREATIC ELASTASE - FECAL|| 80001|82657||9.8|0|9.8|0||ENZYME CELL ACTIVITY|| 80001|82658||9.8|0|9.8|0||ENZYME CELL ACTIVITY - RA|| 80001|82664||56.1|0|56.1|0||ELECTROPHORETIC TEST|| 80001|82668||30.7|0|30.7|0||ASSAY OF ERYTHROPOIETIN|| 80001|82670||45.62|0|45.62|0||ASSAY OF ESTRADIOL|| 80001|82671||52.75|0|52.75|0||ASSAY OF ESTROGENS|| 80001|82672||27.19|0|27.19|0||ASSAY OF ESTROGEN|| 80001|82677||39.49|0|39.49|0||ASSAY OF ESTRIOL|| 80001|82679||40.75|0|40.75|0||ASSAY OF ESTRONE|| 80001|82679|QW|40.75|0|40.75|0||ASSAY OF ESTRONE|| 80001|82693||24.32|0|24.32|0||ASSAY OF ETHYLENE GLYCOL|| 80001|82696||38.51|0|38.51|0||ASSAY OF ETIOCHOLANOLONE|| 80001|82705||8.32|0|8.32|0||FATS/LIPIDS - FECES - QUAL|| 80001|82710||27.44|0|27.44|0||FATS/LIPIDS - FECES - QUANT|| 80001|82715||28.1|0|28.1|0||ASSAY OF FECAL FAT|| 80001|82725||21.74|0|21.74|0||ASSAY OF BLOOD FATTY ACIDS|| 80001|82726||9.8|0|9.8|0||LONG CHAIN FATTY ACIDS|| 80001|82728||22.25|0|22.25|0||ASSAY OF FERRITIN|| 80001|82731||105.18|0|105.18|0||ASSAY OF FETAL FIBRONECTIN|| 80001|82735||30.28|0|30.28|0||ASSAY OF FLUORIDE|| 80001|82746||24.01|0|24.01|0||BLOOD FOLIC ACID SERUM|| 80001|82747||28.28|0|28.28|0||ASSAY OF FOLIC ACID - RBC|| 80001|82757||28.32|0|28.32|0||ASSAY OF SEMEN FRUCTOSE|| 80001|82759||35.09|0|35.09|0||ASSAY OF RBC GALACTOKINASE|| 80001|82760||18.29|0|18.29|0||ASSAY OF GALACTOSE|| 80001|82775||34.4|0|34.4|0||ASSAY GALACTOSE TRANSFERASE|| 80001|82776||13.69|0|13.69|0||GALACTOSE TRANSFERASE TEST|| 80001|82777||35.92|0|35.92|0||GALECTIN 3|| 80001|82784||15.18|0|15.18|0||ASSAY OF GAMMAGLOBULIN IGM|| 80001|82785||26.89|0|26.89|0||ASSAY OF GAMMAGLOBULIN IGE|| 80001|82787||13.09|0|13.09|0||IGG 1 - 2 - 3 OR 4 - EACH|| 80001|82800||13.81|0|13.81|0||BLOOD PH|| 80001|82803||31.6|0|31.6|0||BLOOD GASES: PH - PO2 & PCO2|| 80001|82805||46.34|0|46.34|0||BLOOD GASES W/02 SATURATION|| 80001|82810||14.26|0|14.26|0||BLOOD GASES - O2 SAT ONLY|| 80001|82820||16.31|0|16.31|0||HEMOGLOBIN-OXYGEN AFFINITY|| 80001|82930||8.89|0|8.89|0||GASTRIC ANALY W/PH EA SPEC|| 80001|82938||28.9|0|28.9|0||GASTRIN TEST|| 80001|82941||28.8|0|28.8|0||ASSAY OF GASTRIN|| 80001|82943||23.33|0|23.33|0||ASSAY OF GLUCAGON|| 80001|82945||6.41|0|6.41|0||GLUCOSE OTHER FLUID|| 80001|82946||24.61|0|24.61|0||GLUCAGON TOLERANCE TEST|| 80001|82947||6.41|0|6.41|0||ASSAY - GLUCOSE - BLOOD QUANT|| 80001|82947|QW|6.41|0|6.41|0||ASSAY - GLUCOSE - BLOOD QUANT|| 80001|82948||5.17|0|5.17|0||REAGENT STRIP/BLOOD GLUCOSE|| 80001|82950||7.75|0|7.75|0||GLUCOSE TEST|| 80001|82950|QW|7.75|0|7.75|0||GLUCOSE TEST|| 80001|82951||21.02|0|21.02|0||GLUCOSE TOLERANCE TEST (GTT)|| 80001|82951|QW|21.02|0|21.02|0||GLUCOSE TOLERANCE TEST (GTT)|| 80001|82952||6.41|0|6.41|0||GTT-ADDED SAMPLES|| 80001|82952|QW|6.41|0|6.41|0||GTT-ADDED SAMPLES|| 80001|82955||12.73|0|12.73|0||ASSAY OF G6PD ENZYME|| 80001|82960||9.89|0|9.89|0||TEST FOR G6PD ENZYME|| 80001|82962||3.83|0|3.83|0||GLUCOSE BLOOD TEST|| 80001|82963||35.09|0|35.09|0||ASSAY OF GLUCOSIDASE|| 80001|82965||12.62|0|12.62|0||ASSAY OF GDH ENZYME|| 80001|82977||11.76|0|11.76|0||ASSAY OF GGT|| 80001|82977|QW|11.76|0|11.76|0||ASSAY OF GGT|| 80001|82978||23.28|0|23.28|0||ASSAY OF GLUTATHIONE|| 80001|82979||11.26|0|11.26|0||ASSAY - RBC GLUTATHIONE|| 80001|82985||24.61|0|24.61|0||GLYCATED PROTEIN|| 80001|82985|QW|24.61|0|24.61|0||GLYCATED PROTEIN|| 80001|83001||30.35|0|30.35|0||GONADOTROPIN (FSH)|| 80001|83001|QW|30.35|0|30.35|0||GONADOTROPIN (FSH)|| 80001|83002||30.24|0|30.24|0||GONADOTROPIN (LH)|| 80001|83002|QW|30.24|0|30.24|0||GONADOTROPIN (LH)|| 80001|83003||23.24|0|23.24|0||ASSAY - GROWTH HORMONE (HGH)|| 80001|83006||35.92|0|35.92|0||GROWTH STIMULATION GENE 2|| 80001|83009||22.08|0|22.08|0||H PYLORI (C-13) - BLOOD|| 80001|83010||6.08|0|6.08|0||ASSAY OF HAPTOGLOBIN - QUANT|| 80001|83012||28.08|0|28.08|0||ASSAY OF HAPTOGLOBINS|| 80001|83013||109.99|0|109.99|0||H PYLORI (C-13) - BREATH|| 80001|83014||12.84|0|12.84|0||H PYLORI DRUG ADMIN|| 80001|83015||30.76|0|30.76|0||HEAVY METAL SCREEN|| 80001|83018||35.87|0|35.87|0||QUANTITATIVE SCREEN - METALS|| 80001|83020||15.97|0|15.97|0||HEMOGLOBIN ELECTROPHORESIS|| 80001|83020|26|22.16|0|22.16|0||HEMOGLOBIN ELECTROPHORESIS|| 80001|83021||9.8|0|9.8|0||HEMOGLOBIN CHROMOTOGRAPHY|| 80001|83026||3.86|0|3.86|0||HEMOGLOBIN - COPPER SULFATE|| 80001|83030||13.5|0|13.5|0||FETAL HEMOGLOBIN - CHEMICAL|| 80001|83033||9.73|0|9.73|0||FETAL HEMOGLOBIN ASSAY - QUAL|| 80001|83036||15.85|0|15.85|0||GLYCOSYLATED HEMOGLOBIN TEST|| 80001|83036|QW|15.85|0|15.85|0||GLYCOSYLATED HEMOGLOBIN TEST|| 80001|83037||15.85|0|15.85|0||GLYCOSYLATED HB - HOME DEVICE|| 80001|83037|QW|15.85|0|15.85|0||GLYCOSYLATED HB - HOME DEVICE|| 80001|83045||6.72|0|6.72|0||BLOOD METHEMOGLOBIN TEST|| 80001|83050||11.98|0|11.98|0||BLOOD METHEMOGLOBIN ASSAY|| 80001|83051||11.94|0|11.94|0||ASSAY OF PLASMA HEMOGLOBIN|| 80001|83060||13.5|0|13.5|0||BLOOD SULFHEMOGLOBIN ASSAY|| 80001|83065||11.26|0|11.26|0||ASSAY OF HEMOGLOBIN HEAT|| 80001|83068||13.81|0|13.81|0||HEMOGLOBIN STABILITY SCREEN|| 80001|83069||6.44|0|6.44|0||ASSAY OF URINE HEMOGLOBIN|| 80001|83070||7.75|0|7.75|0||ASSAY OF HEMOSIDERIN - QUAL|| 80001|83080||27.54|0|27.54|0||ASSAY OF B HEXOSAMINIDASE|| 80001|83088||48.23|0|48.23|0||ASSAY OF HISTAMINE|| 80001|83090||27.54|0|27.54|0||ASSAY OF HOMOCYSTINE|| 80001|83150||31.6|0|31.6|0||ASSAY OF FOR HVA|| 80001|83491||28.61|0|28.61|0||ASSAY OF CORTICOSTEROIDS|| 80001|83497||21.06|0|21.06|0||ASSAY OF 5-HIAA|| 80001|83498||44.36|0|44.36|0||ASSAY OF PROGESTERONE|| 80001|83499||41.17|0|41.17|0||ASSAY OF PROGESTERONE|| 80001|83500||36.98|0|36.98|0||ASSAY - FREE HYDROXYPROLINE|| 80001|83505||39.71|0|39.71|0||ASSAY - TOTAL HYDROXYPROLINE|| 80001|83516||17.45|0|17.45|0||IMMUNOASSAY - NONANTIBODY|| 80001|83516|QW|17.45|0|17.45|0||IMMUNOASSAY - NONANTIBODY|| 80001|83518||13.84|0|13.84|0||IMMUNOASSAY - DIPSTICK|| 80001|83518|QW|13.84|0|13.84|0||IMMUNOASSAY - DIPSTICK|| 80001|83519||22.07|0|22.07|0||IMMUNOASSAY - NONANTIBODY|| 80001|83520||21.14|0|21.14|0||IMMUNOASSAY - RIA|| 80001|83520|QW|21.14|0|21.14|0||IMMUNOASSAY - RIA|| 80001|83525||18.66|0|18.66|0||ASSAY OF INSULIN|| 80001|83527||21.14|0|21.14|0||ASSAY OF INSULIN|| 80001|83528||25.98|0|25.98|0||ASSAY OF INTRINSIC FACTOR|| 80001|83540||10.57|0|10.57|0||ASSAY OF IRON|| 80001|83550||14.28|0|14.28|0||IRON BINDING TEST|| 80001|83570||14.45|0|14.45|0||ASSAY OF IDH ENZYME|| 80001|83582||23.14|0|23.14|0||ASSAY OF KETOGENIC STEROIDS|| 80001|83586||20.52|0|20.52|0||ASSAY 17- KETOSTEROIDS|| 80001|83593||42.95|0|42.95|0||FRACTIONATION - KETOSTEROIDS|| 80001|83605||17.44|0|17.44|0||ASSAY OF LACTIC ACID|| 80001|83605|QW|17.44|0|17.44|0||ASSAY OF LACTIC ACID|| 80001|83615||9.85|0|9.85|0||LACTATE (LD) (LDH) ENZYME|| 80001|83625||18.91|0|18.91|0||ASSAY OF LDH ENZYMES|| 80001|83630||32.05|0|32.05|0||LACTOFERRIN - FECAL (QUAL)|| 80001|83631||32.05|0|32.05|0||LACTOFERRIN - FECAL (QUANT)|| 80001|83632||33.01|0|33.01|0||PLACENTAL LACTOGEN|| 80001|83633||8.98|0|8.98|0||TEST URINE FOR LACTOSE|| 80001|83655||19.76|0|19.76|0||ASSAY OF LEAD|| 80001|83655|QW|19.76|0|19.76|0||ASSAY OF LEAD|| 80001|83661||35.9|0|35.9|0||L/S RATIO - FETAL LUNG|| 80001|83662||30.89|0|30.89|0||FOAM STABILITY - FETAL LUNG|| 80001|83663||30.89|0|30.89|0||FLUORO POLARIZE - FETAL LUNG|| 80001|83664||30.89|0|30.89|0||LAMELLAR BDY - FETAL LUNG|| 80001|83670||14.96|0|14.96|0||ASSAY OF LAP ENZYME|| 80001|83690||11.26|0|11.26|0||ASSAY OF LIPASE|| 80001|83695||21.14|0|21.14|0||ASSAY OF LIPOPROTEIN(A)|| 80001|83698||55.43|0|55.43|0||ASSAY LIPOPROTEIN PLA2|| 80001|83700||14.28|0|14.28|0||LIPOPRO BLD - ELECTROPHORETIC|| 80001|83701||40.54|0|40.54|0||LIPOPROTEIN BLD - HR FRACTION|| 80001|83704||51.52|0|51.52|0||LIPOPROTEIN - BLD - BY NMR|| 80001|83718||13.37|0|13.37|0||ASSAY OF LIPOPROTEIN|| 80001|83718|QW|13.37|0|13.37|0||ASSAY OF LIPOPROTEIN|| 80001|83719||19.01|0|19.01|0||ASSAY OF BLOOD LIPOPROTEIN|| 80001|83721||15.59|0|15.59|0||ASSAY OF BLOOD LIPOPROTEIN|| 80001|83721|QW|15.59|0|15.59|0||ASSAY OF BLOOD LIPOPROTEIN|| 80001|83727||28.08|0|28.08|0||ASSAY OF LRH HORMONE|| 80001|83735||10.93|0|10.93|0||ASSAY OF MAGNESIUM|| 80001|83775||12.04|0|12.04|0||ASSAY OF MD ENZYME|| 80001|83785||40.16|0|40.16|0||ASSAY OF MANGANESE|| 80001|83789||9.8|0|9.8|0||MASS SPECTROMETRY QUANT|| 80001|83825||26.54|0|26.54|0||ASSAY OF MERCURY|| 80001|83835||27.66|0|27.66|0||ASSAY OF METANEPHRINES|| 80001|83857||17.54|0|17.54|0||ASSAY OF METHEMALBUMIN|| 80001|83861||26.98|0|26.98|0||MICROFLUID ANALY TEARS|| 80001|83861|QW|26.98|0|26.98|0||MICROFLUID ANALY TEARS|| 80001|83864||32.52|0|32.52|0||MUCOPOLYSACCHARIDES|| 80001|83872||9.58|0|9.58|0||ASSAY SYNOVIAL FLUID MUCIN|| 80001|83873||28.09|0|28.09|0||ASSAY OF CSF PROTEIN|| 80001|83874||21.1|0|21.1|0||ASSAY OF MYOGLOBIN|| 80001|83876||55.43|0|55.43|0||ASSAY - MYELOPEROXIDASE|| 80001|83880||55.43|0|55.43|0||NATRIURETIC PEPTIDE|| 80001|83880|QW|55.43|0|55.43|0||NATRIURETIC PEPTIDE|| 80001|83883||22.2|0|22.2|0||ASSAY - NEPHELOMETRY NOT SPEC|| 80001|83885||40.01|0|40.01|0||ASSAY OF NICKEL|| 80001|83915||18.22|0|18.22|0||ASSAY OF NUCLEOTIDASE|| 80001|83916||32.84|0|32.84|0||OLIGOCLONAL BANDS|| 80001|83918||26.87|0|26.87|0||ORGANIC ACIDS - TOTAL - QUANT|| 80001|83919||26.87|0|26.87|0||ORGANIC ACIDS - QUAL - EACH|| 80001|83921||26.87|0|26.87|0||ORGANIC ACID - SINGLE - QUANT|| 80001|83930||10.8|0|10.8|0||ASSAY OF BLOOD OSMOLALITY|| 80001|83935||11.14|0|11.14|0||ASSAY OF URINE OSMOLALITY|| 80001|83937||48.74|0|48.74|0||ASSAY OF OSTEOCALCIN|| 80001|83945||21.02|0|21.02|0||ASSAY OF OXALATE|| 80001|83950||105.18|0|105.18|0||ONCOPROTEIN - HER-2/NEU|| 80001|83951||105.18|0|105.18|0||ONCOPROTEIN - DCP|| 80001|83970||67.4|0|67.4|0||ASSAY OF PARATHORMONE|| 80001|83986||5.84|0|5.84|0||ASSAY OF BODY FLUID ACIDITY|| 80001|83986|QW|5.84|0|5.84|0||ASSAY OF BODY FLUID ACIDITY|| 80001|83987||25.93|0|25.93|0||EXHALED BREATH CONDENSATE|| 80001|83992||24|0|24|0||ASSAY FOR PHENCYCLIDINE|| 80001|83993||32.05|0|32.05|0||ASSAY FOR CALPROTECTIN FECAL|| 80001|84030||8.98|0|8.98|0||ASSAY OF BLOOD PKU|| 80001|84035||5.98|0|5.98|0||ASSAY OF PHENYLKETONES|| 80001|84060||12.06|0|12.06|0||ASSAY ACID PHOSPHATASE|| 80001|84061||12.91|0|12.91|0||PHOSPHATASE - FORENSIC EXAM|| 80001|84066||15.78|0|15.78|0||ASSAY PROSTATE PHOSPHATASE|| 80001|84075||8.45|0|8.45|0||ASSAY ALKALINE PHOSPHATASE|| 80001|84075|QW|8.45|0|8.45|0||ASSAY ALKALINE PHOSPHATASE|| 80001|84078||11.93|0|11.93|0||ASSAY ALKALINE PHOSPHATASE|| 80001|84080||24.14|0|24.14|0||ASSAY ALKALINE PHOSPHATASES|| 80001|84081||26.98|0|26.98|0||AMNIOTIC FLUID ENZYME TEST|| 80001|84085||11.02|0|11.02|0||ASSAY OF RBC PG6D ENZYME|| 80001|84087||16.86|0|16.86|0||ASSAY PHOSPHOHEXOSE ENZYMES|| 80001|84100||7.74|0|7.74|0||ASSAY OF PHOSPHORUS|| 80001|84105||8.45|0|8.45|0||ASSAY OF URINE PHOSPHORUS|| 80001|84106||6.98|0|6.98|0||TEST FOR PORPHOBILINOGEN|| 80001|84110||13.78|0|13.78|0||ASSAY OF PORPHOBILINOGEN|| 80001|84112||105.18|0|105.18|0||PLACENTA ALPHA MICRO IG C/V|| 80001|84119||14.06|0|14.06|0||TEST URINE FOR PORPHYRINS|| 80001|84120||24.02|0|24.02|0||ASSAY OF URINE PORPHYRINS|| 80001|84126||41.59|0|41.59|0||ASSAY OF FECES PORPHYRINS|| 80001|84132||7.51|0|7.51|0||ASSAY OF SERUM POTASSIUM|| 80001|84132|QW|7.51|0|7.51|0||ASSAY OF SERUM POTASSIUM|| 80001|84133||7.02|0|7.02|0||ASSAY OF URINE POTASSIUM|| 80001|84134||23.81|0|23.81|0||ASSAY OF PREALBUMIN|| 80001|84135||31.24|0|31.24|0||ASSAY OF PREGNANEDIOL|| 80001|84138||30.92|0|30.92|0||ASSAY OF PREGNANETRIOL|| 80001|84140||33.76|0|33.76|0||ASSAY OF PREGNENOLONE|| 80001|84143||37.26|0|37.26|0||ASSAY OF 17-HYDROXYPREGNENO|| 80001|84144||33.26|0|33.26|0||ASSAY OF PROGESTERONE|| 80001|84145||43.74|0|43.74|0||PROCALCITONIN (PCT)|| 80001|84146||31.64|0|31.64|0||ASSAY OF PROLACTIN|| 80001|84150||40.75|0|40.75|0||ASSAY OF PROSTAGLANDIN|| 80001|84152||30.04|0|30.04|0||ASSAY OF PSA - COMPLEXED|| 80001|84153||30.04|0|30.04|0||ASSAY OF PSA - TOTAL|| 80001|84154||30.04|0|30.04|0||ASSAY OF PSA - FREE|| 80001|84155||5.99|0|5.99|0||ASSAY OF PROTEIN - SERUM|| 80001|84155|QW|5.99|0|5.99|0||ASSAY OF PROTEIN - SERUM|| 80001|84156||5.99|0|5.99|0||ASSAY OF PROTEIN - URINE|| 80001|84157||5.99|0|5.99|0||ASSAY OF PROTEIN - OTHER|| 80001|84157|QW|5.99|0|5.99|0||ASSAY OF PROTEIN - OTHER|| 80001|84160||8.45|0|8.45|0||ASSAY OF PROTEIN - ANY SOURCE|| 80001|84163||10.48|0|10.48|0||PAPPA - SERUM|| 80001|84165||17.53|0|17.53|0||PROTEIN E-PHORESIS - SERUM|| 80001|84165|26|22.16|0|22.16|0||PROTEIN E-PHORESIS - SERUM|| 80001|84166||29.12|0|29.12|0||PROTEIN E-PHORESIS/URINE/CSF|| 80001|84166|26|22.16|0|22.16|0||PROTEIN E-PHORESIS/URINE/CSF|| 80001|84181||27.82|0|27.82|0||WESTERN BLOT TEST|| 80001|84181|26|22.16|0|22.16|0||WESTERN BLOT TEST|| 80001|84182||29.39|0|29.39|0||PROTEIN - WESTERN BLOT TEST|| 80001|84182|26|22.16|0|22.16|0||PROTEIN - WESTERN BLOT TEST|| 80001|84202||23.42|0|23.42|0||ASSAY RBC PROTOPORPHYRIN|| 80001|84203||14.05|0|14.05|0||TEST RBC PROTOPORPHYRIN|| 80001|84206||29.09|0|29.09|0||ASSAY OF PROINSULIN|| 80001|84207||45.89|0|45.89|0||ASSAY OF VITAMIN B-6|| 80001|84210||17.72|0|17.72|0||ASSAY OF PYRUVATE|| 80001|84220||15.42|0|15.42|0||ASSAY OF PYRUVATE KINASE|| 80001|84228||19.01|0|19.01|0||ASSAY OF QUININE|| 80001|84233||105.18|0|105.18|0||ASSAY OF ESTROGEN|| 80001|84234||105.95|0|105.95|0||ASSAY OF PROGESTERONE|| 80001|84235||85.48|0|85.48|0||ASSAY OF ENDOCRINE HORMONE|| 80001|84238||59.72|0|59.72|0||ASSAY - NONENDOCRINE RECEPTOR|| 80001|84244||35.92|0|35.92|0||ASSAY OF RENIN|| 80001|84252||33.05|0|33.05|0||ASSAY OF VITAMIN B-2|| 80001|84255||41.69|0|41.69|0||ASSAY OF SELENIUM|| 80001|84260||50.59|0|50.59|0||ASSAY OF SEROTONIN|| 80001|84270||35.5|0|35.5|0||ASSAY OF SEX HORMONE GLOBUL|| 80001|84275||21.95|0|21.95|0||ASSAY OF SIALIC ACID|| 80001|84285||38.45|0|38.45|0||ASSAY OF SILICA|| 80001|84295||7.86|0|7.86|0||ASSAY OF SERUM SODIUM|| 80001|84295|QW|7.86|0|7.86|0||ASSAY OF SERUM SODIUM|| 80001|84300||5.64|0|5.64|0||ASSAY OF URINE SODIUM|| 80001|84302||5.64|0|5.64|0||ASSAY OF SWEAT SODIUM|| 80001|84305||34.72|0|34.72|0||ASSAY OF SOMATOMEDIN|| 80001|84307||29.86|0|29.86|0||ASSAY OF SOMATOSTATIN|| 80001|84311||11.42|0|11.42|0||SPECTROPHOTOMETRY|| 80001|84315||4.1|0|4.1|0||BODY FLUID SPECIFIC GRAVITY|| 80001|84375||32.02|0|32.02|0||CHROMATOGRAM ASSAY - SUGARS|| 80001|84376||8.98|0|8.98|0||SUGARS - SINGLE - QUAL|| 80001|84377||8.98|0|8.98|0||SUGARS - MULTIPLE - QUAL|| 80001|84378||18.83|0|18.83|0||SUGARS - SINGLE - QUANT|| 80001|84379||18.83|0|18.83|0||SUGARS MULTIPLE QUANT|| 80001|84392||7.75|0|7.75|0||ASSAY OF URINE SULFATE|| 80001|84402||41.58|0|41.58|0||ASSAY OF TESTOSTERONE|| 80001|84403||42.16|0|42.16|0||ASSAY OF TOTAL TESTOSTERONE|| 80001|84410||87.06|0|87.06|0||TESTOSTERONE BIOAVAILABLE|| 80001|84425||34.67|0|34.67|0||ASSAY OF VITAMIN B-1|| 80001|84430||9.42|0|9.42|0||ASSAY OF THIOCYANATE|| 80001|84431||27.44|0|27.44|0||THROMBOXANE - URINE|| 80001|84432||26.23|0|26.23|0||ASSAY OF THYROGLOBULIN|| 80001|84436||11.22|0|11.22|0||ASSAY OF TOTAL THYROXINE|| 80001|84437||10.57|0|10.57|0||ASSAY OF NEONATAL THYROXINE|| 80001|84439||14.72|0|14.72|0||ASSAY OF FREE THYROXINE|| 80001|84442||19.01|0|19.01|0||ASSAY OF THYROID ACTIVITY|| 80001|84443||27.44|0|27.44|0||ASSAY THYROID STIM HORMONE|| 80001|84443|QW|27.44|0|27.44|0||ASSAY THYROID STIM HORMONE|| 80001|84445||13.84|0|13.84|0||ASSAY OF TSI|| 80001|84446||23.15|0|23.15|0||ASSAY OF VITAMIN E|| 80001|84449||29.39|0|29.39|0||ASSAY OF TRANSCORTIN|| 80001|84450||8.45|0|8.45|0||TRANSFERASE (AST) (SGOT)|| 80001|84450|QW|8.45|0|8.45|0||TRANSFERASE (AST) (SGOT)|| 80001|84460||8.65|0|8.65|0||ALANINE AMINO (ALT) (SGPT)|| 80001|84460|QW|8.65|0|8.65|0||ALANINE AMINO (ALT) (SGPT)|| 80001|84466||20.86|0|20.86|0||ASSAY OF TRANSFERRIN|| 80001|84478||9.38|0|9.38|0||ASSAY OF TRIGLYCERIDES|| 80001|84478|QW|9.38|0|9.38|0||ASSAY OF TRIGLYCERIDES|| 80001|84479||10.57|0|10.57|0||ASSAY OF THYROID (T3 OR T4)|| 80001|84480||20.83|0|20.83|0||ASSAY - TRIIODOTHYRONINE (T3)|| 80001|84481||27.66|0|27.66|0||FREE ASSAY (FT-3)|| 80001|84482||25.74|0|25.74|0||T3 REVERSE|| 80001|84484||16.07|0|16.07|0||ASSAY OF TROPONIN - QUANT|| 80001|84485||12.28|0|12.28|0||ASSAY DUODENAL FLUID TRYPSIN|| 80001|84488||11.93|0|11.93|0||TEST FECES FOR TRYPSIN|| 80001|84490||12.42|0|12.42|0||ASSAY OF FECES FOR TRYPSIN|| 80001|84510||16.99|0|16.99|0||ASSAY OF TYROSINE|| 80001|84512||12.05|0|12.05|0||ASSAY OF TROPONIN - QUAL|| 80001|84520||6.44|0|6.44|0||ASSAY OF UREA NITROGEN|| 80001|84520|QW|6.44|0|6.44|0||ASSAY OF UREA NITROGEN|| 80001|84525||3.95|0|3.95|0||UREA NITROGEN SEMI-QUANT|| 80001|84540||7.75|0|7.75|0||ASSAY OF URINE/UREA-N|| 80001|84545||10.79|0|10.79|0||UREA-N CLEARANCE TEST|| 80001|84550||7.38|0|7.38|0||ASSAY OF BLOOD/URIC ACID|| 80001|84550|QW|7.38|0|7.38|0||ASSAY OF BLOOD/URIC ACID|| 80001|84560||7.75|0|7.75|0||ASSAY OF URINE/URIC ACID|| 80001|84577||11.42|0|11.42|0||ASSAY OF FECES/UROBILINOGEN|| 80001|84578||5.32|0|5.32|0||TEST URINE UROBILINOGEN|| 80001|84580||11.59|0|11.59|0||ASSAY OF URINE UROBILINOGEN|| 80001|84583||8.22|0|8.22|0||ASSAY OF URINE UROBILINOGEN|| 80001|84585||25.31|0|25.31|0||ASSAY OF URINE VMA|| 80001|84586||57.71|0|57.71|0||ASSAY OF VIP|| 80001|84588||55.43|0|55.43|0||ASSAY OF VASOPRESSIN|| 80001|84590||18.95|0|18.95|0||ASSAY OF VITAMIN A|| 80001|84591||18.95|0|18.95|0||ASSAY OF NOS VITAMIN|| 80001|84597||22.39|0|22.39|0||ASSAY OF VITAMIN K|| 80001|84600||26.26|0|26.26|0||ASSAY OF VOLATILES|| 80001|84620||19.34|0|19.34|0||XYLOSE TOLERANCE TEST|| 80001|84630||18.6|0|18.6|0||ASSAY OF ZINC|| 80001|84681||25.97|0|25.97|0||ASSAY OF C-PEPTIDE|| 80001|84702||10.48|0|10.48|0||CHORIONIC GONADOTROPIN TEST|| 80001|84703||10.48|0|10.48|0||CHORIONIC GONADOTROPIN ASSAY|| 80001|84703|QW|10.48|0|10.48|0||CHORIONIC GONADOTROPIN ASSAY|| 80001|84704||10.48|0|10.48|0||HCG - FREE BETACHAIN TEST|| 80001|84830||16.38|0|16.38|0||OVULATION TESTS|| 80001|85002||7.36|0|7.36|0||BLEEDING TIME TEST|| 80001|85004||10.57|0|10.57|0||AUTOMATED DIFF WBC COUNT|| 80001|85007||5.62|0|5.62|0||BL SMEAR W/DIFF WBC COUNT|| 80001|85008||5.62|0|5.62|0||BL SMEAR W/O DIFF WBC COUNT|| 80001|85009||6.07|0|6.07|0||MANUAL DIFF WBC COUNT B-COAT|| 80001|85013||3.88|0|3.88|0||SPUN MICROHEMATOCRIT|| 80001|85014||3.88|0|3.88|0||HEMATOCRIT|| 80001|85014|QW|3.88|0|3.88|0||HEMATOCRIT|| 80001|85018||3.88|0|3.88|0||HEMOGLOBIN|| 80001|85018|QW|3.88|0|3.88|0||HEMOGLOBIN|| 80001|85025||12.7|0|12.7|0||COMPLETE CBC W/AUTO DIFF WBC|| 80001|85027||10.57|0|10.57|0||COMPLETE CBC - AUTOMATED|| 80001|85032||7.02|0|7.02|0||MANUAL CELL COUNT - EACH|| 80001|85041||4.93|0|4.93|0||AUTOMATED RBC COUNT|| 80001|85044||7.02|0|7.02|0||MANUAL RETICULOCYTE COUNT|| 80001|85045||6.53|0|6.53|0||AUTOMATED RETICULOCYTE COUNT|| 80001|85046||9.11|0|9.11|0||RETICYTE/HGB CONCENTRATE|| 80001|85048||4.15|0|4.15|0||AUTOMATED LEUKOCYTE COUNT|| 80001|85049||7.31|0|7.31|0||AUTOMATED PLATELET COUNT|| 80001|85055||42.64|0|42.64|0||RETICULATED PLATELET ASSAY|| 80001|85060||29.1|0|29.1|0||BLOOD SMEAR INTERPRETATION|| 80001|85097||57.99|0|57.99|0||BONE MARROW INTERPRETATION|| 80001|85130||19.42|0|19.42|0||CHROMOGENIC SUBSTRATE ASSAY|| 80001|85170||5.9|0|5.9|0||BLOOD CLOT RETRACTION|| 80001|85175||7.43|0|7.43|0||BLOOD CLOT LYSIS TIME|| 80001|85210||21.2|0|21.2|0||BLOOD CLOT FACTOR II TEST|| 80001|85220||28.81|0|28.81|0||BLOOD CLOT FACTOR V TEST|| 80001|85230||29.24|0|29.24|0||BLOOD CLOT FACTOR VII TEST|| 80001|85240||29.24|0|29.24|0||BLOOD CLOT FACTOR VIII TEST|| 80001|85244||33.35|0|33.35|0||BLOOD CLOT FACTOR VIII TEST|| 80001|85245||37.46|0|37.46|0||BLOOD CLOT FACTOR VIII TEST|| 80001|85246||37.46|0|37.46|0||BLOOD CLOT FACTOR VIII TEST|| 80001|85247||37.46|0|37.46|0||BLOOD CLOT FACTOR VIII TEST|| 80001|85250||31.09|0|31.09|0||BLOOD CLOT FACTOR IX TEST|| 80001|85260||29.24|0|29.24|0||BLOOD CLOT FACTOR X TEST|| 80001|85270||29.24|0|29.24|0||BLOOD CLOT FACTOR XI TEST|| 80001|85280||31.6|0|31.6|0||BLOOD CLOT FACTOR XII TEST|| 80001|85290||26.69|0|26.69|0||BLOOD CLOT FACTOR XIII TEST|| 80001|85291||14.53|0|14.53|0||BLOOD CLOT FACTOR XIII TEST|| 80001|85292||30.92|0|30.92|0||BLOOD CLOT FACTOR ASSAY|| 80001|85293||30.92|0|30.92|0||BLOOD CLOT FACTOR ASSAY|| 80001|85300||19.36|0|19.36|0||ANTITHROMBIN III TEST|| 80001|85301||17.65|0|17.65|0||ANTITHROMBIN III TEST|| 80001|85302||19.62|0|19.62|0||BLOOD CLOT INHIBITOR ANTIGEN|| 80001|85303||22.58|0|22.58|0||BLOOD CLOT INHIBITOR TEST|| 80001|85305||18.95|0|18.95|0||BLOOD CLOT INHIBITOR ASSAY|| 80001|85306||25.02|0|25.02|0||BLOOD CLOT INHIBITOR TEST|| 80001|85307||25.02|0|25.02|0||ASSAY ACTIVATED PROTEIN C|| 80001|85335||21.02|0|21.02|0||FACTOR INHIBITOR TEST|| 80001|85337||17.03|0|17.03|0||THROMBOMODULIN|| 80001|85345||5.64|0|5.64|0||COAGULATION TIME|| 80001|85347||6.95|0|6.95|0||COAGULATION TIME|| 80001|85348||5.64|0|5.64|0||COAGULATION TIME|| 80001|85360||13.72|0|13.72|0||EUGLOBULIN LYSIS|| 80001|85362||11.26|0|11.26|0||FIBRIN DEGRADATION PRODUCTS|| 80001|85366||14.06|0|14.06|0||FIBRINOGEN TEST|| 80001|85370||18.54|0|18.54|0||FIBRINOGEN TEST|| 80001|85378||11.65|0|11.65|0||FIBRIN DEGRADE - SEMIQUANT|| 80001|85379||16.62|0|16.62|0||FIBRIN DEGRADATION - QUANT|| 80001|85380||16.62|0|16.62|0||FIBRIN DEGRADATION - VTE|| 80001|85384||13.87|0|13.87|0||FIBRINOGEN|| 80001|85385||13.87|0|13.87|0||FIBRINOGEN|| 80001|85390||8.45|0|8.45|0||FIBRINOLYSINS SCREEN|| 80001|85390|26|22.16|0|22.16|0||FIBRINOLYSINS SCREEN|| 80001|85396||24.1|0|24.1|0||CLOTTING ASSAY - WHOLE BLOOD|| 80001|85397||37.46|0|37.46|0||CLOTTING FUNCT ACTIVITY|| 80001|85400||14.45|0|14.45|0||FIBRINOLYTIC PLASMIN|| 80001|85410||12.59|0|12.59|0||FIBRINOLYTIC ANTIPLASMIN|| 80001|85415||28.08|0|28.08|0||FIBRINOLYTIC PLASMINOGEN|| 80001|85420||10.67|0|10.67|0||FIBRINOLYTIC PLASMINOGEN|| 80001|85421||16.63|0|16.63|0||FIBRINOLYTIC PLASMINOGEN|| 80001|85441||6.86|0|6.86|0||HEINZ BODIES - DIRECT|| 80001|85445||11.14|0|11.14|0||HEINZ BODIES - INDUCED|| 80001|85460||3.95|0|3.95|0||HEMOGLOBIN - FETAL|| 80001|85461||10.84|0|10.84|0||HEMOGLOBIN - FETAL|| 80001|85475||8.52|0|8.52|0||HEMOLYSIN|| 80001|85520||21.38|0|21.38|0||HEPARIN ASSAY|| 80001|85525||19.34|0|19.34|0||HEPARIN NEUTRALIZATION|| 80001|85530||23.15|0|23.15|0||HEPARIN-PROTAMINE TOLERANCE|| 80001|85536||10.57|0|10.57|0||IRON STAIN PERIPHERAL BLOOD|| 80001|85540||9.88|0|9.88|0||WBC ALKALINE PHOSPHATASE|| 80001|85547||9.88|0|9.88|0||RBC MECHANICAL FRAGILITY|| 80001|85549||30.62|0|30.62|0||MURAMIDASE|| 80001|85555||10.91|0|10.91|0||RBC OSMOTIC FRAGILITY|| 80001|85557||21.82|0|21.82|0||RBC OSMOTIC FRAGILITY|| 80001|85576||35.09|0|35.09|0||BLOOD PLATELET AGGREGATION|| 80001|85576|26|22.16|0|22.16|0||BLOOD PLATELET AGGREGATION|| 80001|85576|QW|35.09|0|35.09|0||BLOOD PLATELET AGGREGATION|| 80001|85597||29.35|0|29.35|0||PLATELET NEUTRALIZATION|| 80001|85598||29.35|0|29.35|0||HEXAGNAL PHOSPH PLTLT NEUTRL|| 80001|85610||6.42|0|6.42|0||PROTHROMBIN TIME|| 80001|85610|QW|6.42|0|6.42|0||PROTHROMBIN TIME|| 80001|85611||6.43|0|6.43|0||PROTHROMBIN TEST|| 80001|85612||15.64|0|15.64|0||VIPER VENOM PROTHROMBIN TIME|| 80001|85613||15.64|0|15.64|0||RUSSELL VIPER VENOM - DILUTED|| 80001|85635||16.07|0|16.07|0||REPTILASE TEST|| 80001|85651||5.78|0|5.78|0||RBC SED RATE - NONAUTOMATED|| 80001|85652||4.42|0|4.42|0||RBC SED RATE - AUTOMATED|| 80001|85660||9|0|9|0||RBC SICKLE CELL TEST|| 80001|85670||9.42|0|9.42|0||THROMBIN TIME - PLASMA|| 80001|85675||9.88|0|9.88|0||THROMBIN TIME - TITER|| 80001|85705||15.72|0|15.72|0||THROMBOPLASTIN INHIBITION|| 80001|85730||9.8|0|9.8|0||THROMBOPLASTIN TIME - PARTIAL|| 80001|85732||10.57|0|10.57|0||THROMBOPLASTIN TIME - PARTIAL|| 80001|85810||19.07|0|19.07|0||BLOOD VISCOSITY EXAMINATION|| 80001|86000||11.4|0|11.4|0||AGGLUTININS - FEBRILE|| 80001|86001||8.52|0|8.52|0||ALLERGEN SPECIFIC IGG|| 80001|86003||8.52|0|8.52|0||ALLERGEN SPECIFIC IGE|| 80001|86005||8.99|0|8.99|0||ALLERGEN SPECIFIC IGE|| 80001|86008||26.57|0|26.57|0||ALLG SPEC IGE RECOMB EA|| 80001|86021||24.59|0|24.59|0||WBC ANTIBODY IDENTIFICATION|| 80001|86022||30|0|30|0||PLATELET ANTIBODIES|| 80001|86023||20.34|0|20.34|0||IMMUNOGLOBULIN ASSAY|| 80001|86038||19.74|0|19.74|0||ANTINUCLEAR ANTIBODIES|| 80001|86039||18.23|0|18.23|0||ANTINUCLEAR ANTIBODIES (ANA)|| 80001|86060||11.42|0|11.42|0||ANTISTREPTOLYSIN O - TITER|| 80001|86063||9.42|0|9.42|0||ANTISTREPTOLYSIN O - SCREEN|| 80001|86077||61.09|0|61.09|0||PHYSICIAN BLOOD BANK SERVICE|| 80001|86078||60.7|0|60.7|0||PHYSICIAN BLOOD BANK SERVICE|| 80001|86079||59.93|0|59.93|0||PHYSICIAN BLOOD BANK SERVICE|| 80001|86140||8.45|0|8.45|0||C-REACTIVE PROTEIN|| 80001|86141||21.14|0|21.14|0||C-REACTIVE PROTEIN - HS|| 80001|86146||41.54|0|41.54|0||GLYCOPROTEIN ANTIBODY|| 80001|86147||41.54|0|41.54|0||CARDIOLIPIN ANTIBODY|| 80001|86148||26.24|0|26.24|0||PHOSPHOLIPID ANTIBODY|| 80001|86152||401.24|0|401.24|0||CELL ENUMERATION & ID|| 80001|86153|26|41.39|0|41.39|0||CELL ENUMERATION PHYS INTERP|| 80001|86155||26.11|0|26.11|0||CHEMOTAXIS ASSAY|| 80001|86156||10.94|0|10.94|0||COLD AGGLUTININ - SCREEN|| 80001|86157||13.16|0|13.16|0||COLD AGGLUTININ - TITER|| 80001|86160||19.6|0|19.6|0||COMPLEMENT - ANTIGEN|| 80001|86161||19.6|0|19.6|0||COMPLEMENT/FUNCTION ACTIVITY|| 80001|86162||33.18|0|33.18|0||COMPLEMENT - TOTAL (CH50)|| 80001|86171||11.42|0|11.42|0||COMPLEMENT FIXATION - EACH|| 80001|86185||14.6|0|14.6|0||COUNTERIMMUNOELECTROPHORESIS|| 80001|86200||21.14|0|21.14|0||CCP ANTIBODY|| 80001|86215||21.64|0|21.64|0||DEOXYRIBONUCLEASE - ANTIBODY|| 80001|86225||22.43|0|22.43|0||DNA ANTIBODY|| 80001|86226||19.78|0|19.78|0||DNA ANTIBODY - SINGLE STRAND|| 80001|86235||29.29|0|29.29|0||NUCLEAR ANTIGEN ANTIBODY|| 80001|86243||33.5|0|33.5|0||FC RECEPTOR|| 80001|86255||19.68|0|19.68|0||FLUORESCENT ANTIBODY - SCREEN|| 80001|86255|26|22.16|0|22.16|0||FLUORESCENT ANTIBODY - SCREEN|| 80001|86256||19.68|0|19.68|0||FLUORESCENT ANTIBODY - TITER|| 80001|86256|26|22.16|0|22.16|0||FLUORESCENT ANTIBODY - TITER|| 80001|86277||25.7|0|25.7|0||GROWTH HORMONE ANTIBODY|| 80001|86280||13.37|0|13.37|0||HEMAGGLUTINATION INHIBITION|| 80001|86294||18.92|0|18.92|0||IMMUNOASSAY - TUMOR - QUAL|| 80001|86294|QW|18.92|0|18.92|0||IMMUNOASSAY - TUMOR - QUAL|| 80001|86300||33.98|0|33.98|0||IMMUNOASSAY - TUMOR - CA 15-3|| 80001|86301||33.98|0|33.98|0||IMMUNOASSAY - TUMOR - CA 19-9|| 80001|86304||33.98|0|33.98|0||IMMUNOASSAY - TUMOR - CA 125|| 80001|86305||33.98|0|33.98|0||HUMAN EPIDIDYMIS PROTEIN 4|| 80001|86308||8.45|0|8.45|0||HETEROPHILE ANTIBODIES|| 80001|86308|QW|8.45|0|8.45|0||HETEROPHILE ANTIBODIES|| 80001|86309||10.57|0|10.57|0||HETEROPHILE ANTIBODIES|| 80001|86310||12.01|0|12.01|0||HETEROPHILE ANTIBODIES|| 80001|86316||33.98|0|33.98|0||IMMUNOASSAY - TUMOR OTHER|| 80001|86317||19.61|0|19.61|0||IMMUNOASSAY - INFECTIOUS AGENT|| 80001|86318||21.14|0|21.14|0||IMMUNOASSAY - INFECTIOUS AGENT|| 80001|86318|QW|21.14|0|21.14|0||IMMUNOASSAY - INFECTIOUS AGENT|| 80001|86320||36.6|0|36.6|0||SERUM IMMUNOELECTROPHORESIS|| 80001|86320|26|22.16|0|22.16|0||SERUM IMMUNOELECTROPHORESIS|| 80001|86325||36.53|0|36.53|0||OTHER IMMUNOELECTROPHORESIS|| 80001|86325|26|22.16|0|22.16|0||OTHER IMMUNOELECTROPHORESIS|| 80001|86327||37.06|0|37.06|0||IMMUNOELECTROPHORESIS ASSAY|| 80001|86327|26|25.48|0|25.48|0||IMMUNOELECTROPHORESIS ASSAY|| 80001|86329||22.93|0|22.93|0||IMMUNODIFFUSION|| 80001|86331||19.56|0|19.56|0||IMMUNODIFFUSION OUCHTERLONY|| 80001|86332||39.8|0|39.8|0||IMMUNE COMPLEX ASSAY|| 80001|86334||36.49|0|36.49|0||IMMUNOFIX E-PHORESIS - SERUM|| 80001|86334|26|22.16|0|22.16|0||IMMUNOFIX E-PHORESIS - SERUM|| 80001|86335||47.93|0|47.93|0||IMMUNFIX E-PHORSIS/URINE/CSF|| 80001|86335|26|22.16|0|22.16|0||IMMUNFIX E-PHORSIS/URINE/CSF|| 80001|86336||21.16|0|21.16|0||INHIBIN A|| 80001|86337||34.96|0|34.96|0||INSULIN ANTIBODIES|| 80001|86340||24.61|0|24.61|0||INTRINSIC FACTOR ANTIBODY|| 80001|86341||32.3|0|32.3|0||ISLET CELL ANTIBODY|| 80001|86343||20.35|0|20.35|0||LEUKOCYTE HISTAMINE RELEASE|| 80001|86344||13.04|0|13.04|0||LEUKOCYTE PHAGOCYTOSIS|| 80001|86352||221.87|0|221.87|0||CELL FUNCTION ASSAY W/STIM|| 80001|86353||80.06|0|80.06|0||LYMPHOCYTE TRANSFORMATION|| 80001|86355||38.48|0|38.48|0||B CELLS - TOTAL COUNT|| 80001|86356||42.64|0|42.64|0||MONONUCLEAR CELL ANTIGEN|| 80001|86357||38.48|0|38.48|0||NK CELLS - TOTAL COUNT|| 80001|86359||38.48|0|38.48|0||T CELLS - TOTAL COUNT|| 80001|86360||76.73|0|76.73|0||T CELL - ABSOLUTE COUNT/RATIO|| 80001|86361||42.64|0|42.64|0||T CELL - ABSOLUTE COUNT|| 80001|86367||38.48|0|38.48|0||STEM CELLS - TOTAL COUNT|| 80001|86376||23.76|0|23.76|0||MICROSOMAL ANTIBODY|| 80001|86378||32.16|0|32.16|0||MIGRATION INHIBITORY FACTOR|| 80001|86382||27.61|0|27.61|0||NEUTRALIZATION TEST - VIRAL|| 80001|86384||18.6|0|18.6|0||NITROBLUE TETRAZOLIUM DYE|| 80001|86386||26.08|0|26.08|0||NUCLEAR MATRIX PROTEIN 22|| 80001|86386|QW|26.08|0|26.08|0||NUCLEAR MATRIX PROTEIN 22|| 80001|86403||16.64|0|16.64|0||PARTICLE AGGLUTINATION TEST|| 80001|86406||17.36|0|17.36|0||PARTICLE AGGLUTINATION TEST|| 80001|86430||9.26|0|9.26|0||RHEUMATOID FACTOR TEST|| 80001|86431||9.26|0|9.26|0||RHEUMATOID FACTOR - QUANT|| 80001|86480||101.22|0|101.22|0||TB TEST - CELL IMMUN MEASURE|| 80001|86481||122.35|0|122.35|0||TB AG RESPONSE T-CELL SUSP|| 80001|86486||5.43|0|5.43|0||SKIN TEST - NOS ANTIGEN|| 80001|86490||7.37|0|7.37|0||COCCIDIOIDOMYCOSIS SKIN TEST|| 80001|86510||6.59|0|6.59|0||HISTOPLASMOSIS SKIN TEST|| 80001|86580||8.53|0|8.53|0||TB INTRADERMAL TEST|| 80001|86590||18.04|0|18.04|0||STREPTOKINASE - ANTIBODY|| 80001|86592||6.97|0|6.97|0||BLOOD SEROLOGY - QUALITATIVE|| 80001|86593||7.19|0|7.19|0||BLOOD SEROLOGY - QUANTITATIVE|| 80001|86602||16.62|0|16.62|0||ANTINOMYCES ANTIBODY|| 80001|86603||21.01|0|21.01|0||ADENOVIRUS ANTIBODY|| 80001|86606||24.59|0|24.59|0||ASPERGILLUS ANTIBODY|| 80001|86609||21.04|0|21.04|0||BACTERIUM ANTIBODY|| 80001|86611||16.62|0|16.62|0||BARTONELLA ANTIBODY|| 80001|86612||21.07|0|21.07|0||BLASTOMYCES ANTIBODY|| 80001|86615||21.54|0|21.54|0||BORDETELLA ANTIBODY|| 80001|86617||25.3|0|25.3|0||LYME DISEASE ANTIBODY|| 80001|86618||27.82|0|27.82|0||LYME DISEASE ANTIBODY|| 80001|86618|QW|27.82|0|27.82|0||LYME DISEASE ANTIBODY|| 80001|86619||21.85|0|21.85|0||BORRELIA ANTIBODY|| 80001|86622||14.59|0|14.59|0||BRUCELLA ANTIBODY|| 80001|86625||21.43|0|21.43|0||CAMPYLOBACTER ANTIBODY|| 80001|86628||19.61|0|19.61|0||CANDIDA ANTIBODY|| 80001|86631||19.31|0|19.31|0||CHLAMYDIA ANTIBODY|| 80001|86632||20.72|0|20.72|0||CHLAMYDIA IGM ANTIBODY|| 80001|86635||18.73|0|18.73|0||COCCIDIOIDES ANTIBODY|| 80001|86638||19.8|0|19.8|0||Q FEVER ANTIBODY|| 80001|86641||23.53|0|23.53|0||CRYPTOCOCCUS ANTIBODY|| 80001|86644||19.01|0|19.01|0||CMV ANTIBODY|| 80001|86645||27.52|0|27.52|0||CMV ANTIBODY - IGM|| 80001|86648||24.83|0|24.83|0||DIPHTHERIA ANTIBODY|| 80001|86651||21.54|0|21.54|0||ENCEPHALITIS ANTIBODY|| 80001|86652||21.54|0|21.54|0||ENCEPHALITIS ANTIBODY|| 80001|86653||21.54|0|21.54|0||ENCEPHALITIS ANTIBODY|| 80001|86654||21.54|0|21.54|0||ENCEPHALITIS ANTIBODY|| 80001|86658||21.28|0|21.28|0||ENTEROVIRUS ANTIBODY|| 80001|86663||21.43|0|21.43|0||EPSTEIN-BARR ANTIBODY|| 80001|86664||24.98|0|24.98|0||EPSTEIN-BARR ANTIBODY|| 80001|86665||29.63|0|29.63|0||EPSTEIN-BARR ANTIBODY|| 80001|86666||16.62|0|16.62|0||EHRLICHIA ANTIBODY|| 80001|86668||16.99|0|16.99|0||FRANCISELLA TULARENSIS|| 80001|86671||20.02|0|20.02|0||FUNGUS ANTIBODY|| 80001|86674||24.04|0|24.04|0||GIARDIA LAMBLIA ANTIBODY|| 80001|86677||23.69|0|23.69|0||HELICOBACTER PYLORI|| 80001|86682||21.24|0|21.24|0||HELMINTH ANTIBODY|| 80001|86684||25.87|0|25.87|0||HEMOPHILUS INFLUENZA|| 80001|86687||13.7|0|13.7|0||HTLV-I ANTIBODY|| 80001|86688||22.87|0|22.87|0||HTLV-II ANTIBODY|| 80001|86689||31.61|0|31.61|0||HTLV/HIV CONFIRMATORY TEST|| 80001|86692||28.02|0|28.02|0||HEPATITIS - DELTA AGENT|| 80001|86694||19.01|0|19.01|0||HERPES SIMPLEX TEST|| 80001|86695||21.54|0|21.54|0||HERPES SIMPLEX TEST|| 80001|86696||31.61|0|31.61|0||HERPES SIMPLEX TYPE 2|| 80001|86698||20.41|0|20.41|0||HISTOPLASMA|| 80001|86701||14.51|0|14.51|0||HIV-1|| 80001|86701|QW|14.51|0|14.51|0||HIV-1|| 80001|86702||22.07|0|22.07|0||HIV-2|| 80001|86703||22.39|0|22.39|0||HIV-1/HIV-2 - SINGLE ASSAY|| 80001|86704||19.68|0|19.68|0||HEP B CORE ANTIBODY - TOTAL|| 80001|86705||19.24|0|19.24|0||HEP B CORE ANTIBODY - IGM|| 80001|86706||17.54|0|17.54|0||HEP B SURFACE ANTIBODY|| 80001|86707||18.9|0|18.9|0||HEP BE ANTIBODY|| 80001|86708||20.23|0|20.23|0||HEP A ANTIBODY - TOTAL|| 80001|86709||18.38|0|18.38|0||HEP A ANTIBODY - IGM|| 80001|86710||22.13|0|22.13|0||INFLUENZA VIRUS ANTIBODY|| 80001|86711||19.01|0|19.01|0||JOHN CUNNINGHAM ANTIBODY|| 80001|86713||24.98|0|24.98|0||LEGIONELLA ANTIBODY|| 80001|86717||20|0|20|0||LEISHMANIA ANTIBODY|| 80001|86720||21.54|0|21.54|0||LEPTOSPIRA ANTIBODY|| 80001|86723||21.54|0|21.54|0||LISTERIA MONOCYTOGENES AB|| 80001|86727||21.01|0|21.01|0||LYMPH CHORIOMENINGITIS AB|| 80001|86729||19.51|0|19.51|0||LYMPHO VENEREUM ANTIBODY|| 80001|86732||21.54|0|21.54|0||MUCORMYCOSIS ANTIBODY|| 80001|86735||21.31|0|21.31|0||MUMPS ANTIBODY|| 80001|86738||21.62|0|21.62|0||MYCOPLASMA ANTIBODY|| 80001|86741||21.54|0|21.54|0||NEISSERIA MENINGITIDIS|| 80001|86744||21.54|0|21.54|0||NOCARDIA ANTIBODY|| 80001|86747||24.55|0|24.55|0||PARVOVIRUS ANTIBODY|| 80001|86750||21.54|0|21.54|0||MALARIA ANTIBODY|| 80001|86753||20.23|0|20.23|0||PROTOZOA ANTIBODY NOS|| 80001|86756||21.05|0|21.05|0||RESPIRATORY VIRUS ANTIBODY|| 80001|86757||31.61|0|31.61|0||RICKETTSIA ANTIBODY|| 80001|86759||21.54|0|21.54|0||ROTAVIRUS ANTIBODY|| 80001|86762||19.01|0|19.01|0||RUBELLA ANTIBODY|| 80001|86765||21.04|0|21.04|0||RUBEOLA ANTIBODY|| 80001|86768||21.54|0|21.54|0||SALMONELLA ANTIBODY|| 80001|86771||21.54|0|21.54|0||SHIGELLA ANTIBODY|| 80001|86774||24.17|0|24.17|0||TETANUS ANTIBODY|| 80001|86777||19.01|0|19.01|0||TOXOPLASMA ANTIBODY|| 80001|86778||23.52|0|23.52|0||TOXOPLASMA ANTIBODY - IGM|| 80001|86780||21.62|0|21.62|0||TREPONEMA PALLIDUM|| 80001|86784||20.51|0|20.51|0||TRICHINELLA ANTIBODY|| 80001|86787||21.04|0|21.04|0||VARICELLA-ZOSTER ANTIBODY|| 80001|86788||27.52|0|27.52|0||WEST NILE VIRUS AB - IGM|| 80001|86789||19.01|0|19.01|0||WEST NILE VIRUS ANTIBODY|| 80001|86790||21.04|0|21.04|0||VIRUS ANTIBODY NOS|| 80001|86793||21.54|0|21.54|0||YERSINIA ANTIBODY|| 80001|86794||24.96|0|24.96|0||ZIKA VIRUS IGM ANTIBODY|| 80001|86800||25.98|0|25.98|0||THYROGLOBULIN ANTIBODY|| 80001|86803||23.3|0|23.3|0||HEPATITIS C AB TEST|| 80001|86803|QW|23.3|0|23.3|0||HEPATITIS C AB TEST|| 80001|86804||25.3|0|25.3|0||HEP C AB TEST - CONFIRM|| 80001|86805||85.39|0|85.39|0||LYMPHOCYTOTOXICITY ASSAY|| 80001|86806||77.71|0|77.71|0||LYMPHOCYTOTOXICITY ASSAY|| 80001|86807||64.63|0|64.63|0||CYTOTOXIC ANTIBODY SCREENING|| 80001|86808||48.47|0|48.47|0||CYTOTOXIC ANTIBODY SCREENING|| 80001|86812||42.14|0|42.14|0||HLA TYPING - A - B - OR C|| 80001|86813||94.7|0|94.7|0||HLA TYPING - A - B - OR C|| 80001|86816||45.49|0|45.49|0||HLA TYPING - DR/DQ|| 80001|86817||105.14|0|105.14|0||HLA TYPING - DR/DQ|| 80001|86821||92.2|0|92.2|0||LYMPHOCYTE CULTURE - MIXED|| 80001|86822||59.7|0|59.7|0||LYMPHOCYTE CULTURE - PRIMED|| 80001|86825||127.9|0|127.9|0||HLA X-MATCH - NON-CYTOTOXIC|| 80001|86826||42.64|0|42.64|0||HLA X-MATCH - NON-CYT ADD-ON|| 80001|86828||64.63|0|64.63|0||HLA CLASS I&II ANTIBODY QUAL|| 80001|86829||48.47|0|48.47|0||HLA CLASS I/II ANTIBODY QUAL|| 80001|86830||122.16|0|122.16|0||HLA CLASS I PHENOTYPE QUAL|| 80001|86831||104.71|0|104.71|0||HLA CLASS II PHENOTYPE QUAL|| 80001|86832||191.98|0|191.98|0||HLA CLASS I HIGH DEFIN QUAL|| 80001|86833||174.53|0|174.53|0||HLA CLASS II HIGH DEFIN QUAL|| 80001|86834||541.01|0|541.01|0||HLA CLASS I SEMIQUANT PANEL|| 80001|86835||488.66|0|488.66|0||HLA CLASS II SEMIQUANT PANEL|| 80001|86850||6.3|0|6.3|||RBC ANTIBODY SCREEN|| 80001|86880||8.8|0|8.8|0||COOMBS TEST - DIRECT|| 80001|86885||9.35|0|9.35|0||COOMBS TEST - INDIRECT - QUAL|| 80001|86886||7.58|0|7.58|0||COOMBS TEST - INDIRECT - TITER|| 80001|86900||4.87|0|4.87|0||BLOOD TYPING - ABO|| 80001|86901||4.87|0|4.87|0||BLOOD TYPING - RH (D)|| 80001|86902||6.24|0|6.24|0||BLOOD TYPE ANTIGEN DONOR EA|| 80001|86904||15.53|0|15.53|0||BLOOD TYPING - PATIENT SERUM|| 80001|86905||6.24|0|6.24|0||BLOOD TYPING - RBC ANTIGENS|| 80001|86906||12.66|0|12.66|0||BLOOD TYPING - RH PHENOTYPE|| 80001|86940||13.39|0|13.39|0||HEMOLYSINS/AGGLUTININS - AUTO|| 80001|86941||19.78|0|19.78|0||HEMOLYSINS/AGGLUTININS|| 80001|87003||27.49|0|27.49|0||SMALL ANIMAL INOCULATION|| 80001|87015||10.91|0|10.91|0||SPECIMEN CONCENTRATION|| 80001|87040||16.86|0|16.86|0||BLOOD CULTURE FOR BACTERIA|| 80001|87045||15.42|0|15.42|0||FECES CULTURE - BACTERIA|| 80001|87046||15.42|0|15.42|0||STOOL CULTR - BACTERIA - EACH|| 80001|87070||14.06|0|14.06|0||CULTURE - BACTERIA - OTHER|| 80001|87071||15.42|0|15.42|0||CULTURE BACTERI AEROBIC OTHR|| 80001|87073||15.42|0|15.42|0||CULTURE BACTERIA ANAEROBIC|| 80001|87075||15.46|0|15.46|0||CULTR BACTERIA - EXCEPT BLOOD|| 80001|87076||13.2|0|13.2|0||CULTURE ANAEROBE IDENT - EACH|| 80001|87077||13.2|0|13.2|0||CULTURE AEROBIC IDENTIFY|| 80001|87077|QW|13.2|0|13.2|0||CULTURE AEROBIC IDENTIFY|| 80001|87081||10.82|0|10.82|0||CULTURE SCREEN ONLY|| 80001|87084||14.06|0|14.06|0||CULTURE OF SPECIMEN BY KIT|| 80001|87086||13.19|0|13.19|0||URINE CULTURE/COLONY COUNT|| 80001|87088||13.22|0|13.22|0||URINE BACTERIA CULTURE|| 80001|87101||12.59|0|12.59|0||SKIN FUNGI CULTURE|| 80001|87102||13.72|0|13.72|0||FUNGUS ISOLATION CULTURE|| 80001|87103||14.72|0|14.72|0||BLOOD FUNGUS CULTURE|| 80001|87106||16.86|0|16.86|0||FUNGI IDENTIFICATION - YEAST|| 80001|87107||16.86|0|16.86|0||FUNGI IDENTIFICATION - MOLD|| 80001|87109||25.13|0|25.13|0||MYCOPLASMA|| 80001|87110||31.99|0|31.99|0||CHLAMYDIA CULTURE|| 80001|87116||11.88|0|11.88|0||MYCOBACTERIA CULTURE|| 80001|87118||17.88|0|17.88|0||MYCOBACTERIC IDENTIFICATION|| 80001|87140||9.11|0|9.11|0||CULTURE TYPE IMMUNOFLUORESC|| 80001|87143||20.46|0|20.46|0||CULTURE TYPING - GLC/HPLC|| 80001|87147||7.27|0|7.27|0||CULTURE TYPE - IMMUNOLOGIC|| 80001|87149||32.21|0|32.21|0||CULTURE TYPE - NUCLEIC ACID|| 80001|87150||32.04|0|32.04|0||DNA/RNA - AMPLIFIED PROBE|| 80001|87152||8.54|0|8.54|0||CULTURE TYPE PULSE FIELD GEL|| 80001|87153||115.69|0|115.69|0||DNA/RNA SEQUENCING|| 80001|87158||8.54|0|8.54|0||CULTURE TYPING - ADDED METHOD|| 80001|87164||14.28|0|14.28|0||DARK FIELD EXAMINATION|| 80001|87164|26|22.16|0|22.16|0||DARK FIELD EXAMINATION|| 80001|87166||18.44|0|18.44|0||DARK FIELD EXAMINATION|| 80001|87168||6.97|0|6.97|0||MACROSCOPIC EXAM ARTHROPOD|| 80001|87169||6.97|0|6.97|0||MACROSCOPIC EXAM PARASITE|| 80001|87172||6.97|0|6.97|0||PINWORM EXAM|| 80001|87176||9.61|0|9.61|0||TISSUE HOMOGENIZATION - CULTR|| 80001|87177||14.53|0|14.53|0||OVA AND PARASITES SMEARS|| 80001|87181||7.75|0|7.75|0||MICROBE SUSCEPTIBLE - DIFFUSE|| 80001|87184||11.27|0|11.27|0||MICROBE SUSCEPTIBLE - DISK|| 80001|87185||7.75|0|7.75|0||MICROBE SUSCEPTIBLE - ENZYME|| 80001|87186||14.12|0|14.12|0||MICROBE SUSCEPTIBLE - MIC|| 80001|87187||16.92|0|16.92|0||MICROBE SUSCEPTIBLE - MLC|| 80001|87188||10.85|0|10.85|0||MICROBE SUSCEPT - MACROBROTH|| 80001|87190||9.23|0|9.23|0||MICROBE SUSCEPT - MYCOBACTERI|| 80001|87197||24.54|0|24.54|0||BACTERICIDAL LEVEL - SERUM|| 80001|87205||3.83|0|3.83|0||SMEAR - GRAM STAIN|| 80001|87206||8.8|0|8.8|0||SMEAR - FLUORESCENT/ACID STAI|| 80001|87207||9.78|0|9.78|0||SMEAR - SPECIAL STAIN|| 80001|87207|26|22.16|0|22.16|0||SMEAR - SPECIAL STAIN|| 80001|87209||29.35|0|29.35|0||SMEAR - COMPLEX STAIN|| 80001|87210||6.97|0|6.97|0||SMEAR - WET MOUNT - SALINE/INK|| 80001|87210|QW|6.97|0|6.97|0||SMEAR - WET MOUNT - SALINE/INK|| 80001|87220||6.97|0|6.97|0||TISSUE EXAM FOR FUNGI|| 80001|87230||32.24|0|32.24|0||ASSAY - TOXIN OR ANTITOXIN|| 80001|87250||31.94|0|31.94|0||VIRUS INOCULATE - EGGS/ANIMAL|| 80001|87252||36.11|0|36.11|0||VIRUS INOCULATION - TISSUE|| 80001|87253||26.59|0|26.59|0||VIRUS INOCULATE TISSUE - ADDL|| 80001|87254||31.94|0|31.94|0||VIRUS INOCULATION - SHELL VIA|| 80001|87255||49.42|0|49.42|0||GENET VIRUS ISOLATE - HSV|| 80001|87260||19.58|0|19.58|0||ADENOVIRUS AG - IF|| 80001|87265||19.58|0|19.58|0||PERTUSSIS AG - IF|| 80001|87267||19.58|0|19.58|0||ENTEROVIRUS ANTIBODY - DFA|| 80001|87269||19.58|0|19.58|0||GIARDIA AG - IF|| 80001|87270||19.58|0|19.58|0||CHLAMYDIA TRACHOMATIS AG - IF|| 80001|87271||19.58|0|19.58|0||CRYPTOSPORIDUM/GARDIA AG - IF|| 80001|87272||19.58|0|19.58|0||CRYPTOSPORIDIUM AG - IF|| 80001|87273||19.58|0|19.58|0||HERPES SIMPLEX 2 - AG - IF|| 80001|87274||19.58|0|19.58|0||HERPES SIMPLEX 1 - AG - IF|| 80001|87275||19.58|0|19.58|0||INFLUENZA B - AG - IF|| 80001|87276||19.58|0|19.58|0||INFLUENZA A - AG - IF|| 80001|87277||19.58|0|19.58|0||LEGIONELLA MICDADEI - AG - IF|| 80001|87278||19.58|0|19.58|0||LEGION PNEUMOPHILIA AG - IF|| 80001|87279||19.58|0|19.58|0||PARAINFLUENZA - AG - IF|| 80001|87280||19.58|0|19.58|0||RESPIRATORY SYNCYTIAL AG - IF|| 80001|87281||19.58|0|19.58|0||PNEUMOCYSTIS CARINII - AG - IF|| 80001|87283||19.58|0|19.58|0||RUBEOLA - AG - IF|| 80001|87285||19.58|0|19.58|0||TREPONEMA PALLIDUM - AG - IF|| 80001|87290||19.58|0|19.58|0||VARICELLA ZOSTER - AG - IF|| 80001|87299||19.58|0|19.58|0||ANTIBODY DETECTION - NOS - IF|| 80001|87300||19.58|0|19.58|0||AG DETECTION - POLYVAL - IF|| 80001|87301||19.58|0|19.58|0||ADENOVIRUS AG - EIA|| 80001|87305||19.58|0|19.58|0||ASPERGILLUS AG - EIA|| 80001|87320||19.58|0|19.58|0||CHYLMD TRACH AG - EIA|| 80001|87324||19.58|0|19.58|0||CLOSTRIDIUM AG - EIA|| 80001|87327||19.58|0|19.58|0||CRYPTOCOCCUS NEOFORM AG - EIA|| 80001|87328||19.58|0|19.58|0||CRYPTOSPORIDIUM AG - EIA|| 80001|87329||19.58|0|19.58|0||GIARDIA AG - EIA|| 80001|87332||19.58|0|19.58|0||CYTOMEGALOVIRUS AG - EIA|| 80001|87335||19.58|0|19.58|0||E COLI 0157 AG - EIA|| 80001|87336||19.58|0|19.58|0||ENTAMOEB HIST DISPR - AG - EIA|| 80001|87337||19.58|0|19.58|0||ENTAMOEB HIST GROUP - AG - EIA|| 80001|87338||23.48|0|23.48|0||HPYLORI - STOOL - EIA|| 80001|87339||19.58|0|19.58|0||H PYLORI AG - EIA|| 80001|87340||16.87|0|16.87|0||HEPATITIS B SURFACE AG - EIA|| 80001|87341||16.87|0|16.87|0||HEPATITIS B SURFACE - AG - EIA|| 80001|87350||18.83|0|18.83|0||HEPATITIS BE AG - EIA|| 80001|87380||26.8|0|26.8|0||HEPATITIS DELTA AG - EIA|| 80001|87385||19.58|0|19.58|0||HISTOPLASMA CAPSUL AG - EIA|| 80001|87389||39.32|0|39.32|0||HIV-1 AG W/HIV-1 & HIV-2 AB|| 80001|87390||28.81|0|28.81|0||HIV-1 AG - EIA|| 80001|87391||28.81|0|28.81|0||HIV-2 AG - EIA|| 80001|87400||19.58|0|19.58|0||INFLUENZA A/B - AG - EIA|| 80001|87420||19.58|0|19.58|0||RESP SYNCYTIAL AG - EIA|| 80001|87425||19.58|0|19.58|0||ROTAVIRUS AG - EIA|| 80001|87427||19.58|0|19.58|0||SHIGA-LIKE TOXIN AG - EIA|| 80001|87430||19.58|0|19.58|0||STREP A AG - EIA|| 80001|87449||19.58|0|19.58|0||AG DETECT NOS - EIA - MULT|| 80001|87449|QW|19.58|0|19.58|0||AG DETECT NOS - EIA - MULT|| 80001|87450||15.66|0|15.66|0||AG DETECT NOS - EIA - SINGLE|| 80001|87451||15.66|0|15.66|0||AG DETECT POLYVAL - EIA - MULT|| 80001|87470||32.21|0|32.21|0||BARTONELLA - DNA - DIR PROBE|| 80001|87471||32.04|0|32.04|0||BARTONELLA - DNA - AMP PROBE|| 80001|87472||69.95|0|69.95|0||BARTONELLA - DNA - QUANT|| 80001|87475||32.21|0|32.21|0||LYME DIS - DNA - DIR PROBE|| 80001|87476||32.04|0|32.04|0||LYME DIS - DNA - AMP PROBE|| 80001|87477||69.95|0|69.95|0||LYME DIS - DNA - QUANT|| 80001|87480||32.21|0|32.21|0||CANDIDA - DNA - DIR PROBE|| 80001|87481||32.04|0|32.04|0||CANDIDA - DNA - AMP PROBE|| 80001|87482||68.18|0|68.18|0||CANDIDA - DNA - QUANT|| 80001|87483||290.26|0|290.26|0||CNS DNA AMP PROBE TYPE 12-25|| 80001|87485||32.21|0|32.21|0||CHYLMD PNEUM - DNA - DIR PROBE|| 80001|87486||32.04|0|32.04|0||CHYLMD PNEUM - DNA - AMP PROBE|| 80001|87487||69.95|0|69.95|0||CHYLMD PNEUM - DNA - QUANT|| 80001|87490||32.21|0|32.21|0||CHYLMD TRACH - DNA - DIR PROBE|| 80001|87491||32.04|0|32.04|0||CHYLMD TRACH - DNA - AMP PROBE|| 80001|87492||57.08|0|57.08|0||CHYLMD TRACH - DNA - QUANT|| 80001|87493||32.04|0|32.04|0||C DIFF AMPLIFIED PROBE|| 80001|87495||32.21|0|32.21|0||CYTOMEG - DNA - DIR PROBE|| 80001|87496||32.04|0|32.04|0||CYTOMEG - DNA - AMP PROBE|| 80001|87497||69.95|0|69.95|0||CYTOMEG - DNA - QUANT|| 80001|87498||32.04|0|32.04|0||ENTEROVIRUS - DNA - AMP PROBE|| 80001|87500||32.04|0|32.04|0||VANOMYCIN - DNA - AMP PROBE|| 80001|87501||52.73|0|52.73|0||INFLUENZA DNA AMP PROB 1+|| 80001|87502||84.74|0|84.74|0||INFLUENZA DNA AMP PROBE|| 80001|87503||12.7|0|12.7|0||INFLUENZA DNA AMP PROB ADDL|| 80001|87505||110.15|0|110.15|0||NFCT AGENT DETECTION GI|| 80001|87506||160.94|0|160.94|0||IADNA-DNA/RNA PROBE TQ 6-11|| 80001|87507||287.95|0|287.95|0||IADNA-DNA/RNA PROBE TQ 12-25|| 80001|87510||32.21|0|32.21|0||GARDNER VAG - DNA - DIR PROBE|| 80001|87511||32.04|0|32.04|0||GARDNER VAG - DNA - AMP PROBE|| 80001|87512||68.18|0|68.18|0||GARDNER VAG - DNA - QUANT|| 80001|87515||32.21|0|32.21|0||HEPATITIS B - DNA - DIR PROBE|| 80001|87516||32.04|0|32.04|0||HEPATITIS B - DNA - AMP PROBE|| 80001|87517||69.95|0|69.95|0||HEPATITIS B - DNA - QUANT|| 80001|87520||32.21|0|32.21|0||HEPATITIS C - RNA - DIR PROBE|| 80001|87521||32.04|0|32.04|0||HEPATITIS C - RNA - AMP PROBE|| 80001|87522||69.95|0|69.95|0||HEPATITIS C - RNA - QUANT|| 80001|87525||32.21|0|32.21|0||HEPATITIS G - DNA - DIR PROBE|| 80001|87526||32.04|0|32.04|0||HEPATITIS G - DNA - AMP PROBE|| 80001|87527||68.18|0|68.18|0||HEPATITIS G - DNA - QUANT|| 80001|87528||32.21|0|32.21|0||HSV - DNA - DIR PROBE|| 80001|87529||32.04|0|32.04|0||HSV - DNA - AMP PROBE|| 80001|87530||69.95|0|69.95|0||HSV - DNA - QUANT|| 80001|87531||32.21|0|32.21|0||HHV-6 - DNA - DIR PROBE|| 80001|87532||32.04|0|32.04|0||HHV-6 - DNA - AMP PROBE|| 80001|87533||68.18|0|68.18|0||HHV-6 - DNA - QUANT|| 80001|87534||32.21|0|32.21|0||HIV-1 - DNA - DIR PROBE|| 80001|87535||32.04|0|32.04|0||HIV-1 - DNA - AMP PROBE|| 80001|87536||84.74|0|84.74|0||HIV-1 - DNA - QUANT|| 80001|87537||32.21|0|32.21|0||HIV-2 - DNA - DIR PROBE|| 80001|87538||32.04|0|32.04|0||HIV-2 - DNA - AMP PROBE|| 80001|87539||69.95|0|69.95|0||HIV-2 - DNA - QUANT|| 80001|87540||32.21|0|32.21|0||LEGION PNEUMO - DNA - DIR PROB|| 80001|87541||32.04|0|32.04|0||LEGION PNEUMO - DNA - AMP PROB|| 80001|87542||68.18|0|68.18|0||LEGION PNEUMO - DNA - QUANT|| 80001|87550||32.21|0|32.21|0||MYCOBACTERIA - DNA - DIR PROBE|| 80001|87551||32.04|0|32.04|0||MYCOBACTERIA - DNA - AMP PROBE|| 80001|87552||69.95|0|69.95|0||MYCOBACTERIA - DNA - QUANT|| 80001|87555||32.21|0|32.21|0||M.TUBERCULO - DNA - DIR PROBE|| 80001|87556||32.04|0|32.04|0||M.TUBERCULO - DNA - AMP PROBE|| 80001|87557||69.95|0|69.95|0||M.TUBERCULO - DNA - QUANT|| 80001|87560||32.21|0|32.21|0||M.AVIUM-INTRA - DNA - DIR PROB|| 80001|87561||32.04|0|32.04|0||M.AVIUM-INTRA - DNA - AMP PROB|| 80001|87562||69.95|0|69.95|0||M.AVIUM-INTRA - DNA - QUANT|| 80001|87580||32.21|0|32.21|0||M.PNEUMON - DNA - DIR PROBE|| 80001|87581||32.04|0|32.04|0||M.PNEUMON - DNA - AMP PROBE|| 80001|87582||68.18|0|68.18|0||M.PNEUMON - DNA - QUANT|| 80001|87590||32.21|0|32.21|0||N.GONORRHOEAE - DNA - DIR PROB|| 80001|87591||32.04|0|32.04|0||N.GONORRHOEAE - DNA - AMP PROB|| 80001|87592||69.95|0|69.95|0||N.GONORRHOEAE - DNA - QUANT|| 80001|87623||32.04|0|32.04|0||HPV LOW-RISK TYPES|| 80001|87624||32.04|0|32.04|0||HPV HIGH-RISK TYPES|| 80001|87625||32.04|0|32.04|0||HPV TYPES 16 & 18 ONLY|| 80001|87631||110.15|0|110.15|0||RESP VIRUS 3-11 TARGETS|| 80001|87632||160.94|0|160.94|0||RESP VIRUS 6-11 TARGETS|| 80001|87633||287.95|0|287.95|0||RESP VIRUS 12-25 TARGETS|| 80001|87634||103.99|0|103.99|0||RSV DNA/RNA AMP PROBE|| 80001|87640||32.04|0|32.04|0||STAPH A - DNA - AMP PROBE|| 80001|87641||32.04|0|32.04|0||MR-STAPH - DNA - AMP PROBE|| 80001|87650||32.21|0|32.21|0||STREP A - DNA - DIR PROBE|| 80001|87651||32.04|0|32.04|0||STREP A - DNA - AMP PROBE|| 80001|87652||68.18|0|68.18|0||STREP A - DNA - QUANT|| 80001|87653||32.04|0|32.04|0||STREP B - DNA - AMP PROBE|| 80001|87660||32.21|0|32.21|0||TRICHOMONAS VAGIN - DIR PROBE|| 80001|87661||32.04|0|32.04|0||TRICHOMONAS VAGINALIS AMPLIF|| 80001|87662||76.02|0|76.02|0||ZIKA VIRUS DNA/RNA AMP PROBE|| 80001|87797||32.21|0|32.21|0||DETECT AGENT NOS - DNA - DIR|| 80001|87798||32.04|0|32.04|0||DETECT AGENT NOS - DNA - AMP|| 80001|87799||69.95|0|69.95|0||DETECT AGENT NOS - DNA - QUANT|| 80001|87800||64.4|0|64.4|0||DETECT AGNT MULT - DNA - DIREC|| 80001|87801||64.09|0|64.09|0||DETECT AGNT MULT - DNA - AMPLI|| 80001|87802||19.58|0|19.58|0||STREP B ASSAY W/OPTIC|| 80001|87803||19.58|0|19.58|0||CLOSTRIDIUM TOXIN A W/OPTIC|| 80001|87804||19.58|0|19.58|0||INFLUENZA ASSAY W/OPTIC|| 80001|87804|QW|19.58|0|19.58|0||INFLUENZA ASSAY W/OPTIC|| 80001|87806||39.32|0|39.32|0||HIV ANTIGEN W/HIV ANTIBODIES|| 80001|87807||19.58|0|19.58|0||RSV ASSAY W/OPTIC|| 80001|87807|QW|19.58|0|19.58|0||RSV ASSAY W/OPTIC|| 80001|87808||19.58|0|19.58|0||TRICHOMONAS ASSAY W/OPTIC|| 80001|87808|QW|19.58|0|19.58|0||TRICHOMONAS ASSAY W/OPTIC|| 80001|87809||19.58|0|19.58|0||ADENOVIRUS ASSAY W/OPTIC|| 80001|87809|QW|19.58|0|19.58|0||ADENOVIRUS ASSAY W/OPTIC|| 80001|87810||19.58|0|19.58|0||CHYLMD TRACH ASSAY W/OPTIC|| 80001|87850||19.58|0|19.58|0||N. GONORRHOEAE ASSAY W/OPTIC|| 80001|87880||19.58|0|19.58|0||STREP A ASSAY W/OPTIC|| 80001|87880|QW|19.58|0|19.58|0||STREP A ASSAY W/OPTIC|| 80001|87899||19.58|0|19.58|0||AGENT NOS ASSAY W/OPTIC|| 80001|87899|QW|19.58|0|19.58|0||AGENT NOS ASSAY W/OPTIC|| 80001|87900||180.52|0|180.52|0||PHENOTYPE - INFECT AGENT DRUG|| 80001|87901||142.42|0|142.42|0||GENOTYPE - DNA - HIV REVERSE T|| 80001|87902||142.42|0|142.42|0||GENOTYPE - DNA - HEPATITIS C|| 80001|87903||552.35|0|552.35|0||PHENOTYPE - DNA HIV W/CULTURE|| 80001|87904||36.11|0|36.11|0||PHENOTYPE - DNA HIV W/CLT ADD|| 80001|87905||19.96|0|19.96|0||SIALIDASE ENZYME ASSAY|| 80001|87905|QW|19.96|0|19.96|0||SIALIDASE ENZYME ASSAY|| 80001|87906||71.21|0|71.21|0||GENOTYPE DNA HIV REVERSE T|| 80001|87910||142.42|0|142.42|0||GENOTYPE CYTOMEGALOVIRUS|| 80001|87912||142.42|0|142.42|0||GENOTYPE DNA HEPATITIS B|| 80001|88104||83.85|0|83.85|0||CYTOPATHOLOGY - FLUIDS|| 80001|88104|26|34.62|0|34.62|0||CYTOPATHOLOGY - FLUIDS|| 80001|88104|TC|49.23|0|49.23|0||CYTOPATHOLOGY - FLUIDS|| 80001|88106||96.98|0|96.98|0||CYTOPATHOLOGY - FLUIDS|| 80001|88106|26|23.32|0|23.32|0||CYTOPATHOLOGY - FLUIDS|| 80001|88106|TC|73.66|0|73.66|0||CYTOPATHOLOGY - FLUIDS|| 80001|88108||93.79|0|93.79|0||CYTOPATH - CONCENTRATE TECH|| 80001|88108|26|27.5|0|27.5|0||CYTOPATH - CONCENTRATE TECH|| 80001|88108|TC|66.29|0|66.29|0||CYTOPATH - CONCENTRATE TECH|| 80001|88112||72.61|0|72.61|0||CYTOPATH - CELL ENHANCE TECH|| 80001|88112|26|33.45|0|33.45|0||CYTOPATH - CELL ENHANCE TECH|| 80001|88112|TC|39.15|0|39.15|0||CYTOPATH - CELL ENHANCE TECH|| 80001|88120||680.91|0|680.91|0||CYTP URNE 3-5 PROBES EA SPEC|| 80001|88120|26|69.19|0|69.19|0||CYTP URNE 3-5 PROBES EA SPEC|| 80001|88120|TC|611.72|0|611.72|0||CYTP URNE 3-5 PROBES EA SPEC|| 80001|88121||605.22|0|605.22|0||CYTP URINE 3-5 PROBES CMPTR|| 80001|88121|26|60.18|0|60.18|0||CYTP URINE 3-5 PROBES CMPTR|| 80001|88121|TC|545.04|0|545.04|0||CYTP URINE 3-5 PROBES CMPTR|| 80001|88125||29.82|0|29.82|0||FORENSIC CYTOPATHOLOGY|| 80001|88125|26|17.03|0|17.03|0||FORENSIC CYTOPATHOLOGY|| 80001|88125|TC|12.79|0|12.79|0||FORENSIC CYTOPATHOLOGY|| 80001|88130||24.58|0|24.58|0||SEX CHROMATIN IDENTIFICATION|| 80001|88140||13.06|0|13.06|0||SEX CHROMATIN IDENTIFICATION|| 80001|88141||37.11|0|37.11|0||CYTOPATH - C/V - INTERPRET|| 80001|88142||33.08|0|33.08|0||CYTOPATH - C/V - THIN LAYER|| 80001|88143||33.08|0|33.08|0||CYTOPATH C/V THIN LAYER REDO|| 80001|88147||17.26|0|17.26|0||CYTOPATH - C/V - AUTOMATED|| 80001|88148||17.26|0|17.26|0||CYTOPATH - C/V - AUTO RESCREEN|| 80001|88150||17.26|0|17.26|0||CYTOPATH - C/V - MANUAL|| 80001|88152||17.26|0|17.26|0||CYTOPATH - C/V - AUTO REDO|| 80001|88153||17.26|0|17.26|0||CYTOPATH - C/V - REDO|| 80001|88154||17.26|0|17.26|0||CYTOPATH - C/V - SELECT|| 80001|88155||9.78|0|9.78|0||CYTOPATH - C/V - INDEX ADD-ON|| 80001|88160||75.06|0|75.06|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88160|26|31.25|0|31.25|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88160|TC|43.81|0|43.81|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88161||68.08|0|68.08|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88161|26|30.09|0|30.09|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88161|TC|37.99|0|37.99|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88162||111.86|0|111.86|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88162|26|47.89|0|47.89|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88162|TC|63.96|0|63.96|0||CYTOPATH SMEAR - OTHER SOURCE|| 80001|88164||17.26|0|17.26|0||CYTOPATH TBS - C/V - MANUAL|| 80001|88165||17.26|0|17.26|0||CYTOPATH TBS - C/V - REDO|| 80001|88166||17.26|0|17.26|0||CYTOPATH TBS - C/V - AUTO REDO|| 80001|88167||17.26|0|17.26|0||CYTOPATH TBS - C/V - SELECT|| 80001|88172||64.65|0|64.65|0||CYTOPATHOLOGY EVAL OF FNA|| 80001|88172|26|43.32|0|43.32|0||CYTOPATHOLOGY EVAL OF FNA|| 80001|88172|TC|21.32|0|21.32|0||CYTOPATHOLOGY EVAL OF FNA|| 80001|88173||170.42|0|170.42|0||CYTOPATH EVAL - FNA - REPORT|| 80001|88173|26|84.36|0|84.36|0||CYTOPATH EVAL - FNA - REPORT|| 80001|88173|TC|86.06|0|86.06|0||CYTOPATH EVAL - FNA - REPORT|| 80001|88174||34.9|0|34.9|0||CYTOPATH - C/V AUTO - IN FLUID|| 80001|88175||43.22|0|43.22|0||CYTOPATH C/V AUTO FLUID REDO|| 80001|88177||35.17|0|35.17|0||CYTP C/V AUTO THIN LYR ADDL|| 80001|88177|26|26.64|0|26.64|0||CYTP C/V AUTO THIN LYR ADDL|| 80001|88177|TC|8.53|0|8.53|0||CYTP C/V AUTO THIN LYR ADDL|| 80001|88182||121.21|0|121.21|0||CELL MARKER STUDY|| 80001|88182|26|42.51|0|42.51|0||CELL MARKER STUDY|| 80001|88182|TC|78.7|0|78.7|0||CELL MARKER STUDY|| 80001|88184||101.95|0|101.95|0||FLOWCYTOMETRY/ TC - 1 MARKER|| 80001|88185||62.03|0|62.03|0||FLOWCYTOMETRY/TC - ADD-ON|| 80001|88187||84.24|0|84.24|0||FLOWCYTOMETRY/READ - 2-8|| 80001|88188||107.01|0|107.01|0||FLOWCYTOMETRY/READ - 9-15|| 80001|88189||132.62|0|132.62|0||FLOWCYTOMETRY/READ - 16 & >|| 80001|88230||190.25|0|190.25|0||TISSUE CULTURE - LYMPHOCYTE|| 80001|88233||229.81|0|229.81|0||TISSUE CULTURE - SKIN/BIOPSY|| 80001|88235||240.48|0|240.48|0||TISSUE CULTURE - PLACENTA|| 80001|88237||144.18|0|144.18|0||TISSUE CULTURE - BONE MARROW|| 80001|88239||240.9|0|240.9|0||TISSUE CULTURE - TUMOR|| 80001|88240||13.3|0|13.3|0||CELL CRYOPRESERVE/STORAGE|| 80001|88241||13.3|0|13.3|0||FROZEN CELL PREPARATION|| 80001|88245||243.1|0|243.1|0||CHROMOSOME ANALYSIS - 20-25|| 80001|88248||282.8|0|282.8|0||CHROMOSOME ANALYSIS - 50-100|| 80001|88249||282.8|0|282.8|0||CHROMOSOME ANALYSIS - 100|| 80001|88261||288.61|0|288.61|0||CHROMOSOME ANALYSIS - 5|| 80001|88262||203.54|0|203.54|0||CHROMOSOME ANALYSIS - 15-20|| 80001|88263||245.42|0|245.42|0||CHROMOSOME ANALYSIS - 45|| 80001|88264||203.54|0|203.54|0||CHROMOSOME ANALYSIS - 20-25|| 80001|88267||293.57|0|293.57|0||CHROMOSOME ANALYS - PLACENTA|| 80001|88269||271.61|0|271.61|0||CHROMOSOME ANALYS - AMNIOTIC|| 80001|88271||34.97|0|34.97|0||CYTOGENETICS - DNA PROBE|| 80001|88272||43.73|0|43.73|0||CYTOGENETICS - 3-5|| 80001|88273||52.48|0|52.48|0||CYTOGENETICS - 10-30|| 80001|88274||56.84|0|56.84|0||CYTOGENETICS - 25-99|| 80001|88275||65.58|0|65.58|0||CYTOGENETICS - 100-300|| 80001|88280||40.98|0|40.98|0||CHROMOSOME KARYOTYPE STUDY|| 80001|88283||58.24|0|58.24|0||CHROMOSOME BANDING STUDY|| 80001|88285||31.03|0|31.03|0||CHROMOSOME COUNT - ADDITIONAL|| 80001|88289||56.23|0|56.23|0||CHROMOSOME STUDY - ADDITIONAL|| 80001|88291||36.77|0|36.77|0||CYTO/MOLECULAR REPORT|| 80001|88300||17.02|0|17.02|0||SURGICAL PATH - GROSS|| 80001|88300|26|5.39|0|5.39|0||SURGICAL PATH - GROSS|| 80001|88300|TC|11.63|0|11.63|0||SURGICAL PATH - GROSS|| 80001|88302||35.46|0|35.46|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88302|26|8.32|0|8.32|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88302|TC|27.14|0|27.14|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88304||50.58|0|50.58|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88304|26|13.75|0|13.75|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88304|TC|36.83|0|36.83|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88305||82.35|0|82.35|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88305|26|45.52|0|45.52|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88305|TC|36.83|0|36.83|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88307||338.76|0|338.76|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88307|26|99.97|0|99.97|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88307|TC|238.8|0|238.8|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88309||515.77|0|515.77|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88309|26|176.57|0|176.57|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88309|TC|339.2|0|339.2|0||TISSUE EXAM BY PATHOLOGIST|| 80001|88311||23.92|0|23.92|0||DECALCIFY TISSUE|| 80001|88311|26|15|0|15|0||DECALCIFY TISSUE|| 80001|88311|TC|8.92|0|8.92|0||DECALCIFY TISSUE|| 80001|88312||108.18|0|108.18|0||SPECIAL STAINS|| 80001|88312|26|32.59|0|32.59|0||SPECIAL STAINS|| 80001|88312|TC|75.59|0|75.59|0||SPECIAL STAINS|| 80001|88313||74.7|0|74.7|0||SPECIAL STAINS|| 80001|88313|26|14.62|0|14.62|0||SPECIAL STAINS|| 80001|88313|TC|60.09|0|60.09|0||SPECIAL STAINS|| 80001|88314||82.98|0|82.98|0||HISTOCHEMICAL STAIN|| 80001|88314|26|26.77|0|26.77|0||HISTOCHEMICAL STAIN|| 80001|88314|TC|56.21|0|56.21|0||HISTOCHEMICAL STAIN|| 80001|88319||98.45|0|98.45|0||ENZYME HISTOCHEMISTRY|| 80001|88319|26|32.94|0|32.94|0||ENZYME HISTOCHEMISTRY|| 80001|88319|TC|65.52|0|65.52|0||ENZYME HISTOCHEMISTRY|| 80001|88321||100.93|0|100.93|0||MICROSLIDE CONSULTATION|| 80001|88323||173.12|0|173.12|0||MICROSLIDE CONSULTATION|| 80001|88323|26|104.89|0|104.89|0||MICROSLIDE CONSULTATION|| 80001|88323|TC|68.23|0|68.23|0||MICROSLIDE CONSULTATION|| 80001|88325||159|0|159|0||COMPREHENSIVE REVIEW OF DATA|| 80001|88329||42.85|0|42.85|0||PATH CONSULT INTROP|| 80001|88331||117.22|0|117.22|0||PATH CONSULT INTRAOP - 1 BLOC|| 80001|88331|26|74.96|0|74.96|0||PATH CONSULT INTRAOP - 1 BLOC|| 80001|88331|TC|42.26|0|42.26|0||PATH CONSULT INTRAOP - 1 BLOC|| 80001|88332||51.81|0|51.81|0||PATH CONSULT INTRAOP - ADD'L|| 80001|88332|26|37.07|0|37.07|0||PATH CONSULT INTRAOP - ADD'L|| 80001|88332|TC|14.73|0|14.73|0||PATH CONSULT INTRAOP - ADD'L|| 80001|88333||123.47|0|123.47|0||INTRAOP CYTO PATH CONSULT - 1|| 80001|88333|26|75.4|0|75.4|0||INTRAOP CYTO PATH CONSULT - 1|| 80001|88333|TC|48.07|0|48.07|0||INTRAOP CYTO PATH CONSULT - 1|| 80001|88334||75.68|0|75.68|0||INTRAOP CYTO PATH CONSULT - 2|| 80001|88334|26|46.21|0|46.21|0||INTRAOP CYTO PATH CONSULT - 2|| 80001|88334|TC|29.46|0|29.46|0||INTRAOP CYTO PATH CONSULT - 2|| 80001|88341||75.1|0|75.1|0||IMMUNOHISTO ANTIBODY SLIDE|| 80001|88341|26|25.48|0|25.48|0||IMMUNOHISTO ANTIBODY SLIDE|| 80001|88341|TC|49.62|0|49.62|0||IMMUNOHISTO ANTIBODY SLIDE|| 80001|88342||101.13|0|101.13|0||IMMUNOHISTOCHEMISTRY|| 80001|88342|26|42.59|0|42.59|0||IMMUNOHISTOCHEMISTRY|| 80001|88342|TC|58.54|0|58.54|0||IMMUNOHISTOCHEMISTRY|| 80001|88344||130.12|0|130.12|0||IMMUNOHISTO ANTIBODY SLIDE|| 80001|88344|26|46.77|0|46.77|0||IMMUNOHISTO ANTIBODY SLIDE|| 80001|88344|TC|83.35|0|83.35|0||IMMUNOHISTO ANTIBODY SLIDE|| 80001|88346||123.53|0|123.53|0||IMMUNOFLUORESCENT STUDY|| 80001|88346|26|51.04|0|51.04|0||IMMUNOFLUORESCENT STUDY|| 80001|88346|TC|72.49|0|72.49|0||IMMUNOFLUORESCENT STUDY|| 80001|88347||104.54|0|104.54|0||IMMUNOFLUORESCENT STUDY|| 80001|88347|26|50.27|0|50.27|0||IMMUNOFLUORESCENT STUDY|| 80001|88347|TC|54.27|0|54.27|0||IMMUNOFLUORESCENT STUDY|| 80001|88348||382.61|0|382.61|0||ELECTRON MICROSCOPY|| 80001|88348|26|91.09|0|91.09|0||ELECTRON MICROSCOPY|| 80001|88348|TC|291.52|0|291.52|0||ELECTRON MICROSCOPY|| 80001|88350||80.46|0|80.46|0||IMMUNOFLUOR ANTB ADDL STAIN|| 80001|88350|26|33.33|0|33.33|0||IMMUNOFLUOR ANTB ADDL STAIN|| 80001|88350|TC|47.12|0|47.12|0||IMMUNOFLUOR ANTB ADDL STAIN|| 80001|88355||197.62|0|197.62|0||ANALYSIS - SKELETAL MUSCLE|| 80001|88355|26|98.38|0|98.38|0||ANALYSIS - SKELETAL MUSCLE|| 80001|88355|TC|99.24|0|99.24|0||ANALYSIS - SKELETAL MUSCLE|| 80001|88356||235.1|0|235.1|0||ANALYSIS - NERVE|| 80001|88356|26|144.77|0|144.77|0||ANALYSIS - NERVE|| 80001|88356|TC|90.33|0|90.33|0||ANALYSIS - NERVE|| 80001|88358||95.63|0|95.63|0||ANALYSIS - TUMOR|| 80001|88358|26|53.37|0|53.37|0||ANALYSIS - TUMOR|| 80001|88358|TC|42.26|0|42.26|0||ANALYSIS - TUMOR|| 80001|88360||152.1|0|152.1|0||TUMOR IMMUNOHISTOCHEM/MANUAL|| 80001|88360|26|64.88|0|64.88|0||TUMOR IMMUNOHISTOCHEM/MANUAL|| 80001|88360|TC|87.22|0|87.22|0||TUMOR IMMUNOHISTOCHEM/MANUAL|| 80001|88361||188.89|0|188.89|0||TUMOR IMMUNOHISTOCHEM/COMPUT|| 80001|88361|26|70.27|0|70.27|0||TUMOR IMMUNOHISTOCHEM/COMPUT|| 80001|88361|TC|118.62|0|118.62|0||TUMOR IMMUNOHISTOCHEM/COMPUT|| 80001|88362||330.46|0|330.46|0||NERVE TEASING PREPARATIONS|| 80001|88362|26|131.58|0|131.58|0||NERVE TEASING PREPARATIONS|| 80001|88362|TC|198.88|0|198.88|0||NERVE TEASING PREPARATIONS|| 80001|88363||22.94|0|22.94|0||XM ARCHIVE TISSUE MOLEC ANAL|| 80001|88364||107.75|0|107.75|0||INSITU HYBRIDIZATION (FISH)|| 80001|88364|26|31.77|0|31.77|0||INSITU HYBRIDIZATION (FISH)|| 80001|88364|TC|75.98|0|75.98|0||INSITU HYBRIDIZATION (FISH)|| 80001|88365||173.63|0|173.63|0||INSITU HYBRIDIZATION (FISH)|| 80001|88365|26|52.29|0|52.29|0||INSITU HYBRIDIZATION (FISH)|| 80001|88365|TC|121.34|0|121.34|0||INSITU HYBRIDIZATION (FISH)|| 80001|88366||258.54|0|258.54|0||INSITU HYBRIDIZATION (FISH)|| 80001|88366|26|73.63|0|73.63|0||INSITU HYBRIDIZATION (FISH)|| 80001|88366|TC|184.91|0|184.91|0||INSITU HYBRIDIZATION (FISH)|| 80001|88367||119.48|0|119.48|0||INSITU HYBRIDIZATION - AUTO|| 80001|88367|26|41.56|0|41.56|0||INSITU HYBRIDIZATION - AUTO|| 80001|88367|TC|77.92|0|77.92|0||INSITU HYBRIDIZATION - AUTO|| 80001|88368||121.68|0|121.68|0||INSITU HYBRIDIZATION - MANUAL|| 80001|88368|26|48.41|0|48.41|0||INSITU HYBRIDIZATION - MANUAL|| 80001|88368|TC|73.27|0|73.27|0||INSITU HYBRIDIZATION - MANUAL|| 80001|88369||82.17|0|82.17|0||M/PHMTRC ALYSISHQUANT/SEMIQ|| 80001|88369|26|29.45|0|29.45|0||M/PHMTRC ALYSISHQUANT/SEMIQ|| 80001|88369|TC|52.72|0|52.72|0||M/PHMTRC ALYSISHQUANT/SEMIQ|| 80001|88371||36.29|0|36.29|0||PROTEIN - WESTERN BLOT TISSUE|| 80001|88371|26|22.16|0|22.16|0||PROTEIN - WESTERN BLOT TISSUE|| 80001|88372||37.14|0|37.14|0||PROTEIN ANALYSIS W/PROBE|| 80001|88372|26|22.16|0|22.16|0||PROTEIN ANALYSIS W/PROBE|| 80001|88373||67.39|0|67.39|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88373|26|24.75|0|24.75|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88373|TC|42.64|0|42.64|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88374||225.79|0|225.79|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88374|26|52.9|0|52.9|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88374|TC|172.89|0|172.89|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88375||55.92|0|55.92|0||OPTICAL ENDOMICROSCPY INTERP|| 80001|88377||237.92|0|237.92|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88377|26|77.04|0|77.04|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88377|TC|160.88|0|160.88|0||M/PHMTRC ALYS ISHQUANT/SEMIQ|| 80001|88380||148.79|0|148.79|0||MICRODISSECTION|| 80001|88380|26|66.22|0|66.22|0||MICRODISSECTION|| 80001|88380|TC|82.57|0|82.57|0||MICRODISSECTION|| 80001|88381||137.22|0|137.22|0||MICRODISSECTION - MANUAL|| 80001|88381|26|30.61|0|30.61|0||MICRODISSECTION - MANUAL|| 80001|88381|TC|106.61|0|106.61|0||MICRODISSECTION - MANUAL|| 80001|88387||49.22|0|49.22|0||TISS EXAM MOLECULAR STUDY|| 80001|88387|26|38.37|0|38.37|0||TISS EXAM MOLECULAR STUDY|| 80001|88387|TC|10.86|0|10.86|0||TISS EXAM MOLECULAR STUDY|| 80001|88388||39.18|0|39.18|0||TISS EX MOLECUL STUDY ADD-ON|| 80001|88388|26|28.71|0|28.71|0||TISS EX MOLECUL STUDY ADD-ON|| 80001|88388|TC|10.47|0|10.47|0||TISS EX MOLECUL STUDY ADD-ON|| 80001|88720||8.2|0|8.2|0||BILIRUBIN TOTAL TRANSCUT|| 80001|88738||8.2|0|8.2|0||HGB QUANT TRANSCUTANEOUS|| 80001|88740||8.2|0|8.2|0||TRANSCUTANEOUS CARBOXYHB|| 80001|88741||8.2|0|8.2|0||TRANSCUTANEOUS METHB|| 80001|89049||74.35|0|74.35|0||CHCT FOR MAL HYPERTHERMIA|| 80001|89050||7.72|0|7.72|0||BODY FLUID CELL COUNT|| 80001|89051||2.88|0|2.88|0||BODY FLUID CELL COUNT|| 80001|89055||3.83|0|3.83|0||LEUKOCYTE ASSESSMENT - FECAL|| 80001|89060||11.69|0|11.69|0||EXAM - SYNOVIAL FLUID CRYSTALS|| 80001|89060|26|22.16|0|22.16|0||EXAM - SYNOVIAL FLUID CRYSTALS|| 80001|89125||7.06|0|7.06|0||SPECIMEN FAT STAIN|| 80001|89160||6.02|0|6.02|0||EXAM FECES FOR MEAT FIBERS|| 80001|89190||7.75|0|7.75|0||NASAL SMEAR FOR EOSINOPHILS|| 80001|89220||17.06|0|17.06|0||SPUTUM SPECIMEN COLLECTION|| 80001|89230||2.72|0|2.72|0||COLLECT SWEAT FOR TEST|| 80001|89300||14.57|0|14.57|0||SEMEN ANALYSIS W/HUHNER|| 80001|89300|QW|14.57|0|14.57|0||SEMEN ANALYSIS W/HUHNER|| 80001|89310||14.05|0|14.05|0||SEMEN ANALYSIS W/COUNT|| 80001|89320||9.42|0|9.42|0||SEMEN ANALYSIS - COMPLETE|| 80001|89321||9.42|0|9.42|0||SEMEN ANALYSIS & MOTILITY|| 80001|89321|QW|9.42|0|9.42|0||SEMEN ANALYSIS & MOTILITY|| 80001|89322||18.85|0|18.85|0||SEMEN ANAL - STRICT CRITERIA|| 80001|89325||17.44|0|17.44|0||SPERM ANTIBODY TEST|| 80001|89329||34.24|0|34.24|0||SPERM EVALUATION TEST|| 80001|89330||16.15|0|16.15|0||EVALUATION - CERVICAL MUCUS|| 80001|89331||25.54|0|25.54|0||RETROGRADE EJACULATION ANAL|| 80001|90281||0|0|0|0||HUMAN IG - IM|| 80001|90283||0|0|0|0||HUMAN IG - IV|| 80001|90284||0|0|0|0||HUMAN IG - SC|| 80001|90287||0|0|0|0||BOTULINUM ANTITOXIN|| 80001|90288||0|0|0|0||BOTULISM IG - IV|| 80001|90291||0|0|0|0||CMV IG - IV|| 80001|90296||0|0|0|0||DIPHTHERIA ANTITOXIN|| 80001|90371||143.04|0|143.04|0||HEP B IG - IM|| 80001|90371||135.3|0|0|0||HEP B IG - IM|| 80001|90375||354.54|0|354.54|0||RABIES IG - IM/SC|| 80001|90375||359.11|0|0|0||RABIES IG - IM/SC|| 80001|90376||340.1|0|340.1|0||RABIES IG - HEAT TREATED|| 80001|90376||392.46|0|0|0||RABIES IG - HEAT TREATED|| 80001|90378||0|0|0|0||RSV IG - IM - 50MG|| 80001|90384||0|0|0|0||RH IG - FULL-DOSE - IM|| 80001|90385||0|0|0|0||RH IG - MINIDOSE - IM|| 80001|90386||0|0|0|0||RH IG - IV|| 80001|90389||0|0|0|0||TETANUS IG - IM|| 80001|90393||0|0|0|0||VACCINA IG - IM|| 80001|90396||0|0|0|0||VARICELLA-ZOSTER IG - IM|| 80001|90399||0|0|0|0||IMMUNE GLOBULIN|| 80001|90460||28.27|0|28.27|0||IMADM ANY ROUTE 1ST VAC/TOX|| 80001|90461||14.61|0|14.61|0||INADM ANY ROUTE ADDL VAC/TOX|| 80001|90471||28.27|0|28.27|0||IMMUNIZATION ADMIN|| 80001|90472||14.61|0|14.61|0||IMMUNIZATION ADMIN - EACH ADD|| 80001|90473||28.27|0|28.27|0||IMMUNE ADMIN ORAL/NASAL|| 80001|90474||14.61|0|14.61|0||IMMUNE ADMIN ORAL/NASAL ADDL|| 80001|90476||0|0|0|0||ADENOVIRUS VACCINE - TYPE 4|| 80001|90477||0|0|0|0||ADENOVIRUS VACCINE - TYPE 7|| 80001|90581||0|0|0|0||ANTHRAX VACCINE - SC|| 80001|90585||154.24|0|154.24|0||BCG VACCINE - PERCUT|| 80001|90585||160.85|0|0|0||BCG VACCINE - PERCUT|| 80001|90586||154.24|0|154.24|0||BCG VACCINE - INTRAVESICAL|| 80001|90586||160.85|0|0|0||BCG VACCINE - INTRAVESICAL|| 80001|90620||65|0|0||%|MENB RP W/OMV VACCINE IM|| 80001|90621||0|0|0|0||MENB RLP VACCINE IM|| 80001|90621||0|0|0|0||MENB RLP VACCINE IM|| 80001|90625||0|0|0|0||CHOLERA VACCINE LIVE ORAL|| 80001|90630||29.33|0|29.33|0||FLU VACC IIV4 NO PRESERV ID|| 80001|90630||25.43|0|0|0||FLU VACC IIV4 NO PRESERV ID|| 80001|90632||63.55|0|63.55|0||HEP A VACCINE - ADULT IM|| 80001|90632||68.72|0|0|0||HEP A VACCINE - ADULT IM|| 80001|90633||65|0|0|0|%|HEP A VACC - PED/ADOL - 2 DOSE|| 80001|90634||0|0|0|0||HEP A VACC - PED/ADOL - 3 DOSE|| 80001|90636||54.45|0|54.45|||HEP A/HEP B VACC - ADULT IM|| 80001|90644||30.93|0|30.93|0||HIB/MEN/TT VACCINE - IM|| 80001|90645||0|0|0|0||HIB VACCINE - HBOC - IM|| 80001|90646||0|0|0|0||HIB VACCINE - PRP-D - IM|| 80001|90647||65|0|0||%|HIB VACCINE - PRP-OMP - IM|| 80001|90648||23.75|0|23.75|0||HIB VACCINE - PRP-T - IM|| 80001|90649||65|0|0||%|H PAPILLOMA VACC 3 DOSE IM|| 80001|90650||0|0|0|0||HPV TYP BIVAL 3 DOSE IM|| 80001|90651||65|0|65|0|%|HPV VACCINE NON VALENT IM|| 80001|90653||0|0|0|0||FLU VACCINE ADJUVANT IM|| 80001|90653||46.73|0|0|0||FLU VACCINE ADJUVANT IM|| 80001|90654||0|0|0|0||FLU VACCINE NO PRESERV - ID|| 80001|90655||0|0|0|0||FLU VACCINE NO PRESERV 6-35M|| 80001|90656||17.35|0|17.35|0||FLU VACCINE NO PRESERV 3 & >|| 80001|90656||22.15|0|0|0||FLU VACCINE NO PRESERV 3 & >|| 80001|90657||7.53|0|7.53|0||FLU VACCINE - 6-35 MO - IM|| 80001|90658||13.82|0|0|||FLU VACCINE AGE 3 & OVER - IM|| 80001|90660||0|0|0|0||FLU VACCINE - NASAL|| 80001|90661||27.86|0|27.86|0||FLU VACC CELL CULT PRSV FREE|| 80001|90662||45.39|0|45.39|0||FLU VACC PRSV FREE INC ANTIG|| 80001|90662||53.4|0|0|0||FLU VACC PRSV FREE INC ANTIG|| 80001|90664||0|0|0|0||FLU VACC PANDEMIC INTRANASAL|| 80001|90666||0|0|0|0||FLU VAC PANDEM PRSRV FREE IM|| 80001|90667||0|0|0|0||FLU VAC PANDEMIC ADJUVANT IM|| 80001|90668||0|0|0|0||FLU VAC PANDEMIC SPLT IM|| 80001|90669||0|0|0|0||PNEUMOCOCCAL VACC - PED <5|| 80001|90670||226.33|0|226.33|0||PNEUMOCOCCAL VACC - 13 VAL IM|| 80001|90670||240.8|0|0|0||PNEUMOCOCCAL VACC - 13 VAL IM|| 80001|90672||33.59|0|33.59|0||FLU VACCINE 4 VALENT NASAL|| 80001|90672||33.59|0|0|0||FLU VACCINE 4 VALENT NASAL|| 80001|90673||46.49|0|46.49|0||FLU VACC RIV3 NO PRESERV|| 80001|90673||50.77|0|0|0||FLU VACC RIV3 NO PRESERV|| 80001|90674||28.67|0|0|0||CCIIV4 VAC NO PRSV 0.5 ML IM|| 80001|90675||323.42|0|323.42|0||RABIES VACCINE - IM|| 80001|90675||353.77|0|0|0||RABIES VACCINE - IM|| 80001|90676||0|0|0|0||RABIES VACCINE - ID|| 80001|90680||66.08|0|66.08|0||ROTOVIRUS VACC 3 DOSE - ORAL|| 80001|90681||66.08|0|66.08|0||ROTAVIRUS VACC 2 DOSE ORAL|| 80001|90685||30.74|0|30.74|0||FLU VAC NO PRSV 4 VAL 6-35 M|| 80001|90685||32.84|0|0|0||FLU VAC NO PRSV 4 VAL 6-35 M|| 80001|90686||22.69|0|22.69|0||FLU VAC NO PRSV 4 VAL 3 YRS+|| 80001|90686||23.79|0|0|0||FLU VAC NO PRSV 4 VAL 3 YRS+|| 80001|90687||11.42|0|11.42|0||FLU VACCINE 4 VAL 6-35 MO IM|| 80001|90687||11.75|0|0|0||FLU VACCINE 4 VAL 6-35 MO IM|| 80001|90688||22.84|0|22.84|0||FLU VACC 4 VAL 3 YRS PLUS IM|| 80001|90688||22.29|0|0|0||FLU VACC 4 VAL 3 YRS PLUS IM|| 80001|90690||0|0|0|0||TYPHOID VACCINE - ORAL|| 80001|90691||112.6|0|112.6|0||TYPHOID VACCINE - IM|| 80001|90691||100.07|0|0|0||TYPHOID VACCINE - IM|| 80001|90692||0|0|0|0||TYPHOID VACCINE - H-P - SC/ID|| 80001|90693||65|0|0|0|%|TYPHOID VACCINE - AKD - SC|| 80001|90696||65|0|0||%|DTAP-IPV VACC 4-6 YR IM|| 80001|90697||0|0|0|0||DTAP-IPV-HIB-HEPB VACCINE IM|| 80001|90697||0|0|0|0||DTAP-IPV-HIB-HEPB VACCINE IM|| 80001|90698||66.08|0|66.08|0||DTAP-HIB-IP VACCINE - IM|| 80001|90700||22.02|0|22.02|0||DTAP VACCINE - < 7 YRS - IM|| 80001|90702||0|0|0|0||DT VACCINE < 7 - IM|| 80001|90707||65|0|0|0|%|MMR VACCINE - SC|| 80001|90710||117.9|0|117.9|0||MMRV VACCINE - SC|| 80001|90713||65|0|0|0|%|POLIOVIRUS - IPV - SC/IM|| 80001|90714||29|0|29|0||TD VACCINE NO PRSRV >/= 7 IM|| 80001|90714||26.93|0|0|0||TD VACCINE NO PRSRV >/= 7 IM|| 80001|90715||38.29|0|38.29|0||TDAP VACCINE >7 IM|| 80001|90715||37.62|0|0|0||TDAP VACCINE >7 IM|| 80001|90716||64.78|0|64.78|0||CHICKEN POX VACCINE - SC|| 80001|90717||0|0|0|0||YELLOW FEVER VACCINE - SC|| 80001|90723||64.78|0|64.78|0||DTAP-HEP B-IPV VACCINE - IM|| 80001|90732||112.43|0|112.43|0||PNEUMOCOCCAL VACCINE|| 80001|90732||123.56|0|0|0||PNEUMOCOCCAL VACCINE|| 80001|90733||0|0|0|0||MENINGOCOCCAL VACCINE - SC|| 80001|90734||112.44|0|112.44|||MENINGOCOCCAL VACCINE - IM|| 80001|90736||244.85|0|244.85|||ZOSTER VACC - SC|| 80001|90738||0|0|0|0||INACTIVATED JE VACC IM|| 80001|90739||0|0|0|0||HEP B VACC ADULT 2 DOSE IM|| 80001|90740||153.7|0|153.7|0||HEPB VACC - ILL PAT 3 DOSE IM|| 80001|90740||158.25|0|0|0||HEPB VACC - ILL PAT 3 DOSE IM|| 80001|90743||31.74|0|31.74|0||HEP B VACC - ADOL - 2 DOSE - IM|| 80001|90743||32.67|0|0|0||HEP B VACC - ADOL - 2 DOSE - IM|| 80001|90744||31.74|0|31.74|0||HEPB VACC PED/ADOL 3 DOSE IM|| 80001|90744||32.67|0|0|0||HEPB VACC PED/ADOL 3 DOSE IM|| 80001|90746||76.84|0|76.84|0||HEP B VACCINE - ADULT - IM|| 80001|90746||79.12|0|0|0||HEP B VACCINE - ADULT - IM|| 80001|90747||153.7|0|153.7|0||HEPB VACC - ILL PAT 4 DOSE IM|| 80001|90747||158.25|0|0|0||HEPB VACC - ILL PAT 4 DOSE IM|| 80001|90748||0|0|0|0||HEP B/HIB VACCINE - IM|| 80001|90749||0|0|0|0||VACCINE TOXOID|| 80001|90785||16.95|0|16.95|0||INTERACTIVE COMPLEXITY|| 80001|90791||155.35|0|151.09|0||PSYCHIATRIC DIAGNOSTIC EVAL|| 80001|90792||173.9|0|169.24|0||PSYCHIATRIC DIAG EVAL W/MED SV|| 80001|90832||75.93|0|75.16|0||PSYTX PT&/FAMILY 30 MINUTES|| 80001|90833||77.87|0|77.1|0||PSYTX PT&/FAM W/E&M 30 MIN|| 80001|90834||100.6|0|99.82|0||PSYTX - 45 MIN PT &/OR FAMLY MBR|| 80001|90836||98.61|0|98.22|0||PSYTX PT&/FAM W/E&M 45 MIN|| 80001|90837||151.09|0|150.32|0||PSYTX PT&/FAMILY 60 MINUTES|| 80001|90838||130.31|0|129.53|0||PSYTX PT&/FAM W/E&M 60 MIN|| 80001|90839||157.86|0|156.7|0||PSYTX CRISIS INITIAL 60 MIN|| 80001|90840||75.55|0|75.16|0||PSYTX CRISIS EA ADDL 30 MIN|| 80001|90845||108.01|0|107.62|0||PSYCHOANALYSIS|| 80001|90846||121.72|0|120.95|0||FAMILY PSYTX W/O PATIENT|| 80001|90847||126.81|0|126.04|0||FAMILY PSYTX W/PATIENT|| 80001|90849||40.95|0|37.08|0||MULTIPLE FAMILY GROUP PSYTX|| 80001|90853||30.48|0|30.1|0||GROUP PSYCHOTHERAPY|| 80001|90863||0|0|0|0||PHARMACOLOGIC MANAGEMENT|| 80001|90865||195.75|0|151.56|0||NARCOSYNTHESIS|| 80001|90867||0|0|0|0||TCRANIAL MAGN STIM TX PLAN|| 80001|90868||0|0|0|0||TCRANIAL MAGN STIM TX DELI|| 80001|90869||0|0|0|0||TCRAN MAGN STIM REDETEMINE|| 80001|90870||204.34|0|131.47|0||ELECTROCONVULSIVE THERAPY|| 80001|90875||72.3|0|72.3|0||PSYCHOPHYSIOLOGICAL THERAPY|| 80001|90876||127.31|0|115.68|0||PSYCHOPHYSIOLOGICAL THERAPY|| 80001|90880||119.65|0|111.89|0||HYPNOTHERAPY|| 80001|90882||0|0|0|0||ENVIRONMENTAL MANIPULATION|| 80001|90885||58.51|0|58.51|0||PSY EVALUATION OF RECORDS|| 80001|90887||103.38|0|89.81|0||CONSULTATION WITH FAMILY|| 80001|90889||0|0|0|0||PREPARATION OF REPORT|| 80001|90899||0|0|0|0||PSYCHIATRIC SERVICE/THERAPY|| 80001|90901||43.27|0|23.89|0||BIOFEEDBACK TRAIN - ANY METH|| 80001|90911||96.15|0|52.73|0||BIOFEEDBACK PERI/URO/RECTAL|| 80001|90935||85.93|0|85.93|0||HEMODIALYSIS - ONE EVALUATION|| 80001|90937||123.18|0|123.18|0||HEMODIALYSIS - REPEATED EVAL|| 80001|90940||0|0|0|0||HEMODIALYSIS ACCESS STUDY|| 80001|90945||100.62|0|100.62|0||DIALYSIS - ONE EVALUATION|| 80001|90947||146.69|0|146.69|0||DIALYSIS - REPEATED EVAL|| 80001|90951||1108.68|0|1108.3|0||ESRD SERV - 4 VISITS P MO - <2|| 80001|90952||0|0|0|0||ESRD SERV - 2-3 VSTS P MO - <2|| 80001|90953||0|0|0|0||ESRD SERV - 1 VISIT P MO - <2|| 80001|90954||964.89|0|964.51|0||ESRD SERV - 4 VSTS P MO - 2-11|| 80001|90955||539.24|0|538.85|0||ESRD SRV 2-3 VSTS P MO - 2-11|| 80001|90956||376.42|0|376.42|0||ESRD SRV - 1 VISIT P MO - 2-11|| 80001|90957||760.21|0|759.83|0||ESRD SRV - 4 VSTS P MO - 12-19|| 80001|90958||512.46|0|512.07|0||ESRD SRV 2-3 VSTS P MO 12-19|| 80001|90959||347.71|0|347.71|0||ESRD SERV - 1 VST P MO - 12-19|| 80001|90960||333.13|0|333.13|0||ESRD SRV - 4 VISITS P MO - 20+|| 80001|90961||279.89|0|279.89|0||ESRD SRV - 2-3 VSTS P MO - 20+|| 80001|90962||214.95|0|214.95|0||ESRD SERV - 1 VISIT P MO - 20+|| 80001|90963||642.72|0|642.33|0||ESRD HOME PT - SERV P MO - <2|| 80001|90964||559.76|0|559.37|0||ESRD HOME PT SERV P MO - 2-11|| 80001|90965||533.76|0|533.37|0||ESRD HOME PT SERV P MO 12-19|| 80001|90966||278.72|0|278.72|0||ESRD HOME PT - SERV P MO - 20+|| 80001|90967||21.3|0|21.3|0||ESRD HOME PT SERV P DAY - <2|| 80001|90968||18.37|0|18.37|0||ESRD HOME PT SRV P DAY - 2-11|| 80001|90969||17.94|0|17.94|0||ESRD HOME PT SRV P DAY 12-19|| 80001|90970||9.14|0|9.14|0||ESRD HOME PT SERV P DAY - 20+|| 80001|90989||0|0|0|0||DIALYSIS TRAINING - COMPLETE|| 80001|90993||0|0|0|0||DIALYSIS TRAINING - INCOMPL|| 80001|90997||111.54|0|111.54|0||HEMOPERFUSION|| 80001|90999||0|0|0|0||DIALYSIS PROCEDURE|| 80001|91010||200.58|0|200.58|0||ESOPHAGUS MOTILITY STUDY|| 80001|91010|26|80.8|0|80.8|0||ESOPHAGUS MOTILITY STUDY|| 80001|91010|TC|119.79|0|119.79|0||ESOPHAGUS MOTILITY STUDY|| 80001|91013||27.15|0|27.15|0||ESOPHGL MOTIL W/STIM/PERFUS|| 80001|91013|26|11.25|0|11.25|0||ESOPHGL MOTIL W/STIM/PERFUS|| 80001|91013|TC|15.9|0|15.9|0||ESOPHGL MOTIL W/STIM/PERFUS|| 80001|91020||263.3|0|263.3|0||GASTRIC MOTILITY STUDIES|| 80001|91020|26|89.24|0|89.24|0||GASTRIC MOTILITY STUDIES|| 80001|91020|TC|174.06|0|174.06|0||GASTRIC MOTILITY STUDIES|| 80001|91022||193.13|0|193.13|0||DUODENAL MOTILITY STUDY|| 80001|91022|26|89.63|0|89.63|0||DUODENAL MOTILITY STUDY|| 80001|91022|TC|103.5|0|103.5|0||DUODENAL MOTILITY STUDY|| 80001|91030||154.77|0|154.77|0||ACID PERFUSION OF ESOPHAGUS|| 80001|91030|26|56.3|0|56.3|0||ACID PERFUSION OF ESOPHAGUS|| 80001|91030|TC|98.47|0|98.47|0||ACID PERFUSION OF ESOPHAGUS|| 80001|91034||210.47|0|210.47|0||GASTROESOPHAGEAL REFLUX TEST|| 80001|91034|26|59.67|0|59.67|0||GASTROESOPHAGEAL REFLUX TEST|| 80001|91034|TC|150.8|0|150.8|0||GASTROESOPHAGEAL REFLUX TEST|| 80001|91035||538.03|0|538.03|0||G-ESOPH REFLX TST W/ELECTROD|| 80001|91035|26|99.2|0|99.2|0||G-ESOPH REFLX TST W/ELECTROD|| 80001|91035|TC|438.82|0|438.82|0||G-ESOPH REFLX TST W/ELECTROD|| 80001|91037||181.78|0|181.78|0||ESOPH IMPED FUNCTION TEST|| 80001|91037|26|60.83|0|60.83|0||ESOPH IMPED FUNCTION TEST|| 80001|91037|TC|120.95|0|120.95|0||ESOPH IMPED FUNCTION TEST|| 80001|91038||504.49|0|504.49|0||ESOPH IMPED FUNCT TEST > 1H|| 80001|91038|26|69.94|0|69.94|0||ESOPH IMPED FUNCT TEST > 1H|| 80001|91038|TC|434.56|0|434.56|0||ESOPH IMPED FUNCT TEST > 1H|| 80001|91040||486.86|0|486.86|0||ESOPH BALLOON DISTENSION TST|| 80001|91040|26|60.05|0|60.05|0||ESOPH BALLOON DISTENSION TST|| 80001|91040|TC|426.81|0|426.81|0||ESOPH BALLOON DISTENSION TST|| 80001|91065||90.03|0|90.03|0||BREATH HYDROGEN TEST|| 80001|91065|26|12.5|0|12.5|0||BREATH HYDROGEN TEST|| 80001|91065|TC|77.53|0|77.53|0||BREATH HYDROGEN TEST|| 80001|91110||997.03|0|997.03|0||GI TRACT CAPSULE ENDOSCOPY|| 80001|91110|26|227.54|0|227.54|0||GI TRACT CAPSULE ENDOSCOPY|| 80001|91110|TC|769.49|0|769.49|0||GI TRACT CAPSULE ENDOSCOPY|| 80001|91111||809.13|0|809.13|0||ESOPHAGEAL CAPSULE ENDOSCOPY|| 80001|91111|26|62.12|0|62.12|0||ESOPHAGEAL CAPSULE ENDOSCOPY|| 80001|91111|TC|747|0|747|0||ESOPHAGEAL CAPSULE ENDOSCOPY|| 80001|91112||1202.75|0|1202.75|0||GI WIRELESS CAPSULE MEASURE|| 80001|91112|26|131.28|0|131.28|0||GI WIRELESS CAPSULE MEASURE|| 80001|91112|TC|1071.47|0|1071.47|0||GI WIRELESS CAPSULE MEASURE|| 80001|91117||166.54|0|166.54|0||COLON MOTILITY 6 HR STUDY|| 80001|91120||477.18|0|477.18|0||RECTAL SENSATION TEST|| 80001|91120|26|60.84|0|60.84|0||RECTAL SENSATION TEST|| 80001|91120|TC|416.34|0|416.34|0||RECTAL SENSATION TEST|| 80001|91122||255.06|0|255.06|0||ANAL PRESSURE RECORD|| 80001|91122|26|106.58|0|106.58|0||ANAL PRESSURE RECORD|| 80001|91122|TC|148.47|0|148.47|0||ANAL PRESSURE RECORD|| 80001|91132||165.86|0|165.86|0||ELECTROGASTROGRAPHY|| 80001|91132|26|32.51|0|32.51|0||ELECTROGASTROGRAPHY|| 80001|91132|TC|133.35|0|133.35|0||ELECTROGASTROGRAPHY|| 80001|91133||192.44|0|192.44|0||ELECTROGASTROGRAPHY W/TEST|| 80001|91133|26|40.87|0|40.87|0||ELECTROGASTROGRAPHY W/TEST|| 80001|91133|TC|151.57|0|151.57|0||ELECTROGASTROGRAPHY W/TEST|| 80001|91200||40.46|0|40.46|0||LIVER ELASTOGRAPHY|| 80001|91200|26|17.2|0|17.2|0||LIVER ELASTOGRAPHY|| 80001|91200|TC|23.26|0|23.26|0||LIVER ELASTOGRAPHY|| 80001|91299||0|0|0|0||GASTROENTEROLOGY PROCEDURE|| 80001|91299|26|0|0|0|0||GASTROENTEROLOGY PROCEDURE|| 80001|91299|TC|0|0|0|0||GASTROENTEROLOGY PROCEDURE|| 80001|92002||92.22|0|56.17|0||EYE EXAM - NEW PATIENT|| 80001|92004||169.59|0|116.87|0||EYE EXAM - NEW PATIENT|| 80001|92012||97.05|0|61.39|0||EYE EXAM ESTABLISHED PAT|| 80001|92014||140.71|0|93.42|0||EYE EXAM & TREATMENT|| 80001|92015||23.37|0|22.98|0||REFRACTION|| 80001|92018||169.85|0|169.85|0||NEW EYE EXAM & TREATMENT|| 80001|92019||84.41|0|84.41|0||EYE EXAM & TREATMENT|| 80001|92020||30.69|0|24.48|0||SPECIAL EYE EVALUATION|| 80001|92025||43.01|0|43.01|0||CORNEAL TOPOGRAPHY|| 80001|92025|26|23.62|0|23.62|0||CORNEAL TOPOGRAPHY|| 80001|92025|TC|19.38|0|19.38|0||CORNEAL TOPOGRAPHY|| 80001|92060||73.95|0|73.95|0||SPECIAL EYE EVALUATION|| 80001|92060|26|44.87|0|44.87|0||SPECIAL EYE EVALUATION|| 80001|92060|TC|29.08|0|29.08|0||SPECIAL EYE EVALUATION|| 80001|92065||60.15|0|60.15|0||ORTHOPTIC/PLEOPTIC TRAINING|| 80001|92065|26|21.38|0|21.38|0||ORTHOPTIC/PLEOPTIC TRAINING|| 80001|92065|TC|38.77|0|38.77|0||ORTHOPTIC/PLEOPTIC TRAINING|| 80001|92071||44.14|0|39.49|0||CONTACT LENS FITTING FOR TX|| 80001|92072||155.51|0|121.01|0||FIT CONTAC LENS FOR MANAGMNT|| 80001|92081||38.53|0|38.53|0||VISUAL FIELD EXAMINATION(S)|| 80001|92081|26|19.14|0|19.14|0||VISUAL FIELD EXAMINATION(S)|| 80001|92081|TC|19.38|0|19.38|0||VISUAL FIELD EXAMINATION(S)|| 80001|92082||54.08|0|54.08|0||VISUAL FIELD EXAMINATION(S)|| 80001|92082|26|25.39|0|25.39|0||VISUAL FIELD EXAMINATION(S)|| 80001|92082|TC|28.69|0|28.69|0||VISUAL FIELD EXAMINATION(S)|| 80001|92083||72.35|0|72.35|0||VISUAL FIELD EXAMINATION(S)|| 80001|92083|26|32.8|0|32.8|0||VISUAL FIELD EXAMINATION(S)|| 80001|92083|TC|39.54|0|39.54|0||VISUAL FIELD EXAMINATION(S)|| 80001|92100||90.27|0|39.88|0||SERIAL TONOMETRY EXAM(S)|| 80001|92132||39.52|0|39.52|0||CMPTR OPHTH DX IMG ANT SEGMT|| 80001|92132|26|22.46|0|22.46|0||CMPTR OPHTH DX IMG ANT SEGMT|| 80001|92132|TC|17.06|0|17.06|0||CMPTR OPHTH DX IMG ANT SEGMT|| 80001|92133||50.25|0|50.25|0||CMPTR OPHTH IMG OPTIC NERVE|| 80001|92133|26|32.8|0|32.8|0||CMPTR OPHTH IMG OPTIC NERVE|| 80001|92133|TC|17.45|0|17.45|0||CMPTR OPHTH IMG OPTIC NERVE|| 80001|92134||51.41|0|51.41|0||CPTR OPHTH DX IMG POST SEGMT|| 80001|92134|26|33.58|0|33.58|0||CPTR OPHTH DX IMG POST SEGMT|| 80001|92134|TC|17.83|0|17.83|0||CPTR OPHTH DX IMG POST SEGMT|| 80001|92136||100.82|0|100.82|0||OPHTHALMIC BIOMETRY|| 80001|92136|26|36.47|0|36.47|0||OPHTHALMIC BIOMETRY|| 80001|92136|TC|64.35|0|64.35|0||OPHTHALMIC BIOMETRY|| 80001|92140||70.8|0|31.26|0||GLAUCOMA PROVOCATIVE TESTS|| 80001|92145||17.8|0|17.8|0||CORNEAL HYSTERESIS DETER|| 80001|92145|26|10.43|0|10.43|0||CORNEAL HYSTERESIS DETER|| 80001|92145|TC|7.37|0|7.37|0||CORNEAL HYSTERESIS DETER|| 80001|92225||31.12|0|24.92|0||SPECIAL EYE EXAM - INITIAL|| 80001|92226||28.57|0|22.37|0||SPECIAL EYE EXAM - SUBSEQUENT|| 80001|92227||15.9|0|15.9|0||REMOTE DX RETINAL IMAGING|| 80001|92228||40.38|0|40.38|0||REMOTE RETINAL IMAGING MGMT|| 80001|92228|26|25.26|0|25.26|0||REMOTE RETINAL IMAGING MGMT|| 80001|92228|TC|15.12|0|15.12|0||REMOTE RETINAL IMAGING MGMT|| 80001|92230||65.81|0|39.06|0||EYE EXAM WITH PHOTOS|| 80001|92235||123.32|0|123.32|0||EYE EXAM WITH PHOTOS|| 80001|92235|26|55.09|0|55.09|0||EYE EXAM WITH PHOTOS|| 80001|92235|TC|68.23|0|68.23|0||EYE EXAM WITH PHOTOS|| 80001|92240||282.74|0|282.74|0||ICG ANGIOGRAPHY|| 80001|92240|26|74.57|0|74.57|0||ICG ANGIOGRAPHY|| 80001|92240|TC|208.17|0|208.17|0||ICG ANGIOGRAPHY|| 80001|92242||275.63|0|275.63|0||FLUORESCEIN ICG ANGIOGRAPHY|| 80001|92242|26|208.01|0|208.01|0||FLUORESCEIN ICG ANGIOGRAPHY|| 80001|92242|TC|67.61|0|67.61|0||FLUORESCEIN ICG ANGIOGRAPHY|| 80001|92250||87.98|0|87.98|0||EYE EXAM WITH PHOTOS|| 80001|92250|26|28.28|0|28.28|0||EYE EXAM WITH PHOTOS|| 80001|92250|TC|59.7|0|59.7|0||EYE EXAM WITH PHOTOS|| 80001|92260||21.03|0|12.89|0||OPHTHALMOSCOPY/DYNAMOMETRY|| 80001|92265||97.34|0|97.34|0||EYE MUSCLE EVALUATION|| 80001|92265|26|54.7|0|54.7|0||EYE MUSCLE EVALUATION|| 80001|92265|TC|42.64|0|42.64|0||EYE MUSCLE EVALUATION|| 80001|92270||103.94|0|103.94|0||ELECTRO-OCULOGRAPHY|| 80001|92270|26|48.89|0|48.89|0||ELECTRO-OCULOGRAPHY|| 80001|92270|TC|55.05|0|55.05|0||ELECTRO-OCULOGRAPHY|| 80001|92275||164.5|0|164.5|0||ELECTRORETINOGRAPHY|| 80001|92275|26|62.94|0|62.94|0||ELECTRORETINOGRAPHY|| 80001|92275|TC|101.57|0|101.57|0||ELECTRORETINOGRAPHY|| 80001|92283||61.99|0|61.99|0||COLOR VISION EXAMINATION|| 80001|92283|26|11.21|0|11.21|0||COLOR VISION EXAMINATION|| 80001|92283|TC|50.78|0|50.78|0||COLOR VISION EXAMINATION|| 80001|92284||69.28|0|69.28|0||DARK ADAPTATION EYE EXAM|| 80001|92284|26|15|0|15|0||DARK ADAPTATION EYE EXAM|| 80001|92284|TC|54.27|0|54.27|0||DARK ADAPTATION EYE EXAM|| 80001|92285||22.71|0|22.71|0||EYE PHOTOGRAPHY|| 80001|92285|26|3.71|0|3.71|0||EYE PHOTOGRAPHY|| 80001|92285|TC|19|0|19|0||EYE PHOTOGRAPHY|| 80001|92286||43.61|0|43.61|0||INTERNAL EYE PHOTOGRAPHY|| 80001|92286|26|26.17|0|26.17|0||INTERNAL EYE PHOTOGRAPHY|| 80001|92286|TC|17.45|0|17.45|0||INTERNAL EYE PHOTOGRAPHY|| 80001|92287||153.94|0|153.94|0||INTERNAL EYE PHOTOGRAPHY|| 80001|92287|26|54.7|0|54.7|0||INTERNAL EYE PHOTOGRAPHY|| 80001|92287|TC|99.24|0|99.24|0||INTERNAL EYE PHOTOGRAPHY|| 80001|92310||109.78|0|70.62|0||CONTACT LENS FITTING|| 80001|92311||114.8|0|65.57|0||CONTACT LENS FITTING|| 80001|92312||133.81|0|76.05|0||CONTACT LENS FITTING|| 80001|92313||110.23|0|55.96|0||CONTACT LENS FITTING|| 80001|92314||90.24|0|41.39|0||PRESCRIPTION OF CONTACT LENS|| 80001|92315||81.43|0|25.61|0||PRESCRIPTION OF CONTACT LENS|| 80001|92316||102.98|0|39.02|0||PRESCRIPTION OF CONTACT LENS|| 80001|92317||84.92|0|26|0||PRESCRIPTION OF CONTACT LENS|| 80001|92325||46.13|0|46.13|0||MODIFICATION OF CONTACT LENS|| 80001|92326||38.38|0|38.38|0||REPLACEMENT OF CONTACT LENS|| 80001|92340||40.38|0|22.16|0||FITTING OF SPECTACLES|| 80001|92341||46.25|0|28.41|0||FITTING OF SPECTACLES|| 80001|92342||50|0|31.78|0||FITTING OF SPECTACLES|| 80001|92352||45.81|0|22.16|0||SPECIAL SPECTACLES FITTING|| 80001|92353||53.74|0|30.09|0||SPECIAL SPECTACLES FITTING|| 80001|92354||14.73|0|14.73|0||SPECIAL SPECTACLES FITTING|| 80001|92355||22.87|0|22.87|0||SPECIAL SPECTACLES FITTING|| 80001|92358||12.41|0|12.41|0||EYE PROSTHESIS SERVICE|| 80001|92370||35.12|0|19.23|0||REPAIR & ADJUST SPECTACLES|| 80001|92371||12.79|0|12.79|0||REPAIR & ADJUST SPECTACLES|| 80001|92499||0|0|0|0||EYE SERVICE OR PROCEDURE|| 80001|92499|26|0|0|0|0||EYE SERVICE OR PROCEDURE|| 80001|92499|TC|0|0|0|0||EYE SERVICE OR PROCEDURE|| 80001|92502||113.2|0|113.2|0||EAR AND THROAT EXAMINATION|| 80001|92504||33.74|0|11.25|0||EAR MICROSCOPY EXAMINATION|| 80001|92507||92.12|0|92.12|0||SPEECH/HEARING THERAPY|| 80001|92508||27.02|0|27.02|0||SPEECH/HEARING THERAPY|| 80001|92511||151.91|0|56.16|0||NASOPHARYNGOSCOPY|| 80001|92512||69.47|0|33.8|0||NASAL FUNCTION STUDIES|| 80001|92516||79.02|0|26.69|0||FACIAL NERVE FUNCTION TEST|| 80001|92520||85.46|0|48.63|0||LARYNGEAL FUNCTION STUDIES|| 80001|92521||125.48|0|125.48|0||EVALUATION OF SPEECH FLUENCY|| 80001|92522||107.33|0|107.33|0||EVALUATE SPEECH PRODUCTION|| 80001|92523||218.55|0|218.55|0||SPEECH SOUND LANG COMPREHEN|| 80001|92524||105.02|0|105.02|0||BEHAVRAL QUALIT ANALYS VOICE|| 80001|92526||99.66|0|99.66|0||ORAL FUNCTION THERAPY|| 80001|92531||0|0|0|0||SPONTANEOUS NYSTAGMUS STUDY|| 80001|92532||0|0|0|0||POSITIONAL NYSTAGMUS TEST|| 80001|92533||0|0|0|0||CALORIC VESTIBULAR TEST|| 80001|92534||0|0|0|0||OPTOKINETIC NYSTAGMUS TEST|| 80001|92537||46.64|0|46.64|0||CALORIC VSTBLR TEST W/REC|| 80001|92537|26|37.37|0|37.37|0||CALORIC VSTBLR TEST W/REC|| 80001|92537|TC|9.27|0|9.27|0||CALORIC VSTBLR TEST W/REC|| 80001|92538||23.71|0|23.71|0||CALORIC VSTBLR TEST W/REC|| 80001|92538|26|18.69|0|18.69|0||CALORIC VSTBLR TEST W/REC|| 80001|92538|TC|5.02|0|5.02|0||CALORIC VSTBLR TEST W/REC|| 80001|92540||117.8|0|117.8|0||BASIC VESTIBULAR EVALUATION|| 80001|92540|26|93.38|0|93.38|0||BASIC VESTIBULAR EVALUATION|| 80001|92540|TC|24.42|0|24.42|0||BASIC VESTIBULAR EVALUATION|| 80001|92541||26.17|0|26.17|0||SPONTANEOUS NYSTAGMUS TEST|| 80001|92541|26|24.62|0|24.62|0||SPONTANEOUS NYSTAGMUS TEST|| 80001|92541|TC|1.55|0|1.55|0||SPONTANEOUS NYSTAGMUS TEST|| 80001|92542||30.78|0|30.78|0||POSITIONAL NYSTAGMUS TEST|| 80001|92542|26|29.23|0|29.23|0||POSITIONAL NYSTAGMUS TEST|| 80001|92542|TC|1.55|0|1.55|0||POSITIONAL NYSTAGMUS TEST|| 80001|92543||17.88|0|17.88|0||CALORIC VESTIBULAR TEST|| 80001|92543|26|6.64|0|6.64|0||CALORIC VESTIBULAR TEST|| 80001|92543|TC|11.24|0|11.24|0||CALORIC VESTIBULAR TEST|| 80001|92544||18.24|0|18.24|0||OPTOKINETIC NYSTAGMUS TEST|| 80001|92544|26|16.68|0|16.68|0||OPTOKINETIC NYSTAGMUS TEST|| 80001|92544|TC|1.55|0|1.55|0||OPTOKINETIC NYSTAGMUS TEST|| 80001|92545||16.99|0|16.99|0||OSCILLATING TRACKING TEST|| 80001|92545|26|15.43|0|15.43|0||OSCILLATING TRACKING TEST|| 80001|92545|TC|1.55|0|1.55|0||OSCILLATING TRACKING TEST|| 80001|92546||113.69|0|113.69|0||SINUSOIDAL ROTATIONAL TEST|| 80001|92546|26|17.55|0|17.55|0||SINUSOIDAL ROTATIONAL TEST|| 80001|92546|TC|96.14|0|96.14|0||SINUSOIDAL ROTATIONAL TEST|| 80001|92547||6.98|0|6.98|0||SUPPLEMENTAL ELECTRICAL TEST|| 80001|92548||114.99|0|114.99|0||POSTUROGRAPHY|| 80001|92548|26|30.87|0|30.87|0||POSTUROGRAPHY|| 80001|92548|TC|84.12|0|84.12|0||POSTUROGRAPHY|| 80001|92550||24.4|0|24.4|0||TYMPANOMETRY & REFLEX THRESH|| 80001|92551||13.18|0|13.18|0||PURE TONE HEARING TEST - AIR|| 80001|92552||34.12|0|34.12|0||PURE TONE AUDIOMETRY - AIR|| 80001|92553||40.32|0|40.32|0||AUDIOMETRY - AIR & BONE|| 80001|92555||25.2|0|25.2|0||SPEECH THRESHOLD AUDIOMETRY|| 80001|92556||40.71|0|40.71|0||SPEECH AUDIOMETRY - COMPLETE|| 80001|92557||43.32|0|37.89|0||COMPREHENSIVE HEARING TEST|| 80001|92558||0|0|0|0||EVOKED AUDITORY TEST QUAL|| 80001|92559||0|0|0|0||GROUP AUDIOMETRIC TESTING|| 80001|92560||0|0|0|0||BEKESY AUDIOMETRY - SCREEN|| 80001|92561||41.09|0|41.09|0||BEKESY AUDIOMETRY - DIAGNOSIS|| 80001|92562||50.4|0|50.4|0||LOUDNESS BALANCE TEST|| 80001|92563||33.73|0|33.73|0||TONE DECAY HEARING TEST|| 80001|92564||31.01|0|31.01|0||SISI HEARING TEST|| 80001|92565||17.06|0|17.06|0||STENGER TEST - PURE TONE|| 80001|92567||16.77|0|12.89|0||TYMPANOMETRY|| 80001|92568||18.32|0|17.93|0||ACOUSTIC REFL THRESHOLD TST|| 80001|92570||37.29|0|34.96|0||ACOUSTIC IMMITTANCE TESTING|| 80001|92571||29.85|0|29.85|0||FILTERED SPEECH HEARING TEST|| 80001|92572||34.12|0|34.12|0||STAGGERED SPONDAIC WORD TEST|| 80001|92575||77.53|0|77.53|0||SENSORINEURAL ACUITY TEST|| 80001|92576||38.38|0|38.38|0||SYNTHETIC SENTENCE TEST|| 80001|92577||17.45|0|17.45|0||STENGER TEST - SPEECH|| 80001|92579||52.28|0|44.53|0||VISUAL AUDIOMETRY (VRA)|| 80001|92582||77.92|0|77.92|0||CONDITIONING PLAY AUDIOMETRY|| 80001|92583||55.44|0|55.44|0||SELECT PICTURE AUDIOMETRY|| 80001|92584||80.63|0|80.63|0||ELECTROCOCHLEOGRAPHY|| 80001|92585||149.88|0|149.88|0||AUDITOR EVOKE POTENT - COMPRE|| 80001|92585|26|31.25|0|31.25|0||AUDITOR EVOKE POTENT - COMPRE|| 80001|92585|TC|118.62|0|118.62|0||AUDITOR EVOKE POTENT - COMPRE|| 80001|92586||91.1|0|91.1|0||AUDITOR EVOKE POTENT - LIMIT|| 80001|92587||25.18|0|25.18|0||EVOKED AUDITORY TEST|| 80001|92587|26|21.68|0|21.68|0||EVOKED AUDITORY TEST|| 80001|92587|TC|3.49|0|3.49|0||EVOKED AUDITORY TEST|| 80001|92588||38.45|0|38.45|0||EVOKED AUDITORY TEST|| 80001|92588|26|34.18|0|34.18|0||EVOKED AUDITORY TEST|| 80001|92588|TC|4.27|0|4.27|0||EVOKED AUDITORY TEST|| 80001|92590||0|0|0|0||HEARING AID EXAM - ONE EAR|| 80001|92591||0|0|0|0||HEARING AID EXAM - BOTH EARS|| 80001|92592||0|0|0|0||HEARING AID CHECK - ONE EAR|| 80001|92593||0|0|0|0||HEARING AID CHECK - BOTH EARS|| 80001|92594||0|0|0|0||ELECTRO HEARNG AID TEST - ONE|| 80001|92595||0|0|0|0||ELECTRO HEARNG AID TST - BOTH|| 80001|92596||45.74|0|45.74|0||EAR PROTECTOR EVALUATION|| 80001|92597||84.19|0|84.19|0||ORAL SPEECH DEVICE EVAL|| 80001|92601||160.46|0|139.53|0||COCHLEAR IMPLT F/UP EXAM < 7|| 80001|92602||103.36|0|80.1|0||REPROGRAM COCHLEAR IMPLT < 7|| 80001|92603||173.02|0|143.56|0||COCHLEAR IMPLT F/UP EXAM 7 >|| 80001|92604||102.37|0|79.49|0||REPROGRAM COCHLEAR IMPLT 7 >|| 80001|92605||110.37|0|106.11|0||EVAL FOR NONSPEECH DEVICE RX|| 80001|92606||97.99|0|85.2|0||NON-SPEECH DEVICE SERVICE|| 80001|92607||143.75|0|143.75|0||EX FOR SPEECH DEVICE RX - 1HR|| 80001|92608||61.2|0|61.2|0||EX FOR SPEECH DEVICE RX ADDL|| 80001|92609||127.49|0|127.49|0||USE OF SPEECH DEVICE SERVICE|| 80001|92610||98.32|0|85.14|0||EVALUATE SWALLOWING FUNCTION|| 80001|92611||100.44|0|100.44|0||MOTION FLUOROSCOPY/SWALLOW|| 80001|92612||194.72|0|80.36|0||ENDOSCOPY SWALLOW TST (FEES)|| 80001|92613||45.36|0|45.36|0||ENDOSCOPY SWALLOW TST (FEES)|| 80001|92614||163.32|0|79.59|0||LARYNGOSCOPIC SENSORY TEST|| 80001|92615||39.58|0|39.58|0||EVAL LARYNGOSCOPY SENSE TST|| 80001|92616||233.05|0|119.08|0||FEES W/LARYNGEAL SENSE TEST|| 80001|92617||49.19|0|49.19|0||INTERPRT FEES/LARYNGEAL TEST|| 80001|92618||40.05|0|39.28|0||EX FOR NONSPEECH DEV RX ADD|| 80001|92620||109.27|0|96.87|0||AUDITORY FUNCTION - 60 MIN|| 80001|92621||25.95|0|22.46|0||AUDITORY FUNCTION - + 15 MIN|| 80001|92625||81.38|0|73.24|0||TINNITUS ASSESSMENT|| 80001|92626||104.18|0|89.45|0||EVAL AUD REHAB STATUS|| 80001|92627||25.47|0|20.82|0||EVAL AUD STATUS REHAB ADD-ON|| 80001|92630||0|0|0|0||AUD REHAB PRE-LING HEAR LOSS|| 80001|92633||0|0|0|0||AUD REHAB POSTLING HEAR LOSS|| 80001|92640||131.72|0|112.34|0||AUD BRAINSTEM IMPLT PROGRAMG|| 80001|92700||0|0|0|0||ENT PROCEDURE/SERVICE|| 80001|92920||658.52|0|658.52|0||PRQ CARDIAC ANGIOPLAST 1 ART|| 80001|92921||0|0|0|0||PRQ CARDIAC ANGIO ADDL ART|| 80001|92924||781.2|0|781.2|0||PRQ CARD ANGIO/ATHRECT 1 ART|| 80001|92925||0|0|0|0||PRQ CARD ANGIO/ATHRECT ADDL|| 80001|92928||730.47|0|730.47|0||PRQ CARD STENT W/ANGIO 1 VSL|| 80001|92929||0|0|0|0||PRQ CARD STENT W/ANGIO ADDL|| 80001|92933||817.35|0|817.35|0||PRQ CARD STENT/ATH/ANGIO|| 80001|92934||0|0|0|0||PRQ CARD STENT/ATH/ANGIO|| 80001|92937||730.04|0|730.04|0||PRQ REVASC BYP GRAFT 1 VSL|| 80001|92938||0|0|0|0||PRQ REVASC BYP GRAFT ADDL|| 80001|92941||818.6|0|818.6|0||PRQ CARD REVASC MI 1 VSL|| 80001|92943||817.82|0|817.82|0||PRQ CARD REVASC CHRONIC 1VSL|| 80001|92944||0|0|0|0||PRQ CARD REVASC CHRONIC ADDL|| 80001|92950||352.04|0|224.9|0||HEART/LUNG RESUSCITATION CPR|| 80001|92953||13.41|0|13.41|0||TEMPORARY EXTERNAL PACING|| 80001|92960||236.22|0|145.12|0||CARDIOVERSION ELECTRIC - EXT|| 80001|92961||312.49|0|312.49|0||CARDIOVERSION - ELECTRIC - INT|| 80001|92970||223.95|0|223.95|0||CARDIOASSIST - INTERNAL|| 80001|92971||120.99|0|120.99|0||CARDIOASSIST - EXTERNAL|| 80001|92973||214.08|0|214.08|0||PERCUT CORONARY THROMBECTOMY|| 80001|92974||195.4|0|195.4|0||CATH PLACE - CARDIO BRACHYTX|| 80001|92975||472.64|0|472.64|0||DISSOLVE CLOT - HEART VESSEL|| 80001|92977||62.82|0|62.82|0||DISSOLVE CLOT - HEART VESSEL|| 80001|92978||0|0|0|0||INTRAVASC US - HEART ADD-ON|| 80001|92978|26|117.63|0|117.63|0||INTRAVASC US - HEART ADD-ON|| 80001|92978|TC|0|0|0|0||INTRAVASC US - HEART ADD-ON|| 80001|92979||0|0|0|0||INTRAVASC US - HEART ADD-ON|| 80001|92979|26|93.95|0|93.95|0||INTRAVASC US - HEART ADD-ON|| 80001|92979|TC|0|0|0|0||INTRAVASC US - HEART ADD-ON|| 80001|92986||1598.13|0|1598.13|0||REVISION OF AORTIC VALVE|| 80001|92987||1647.65|0|1647.65|0||REVISION OF MITRAL VALVE|| 80001|92990||1302.36|0|1302.36|0||REVISION OF PULMONARY VALVE|| 80001|92992||0|0|0|0||REVISION OF HEART CHAMBER|| 80001|92993||0|0|0|0||REVISION OF HEART CHAMBER|| 80001|92997||798.23|0|798.23|0||PUL ART BALLOON REPR - PERCUT|| 80001|92998||391.16|0|391.16|0||PUL ART BALLOON REPR - PERCUT|| 80001|93000||19.35|0|19.35|0||ELECTROCARDIOGRAM - COMPLETE|| 80001|93005||9.31|0|9.31|0||ELECTROCARDIOGRAM - TRACING|| 80001|93010||10.05|0|10.05|0||ELECTROCARDIOGRAM REPORT|| 80001|93015||86.62|0|86.62|0||CARDIOVASCULAR STRESS TEST|| 80001|93016||26.39|0|26.39|0||CARDIOVASCULAR STRESS TEST|| 80001|93017||43.03|0|43.03|0||CARDIOVASCULAR STRESS TEST|| 80001|93018||17.2|0|17.2|0||CARDIOVASCULAR STRESS TEST|| 80001|93024||127.99|0|127.99|0||CARDIAC DRUG STRESS TEST|| 80001|93024|26|67.9|0|67.9|0||CARDIAC DRUG STRESS TEST|| 80001|93024|TC|60.09|0|60.09|0||CARDIAC DRUG STRESS TEST|| 80001|93025||181.98|0|181.98|0||MICROVOLT T-WAVE ASSESS|| 80001|93025|26|43.98|0|43.98|0||MICROVOLT T-WAVE ASSESS|| 80001|93025|TC|138.01|0|138.01|0||MICROVOLT T-WAVE ASSESS|| 80001|93040||14.61|0|14.61|0||RHYTHM ECG WITH REPORT|| 80001|93041||6.2|0|6.2|0||RHYTHM ECG - TRACING|| 80001|93042||8.41|0|8.41|0||RHYTHM ECG - REPORT|| 80001|93050||19.67|0|19.67|0||ART PRESSURE WAVEFORM ANALYS|| 80001|93050|26|10.01|0|10.01|0||ART PRESSURE WAVEFORM ANALYS|| 80001|93050|TC|9.66|0|9.66|0||ART PRESSURE WAVEFORM ANALYS|| 80001|93224||102.67|0|102.67|0||ECG MONITOR/REPORT - 24 HRS|| 80001|93225||29.46|0|29.46|0||ECG MONITOR/RECORD - 24 HRS|| 80001|93226||41.48|0|41.48|0||ECG MONITOR/REPORT - 24 HRS|| 80001|93227||31.73|0|31.73|0||ECG MONITOR/REVIEW - 24 HRS|| 80001|93228||30.96|0|30.96|0||REMOTE 30 DAY ECG REV/REPORT|| 80001|93229||737.32|0|737.32|0||REMOTE 30 DAY ECG TECH SUPP|| 80001|93260||76.98|0|76.98|0||PRGRMG DEV EVAL IMPLTBL SYS|| 80001|93260|26|52.55|0|52.55|0||PRGRMG DEV EVAL IMPLTBL SYS|| 80001|93260|TC|24.42|0|24.42|0||PRGRMG DEV EVAL IMPLTBL SYS|| 80001|93261||70.29|0|70.29|0||INTERROGATE SUBQ DEFIB|| 80001|93261|26|45.87|0|45.87|0||INTERROGATE SUBQ DEFIB|| 80001|93261|TC|24.42|0|24.42|0||INTERROGATE SUBQ DEFIB|| 80001|93268||226.34|0|226.34|0||ECG RECORD/REVIEW|| 80001|93270||10.08|0|10.08|0||ECG RECORDING|| 80001|93271||186.08|0|186.08|0||ECG/MONITORING AND ANALYSIS|| 80001|93272||30.18|0|30.18|0||ECG/REVIEW - INTERPRET ONLY|| 80001|93278||34.43|0|34.43|0||ECG/SIGNAL-AVERAGED|| 80001|93278|26|14.66|0|14.66|0||ECG/SIGNAL-AVERAGED|| 80001|93278|TC|19.77|0|19.77|0||ECG/SIGNAL-AVERAGED|| 80001|93279||57.11|0|57.11|0||PM DEVICE PROGR EVAL - SNGL|| 80001|93279|26|38.11|0|38.11|0||PM DEVICE PROGR EVAL - SNGL|| 80001|93279|TC|19|0|19|0||PM DEVICE PROGR EVAL - SNGL|| 80001|93280||67.32|0|67.32|0||PM DEVICE PROGR EVAL - DUAL|| 80001|93280|26|45.61|0|45.61|0||PM DEVICE PROGR EVAL - DUAL|| 80001|93280|TC|21.71|0|21.71|0||PM DEVICE PROGR EVAL - DUAL|| 80001|93281||78.36|0|78.36|0||PM DEVICE PROGR EVAL - MULTI|| 80001|93281|26|53.16|0|53.16|0||PM DEVICE PROGR EVAL - MULTI|| 80001|93281|TC|25.2|0|25.2|0||PM DEVICE PROGR EVAL - MULTI|| 80001|93282||73.1|0|73.1|0||ICD DEVICE PROG EVAL - 1 SNGL|| 80001|93282|26|50.61|0|50.61|0||ICD DEVICE PROG EVAL - 1 SNGL|| 80001|93282|TC|22.49|0|22.49|0||ICD DEVICE PROG EVAL - 1 SNGL|| 80001|93283||94.18|0|94.18|0||ICD DEVICE PROGR EVAL - DUAL|| 80001|93283|26|68.2|0|68.2|0||ICD DEVICE PROGR EVAL - DUAL|| 80001|93283|TC|25.97|0|25.97|0||ICD DEVICE PROGR EVAL - DUAL|| 80001|93284||103.53|0|103.53|0||ICD DEVICE PROGR EVAL - MULT|| 80001|93284|26|74.07|0|74.07|0||ICD DEVICE PROGR EVAL - MULT|| 80001|93284|TC|29.46|0|29.46|0||ICD DEVICE PROGR EVAL - MULT|| 80001|93285||48.4|0|48.4|0||ILR DEVICE EVAL PROGR|| 80001|93285|26|30.96|0|30.96|0||ILR DEVICE EVAL PROGR|| 80001|93285|TC|17.45|0|17.45|0||ILR DEVICE EVAL PROGR|| 80001|93286||31.16|0|31.16|0||PRE-OP PM DEVICE EVAL|| 80001|93286|26|17.98|0|17.98|0||PRE-OP PM DEVICE EVAL|| 80001|93286|TC|13.18|0|13.18|0||PRE-OP PM DEVICE EVAL|| 80001|93287||41.51|0|41.51|0||PRE-OP ICD DEVICE EVAL|| 80001|93287|26|27.16|0|27.16|0||PRE-OP ICD DEVICE EVAL|| 80001|93287|TC|14.35|0|14.35|0||PRE-OP ICD DEVICE EVAL|| 80001|93288||42.97|0|42.97|0||PM DEVICE EVAL IN PERSON|| 80001|93288|26|25.52|0|25.52|0||PM DEVICE EVAL IN PERSON|| 80001|93288|TC|17.45|0|17.45|0||PM DEVICE EVAL IN PERSON|| 80001|93289||75.34|0|75.34|0||ICD DEVICE INTERROGATE|| 80001|93289|26|54.02|0|54.02|0||ICD DEVICE INTERROGATE|| 80001|93289|TC|21.32|0|21.32|0||ICD DEVICE INTERROGATE|| 80001|93290||35.6|0|35.6|0||ICM DEVICE EVAL|| 80001|93290|26|25.13|0|25.13|0||ICM DEVICE EVAL|| 80001|93290|TC|10.47|0|10.47|0||ICM DEVICE EVAL|| 80001|93291||41.03|0|41.03|0||ILR DEVICE INTERROGATE|| 80001|93291|26|25.13|0|25.13|0||ILR DEVICE INTERROGATE|| 80001|93291|TC|15.9|0|15.9|0||ILR DEVICE INTERROGATE|| 80001|93292||37.15|0|37.15|0||WCD DEVICE INTERROGATE|| 80001|93292|26|25.13|0|25.13|0||WCD DEVICE INTERROGATE|| 80001|93292|TC|12.02|0|12.02|0||WCD DEVICE INTERROGATE|| 80001|93293||59.93|0|59.93|0||PM PHONE R-STRIP DEVICE EVAL|| 80001|93293|26|18.45|0|18.45|0||PM PHONE R-STRIP DEVICE EVAL|| 80001|93293|TC|41.48|0|41.48|0||PM PHONE R-STRIP DEVICE EVAL|| 80001|93294||40.05|0|40.05|0||PM DEVICE INTERROGATE REMOTE|| 80001|93295||79.68|0|79.68|0||ICD DEVICE INTERROGAT REMOTE|| 80001|93296||28.3|0|28.3|0||PM/ICD REMOTE TECH SERV|| 80001|93297||31.34|0|31.34|0||ICM DEVICE INTERROGAT REMOTE|| 80001|93298||31.34|0|31.34|0||ILR DEVICE INTERROGAT REMOTE|| 80001|93299||0|0|0|0||ICM/ILR REMOTE TECH SERV|| 80001|93303||265.01|0|265.01|0||ECHO TRANSTHORACIC|| 80001|93303|26|75.45|0|75.45|0||ECHO TRANSTHORACIC|| 80001|93303|TC|189.57|0|189.57|0||ECHO TRANSTHORACIC|| 80001|93304||172.29|0|172.29|0||ECHO TRANSTHORACIC|| 80001|93304|26|43.2|0|43.2|0||ECHO TRANSTHORACIC|| 80001|93304|TC|129.09|0|129.09|0||ECHO TRANSTHORACIC|| 80001|93306||253.77|0|253.77|0||TTE W/DOPPLER - COMPLETE|| 80001|93306|26|75.06|0|75.06|0||TTE W/DOPPLER - COMPLETE|| 80001|93306|TC|178.71|0|178.71|0||TTE W/DOPPLER - COMPLETE|| 80001|93307||146.28|0|146.28|0||ECHO EXAM OF HEART|| 80001|93307|26|53.63|0|53.63|0||ECHO EXAM OF HEART|| 80001|93307|TC|92.65|0|92.65|0||ECHO EXAM OF HEART|| 80001|93308||138.38|0|138.38|0||ECHO EXAM OF HEART|| 80001|93308|26|30.61|0|30.61|0||ECHO EXAM OF HEART|| 80001|93308|TC|107.77|0|107.77|0||ECHO EXAM OF HEART|| 80001|93312||345.29|0|345.29|0||ECHO TRANSESOPHAGEAL|| 80001|93312|26|144.48|0|144.48|0||ECHO TRANSESOPHAGEAL|| 80001|93312|TC|200.81|0|200.81|0||ECHO TRANSESOPHAGEAL|| 80001|93313||27.04|0|27.04|0||ECHO TRANSESOPHAGEAL|| 80001|93314||330.13|0|330.13|0||ECHO TRANSESOPHAGEAL|| 80001|93314|26|117.69|0|117.69|0||ECHO TRANSESOPHAGEAL|| 80001|93314|TC|212.44|0|212.44|0||ECHO TRANSESOPHAGEAL|| 80001|93315||0|0|0|0||ECHO TRANSESOPHAGEAL|| 80001|93315|26|172.95|0|172.95|0||ECHO TRANSESOPHAGEAL|| 80001|93315|TC|0|0|0|0||ECHO TRANSESOPHAGEAL|| 80001|93316||45.58|0|45.58|0||ECHO TRANSESOPHAGEAL|| 80001|93317||0|0|0|0||ECHO TRANSESOPHAGEAL|| 80001|93317|26|128.94|0|128.94|0||ECHO TRANSESOPHAGEAL|| 80001|93317|TC|0|0|0|0||ECHO TRANSESOPHAGEAL|| 80001|93318||0|0|0|0||ECHO TRANSESOPHAGEAL INTRAOP|| 80001|93318|26|142.7|0|142.7|0||ECHO TRANSESOPHAGEAL INTRAOP|| 80001|93318|TC|0|0|0|0||ECHO TRANSESOPHAGEAL INTRAOP|| 80001|93320||61.36|0|61.36|0||DOPPLER ECHO EXAM - HEART|| 80001|93320|26|21.81|0|21.81|0||DOPPLER ECHO EXAM - HEART|| 80001|93320|TC|39.54|0|39.54|0||DOPPLER ECHO EXAM - HEART|| 80001|93321||30.89|0|30.89|0||DOPPLER ECHO EXAM - HEART|| 80001|93321|26|8.8|0|8.8|0||DOPPLER ECHO EXAM - HEART|| 80001|93321|TC|22.1|0|22.1|0||DOPPLER ECHO EXAM - HEART|| 80001|93325||29|0|29|0||DOPPLER COLOR FLOW ADD-ON|| 80001|93325|26|4.18|0|4.18|0||DOPPLER COLOR FLOW ADD-ON|| 80001|93325|TC|24.81|0|24.81|0||DOPPLER COLOR FLOW ADD-ON|| 80001|93350||269.2|0|269.2|0||ECHO TRANSTHORACIC|| 80001|93350|26|84.67|0|84.67|0||ECHO TRANSTHORACIC|| 80001|93350|TC|184.53|0|184.53|0||ECHO TRANSTHORACIC|| 80001|93351||303.03|0|303.03|0||STRESS TTE COMPLETE|| 80001|93351|26|101.45|0|101.45|0||STRESS TTE COMPLETE|| 80001|93351|TC|201.58|0|201.58|0||STRESS TTE COMPLETE|| 80001|93352||38.05|0|38.05|0||ADMIN ECG CONTRAST AGENT|| 80001|93355||269.62|0|269.62|0||ECHO TRANSESOPHAGEAL (TEE)|| 80001|93451||872.94|0|872.94|0||RIGHT HEART CATH|| 80001|93451|26|174|0|174|0||RIGHT HEART CATH|| 80001|93451|TC|698.94|0|698.94|0||RIGHT HEART CATH|| 80001|93452||994.29|0|994.29|0||LEFT HRT CATH W/VENTRCLGRPHY|| 80001|93452|26|305.81|0|305.81|0||LEFT HRT CATH W/VENTRCLGRPHY|| 80001|93452|TC|688.48|0|688.48|0||LEFT HRT CATH W/VENTRCLGRPHY|| 80001|93453||1280.74|0|1280.74|0||R&L HRT CATH W/VENTRICLGRPHY|| 80001|93453|26|402.31|0|402.31|0||R&L HRT CATH W/VENTRICLGRPHY|| 80001|93453|TC|878.43|0|878.43|0||R&L HRT CATH W/VENTRICLGRPHY|| 80001|93454||1006.1|0|1006.1|0||CORONARY ARTERY ANGIO S&I|| 80001|93454|26|307.93|0|307.93|0||CORONARY ARTERY ANGIO S&I|| 80001|93454|TC|698.17|0|698.17|0||CORONARY ARTERY ANGIO S&I|| 80001|93455||1171.44|0|1171.44|0||CORONARY ART/GRFT ANGIO S&I|| 80001|93455|26|356.59|0|356.59|0||CORONARY ART/GRFT ANGIO S&I|| 80001|93455|TC|814.85|0|814.85|0||CORONARY ART/GRFT ANGIO S&I|| 80001|93456||1260.18|0|1260.18|0||R HRT CORONARY ARTERY ANGIO|| 80001|93456|26|396.1|0|396.1|0||R HRT CORONARY ARTERY ANGIO|| 80001|93456|TC|864.08|0|864.08|0||R HRT CORONARY ARTERY ANGIO|| 80001|93457||1422.37|0|1422.37|0||R HRT ART/GRFT ANGIO|| 80001|93457|26|442.77|0|442.77|0||R HRT ART/GRFT ANGIO|| 80001|93457|TC|979.6|0|979.6|0||R HRT ART/GRFT ANGIO|| 80001|93458||1206.13|0|1206.13|0||L HRT ARTERY/VENTRICLE ANGIO|| 80001|93458|26|375|0|375|0||L HRT ARTERY/VENTRICLE ANGIO|| 80001|93458|TC|831.13|0|831.13|0||L HRT ARTERY/VENTRICLE ANGIO|| 80001|93459||1333.09|0|1333.09|0||L HRT ART/GRFT ANGIO|| 80001|93459|26|422.88|0|422.88|0||L HRT ART/GRFT ANGIO|| 80001|93459|TC|910.21|0|910.21|0||L HRT ART/GRFT ANGIO|| 80001|93460||1432.53|0|1432.53|0||R&L HRT ART/VENTRICLE ANGIO|| 80001|93460|26|471.92|0|471.92|0||R&L HRT ART/VENTRICLE ANGIO|| 80001|93460|TC|960.61|0|960.61|0||R&L HRT ART/VENTRICLE ANGIO|| 80001|93461||1636.64|0|1636.64|0||R&L HRT ART/VENTRICLE ANGIO|| 80001|93461|26|520.97|0|520.97|0||R&L HRT ART/VENTRICLE ANGIO|| 80001|93461|TC|1115.67|0|1115.67|0||R&L HRT ART/VENTRICLE ANGIO|| 80001|93462||250.18|0|250.18|0||L HRT CATH TRNSPTL PUNCTURE|| 80001|93463||118.06|0|118.06|0||DRUG ADMIN & HEMODYNMIC MEAS|| 80001|93464||308.67|0|308.67|0||EXERCISE W/HEMODYNAMIC MEAS|| 80001|93464|26|103.99|0|103.99|0||EXERCISE W/HEMODYNAMIC MEAS|| 80001|93464|TC|204.68|0|204.68|0||EXERCISE W/HEMODYNAMIC MEAS|| 80001|93503||156.16|0|156.16|0||INSERT/PLACE HEART CATHETER|| 80001|93505||860.04|0|860.04|0||BIOPSY OF HEART LINING|| 80001|93505|26|280.89|0|280.89|0||BIOPSY OF HEART LINING|| 80001|93505|TC|579.16|0|579.16|0||BIOPSY OF HEART LINING|| 80001|93530||0|0|0|0||RT HEART CATH - CONGENITAL|| 80001|93530|26|270.53|0|270.53|0||RT HEART CATH - CONGENITAL|| 80001|93530|TC|0|0|0|0||RT HEART CATH - CONGENITAL|| 80001|93531||0|0|0|0||R & L HEART CATH - CONGENITAL|| 80001|93531|26|528.58|0|528.58|0||R & L HEART CATH - CONGENITAL|| 80001|93531|TC|0|0|0|0||R & L HEART CATH - CONGENITAL|| 80001|93532||0|0|0|0||R & L HEART CATH - CONGENITAL|| 80001|93532|26|653.01|0|652.62|0||R & L HEART CATH - CONGENITAL|| 80001|93532|TC|0|0|0|0||R & L HEART CATH - CONGENITAL|| 80001|93533||0|0|0|0||R & L HEART CATH - CONGENITAL|| 80001|93533|26|437.67|0|437.67|0||R & L HEART CATH - CONGENITAL|| 80001|93533|TC|0|0|0|0||R & L HEART CATH - CONGENITAL|| 80001|93561||0|0|0|0||CARDIAC OUTPUT MEASUREMENT|| 80001|93561|26|29.32|0|29.32|0||CARDIAC OUTPUT MEASUREMENT|| 80001|93561|TC|0|0|0|0||CARDIAC OUTPUT MEASUREMENT|| 80001|93562||0|0|0|0||CARDIAC OUTPUT MEASUREMENT|| 80001|93562|26|9.61|0|9.61|0||CARDIAC OUTPUT MEASUREMENT|| 80001|93562|TC|0|0|0|0||CARDIAC OUTPUT MEASUREMENT|| 80001|93563||71.17|0|71.17|0||INJECT CONGENITAL CARD CATH|| 80001|93564||74.37|0|74.37|0||INJECT HRT CONGNTL ART/GRFT|| 80001|93565||55.73|0|55.73|0||INJECT L VENTR/ATRIAL ANGIO|| 80001|93566||191.8|0|55.73|0||INJECT R VENTR/ATRIAL ANGIO|| 80001|93567||160.11|0|63.19|0||INJECT SUPRVLV AORTOGRAPHY|| 80001|93568||172.89|0|56.98|0||INJECT PULM ART HRT CATH|| 80001|93571||0|0|0|0||HEART FLOW RESERVE MEASURE|| 80001|93571|26|117.63|0|117.63|0||HEART FLOW RESERVE MEASURE|| 80001|93571|TC|0|0|0|0||HEART FLOW RESERVE MEASURE|| 80001|93572||0|0|0|0||HEART FLOW RESERVE MEASURE|| 80001|93572|26|93.95|0|93.95|0||HEART FLOW RESERVE MEASURE|| 80001|93572|TC|0|0|0|0||HEART FLOW RESERVE MEASURE|| 80001|93580||1176.15|0|1176.15|0||TRANSCATH CLOSURE OF ASD|| 80001|93581||1606.88|0|1606.88|0||TRANSCATH CLOSURE OF VSD|| 80001|93582||811.59|0|811.59|0||PERQ TRANSCATH CLOSURE PDA|| 80001|93583||904.76|0|904.76|0||PERQ TRANSCATH SEPTAL REDUXN|| 80001|93590||1494.41|0|1494.41|0||PERQ TRANSCATH CLS MITRAL|| 80001|93591||1240.31|0|1240.31|0||PERQ TRANSCATH CLS AORTIC|| 80001|93592||546.51|0|546.51|0||PERQ TRANSCATH CLOSURE EACH|| 80001|93600||0|0|0|0||BUNDLE OF HIS RECORDING|| 80001|93600|26|144.24|0|144.24|0||BUNDLE OF HIS RECORDING|| 80001|93600|TC|0|0|0|0||BUNDLE OF HIS RECORDING|| 80001|93602||0|0|0|0||INTRA-ATRIAL RECORDING|| 80001|93602|26|141.53|0|141.53|0||INTRA-ATRIAL RECORDING|| 80001|93602|TC|0|0|0|0||INTRA-ATRIAL RECORDING|| 80001|93603||0|0|0|0||RIGHT VENTRICULAR RECORDING|| 80001|93603|26|141.53|0|141.53|0||RIGHT VENTRICULAR RECORDING|| 80001|93603|TC|0|0|0|0||RIGHT VENTRICULAR RECORDING|| 80001|93609||0|0|0|0||MAP TACHYCARDIA - ADD-ON|| 80001|93609|26|338.3|0|338.3|0||MAP TACHYCARDIA - ADD-ON|| 80001|93609|TC|0|0|0|0||MAP TACHYCARDIA - ADD-ON|| 80001|93610||0|0|0|0||INTRA-ATRIAL PACING|| 80001|93610|26|200.54|0|200.54|0||INTRA-ATRIAL PACING|| 80001|93610|TC|0|0|0|0||INTRA-ATRIAL PACING|| 80001|93612||0|0|0|0||INTRAVENTRICULAR PACING|| 80001|93612|26|199.37|0|199.37|0||INTRAVENTRICULAR PACING|| 80001|93612|TC|0|0|0|0||INTRAVENTRICULAR PACING|| 80001|93613||476.2|0|476.2|0||ELECTROPHYS MAP 3D - ADD-ON|| 80001|93615||0|0|0|0||ESOPHAGEAL RECORDING|| 80001|93615|26|61.7|0|61.7|0||ESOPHAGEAL RECORDING|| 80001|93615|TC|0|0|0|0||ESOPHAGEAL RECORDING|| 80001|93616||0|0|0|0||ESOPHAGEAL RECORDING|| 80001|93616|26|78.23|0|78.23|0||ESOPHAGEAL RECORDING|| 80001|93616|TC|0|0|0|0||ESOPHAGEAL RECORDING|| 80001|93618||0|0|0|0||HEART RHYTHM PACING|| 80001|93618|26|286.97|0|286.97|0||HEART RHYTHM PACING|| 80001|93618|TC|0|0|0|0||HEART RHYTHM PACING|| 80001|93619||0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93619|26|492.72|0|492.72|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93619|TC|0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93620||0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93620|26|783.23|0|782.84|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93620|TC|0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93621||0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93621|26|142.6|0|142.6|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93621|TC|0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93622||0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93622|26|208.25|0|208.25|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93622|TC|0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93623||0|0|0|0||STIMULATION - PACING HEART|| 80001|93623|26|194.36|0|194.36|0||STIMULATION - PACING HEART|| 80001|93623|TC|0|0|0|0||STIMULATION - PACING HEART|| 80001|93624||0|0|0|0||ELECTROPHYSIOLOGIC STUDY|| 80001|93624|26|313.82|0|313.82|0||ELECTROPHYSIOLOGIC STUDY|| 80001|93624|TC|0|0|0|0||ELECTROPHYSIOLOGIC STUDY|| 80001|93631||0|0|0|0||HEART PACING - MAPPING|| 80001|93631|26|488.54|0|488.54|0||HEART PACING - MAPPING|| 80001|93631|TC|0|0|0|0||HEART PACING - MAPPING|| 80001|93640||0|0|0|0||EVALUATION HEART DEVICE|| 80001|93640|26|234.87|0|234.87|0||EVALUATION HEART DEVICE|| 80001|93640|TC|0|0|0|0||EVALUATION HEART DEVICE|| 80001|93641||0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93641|26|398.99|0|398.99|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93641|TC|0|0|0|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93642||491.69|0|491.69|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93642|26|325.38|0|325.38|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93642|TC|166.31|0|166.31|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93644||343.21|0|343.21|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93644|26|227.3|0|227.3|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93644|TC|115.91|0|115.91|0||ELECTROPHYSIOLOGY EVALUATION|| 80001|93650||723.43|0|723.43|0||ABLATE HEART DYSRHYTHM FOCUS|| 80001|93653||1018.91|0|1018.91|0||EP & ABLATE SUPRAVENT ARRHYT|| 80001|93654||1355.71|0|1355.71|0||EP & ABLATE VENTRIC TACHY|| 80001|93655||509.07|0|509.07|0||ABLATE ARRHYTHMIA ADD ON|| 80001|93656||1361.22|0|1361.22|0||TX ATRIAL FIB PULM VEIN ISOL|| 80001|93657||508.68|0|508.68|0||TX L/R ATRIAL FIB ADDL|| 80001|93660||181.14|0|181.14|0||TILT TABLE EVALUATION|| 80001|93660|26|111.75|0|111.75|0||TILT TABLE EVALUATION|| 80001|93660|TC|69.39|0|69.39|0||TILT TABLE EVALUATION|| 80001|93662||0|0|0|0||INTRACARDIAC ECG (ICE)|| 80001|93662|26|172.72|0|172.72|0||INTRACARDIAC ECG (ICE)|| 80001|93662|TC|0|0|0|0||INTRACARDIAC ECG (ICE)|| 80001|93668||20.94|0|20.94|0||PERIPHERAL VASCULAR REHAB|| 80001|93701||26.75|0|26.75|0||BIOIMPEDANCE - THORACIC|| 80001|93702||124.05|0|124.05|0||BIS XTRACELL FLUID ANALYSIS|| 80001|93724||321.34|0|321.34|0||ANALYZE PACEMAKER SYSTEM|| 80001|93724|26|290.33|0|290.33|0||ANALYZE PACEMAKER SYSTEM|| 80001|93724|TC|31.01|0|31.01|0||ANALYZE PACEMAKER SYSTEM|| 80001|93740||9.61|0|9.61|0||TEMPERATURE GRADIENT STUDIES|| 80001|93745||0|0|0|0||SET-UP CARDIOVERT-DEFIBRILL|| 80001|93745|26|0|0|0|0||SET-UP CARDIOVERT-DEFIBRILL|| 80001|93745|TC|0|0|0|0||SET-UP CARDIOVERT-DEFIBRILL|| 80001|93750||65.28|0|55.2|0||INTERROGATION VAD - IN PERSON|| 80001|93770||9.61|0|9.61|0||MEASURE VENOUS PRESSURE|| 80001|93784||60.58|0|60.58|0||AMBULATORY BP MONITORING|| 80001|93786||32.56|0|32.56|0||AMBULATORY BP RECORDING|| 80001|93788||5.82|0|5.82|0||AMBULATORY BP ANALYSIS|| 80001|93790||22.2|0|22.2|0||REVIEW/REPORT BP RECORDING|| 80001|93792||59.57|0|59.57|0||PT/CAREGIVER TRAINJ HOME INR|| 80001|93793||14.06|0|14.06|0||ANTICOAG MGMT PT WARFARIN|| 80001|93797||18.62|0|10.48|0||CARDIAC REHAB|| 80001|93798||28.75|0|16.73|0||CARDIAC REHAB/MONITOR|| 80001|93799||0|0|0|0||CARDIOVASCULAR PROCEDURE|| 80001|93799|26|0|0|0|0||CARDIOVASCULAR PROCEDURE|| 80001|93799|TC|0|0|0|0||CARDIOVASCULAR PROCEDURE|| 80001|93880||224.85|0|224.85|0||EXTRACRANIAL STUDY|| 80001|93880|26|46.91|0|46.91|0||EXTRACRANIAL STUDY|| 80001|93880|TC|177.94|0|177.94|0||EXTRACRANIAL STUDY|| 80001|93882||143.3|0|143.3|0||EXTRACRANIAL STUDY|| 80001|93882|26|29.32|0|29.32|0||EXTRACRANIAL STUDY|| 80001|93882|TC|113.97|0|113.97|0||EXTRACRANIAL STUDY|| 80001|93886||259.82|0|0|0||INTRACRANIAL STUDY|| 80001|93886|26|55.14|0|55.14|0||INTRACRANIAL STUDY|| 80001|93886|TC|204.68|0|0|0||INTRACRANIAL STUDY|| 80001|93888||165.77|0|165.77|0||INTRACRANIAL STUDY|| 80001|93888|26|30.09|0|30.09|0||INTRACRANIAL STUDY|| 80001|93888|TC|135.68|0|135.68|0||INTRACRANIAL STUDY|| 80001|93890||205.56|0|0|0||TCD - VASOREACTIVITY STUDY|| 80001|93890|26|60.19|0|60.19|0||TCD - VASOREACTIVITY STUDY|| 80001|93890|TC|145.37|0|0|0||TCD - VASOREACTIVITY STUDY|| 80001|93892||215.12|0|0|0||TCD - EMBOLI DETECT W/O INJ|| 80001|93892|26|69.76|0|69.76|0||TCD - EMBOLI DETECT W/O INJ|| 80001|93892|TC|145.37|0|0|0||TCD - EMBOLI DETECT W/O INJ|| 80001|93893||215.12|0|0|0||TCD - EMBOLI DETECT W/INJ|| 80001|93893|26|69.76|0|69.76|0||TCD - EMBOLI DETECT W/INJ|| 80001|93893|TC|145.37|0|0|0||TCD - EMBOLI DETECT W/INJ|| 80001|93895||0|0|0|0||CAROTID INTIMA ATHEROMA EVAL|| 80001|93895|26|0|0|0|0||CAROTID INTIMA ATHEROMA EVAL|| 80001|93895|TC|0|0|0|0||CAROTID INTIMA ATHEROMA EVAL|| 80001|93922||99.17|0|99.17|0||EXTREMITY STUDY|| 80001|93922|26|14.66|0|14.66|0||EXTREMITY STUDY|| 80001|93922|TC|84.51|0|84.51|0||EXTREMITY STUDY|| 80001|93923||153.93|0|153.93|0||EXTREMITY STUDY|| 80001|93923|26|26.39|0|26.39|0||EXTREMITY STUDY|| 80001|93923|TC|127.54|0|127.54|0||EXTREMITY STUDY|| 80001|93924||191.75|0|191.75|0||EXTREMITY STUDY|| 80001|93924|26|29.32|0|29.32|0||EXTREMITY STUDY|| 80001|93924|TC|162.43|0|162.43|0||EXTREMITY STUDY|| 80001|93925||251.59|0|0|0||LOWER EXTREMITY STUDY|| 80001|93925|26|46.91|0|46.91|0||LOWER EXTREMITY STUDY|| 80001|93925|TC|204.68|0|0|0||LOWER EXTREMITY STUDY|| 80001|93926||170.44|0|170.44|0||LOWER EXTREMITY STUDY|| 80001|93926|26|29.72|0|29.72|0||LOWER EXTREMITY STUDY|| 80001|93926|TC|140.72|0|140.72|0||LOWER EXTREMITY STUDY|| 80001|93930||232.99|0|232.99|0||UPPER EXTREMITY STUDY|| 80001|93930|26|46.91|0|46.91|0||UPPER EXTREMITY STUDY|| 80001|93930|TC|186.08|0|186.08|0||UPPER EXTREMITY STUDY|| 80001|93931||144.85|0|144.85|0||UPPER EXTREMITY STUDY|| 80001|93931|26|29.71|0|29.71|0||UPPER EXTREMITY STUDY|| 80001|93931|TC|115.13|0|115.13|0||UPPER EXTREMITY STUDY|| 80001|93965||133.72|0|133.72|0||EXTREMITY STUDY|| 80001|93965|26|20.52|0|20.52|0||EXTREMITY STUDY|| 80001|93965|TC|113.2|0|113.2|0||EXTREMITY STUDY|| 80001|93970||219.37|0|219.37|0||EXTREMITY STUDY|| 80001|93970|26|41.44|0|41.44|0||EXTREMITY STUDY|| 80001|93970|TC|177.94|0|177.94|0||EXTREMITY STUDY|| 80001|93971||134.93|0|134.93|0||EXTREMITY STUDY|| 80001|93971|26|26.78|0|26.78|0||EXTREMITY STUDY|| 80001|93971|TC|108.16|0|108.16|0||EXTREMITY STUDY|| 80001|93975||272.56|0|0|0||VASCULAR STUDY|| 80001|93975|26|67.87|0|67.87|0||VASCULAR STUDY|| 80001|93975|TC|204.68|0|0|0||VASCULAR STUDY|| 80001|93976||182.59|0|182.59|0||VASCULAR STUDY|| 80001|93976|26|47.69|0|47.69|0||VASCULAR STUDY|| 80001|93976|TC|134.9|0|134.9|0||VASCULAR STUDY|| 80001|93978||212.83|0|212.83|0||VASCULAR STUDY|| 80001|93978|26|46.53|0|46.53|0||VASCULAR STUDY|| 80001|93978|TC|166.31|0|166.31|0||VASCULAR STUDY|| 80001|93979||134.38|0|134.38|0||VASCULAR STUDY|| 80001|93979|26|29.32|0|29.32|0||VASCULAR STUDY|| 80001|93979|TC|105.06|0|105.06|0||VASCULAR STUDY|| 80001|93980||136.48|0|136.48|0||PENILE VASCULAR STUDY|| 80001|93980|26|72.13|0|72.13|0||PENILE VASCULAR STUDY|| 80001|93980|TC|64.35|0|64.35|0||PENILE VASCULAR STUDY|| 80001|93981||80.62|0|80.62|0||PENILE VASCULAR STUDY|| 80001|93981|26|25.18|0|25.18|0||PENILE VASCULAR STUDY|| 80001|93981|TC|55.44|0|55.44|0||PENILE VASCULAR STUDY|| 80001|93982||49|0|49|0||ANEURYSM PRESSURE SENS STUDY|| 80001|93990||175.48|0|0|0||DOPPLER FLOW TESTING|| 80001|93990|26|30.11|0|30.11|0||DOPPLER FLOW TESTING|| 80001|93990|TC|145.37|0|0|0||DOPPLER FLOW TESTING|| 80001|93998||0|0|0|0||NONINVAS VASC DX STUDY PROC|| 80001|94002||110.65|0|110.65|0||VENT MGMT INPAT - INIT DAY|| 80001|94003||79.64|0|79.64|0||VENT MGMT INPAT - SUBQ DAY|| 80001|94004||57.86|0|57.86|0||VENT MGMT NF PER DAY|| 80001|94005||108.51|0|108.51|0||HOME VENT MGMT SUPERVISION|| 80001|94010||40.29|0|40.29|0||BREATHING CAPACITY TEST|| 80001|94010|26|10.05|0|10.05|0||BREATHING CAPACITY TEST|| 80001|94010|TC|30.24|0|30.24|0||BREATHING CAPACITY TEST|| 80001|94011||118.83|0|118.83|0||UP TO 2 YRS OLD - SPIROMETRY|| 80001|94012||195.36|0|195.36|0||2 YRS - SPIROMTRY W/DILATOR|| 80001|94013||37|0|37|0|| 2 YRS - LUNG VOLUMES|| 80001|94014||63.52|0|63.52|0||PATIENT RECORDED SPIROMETRY|| 80001|94015||33.34|0|33.34|0||PATIENT RECORDED SPIROMETRY|| 80001|94016||30.18|0|30.18|0||REVIEW PATIENT SPIROMETRY|| 80001|94060||67.86|0|67.86|0||EVALUATION OF WHEEZING|| 80001|94060|26|15.52|0|15.52|0||EVALUATION OF WHEEZING|| 80001|94060|TC|52.33|0|52.33|0||EVALUATION OF WHEEZING|| 80001|94070||67.74|0|67.74|0||EVALUATION OF WHEEZING|| 80001|94070|26|34.02|0|34.02|0||EVALUATION OF WHEEZING|| 80001|94070|TC|33.73|0|33.73|0||EVALUATION OF WHEEZING|| 80001|94150||28.22|0|28.22|0||VITAL CAPACITY TEST|| 80001|94150|26|4.57|0|4.57|0||VITAL CAPACITY TEST|| 80001|94150|TC|23.65|0|23.65|0||VITAL CAPACITY TEST|| 80001|94200||28.39|0|28.39|0||LUNG FUNCTION TEST (MBC/MVV)|| 80001|94200|26|6.68|0|6.68|0||LUNG FUNCTION TEST (MBC/MVV)|| 80001|94200|TC|21.71|0|21.71|0||LUNG FUNCTION TEST (MBC/MVV)|| 80001|94250||29.17|0|29.17|0||EXPIRED GAS COLLECTION|| 80001|94250|26|6.3|0|6.3|0||EXPIRED GAS COLLECTION|| 80001|94250|TC|22.87|0|22.87|0||EXPIRED GAS COLLECTION|| 80001|94375||44.38|0|44.38|0||RESPIRATORY FLOW VOLUME LOOP|| 80001|94375|26|17.63|0|17.63|0||RESPIRATORY FLOW VOLUME LOOP|| 80001|94375|TC|26.75|0|26.75|0||RESPIRATORY FLOW VOLUME LOOP|| 80001|94400||63.77|0|63.77|0||CO2 BREATHING RESPONSE CURVE|| 80001|94400|26|23.06|0|23.06|0||CO2 BREATHING RESPONSE CURVE|| 80001|94400|TC|40.71|0|40.71|0||CO2 BREATHING RESPONSE CURVE|| 80001|94450||74.62|0|74.62|0||HYPOXIA RESPONSE CURVE|| 80001|94450|26|23.06|0|23.06|0||HYPOXIA RESPONSE CURVE|| 80001|94450|TC|51.56|0|51.56|0||HYPOXIA RESPONSE CURVE|| 80001|94452||64.54|0|64.54|0||HAST W/REPORT|| 80001|94452|26|17.25|0|17.25|0||HAST W/REPORT|| 80001|94452|TC|47.3|0|47.3|0||HAST W/REPORT|| 80001|94453||89.36|0|89.36|0||HAST W/OXYGEN TITRATE|| 80001|94453|26|22.68|0|22.68|0||HAST W/OXYGEN TITRATE|| 80001|94453|TC|66.68|0|66.68|0||HAST W/OXYGEN TITRATE|| 80001|94610||67.1|0|67.1|0||SURFACTANT ADMIN THRU TUBE|| 80001|94617||108.29|0|108.29|0||EXERCISE TST BRNCSPSM|| 80001|94617|26|40.17|0|40.17|0||EXERCISE TST BRNCSPSM|| 80001|94617|TC|68.11|0|68.11|0||EXERCISE TST BRNCSPSM|| 80001|94618||39.99|0|39.99|||PULMONARY STRESS TESTING|| 80001|94618||39.99|0|39.99|0||PULMONARY STRESS TESTING|| 80001|94618|26|27.49|0|27.49|0||PULMONARY STRESS TESTING|| 80001|94618|TC|12.5|0|12.5|0||PULMONARY STRESS TESTING|| 80001|94620||64.04|0|64.04|0||PULMONARY STRESS TEST/SIMPLE|| 80001|94620|26|36.13|0|36.13|0||PULMONARY STRESS TEST/SIMPLE|| 80001|94620|TC|27.91|0|27.91|0||PULMONARY STRESS TEST/SIMPLE|| 80001|94621||185.68|0|185.68|0||PULM STRESS TEST/COMPLEX|| 80001|94621|26|81.79|0|81.79|0||PULM STRESS TEST/COMPLEX|| 80001|94621|TC|103.89|0|103.89|0||PULM STRESS TEST/COMPLEX|| 80001|94640||20.16|0|20.16|0||AIRWAY INHALATION TREATMENT|| 80001|94642||0|0|0|0||AEROSOL INHALATION TREATMENT|| 80001|94644||47.68|0|47.68|0||CBT - 1ST HOUR|| 80001|94645||15.12|0|15.12|0||CBT - EACH ADDL HOUR|| 80001|94660||71.93|0|44.8|0||POS AIRWAY PRESSURE - CPAP|| 80001|94662||40.93|0|40.93|0||NEG PRESS VENTILATION - CNP|| 80001|94664||19|0|19|0||EVALUATE PT USE OF INHALER|| 80001|94667||28.69|0|28.69|0||CHEST WALL MANIPULATION|| 80001|94668||31.4|0|31.4|0||CHEST WALL MANIPULATION|| 80001|94669||38.77|0|38.77|0||MECHANICAL CHEST WALL OSCILL|| 80001|94680||63.94|0|63.94|0||EXHALED AIR ANALYSIS - O2|| 80001|94680|26|15.09|0|15.09|0||EXHALED AIR ANALYSIS - O2|| 80001|94680|TC|48.85|0|48.85|0||EXHALED AIR ANALYSIS - O2|| 80001|94681||59.41|0|59.41|0||EXHALED AIR ANALYSIS - O2/CO2|| 80001|94681|26|11.73|0|11.73|0||EXHALED AIR ANALYSIS - O2/CO2|| 80001|94681|TC|47.68|0|47.68|0||EXHALED AIR ANALYSIS - O2/CO2|| 80001|94690||54.58|0|54.58|0||EXHALED AIR ANALYSIS|| 80001|94690|26|4.57|0|4.57|0||EXHALED AIR ANALYSIS|| 80001|94690|TC|50.01|0|50.01|0||EXHALED AIR ANALYSIS|| 80001|94726||58.9|0|58.9|0||PULM FUNCT TST PLETHYSMOGRAP|| 80001|94726|26|14.7|0|14.7|0||PULM FUNCT TST PLETHYSMOGRAP|| 80001|94726|TC|44.19|0|44.19|0||PULM FUNCT TST PLETHYSMOGRAP|| 80001|94727||47.27|0|47.27|0||PULM FUNCTION TEST BY GAS|| 80001|94727|26|14.7|0|14.7|0||PULM FUNCTION TEST BY GAS|| 80001|94727|TC|32.56|0|32.56|0||PULM FUNCTION TEST BY GAS|| 80001|94728||44.17|0|44.17|0||PULM FUNCT TEST OSCILLOMETRY|| 80001|94728|26|14.7|0|14.7|0||PULM FUNCT TEST OSCILLOMETRY|| 80001|94728|TC|29.46|0|29.46|0||PULM FUNCT TEST OSCILLOMETRY|| 80001|94729||60.53|0|60.53|0||C0/MEMBANE DIFFUSE CAPACITY|| 80001|94729|26|10.91|0|10.91|0||C0/MEMBANE DIFFUSE CAPACITY|| 80001|94729|TC|49.62|0|49.62|0||C0/MEMBANE DIFFUSE CAPACITY|| 80001|94750||89.78|0|89.78|0||PULMONARY COMPLIANCE STUDY|| 80001|94750|26|13.41|0|13.41|0||PULMONARY COMPLIANCE STUDY|| 80001|94750|TC|76.37|0|76.37|0||PULMONARY COMPLIANCE STUDY|| 80001|94760||3.49|0|3.49|0||MEASURE BLOOD OXYGEN LEVEL|| 80001|94761||5.43|0|5.43|0||MEASURE BLOOD OXYGEN LEVEL|| 80001|94762||26.75|0|26.75|0||MEASURE BLOOD OXYGEN LEVEL|| 80001|94770||8.8|0|8.8|0||EXHALED CARBON DIOXIDE TEST|| 80001|94772||0|0|0|0||BREATH RECORDING - INFANT|| 80001|94772|26|0|0|0|0||BREATH RECORDING - INFANT|| 80001|94772|TC|0|0|0|0||BREATH RECORDING - INFANT|| 80001|94774||0|0|0|0||PED HOME APNEA REC - COMPL|| 80001|94775||0|0|0|0||PED HOME APNEA REC - HK-UP|| 80001|94776||0|0|0|0||PED HOME APNEA REC - DOWNLD|| 80001|94777||0|0|0|0||PED HOME APNEA REC - REPORT|| 80001|94780||70.71|0|29.62|0||CAR SEAT/BED TEST 60 MIN|| 80001|94781||25.94|0|10.43|0||CAR SEAT/BED TEST + 30 MIN|| 80001|94799||0|0|0|0||PULMONARY SERVICE/PROCEDURE|| 80001|94799|26|0|0|0|0||PULMONARY SERVICE/PROCEDURE|| 80001|94799|TC|0|0|0|0||PULMONARY SERVICE/PROCEDURE|| 80001|95004||7.02|0|7.02|0||PERCUT ALLERGY SKIN TESTS|| 80001|95012||21.32|0|21.32|0||EXHALED NITRIC OXIDE MEAS|| 80001|95017||8.84|0|4.18|0||PERQ & ICUT ALLG TEST VENOMS|| 80001|95018||21.16|0|8.36|0||PERQ&IC ALLG TEST DRUGS/BIOL|| 80001|95024||8.57|0|1.21|0||ID ALLERGY TEST - DRUG/BUG|| 80001|95027||5.09|0|5.09|0||ID ALLERGY TITRATE-AIRBORNE|| 80001|95028||14.73|0|14.73|0||ID ALLERGY TEST-DELAYED TYPE|| 80001|95044||6.2|0|6.2|0||ALLERGY PATCH TESTS|| 80001|95052||7.37|0|7.37|0||PHOTO PATCH TEST|| 80001|95056||48.46|0|48.46|0||PHOTOSENSITIVITY TESTS|| 80001|95060||38.38|0|38.38|0||EYE ALLERGY TESTS|| 80001|95065||27.53|0|27.53|0||NOSE ALLERGY TEST|| 80001|95070||32.95|0|32.95|0||BRONCHIAL ALLERGY TESTS|| 80001|95071||37.99|0|37.99|0||BRONCHIAL ALLERGY TESTS|| 80001|95076||133.31|0|86.4|0||INGEST CHALLENGE INI 120 MIN|| 80001|95079||96.34|0|79.28|0||INGEST CHALLENGE ADDL 60 MIN|| 80001|95115||9.69|0|9.69|0||IMMUNOTHERAPY - ONE INJECTION|| 80001|95117||11.24|0|11.24|0||IMMUNOTHERAPY INJECTIONS|| 80001|95120||0|0|0|0||IMMUNOTHERAPY - ONE INJECTION|| 80001|95125||0|0|0|0||IMMUNOTHERAPY - MANY ANTIGENS|| 80001|95130||0|0|0|0||IMMUNOTHERAPY - INSECT VENOM|| 80001|95131||0|0|0|0||IMMUNOTHERAPY - INSECT VENOMS|| 80001|95132||0|0|0|0||IMMUNOTHERAPY - INSECT VENOMS|| 80001|95133||0|0|0|0||IMMUNOTHERAPY - INSECT VENOMS|| 80001|95134||0|0|0|0||IMMUNOTHERAPY - INSECT VENOMS|| 80001|95144||13.83|0|3.75|0||ANTIGEN THERAPY SERVICES|| 80001|95145||24.3|0|3.75|0||ANTIGEN THERAPY SERVICES|| 80001|95146||42.91|0|3.75|0||ANTIGEN THERAPY SERVICES|| 80001|95147||38.64|0|3.75|0||ANTIGEN THERAPY SERVICES|| 80001|95148||57.64|0|3.75|0||ANTIGEN THERAPY SERVICES|| 80001|95149||77.02|0|3.75|0||ANTIGEN THERAPY SERVICES|| 80001|95165||14.22|0|3.75|0||ANTIGEN THERAPY SERVICES|| 80001|95170||10.73|0|3.75|0||ANTIGEN THERAPY SERVICES|| 80001|95180||154.91|0|119.64|0||RAPID DESENSITIZATION|| 80001|95199||0|0|0|0||ALLERGY IMMUNOLOGY SERVICES|| 80001|95249||60.81|0|60.81|0||CONT GLUC MNTR PT PROV EQP|| 80001|95250||172.12|0|172.12|0||GLUCOSE MONITORING - CONT|| 80001|95251||51|0|51|0||GLUC MONITOR - CONT - PHYS I&R|| 80001|95782||1008.81|0|1008.81|0||POLYSOM <6 YRS 4/> PARAMTRS|| 80001|95782|26|145.48|0|145.48|0||POLYSOM <6 YRS 4/> PARAMTRS|| 80001|95782|TC|863.33|0|863.33|0||POLYSOM <6 YRS 4/> PARAMTRS|| 80001|95783||1373.05|0|1373.05|0||POLYSOM <6 YRS CPAP/BILVL|| 80001|95783|26|174.78|0|174.78|0||POLYSOM <6 YRS CPAP/BILVL|| 80001|95783|TC|1198.27|0|1198.27|0||POLYSOM <6 YRS CPAP/BILVL|| 80001|95800||201.12|0|201.12|0||SLP STDY UNATTENDED|| 80001|95800|26|61.57|0|61.57|0||SLP STDY UNATTENDED|| 80001|95800|TC|139.56|0|139.56|0||SLP STDY UNATTENDED|| 80001|95801||104.77|0|104.77|0||SLP STDY UNATND W/ANAL|| 80001|95801|26|58.63|0|58.63|0||SLP STDY UNATND W/ANAL|| 80001|95801|TC|46.13|0|46.13|0||SLP STDY UNATND W/ANAL|| 80001|95803||158.6|0|158.6|0||ACTIGRAPHY TESTING|| 80001|95803|26|51.22|0|51.22|0||ACTIGRAPHY TESTING|| 80001|95803|TC|107.38|0|107.38|0||ACTIGRAPHY TESTING|| 80001|95805||463.45|0|463.45|0||MULTIPLE SLEEP LATENCY TEST|| 80001|95805|26|69.97|0|69.97|0||MULTIPLE SLEEP LATENCY TEST|| 80001|95805|TC|393.48|0|393.48|0||MULTIPLE SLEEP LATENCY TEST|| 80001|95806||189.2|0|189.2|0||SLEEP STUDY - UNATTENDED|| 80001|95806|26|72.13|0|72.13|0||SLEEP STUDY - UNATTENDED|| 80001|95806|TC|117.07|0|117.07|0||SLEEP STUDY - UNATTENDED|| 80001|95807||517.29|0|517.29|0||SLEEP STUDY - ATTENDED|| 80001|95807|26|73.42|0|73.42|0||SLEEP STUDY - ATTENDED|| 80001|95807|TC|443.87|0|443.87|0||SLEEP STUDY - ATTENDED|| 80001|95808||665.44|0|665.44|0||POLYSOMNOGRAPHY - 1-3|| 80001|95808|26|102.56|0|102.56|0||POLYSOMNOGRAPHY - 1-3|| 80001|95808|TC|562.88|0|562.88|0||POLYSOMNOGRAPHY - 1-3|| 80001|95810||689.32|0|689.32|0||POLYSOMNOGRAPHY - 4 OR MORE|| 80001|95810|26|144.26|0|144.26|0||POLYSOMNOGRAPHY - 4 OR MORE|| 80001|95810|TC|545.06|0|545.06|0||POLYSOMNOGRAPHY - 4 OR MORE|| 80001|95811||723.87|0|723.87|0||POLYSOMNOGRAPHY W/CPAP|| 80001|95811|26|149.73|0|149.73|0||POLYSOMNOGRAPHY W/CPAP|| 80001|95811|TC|574.13|0|574.13|0||POLYSOMNOGRAPHY W/CPAP|| 80001|95812||461.76|0|461.76|0||EEG - 41-60 MINUTES|| 80001|95812|26|67.9|0|67.9|0||EEG - 41-60 MINUTES|| 80001|95812|TC|393.86|0|393.86|0||EEG - 41-60 MINUTES|| 80001|95813||554.54|0|554.54|0||EEG - OVER 1 HOUR|| 80001|95813|26|109.12|0|109.12|0||EEG - OVER 1 HOUR|| 80001|95813|TC|445.42|0|445.42|0||EEG - OVER 1 HOUR|| 80001|95816||396.63|0|396.63|0||EEG - AWAKE AND DROWSY|| 80001|95816|26|67.9|0|67.9|0||EEG - AWAKE AND DROWSY|| 80001|95816|TC|328.73|0|328.73|0||EEG - AWAKE AND DROWSY|| 80001|95819||451.68|0|451.68|0||EEG - AWAKE AND ASLEEP|| 80001|95819|26|67.9|0|67.9|0||EEG - AWAKE AND ASLEEP|| 80001|95819|TC|383.78|0|383.78|0||EEG - AWAKE AND ASLEEP|| 80001|95822||409.04|0|409.04|0||EEG - COMA OR SLEEP ONLY|| 80001|95822|26|67.9|0|67.9|0||EEG - COMA OR SLEEP ONLY|| 80001|95822|TC|341.14|0|341.14|0||EEG - COMA OR SLEEP ONLY|| 80001|95824||0|0|0|0||EEG - CEREBRAL DEATH ONLY|| 80001|95824|26|47.43|0|47.43|0||EEG - CEREBRAL DEATH ONLY|| 80001|95824|TC|0|0|0|0||EEG - CEREBRAL DEATH ONLY|| 80001|95827||861.44|0|861.44|0||EEG - ALL NIGHT RECORDING|| 80001|95827|26|67.51|0|67.51|0||EEG - ALL NIGHT RECORDING|| 80001|95827|TC|793.93|0|793.93|0||EEG - ALL NIGHT RECORDING|| 80001|95829||2085.9|0|2085.9|0||SURGERY ELECTROCORTICOGRAM|| 80001|95829|26|391.08|0|391.08|0||SURGERY ELECTROCORTICOGRAM|| 80001|95829|TC|1694.82|0|1694.82|0||SURGERY ELECTROCORTICOGRAM|| 80001|95830||276.47|0|108.23|0||INSERT ELECTRODES FOR EEG|| 80001|95831||34.95|0|17.89|0||LIMB MUSCLE TESTING - MANUAL|| 80001|95832||34.61|0|19.1|0||HAND MUSCLE TESTING - MANUAL|| 80001|95833||43.14|0|25.7|0||BODY MUSCLE TESTING - MANUAL|| 80001|95834||58.06|0|37.12|0||BODY MUSCLE TESTING - MANUAL|| 80001|95851||20.86|0|9.23|0||RANGE OF MOTION MEASUREMENTS|| 80001|95852||18.31|0|7.07|0||RANGE OF MOTION MEASUREMENTS|| 80001|95857||61.24|0|34.49|0||TENSILON TEST|| 80001|95860||138.71|0|138.71|0||MUSCLE TEST - ONE LIMB|| 80001|95860|26|61.17|0|61.17|0||MUSCLE TEST - ONE LIMB|| 80001|95860|TC|77.53|0|77.53|0||MUSCLE TEST - ONE LIMB|| 80001|95861||195.51|0|195.51|0||MUSCLE TEST - 2 LIMBS|| 80001|95861|26|97.04|0|97.04|0||MUSCLE TEST - 2 LIMBS|| 80001|95861|TC|98.47|0|98.47|0||MUSCLE TEST - 2 LIMBS|| 80001|95863||241.53|0|241.53|0||MUSCLE TEST - 3 LIMBS|| 80001|95863|26|119.03|0|119.03|0||MUSCLE TEST - 3 LIMBS|| 80001|95863|TC|122.5|0|122.5|0||MUSCLE TEST - 3 LIMBS|| 80001|95864||273.84|0|273.84|0||MUSCLE TEST - 4 LIMBS|| 80001|95864|26|126.53|0|126.53|0||MUSCLE TEST - 4 LIMBS|| 80001|95864|TC|147.31|0|147.31|0||MUSCLE TEST - 4 LIMBS|| 80001|95865||164.63|0|164.63|0||MUSCLE TEST - LARYNX|| 80001|95865|26|99.12|0|99.12|0||MUSCLE TEST - LARYNX|| 80001|95865|TC|65.52|0|65.52|0||MUSCLE TEST - LARYNX|| 80001|95866||151.21|0|151.21|0||MUSCLE TEST - HEMIDIAPHRAGM|| 80001|95866|26|79.88|0|79.88|0||MUSCLE TEST - HEMIDIAPHRAGM|| 80001|95866|TC|71.33|0|71.33|0||MUSCLE TEST - HEMIDIAPHRAGM|| 80001|95867||105.4|0|105.4|0||MUSCLE TEST CRAN NERV UNILAT|| 80001|95867|26|49.19|0|49.19|0||MUSCLE TEST CRAN NERV UNILAT|| 80001|95867|TC|56.21|0|56.21|0||MUSCLE TEST CRAN NERV UNILAT|| 80001|95868||149.75|0|149.75|0||MUSCLE TEST CRAN NERVE BILAT|| 80001|95868|26|74.54|0|74.54|0||MUSCLE TEST CRAN NERVE BILAT|| 80001|95868|TC|75.21|0|75.21|0||MUSCLE TEST CRAN NERVE BILAT|| 80001|95869||90.78|0|90.78|0||MUSCLE TEST - THOR PARASPINAL|| 80001|95869|26|23.32|0|23.32|0||MUSCLE TEST - THOR PARASPINAL|| 80001|95869|TC|67.45|0|67.45|0||MUSCLE TEST - THOR PARASPINAL|| 80001|95870||98.14|0|98.14|0||MUSCLE TEST - NONPARASPINAL|| 80001|95870|26|22.93|0|22.93|0||MUSCLE TEST - NONPARASPINAL|| 80001|95870|TC|75.21|0|75.21|0||MUSCLE TEST - NONPARASPINAL|| 80001|95872||229.27|0|229.27|0||MUSCLE TEST - ONE FIBER|| 80001|95872|26|181.98|0|181.98|0||MUSCLE TEST - ONE FIBER|| 80001|95872|TC|47.3|0|47.3|0||MUSCLE TEST - ONE FIBER|| 80001|95873||83.41|0|83.41|0||GUIDE NERV DESTR - ELEC STIM|| 80001|95873|26|24.1|0|24.1|0||GUIDE NERV DESTR - ELEC STIM|| 80001|95873|TC|59.31|0|59.31|0||GUIDE NERV DESTR - ELEC STIM|| 80001|95874||80.31|0|80.31|0||GUIDE NERV DESTR - NEEDLE EMG|| 80001|95874|26|23.32|0|23.32|0||GUIDE NERV DESTR - NEEDLE EMG|| 80001|95874|TC|56.99|0|56.99|0||GUIDE NERV DESTR - NEEDLE EMG|| 80001|95875||136.99|0|136.99|0||LIMB EXERCISE TEST|| 80001|95875|26|68.76|0|68.76|0||LIMB EXERCISE TEST|| 80001|95875|TC|68.23|0|68.23|0||LIMB EXERCISE TEST|| 80001|95885||65.49|0|65.49|0||MUSC TST DONE W/NERV TST LIM|| 80001|95885|26|22.07|0|22.07|0||MUSC TST DONE W/NERV TST LIM|| 80001|95885|TC|43.42|0|43.42|0||MUSC TST DONE W/NERV TST LIM|| 80001|95886||103.38|0|103.38|0||MUSC TEST DONE W/N TEST COMP|| 80001|95886|26|54.15|0|54.15|0||MUSC TEST DONE W/N TEST COMP|| 80001|95886|TC|49.23|0|49.23|0||MUSC TEST DONE W/N TEST COMP|| 80001|95887||92.26|0|92.26|0||MUSC TST DONE W/N TST NONEXT|| 80001|95887|26|44.96|0|44.96|0||MUSC TST DONE W/N TST NONEXT|| 80001|95887|TC|47.3|0|47.3|0||MUSC TST DONE W/N TST NONEXT|| 80001|95905||78.53|0|78.53|0||MOTOR/SENS NRVE CONDUCT TEST|| 80001|95905|26|3.32|0|3.32|0||MOTOR/SENS NRVE CONDUCT TEST|| 80001|95905|TC|75.21|0|75.21|0||MOTOR/SENS NRVE CONDUCT TEST|| 80001|95907||110.58|0|110.58|0||NVR CNDJ TST 1-2 STUDIES|| 80001|95907|26|62.9|0|62.9|0||NVR CNDJ TST 1-2 STUDIES|| 80001|95907|TC|47.68|0|47.68|0||NVR CNDJ TST 1-2 STUDIES|| 80001|95908||141.91|0|141.91|0||NVR CNDJ TST 3-4 STUDIES|| 80001|95908|26|79.5|0|79.5|0||NVR CNDJ TST 3-4 STUDIES|| 80001|95908|TC|62.41|0|62.41|0||NVR CNDJ TST 3-4 STUDIES|| 80001|95909||168.2|0|168.2|0||NVR CNDJ TST 5-6 STUDIES|| 80001|95909|26|94.93|0|94.93|0||NVR CNDJ TST 5-6 STUDIES|| 80001|95909|TC|73.27|0|73.27|0||NVR CNDJ TST 5-6 STUDIES|| 80001|95910||223.49|0|223.49|0||NVR CNDJ TST 7-8 STUDIES|| 80001|95910|26|126.96|0|126.96|0||NVR CNDJ TST 7-8 STUDIES|| 80001|95910|TC|96.53|0|96.53|0||NVR CNDJ TST 7-8 STUDIES|| 80001|95911||266.38|0|266.38|0||NVR CNDJ TST 9-10 STUDIES|| 80001|95911|26|158.22|0|158.22|0||NVR CNDJ TST 9-10 STUDIES|| 80001|95911|TC|108.16|0|108.16|0||NVR CNDJ TST 9-10 STUDIES|| 80001|95912||298.02|0|298.02|0||NVR CNDJ TST 11-12 STUDIES|| 80001|95912|26|187.93|0|187.93|0||NVR CNDJ TST 11-12 STUDIES|| 80001|95912|TC|110.09|0|110.09|0||NVR CNDJ TST 11-12 STUDIES|| 80001|95913||338.45|0|338.45|0||NVR CNDJ TST 13/> STUDIES|| 80001|95913|26|221.77|0|221.77|0||NVR CNDJ TST 13/> STUDIES|| 80001|95913|TC|116.68|0|116.68|0||NVR CNDJ TST 13/> STUDIES|| 80001|95921||99.68|0|99.68|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95921|26|53.93|0|53.93|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95921|TC|45.74|0|45.74|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95922||113.89|0|113.89|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95922|26|57.3|0|57.3|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95922|TC|56.6|0|56.6|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95923||213.26|0|213.26|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95923|26|54.32|0|54.32|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95923|TC|158.94|0|158.94|0||AUTONOMIC NERV FUNCTION TEST|| 80001|95924||175.01|0|175.01|0||ANS PARASYMP & SYMP W/TILT|| 80001|95924|26|104.85|0|104.85|0||ANS PARASYMP & SYMP W/TILT|| 80001|95924|TC|70.17|0|70.17|0||ANS PARASYMP & SYMP W/TILT|| 80001|95925||174.09|0|174.09|0||SOMATOSENSORY TESTING|| 80001|95925|26|33.37|0|33.37|0||SOMATOSENSORY TESTING|| 80001|95925|TC|140.72|0|140.72|0||SOMATOSENSORY TESTING|| 80001|95926||159.75|0|159.75|0||SOMATOSENSORY TESTING|| 80001|95926|26|32.21|0|32.21|0||SOMATOSENSORY TESTING|| 80001|95926|TC|127.54|0|127.54|0||SOMATOSENSORY TESTING|| 80001|95927||169.05|0|169.05|0||SOMATOSENSORY TESTING|| 80001|95927|26|32.59|0|32.59|0||SOMATOSENSORY TESTING|| 80001|95927|TC|136.46|0|136.46|0||SOMATOSENSORY TESTING|| 80001|95928||289.54|0|289.54|0||C MOTOR EVOKED - UPPR LIMBS|| 80001|95928|26|94.54|0|94.54|0||C MOTOR EVOKED - UPPR LIMBS|| 80001|95928|TC|194.99|0|194.99|0||C MOTOR EVOKED - UPPR LIMBS|| 80001|95929||289.14|0|289.14|0||C MOTOR EVOKED - LWR LIMBS|| 80001|95929|26|92.6|0|92.6|0||C MOTOR EVOKED - LWR LIMBS|| 80001|95929|TC|196.54|0|196.54|0||C MOTOR EVOKED - LWR LIMBS|| 80001|95930||141.86|0|141.86|0||VISUAL EVOKED POTENTIAL TEST|| 80001|95930|26|21.68|0|21.68|0||VISUAL EVOKED POTENTIAL TEST|| 80001|95930|TC|120.18|0|120.18|0||VISUAL EVOKED POTENTIAL TEST|| 80001|95933||94.45|0|94.45|0||BLINK REFLEX TEST|| 80001|95933|26|37.08|0|37.08|0||BLINK REFLEX TEST|| 80001|95933|TC|57.37|0|57.37|0||BLINK REFLEX TEST|| 80001|95937||93.55|0|93.55|0||NEUROMUSCULAR JUNCTION TEST|| 80001|95937|26|40.83|0|40.83|0||NEUROMUSCULAR JUNCTION TEST|| 80001|95937|TC|52.72|0|52.72|0||NEUROMUSCULAR JUNCTION TEST|| 80001|95938||376.68|0|376.68|0||SOMATOSENSORY TESTING|| 80001|95938|26|53.76|0|53.76|0||SOMATOSENSORY TESTING|| 80001|95938|TC|322.92|0|322.92|0||SOMATOSENSORY TESTING|| 80001|95939||559.14|0|559.14|0||C MOTOR EVOKED UPR&LWR LIMBS|| 80001|95939|26|143.19|0|143.19|0||C MOTOR EVOKED UPR&LWR LIMBS|| 80001|95939|TC|415.96|0|415.96|0||C MOTOR EVOKED UPR&LWR LIMBS|| 80001|95940||38.68|0|38.68|0||IONM IN OPERATNG ROOM 15 MIN|| 80001|95941||0|0|0|0||IONM REMOTE/>1 PT OR PER HR|| 80001|95943||0|0|0|0||PARASYMP&SYMP HRT RATE TEST|| 80001|95943|26|0|0|0|0||PARASYMP&SYMP HRT RATE TEST|| 80001|95943|TC|0|0|0|0||PARASYMP&SYMP HRT RATE TEST|| 80001|95950||365.56|0|365.56|0||AMBULATORY EEG MONITORING|| 80001|95950|26|94.2|0|94.2|0||AMBULATORY EEG MONITORING|| 80001|95950|TC|271.36|0|271.36|0||AMBULATORY EEG MONITORING|| 80001|95951||0|0|0|0||EEG MONITORING/VIDEORECORD|| 80001|95951|26|385.55|0|385.55|0||EEG MONITORING/VIDEORECORD|| 80001|95951|TC|0|0|0|0||EEG MONITORING/VIDEORECORD|| 80001|95953||470.88|0|470.88|0||EEG MONITORING/COMPUTER|| 80001|95953|26|193.71|0|193.71|0||EEG MONITORING/COMPUTER|| 80001|95953|TC|277.17|0|277.17|0||EEG MONITORING/COMPUTER|| 80001|95954||512.32|0|512.32|0||EEG MONITORING/GIVING DRUGS|| 80001|95954|26|147.92|0|147.92|0||EEG MONITORING/GIVING DRUGS|| 80001|95954|TC|364.4|0|364.4|0||EEG MONITORING/GIVING DRUGS|| 80001|95955||237.78|0|237.78|0||EEG DURING SURGERY|| 80001|95955|26|63.33|0|63.33|0||EEG DURING SURGERY|| 80001|95955|TC|174.44|0|174.44|0||EEG DURING SURGERY|| 80001|95956||1838.53|0|1838.53|0||EEG MONITORING - CABLE/RADIO|| 80001|95956|26|226.26|0|226.26|0||EEG MONITORING - CABLE/RADIO|| 80001|95956|TC|1612.28|0|1612.28|0||EEG MONITORING - CABLE/RADIO|| 80001|95957||354.44|0|354.44|0||EEG DIGITAL ANALYSIS|| 80001|95957|26|124.55|0|124.55|0||EEG DIGITAL ANALYSIS|| 80001|95957|TC|229.88|0|229.88|0||EEG DIGITAL ANALYSIS|| 80001|95958||653.89|0|653.89|0||EEG MONITORING/FUNCTION TEST|| 80001|95958|26|265.06|0|265.06|0||EEG MONITORING/FUNCTION TEST|| 80001|95958|TC|388.82|0|388.82|0||EEG MONITORING/FUNCTION TEST|| 80001|95961||330.07|0|330.07|0||ELECTRODE STIMULATION - BRAIN|| 80001|95961|26|186.25|0|186.25|0||ELECTRODE STIMULATION - BRAIN|| 80001|95961|TC|143.82|0|143.82|0||ELECTRODE STIMULATION - BRAIN|| 80001|95962||294.27|0|294.27|0||ELECTRODE STIM - BRAIN ADD-ON|| 80001|95962|26|198.91|0|198.91|0||ELECTRODE STIM - BRAIN ADD-ON|| 80001|95962|TC|95.36|0|95.36|0||ELECTRODE STIM - BRAIN ADD-ON|| 80001|95965||0|0|0|0||MEG - SPONTANEOUS|| 80001|95965|26|510.6|0|510.21|0||MEG - SPONTANEOUS|| 80001|95965|TC|0|0|0|0||MEG - SPONTANEOUS|| 80001|95966||0|0|0|0||MEG - EVOKED - SINGLE|| 80001|95966|26|257.02|0|257.02|0||MEG - EVOKED - SINGLE|| 80001|95966|TC|0|0|0|0||MEG - EVOKED - SINGLE|| 80001|95967||0|0|0|0||MEG - EVOKED - EACH ADD'L|| 80001|95967|26|224.98|0|224.98|0||MEG - EVOKED - EACH ADD'L|| 80001|95967|TC|0|0|0|0||MEG - EVOKED - EACH ADD'L|| 80001|95970||75.23|0|28.33|0||ANALYZE NEUROSTIM - NO PROG|| 80001|95971||66.21|0|47.99|0||ANALYZE NEUROSTIM - SIMPLE|| 80001|95972||63.97|0|49.24|0||ANALYZE NEUROSTIM - COMPLEX|| 80001|95973||46.33|0|30.83|0||ANALYZE NEUROSTIM - COMPLEX|| 80001|95974||241.46|0|194.16|0||CRANIAL NEUROSTIM - COMPLEX|| 80001|95975||129.93|0|109.78|0||CRANIAL NEUROSTIM - COMPLEX|| 80001|95978||288.61|0|227.36|0||ANALYZE NEUROSTIM BRAIN/1H|| 80001|95979||126.18|0|106.03|0||ANALYZ NEUROSTIM BRAIN ADDON|| 80001|95980||54.3|0|54.3|0||IO ANAL GAST N-STIM INIT|| 80001|95981||36.2|0|20.7|0||IO ANAL GAST N-STIM SUBSQ|| 80001|95982||61|0|43.55|0||IO GA N-STIM SUBSQ W/REPROG|| 80001|95990||98.47|0|98.47|0||SPIN/BRAIN PUMP REFIL & MAIN|| 80001|95991||135.55|0|46.78|0||SPIN/BRAIN PUMP REFIL & MAIN|| 80001|95992||49.79|0|43.98|0||CANALITH REPOSITIONING PROC|| 80001|95999||0|0|0|0||NEUROLOGICAL PROCEDURE|| 80001|96000||112.53|0|112.53|0||MOTION ANALYSIS - VIDEO/3D|| 80001|96001||120.65|0|120.65|0||MOTION TEST W/FT PRESS MEAS|| 80001|96002||25.83|0|25.83|0||DYNAMIC SURFACE EMG|| 80001|96003||22.55|0|22.55|0||DYNAMIC FINE WIRE EMG|| 80001|96004||138.44|0|138.44|0||PHYS REVIEW OF MOTION TESTS|| 80001|96020||0|0|0|0||FUNCTIONAL BRAIN MAPPING|| 80001|96020|26|200.3|0|200.3|0||FUNCTIONAL BRAIN MAPPING|| 80001|96020|TC|0|0|0|0||FUNCTIONAL BRAIN MAPPING|| 80001|96040||51.56|0|51.56|0||GENETIC COUNSELING - 30 MIN|| 80001|96101||94.95|0|94.17|0||PSYCHO TESTING BY PSYCH/PHYS|| 80001|96102||71.57|0|27.38|0||PSYCHO TESTING BY TECHNICIAN|| 80001|96103||32.08|0|31.3|0||PSYCHO TESTING ADMIN BY COMP|| 80001|96105||121.22|0|121.22|0||ASSESSMENT OF APHASIA|| 80001|96110||10.47|0|10.47|0||DEVELOPMENTAL TEST - LIM|| 80001|96111||151.29|0|143.93|0||DEVELOPMENTAL TEST - EXTEND|| 80001|96116||109.69|0|103.1|0||NEUROBEHAVIORAL STATUS EXAM|| 80001|96118||114.33|0|93.78|0||NEUROPSYCH TST BY PSYCH/PHYS|| 80001|96119||90.78|0|28.37|0||NEUROPSYCH TESTING BY TECH|| 80001|96120||54.56|0|30.53|0||NEUROPSYCH TST ADMIN W/COMP|| 80001|96125||135.35|0|135.35|0||COGNITIVE TEST BY HC PRO|| 80001|96127||5.82|0|5.82|0||BRIEF EMOTIONAL/BEHAV ASSMT|| 80001|96150||25.83|0|25.44|0||ASSESS HLTH/BEHAVE - INIT|| 80001|96151||24.58|0|24.19|0||ASSESS HLTH/BEHAVE - SUBSEQ|| 80001|96152||23.33|0|22.94|0||INTERVENE HLTH/BEHAVE - INDIV|| 80001|96153||5.48|0|5.09|0||INTERVENE HLTH/BEHAVE - GROUP|| 80001|96154||22.9|0|22.51|0||INTERV HLTH/BEHAV - FAM W/PT|| 80001|96155||26.73|0|26.73|0||INTERV HLTH/BEHAV FAM NO PT|| 80001|96160||5.6|0|5.6|0||PT-FOCUSED HLTH RISK ASSMT|| 80001|96161||5.6|0|5.6|0||CAREGIVER HEALTH RISK ASSMT|| 80001|96360||63.55|0|63.55|0||HYDRATION IV INFUSION - INIT|| 80001|96361||17.06|0|17.06|0||HYDRATE IV INFUSION - ADD-ON|| 80001|96365||76.9|0|76.9|0||THER/PROPH/DIAG IV INF - INIT|| 80001|96366||21.33|0|21.33|0||THER/PROPH/DIAG IV INF ADDON|| 80001|96367||33.78|0|33.78|0||TX/PROPH/DG ADDL SEQ IV INF|| 80001|96368||23.23|0|23.23|0||THER/DIAG CONCURRENT INF|| 80001|96369||213.35|0|213.35|0||SC THER INFUSION - UP TO 1 HR|| 80001|96370||17.46|0|17.46|0||SC THER INFUSION - ADDL HR|| 80001|96371||98.08|0|98.08|0||SC THER INFUSION - RESET PUMP|| 80001|96372||28.27|0|28.27|0||THER/PROPH/DIAG INJ - SC/IM|| 80001|96373||22.06|0|22.06|0||THER/PROPH/DIAG INJ - IA|| 80001|96374||62.81|0|62.81|0||THER/PROPH/DIAG INJ - IV PUSH|| 80001|96375||24.86|0|24.86|0||TX/PRO/DX INJ NEW DRUG ADDON|| 80001|96376||0|0|0|0||TX/PRO/DX INJ NEW DRUG ADON|| 80001|96379||0|0|0|0||THER/PROP/DIAG INJ/INF PROC|| 80001|96401||82.33|0|82.33|0||CHEMO - ANTI-NEOPL - SQ/IM|| 80001|96402||36.11|0|36.11|0||CHEMO HORMON ANTINEOPL SQ/IM|| 80001|96405||91.43|0|34.83|0||CHEMO INTRALESIONAL - UP TO 7|| 80001|96406||132.97|0|54.27|0||CHEMO INTRALESIONAL OVER 7|| 80001|96409||121.62|0|121.62|0||CHEMO - IV PUSH - SNGL DRUG|| 80001|96411||68.33|0|68.33|0||CHEMO - IV PUSH - ADDL DRUG|| 80001|96413||148.54|0|148.54|0||CHEMO - IV INFUSION - 1 HR|| 80001|96415||31.45|0|31.45|0||CHEMO - IV INFUSION - ADDL HR|| 80001|96416||153.66|0|153.66|0||CHEMO PROLONG INFUSE W/PUMP|| 80001|96417||69.15|0|69.15|0||CHEMO IV INFUS EACH ADDL SEQ|| 80001|96420||113.95|0|113.95|0||CHEMO - IA - PUSH TECNIQUE|| 80001|96422||186.06|0|186.06|0||CHEMO IA INFUSION UP TO 1 HR|| 80001|96423||86.81|0|86.81|0||CHEMO IA INFUSE EACH ADDL HR|| 80001|96425||197.31|0|197.31|0||CHEMOTHERAPY - INFUSION METHOD|| 80001|96440||949.33|0|165.89|0||CHEMOTHERAPY - INTRACAVITARY|| 80001|96446||221.08|0|33.85|0||CHEMOTX ADMN PRTL CAVITY|| 80001|96450||205.55|0|95.46|0||CHEMOTHERAPY - INTO CNS|| 80001|96521||151.34|0|151.34|0||REFILL/MAINT - PORTABLE PUMP|| 80001|96522||124.98|0|124.98|0||REFILL/MAINT PUMP/RESVR SYST|| 80001|96523||27.31|0|27.31|0||IRRIG DRUG DELIVERY DEVICE|| 80001|96542||133.92|0|49.41|0||CHEMOTHERAPY INJECTION|| 80001|96549||0|0|0|0||CHEMOTHERAPY - UNSPECIFIED|| 80001|96567||146.92|0|146.92|0||PHOTODYNAMIC TX - SKIN|| 80001|96570||68.02|0|68.02|0||PHOTODYNAMIC TX - 30 MIN|| 80001|96571||31.48|0|31.48|0||PHOTODYNAMIC TX - ADDL 15 MIN|| 80001|96573||210.87|0|210.87|0||PDT DSTR PRMLG LES PHYS/QHP|| 80001|96574||273.53|0|273.53|0||DBRDMT PRMLG LES W/PDT|| 80001|96900||22.49|0|22.49|0||ULTRAVIOLET LIGHT THERAPY|| 80001|96902||25.44|0|24.66|0||TRICHOGRAM|| 80001|96904||68.62|0|68.62|0||WHOLE BODY PHOTOGRAPHY|| 80001|96910||77.92|0|77.92|0||PHOTOCHEMOTHERAPY WITH UV-B|| 80001|96912||100.02|0|100.02|0||PHOTOCHEMOTHERAPY WITH UV-A|| 80001|96913||140.72|0|140.72|0||PHOTOCHEMOTHERAPY - UV-A OR B|| 80001|96920||174.42|0|78.28|0||LASER TX - SKIN < 250 SQ CM|| 80001|96921||192.91|0|88.63|0||LASER TX - SKIN 250-500 SQ CM|| 80001|96922||268.12|0|143.29|0||LASER TX - SKIN > 500 SQ CM|| 80001|96931||0|0|0|0||RCM CELULR SUBCELULR IMG SKN|| 80001|96932||0|0|0|0||RCM CELULR SUBCELULR IMG SKN|| 80001|96933||0|0|0|0||RCM CELULR SUBCELULR IMG SKN|| 80001|96934||0|0|0|0||RCM CELULR SUBCELULR IMG SKN|| 80001|96935||0|0|0|0||RCM CELULR SUBCELULR IMG SKN|| 80001|96936||0|0|0|0||RCM CELULR SUBCELULR IMG SKN|| 80001|96999||0|0|0|0||DERMATOLOGICAL PROCEDURE|| 80001|97001||87.03|0|87.03|0||PT EVALUATION|| 80001|97002||48.36|0|48.36|0||PT RE-EVALUATION|| 80001|97003||97.89|0|97.89|0||OT EVALUATION|| 80001|97004||59.99|0|59.99|0||OT RE-EVALUATION|| 80001|97005||0|0|0|0||ATHLETIC TRAIN EVAL|| 80001|97006||0|0|0|0||ATHLETIC TRAIN REEVAL|| 80001|97010||6.85|0|6.85|0||HOT OR COLD PACKS THERAPY|| 80001|97012||18.54|0|18.54|0||MECHANICAL TRACTION THERAPY|| 80001|97014||18.23|0|18.23|0||ELECTRIC STIMULATION THERAPY|| 80001|97016||21.72|0|21.72|0||VASOPNEUMATIC DEVICE THERAPY|| 80001|97018||12.28|0|12.28|0||PARAFFIN BATH THERAPY|| 80001|97022||26.33|0|26.33|0||WHIRLPOOL THERAPY|| 80001|97024||7.24|0|7.24|0||DIATHERMY EG - MICROWAVE|| 80001|97026||6.85|0|6.85|0||INFRARED THERAPY|| 80001|97028||8.49|0|8.49|0||ULTRAVIOLET THERAPY|| 80001|97032||22.02|0|22.02|0||ELECTRICAL STIMULATION|| 80001|97033||36.8|0|36.8|0||ELECTRIC CURRENT THERAPY|| 80001|97034||20.69|0|20.69|0||CONTRAST BATH THERAPY|| 80001|97035||14.87|0|14.87|0||ULTRASOUND THERAPY|| 80001|97036||37.66|0|37.66|0||HYDROTHERAPY|| 80001|97039||0|0|0|0||PHYSICAL THERAPY TREATMENT|| 80001|97110||37.24|0|37.24|0||THERAPEUTIC EXERCISES|| 80001|97112||38.4|0|38.4|0||NEUROMUSCULAR REEDUCATION|| 80001|97113||48.82|0|48.82|0||AQUATIC THERAPY/EXERCISES|| 80001|97116||32.76|0|32.76|0||GAIT TRAINING THERAPY|| 80001|97124||30.6|0|30.6|0||MASSAGE THERAPY|| 80001|97139||0|0|0|0||PHYSICAL MEDICINE PROCEDURE|| 80001|97140||34.44|0|34.44|0||MANUAL THERAPY|| 80001|97150||20.26|0|20.26|0||GROUP THERAPEUTIC PROCEDURES|| 80001|97161||98.19|0|98.19|0||PT EVAL LOW COMPLEX 20 MIN|| 80001|97162||98.19|0|98.19|0||PT EVAL MOD COMPLEX 30 MIN|| 80001|97163||98.19|0|98.19|0||PT EVAL HIGH COMPLEX 45 MIN|| 80001|97164||66.75|0|66.75|0||PT RE-EVAL EST PLAN CARE|| 80001|97165||95.18|0|95.18|0||OT EVAL LOW COMPLEX 30 MIN|| 80001|97166||95.18|0|95.18|0||OT EVAL MOD COMPLEX 45 MIN|| 80001|97167||95.18|0|95.18|0||OT EVAL HIGH COMPLEX 60 MIN|| 80001|97168||62.88|0|62.88|0||OT RE-EVAL EST PLAN CARE|| 80001|97530||39.91|0|39.91|0||THERAPEUTIC ACTIVITIES|| 80001|97532||30.99|0|30.99|0||COGNITIVE SKILLS DEVELOPMENT|| 80001|97533||33.71|0|33.71|0||SENSORY INTEGRATION|| 80001|97535||39.95|0|39.95|0||SELF CARE MNGMENT TRAINING|| 80001|97537||34.91|0|34.91|0||COMMUNITY/WORK REINTEGRATION|| 80001|97542||35.3|0|35.3|0||WHEELCHAIR MNGMENT TRAINING|| 80001|97545||0|0|0|0||WORK HARDENING|| 80001|97546||0|0|0|0||WORK HARDENING ADD-ON|| 80001|97597||85.57|0|28.59|0||ACTIVE WOUND CARE/20 CM OR <|| 80001|97598||28.57|0|13.84|0||ACTIVE WOUND CARE > 20 CM|| 80001|97602||0|0|0|0||WOUND(S) CARE NON-SELECTIVE|| 80001|97605||50.1|0|32.65|0||NEG PRESS WOUND TX - < 50 CM|| 80001|97606||59.23|0|35.97|0||NEG PRESS WOUND TX - > 50 CM|| 80001|97607||0|0|0|0||NEG PRESS WND TX 50 CM|| 80001|97610||134.5|0|21.31|0||LOW FREQUENCY NON-THERMAL US|| 80001|97750||38.02|0|38.02|0||PHYSICAL PERFORMANCE TEST|| 80001|97755||41.86|0|41.86|0||ASSISTIVE TECHNOLOGY ASSESS|| 80001|97760||43.44|0|43.44|0||ORTHOTIC MGMT AND TRAINING|| 80001|97761||38.02|0|38.02|0||PROSTHETIC TRAINING|| 80001|97762||53.42|0|53.42|0||C/O FOR ORTHOTIC/PROSTH USE|| 80001|97763||55.45|0|55.45|0||ORTHC/PROSTC MGMT SBSQ ENC|| 80001|97799||0|0|0|0||PHYSICAL MEDICINE PROCEDURE|| 80001|97802||40.3|0|37.98|0||MEDICAL NUTRITION - INDIV - IN|| 80001|97803||34.52|0|31.81|0||MED NUTRITION - INDIV - SUBSEQ|| 80001|97804||18.54|0|17.76|0||MEDICAL NUTRITION - GROUP|| 80001|97810||42.55|0|36.35|0||ACUPUNCT W/O STIMUL 15 MIN|| 80001|97811||32.03|0|30.09|0||ACUPUNCT W/O STIMUL ADDL 15M|| 80001|97813||45.48|0|39.28|0||ACUPUNCT W/STIMUL 15 MIN|| 80001|97814||36.13|0|33.03|0||ACUPUNCT W/STIMUL ADDL 15M|| 80001|98925||36.12|0|27.98|0||OSTEOPATHIC MANIPULATION|| 80001|98926||52.72|0|42.25|0||OSTEOPATHIC MANIPULATION|| 80001|98927||68.93|0|56.13|0||OSTEOPATHIC MANIPULATION|| 80001|98928||84.75|0|70.79|0||OSTEOPATHIC MANIPULATION|| 80001|98929||101.35|0|85.06|0||OSTEOPATHIC MANIPULATION|| 80001|98940||32.63|0|26.43|0||CHIROPRACTIC MANIPULATION|| 80001|98941||47.68|0|41.09|0||CHIROPRACTIC MANIPULATION|| 80001|98942||62.33|0|55.36|0||CHIROPRACTIC MANIPULATION|| 80001|98943||31.86|0|27.98|0||CHIROPRACTIC MANIPULATION|| 80001|98960||30.63|0|30.63|0||SELF-MGMT EDUC & TRAIN - 1 PT|| 80001|98961||14.73|0|14.73|0||SELF-MGMT EDUC/TRAIN - 2-4 PT|| 80001|98962||10.86|0|10.86|0||SELF-MGMT EDUC/TRAIN - 5-8 PT|| 80001|98966||16.6|0|15.44|0||HC PRO PHONE CALL 5-10 MIN|| 80001|98967||31.65|0|30.09|0||HC PRO PHONE CALL 11-20 MIN|| 80001|98968||47.08|0|45.53|0||HC PRO PHONE CALL 21-30 MIN|| 80001|98969||0|0|0|0||ONLINE SERVICE BY HC PRO|| 80001|99000||0|0|0|0||SPECIMEN HANDLING|| 80001|99001||0|0|0|0||SPECIMEN HANDLING|| 80001|99002||0|0|0|0||DEVICE HANDLING|| 80001|99024||0|0|0|0||POSTOP FOLLOW-UP VISIT|| 80001|99026||0|0|0|0||IN-HOSPITAL ON CALL SERVICE|| 80001|99027||0|0|0|0||OUT-OF-HOSP ON CALL SERVICE|| 80001|99050||0|0|0|0||MEDICAL SERVICES AFTER HRS|| 80001|99051||65|0|0||%|MED SERV - EVE/WKEND/HOLIDAY|| 80001|99053||0|0|0|0||MED SERV 10PM-8AM - 24 HR FAC|| 80001|99056||0|0|0|0||MED SERVICE OUT OF OFFICE|| 80001|99058||0|0|0|0||OFFICE EMERGENCY CARE|| 80001|99060||0|0|0|0||OUT OF OFFICE EMERG MED SERV|| 80001|99070||0|0|0|0||SPECIAL SUPPLIES|| 80001|99071||0|0|0|0||PATIENT EDUCATION MATERIALS|| 80001|99075||0|0|0|0||MEDICAL TESTIMONY|| 80001|99078||0|0|0|0||GROUP HEALTH EDUCATION|| 80001|99080||0|0|0|0||SPECIAL REPORTS OR FORMS|| 80001|99082||0|0|0|0||UNUSUAL PHYSICIAN TRAVEL|| 80001|99090||0|0|0|0||COMPUTER DATA ANALYSIS|| 80001|99091||66.44|0|66.44|0||COLLECT/REVIEW DATA FROM PT|| 80001|99100||0|0|0|0||SPECIAL ANESTHESIA SERVICE|| 80001|99116||0|0|0|0||ANESTHESIA WITH HYPOTHERMIA|| 80001|99135||0|0|0|0||SPECIAL ANESTHESIA PROCEDURE|| 80001|99140||0|0|0|0||EMERGENCY ANESTHESIA|| 80001|99143||0|0|0|0||MOD CS BY SAME PHYS - < 5 YRS|| 80001|99144||0|0|0|0||MOD CS BY SAME PHYS - 5 YRS +|| 80001|99145||0|0|0|0||MOD CS BY SAME PHYS ADD-ON|| 80001|99148||0|0|0|0||MOD CS DIFF PHYS < 5 YRS|| 80001|99149||0|0|0|0||MOD CS DIFF PHYS 5 YRS +|| 80001|99150||0|0|0|0||MOD CS DIFF PHYS ADD-ON|| 80001|99151||93.88|0|28.85|0||MODERATE SEDATION SERVICES|| 80001|99152||62.45|0|15.07|0||MODERATE SEDATION SERVICES|| 80001|99153||13.35|0|13.35|0||MOD SED SAME PHYS/QHP EA|| 80001|99155||113.26|0|113.26|0||MOD SED OTH PHYS/QHP <5 YRS|| 80001|99156||92.59|0|92.59|0||MOD SED OTH PHYS/QHP 5/>YRS|| 80001|99157||70.2|0|70.2|0||MOD SED OTHER PHYS/QHP EA|| 80001|99170||182.47|0|96.42|0||ANOGENITAL EXAM - CHILD|| 80001|99172||0|0|0|0||OCULAR FUNCTION SCREEN|| 80001|99173||3.49|0|3.49|0||VISUAL ACUITY SCREEN|| 80001|99174||0|0|0|0||OCULAR PHOTOSCREENING|| 80001|99175||18.61|0|18.61|0||INDUCTION OF VOMITING|| 80001|99177||0|0|0|0||OCULAR INSTRUMNT SCREEN BIL|| 80001|99183||131.36|0|131.36|0||HYPERBARIC OXYGEN THERAPY|| 80001|99184||276.31|0|276.31|0||HYPOTHERMIA ILL NEONATE|| 80001|99188||0|0|0|0||APP TOPICAL FLUORIDE VARNISH|| 80001|99190||0|0|0|0||SPECIAL PUMP SERVICES|| 80001|99191||0|0|0|0||SPECIAL PUMP SERVICES|| 80001|99192||0|0|0|0||SPECIAL PUMP SERVICES|| 80001|99195||109.72|0|109.72|0||PHLEBOTOMY|| 80001|99199||0|0|0|0||SPECIAL SERVICE/PROC/REPORT|| 80001|99201||49.78|0|31.17|0||OFFICE/OUTPATIENT VISIT - NEW|| 80001|99202||85.47|0|58.72|0||OFFICE/OUTPATIENT VISIT - NEW|| 80001|99203||124.45|0|90.34|0||OFFICE/OUTPATIENT VISIT - NEW|| 80001|99204||190.5|0|152.9|0||OFFICE/OUTPATIENT VISIT - NEW|| 80001|99205||239.87|0|198.78|0||OFFICE/OUTPATIENT VISIT - NEW|| 80001|99211||22.49|0|10.86|0||OFFICE/OUTPATIENT VISIT - EST|| 80001|99212||49.78|0|30.01|0||OFFICE/OUTPATIENT VISIT - EST|| 80001|99213||83.32|0|59.67|0||OFFICE/OUTPATIENT VISIT - EST|| 80001|99214||124.01|0|92.23|0||OFFICE/OUTPATIENT VISIT - EST|| 80001|99215||167.77|0|130.95|0||OFFICE/OUTPATIENT VISIT - EST|| 80001|99217||85.06|0|85.06|0||OBSERVATION CARE DISCHARGE|| 80001|99218||118.1|0|118.1|0||OBSERVATION CARE|| 80001|99219||159.83|0|159.83|0||OBSERVATION CARE|| 80001|99220||219.08|0|219.08|0||OBSERVATION CARE|| 80001|99221||119.66|0|119.66|0||INITIAL HOSPITAL CARE|| 80001|99222||161.43|0|161.43|0||INITIAL HOSPITAL CARE|| 80001|99223||239|0|239|0||INITIAL HOSPITAL CARE|| 80001|99224||46.35|0|46.35|0||SUBSEQUENT OBSERVATION CARE|| 80001|99225||85.54|0|85.54|0||SUBSEQUENT OBSERVATION CARE|| 80001|99226||123.87|0|123.87|0||SUBSEQUENT OBSERVATION CARE|| 80001|99231||45.96|0|45.96|0||SUBSEQUENT HOSPITAL CARE|| 80001|99232||85.15|0|85.15|0||SUBSEQUENT HOSPITAL CARE|| 80001|99233||122.71|0|122.71|0||SUBSEQUENT HOSPITAL CARE|| 80001|99234||157.73|0|157.73|0||OBSERV/HOSP SAME DATE|| 80001|99235||199.07|0|199.07|0||OBSERV/HOSP SAME DATE|| 80001|99236||256.76|0|256.76|0||OBSERV/HOSP SAME DATE|| 80001|99238||85.45|0|85.45|0||HOSPITAL DISCHARGE DAY|| 80001|99239||125.76|0|125.76|0||HOSPITAL DISCHARGE DAY|| 80001|99241||55.91|0|39.63|0||OFFICE CONSULTATION|| 80001|99242||105.49|0|82.62|0||OFFICE CONSULTATION|| 80001|99243||144.29|0|115.22|0||OFFICE CONSULTATION|| 80001|99244||214.39|0|182.6|0||OFFICE CONSULTATION|| 80001|99245||262.64|0|226.97|0||OFFICE CONSULTATION|| 80001|99251||58.25|0|58.25|0||INITIAL INPATIENT CONSULT|| 80001|99252||89.13|0|89.13|0||INITIAL INPATIENT CONSULT|| 80001|99253||135.9|0|135.9|0||INITIAL INPATIENT CONSULT|| 80001|99254||196.17|0|196.17|0||INITIAL INPATIENT CONSULT|| 80001|99255||237.27|0|237.27|0||INITIAL INPATIENT CONSULT|| 80001|99281||24.84|0|24.84|0||EMERGENCY DEPT VISIT|| 80001|99282||48.82|0|48.82|0||EMERGENCY DEPT VISIT|| 80001|99283||73.7|0|73.7|0||EMERGENCY DEPT VISIT|| 80001|99284||140.29|0|140.29|0||EMERGENCY DEPT VISIT|| 80001|99285||207.74|0|207.74|0||EMERGENCY DEPT VISIT|| 80001|99288||0|0|0|0||DIRECT ADVANCED LIFE SUPPORT|| 80001|99291||320.89|0|265.07|0||CRITICAL CARE - FIRST HOUR|| 80001|99292||143.97|0|132.34|0||CRITICAL CARE - ADD'L 30 MIN|| 80001|99304||107.18|0|107.18|0||NURSING FACILITY CARE - INIT|| 80001|99305||152.92|0|152.92|0||NURSING FACILITY CARE - INIT|| 80001|99306||195.18|0|195.18|0||NURSING FACILITY CARE - INIT|| 80001|99307||51.77|0|51.77|0||NURSING FAC CARE - SUBSEQ|| 80001|99308||79.88|0|79.88|0||NURSING FAC CARE - SUBSEQ|| 80001|99309||106.01|0|106.01|0||NURSING FAC CARE - SUBSEQ|| 80001|99310||157.96|0|157.96|0||NURSING FAC CARE - SUBSEQ|| 80001|99315||85.06|0|85.06|0||NURSING FAC DISCHARGE DAY|| 80001|99316||123.04|0|123.04|0||NURSING FAC DISCHARGE DAY|| 80001|99318||112.13|0|112.13|0||ANNUAL NURSING FAC ASSESSMNT|| 80001|99324||64.5|0|64.5|0||DOMICIL/R-HOME VISIT NEW PAT|| 80001|99325||94.25|0|94.25|0||DOMICIL/R-HOME VISIT NEW PAT|| 80001|99326||163.06|0|163.06|0||DOMICIL/R-HOME VISIT NEW PAT|| 80001|99327||217.47|0|217.47|0||DOMICIL/R-HOME VISIT NEW PAT|| 80001|99328||254.72|0|254.72|0||DOMICIL/R-HOME VISIT NEW PAT|| 80001|99334||70.19|0|70.19|0||DOMICIL/R-HOME VISIT EST PAT|| 80001|99335||111.02|0|111.02|0||DOMICIL/R-HOME VISIT EST PAT|| 80001|99336||157.28|0|157.28|0||DOMICIL/R-HOME VISIT EST PAT|| 80001|99337||225.36|0|225.36|0||DOMICIL/R-HOME VISIT EST PAT|| 80001|99339||90.75|0|90.75|0||DOMICIL/R-HOME CARE SUPERVIS|| 80001|99340||126.87|0|126.87|0||DOMICIL/R-HOME CARE SUPERVIS|| 80001|99341||64.11|0|64.11|0||HOME VISIT - NEW PATIENT|| 80001|99342||93.48|0|93.48|0||HOME VISIT - NEW PATIENT|| 80001|99343||152.55|0|152.55|0||HOME VISIT - NEW PATIENT|| 80001|99344||213.24|0|213.24|0||HOME VISIT - NEW PATIENT|| 80001|99345||258.21|0|258.21|0||HOME VISIT - NEW PATIENT|| 80001|99347||64.84|0|64.84|0||HOME VISIT - EST PATIENT|| 80001|99348||98.3|0|98.3|0||HOME VISIT - EST PATIENT|| 80001|99349||149.73|0|149.73|0||HOME VISIT - EST PATIENT|| 80001|99350||207.38|0|207.38|0||HOME VISIT - EST PATIENT|| 80001|99354||116.66|0|108.91|0||PROLONGED SERVICE - OFFICE|| 80001|99355||113.56|0|105.42|0||PROLONGED SERVICE - OFFICE|| 80001|99356||107.87|0|107.87|0||PROLONGED SERVICE - INPATIENT|| 80001|99357||106.71|0|106.71|0||PROLONGED SERVICE - INPATIENT|| 80001|99358||128.96|0|128.96|0||PROLONGED SERV - W/O CONTACT|| 80001|99359||61.74|0|61.74|0||PROLONGED SERV - W/O CONTACT|| 80001|99360||0|0|0|0||PHYSICIAN STANDBY SERVICES|| 80001|99363||146.76|0|99.86|0||ANTICOAG MGMT - INIT|| 80001|99364||50.05|0|38.03|0||ANTICOAG MGMT - SUBSEQ|| 80001|99366||50.49|0|49.32|0||TEAM CONF W/PAT BY HC PRO|| 80001|99367||66.44|0|66.44|0||TEAM CONF W/O PAT BY PHYS|| 80001|99368||43.46|0|43.46|0||TEAM CONF W/O PAT BY HC PRO|| 80001|99374||81.17|0|66.44|0||HOME HEALTH CARE SUPERVISION|| 80001|99375||122.69|0|104.86|0||HOME HEALTH CARE SUPERVISION|| 80001|99377||81.17|0|66.44|0||HOSPICE CARE SUPERVISION|| 80001|99378||122.69|0|104.86|0||HOSPICE CARE SUPERVISION|| 80001|99379||81.17|0|66.44|0||NURSING FAC CARE SUPERVISION|| 80001|99380||122.69|0|104.86|0||NURSING FAC CARE SUPERVISION|| 80001|99381||127.5|0|90.67|0||PREV VISIT - NEW - INFANT|| 80001|99382||133.37|0|96.93|0||PREV VISIT - NEW - AGE 1-4|| 80001|99383||138.84|0|102.79|0||PREV VISIT - NEW - AGE 5-11|| 80001|99384||157.6|0|121.55|0||PREV VISIT - NEW - AGE 12-17|| 80001|99385||152.99|0|116.55|0||PREV VISIT - NEW - AGE 18-39|| 80001|99386||177.26|0|141.21|0||PREV VISIT - NEW - AGE 40-64|| 80001|99387||191.96|0|151.64|0||PREV VISIT - NEW - 65 & OVER|| 80001|99391||114.53|0|82.74|0||PREV VISIT - EST - INFANT|| 80001|99392||122.46|0|90.67|0||PREV VISIT - EST - AGE 1-4|| 80001|99393||122.07|0|90.67|0||PREV VISIT - EST - AGE 5-11|| 80001|99394||134.19|0|102.79|0||PREV VISIT - EST - AGE 12-17|| 80001|99395||137.51|0|106.11|0||PREV VISIT - EST - AGE 18-39|| 80001|99396||147.08|0|115.68|0||PREV VISIT - EST - AGE 40-64|| 80001|99397||157.99|0|121.55|0||PREV VISIT - EST - 65 & OVER|| 80001|99401||41.64|0|28.84|0||PREVENTIVE COUNSELING - INDIV|| 80001|99402||71.73|0|58.94|0||PREVENTIVE COUNSELING - INDIV|| 80001|99403||100.97|0|88.56|0||PREVENTIVE COUNSELING - INDIV|| 80001|99404||131.02|0|118.62|0||PREVENTIVE COUNSELING - INDIV|| 80001|99406||16.56|0|14.62|0||BEHAV CHNG SMOKING 3-10 MIN|| 80001|99407||32.03|0|30.09|0||BEHAV CHNG SMOKING < 10 MIN|| 80001|99408||41.22|0|39.28|0||AUDIT/DAST - 15-30 MIN|| 80001|99409||80.89|0|78.95|0||AUDIT/DAST - OVER 30 MIN|| 80001|99411||18.49|0|9.18|0||PREVENTIVE COUNSELING - GROUP|| 80001|99412||24.74|0|15.44|0||PREVENTIVE COUNSELING - GROUP|| 80001|99415||9.66|0|9.66|0||PROLONG CLINCL STAFF SVC|| 80001|99416||5.41|0|5.41|0||PROLONG CLINCL STAFF SVC ADD|| 80001|99420||12.02|0|12.02|0||HEALTH RISK ASSESSMENT TEST|| 80001|99429||0|0|0|0||UNLISTED PREVENTIVE SERVICE|| 80001|99441||16.6|0|15.44|0||PHONE E/M BY PHYS 5-10 MIN|| 80001|99442||31.65|0|30.09|0||PHONE E/M BY PHYS 11-20 MIN|| 80001|99443||47.08|0|45.53|0||PHONE E/M BY PHYS 21-30 MIN|| 80001|99444||0|0|0|0||ONLINE E/M BY PHYS|| 80001|99446||0|0|0|0||INTERPROF PHONE/ONLINE 5-10|| 80001|99447||0|0|0|0||INTERPROF PHONE/ONLINE 11-20|| 80001|99448||0|0|0|0||INTERPROF PHONE/ONLINE 21-30|| 80001|99449||0|0|0|0||INTERPROF PHONE/ONLINE 31/>|| 80001|99450||0|0|0|0||LIFE/DISABILITY EVALUATION|| 80001|99455||0|0|0|0||DISABILITY EXAMINATION|| 80001|99456||0|0|0|0||DISABILITY EXAMINATION|| 80001|99460||116.93|0|116.93|0||INIT NB EM PER DAY - HOSP|| 80001|99461||103.58|0|74.12|0||INIT NB EM PER DAY - NON-FAC|| 80001|99462||49.02|0|49.02|0||SBSQ NB EM PER DAY - HOSP|| 80001|99463||140.33|0|140.33|0||SAME DAY NB DISCHARGE|| 80001|99464||87.96|0|87.96|0||ATTENDANCE AT DELIVERY|| 80001|99465||177.55|0|177.55|0||NB RESUSCITATION|| 80001|99466||290.35|0|290.35|0||PED CRIT CARE TRANSPORT|| 80001|99467||145.78|0|145.78|0||PED CRIT CARE TRANSPORT ADDL|| 80001|99468||1083.49|0|1083.49|0||NEONATE CRIT CARE - INITIAL|| 80001|99469||469.46|0|469.46|0||NEONATE CRIT CARE - SUBSQ|| 80001|99471||1023.54|0|1023.54|0||PED CRITICAL CARE - INITIAL|| 80001|99472||481.11|0|481.11|0||PED CRITICAL CARE - SUBSQ|| 80001|99475||679.1|0|679.1|0||PED CRIT CARE AGE 2-5 - INIT|| 80001|99476||409.01|0|409.01|0||PED CRIT CARE AGE 2-5 - SUBSQ|| 80001|99477||424.83|0|424.83|0||INIT DAY HOSP NEONATE CARE|| 80001|99478||166.69|0|166.69|0||IC - LBW INF < 1500 GM SUBSQ|| 80001|99479||146.99|0|146.99|0||IC LBW INF 1500-2500 G SUBSQ|| 80001|99480||141.12|0|141.12|0||IC INF PBW 2501-5000 G SUBSQ|| 80001|99483||277.49|0|209.53|0||ASSMT & CARE PLN PT COG IMP|| 80001|99484||55.39|0|38.3|0||CARE MGMT SVC BHVL HLTH COND|| 80001|99485||90.67|0|90.67|0||SUPRV INTERFACILTY TRANSPORT|| 80001|99486||78.95|0|78.95|0||SUPRV INTERFAC TRNSPORT ADDL|| 80001|99487||0|0|0|0||CMPLX CHRON CARE W/O PT VSIT|| 80001|99489||0|0|0|0||COMPLX CHRON CARE ADDL30 MIN|| 80001|99490||49.19|0|38.33|0||CHRON CARE MGMT SRVC 20 MIN|| 80001|99492||182.23|0|105.72|0||1ST PSYC COLLAB CARE MGMT|| 80001|99493||146.46|0|95.59|0||SBSQ PSYC COLLAB CARE MGMT|| 80001|99494||75.8|0|50.95|0||1ST/SBSQ PSYC COLLAB CARE|| 80001|99495||188.7|0|130.55|0||TRANS CARE MGMT 14 DAY DISCH|| 80001|99496||265.3|0|188.15|0||TRANS CARE MGMT 7 DAY DISCH|| 80001|99497||96.31|0|90.89|||ADVNCD CARE PLAN 30 MIN|| 80001|99497|25|96.31|0|90.89|||ADVNCD CARE PLAN 30 MIN|| 80001|99498||0|0|0|0||ADVNCD CARE PLAN ADDL 30 MIN|| 80001|99499||0|0|0|0||UNLISTED E&M SERVICE|| 80001|99500||0|0|0|0||HOME VISIT - PRENATAL|| 80001|99501||0|0|0|0||HOME VISIT - POSTNATAL|| 80001|99502||0|0|0|0||HOME VISIT - NB CARE|| 80001|99503||0|0|0|0||HOME VISIT - RESP THERAPY|| 80001|99504||0|0|0|0||HOME VISIT MECH VENTILATOR|| 80001|99505||0|0|0|0||HOME VISIT - STOMA CARE|| 80001|99506||0|0|0|0||HOME VISIT - IM INJECTION|| 80001|99507||0|0|0|0||HOME VISIT - CATH MAINTAIN|| 80001|99509||0|0|0|0||HOME VISIT DAY LIFE ACTIVITY|| 80001|99510||0|0|0|0||HOME VISIT - SING/M/FAM COUNS|| 80001|99511||0|0|0|0||HOME VISIT - FECAL/ENEMA MGMT|| 80001|99512||0|0|0|0||HOME VISIT FOR HEMODIALYSIS|| 80001|99600||0|0|0|0||HOME VISIT NOS|| 80001|99601||0|0|0|0||HOME INFUSION/VISIT - 2 HRS|| 80001|99602||0|0|0|0||HOME INFUSION - EACH ADDTL HR|| 80001|99605||0|0|0|0||MTMS BY PHARM - NP - 15 MIN|| 80001|99606||0|0|0|0||MTMS BY PHARM - EST - 15 MIN|| 80001|99607||0|0|0|0||MTMS BY PHARM - ADDL 15 MIN|| 80001|A4216||0.59|0|0.59|0||STERILE WATER/SALINE - 10 ML|| 80001|A4217||4.18|0|4.18|0||STERILE WATER/SALINE - 500 ML|| 80001|A4221||30.16|0|30.16|0||MAINT DRUG INFUS CATH PER WK|| 80001|A4222||62.26|0|62.26|0||INFUSION SUPPLIES WITH PUMP|| 80001|A4233|NU|0.92|0|0.92|0||ALKALIN BATT FOR GLUCOSE MON|| 80001|A4234|NU|4.18|0|4.18|0||J-CELL BATT FOR GLUCOSE MON|| 80001|A4235|NU|2.69|0|2.69|0||LITHIUM BATT FOR GLUCOSE MON|| 80001|A4236|NU|1.93|0|1.93|0||SILVR OXIDE BATT GLUCOSE MON|| 80001|A4253|NU|40.75|0|40.75|0||BLOOD GLUCOSE/REAGENT STRIPS|| 80001|A4255||5.39|0|5.39|0||GLUCOSE MONITOR PLATFORMS|| 80001|A4256||4.8|0|4.8|0||CALIBRATOR SOLUTION/CHIPS|| 80001|A4256|KL|11.16|0|11.16|0||CALIBRATOR SOLUTION/CHIPS|| 80001|A4257||16.99|0|16.99|0||REPLACE LENSSHIELD CARTRIDGE|| 80001|A4258||3.02|0|3.02|0||LANCET DEVICE EACH|| 80001|A4258|KL|20.72|0|20.72|0||LANCET DEVICE EACH|| 80001|A4259||1.98|0|1.98|0||LANCETS PER BOX|| 80001|A4259|KL|13.84|0|13.84|0||LANCETS PER BOX|| 80001|A4265||4.54|0|4.54|0||PARAFFIN|| 80001|A4280||7.1|0|7.1|0||BRST PRSTHS ADHSV ATTCHMNT|| 80001|A4310||9.24|0|9.24|0||INSERT TRAY W/O BAG/CATH|| 80001|A4311||19.75|0|19.75|0||CATHETER W/O BAG 2-WAY LATEX|| 80001|A4312||20.42|0|20.42|0||CATH W/O BAG 2-WAY SILICONE|| 80001|A4313||20.98|0|20.98|0||CATHETER W/BAG 3-WAY|| 80001|A4314||31.08|0|31.08|0||CATH W/DRAINAGE 2-WAY LATEX|| 80001|A4315||29.88|0|29.88|0||CATH W/DRAINAGE 2-WAY SILCNE|| 80001|A4316||37.82|0|37.82|0||CATH W/DRAINAGE 3-WAY|| 80001|A4320||6.29|0|6.29|0||IRRIGATION TRAY|| 80001|A4321||0|0|0|0||CATH THERAPEUTIC IRRIG AGENT|| 80001|A4322||3.95|0|3.95|0||IRRIGATION SYRINGE|| 80001|A4326||14.38|0|14.38|0||MALE EXTERNAL CATHETER|| 80001|A4327||59.41|0|59.41|0||FEM URINARY COLLECT DEV CUP|| 80001|A4328||13.63|0|13.63|0||FEM URINARY COLLECT POUCH|| 80001|A4330||9.53|0|9.53|0||STOOL COLLECTION POUCH|| 80001|A4331||4.24|0|4.24|0||EXTENSION DRAINAGE TUBING|| 80001|A4332||0.16|0|0.16|0||LUBE STERILE PACKET|| 80001|A4333||2.94|0|2.94|0||URINARY CATH ANCHOR DEVICE|| 80001|A4334||6.55|0|6.55|0||URINARY CATH LEG STRAP|| 80001|A4336||1.92|0|1.92|0||URETHRAL INSERT|| 80001|A4338||13.88|0|13.88|0||INDWELLING CATHETER LATEX|| 80001|A4340||36.11|0|36.11|0||INDWELLING CATHETER SPECIAL|| 80001|A4344||18.12|0|18.12|0||CATH INDW FOLEY 2 WAY SILICN|| 80001|A4346||22.18|0|22.18|0||CATH INDW FOLEY 3 WAY|| 80001|A4349||2.69|0|2.69|0||DISPOSABLE MALE EXTERNAL CAT|| 80001|A4351||2.41|0|2.41|0||STRAIGHT TIP URINE CATHETER|| 80001|A4352||8.4|0|8.4|0||COUDE TIP URINARY CATHETER|| 80001|A4353||9.32|0|9.32|0||INTERMITTENT URINARY CATH|| 80001|A4354||13.37|0|13.37|0||CATH INSERTION TRAY W/BAG|| 80001|A4355||10.82|0|10.82|0||BLADDER IRRIGATION TUBING|| 80001|A4356||60.77|0|60.77|0||EXT URETH CLMP OR COMPR DVC|| 80001|A4357||10.98|0|10.98|0||BEDSIDE DRAINAGE BAG|| 80001|A4358||8.64|0|8.64|0||URINARY LEG OR ABDOMEN BAG|| 80001|A4360||0.65|0|0.65|0||ADULT INCONTINENCE GARMENT - E|| 80001|A4361||21.48|0|21.48|0||OSTOMY FACE PLATE|| 80001|A4362||3.92|0|3.92|0||SOLID SKIN BARRIER|| 80001|A4363||2.69|0|2.69|0||OSTOMY CLAMP - REPLACEMENT|| 80001|A4364||3.32|0|3.32|0||ADHESIVE - LIQUID OR EQUAL|| 80001|A4366||1.73|0|1.73|0||OSTOMY VENT|| 80001|A4367||8.98|0|8.98|0||OSTOMY BELT|| 80001|A4368||0.34|0|0.34|0||OSTOMY FILTER|| 80001|A4369||3.23|0|3.23|0||SKIN BARRIER LIQUID PER OZ|| 80001|A4371||4.86|0|4.86|0||SKIN BARRIER POWDER PER OZ|| 80001|A4372||5.59|0|5.59|0||SKIN BARRIER SOLID 4X4 EQUIV|| 80001|A4373||8.35|0|8.35|0||SKIN BARRIER WITH FLANGE|| 80001|A4375||22.88|0|22.88|0||DRAINABLE PLASTIC PCH W FCPL|| 80001|A4376||63.38|0|63.38|0||DRAINABLE RUBBER PCH W FCPLT|| 80001|A4377||5.72|0|5.72|0||DRAINABLE PLSTIC PCH W/O FP|| 80001|A4378||40.94|0|40.94|0||DRAINABLE RUBBER PCH W/O FP|| 80001|A4379||20|0|20|0||URINARY PLASTIC POUCH W FCPL|| 80001|A4380||49.72|0|49.72|0||URINARY RUBBER POUCH W FCPLT|| 80001|A4381||6.16|0|6.16|0||URINARY PLASTIC POUCH W/O FP|| 80001|A4382||32.78|0|32.78|0||URINARY HVY PLSTC PCH W/O FP|| 80001|A4383||37.55|0|37.55|0||URINARY RUBBER POUCH W/O FP|| 80001|A4384||12.8|0|12.8|0||OSTOMY FACEPLT/SILICONE RING|| 80001|A4385||6.79|0|6.79|0||OST SKN BARRIER SLD EXT WEAR|| 80001|A4387||2.99|0|2.99|0||OST CLSD POUCH W ATT ST BARR|| 80001|A4388||5.82|0|5.82|0||DRAINABLE PCH W EX WEAR BARR|| 80001|A4389||8.28|0|8.28|0||DRAINABLE PCH W ST WEAR BARR|| 80001|A4390||12.79|0|12.79|0||DRAINABLE PCH EX WEAR CONVEX|| 80001|A4391||9.42|0|9.42|0||URINARY POUCH W EX WEAR BARR|| 80001|A4392||10.9|0|10.9|0||URINARY POUCH W ST WEAR BARR|| 80001|A4393||12.05|0|12.05|0||URINE PCH W EX WEAR BAR CONV|| 80001|A4394||3.44|0|3.44|0||OSTOMY POUCH LIQ DEODORANT|| 80001|A4395||0.06|0|0.06|0||OSTOMY POUCH SOLID DEODORANT|| 80001|A4396||53.92|0|53.92|0||PERISTOMAL HERNIA SUPPRT BLT|| 80001|A4397||5.88|0|5.88|0||IRRIGATION SUPPLY SLEEVE|| 80001|A4398||16.87|0|16.87|0||OSTOMY IRRIGATION BAG|| 80001|A4399||14.18|0|14.18|0||OSTOMY IRRIG CONE/CATH W BRS|| 80001|A4400||55.32|0|55.32|0||OSTOMY IRRIGATION SET|| 80001|A4402||1.81|0|1.81|0||LUBRICANT PER OUNCE|| 80001|A4404||2.24|0|2.24|0||OSTOMY RING EACH|| 80001|A4405||4.55|0|4.55|0||NONPECTIN BASED OSTOMY PASTE|| 80001|A4406||7.63|0|7.63|0||PECTIN BASED OSTOMY PASTE|| 80001|A4407||11.66|0|11.66|0||"EXT WEAR OST SKN BARR <=4SQ"""|| 80001|A4408||13.14|0|13.14|0||"EXT WEAR OST SKN BARR >4SQ"""|| 80001|A4409||8.28|0|8.28|0||OST SKN BARR CONVEX <=4 SQ I|| 80001|A4410||12.05|0|12.05|0||OST SKN BARR EXTND >4 SQ|| 80001|A4411||6.79|0|6.79|0||OST SKN BARR EXTND =4SQ|| 80001|A4412||3.6|0|3.6|0||OST POUCH DRAIN HIGH OUTPUT|| 80001|A4413||7.33|0|7.33|0||2 PC DRAINABLE OST POUCH|| 80001|A4414||6.55|0|6.55|0||OST SKNBAR W/O CONV<=4 SQ IN|| 80001|A4415||7.98|0|7.98|0||OST SKN BARR W/O CONV >4 SQI|| 80001|A4416||3.67|0|3.67|0||OST PCH CLSD W BARRIER/FILTR|| 80001|A4417||4.96|0|4.96|0||OST PCH W BAR/BLTINCONV/FLTR|| 80001|A4418||2.42|0|2.42|0||OST PCH CLSD W/O BAR W FILTR|| 80001|A4419||2.32|0|2.32|0||OST PCH FOR BAR W FLANGE/FLT|| 80001|A4420||0|0|0|0||OST PCH CLSD FOR BAR W LK FL|| 80001|A4422||0.16|0|0.16|0||OST POUCH ABSORBENT MATERIAL|| 80001|A4423||2.48|0|2.48|0||OST PCH FOR BAR W LK FL/FLTR|| 80001|A4424||6.34|0|6.34|0||OST PCH DRAIN W BAR & FILTER|| 80001|A4425||4.78|0|4.78|0||OST PCH DRAIN FOR BARRIER FL|| 80001|A4426||3.64|0|3.64|0||OST PCH DRAIN 2 PIECE SYSTEM|| 80001|A4427||3.71|0|3.71|0||OST PCH DRAIN/BARR LK FLNG/F|| 80001|A4428||8.68|0|8.68|0||URINE OST POUCH W FAUCET/TAP|| 80001|A4429||10.99|0|10.99|0||URINE OST POUCH W BLTINCONV|| 80001|A4430||11.34|0|11.34|0||OST URINE PCH W B/BLTIN CONV|| 80001|A4431||8.28|0|8.28|0||OST PCH URINE W BARRIER/TAPV|| 80001|A4432||4.79|0|4.79|0||OS PCH URINE W BAR/FANGE/TAP|| 80001|A4433||4.45|0|4.45|0||URINE OST PCH BAR W LOCK FLN|| 80001|A4434||5|0|5|0||OST PCH URINE W LOCK FLNG/FT|| 80001|A4435||7.69|0|7.69|0||1PC OST PCH DRAIN HGH OUTPUT|| 80001|A4455||1.91|0|1.91|0||ADHESIVE REMOVER PER OUNCE|| 80001|A4456||0.32|0|0.32|0||ADHESIVE REMOVER - WIPES|| 80001|A4461||4.38|0|4.38|0||SURGICL DRESS HOLD NON-REUSE|| 80001|A4463||17.74|0|17.74|0||SURGICAL DRESS HOLDER REUSE|| 80001|A4481||0.5|0|0.5|0||TRACHEOSTOMA FILTER|| 80001|A4483||0|0|0|0||MOISTURE EXCHANGER|| 80001|A4556||16.18|0|16.18|0||ELECTRODES - PAIR|| 80001|A4557||28.12|0|28.12|0||LEAD WIRES - PAIR|| 80001|A4558||7.26|0|7.26|0||CONDUCTIVE PASTE OR GEL|| 80001|A4559||0.13|0|0.13|0||COUPLING GEL OR PASTE|| 80001|A4561||27.43|0|27.43|0||PESSARY RUBBER - ANY TYPE|| 80001|A4562||68.17|0|68.17|0||PESSARY - NON RUBBER - ANY TYPE|| 80001|A4565||10.25|0|10.25|0||SLINGS|| 80001|A4590||36.4|0|36.4|||SPECIAL CASTING MATERIAL|| 80001|A4595||38.38|0|38.38|0||TENS SUPPL 2 LEAD PER MONTH|| 80001|A4602|NU|4.96|0|4.96|0||REPLACE LITHIUM BATTERY 1.5V|| 80001|A4604|NU|76.68|0|76.68|0||TUBING WITH HEATING ELEMENT|| 80001|A4605|NU|21.84|0|21.84|0||TRACH SUCTION CATH CLOSE SYS|| 80001|A4608||66.76|0|66.76|0||TRANSTRACHEAL OXYGEN CATH|| 80001|A4614||31.68|0|31.68|0||HAND-HELD PEFR METER|| 80001|A4615||0.96|0|0.96|0||CANNULA NASAL|| 80001|A4616||0.08|0|0.08|0||TUBING (OXYGEN) PER FOOT|| 80001|A4617||4.13|0|4.13|0||MOUTH PIECE|| 80001|A4618|NU|10.9|0|10.9|0||BREATHING CIRCUITS|| 80001|A4618|RR|1.16|0|1.16|0||BREATHING CIRCUITS|| 80001|A4619|NU|2.47|0|2.47|0||FACE TENT|| 80001|A4620||0.84|0|0.84|0||VARIABLE CONCENTRATION MASK|| 80001|A4623||8.34|0|8.34|0||TRACHEOSTOMY INNER CANNULA|| 80001|A4624|NU|3.5|0|3.5|0||TRACHEAL SUCTION TUBE|| 80001|A4625||9.23|0|9.23|0||TRACH CARE KIT FOR NEW TRACH|| 80001|A4626||4.25|0|4.25|0||TRACHEOSTOMY CLEANING BRUSH|| 80001|A4628|NU|4.98|0|4.98|0||OROPHARYNGEAL SUCTION CATH|| 80001|A4629||6.18|0|6.18|0||TRACHEOSTOMY CARE KIT|| 80001|A4630|NU|7.07|0|7.07|0||REPL BAT T.E.N.S. OWN BY PT|| 80001|A4633|NU|54.65|0|54.65|0||UVL REPLACEMENT BULB|| 80001|A4635|NU|5.8|0|5.8|0||UNDERARM CRUTCH PAD|| 80001|A4635|RR|0.78|0|0.78|0||UNDERARM CRUTCH PAD|| 80001|A4636|NU|4.12|0|4.12|0||HANDGRIP FOR CANE ETC|| 80001|A4636|RR|0.42|0|0.42|0||HANDGRIP FOR CANE ETC|| 80001|A4637|NU|2.09|0|2.09|0||REPL TIP CANE/CRUTCH/WALKER|| 80001|A4637|RR|0.29|0|0.29|0||REPL TIP CANE/CRUTCH/WALKER|| 80001|A4638|NU|0|0|0|0||REPL BATT PULSE GEN SYS|| 80001|A4638|RR|0|0|0|0||REPL BATT PULSE GEN SYS|| 80001|A4639|RR|38.27|0|38.27|0||INFRARED HT SYS REPLCMNT PAD|| 80001|A4640|NU|84.34|0|84.34|0||ALTERNATING PRESSURE PAD|| 80001|A4640|RR|8.59|0|8.59|0||ALTERNATING PRESSURE PAD|| 80001|A5051||2.75|0|2.75|0||POUCH CLSD W BARR ATTACHED|| 80001|A5052||1.98|0|1.98|0||CLSD OSTOMY POUCH W/O BARR|| 80001|A5053||1.98|0|1.98|0||CLSD OSTOMY POUCH FACEPLATE|| 80001|A5054||2.4|0|2.4|0||CLSD OSTOMY POUCH W/FLANGE|| 80001|A5055||1.92|0|1.92|0||STOMA CAP|| 80001|A5056||6.22|0|6.22|0||1 PC OST POUCH W FILTER|| 80001|A5057||12.79|0|12.79|0||1 PC OST POU W BUILT-IN CONV|| 80001|A5061||4.7|0|4.7|0||POUCH DRAINABLE W BARRIER AT|| 80001|A5062||2.96|0|2.96|0||DRNBLE OSTOMY POUCH W/O BARR|| 80001|A5063||3.6|0|3.6|0||DRAIN OSTOMY POUCH W/FLANGE|| 80001|A5071||8|0|8|0||URINARY POUCH W/BARRIER|| 80001|A5072||4.7|0|4.7|0||URINARY POUCH W/O BARRIER|| 80001|A5073||4.24|0|4.24|0||URINARY POUCH ON BARR W/FLNG|| 80001|A5081||3.74|0|3.74|0||CONTINENT STOMA PLUG|| 80001|A5082||15.84|0|15.84|0||CONTINENT STOMA CATHETER|| 80001|A5083||0.85|0|0.85|0||STOMA ABSORPTIVE COVER|| 80001|A5093||2.6|0|2.6|0||OSTOMY ACCESSORY CONVEX INSE|| 80001|A5102||30.07|0|30.07|0||BEDSIDE DRAIN BTL W/WO TUBE|| 80001|A5105||54.3|0|54.3|0||URINARY SUSPENSORY|| 80001|A5112||46.1|0|46.1|0||URINARY LEG BAG|| 80001|A5113||6.28|0|6.28|0||LATEX LEG STRAP|| 80001|A5114||10.14|0|10.14|0||FOAM/FABRIC LEG STRAP|| 80001|A5121||8.44|0|8.44|0||SOLID SKIN BARRIER 6X6|| 80001|A5122||17.11|0|17.11|0||SOLID SKIN BARRIER 8X8|| 80001|A5126||1.75|0|1.75|0||DISK/FOAM PAD +OR- ADHESIVE|| 80001|A5131||21.12|0|21.12|0||APPLIANCE CLEANER|| 80001|A5200||15.06|0|15.06|0||PERCUTANEOUS CATHETER ANCHOR|| 80001|A5500||84.68|0|84.68|0||DIAB SHOE FOR DENSITY INSERT|| 80001|A5501||254.02|0|254.02|0||DIABETIC CUSTOM MOLDED SHOE|| 80001|A5503||41.48|0|41.48|0||DIABETIC SHOE W/ROLLER/ROCKR|| 80001|A5504||41.48|0|41.48|0||DIABETIC SHOE WITH WEDGE|| 80001|A5505||41.48|0|41.48|0||DIAB SHOE W/METATARSAL BAR|| 80001|A5506||41.48|0|41.48|0||DIABETIC SHOE W/OFF SET HEEL|| 80001|A5507||41.48|0|41.48|0||MODIFICATION DIABETIC SHOE|| 80001|A5512||34.55|0|34.55|0||MULTI DEN INSERT DIRECT FORM|| 80001|A5513||51.55|0|51.55|0||MULTI DEN INSERT CUSTOM MOLD|| 80001|A6010||41.26|0|41.26|0||COLLAGEN BASED WOUND FILLER|| 80001|A6011||3.04|0|3.04|0||COLLAGEN GEL/PASTE WOUND FIL|| 80001|A6021||28|0|28|0||COLLAGEN DRESSING <=16 SQ IN|| 80001|A6022||28|0|28|0||COLLAGEN DRSG>6<=48 SQ IN|| 80001|A6023||253.48|0|253.48|0||COLLAGEN DRESSING >48 SQ IN|| 80001|A6024||8.24|0|8.24|0||COLLAGEN DSG WOUND FILLER|| 80001|A6154||19.15|0|19.15|0||WOUND POUCH EACH|| 80001|A6196||9.79|0|9.79|0||ALGINATE DRESSING <=16 SQ IN|| 80001|A6197||21.89|0|21.89|0||ALGINATE DRSG >16 <=48 SQ IN|| 80001|A6199||7.04|0|7.04|0||ALGINATE DRSG WOUND FILLER|| 80001|A6203||4.48|0|4.48|0||COMPOSITE DRSG <= 16 SQ IN|| 80001|A6204||8.29|0|8.29|0||COMPOSITE DRSG >16<=48 SQ IN|| 80001|A6207||9.77|0|9.77|0||CONTACT LAYER >16<= 48 SQ IN|| 80001|A6209||9.95|0|9.95|0||FOAM DRSG <=16 SQ IN W/O BDR|| 80001|A6210||26.54|0|26.54|0||FOAM DRG >16<=48 SQ IN W/O B|| 80001|A6211||39.12|0|39.12|0||FOAM DRG > 48 SQ IN W/O BRDR|| 80001|A6212||12.92|0|12.92|0||FOAM DRG <=16 SQ IN W/BORDER|| 80001|A6214||13.7|0|13.7|0||FOAM DRG > 48 SQ IN W/BORDER|| 80001|A6216||0.06|0|0.06|0||NON-STERILE GAUZE<=16 SQ IN|| 80001|A6217||0|0|0|0||NON-STERILE GAUZE>16<=48 SQ|| 80001|A6219||1.27|0|1.27|0||GAUZE <= 16 SQ IN W/BORDER|| 80001|A6220||3.44|0|3.44|0||GAUZE >16 <=48 SQ IN W/BORDR|| 80001|A6222||2.83|0|2.83|0||GAUZE <=16 IN NO W/SAL W/O B|| 80001|A6223||3.23|0|3.23|0||GAUZE >16<=48 NO W/SAL W/O B|| 80001|A6224||4.81|0|4.81|0||GAUZE > 48 IN NO W/SAL W/O B|| 80001|A6229||4.81|0|4.81|0||GAUZE >16<=48 SQ IN WATR/SAL|| 80001|A6231||6.24|0|6.24|0||HYDROGEL DSG<=16 SQ IN|| 80001|A6232||9.14|0|9.14|0||HYDROGEL DSG>16<=48 SQ IN|| 80001|A6233||25.55|0|25.55|0||HYDROGEL DRESSING >48 SQ IN|| 80001|A6234||8.71|0|8.71|0||HYDROCOLLD DRG <=16 W/O BDR|| 80001|A6235||22.39|0|22.39|0||HYDROCOLLD DRG >16<=48 W/O B|| 80001|A6236||36.3|0|36.3|0||HYDROCOLLD DRG > 48 IN W/O B|| 80001|A6237||10.55|0|10.55|0||HYDROCOLLD DRG <=16 IN W/BDR|| 80001|A6238||30.36|0|30.36|0||HYDROCOLLD DRG >16<=48 W/BDR|| 80001|A6240||16.31|0|16.31|0||HYDROCOLLD DRG FILLER PASTE|| 80001|A6241||3.42|0|3.42|0||HYDROCOLLOID DRG FILLER DRY|| 80001|A6242||8.08|0|8.08|0||HYDROGEL DRG <=16 IN W/O BDR|| 80001|A6243||16.4|0|16.4|0||HYDROGEL DRG >16<=48 W/O BDR|| 80001|A6244||52.32|0|52.32|0||HYDROGEL DRG >48 IN W/O BDR|| 80001|A6245||9.67|0|9.67|0||HYDROGEL DRG <= 16 IN W/BDR|| 80001|A6246||13.22|0|13.22|0||HYDROGEL DRG >16<=48 IN W/B|| 80001|A6247||31.68|0|31.68|0||HYDROGEL DRG > 48 SQ IN W/B|| 80001|A6248||21.64|0|21.64|0||HYDROGEL DRSG GEL FILLER|| 80001|A6251||2.65|0|2.65|0||ABSORPT DRG <=16 SQ IN W/O B|| 80001|A6252||4.33|0|4.33|0||ABSORPT DRG >16 <=48 W/O BDR|| 80001|A6253||8.44|0|8.44|0||ABSORPT DRG > 48 SQ IN W/O B|| 80001|A6254||1.61|0|1.61|0||ABSORPT DRG <=16 SQ IN W/BDR|| 80001|A6255||4.04|0|4.04|0||ABSORPT DRG >16<=48 IN W/BDR|| 80001|A6257||2.05|0|2.05|0||TRANSPARENT FILM <= 16 SQ IN|| 80001|A6258||5.75|0|5.75|0||TRANSPARENT FILM >16<=48 IN|| 80001|A6259||14.58|0|14.58|0||TRANSPARENT FILM > 48 SQ IN|| 80001|A6266||2.57|0|2.57|0||IMPREG GAUZE NO H20/SAL/YARD|| 80001|A6402||0.16|0|0.16|0||STERILE GAUZE <= 16 SQ IN|| 80001|A6403||0.56|0|0.56|0||STERILE GAUZE>16 <= 48 SQ IN|| 80001|A6407||2.51|0|2.51|0||PACKING STRIPS - NON-IMPREG|| 80001|A6410||0.52|0|0.52|0||STERILE EYE PAD|| 80001|A6411||0|0|0|0||NON-STERILE EYE PAD|| 80001|A6441||0.9|0|0.9|0||PAD BAND W>=3 IN <5 IN /YD|| 80001|A6442||0.22|0|0.22|0||CONFORM BAND N/S W<3 IN/YD|| 80001|A6443||0.37|0|0.37|0||"CONFORM BAND N/S W>=3""<5""/YD"|| 80001|A6444||0.74|0|0.74|0||CONFORM BAND N/S W>=5 IN/YD|| 80001|A6445||0.43|0|0.43|0||CONFORM BAND S W <3 IN/YD|| 80001|A6446||0.54|0|0.54|0||"CONFORM BAND S W>=3"" <5""/YD"|| 80001|A6447||0.9|0|0.9|0||CONFORM BAND S W >=5 IN/YD|| 80001|A6448||1.55|0|1.55|0||LT COMPRES BAND <3 IN/YD|| 80001|A6449||2.34|0|2.34|0||"LT COMPRES BAND >=3"" <5""/YD"|| 80001|A6450||0|0|0|0||LT COMPRES BAND >=5 IN/YD|| 80001|A6451||0|0|0|0||"MOD COMPRES BAND W>=3""<5""/YD"|| 80001|A6452||7.87|0|7.87|0||"HIGH COMPRES BAND W>=3""<5""YD"|| 80001|A6453||0.83|0|0.83|0||SELF-ADHER BAND W <3 IN/YD|| 80001|A6454||1.03|0|1.03|0||"SELF-ADHER BAND W>=3"" <5""/YD"|| 80001|A6455||1.86|0|1.86|0||SELF-ADHER BAND >=5 IN/YD|| 80001|A6456||1.69|0|1.69|0||"ZINC PASTE BAND W >=3""<5""/YD"|| 80001|A6457||1.52|0|1.52|0||TUBULAR DRESSING|| 80001|A6501||0|0|0|0||COMPRES BURNGARMENT BODYSUIT|| 80001|A6502||0|0|0|0||COMPRES BURNGARMENT CHINSTRP|| 80001|A6503||0|0|0|0||COMPRES BURNGARMENT FACEHOOD|| 80001|A6504||0|0|0|0||CMPRSBURNGARMENT GLOVE-WRIST|| 80001|A6505||0|0|0|0||CMPRSBURNGARMENT GLOVE-ELBOW|| 80001|A6506||0|0|0|0||CMPRSBURNGRMNT GLOVE-AXILLA|| 80001|A6507||0|0|0|0||CMPRS BURNGARMENT FOOT-KNEE|| 80001|A6508||0|0|0|0||CMPRS BURNGARMENT FOOT-THIGH|| 80001|A6509||0|0|0|0||COMPRES BURN GARMENT JACKET|| 80001|A6510||0|0|0|0||COMPRES BURN GARMENT LEOTARD|| 80001|A6511||0|0|0|0||COMPRES BURN GARMENT PANTY|| 80001|A6513||0|0|0|0||COMPRESS BURN MASK FACE/NECK|| 80001|A6530||48|0|48|||COMPRESSION STOCKING BK18-30|| 80001|A6531||31.86|0|0|0||COMPRESSION STOCKING BK30-40|| 80001|A6531|NU|31.86|0|0|||COMPRESSION STOCKING BK30-40|| 80001|A6532||65|0|0|0||COMPRESSION STOCKING BK40-50|| 80001|A6532|NU|65|0|0|||COMPRESSION STOCKING BK40-50|| 80001|A6533||73.8|0|73.8|||GC STOCKING THIGHLNGTH 18-30|| 80001|A6534||48|0|48|||GC STOCKING THIGHLNGTH 30-40|| 80001|A6534||48|0|48|||GC STOCKING THIGHLNGTH 30-40|| 80001|A6535||41.4|0|41.4|||GC STOCKING THIGHLNGTH 40-50|| 80001|A6536||51|0|51|||GC STOCKING FULL LNGTH 18-30|| 80001|A6537||52.5|0|52.5|||GC STOCKING FULL LNGTH 30-40|| 80001|A6538||40|0|40|||GC STOCKING FULL LNGTH 40-50|| 80001|A6539||83.04|0|83.04|||GC STOCKING WAISTLNGTH 18-30|| 80001|A6540||82.2|0|82.2|||GC STOCKING WAISTLNGTH 30-40|| 80001|A6540|NU|82.2|0|82.2|||GC STOCKING WAISTLNGTH 30-40|| 80001|A6541||2.4|0|2.4|||GC STOCKING WAISTLNGTH 40-50|| 80001|A6545||84.5|0|84.5|||GRAD COMP NON-ELASTIC BK|| 80001|A6545|NU|84.5|0|84.5|||GRAD COMP NON-ELASTIC BK|| 80001|A6549||141|0|141|||G COMPRESSION STOCKING|| 80001|A6550||31.5|0|31.5|0||NEG PRES WOUND THER DRSG SET|| 80001|A7000|NU|10.86|0|10.86|0||DISPOSABLE CANISTER FOR PUMP|| 80001|A7001|NU|38.53|0|38.53|0||NONDISPOSABLE PUMP CANISTER|| 80001|A7002|NU|4.33|0|4.33|0||TUBING USED W SUCTION PUMP|| 80001|A7003|NU|3.6|0|3.6|0||NEBULIZER ADMINISTRATION SET|| 80001|A7004|NU|2.05|0|2.05|0||DISPOSABLE NEBULIZER SML VOL|| 80001|A7005|NU|34.91|0|34.91|0||NONDISPOSABLE NEBULIZER SET|| 80001|A7006|NU|12.71|0|12.71|0||FILTERED NEBULIZER ADMIN SET|| 80001|A7007|NU|5.76|0|5.76|0||LG VOL NEBULIZER DISPOSABLE|| 80001|A7008|NU|12.46|0|12.46|0||DISPOSABLE NEBULIZER PREFILL|| 80001|A7009|NU|54.1|0|54.1|0||NEBULIZER RESERVOIR BOTTLE|| 80001|A7010|NU|26.71|0|26.71|0||DISPOSABLE CORRUGATED TUBING|| 80001|A7012|NU|4.99|0|4.99|0||NEBULIZER WATER COLLEC DEVIC|| 80001|A7013|NU|0.94|0|0.94|0||DISPOSABLE COMPRESSOR FILTER|| 80001|A7014|NU|5.98|0|5.98|0||COMPRESSOR NONDISPOS FILTER|| 80001|A7015|NU|2.51|0|2.51|0||AEROSOL MASK USED W NEBULIZE|| 80001|A7016|NU|9|0|9|0||NEBULIZER DOME & MOUTHPIECE|| 80001|A7017|NU|178.52|0|178.52|0||NEBULIZER NOT USED W OXYGEN|| 80001|A7017|RR|17.87|0|17.87|0||NEBULIZER NOT USED W OXYGEN|| 80001|A7018||0.43|0|0.43|0||WATER DISTILLED W/NEBULIZER|| 80001|A7020|NU|19.28|0|19.28|0||STERL WATR/SALINE 1000 ML W/LG|| 80001|A7025|RR|57.94|0|57.94|0||REPLACE CHEST COMPRESS VEST|| 80001|A7026|NU|38.29|0|38.29|0||REPLACE CHST CMPRSS SYS HOSE|| 80001|A7027|NU|248.44|0|248.44|0||COMBINATION ORAL/NASAL MASK|| 80001|A7028|NU|66|0|66|0||REPL ORAL CUSHION COMBO MASK|| 80001|A7029|NU|26.95|0|26.95|0||REPL NASAL PILLOW COMB MASK|| 80001|A7030|NU|216.56|0|216.56|0||CPAP FULL FACE MASK|| 80001|A7031|NU|80.1|0|80.1|0||REPLACEMENT FACEMASK INTERFA|| 80001|A7032|NU|46.52|0|46.52|0||REPLACEMENT NASAL CUSHION|| 80001|A7033|NU|32.62|0|32.62|0||REPLACEMENT NASAL PILLOWS|| 80001|A7034|NU|135.04|0|135.04|0||NASAL APPLICATION DEVICE|| 80001|A7035|NU|41.44|0|41.44|0||POS AIRWAY PRESS HEADGEAR|| 80001|A7036|NU|17.75|0|17.75|0||POS AIRWAY PRESS CHINSTRAP|| 80001|A7037|NU|45.78|0|45.78|0||POS AIRWAY PRESSURE TUBING|| 80001|A7038|NU|6.14|0|6.14|0||POS AIRWAY PRESSURE FILTER|| 80001|A7039|NU|14.95|0|14.95|0||FILTER - NON DISPOSABLE W PAP|| 80001|A7040||54.18|0|54.18|0||ONE WAY CHEST DRAIN VALVE|| 80001|A7041||101.8|0|101.8|0||WATER SEAL DRAIN CONTAINER|| 80001|A7044|NU|138.8|0|138.8|0||PAP ORAL INTERFACE|| 80001|A7045|NU|22.34|0|22.34|0||REPL EXHALATION PORT FOR PAP|| 80001|A7045|RR|2.23|0|2.23|0||REPL EXHALATION PORT FOR PAP|| 80001|A7046|NU|22.39|0|22.39|0||REPL WATER CHAMBER - PAP DEV|| 80001|A7047|NU|161.04|0|161.04|0||RESP SUCTION ORAL INTERFACE|| 80001|A7048||56.66|0|56.66|0||VACUUM DRAIN BOTTLE/TUBE KIT|| 80001|A7501||139.88|0|139.88|0||TRACHEOSTOMA VALVE W DIAPHRA|| 80001|A7502||66.49|0|66.49|0||REPLACEMENT DIAPHRAGM/FPLATE|| 80001|A7503||15.11|0|15.11|0||HMES FILTER HOLDER OR CAP|| 80001|A7504||0.9|0|0.9|0||TRACHEOSTOMA HMES FILTER|| 80001|A7505||6.24|0|6.24|0||HMES OR TRACH VALVE HOUSING|| 80001|A7506||0.44|0|0.44|0||HMES/TRACHVALVE ADHESIVEDISK|| 80001|A7507||3.31|0|3.31|0||INTEGRATED FILTER & HOLDER|| 80001|A7508||3.82|0|3.82|0||HOUSING & INTEGRATED ADHESIV|| 80001|A7509||1.88|0|1.88|0||HEAT & MOISTURE EXCHANGE SYS|| 80001|A7520||63.24|0|63.24|0||TRACH/LARYN TUBE NON-CUFFED|| 80001|A7521||62.65|0|62.65|0||TRACH/LARYN TUBE CUFFED|| 80001|A7522||60.16|0|60.16|0||TRACH/LARYN TUBE STAINLESS|| 80001|A7524||103.1|0|103.1|0||TRACHEOSTOMA STENT/STUD/BTTN|| 80001|A7525||2.75|0|2.75|0||TRACHEOSTOMY MASK|| 80001|A7526||4.5|0|4.5|0||TRACHEOSTOMY TUBE COLLAR|| 80001|A7527||4.78|0|4.78|0||TRACH/LARYN TUBE PLUG/STOP|| 80001|A8000|NU|204.26|0|204.26|0||SOFT PROTECT HELMET PREFAB|| 80001|A8000|RR|20.42|0|20.42|0||SOFT PROTECT HELMET PREFAB|| 80001|A8001|NU|204.26|0|204.26|0||HARD PROTECT HELMET PREFAB|| 80001|A8001|RR|20.42|0|20.42|0||HARD PROTECT HELMET PREFAB|| 80001|A8002|NU|0|0|0|0||SOFT PROTECT HELMET CUSTOM|| 80001|A8002|RR|0|0|0|0||SOFT PROTECT HELMET CUSTOM|| 80001|A8003|NU|0|0|0|0||HARD PROTECT HELMET CUSTOM|| 80001|A8003|RR|0|0|0|0||HARD PROTECT HELMET CUSTOM|| 80001|A8004|NU|0|0|0|0||REPL SOFT INTERFACE - HELMET|| 80001|A8004|RR|0|0|0|0||REPL SOFT INTERFACE - HELMET|| 80001|A9282|NU|260|0|0|0||WIG ANY TYPE|| 80001|A9575||0.26|0|0.26|0||INJ GADOTERATE MEGLUMI 0.1ML|| 80001|A9575||0.29|0|0|0||INJ GADOTERATE MEGLUMI 0.1ML|| 80001|A9576||2.25|0|2.25|0||INJ PROHANCE MULTIPACK|| 80001|A9576||2.19|0|0|0||INJ PROHANCE MULTIPACK|| 80001|A9577||2.62|0|2.62|0||INJ MULTIHANCE|| 80001|A9577||2.6|0|0|0||INJ MULTIHANCE|| 80001|A9578||2.5|0|2.5|0||INJ MULTIHANCE MULTIPACK|| 80001|A9578||2.57|0|0|0||INJ MULTIHANCE MULTIPACK|| 80001|A9579||2.36|0|2.36|0||GAD-BASE MR CONTRAST NOS - 1ML|| 80001|A9579||2.33|0|0|0||GAD-BASE MR CONTRAST NOS - 1ML|| 80001|A9581||17.47|0|17.47|0||GADOXETATE DISODIUM INJ|| 80001|A9581||17.43|0|0|0||GADOXETATE DISODIUM INJ|| 80001|A9583||22.25|0|22.25|0||GADOFOSVESET TRISODIUM INJ|| 80001|A9585||0.48|0|0.48|0||GADOBUTROL INJECTION|| 80001|A9585||0.47|0|0|0||GADOBUTROL INJECTION|| 80001|A9606||0|0|0|0||RADIUM RA223 DICHLORIDE THER|| 80001|A9606||0|0|0|0||RADIUM RA223 DICHLORIDE THER|| 80001|ANEST||48.4|15|1||||| 80001|D1206||5|0|5||||| 80001|E0100|NU|28.07|0|28.07|0||CANE ADJUST/FIXED WITH TIP|| 80001|E0100|RR|6.72|0|6.72|0||CANE ADJUST/FIXED WITH TIP|| 80001|E0105|NU|65.42|0|65.42|0||CANE ADJUST/FIXED QUAD/3 PRO|| 80001|E0105|RR|10.03|0|10.03|0||CANE ADJUST/FIXED QUAD/3 PRO|| 80001|E0110|NU|87.84|0|87.84|0||CRUTCH FOREARM PAIR|| 80001|E0110|RR|18.1|0|18.1|0||CRUTCH FOREARM PAIR|| 80001|E0111|NU|65.52|0|65.52|0||CRUTCH FOREARM EACH|| 80001|E0111|RR|9.54|0|9.54|0||CRUTCH FOREARM EACH|| 80001|E0112|NU|41.89|0|41.89|0||CRUTCH UNDERARM PAIR WOOD|| 80001|E0112|RR|11.26|0|11.26|0||CRUTCH UNDERARM PAIR WOOD|| 80001|E0113|NU|23.93|0|23.93|0||CRUTCH UNDERARM EACH WOOD|| 80001|E0113|RR|5.82|0|5.82|0||CRUTCH UNDERARM EACH WOOD|| 80001|E0114|NU|53.42|0|53.42|0||CRUTCH UNDERARM PAIR NO WOOD|| 80001|E0114|RR|9.7|0|9.7|0||CRUTCH UNDERARM PAIR NO WOOD|| 80001|E0116|NU|31.42|0|31.42|0||CRUTCH UNDERARM EACH NO WOOD|| 80001|E0116|RR|6.12|0|6.12|0||CRUTCH UNDERARM EACH NO WOOD|| 80001|E0117|RR|25.66|0|25.66|0||UNDERARM SPRINGASSIST CRUTCH|| 80001|E0118|NU|476.34|0|476.34|||CRUTCH SUBSTITUTE|| 80001|E0118|RR|48.75|0|48.75|||CRUTCH SUBSTITUTE|| 80001|E0130|NU|80.63|0|80.63|0||WALKER RIGID ADJUST/FIXED HT|| 80001|E0130|RR|19.3|0|19.3|0||WALKER RIGID ADJUST/FIXED HT|| 80001|E0135|NU|86.76|0|86.76|0||WALKER FOLDING ADJUST/FIXED|| 80001|E0135|RR|19.8|0|19.8|0||WALKER FOLDING ADJUST/FIXED|| 80001|E0140|NU|414.1|0|414.1|0||WALKER W TRUNK SUPPORT|| 80001|E0140|RR|41.42|0|41.42|0||WALKER W TRUNK SUPPORT|| 80001|E0141|NU|127.92|0|127.92|0||RIGID WHEELED WALKER ADJ/FIX|| 80001|E0141|RR|21.84|0|21.84|0||RIGID WHEELED WALKER ADJ/FIX|| 80001|E0143|NU|127.92|0|127.92|0||WALKER FOLDING WHEELED W/O S|| 80001|E0143|RR|21.07|0|21.07|0||WALKER FOLDING WHEELED W/O S|| 80001|E0144|RR|36.58|0|36.58|0||ENCLOSED WALKER W REAR SEAT|| 80001|E0147|NU|659.88|0|659.88|0||WALKER VARIABLE WHEEL RESIST|| 80001|E0147|RR|66|0|66|0||WALKER VARIABLE WHEEL RESIST|| 80001|E0148|NU|145.87|0|145.87|0||HEAVYDUTY WALKER NO WHEELS|| 80001|E0148|RR|14.6|0|14.6|0||HEAVYDUTY WALKER NO WHEELS|| 80001|E0149|NU|256.24|0|256.24|0||HEAVY DUTY WHEELED WALKER|| 80001|E0149|RR|25.63|0|25.63|0||HEAVY DUTY WHEELED WALKER|| 80001|E0153|NU|80.41|0|80.41|0||FOREARM CRUTCH PLATFORM ATTA|| 80001|E0153|RR|8.88|0|8.88|0||FOREARM CRUTCH PLATFORM ATTA|| 80001|E0154|NU|80.95|0|80.95|0||WALKER PLATFORM ATTACHMENT|| 80001|E0154|RR|8.35|0|8.35|0||WALKER PLATFORM ATTACHMENT|| 80001|E0155|NU|35.14|0|35.14|0||WALKER WHEEL ATTACHMENT - PAIR|| 80001|E0155|RR|3.76|0|3.76|0||WALKER WHEEL ATTACHMENT - PAIR|| 80001|E0156|NU|30.35|0|30.35|0||WALKER SEAT ATTACHMENT|| 80001|E0156|RR|3.89|0|3.89|0||WALKER SEAT ATTACHMENT|| 80001|E0157|NU|83.08|0|83.08|0||WALKER CRUTCH ATTACHMENT|| 80001|E0157|RR|8.78|0|8.78|0||WALKER CRUTCH ATTACHMENT|| 80001|E0158|NU|36.94|0|36.94|0||WALKER LEG EXTENDERS SET OF4|| 80001|E0158|RR|4.08|0|4.08|0||WALKER LEG EXTENDERS SET OF4|| 80001|E0159|NU|20.51|0|20.51|0||BRAKE FOR WHEELED WALKER|| 80001|E0159|RR|2.12|0|2.12|0||BRAKE FOR WHEELED WALKER|| 80001|E0160|NU|37.43|0|37.43|0||SITZ TYPE BATH OR EQUIPMENT|| 80001|E0160|RR|4.92|0|4.92|0||SITZ TYPE BATH OR EQUIPMENT|| 80001|E0161|NU|34.93|0|34.93|0||SITZ BATH/EQUIPMENT W/FAUCET|| 80001|E0161|RR|4.04|0|4.04|0||SITZ BATH/EQUIPMENT W/FAUCET|| 80001|E0162|NU|164.96|0|164.96|0||SITZ BATH CHAIR|| 80001|E0162|RR|17.3|0|17.3|0||SITZ BATH CHAIR|| 80001|E0163|NU|146.89|0|146.89|0||COMMODE CHAIR STATIONRY FXD|| 80001|E0163|RR|30.97|0|30.97|0||COMMODE CHAIR STATIONRY FXD|| 80001|E0165|RR|24.74|0|24.74|0||COMMODE CHAIR STATIONRY DET|| 80001|E0167|NU|13.58|0|13.58|0||COMMODE CHAIR PAIL OR PAN|| 80001|E0167|RR|1.42|0|1.42|0||COMMODE CHAIR PAIL OR PAN|| 80001|E0168|NU|201.02|0|201.02|0||HEAVYDUTY/WIDE COMMODE CHAIR|| 80001|E0168|RR|20.2|0|20.2|0||HEAVYDUTY/WIDE COMMODE CHAIR|| 80001|E0170|RR|214.08|0|214.08|0||COMMODE CHAIR ELECTRIC|| 80001|E0171|RR|38.52|0|38.52|0||COMMODE CHAIR NON-ELECTRIC|| 80001|E0175|NU|88.22|0|88.22|0||COMMODE CHAIR FOOT REST|| 80001|E0175|RR|8.82|0|8.82|0||COMMODE CHAIR FOOT REST|| 80001|E0181|RR|34.7|0|34.7|0||PRESS PAD ALTERNATING W/ PUM|| 80001|E0182|RR|29.63|0|29.63|0||PRESSURE PAD ALTERNATING PUM|| 80001|E0184|NU|259.33|0|259.33|0||DRY PRESSURE MATTRESS|| 80001|E0184|RR|30.1|0|30.1|0||DRY PRESSURE MATTRESS|| 80001|E0185|NU|386.64|0|386.64|0||GEL PRESSURE MATTRESS PAD|| 80001|E0185|RR|50.89|0|50.89|0||GEL PRESSURE MATTRESS PAD|| 80001|E0186|RR|22.98|0|22.98|0||AIR PRESSURE MATTRESS|| 80001|E0187|RR|26.28|0|26.28|0||WATER PRESSURE MATTRESS|| 80001|E0188|NU|35.21|0|35.21|0||SYNTHETIC SHEEPSKIN PAD|| 80001|E0188|RR|4.14|0|4.14|0||SYNTHETIC SHEEPSKIN PAD|| 80001|E0189|NU|69.22|0|69.22|0||LAMBSWOOL SHEEPSKIN PAD|| 80001|E0189|RR|7.49|0|7.49|0||LAMBSWOOL SHEEPSKIN PAD|| 80001|E0191|NU|11.32|0|11.32|0||PROTECTOR HEEL OR ELBOW|| 80001|E0191|RR|1.16|0|1.16|0||PROTECTOR HEEL OR ELBOW|| 80001|E0193|RR|978.71|0|978.71|0||POWERED AIR FLOTATION BED|| 80001|E0194|RR|3684.4|0|3684.4|0||AIR FLUIDIZED BED|| 80001|E0196|RR|36.78|0|36.78|0||GEL PRESSURE MATTRESS|| 80001|E0197|NU|250.86|0|250.86|0||AIR PRESSURE PAD FOR MATTRES|| 80001|E0197|RR|34.61|0|34.61|0||AIR PRESSURE PAD FOR MATTRES|| 80001|E0198|RR|25.09|0|25.09|0||WATER PRESSURE PAD FOR MATTR|| 80001|E0199|NU|42.71|0|42.71|0||DRY PRESSURE PAD FOR MATTRES|| 80001|E0199|RR|4.25|0|4.25|0||DRY PRESSURE PAD FOR MATTRES|| 80001|E0200|NU|105.6|0|105.6|0||HEAT LAMP WITHOUT STAND|| 80001|E0200|RR|14.34|0|14.34|0||HEAT LAMP WITHOUT STAND|| 80001|E0202|RR|70.9|0|70.9|0||PHOTOTHERAPY LIGHT W/ PHOTOM|| 80001|E0205|NU|258.48|0|258.48|0||HEAT LAMP WITH STAND|| 80001|E0205|RR|28.43|0|28.43|0||HEAT LAMP WITH STAND|| 80001|E0210|NU|38.81|0|38.81|0||ELECTRIC HEAT PAD STANDARD|| 80001|E0210|RR|3.86|0|3.86|0||ELECTRIC HEAT PAD STANDARD|| 80001|E0215|NU|80.21|0|80.21|0||ELECTRIC HEAT PAD MOIST|| 80001|E0215|RR|8.39|0|8.39|0||ELECTRIC HEAT PAD MOIST|| 80001|E0217|NU|657.66|0|657.66|0||WATER CIRC HEAT PAD W PUMP|| 80001|E0217|RR|65.74|0|65.74|0||WATER CIRC HEAT PAD W PUMP|| 80001|E0225|NU|517.66|0|517.66|0||HYDROCOLLATOR UNIT|| 80001|E0225|RR|51.02|0|51.02|0||HYDROCOLLATOR UNIT|| 80001|E0235|RR|22.98|0|22.98|0||PARAFFIN BATH UNIT PORTABLE|| 80001|E0236|RR|52.48|0|52.48|0||PUMP FOR WATER CIRCULATING P|| 80001|E0239|NU|599.15|0|599.15|0||HYDROCOLLATOR UNIT PORTABLE|| 80001|E0239|RR|59.93|0|59.93|0||HYDROCOLLATOR UNIT PORTABLE|| 80001|E0249|NU|132.67|0|132.67|0||PAD WATER CIRCULATING HEAT U|| 80001|E0249|RR|14.59|0|14.59|0||PAD WATER CIRCULATING HEAT U|| 80001|E0250|RR|97.69|0|97.69|0||HOSP BED FIXED HT W/ MATTRES|| 80001|E0251|RR|73.24|0|73.24|0||HOSP BED FIXD HT W/O MATTRES|| 80001|E0255|RR|115.6|0|115.6|0||HOSPITAL BED VAR HT W/ MATTR|| 80001|E0256|RR|81.34|0|81.34|0||HOSPITAL BED VAR HT W/O MATT|| 80001|E0260|RR|161.26|0|161.26|0||HOSP BED SEMI-ELECTR W/ MATT|| 80001|E0261|RR|133.63|0|133.63|0||HOSP BED SEMI-ELECTR W/O MAT|| 80001|E0265|RR|195.06|0|195.06|0||HOSP BED TOTAL ELECTR W/ MAT|| 80001|E0266|RR|173.3|0|173.3|0||HOSP BED TOTAL ELEC W/O MATT|| 80001|E0271|NU|233.09|0|233.09|0||MATTRESS INNERSPRING|| 80001|E0271|RR|23.33|0|23.33|0||MATTRESS INNERSPRING|| 80001|E0272|NU|232.32|0|232.32|0||MATTRESS FOAM RUBBER|| 80001|E0272|RR|24.26|0|24.26|0||MATTRESS FOAM RUBBER|| 80001|E0275|NU|20.4|0|20.4|0||BED PAN STANDARD|| 80001|E0275|RR|2.14|0|2.14|0||BED PAN STANDARD|| 80001|E0276|NU|17.72|0|17.72|0||BED PAN FRACTURE|| 80001|E0276|RR|2.1|0|2.1|0||BED PAN FRACTURE|| 80001|E0277|RR|807.59|0|807.59|0||POWERED PRES-REDU AIR MATTRS|| 80001|E0280|NU|43.86|0|43.86|0||BED CRADLE|| 80001|E0280|RR|4.73|0|4.73|0||BED CRADLE|| 80001|E0290|RR|72.94|0|72.94|0||HOSP BED FX HT W/O RAILS W/M|| 80001|E0291|RR|52.99|0|52.99|0||HOSP BED FX HT W/O RAIL W/O|| 80001|E0292|RR|82|0|82|0||HOSP BED VAR HT W/O RAIL W/O|| 80001|E0293|RR|69.79|0|69.79|0||HOSP BED VAR HT W/O RAIL W/|| 80001|E0294|RR|127.49|0|127.49|0||HOSP BED SEMI-ELECT W/ MATTR|| 80001|E0295|RR|124.26|0|124.26|0||HOSP BED SEMI-ELECT W/O MATT|| 80001|E0296|RR|160.22|0|160.22|0||HOSP BED TOTAL ELECT W/ MATT|| 80001|E0297|RR|137.26|0|137.26|0||HOSP BED TOTAL ELECT W/O MAT|| 80001|E0300|RR|325.86|0|325.86|0||ENCLOSED PED CRIB HOSP GRADE|| 80001|E0301|RR|301.01|0|301.01|0||HD HOSP BED - 350-600 LBS|| 80001|E0302|RR|821.32|0|821.32|0||EX HD HOSP BED > 600 LBS|| 80001|E0303|RR|339.17|0|339.17|0||HOSP BED HVY DTY XTRA WIDE|| 80001|E0304|RR|884.74|0|884.74|0||HOSP BED XTRA HVY DTY X WIDE|| 80001|E0305|RR|17.36|0|17.36|0||RAILS BED SIDE HALF LENGTH|| 80001|E0310|NU|222.86|0|222.86|0||RAILS BED SIDE FULL LENGTH|| 80001|E0310|RR|24.95|0|24.95|0||RAILS BED SIDE FULL LENGTH|| 80001|E0316|RR|242.54|0|242.54|0||BED SAFETY ENCLOSURE|| 80001|E0325|NU|11.46|0|11.46|0||URINAL MALE JUG-TYPE|| 80001|E0325|RR|1.72|0|1.72|0||URINAL MALE JUG-TYPE|| 80001|E0326|NU|12.28|0|12.28|0||URINAL FEMALE JUG-TYPE|| 80001|E0326|RR|1.34|0|1.34|0||URINAL FEMALE JUG-TYPE|| 80001|E0371|RR|494.93|0|494.93|0||NONPOWER MATTRESS OVERLAY|| 80001|E0372|RR|600.55|0|600.55|0||POWERED AIR MATTRESS OVERLAY|| 80001|E0373|RR|687.92|0|687.92|0||NONPOWERED PRESSURE MATTRESS|| 80001|E0424|RR|217.1|0|217.1|0||STATIONARY COMPRESSED GAS 02|| 80001|E0431|RR|36.5|0|36.5|0||PORTABLE GASEOUS 02|| 80001|E0433|RR|61.96|0|61.96|0||PORTABLE LIQUID OXYGEN SYS|| 80001|E0434|RR|36.5|0|36.5|0||PORTABLE LIQUID 02|| 80001|E0439|RR|217.1|0|217.1|0||STATIONARY LIQUID 02|| 80001|E0441||92.94|0|92.94|0||OXYGEN CONTENTS - GASEOUS|| 80001|E0442||92.94|0|92.94|0||OXYGEN CONTENTS - LIQUID|| 80001|E0443||92.94|0|92.94|0||PORTABLE 02 CONTENTS - GAS|| 80001|E0444||92.94|0|92.94|0||PORTABLE 02 CONTENTS - LIQUID|| 80001|E0450|RR|1271.36|0|1271.36|0||VOL CONTROL VENT INVASIV INT|| 80001|E0460|RR|977.06|0|977.06|0||NEG PRESS VENT PORTABL/STATN|| 80001|E0461|RR|1271.36|0|1271.36|0||VOL CONTROL VENT NONINV INT|| 80001|E0462|RR|388.13|0|388.13|0||ROCKING BED W/ OR W/O SIDE R|| 80001|E0463|RR|1873.22|0|1873.22|0||PRESS SUPP VENT INVASIVE INT|| 80001|E0464|RR|1873.22|0|1873.22|0||PRESS SUPP VENT NONINV INT|| 80001|E0470|NU|1980.22|0|1980.22|||RAD W/O BACKUP NON-INV INTFC|| 80001|E0470|RR|294.58|0|294.58|0||RAD W/O BACKUP NON-INV INTFC|| 80001|E0471|RR|737.21|0|737.21|0||RAD W/BACKUP NON INV INTRFC|| 80001|E0472|RR|737.21|0|737.21|0||RAD W BACKUP INVASIVE INTRFC|| 80001|E0480|RR|57.54|0|57.54|0||PERCUSSOR ELECT/PNEUM HOME M|| 80001|E0482|RR|555.56|0|555.56|0||COUGH STIMULATING DEVICE|| 80001|E0483|RR|1416.02|0|1416.02|0||CHEST COMPRESSION GEN SYSTEM|| 80001|E0484|NU|49.19|0|49.19|0||NON-ELEC OSCILLATORY PEP DVC|| 80001|E0484|RR|4.91|0|4.91|0||NON-ELEC OSCILLATORY PEP DVC|| 80001|E0485|NU|0|0|0|0||ORAL DEVICE/APPLIANCE PREFAB|| 80001|E0485|RR|0|0|0|0||ORAL DEVICE/APPLIANCE PREFAB|| 80001|E0486|NU|0|0|0|0||ORAL DEVICE/APPLIANCE CUSFAB|| 80001|E0486|RR|0|0|0|0||ORAL DEVICE/APPLIANCE CUSFAB|| 80001|E0500|RR|124.27|0|124.27|0||IPPB ALL TYPES|| 80001|E0550|RR|66.77|0|66.77|0||HUMIDIF EXTENS SUPPLE W IPPB|| 80001|E0560|NU|167.36|0|167.36|0||HUMIDIFIER SUPPLEMENTAL W/ I|| 80001|E0560|RR|21.13|0|21.13|0||HUMIDIFIER SUPPLEMENTAL W/ I|| 80001|E0561|NU|122.83|0|122.83|0||HUMIDIFIER NONHEATED W PAP|| 80001|E0561|RR|12.26|0|12.26|0||HUMIDIFIER NONHEATED W PAP|| 80001|E0562|NU|345.8|0|345.8|0||HUMIDIFIER HEATED USED W PAP|| 80001|E0562|RR|34.56|0|34.56|0||HUMIDIFIER HEATED USED W PAP|| 80001|E0565|RR|81.26|0|81.26|0||COMPRESSOR AIR POWER SOURCE|| 80001|E0570|NU|126.16|0|126.16|||NEBULIZER WITH COMPRESSION|| 80001|E0570|RR|21.44|0|21.44|0||NEBULIZER WITH COMPRESSION|| 80001|E0572|RR|49.49|0|49.49|0||AEROSOL COMPRESSOR ADJUST PR|| 80001|E0574|RR|52.32|0|52.32|0||ULTRASONIC GENERATOR W SVNEB|| 80001|E0575|RR|134.23|0|134.23|0||NEBULIZER ULTRASONIC|| 80001|E0580|NU|153.89|0|153.89|0||NEBULIZER FOR USE W/ REGULAT|| 80001|E0580|RR|15.4|0|15.4|0||NEBULIZER FOR USE W/ REGULAT|| 80001|E0585|RR|39.7|0|39.7|0||NEBULIZER W/ COMPRESSOR & HE|| 80001|E0600|RR|54.24|0|54.24|0||SUCTION PUMP PORTAB HOM MODL|| 80001|E0601|NU|1113.1|0|1113.1|||CONT AIRWAY PRESSURE DEVICE|| 80001|E0601|RR|128.24|0|128.24|0||CONT AIRWAY PRESSURE DEVICE|| 80001|E0602|NU|39.31|0|39.31|0||MANUAL BREAST PUMP|| 80001|E0602|RR|3.95|0|3.95|0||MANUAL BREAST PUMP|| 80001|E0603|NU|153|0|153|||ELECTRIC BREAST PUMP|| 80001|E0603|RR|15.3|0|15.3|||ELECTRIC BREAST PUMP|| 80001|E0604|NU|153|0|153|||HOSP GRADE ELEC BREAST PUMP|| 80001|E0605|NU|29.93|0|29.93|0||VAPORIZER ROOM TYPE|| 80001|E0605|RR|3.48|0|3.48|0||VAPORIZER ROOM TYPE|| 80001|E0606|RR|30.58|0|30.58|0||DRAINAGE BOARD POSTURAL|| 80001|E0607|NU|88.99|0|88.99|0||BLOOD GLUCOSE MONITOR HOME|| 80001|E0607|RR|8.89|0|8.89|0||BLOOD GLUCOSE MONITOR HOME|| 80001|E0610|NU|280.25|0|280.25|0||PACEMAKER MONITR AUDIBLE/VIS|| 80001|E0610|RR|28.39|0|28.39|0||PACEMAKER MONITR AUDIBLE/VIS|| 80001|E0615|NU|637.74|0|637.74|0||PACEMAKER MONITR DIGITAL/VIS|| 80001|E0615|RR|77.92|0|77.92|0||PACEMAKER MONITR DIGITAL/VIS|| 80001|E0617|RR|404.96|0|404.96|0||AUTOMATIC EXT DEFIBRILLATOR|| 80001|E0618|RR|373.43|0|373.43|0||APNEA MONITOR|| 80001|E0619|RR|0|0|0|0||APNEA MONITOR W RECORDER|| 80001|E0620|RR|116.45|0|116.45|0||CAP BLD SKIN PIERCING LASER|| 80001|E0621|NU|108.67|0|108.67|0||PATIENT LIFT SLING OR SEAT|| 80001|E0621|RR|10.46|0|10.46|0||PATIENT LIFT SLING OR SEAT|| 80001|E0627|NU|449.29|0|449.29|0||SEAT LIFT INCORP LIFT-CHAIR|| 80001|E0627|RR|44.94|0|44.94|0||SEAT LIFT INCORP LIFT-CHAIR|| 80001|E0628|NU|449.29|0|449.29|0||SEAT LIFT FOR PT FURN-ELECTR|| 80001|E0628|RR|44.94|0|44.94|0||SEAT LIFT FOR PT FURN-ELECTR|| 80001|E0629|NU|440.48|0|440.48|0||SEAT LIFT FOR PT FURN-NON-EL|| 80001|E0629|RR|44.05|0|44.05|0||SEAT LIFT FOR PT FURN-NON-EL|| 80001|E0630|RR|122.3|0|122.3|0||PATIENT LIFT HYDRAULIC|| 80001|E0635|RR|162.97|0|162.97|0||PATIENT LIFT ELECTRIC|| 80001|E0636|RR|1404.61|0|1404.61|0||PT SUPPORT & POSITIONING SYS|| 80001|E0639|RR|146.32|0|146.32|0||MOVEABLE PATIENT LIFT SYSTEM|| 80001|E0640|RR|146.32|0|146.32|0||FIXED PATIENT LIFT SYSTEM|| 80001|E0650|NU|815.39|0|815.39|0||PNEUMA COMPRESOR NON-SEGMENT|| 80001|E0650|RR|106.36|0|106.36|0||PNEUMA COMPRESOR NON-SEGMENT|| 80001|E0651|NU|1223.27|0|1223.27|0||PNEUM COMPRESSOR SEGMENTAL|| 80001|E0651|RR|124.97|0|124.97|0||PNEUM COMPRESSOR SEGMENTAL|| 80001|E0652|NU|7061.2|0|7061.2|0||PNEUM COMPRES W/CAL PRESSURE|| 80001|E0652|RR|697.86|0|697.86|0||PNEUM COMPRES W/CAL PRESSURE|| 80001|E0655|NU|125.74|0|125.74|0||PNEUMATIC APPLIANCE HALF ARM|| 80001|E0655|RR|14.36|0|14.36|0||PNEUMATIC APPLIANCE HALF ARM|| 80001|E0656|RR|76.97|0|76.97|0||SEGMENTAL PNEUMATIC TRUNK|| 80001|E0657|RR|72.3|0|72.3|0||SEGMENTAL PNEUMATIC CHEST|| 80001|E0660|NU|212.77|0|212.77|0||PNEUMATIC APPLIANCE FULL LEG|| 80001|E0660|RR|21.7|0|21.7|0||PNEUMATIC APPLIANCE FULL LEG|| 80001|E0665|NU|178.54|0|178.54|0||PNEUMATIC APPLIANCE FULL ARM|| 80001|E0665|RR|17.87|0|17.87|0||PNEUMATIC APPLIANCE FULL ARM|| 80001|E0666|NU|183.94|0|183.94|0||PNEUMATIC APPLIANCE HALF LEG|| 80001|E0666|RR|18.95|0|18.95|0||PNEUMATIC APPLIANCE HALF LEG|| 80001|E0667|NU|431.24|0|431.24|0||SEG PNEUMATIC APPL FULL LEG|| 80001|E0667|RR|48.7|0|48.7|0||SEG PNEUMATIC APPL FULL LEG|| 80001|E0668|NU|588.55|0|588.55|0||SEG PNEUMATIC APPL FULL ARM|| 80001|E0668|RR|58.08|0|58.08|0||SEG PNEUMATIC APPL FULL ARM|| 80001|E0669|NU|241.12|0|241.12|0||SEG PNEUMATIC APPLI HALF LEG|| 80001|E0669|RR|24.13|0|24.13|0||SEG PNEUMATIC APPLI HALF LEG|| 80001|E0670|NU|1674.31|0|1674.31|0||SEG PNEUM INT LEGS/TRUNK|| 80001|E0670|RR|179.24|0|179.24|0||SEG PNEUM INT LEGS/TRUNK|| 80001|E0671|NU|553.22|0|553.22|0||PRESSURE PNEUM APPL FULL LEG|| 80001|E0671|RR|55.34|0|55.34|0||PRESSURE PNEUM APPL FULL LEG|| 80001|E0672|NU|429.84|0|429.84|0||PRESSURE PNEUM APPL FULL ARM|| 80001|E0672|RR|43|0|43|0||PRESSURE PNEUM APPL FULL ARM|| 80001|E0673|NU|357.18|0|357.18|0||PRESSURE PNEUM APPL HALF LEG|| 80001|E0673|RR|35.72|0|35.72|0||PRESSURE PNEUM APPL HALF LEG|| 80001|E0675|RR|512.2|0|512.2|0||PNEUMATIC COMPRESSION DEVICE|| 80001|E0691|NU|1196.87|0|1196.87|0||UVL PNL 2 SQ FT OR LESS|| 80001|E0691|RR|119.68|0|119.68|0||UVL PNL 2 SQ FT OR LESS|| 80001|E0692|NU|1502.94|0|1502.94|0||UVL SYS PANEL 4 FT|| 80001|E0692|RR|150.28|0|150.28|0||UVL SYS PANEL 4 FT|| 80001|E0693|NU|1852.7|0|1852.7|0||UVL SYS PANEL 6 FT|| 80001|E0693|RR|185.28|0|185.28|0||UVL SYS PANEL 6 FT|| 80001|E0694|NU|5896.94|0|5896.94|0||UVL MD CABINET SYS 6 FT|| 80001|E0694|RR|589.69|0|589.69|0||UVL MD CABINET SYS 6 FT|| 80001|E0705|NU|73.42|0|73.42|0||TRANSFER BOARD OR DEVICE|| 80001|E0705|RR|7.46|0|7.46|0||TRANSFER BOARD OR DEVICE|| 80001|E0720|NU|489.59|0|489.59|0||TENS TWO LEAD|| 80001|E0730|NU|493.56|0|493.56|0||TENS FOUR LEAD|| 80001|E0731|NU|475.09|0|475.09|0||CONDUCTIVE GARMENT FOR TENS/|| 80001|E0740|RR|69.66|0|69.66|0||INCONTINENCE TREATMENT SYSTM|| 80001|E0744|RR|121.97|0|121.97|0||NEUROMUSCULAR STIM FOR SCOLI|| 80001|E0745|RR|119.23|0|119.23|0||NEUROMUSCULAR STIM FOR SHOCK|| 80001|E0762|RR|146.45|0|146.45|0||TRANS ELEC JT STIM DEV SYS|| 80001|E0765|NU|112.06|0|112.06|0||NERVE STIMULATOR FOR TX N&V|| 80001|E0765|RR|11.22|0|11.22|0||NERVE STIMULATOR FOR TX N&V|| 80001|E0776|NU|162.08|0|162.08|0||IV POLE|| 80001|E0776|RR|21.12|0|21.12|0||IV POLE|| 80001|E0779|RR|21.74|0|21.74|0||AMB INFUSION PUMP MECHANICAL|| 80001|E0780|NU|13.81|0|13.81|0||MECH AMB INFUSION PUMP <8HRS|| 80001|E0781|RR|342.22|0|342.22|0||EXTERNAL AMBULATORY INFUS PU|| 80001|E0784|RR|556.18|0|556.18|0||EXT AMB INFUSN PUMP INSULIN|| 80001|E0791|RR|357.98|0|357.98|0||PARENTERAL INFUSION PUMP STA|| 80001|E0840|NU|94.64|0|94.64|0||TRACT FRAME ATTACH HEADBOARD|| 80001|E0840|RR|21.74|0|21.74|0||TRACT FRAME ATTACH HEADBOARD|| 80001|E0849|RR|68.65|0|68.65|0||CERVICAL PNEUM TRAC EQUIP|| 80001|E0850|NU|118.93|0|118.93|0||TRACTION STAND FREE STANDING|| 80001|E0850|RR|16.33|0|16.33|0||TRACTION STAND FREE STANDING|| 80001|E0855|RR|66.94|0|66.94|0||CERVICAL TRACTION EQUIPMENT|| 80001|E0856|RR|20.5|0|20.5|0||CERVIC COLLAR W AIR BLADDER|| 80001|E0860|NU|48.19|0|48.19|0||TRACT EQUIP CERVICAL TRACT|| 80001|E0860|RR|7.38|0|7.38|0||TRACT EQUIP CERVICAL TRACT|| 80001|E0870|NU|131.69|0|131.69|0||TRACT FRAME ATTACH FOOTBOARD|| 80001|E0870|RR|15.19|0|15.19|0||TRACT FRAME ATTACH FOOTBOARD|| 80001|E0880|NU|142.14|0|142.14|0||TRAC STAND FREE STAND EXTREM|| 80001|E0880|RR|22.32|0|22.32|0||TRAC STAND FREE STAND EXTREM|| 80001|E0890|NU|136.31|0|136.31|0||TRACTION FRAME ATTACH PELVIC|| 80001|E0890|RR|43.49|0|43.49|0||TRACTION FRAME ATTACH PELVIC|| 80001|E0900|NU|145.07|0|145.07|0||TRAC STAND FREE STAND PELVIC|| 80001|E0900|RR|31.27|0|31.27|0||TRAC STAND FREE STAND PELVIC|| 80001|E0910|RR|21.59|0|21.59|0||TRAPEZE BAR ATTACHED TO BED|| 80001|E0911|RR|57.22|0|57.22|0||HD TRAPEZE BAR ATTACH TO BED|| 80001|E0912|RR|131.42|0|131.42|0||HD TRAPEZE BAR FREE STANDING|| 80001|E0920|RR|54.61|0|54.61|0||FRACTURE FRAME ATTACHED TO B|| 80001|E0930|RR|51.72|0|51.72|0||FRACTURE FRAME FREE STANDING|| 80001|E0935|RR|25.74|0|25.74|0||CONT PAS MOTION EXERCISE DEV|| 80001|E0940|RR|33.92|0|33.92|0||TRAPEZE BAR FREE STANDING|| 80001|E0941|RR|57.8|0|57.8|0||GRAVITY ASSISTED TRACTION DE|| 80001|E0942|NU|22.91|0|22.91|0||CERVICAL HEAD HARNESS/HALTER|| 80001|E0942|RR|2.66|0|2.66|0||CERVICAL HEAD HARNESS/HALTER|| 80001|E0944|NU|59.7|0|59.7|0||PELVIC BELT/HARNESS/BOOT|| 80001|E0944|RR|5.98|0|5.98|0||PELVIC BELT/HARNESS/BOOT|| 80001|E0945|NU|50.18|0|50.18|0||BELT/HARNESS EXTREMITY|| 80001|E0945|RR|5.03|0|5.03|0||BELT/HARNESS EXTREMITY|| 80001|E0946|RR|66.98|0|66.98|0||FRACTURE FRAME DUAL W CROSS|| 80001|E0947|NU|715.6|0|715.6|0||FRACTURE FRAME ATTACHMNTS PE|| 80001|E0947|RR|72.44|0|72.44|0||FRACTURE FRAME ATTACHMNTS PE|| 80001|E0948|NU|715.6|0|715.6|0||FRACTURE FRAME ATTACHMNTS CE|| 80001|E0948|RR|71.57|0|71.57|0||FRACTURE FRAME ATTACHMNTS CE|| 80001|E0950|NU|101.44|0|101.44|0||TRAY|| 80001|E0950|RR|10.16|0|10.16|0||TRAY|| 80001|E0951|NU|21.79|0|21.79|0||LOOP HEEL|| 80001|E0951|RR|2.24|0|2.24|0||LOOP HEEL|| 80001|E0952|NU|18.38|0|18.38|0||TOE LOOP/HOLDER - EACH|| 80001|E0952|RR|1.91|0|1.91|0||TOE LOOP/HOLDER - EACH|| 80001|E0953|NU|87.48|0|87.48|0||PNEUMATIC TIRE EACH|| 80001|E0953|RR|8.75|0|8.75|0||PNEUMATIC TIRE EACH|| 80001|E0954|NU|60.82|0|60.82|0||SEMI-PNEUMATIC CASTER EACH|| 80001|E0954|RR|6.11|0|6.11|0||SEMI-PNEUMATIC CASTER EACH|| 80001|E0955|NU|232.12|0|232.12|0||CUSHIONED HEADREST|| 80001|E0955|RR|23.23|0|23.23|0||CUSHIONED HEADREST|| 80001|E0956|NU|113.16|0|113.16|0||W/C LATERAL TRUNK/HIP SUPPOR|| 80001|E0956|RR|11.32|0|11.32|0||W/C LATERAL TRUNK/HIP SUPPOR|| 80001|E0957|NU|158.35|0|158.35|0||W/C MEDIAL THIGH SUPPORT|| 80001|E0957|RR|15.84|0|15.84|0||W/C MEDIAL THIGH SUPPORT|| 80001|E0958|RR|57.11|0|57.11|0||WHLCHR ATT- CONV 1 ARM DRIVE|| 80001|E0959|NU|51.29|0|51.29|0||AMPUTEE ADAPTER|| 80001|E0959|RR|5.11|0|5.11|0||AMPUTEE ADAPTER|| 80001|E0960|NU|104.45|0|104.45|0||W/C SHOULDER HARNESS/STRAPS|| 80001|E0960|RR|10.46|0|10.46|0||W/C SHOULDER HARNESS/STRAPS|| 80001|E0961|NU|33.68|0|33.68|0||WHEELCHAIR BRAKE EXTENSION|| 80001|E0961|RR|3.52|0|3.52|0||WHEELCHAIR BRAKE EXTENSION|| 80001|E0966|NU|87.32|0|87.32|0||WHEELCHAIR HEAD REST EXTENSI|| 80001|E0966|RR|8.72|0|8.72|0||WHEELCHAIR HEAD REST EXTENSI|| 80001|E0967|NU|87.48|0|87.48|0||WHEELCHAIR HAND RIMS|| 80001|E0967|RR|8.76|0|8.76|0||WHEELCHAIR HAND RIMS|| 80001|E0968|RR|22.96|0|22.96|0||WHEELCHAIR COMMODE SEAT|| 80001|E0969|NU|208.63|0|208.63|0||WHEELCHAIR NARROWING DEVICE|| 80001|E0969|RR|20.65|0|20.65|0||WHEELCHAIR NARROWING DEVICE|| 80001|E0971|NU|57.78|0|57.78|0||WHEELCHAIR ANTI-TIPPING DEVI|| 80001|E0971|RR|5.8|0|5.8|0||WHEELCHAIR ANTI-TIPPING DEVI|| 80001|E0973|NU|131.99|0|131.99|0||W/CH ACCESS DET ADJ ARMREST|| 80001|E0973|RR|12.56|0|12.56|0||W/CH ACCESS DET ADJ ARMREST|| 80001|E0974|NU|104.44|0|104.44|0||W/CH ACCESS ANTI-ROLLBACK|| 80001|E0974|RR|11.08|0|11.08|0||W/CH ACCESS ANTI-ROLLBACK|| 80001|E0978|NU|49.02|0|49.02|0||W/C ACC - SAF BELT PELV STRAP|| 80001|E0978|RR|4.91|0|4.91|0||W/C ACC - SAF BELT PELV STRAP|| 80001|E0980|NU|37.43|0|37.43|0||WHEELCHAIR SAFETY VEST|| 80001|E0980|RR|3.74|0|3.74|0||WHEELCHAIR SAFETY VEST|| 80001|E0981|NU|52.34|0|52.34|0||SEAT UPHOLSTERY - REPLACEMENT|| 80001|E0981|RR|5.23|0|5.23|0||SEAT UPHOLSTERY - REPLACEMENT|| 80001|E0982|NU|59.15|0|59.15|0||BACK UPHOLSTERY - REPLACEMENT|| 80001|E0982|RR|5.92|0|5.92|0||BACK UPHOLSTERY - REPLACEMENT|| 80001|E0983|RR|323.54|0|323.54|0||ADD PWR JOYSTICK|| 80001|E0984|RR|254.46|0|254.46|0||ADD PWR TILLER|| 80001|E0985|NU|270.19|0|270.19|0||W/C SEAT LIFT MECHANISM|| 80001|E0985|RR|27.04|0|27.04|0||W/C SEAT LIFT MECHANISM|| 80001|E0986|RR|647.9|0|647.9|0||MAN W/C PUSH-RIM POW ASSIST|| 80001|E0988|RR|398.71|0|398.71|0||LEVER-ACTIVATED WHEEL DRIVE|| 80001|E0990|NU|134.81|0|134.81|0||WHELLCHAIR ELEVATING LEG RES|| 80001|E0990|RR|13.49|0|13.49|0||WHELLCHAIR ELEVATING LEG RES|| 80001|E0992|NU|107.74|0|107.74|0||WHEELCHAIR SOLID SEAT INSERT|| 80001|E0992|RR|10.67|0|10.67|0||WHEELCHAIR SOLID SEAT INSERT|| 80001|E0994|NU|19.96|0|19.96|0||WHEELCHAIR ARM REST|| 80001|E0994|RR|2.02|0|2.02|0||WHEELCHAIR ARM REST|| 80001|E0995|NU|34.9|0|34.9|0||WHEELCHAIR CALF REST|| 80001|E0995|RR|3.5|0|3.5|0||WHEELCHAIR CALF REST|| 80001|E1002|RR|465.29|0|465.29|0||PWR SEAT TILT|| 80001|E1003|RR|504.13|0|504.13|0||PWR SEAT RECLINE|| 80001|E1004|RR|558.95|0|558.95|0||PWR SEAT RECLINE MECH|| 80001|E1005|RR|605.03|0|605.03|0||PWR SEAT RECLINE PWR|| 80001|E1006|RR|741.1|0|741.1|0||PWR SEAT COMBO W/O SHEAR|| 80001|E1007|RR|1003.51|0|1003.51|0||PWR SEAT COMBO W/SHEAR|| 80001|E1008|RR|1003.58|0|1003.58|0||PWR SEAT COMBO PWR SHEAR|| 80001|E1009|NU|0|0|0|0||ADD MECH LEG ELEVATION|| 80001|E1009|RR|0|0|0|0||ADD MECH LEG ELEVATION|| 80001|E1010|RR|131.32|0|131.32|0||ADD PWR LEG ELEVATION|| 80001|E1011|NU|0|0|0|0||PED WC MODIFY WIDTH ADJUSTM|| 80001|E1011|RR|0|0|0|0||PED WC MODIFY WIDTH ADJUSTM|| 80001|E1014|RR|48.65|0|48.65|0||RECLINING BACK ADD PED W/C|| 80001|E1015|NU|152.78|0|152.78|0||SHOCK ABSORBER FOR MAN W/C|| 80001|E1015|RR|15.26|0|15.26|0||SHOCK ABSORBER FOR MAN W/C|| 80001|E1016|NU|150.76|0|150.76|0||SHOCK ABSORBER FOR POWER W/C|| 80001|E1016|RR|15.1|0|15.1|0||SHOCK ABSORBER FOR POWER W/C|| 80001|E1017|NU|0|0|0|0||HD SHCK ABSRBR FOR HD MAN WC|| 80001|E1017|RR|0|0|0|0||HD SHCK ABSRBR FOR HD MAN WC|| 80001|E1018|NU|0|0|0|0||HD SHCK ABSRBER FOR HD POWWC|| 80001|E1018|RR|0|0|0|0||HD SHCK ABSRBER FOR HD POWWC|| 80001|E1020|NU|279.43|0|279.43|0||RESIDUAL LIMB SUPPORT SYSTEM|| 80001|E1020|RR|27.92|0|27.92|0||RESIDUAL LIMB SUPPORT SYSTEM|| 80001|E1028|NU|237.11|0|237.11|0||W/C MANUAL SWINGAWAY|| 80001|E1028|RR|23.7|0|23.7|0||W/C MANUAL SWINGAWAY|| 80001|E1029|RR|42.41|0|42.41|0||W/C VENT TRAY FIXED|| 80001|E1030|RR|133.78|0|133.78|0||W/C VENT TRAY GIMBALED|| 80001|E1031|RR|57.19|0|57.19|0||ROLLABOUT CHAIR WITH CASTERS|| 80001|E1035|RR|816.76|0|816.76|0||PATIENT TRANSFER SYSTEM|| 80001|E1036|RR|1145|0|1145|0||PATIENT TRANSFER SYSTEM >300|| 80001|E1037|RR|144.49|0|144.49|0||TRANSPORT CHAIR - PED SIZE|| 80001|E1038|RR|24.01|0|24.01|0||TRANSPORT CHAIR PT WT<=300LB|| 80001|E1039|RR|45.54|0|45.54|0||TRANSPORT CHAIR PT WT >300LB|| 80001|E1050|RR|115.3|0|115.3|0||WHELCHR FXD FULL LENGTH ARMS|| 80001|E1060|RR|142.72|0|142.72|0||WHEELCHAIR DETACHABLE ARMS|| 80001|E1070|RR|124.01|0|124.01|0||WHEELCHAIR DETACHABLE FOOT R|| 80001|E1083|RR|89.15|0|89.15|0||HEMI-WHEELCHAIR FIXED ARMS|| 80001|E1084|RR|130.67|0|130.67|0||HEMI-WHEELCHAIR DETACHABLE A|| 80001|E1087|RR|143.24|0|143.24|0||WHEELCHAIR LIGHTWT FIXED ARM|| 80001|E1088|RR|183.37|0|183.37|0||WHEELCHAIR LIGHTWEIGHT DET A|| 80001|E1092|RR|171.18|0|171.18|0||WHEELCHAIR WIDE W/ LEG RESTS|| 80001|E1093|RR|125.12|0|125.12|0||WHEELCHAIR WIDE W/ FOOT REST|| 80001|E1100|RR|117.52|0|117.52|0||WHCHR S-RECL FXD ARM LEG RES|| 80001|E1110|RR|115.09|0|115.09|0||WHEELCHAIR SEMI-RECL DETACH|| 80001|E1150|RR|99.66|0|99.66|0||WHEELCHAIR STANDARD W/ LEG R|| 80001|E1160|RR|70.76|0|70.76|0||WHEELCHAIR FIXED ARMS|| 80001|E1161|RR|315.14|0|315.14|0||MANUAL ADULT WC W TILTINSPAC|| 80001|E1170|RR|101.14|0|101.14|0||WHLCHR AMPU FXD ARM LEG REST|| 80001|E1171|RR|94.42|0|94.42|0||WHEELCHAIR AMPUTEE W/O LEG R|| 80001|E1172|RR|130.48|0|130.48|0||WHEELCHAIR AMPUTEE DETACH AR|| 80001|E1180|RR|114.73|0|114.73|0||WHEELCHAIR AMPUTEE W/ FOOT R|| 80001|E1190|RR|132.55|0|132.55|0||WHEELCHAIR AMPUTEE W/ LEG RE|| 80001|E1195|RR|142.22|0|142.22|0||WHEELCHAIR AMPUTEE HEAVY DUT|| 80001|E1200|RR|98.51|0|98.51|0||WHEELCHAIR AMPUTEE FIXED ARM|| 80001|E1221|RR|63.29|0|63.29|0||WHEELCHAIR SPEC SIZE W FOOT|| 80001|E1222|RR|89.51|0|89.51|0||WHEELCHAIR SPEC SIZE W/ LEG|| 80001|E1223|RR|98.58|0|98.58|0||WHEELCHAIR SPEC SIZE W FOOT|| 80001|E1224|RR|108.08|0|108.08|0||WHEELCHAIR SPEC SIZE W/ LEG|| 80001|E1225|RR|54.1|0|54.1|0||MANUAL SEMI-RECLINING BACK|| 80001|E1226|NU|726.78|0|726.78|0||MANUAL FULLY RECLINING BACK|| 80001|E1226|RR|74.8|0|74.8|0||MANUAL FULLY RECLINING BACK|| 80001|E1227|NU|369.61|0|369.61|0||WHEELCHAIR SPEC SZ SPEC HT A|| 80001|E1227|RR|36.97|0|36.97|0||WHEELCHAIR SPEC SZ SPEC HT A|| 80001|E1228|RR|31.73|0|31.73|0||WHEELCHAIR SPEC SZ SPEC HT B|| 80001|E1230|NU|3012.58|0|3012.58|0||POWER OPERATED VEHICLE|| 80001|E1230|RR|296.29|0|296.29|0||POWER OPERATED VEHICLE|| 80001|E1231|NU|0|0|0|0||RIGID PED W/C TILT-IN-SPACE|| 80001|E1231|RR|0|0|0|0||RIGID PED W/C TILT-IN-SPACE|| 80001|E1232|RR|284.84|0|284.84|0||FOLDING PED WC TILT-IN-SPACE|| 80001|E1233|RR|295.12|0|295.12|0||RIG PED WC TLTNSPC W/O SEAT|| 80001|E1234|RR|256.94|0|256.94|0||FLD PED WC TLTNSPC W/O SEAT|| 80001|E1235|RR|247.42|0|247.42|0||RIGID PED WC ADJUSTABLE|| 80001|E1236|RR|218.27|0|218.27|0||FOLDING PED WC ADJUSTABLE|| 80001|E1237|RR|220.18|0|220.18|0||RGD PED WC ADJSTABL W/O SEAT|| 80001|E1238|RR|218.27|0|218.27|0||FLD PED WC ADJSTABL W/O SEAT|| 80001|E1240|RR|137.22|0|137.22|0||WHCHR LITWT DET ARM LEG REST|| 80001|E1270|RR|105.14|0|105.14|0||WHEELCHAIR LIGHTWEIGHT LEG R|| 80001|E1280|RR|152.28|0|152.28|0||WHCHR H-DUTY DET ARM LEG RES|| 80001|E1295|RR|161.78|0|161.78|0||WHEELCHAIR HEAVY DUTY FIXED|| 80001|E1296|NU|654.85|0|654.85|0||WHEELCHAIR SPECIAL SEAT HEIG|| 80001|E1296|RR|66.53|0|66.53|0||WHEELCHAIR SPECIAL SEAT HEIG|| 80001|E1297|NU|139.33|0|139.33|0||WHEELCHAIR SPECIAL SEAT DEPT|| 80001|E1297|RR|15.48|0|15.48|0||WHEELCHAIR SPECIAL SEAT DEPT|| 80001|E1298|NU|564.29|0|564.29|0||WHEELCHAIR SPEC SEAT DEPTH/W|| 80001|E1298|RR|57.73|0|57.73|0||WHEELCHAIR SPEC SEAT DEPTH/W|| 80001|E1310|NU|2860.2|0|2860.2|0||WHIRLPOOL NON-PORTABLE|| 80001|E1310|RR|244.63|0|244.63|0||WHIRLPOOL NON-PORTABLE|| 80001|E1353||37.73|0|37.73|0||OXYGEN SUPPLIES REGULATOR|| 80001|E1355||28.42|0|28.42|0||OXYGEN SUPPLIES STAND/RACK|| 80001|E1372|NU|184.57|0|184.57|0||OXY SUPPL HEATER FOR NEBULIZ|| 80001|E1372|RR|26.83|0|26.83|0||OXY SUPPL HEATER FOR NEBULIZ|| 80001|E1390|NU|1604.18|0|1604.18|||OXYGEN CONCENTRATOR|| 80001|E1390|RR|217.1|0|217.1|0||OXYGEN CONCENTRATOR|| 80001|E1391|RR|217.1|0|217.1|0||OXYGEN CONCENTRATOR - DUAL|| 80001|E1392|RR|61.96|0|61.96|0||PORTABLE OXYGEN CONCENTRATOR|| 80001|E1405|RR|256.8|0|256.8|0||O2/WATER VAPOR ENRICH W/HEAT|| 80001|E1406|RR|238.55|0|238.55|0||O2/WATER VAPOR ENRICH W/O HE|| 80001|E1700|RR|45.94|0|45.94|0||JAW MOTION REHAB SYSTEM|| 80001|E1701||13.42|0|13.42|0||REPL CUSHIONS FOR JAW MOTION|| 80001|E1702||26.94|0|26.94|0||REPL MEASR SCALES JAW MOTION|| 80001|E1800|RR|138.68|0|138.68|0||ADJUST ELBOW EXT/FLEX DEVICE|| 80001|E1801|RR|166.69|0|166.69|0||SPS ELBOW DEVICE|| 80001|E1802|RR|435.29|0|435.29|0||ADJST FOREARM PRO/SUP DEVICE|| 80001|E1805|RR|143.04|0|143.04|0||ADJUST WRIST EXT/FLEX DEVICE|| 80001|E1806|RR|136.84|0|136.84|0||SPS WRIST DEVICE|| 80001|E1810|RR|141.05|0|141.05|0||ADJUST KNEE EXT/FLEX DEVICE|| 80001|E1811|RR|173.3|0|173.3|0||SPS KNEE DEVICE|| 80001|E1812|RR|114.53|0|114.53|0||KNEE EXT/FLEX W ACT RES CTRL|| 80001|E1815|RR|143.04|0|143.04|0||ADJUST ANKLE EXT/FLEX DEVICE|| 80001|E1816|RR|176|0|176|0||SPS ANKLE DEVICE|| 80001|E1818|RR|179.66|0|179.66|0||SPS FOREARM DEVICE|| 80001|E1820|NU|108.88|0|108.88|0||SOFT INTERFACE MATERIAL|| 80001|E1820|RR|10.88|0|10.88|0||SOFT INTERFACE MATERIAL|| 80001|E1821|NU|140.18|0|140.18|0||REPLACEMENT INTERFACE SPSD|| 80001|E1821|RR|13.99|0|13.99|0||REPLACEMENT INTERFACE SPSD|| 80001|E1825|RR|143.04|0|143.04|0||ADJUST FINGER EXT/FLEX DEVC|| 80001|E1830|RR|143.04|0|143.04|0||ADJUST TOE EXT/FLEX DEVICE|| 80001|E1831|RR|88.01|0|88.01|0||STATIC STR TOE DEV EXT/FLEX|| 80001|E1840|RR|492.89|0|492.89|0||ADJ SHOULDER EXT/FLEX DEVICE|| 80001|E1841|RR|603.35|0|603.35|0||STATIC STR SHLDR DEV ROM ADJ|| 80001|E2000|RR|66.94|0|66.94|0||GASTRIC SUCTION PUMP HME MDL|| 80001|E2100|NU|728.18|0|728.18|0||BLD GLUCOSE MONITOR W VOICE|| 80001|E2100|RR|72.83|0|72.83|0||BLD GLUCOSE MONITOR W VOICE|| 80001|E2101|NU|251.15|0|251.15|0||BLD GLUCOSE MONITOR W LANCE|| 80001|E2101|RR|25.1|0|25.1|0||BLD GLUCOSE MONITOR W LANCE|| 80001|E2120|RR|377.64|0|377.64|0||PULSE GEN SYS TX ENDOLYMP FL|| 80001|E2201|NU|496.96|0|496.96|0||"MAN W/CH ACC SEAT W>=20""<24"""|| 80001|E2201|RR|49.69|0|49.69|0||"MAN W/CH ACC SEAT W>=20""<24"""|| 80001|E2202|NU|631.3|0|631.3|0||SEAT WIDTH 24-27 IN|| 80001|E2202|RR|63.13|0|63.13|0||SEAT WIDTH 24-27 IN|| 80001|E2203|NU|638.08|0|638.08|0||FRAME DEPTH LESS THAN 22 IN|| 80001|E2203|RR|63.79|0|63.79|0||FRAME DEPTH LESS THAN 22 IN|| 80001|E2204|NU|1083.41|0|1083.41|0||FRAME DEPTH 22 TO 25 IN|| 80001|E2204|RR|108.35|0|108.35|0||FRAME DEPTH 22 TO 25 IN|| 80001|E2205|NU|43.51|0|43.51|0||MANUAL WC ACCESSORY - HANDRIM|| 80001|E2205|RR|4.33|0|4.33|0||MANUAL WC ACCESSORY - HANDRIM|| 80001|E2206|NU|54.18|0|54.18|0||COMPLETE WHEEL LOCK ASSEMBLY|| 80001|E2206|RR|5.4|0|5.4|0||COMPLETE WHEEL LOCK ASSEMBLY|| 80001|E2207|NU|57.73|0|57.73|0||CRUTCH AND CANE HOLDER|| 80001|E2207|RR|5.8|0|5.8|0||CRUTCH AND CANE HOLDER|| 80001|E2208|NU|136.37|0|136.37|0||CYLINDER TANK CARRIER|| 80001|E2208|RR|13.63|0|13.63|0||CYLINDER TANK CARRIER|| 80001|E2209|NU|123.02|0|123.02|0||ARM TROUGH EACH|| 80001|E2209|RR|12.32|0|12.32|0||ARM TROUGH EACH|| 80001|E2210|NU|7.51|0|7.51|0||WHEELCHAIR BEARINGS|| 80001|E2210|RR|0.76|0|0.76|0||WHEELCHAIR BEARINGS|| 80001|E2211|NU|48.74|0|48.74|0||PNEUMATIC PROPULSION TIRE|| 80001|E2211|RR|4.85|0|4.85|0||PNEUMATIC PROPULSION TIRE|| 80001|E2212|NU|7.82|0|7.82|0||PNEUMATIC PROP TIRE TUBE|| 80001|E2212|RR|0.83|0|0.83|0||PNEUMATIC PROP TIRE TUBE|| 80001|E2213|NU|40.51|0|40.51|0||PNEUMATIC PROP TIRE INSERT|| 80001|E2213|RR|4.07|0|4.07|0||PNEUMATIC PROP TIRE INSERT|| 80001|E2214|NU|40.76|0|40.76|0||PNEUMATIC CASTER TIRE EACH|| 80001|E2214|RR|4.48|0|4.48|0||PNEUMATIC CASTER TIRE EACH|| 80001|E2215|NU|12.78|0|12.78|0||PNEUMATIC CASTER TIRE TUBE|| 80001|E2215|RR|1.27|0|1.27|0||PNEUMATIC CASTER TIRE TUBE|| 80001|E2216|NU|0|0|0|0||FOAM FILLED PROPULSION TIRE|| 80001|E2216|RR|0|0|0|0||FOAM FILLED PROPULSION TIRE|| 80001|E2217|NU|0|0|0|0||FOAM FILLED CASTER TIRE EACH|| 80001|E2217|RR|0|0|0|0||FOAM FILLED CASTER TIRE EACH|| 80001|E2218|NU|0|0|0|0||FOAM PROPULSION TIRE EACH|| 80001|E2218|RR|0|0|0|0||FOAM PROPULSION TIRE EACH|| 80001|E2219|NU|55.74|0|55.74|0||FOAM CASTER TIRE ANY SIZE EA|| 80001|E2219|RR|6.3|0|6.3|0||FOAM CASTER TIRE ANY SIZE EA|| 80001|E2220|NU|38|0|38|0||SOLID PROPULSION TIRE EACH|| 80001|E2220|RR|3.67|0|3.67|0||SOLID PROPULSION TIRE EACH|| 80001|E2221|NU|34.03|0|34.03|0||SOLID CASTER TIRE EACH|| 80001|E2221|RR|3.44|0|3.44|0||SOLID CASTER TIRE EACH|| 80001|E2222|NU|28.06|0|28.06|0||SOLID CASTER INTEGRATED WHL|| 80001|E2222|RR|2.77|0|2.77|0||SOLID CASTER INTEGRATED WHL|| 80001|E2224|NU|111.01|0|111.01|0||PROPULSION WHL EXCLUDES TIRE|| 80001|E2224|RR|11.65|0|11.65|0||PROPULSION WHL EXCLUDES TIRE|| 80001|E2225|NU|23.18|0|23.18|0||CASTER WHEEL EXCLUDES TIRE|| 80001|E2225|RR|2.32|0|2.32|0||CASTER WHEEL EXCLUDES TIRE|| 80001|E2226|NU|50.54|0|50.54|0||CASTER FORK REPLACEMENT ONLY|| 80001|E2226|RR|5.05|0|5.05|0||CASTER FORK REPLACEMENT ONLY|| 80001|E2227|RR|249.18|0|249.18|0||GEAR REDUCTION DRIVE WHEEL|| 80001|E2228|NU|1247.05|0|1247.05|0||MWC ACC - WHEELCHAIR BRAKE|| 80001|E2228|RR|124.69|0|124.69|0||MWC ACC - WHEELCHAIR BRAKE|| 80001|E2231|NU|204.68|0|204.68|0||SOLID SEAT SUPPORT BASE|| 80001|E2231|RR|20.47|0|20.47|0||SOLID SEAT SUPPORT BASE|| 80001|E2293|NU|399.36|0|399.36|||CONTOUR BACK FOR PED SIZE WC|| 80001|E2294|NU|345.8|0|345.8|||CONTOUR SEAT FOR PED SIZE WC|| 80001|E2310|RR|134.33|0|134.33|0||ELECTRO CONNECT BTW CONTROL|| 80001|E2311|RR|271.99|0|271.99|0||ELECTRO CONNECT BTW 2 SYS|| 80001|E2312|RR|268.61|0|268.61|0||MINI-PROP REMOTE JOYSTICK|| 80001|E2313|RR|42.68|0|42.68|0||PWC HARNESS - EXPAND CONTROL|| 80001|E2321|RR|182.45|0|182.45|0||HAND INTERFACE JOYSTICK|| 80001|E2322|RR|161.89|0|161.89|0||MULT MECH SWITCHES|| 80001|E2323|NU|79.4|0|79.4|0||SPECIAL JOYSTICK HANDLE|| 80001|E2323|RR|7.93|0|7.93|0||SPECIAL JOYSTICK HANDLE|| 80001|E2324|NU|50.3|0|50.3|0||CHIN CUP INTERFACE|| 80001|E2324|RR|5|0|5|0||CHIN CUP INTERFACE|| 80001|E2325|RR|154.63|0|154.63|0||SIP AND PUFF INTERFACE|| 80001|E2326|RR|39.86|0|39.86|0||BREATH TUBE KIT|| 80001|E2327|RR|299.89|0|299.89|0||HEAD CONTROL INTERFACE MECH|| 80001|E2328|RR|568.86|0|568.86|0||HEAD/EXTREMITY CONTROL INTER|| 80001|E2329|RR|202.75|0|202.75|0||HEAD CONTROL NONPROPORTIONAL|| 80001|E2330|RR|392.84|0|392.84|0||HEAD CONTROL PROXIMITY SWITC|| 80001|E2340|NU|477.31|0|477.31|0||W/C WDTH 20-23 IN SEAT FRAME|| 80001|E2340|RR|47.75|0|47.75|0||W/C WDTH 20-23 IN SEAT FRAME|| 80001|E2341|NU|716.03|0|716.03|0||W/C WDTH 24-27 IN SEAT FRAME|| 80001|E2341|RR|71.59|0|71.59|0||W/C WDTH 24-27 IN SEAT FRAME|| 80001|E2342|NU|596.69|0|596.69|0||W/C DPTH 20-21 IN SEAT FRAME|| 80001|E2342|RR|59.66|0|59.66|0||W/C DPTH 20-21 IN SEAT FRAME|| 80001|E2343|NU|954.71|0|954.71|0||W/C DPTH 22-25 IN SEAT FRAME|| 80001|E2343|RR|95.46|0|95.46|0||W/C DPTH 22-25 IN SEAT FRAME|| 80001|E2351|NU|802.03|0|802.03|0||ELECTRONIC SGD INTERFACE|| 80001|E2351|RR|80.23|0|80.23|0||ELECTRONIC SGD INTERFACE|| 80001|E2359|NU|231.95|0|231.95|0||GR34 SEALED LEADACID BATTERY|| 80001|E2359|RR|23.21|0|23.21|0||GR34 SEALED LEADACID BATTERY|| 80001|E2360|NU|127.2|0|127.2|0||22NF NONSEALED LEADACID|| 80001|E2360|RR|12.78|0|12.78|0||22NF NONSEALED LEADACID|| 80001|E2361|NU|160.1|0|160.1|0||22NF SEALED LEADACID BATTERY|| 80001|E2361|RR|16.01|0|16.01|0||22NF SEALED LEADACID BATTERY|| 80001|E2362|NU|122.52|0|122.52|0||GR24 NONSEALED LEADACID|| 80001|E2362|RR|12.25|0|12.25|0||GR24 NONSEALED LEADACID|| 80001|E2363|NU|213.54|0|213.54|0||GR24 SEALED LEADACID BATTERY|| 80001|E2363|RR|21.35|0|21.35|0||GR24 SEALED LEADACID BATTERY|| 80001|E2364|NU|127.2|0|127.2|0||U1NONSEALED LEADACID BATTERY|| 80001|E2364|RR|12.78|0|12.78|0||U1NONSEALED LEADACID BATTERY|| 80001|E2365|NU|128.77|0|128.77|0||U1 SEALED LEADACID BATTERY|| 80001|E2365|RR|12.86|0|12.86|0||U1 SEALED LEADACID BATTERY|| 80001|E2366|NU|257.24|0|257.24|0||BATTERY CHARGER - SINGLE MODE|| 80001|E2366|RR|25.8|0|25.8|0||BATTERY CHARGER - SINGLE MODE|| 80001|E2367|NU|481.09|0|481.09|0||BATTERY CHARGER - DUAL MODE|| 80001|E2367|RR|48.11|0|48.11|0||BATTERY CHARGER - DUAL MODE|| 80001|E2368|NU|593.03|0|593.03|0||POWER WC MOTOR REPLACEMENT|| 80001|E2368|RR|59.3|0|59.3|0||POWER WC MOTOR REPLACEMENT|| 80001|E2369|NU|516.53|0|516.53|0||PWR WC GEAR BOX REPLACEMENT|| 80001|E2369|RR|51.67|0|51.67|0||PWR WC GEAR BOX REPLACEMENT|| 80001|E2370|NU|921.66|0|921.66|0||PWR WC MOTOR/GEAR BOX COMBO|| 80001|E2370|RR|92.17|0|92.17|0||PWR WC MOTOR/GEAR BOX COMBO|| 80001|E2371|NU|173.05|0|173.05|0||GR27 SEALED LEADACID BATTERY|| 80001|E2371|RR|17.32|0|17.32|0||GR27 SEALED LEADACID BATTERY|| 80001|E2372|NU|0|0|0|0||GR27 NON-SEALED LEADACID|| 80001|E2372|RR|0|0|0|0||GR27 NON-SEALED LEADACID|| 80001|E2373|RR|93.61|0|93.61|0||HAND/CHIN CTRL SPEC JOYSTICK|| 80001|E2374|RR|61.32|0|61.32|0||HAND/CHIN CTRL STD JOYSTICK|| 80001|E2375|NU|983.33|0|983.33|0||NON-EXPANDABLE CONTROLLER|| 80001|E2375|RR|98.32|0|98.32|0||NON-EXPANDABLE CONTROLLER|| 80001|E2376|RR|154.09|0|154.09|0||EXPANDABLE CONTROLLER - REPL|| 80001|E2377|RR|55.75|0|55.75|0||EXPANDABLE CONTROLLER - INITL|| 80001|E2378|RR|68.16|0|68.16|0||PW ACTUATOR REPLACEMENT|| 80001|E2381|NU|87.44|0|87.44|0||PNEUM DRIVE WHEEL TIRE|| 80001|E2381|RR|8.77|0|8.77|0||PNEUM DRIVE WHEEL TIRE|| 80001|E2382|NU|23.83|0|23.83|0||TUBE - PNEUM WHEEL DRIVE TIRE|| 80001|E2382|RR|2.38|0|2.38|0||TUBE - PNEUM WHEEL DRIVE TIRE|| 80001|E2383|NU|174.36|0|174.36|0||INSERT - PNEUM WHEEL DRIVE|| 80001|E2383|RR|17.44|0|17.44|0||INSERT - PNEUM WHEEL DRIVE|| 80001|E2384|NU|92.89|0|92.89|0||PNEUMATIC CASTER TIRE|| 80001|E2384|RR|9.31|0|9.31|0||PNEUMATIC CASTER TIRE|| 80001|E2385|NU|56.83|0|56.83|0||TUBE - PNEUMATIC CASTER TIRE|| 80001|E2385|RR|5.71|0|5.71|0||TUBE - PNEUMATIC CASTER TIRE|| 80001|E2386|NU|172.78|0|172.78|0||FOAM FILLED DRIVE WHEEL TIRE|| 80001|E2386|RR|17.28|0|17.28|0||FOAM FILLED DRIVE WHEEL TIRE|| 80001|E2387|NU|77.47|0|77.47|0||FOAM FILLED CASTER TIRE|| 80001|E2387|RR|7.75|0|7.75|0||FOAM FILLED CASTER TIRE|| 80001|E2388|NU|57.83|0|57.83|0||FOAM DRIVE WHEEL TIRE|| 80001|E2388|RR|5.8|0|5.8|0||FOAM DRIVE WHEEL TIRE|| 80001|E2389|NU|31.42|0|31.42|0||FOAM CASTER TIRE|| 80001|E2389|RR|3.16|0|3.16|0||FOAM CASTER TIRE|| 80001|E2390|NU|49.12|0|49.12|0||SOLID DRIVE WHEEL TIRE|| 80001|E2390|RR|4.91|0|4.91|0||SOLID DRIVE WHEEL TIRE|| 80001|E2391|NU|23.52|0|23.52|0||SOLID CASTER TIRE|| 80001|E2391|RR|2.36|0|2.36|0||SOLID CASTER TIRE|| 80001|E2392|NU|61.85|0|61.85|0||SOLID CASTER TIRE - INTEGRATE|| 80001|E2392|RR|6.22|0|6.22|0||SOLID CASTER TIRE - INTEGRATE|| 80001|E2394|NU|88.13|0|88.13|0||DRIVE WHEEL EXCLUDES TIRE|| 80001|E2394|RR|8.83|0|8.83|0||DRIVE WHEEL EXCLUDES TIRE|| 80001|E2395|NU|62.62|0|62.62|0||CASTER WHEEL EXCLUDES TIRE|| 80001|E2395|RR|6.28|0|6.28|0||CASTER WHEEL EXCLUDES TIRE|| 80001|E2396|NU|76.34|0|76.34|0||CASTER FORK|| 80001|E2396|RR|8.1|0|8.1|0||CASTER FORK|| 80001|E2397|NU|551.6|0|551.6|0||PWC ACC - LITH-BASED BATTERY|| 80001|E2397|RR|55.16|0|55.16|0||PWC ACC - LITH-BASED BATTERY|| 80001|E2402|RR|1970.51|0|1970.51|0||NEG PRESS WOUND THERAPY PUMP|| 80001|E2500|NU|520.85|0|520.85|0||SGD DIGITIZED PRE-REC <=8MIN|| 80001|E2500|RR|52.09|0|52.09|0||SGD DIGITIZED PRE-REC <=8MIN|| 80001|E2502|NU|1592.72|0|1592.72|0||SGD PREREC MSG >8MIN <=20MIN|| 80001|E2502|RR|159.28|0|159.28|0||SGD PREREC MSG >8MIN <=20MIN|| 80001|E2504|NU|2101.01|0|2101.01|0||SGD PREREC MSG>20MIN <=40MIN|| 80001|E2504|RR|210.13|0|210.13|0||SGD PREREC MSG>20MIN <=40MIN|| 80001|E2506|NU|3080.72|0|3080.72|0||SGD PREREC MSG > 40 MIN|| 80001|E2506|RR|308.05|0|308.05|0||SGD PREREC MSG > 40 MIN|| 80001|E2508|NU|4763.81|0|4763.81|0||SGD SPELLING PHYS CONTACT|| 80001|E2508|RR|476.38|0|476.38|0||SGD SPELLING PHYS CONTACT|| 80001|E2510|NU|9014.88|0|9014.88|0||SGD W MULTI METHODS MSG/ACCS|| 80001|E2510|RR|901.49|0|901.49|0||SGD W MULTI METHODS MSG/ACCS|| 80001|E2511|NU|0|0|0|0||SGD SFTWRE PRGRM FOR PC/PDA|| 80001|E2511|RR|0|0|0|0||SGD SFTWRE PRGRM FOR PC/PDA|| 80001|E2512|NU|0|0|0|0||SGD ACCESSORY - MOUNTING SYS|| 80001|E2512|RR|0|0|0|0||SGD ACCESSORY - MOUNTING SYS|| 80001|E2601|NU|70.2|0|70.2|0||GEN W/C CUSHION WDTH < 22 IN|| 80001|E2601|RR|7.04|0|7.04|0||GEN W/C CUSHION WDTH < 22 IN|| 80001|E2602|NU|137.06|0|137.06|0||GEN W/C CUSHION WDTH >=22 IN|| 80001|E2602|RR|13.72|0|13.72|0||GEN W/C CUSHION WDTH >=22 IN|| 80001|E2603|NU|174.01|0|174.01|0||SKIN PROTECT WC CUS WD <22IN|| 80001|E2603|RR|17.41|0|17.41|0||SKIN PROTECT WC CUS WD <22IN|| 80001|E2604|NU|216.3|0|216.3|0||SKIN PROTECT WC CUS WD>=22IN|| 80001|E2604|RR|21.62|0|21.62|0||SKIN PROTECT WC CUS WD>=22IN|| 80001|E2605|NU|309.01|0|309.01|0||POSITION WC CUSH WDTH <22 IN|| 80001|E2605|RR|30.91|0|30.91|0||POSITION WC CUSH WDTH <22 IN|| 80001|E2606|NU|482.09|0|482.09|0||POSITION WC CUSH WDTH>=22 IN|| 80001|E2606|RR|48.22|0|48.22|0||POSITION WC CUSH WDTH>=22 IN|| 80001|E2607|NU|332.75|0|332.75|0||SKIN PRO/POS WC CUS WD <22IN|| 80001|E2607|RR|33.28|0|33.28|0||SKIN PRO/POS WC CUS WD <22IN|| 80001|E2608|NU|399.6|0|399.6|0||SKIN PRO/POS WC CUS WD>=22IN|| 80001|E2608|RR|39.95|0|39.95|0||SKIN PRO/POS WC CUS WD>=22IN|| 80001|E2611|NU|358.58|0|358.58|0||GEN USE BACK CUSH WDTH <22IN|| 80001|E2611|RR|35.84|0|35.84|0||GEN USE BACK CUSH WDTH <22IN|| 80001|E2612|NU|485.08|0|485.08|0||GEN USE BACK CUSH WDTH>=22IN|| 80001|E2612|RR|48.5|0|48.5|0||GEN USE BACK CUSH WDTH>=22IN|| 80001|E2613|NU|451.21|0|451.21|0||POSITION BACK CUSH WD <22IN|| 80001|E2613|RR|45.13|0|45.13|0||POSITION BACK CUSH WD <22IN|| 80001|E2614|NU|624.44|0|624.44|0||POSITION BACK CUSH WD>=22IN|| 80001|E2614|RR|62.45|0|62.45|0||POSITION BACK CUSH WD>=22IN|| 80001|E2615|NU|519.25|0|519.25|0||POS BACK POST/LAT WDTH <22IN|| 80001|E2615|RR|51.94|0|51.94|0||POS BACK POST/LAT WDTH <22IN|| 80001|E2616|NU|698.65|0|698.65|0||POS BACK POST/LAT WDTH>=22IN|| 80001|E2616|RR|69.86|0|69.86|0||POS BACK POST/LAT WDTH>=22IN|| 80001|E2619|NU|58.91|0|58.91|0||REPLACE COVER W/C SEAT CUSH|| 80001|E2619|RR|5.89|0|5.89|0||REPLACE COVER W/C SEAT CUSH|| 80001|E2620|NU|628.75|0|628.75|0||WC PLANAR BACK CUSH WD <22IN|| 80001|E2620|RR|62.88|0|62.88|0||WC PLANAR BACK CUSH WD <22IN|| 80001|E2621|NU|659.83|0|659.83|0||WC PLANAR BACK CUSH WD>=22IN|| 80001|E2621|RR|65.99|0|65.99|0||WC PLANAR BACK CUSH WD>=22IN|| 80001|E2622|NU|380.52|0|380.52|0||ADJ SKIN PRO W/C CUS WD<22IN|| 80001|E2622|RR|38.06|0|38.06|0||ADJ SKIN PRO W/C CUS WD<22IN|| 80001|E2623|NU|484.2|0|484.2|0||ADJ SKIN PRO WC CUS WD>=22IN|| 80001|E2623|RR|48.43|0|48.43|0||ADJ SKIN PRO WC CUS WD>=22IN|| 80001|E2624|NU|383.65|0|383.65|0||ADJ SKIN PRO/POS CUS<22IN|| 80001|E2624|RR|38.38|0|38.38|0||ADJ SKIN PRO/POS CUS<22IN|| 80001|E2625|NU|485.68|0|485.68|0||ADJ SKIN PRO/POS WC CUS>=22|| 80001|E2625|RR|48.55|0|48.55|0||ADJ SKIN PRO/POS WC CUS>=22|| 80001|E2626|NU|827.3|0|827.3|0||SEO MOBILE ARM SUP ATT TO WC|| 80001|E2626|RR|82.7|0|82.7|0||SEO MOBILE ARM SUP ATT TO WC|| 80001|E2627|NU|1320.11|0|1320.11|0||ARM SUPP ATT TO WC RANCHO TY|| 80001|E2627|RR|132.05|0|132.05|0||ARM SUPP ATT TO WC RANCHO TY|| 80001|E2628|NU|994.49|0|994.49|0||MOBILE ARM SUPPORTS RECLININ|| 80001|E2628|RR|99.44|0|99.44|0||MOBILE ARM SUPPORTS RECLININ|| 80001|E2629|NU|1258.5|0|1258.5|0||FRICTION DAMPENING ARM SUPP|| 80001|E2629|RR|125.83|0|125.83|0||FRICTION DAMPENING ARM SUPP|| 80001|E2630|NU|880.07|0|880.07|0||MONOSUSPENSION ARM/HAND SUPP|| 80001|E2630|RR|88.01|0|88.01|0||MONOSUSPENSION ARM/HAND SUPP|| 80001|E2631|NU|352.04|0|352.04|0||ELEVAT PROXIMAL ARM SUPPORT|| 80001|E2631|RR|35.21|0|35.21|0||ELEVAT PROXIMAL ARM SUPPORT|| 80001|E2632|NU|223.85|0|223.85|0||OFFSET/LAT ROCKER ARM W/ELA|| 80001|E2632|RR|22.38|0|22.38|0||OFFSET/LAT ROCKER ARM W/ELA|| 80001|E2633|NU|189.86|0|189.86|0||MOBILE ARM SUPPORT SUPINATOR|| 80001|E2633|RR|19|0|19|0||MOBILE ARM SUPPORT SUPINATOR|| 80001|G0008||28.27|0|28.27|||ADMIN INFLUENZA VIRUS VAC|| 80001|G0009||28.27|0|28.37|||ADMIN PNEUMOCOCCAL VACCINE|| 80001|G0010||65|0|0||%|ADMIN HEPATITIS B VACCINE|| 80001|G0027||10.62|0|10.62|0||SEMEN ANALYSIS|| 80001|G0101||43.68|0|32.47|||CA SCREEN;PELVIC/BREAST EXAM|| 80001|G0103||30.04|0|30.04|0||PSA - TOTAL SCREENING|| 80001|G0108||62.57|0|62.57|||DIAB MANAGE TRN PER INDIV|| 80001|G0109||17|0|17|||DIAB MANAGE TRN IND/GROUP|| 80001|G0121||364.07|0|226.62|||COLON CA SCRN NOT HI RSK IND|| 80001|G0121|53|181.82|0|113.68|||COLON CA SCRN NOT HI RSK IND|| 80001|G0123||33.08|0|33.08|0||SCREEN CERV/VAG THIN LAYER|| 80001|G0143||33.08|0|33.08|0||SCR C/V CYTO - THINLAYER - RESCR|| 80001|G0144||34.9|0|34.9|0||SCR C/V CYTO - THINLAYER - RESCR|| 80001|G0145||43.22|0|43.22|0||SCR C/V CYTO - THINLAYER - RESCR|| 80001|G0147||17.26|0|17.26|0||SCR C/V CYTO - AUTOMATED SYS|| 80001|G0148||17.26|0|17.26|0||SCR C/V CYTO - AUTOSYS - RESCR|| 80001|G0180||61.96|0|61.96|||MD CERTIFICATION HHA PATIENT|| 80001|G0204||181.85|0|181.85|||DIAGNOSTICMAMMOGRAPHYDIGITAL|| 80001|G0204|26|51.68|0|51.68|||DIAGNOSTICMAMMOGRAPHYDIGITAL|| 80001|G0204|TC|130.17|0|130.17|||DIAGNOSTICMAMMOGRAPHYDIGITAL|| 80001|G0283||65|0|0||%|ELEC STIM OTHER THAN WOUND|| 80001|G0289||104.59|0|104.59|||ARTHRO - LOOSE BODY + CHONDRO|| 80001|G0306||12.7|0|12.7|0||CBC/DIFFWBC W/O PLATELET|| 80001|G0307||10.57|0|10.57|0||CBC WITHOUT PLATELET|| 80001|G0328||25.98|0|25.98|0||FECAL BLOOD SCRN IMMUNOASSAY|| 80001|G0399||385|0|385|||HOME SLEEP TEST/TYPE III PORTA|| 80001|G0399|26|250.25|0|250.25|||HOME SLEEP TEST/TYPE III PORTA|| 80001|G0402||192.81|0|150.17|||INITIAL PREVENTIVE EXAM|| 80001|G0403||22.16|0|22.16|||EKG FOR INITIAL PREVENT EXAM|| 80001|G0431||113.72|0|113.72|0||DRUG SCREEN SINGLE CLASS|| 80001|G0432||22.39|0|22.39|0||EIA - HIV-1/HIV-2 SCREEN|| 80001|G0433||22.39|0|22.39|0||ELISA HIV-1/HIV-2 SCREEN|| 80001|G0434||22.75|0|22.75|0||DRUG SCREEN MULTI DRUG CLASS|| 80001|G0435||19.58|0|19.58|0||RAPID IMMUNOASSAY HIV-1 - 2|| 80001|G0436||12|0|12|||TOBACCO-USE COUNSEL 3-10 MIN|| 80001|G0438||200.94|0|200.94|||PPPS - INITIAL VISIT|| 80001|G0439||132.84|0|132.84|||PPPS - SUBSEQ VISIT|| 80001|G0439|25|132.84|0|132.84|||PPPS - SUBSEQ VISIT|| 80001|G0447||30.15|0|27.82|||BEHAVIOR COUNSEL OBESITY 15M|| 80001|G0447|59|30.15|0|27.82|||BEHAVIOR COUNSEL OBESITY 15M|| 80001|G0463||124.01|0|92.23|||HOSPITAL OUTPT CLINIC VISIT|| 80001|G0464||460.42|0|460.42|0||COLOREC CA SCR - STO BAS DNA|| 80001|G0471||6|0|6|0||VEN BLOOD COLL SNF/HHA|| 80001|G0477||18.51|0|18.51|||DRUG TEST PRESUMP OPTICAL|| 80001|G6030||29.23|0|29.23|0||ASSAY OF AMITRIPTYLINE|| 80001|G6031||30.2|0|30.2|0||ASSAY OF BENZODIAZEPINES|| 80001|G6032||28.1|0|28.1|0||ASSAY OF DESIPRAMINE|| 80001|G6034||25.31|0|25.31|0||ASSAY OF DOXEPIN|| 80001|G6035||23.7|0|23.7|0||ASSAY OF GOLD|| 80001|G6036||28.1|0|28.1|0||ASSAY OF IMIPRAMINE|| 80001|G6037||18.54|0|18.54|0||ASSAY OF NORTIPTYLINE|| 80001|G6038||11.59|0|11.59|0||ASSAY OF SALICYLATE|| 80001|G6039||33.05|0|33.05|0||ASSAY OF ACETAMINOPHEN|| 80001|G6040||17.64|0|17.64|0||ASSAY OF ETHANOL|| 80001|G6041||49.02|0|49.02|0||ASSAY OF URINE ALKALOIDS|| 80001|G6042||25.38|0|25.38|0||ASSAY OF AMPHETAMINES|| 80001|G6043||18.7|0|18.7|0||ASSAY OF BARBITURATES|| 80001|G6044||15.66|0|15.66|0||ASSAY OF COCAINE|| 80001|G6045||33.72|0|33.72|0||ASSAY OF DIHYDROCODEINONE|| 80001|G6046||41.98|0|41.98|0||ASSAY OF DIHYDROMORPHINONE|| 80001|G6047||42.16|0|42.16|0||ASSAY OF DIHYDROTESTOSTERONE|| 80001|G6048||22.62|0|22.62|0||ASSAY OF DIMETHADIONE|| 80001|G6049||35.09|0|35.09|0||ASSSAY OF EPIANDROSTERONE|| 80001|G6050||28.22|0|28.22|0||ASSAY OF ETHCHLORVYNOL|| 80001|G6051||32.33|0|32.33|0||ASSAY OF FLURAZEPAM|| 80001|G6052||28.78|0|28.78|0||ASSAY OF MEPROBAMATE|| 80001|G6053||26.66|0|26.66|0||ASSAY OF METHADONE|| 80001|G6054||24.19|0|24.19|0||ASSAY OF METHSUXIMIDE|| 80001|G6055||38.68|0|38.68|0||ASSAY OF NICOTINE|| 80001|G6056||31.78|0|31.78|0||ASSAY OF OPIATES|| 80001|G6057||25.43|0|25.43|0||ASSAY OF PHENOTHIAZINE|| 80001|G6058||21.64|0|21.64|0||DRUG CONFIRMATION|| 80001|J0129||52.48|0|52.48|0||ABATACEPT INJECTION|| 80001|J0129||59.52|0|0|0||ABATACEPT INJECTION|| 80001|J0130||1428.68|0|1428.68|0||ABCIXIMAB INJECTION|| 80001|J0130||1544.33|0|0|0||ABCIXIMAB INJECTION|| 80001|J0132||1.98|0|1.98|0||ACETYLCYSTEINE INJECTION|| 80001|J0132||1.58|0|0|0||ACETYLCYSTEINE INJECTION|| 80001|J0133||0.1|0|0.1|0||ACYCLOVIR INJECTION|| 80001|J0133||0.1|0|0|0||ACYCLOVIR INJECTION|| 80001|J0135||1061.3|0|1061.3|0||ADALIMUMAB INJECTION|| 80001|J0153||0.83|0|0.83|0||ADENOSINE INJ 1MG|| 80001|J0153||0.73|0|0|0||ADENOSINE INJ 1MG|| 80001|J0171||0.18|0|0.18|0||ADRENALIN EPINEPHRINE INJECT|| 80001|J0171||0.37|0|0|0||ADRENALIN EPINEPHRINE INJECT|| 80001|J0178||1225.63|0|1225.63|0||AFLIBERCEPT INJECTION|| 80001|J0178||1222.99|0|0|0||AFLIBERCEPT INJECTION|| 80001|J0180||205.55|0|205.55|0||AGALSIDASE BETA INJECTION|| 80001|J0180||213.74|0|0|0||AGALSIDASE BETA INJECTION|| 80001|J0202||2168.2|0|2168.2|0||INJECTION - ALEMTUZUMAB - 1 MG|| 80001|J0202||2227.48|0|0|0||INJECTION - ALEMTUZUMAB - 1 MG|| 80001|J0207||501.78|0|501.78|0||AMIFOSTINE|| 80001|J0207||1292.66|0|0|0||AMIFOSTINE|| 80001|J0210||53|0|53|0||METHYLDOPATE HCL INJECTION|| 80001|J0220||258.38|0|258.38|0||ALGLUCOSIDASE ALFA INJECTION|| 80001|J0221||199.21|0|199.21|0||LUMIZYME INJECTION|| 80001|J0221||199.67|0|0|0||LUMIZYME INJECTION|| 80001|J0256||5.76|0|5.76|0||ALPHA 1 PROTEINASE INHIBITOR|| 80001|J0256||6.18|0|0|0||ALPHA 1 PROTEINASE INHIBITOR|| 80001|J0257||5.47|0|5.47|0||GLASSIA INJECTION|| 80001|J0257||5.79|0|0|0||GLASSIA INJECTION|| 80001|J0278||1.87|0|1.87|0||AMIKACIN SULFATE INJECTION|| 80001|J0278||2.25|0|0|0||AMIKACIN SULFATE INJECTION|| 80001|J0280||9.66|0|9.66|0||AMINOPHYLLIN 250 MG INJ|| 80001|J0280||8.37|0|0|0||AMINOPHYLLIN 250 MG INJ|| 80001|J0285||31.06|0|31.06|0||AMPHOTERICIN B|| 80001|J0285||40.73|0|0|0||AMPHOTERICIN B|| 80001|J0287||16.42|0|16.42|0||AMPHOTERICIN B LIPID COMPLEX|| 80001|J0287||16.35|0|0|0||AMPHOTERICIN B LIPID COMPLEX|| 80001|J0289||23.46|0|23.46|0||AMPHOTERICIN B LIPOSOME INJ|| 80001|J0289||25.94|0|0|0||AMPHOTERICIN B LIPOSOME INJ|| 80001|J0290||1.99|0|1.99|0||AMPICILLIN 500 MG INJ|| 80001|J0290||1.44|0|0|0||AMPICILLIN 500 MG INJ|| 80001|J0295||3.36|0|3.36|0||AMPICILLIN SODIUM PER 1.5 GM|| 80001|J0295||4.62|0|0|0||AMPICILLIN SODIUM PER 1.5 GM|| 80001|J0348||0.66|0|0.66|0||ANADULAFUNGIN INJECTION|| 80001|J0348||0.66|0|0|0||ANADULAFUNGIN INJECTION|| 80001|J0360||6.29|0|6.29|0||HYDRALAZINE HCL INJECTION|| 80001|J0360||4.12|0|0|0||HYDRALAZINE HCL INJECTION|| 80001|J0400||0.95|0|0.95|0||INJ TRIMETHAPHAN CAMSYLATE|| 80001|J0401||5.5|0|5.5|0||INJ ARIPIPRAZOLE EXT REL 1MG|| 80001|J0401||5.98|0|0|0||INJ ARIPIPRAZOLE EXT REL 1MG|| 80001|J0456||5.43|0|5.43|0||AZITHROMYCIN|| 80001|J0456||4.5|0|0|0||AZITHROMYCIN|| 80001|J0461||0.06|0|0.06|0||ATROPINE SULFATE INJECTION|| 80001|J0461||0.07|0|0|0||ATROPINE SULFATE INJECTION|| 80001|J0470||51.91|0|51.91|0||DIMECAPROL INJECTION|| 80001|J0470||59.11|0|0|0||DIMECAPROL INJECTION|| 80001|J0475||222.53|0|222.53|0||BACLOFEN 10 MG INJECTION|| 80001|J0475||210.01|0|0|0||BACLOFEN 10 MG INJECTION|| 80001|J0476||96.28|0|96.28|0||BACLOFEN INTRATHECAL TRIAL|| 80001|J0476||91.51|0|0|0||BACLOFEN INTRATHECAL TRIAL|| 80001|J0480||3975.27|0|3975.27|0||BASILIXIMAB|| 80001|J0480||4279.97|0|0|0||BASILIXIMAB|| 80001|J0485||4.8|0|4.8|0||BELATACEPT INJECTION|| 80001|J0485||4.89|0|0|0||BELATACEPT INJECTION|| 80001|J0490||52.61|0|52.61|0||BELIMUMAB INJECTION|| 80001|J0490||52.48|0|0|0||BELIMUMAB INJECTION|| 80001|J0500||79.38|0|79.38|0||DICYCLOMINE INJECTION|| 80001|J0500||93.48|0|0|0||DICYCLOMINE INJECTION|| 80001|J0515||30.91|0|30.91|0||INJ BENZTROPINE MESYLATE|| 80001|J0515||30.27|0|0|0||INJ BENZTROPINE MESYLATE|| 80001|J0558||9.29|0|9.29|0||PENG BENZATHINE/PROCAINE INJ|| 80001|J0558||11.63|0|0|0||PENG BENZATHINE/PROCAINE INJ|| 80001|J0561||11.9|0|11.9|0||PENICILLIN G BENZATHINE INJ|| 80001|J0561||14.31|0|0|0||PENICILLIN G BENZATHINE INJ|| 80001|J0570||1592.55|0|0|0||PENICILLIN G BENZATHINE INJ|| 80001|J0583||2.37|0|2.37|0||BIVALIRUDIN|| 80001|J0583||1.88|0|0|0||BIVALIRUDIN|| 80001|J0585||7.3|0|7.3|0||BOTULINUM TOXIN A PER UNIT|| 80001|J0585||7.49|0|0|0||BOTULINUM TOXIN A PER UNIT|| 80001|J0586||9.64|0|9.64|0||ABOBOTULINUMTOXINA|| 80001|J0586||9.94|0|0|0||ABOBOTULINUMTOXINA|| 80001|J0587||14.53|0|14.53|0||BOTULINUM TOXIN TYPE B|| 80001|J0587||13.36|0|0|0||BOTULINUM TOXIN TYPE B|| 80001|J0588||6.14|0|6.14|0||INCOBOTULINUMTOXIN A|| 80001|J0588||6.35|0|0|0||INCOBOTULINUMTOXIN A|| 80001|J0592||4.18|0|4.18|0||BUPRENORPHINE HYDROCHLORIDE|| 80001|J0592||4.39|0|0|0||BUPRENORPHINE HYDROCHLORIDE|| 80001|J0594||44.01|0|44.01|0||BUSULFAN INJECTION|| 80001|J0594||44.82|0|0|0||BUSULFAN INJECTION|| 80001|J0595||2.93|0|2.93|0||BUTORPHANOL TARTRATE 1 MG|| 80001|J0595||3.38|0|0|0||BUTORPHANOL TARTRATE 1 MG|| 80001|J0597||58.16|0|58.16|0||C-1 ESTERASE - BERINERT|| 80001|J0597||61.13|0|0|0||C-1 ESTERASE - BERINERT|| 80001|J0598||68.56|0|68.56|0||C1 ESTERASE INHIBITOR INJ|| 80001|J0598||70.52|0|0|0||C1 ESTERASE INHIBITOR INJ|| 80001|J0600||6993.03|0|6993.03|0||EDETATE CALCIUM DISODIUM INJ|| 80001|J0600||6993.03|0|0|0||EDETATE CALCIUM DISODIUM INJ|| 80001|J0610||3.73|0|3.73|0||CALCIUM GLUCONATE INJECTION|| 80001|J0610||3.48|0|0|0||CALCIUM GLUCONATE INJECTION|| 80001|J0630||2910.15|0|2910.15|0||CALCITONIN SALMON INJECTION|| 80001|J0630||2853.73|0|0|0||CALCITONIN SALMON INJECTION|| 80001|J0636||0.51|0|0.51|0||INJ CALCITRIOL PER 0.1 MCG|| 80001|J0636||0.78|0|0|0||INJ CALCITRIOL PER 0.1 MCG|| 80001|J0637||14.88|0|14.88|0||CASPOFUNGIN ACETATE|| 80001|J0637||14.98|0|0|0||CASPOFUNGIN ACETATE|| 80001|J0638||115.53|0|115.53|0||CANAKINUMAB INJECTION|| 80001|J0638||115.63|0|0|0||CANAKINUMAB INJECTION|| 80001|J0640||4.33|0|4.33|0||LEUCOVORIN CALCIUM INJECTION|| 80001|J0640||3.59|0|0|0||LEUCOVORIN CALCIUM INJECTION|| 80001|J0641||1.36|0|1.36|0||LEVOLEUCOVORIN INJECTION|| 80001|J0641||0.88|0|0|0||LEVOLEUCOVORIN INJECTION|| 80001|J0670||3.03|0|3.03|0||INJ MEPIVACAINE HCL/10 ML|| 80001|J0670||3.08|0|0|0||INJ MEPIVACAINE HCL/10 ML|| 80001|J0690||1.2|0|1.2|0||CEFAZOLIN SODIUM INJECTION|| 80001|J0690||1.1|0|0|0||CEFAZOLIN SODIUM INJECTION|| 80001|J0692||3.01|0|3.01|0||CEFEPIME HCL FOR INJECTION|| 80001|J0692||3.38|0|0|0||CEFEPIME HCL FOR INJECTION|| 80001|J0694||5.42|0|5.42|0||CEFOXITIN SODIUM INJECTION|| 80001|J0694||6.37|0|0|0||CEFOXITIN SODIUM INJECTION|| 80001|J0696||0.62|0|0.62|0||CEFTRIAXONE SODIUM INJECTION|| 80001|J0696||0.72|0|0|0||CEFTRIAXONE SODIUM INJECTION|| 80001|J0697||4.88|0|4.88|0||STERILE CEFUROXIME INJECTION|| 80001|J0697||3.88|0|0|0||STERILE CEFUROXIME INJECTION|| 80001|J0698||0.67|0|0.67|0||CEFOTAXIME SODIUM INJECTION|| 80001|J0702||7.51|0|7.51|0||BETAMETHASONE ACET&SOD PHOSP|| 80001|J0702||9.17|0|0|0||BETAMETHASONE ACET&SOD PHOSP|| 80001|J0712||3.08|0|3.08|0||CEFTAROLINE FOSAMIL INJ|| 80001|J0712||3.27|0|0|0||CEFTAROLINE FOSAMIL INJ|| 80001|J0713||3.1|0|3.1|0||INJ CEFTAZIDIME PER 500 MG|| 80001|J0713||3.12|0|0|0||INJ CEFTAZIDIME PER 500 MG|| 80001|J0717||8.83|0|8.83|0||CERTOLIZUMAB PEGOL INJ 1MG|| 80001|J0717||9.64|0|0|0||CERTOLIZUMAB PEGOL INJ 1MG|| 80001|J0720||51.57|0|51.57|0||CHLORAMPHENICOL SODIUM INJEC|| 80001|J0720||49.84|0|0|0||CHLORAMPHENICOL SODIUM INJEC|| 80001|J0725||24.17|0|24.17|0||CHORIONIC GONADOTROPIN/1000U|| 80001|J0725||26.52|0|0|0||CHORIONIC GONADOTROPIN/1000U|| 80001|J0735||17.47|0|17.47|0||CLONIDINE HYDROCHLORIDE|| 80001|J0735||16.24|0|0|0||CLONIDINE HYDROCHLORIDE|| 80001|J0740||732.19|0|732.19|0||CIDOFOVIR INJECTION|| 80001|J0740||610.5|0|0|0||CIDOFOVIR INJECTION|| 80001|J0743||8.67|0|8.67|0||CILASTATIN SODIUM INJECTION|| 80001|J0743||5.68|0|0|0||CILASTATIN SODIUM INJECTION|| 80001|J0744||1.86|0|1.86|0||CIPROFLOXACIN IV|| 80001|J0744||1.73|0|0|0||CIPROFLOXACIN IV|| 80001|J0770||13.85|0|13.85|0||COLISTIMETHATE SODIUM INJ|| 80001|J0770||16.39|0|0|0||COLISTIMETHATE SODIUM INJ|| 80001|J0775||50.04|0|50.04|0||COLLAGENASE - CLOST HIST INJ|| 80001|J0775||50.82|0|0|0||COLLAGENASE - CLOST HIST INJ|| 80001|J0780||15.73|0|15.73|0||PROCHLORPERAZINE INJECTION|| 80001|J0780||14.97|0|0|0||PROCHLORPERAZINE INJECTION|| 80001|J0795||10.06|0|10.06|0||CORTICORELIN OVINE TRIFLUTAL|| 80001|J0795||10.31|0|0|0||CORTICORELIN OVINE TRIFLUTAL|| 80001|J0800||4451.35|0|4451.35|0||CORTICOTROPIN INJECTION|| 80001|J0800||4629.22|0|0|0||CORTICOTROPIN INJECTION|| 80001|J0834||51.84|0|51.84|0||COSYNTROPIN CORTROSYN INJ|| 80001|J0834||50.75|0|0|0||COSYNTROPIN CORTROSYN INJ|| 80001|J0840||3337.79|0|3337.79|0||CROTALIDAE POLY IMMUNE FAB|| 80001|J0840||3588.41|0|0|0||CROTALIDAE POLY IMMUNE FAB|| 80001|J0850||1408.7|0|1408.7|0||CYTOMEGALOVIRUS IMM IV /VIAL|| 80001|J0850||1410.84|0|0|0||CYTOMEGALOVIRUS IMM IV /VIAL|| 80001|J0875||18.86|0|18.86|0||INJECTION - DALBAVANCIN - 5 MG|| 80001|J0875||18.21|0|0|0||INJECTION - DALBAVANCIN - 5 MG|| 80001|J0878||1.12|0|1.12|0||DAPTOMYCIN INJECTION|| 80001|J0878||0.83|0|0|0||DAPTOMYCIN INJECTION|| 80001|J0881||5.01|0|5.01|0||DARBEPOETIN ALFA - NON-ESRD|| 80001|J0881||4.88|0|0|0||DARBEPOETIN ALFA - NON-ESRD|| 80001|J0882||5.01|0|5.01|0||DARBEPOETIN ALFA - ESRD USE|| 80001|J0882||4.88|0|0|0||DARBEPOETIN ALFA - ESRD USE|| 80001|J0885||15.65|0|15.65|0||EPOETIN ALFA - NON-ESRD|| 80001|J0885||17.2|0|0|0||EPOETIN ALFA - NON-ESRD|| 80001|J0886||15.78|0|15.78|0||EPOETIN ALFA - ESRD|| 80001|J0887||2.11|0|2.11|0||EPOETIN BETA ESRD USE - 1 MG|| 80001|J0887||1.74|0|0|0||EPOETIN BETA ESRD USE - 1 MG|| 80001|J0888||2.38|0|2.38|0||EPOETIN BETA NON ESRD|| 80001|J0888||1.74|0|0|0||EPOETIN BETA NON ESRD|| 80001|J0894||27.28|0|27.28|0||DECITABINE INJECTION|| 80001|J0894||24.19|0|0|0||DECITABINE INJECTION|| 80001|J0895||11.1|0|11.1|0||DEFEROXAMINE MESYLATE INJ|| 80001|J0895||10.63|0|0|0||DEFEROXAMINE MESYLATE INJ|| 80001|J0897||20.14|0|20.14|0||DENOSUMAB INJECTION|| 80001|J0897||21.29|0|0|0||DENOSUMAB INJECTION|| 80001|J1000||19.61|0|19.61|0||DEPO-ESTRADIOL CYPIONATE INJ|| 80001|J1000||24.15|0|0|0||DEPO-ESTRADIOL CYPIONATE INJ|| 80001|J1020||5.94|0|5.94|0||METHYLPREDNISOLONE 20 MG INJ|| 80001|J1020||6.75|0|0|0||METHYLPREDNISOLONE 20 MG INJ|| 80001|J1030||6.19|0|6.19|0||METHYLPREDNISOLONE 40 MG INJ|| 80001|J1030||7.5|0|0|0||METHYLPREDNISOLONE 40 MG INJ|| 80001|J1040||11.85|0|11.85|0||METHYLPREDNISOLONE 80 MG INJ|| 80001|J1040||14.41|0|0|0||METHYLPREDNISOLONE 80 MG INJ|| 80001|J1050||0.48|0|0.48|0||INJ MEDRXYPROGSTRNE ACTAT 1MG|| 80001|J1050||0.6|0|0|0||INJ MEDRXYPROGSTRNE ACTAT 1MG|| 80001|J1071||0.04|0|0.04|0||INJ TESTOSTERONE CYPIONATE - 1|| 80001|J1071||0.03|0|0|0||INJ TESTOSTERONE CYPIONATE - 1|| 80001|J1100||0.15|0|0.15|0||DEXAMETHASONE SODIUM PHOS|| 80001|J1100||0.15|0|0|0||DEXAMETHASONE SODIUM PHOS|| 80001|J1110||73.27|0|73.27|0||INJ DIHYDROERGOTAMINE MESYLT|| 80001|J1110||103.76|0|0|0||INJ DIHYDROERGOTAMINE MESYLT|| 80001|J1120||25.71|0|25.71|0||ACETAZOLAMID SODIUM INJECTIO|| 80001|J1120||27.35|0|0|0||ACETAZOLAMID SODIUM INJECTIO|| 80001|J1160||6.2|0|6.2|0||DIGOXIN INJECTION|| 80001|J1160||7.02|0|0|0||DIGOXIN INJECTION|| 80001|J1162||3799.41|0|3799.41|0||DIGOXIN IMMUNE FAB (OVINE)|| 80001|J1162||4083.78|0|0|0||DIGOXIN IMMUNE FAB (OVINE)|| 80001|J1165||0.66|0|0.66|0||PHENYTOIN SODIUM INJECTION|| 80001|J1165||0.65|0|0|0||PHENYTOIN SODIUM INJECTION|| 80001|J1170||2.45|0|2.45|0||HYDROMORPHONE INJECTION|| 80001|J1170||2.6|0|0|0||HYDROMORPHONE INJECTION|| 80001|J1190||226.27|0|226.27|0||DEXRAZOXANE HCL INJECTION|| 80001|J1190||230.83|0|0|0||DEXRAZOXANE HCL INJECTION|| 80001|J1200||0.65|0|0.65|0||DIPHENHYDRAMINE HCL INJECTIO|| 80001|J1200||0.75|0|0|0||DIPHENHYDRAMINE HCL INJECTIO|| 80001|J1205||114.54|0|114.54|0||CHLOROTHIAZIDE SODIUM INJ|| 80001|J1205||83.03|0|0|0||CHLOROTHIAZIDE SODIUM INJ|| 80001|J1212||562.51|0|562.51|0||DIMETHYL SULFOXIDE 50% 50 ML|| 80001|J1212||691.77|0|0|0||DIMETHYL SULFOXIDE 50% 50 ML|| 80001|J1230||15.97|0|15.97|0||METHADONE INJECTION|| 80001|J1230||24.07|0|0|0||METHADONE INJECTION|| 80001|J1240||7.11|0|7.11|0||DIMENHYDRINATE INJECTION|| 80001|J1240||9.33|0|0|0||DIMENHYDRINATE INJECTION|| 80001|J1245||1.03|0|1.03|0||DIPYRIDAMOLE INJECTION|| 80001|J1245||0.98|0|0|0||DIPYRIDAMOLE INJECTION|| 80001|J1250||6.77|0|6.77|0||INJ DOBUTAMINE HCL/250 MG|| 80001|J1250||7.61|0|0|0||INJ DOBUTAMINE HCL/250 MG|| 80001|J1260||7.62|0|7.62|0||DOLASETRON MESYLATE|| 80001|J1265||0.75|0|0.75|0||DOPAMINE INJECTION|| 80001|J1265||0.81|0|0|0||DOPAMINE INJECTION|| 80001|J1267||0.97|0|0.97|0||DORIPENEM INJECTION|| 80001|J1267||0.81|0|0|0||DORIPENEM INJECTION|| 80001|J1270||1.19|0|1.19|0||INJECTION - DOXERCALCIFEROL|| 80001|J1270||0.53|0|0|0||INJECTION - DOXERCALCIFEROL|| 80001|J1290||499.7|0|499.7|0||ECALLANTIDE INJECTION|| 80001|J1290||540.89|0|0|0||ECALLANTIDE INJECTION|| 80001|J1300||272.98|0|272.98|0||ECULIZUMAB INJECTION|| 80001|J1300||283.29|0|0|0||ECULIZUMAB INJECTION|| 80001|J1325||19.4|0|19.4|0||EPOPROSTENOL INJECTION|| 80001|J1325||19.46|0|0|0||EPOPROSTENOL INJECTION|| 80001|J1335||56|0|56|0||ERTAPENEM INJECTION|| 80001|J1335||65.42|0|0|0||ERTAPENEM INJECTION|| 80001|J1364||73.8|0|73.8|0||ERYTHRO LACTOBIONATE /500 MG|| 80001|J1364||78.04|0|0|0||ERYTHRO LACTOBIONATE /500 MG|| 80001|J1380||11.38|0|11.38|0||ESTRADIOL VALERATE 10 MG INJ|| 80001|J1380||9.15|0|0|0||ESTRADIOL VALERATE 10 MG INJ|| 80001|J1410||311.06|0|311.06|0||INJ ESTROGEN CONJUGATE 25 MG|| 80001|J1410||378.95|0|0|0||INJ ESTROGEN CONJUGATE 25 MG|| 80001|J1430||505.12|0|505.12|0||ETHANOLAMINE OLEATE 100 MG|| 80001|J1430||555.12|0|0|0||ETHANOLAMINE OLEATE 100 MG|| 80001|J1438||514.64|0|514.64|0||ETANERCEPT INJECTION|| 80001|J1439||1.32|0|1.32|0||INJ FERRIC CARBOXYMALTOS 1 MG|| 80001|J1439||1.34|0|0|0||INJ FERRIC CARBOXYMALTOS 1 MG|| 80001|J1442||1.25|0|1.25|0||INJ - FILGRASTIM G-CSF 1 MCG|| 80001|J1442||1.26|0|0|0||INJ - FILGRASTIM G-CSF 1 MCG|| 80001|J1446||4.83|0|4.83|0||INJ - TBO-FILGRASTIM - 5 MCG|| 80001|J1447||0.96|0|0.96|0||INJ TBO-FILGRASTIM 1 MICROGRAM|| 80001|J1447||0.81|0|0|0||INJ TBO-FILGRASTIM 1 MICROGRAM|| 80001|J1450||5.04|0|5.04|0||FLUCONAZOLE|| 80001|J1450||5.85|0|0|0||FLUCONAZOLE|| 80001|J1453||2.25|0|2.25|0||FOSAPREPITANT INJECTION|| 80001|J1453||2.39|0|0|0||FOSAPREPITANT INJECTION|| 80001|J1458||454.65|0|454.65|0||GALSULFASE INJECTION|| 80001|J1458||467.26|0|0|0||GALSULFASE INJECTION|| 80001|J1459||47.79|0|47.79|0||INJ IVIG PRIVIGEN 500 MG|| 80001|J1459||48.26|0|0|0||INJ IVIG PRIVIGEN 500 MG|| 80001|J1460||42.29|0|42.29|0||GAMMA GLOBULIN 1 CC INJ|| 80001|J1460||45.46|0|0|0||GAMMA GLOBULIN 1 CC INJ|| 80001|J1556||46.76|0|46.76|0||INJ - IMM GLOB BIVIGAM - 500 MG|| 80001|J1556||47.89|0|0|0||INJ - IMM GLOB BIVIGAM - 500 MG|| 80001|J1557||46.16|0|46.16|0||GAMMAPLEX INJECTION|| 80001|J1557||58.36|0|0|0||GAMMAPLEX INJECTION|| 80001|J1559||12.29|0|12.29|0||HIZENTRA INJECTION|| 80001|J1559||12.29|0|0|0||HIZENTRA INJECTION|| 80001|J1560||422.93|0|422.93|0||GAMMA GLOBULIN > 10 CC INJ|| 80001|J1560||454.57|0|0|0||GAMMA GLOBULIN > 10 CC INJ|| 80001|J1561||51.13|0|51.13|0||INJECTION IMMUNE GLOB IV 500 M|| 80001|J1561||48.01|0|0|0||INJECTION IMMUNE GLOB IV 500 M|| 80001|J1566||42.54|0|42.54|0||IMMUNE GLOBULIN - POWDER|| 80001|J1566||41.18|0|0|0||IMMUNE GLOBULIN - POWDER|| 80001|J1568||49.72|0|49.72|0||OCTAGAM INJECTION|| 80001|J1568||42.66|0|0|0||OCTAGAM INJECTION|| 80001|J1569||50|0|50|0||GAMMAGARD LIQUID INJECTION|| 80001|J1569||50.24|0|0|0||GAMMAGARD LIQUID INJECTION|| 80001|J1570||72.65|0|72.65|0||GANCICLOVIR SODIUM INJECTION|| 80001|J1570||90.99|0|0|0||GANCICLOVIR SODIUM INJECTION|| 80001|J1571||68.44|0|68.44|0||HEPAGAM B IM INJECTION|| 80001|J1571||75.25|0|0|0||HEPAGAM B IM INJECTION|| 80001|J1572||47.36|0|47.36|0||FLEBOGAMMA INJECTION|| 80001|J1572||34.91|0|0|0||FLEBOGAMMA INJECTION|| 80001|J1575||16.25|0|16.25|0||INJ HYQVIA 100 MG IMMUNEGLOBUL|| 80001|J1575||16.3|0|0|0||INJ HYQVIA 100 MG IMMUNEGLOBUL|| 80001|J1580||1.72|0|1.72|0||GARAMYCIN GENTAMICIN INJ|| 80001|J1580||1.92|0|0|0||GARAMYCIN GENTAMICIN INJ|| 80001|J1602||30.92|0|30.92|0||INJ - GOLIMUMAB FOR IV USE 1 MG|| 80001|J1602||30.91|0|0|0||INJ - GOLIMUMAB FOR IV USE 1 MG|| 80001|J1610||250.42|0|250.42|0||GLUCAGON HYDROCHLORIDE/1 MG|| 80001|J1610||243.04|0|0|0||GLUCAGON HYDROCHLORIDE/1 MG|| 80001|J1626||0.4|0|0.4|0||GRANISETRON HCL INJECTION|| 80001|J1626||0.41|0|0|0||GRANISETRON HCL INJECTION|| 80001|J1630||1.6|0|1.6|0||HALOPERIDOL INJECTION|| 80001|J1630||1.53|0|0|0||HALOPERIDOL INJECTION|| 80001|J1631||23.55|0|23.55|0||HALOPERIDOL DECANOATE INJ|| 80001|J1631||22.55|0|0|0||HALOPERIDOL DECANOATE INJ|| 80001|J1640||28.34|0|28.34|0||HEMIN - 1 MG|| 80001|J1640||29.66|0|0|0||HEMIN - 1 MG|| 80001|J1642||0.24|0|0.24|0||INJ HEPARIN SODIUM PER 10 U|| 80001|J1642||0.22|0|0|0||INJ HEPARIN SODIUM PER 10 U|| 80001|J1644||0.27|0|0.27|0||INJ HEPARIN SODIUM PER 1000U|| 80001|J1644||0.26|0|0|0||INJ HEPARIN SODIUM PER 1000U|| 80001|J1645||19.97|0|19.97|0||DALTEPARIN SODIUM|| 80001|J1645||19.17|0|0|0||DALTEPARIN SODIUM|| 80001|J1650||1.1|0|1.1|0||INJ ENOXAPARIN SODIUM|| 80001|J1650||1.08|0|0|0||INJ ENOXAPARIN SODIUM|| 80001|J1652||3.05|0|3.05|0||FONDAPARINUX SODIUM|| 80001|J1652||2.65|0|0|0||FONDAPARINUX SODIUM|| 80001|J1670||482.63|0|482.63|0||TETANUS IMMUNE GLOBULIN INJ|| 80001|J1670||527.55|0|0|0||TETANUS IMMUNE GLOBULIN INJ|| 80001|J1720||10.2|0|10.2|0||HYDROCORTISONE SODIUM SUCC I|| 80001|J1720||13.57|0|0|0||HYDROCORTISONE SODIUM SUCC I|| 80001|J1740||141.94|0|141.94|0||IBANDRONATE SODIUM INJECTION|| 80001|J1740||104.72|0|0|0||IBANDRONATE SODIUM INJECTION|| 80001|J1742||330.55|0|330.55|0||IBUTILIDE FUMARATE INJECTION|| 80001|J1742||82.18|0|0|0||IBUTILIDE FUMARATE INJECTION|| 80001|J1743||653.18|0|653.18|0||IDURSULFASE INJECTION|| 80001|J1743||666.85|0|0|0||IDURSULFASE INJECTION|| 80001|J1745||102.85|0|102.85|0||INFLIXIMAB INJECTION|| 80001|J1745||107.18|0|0|0||INFLIXIMAB INJECTION|| 80001|J1750||15.43|0|15.43|0||INJECTION IRON DEXTRAN 50 MG|| 80001|J1750||16.28|0|0|0||INJECTION IRON DEXTRAN 50 MG|| 80001|J1756||0.32|0|0.32|0||IRON SUCROSE INJECTION|| 80001|J1756||0.32|0|0|0||IRON SUCROSE INJECTION|| 80001|J1786||52.42|0|52.42|0||IMUGLUCERASE INJECTION|| 80001|J1786||52.18|0|0|0||IMUGLUCERASE INJECTION|| 80001|J1790||2.67|0|2.67|0||DROPERIDOL INJECTION|| 80001|J1800||5.55|0|5.55|0||PROPRANOLOL INJECTION|| 80001|J1800||2.07|0|0|0||PROPRANOLOL INJECTION|| 80001|J1815||0.93|0|0.93|0||INSULIN INJECTION|| 80001|J1815||1.04|0|0|0||INSULIN INJECTION|| 80001|J1817||10.3|0|10.3|0||INSULIN FOR INSULIN PUMP USE|| 80001|J1817||11.97|0|0|0||INSULIN FOR INSULIN PUMP USE|| 80001|J1840||9.61|0|9.61|0||KANAMYCIN SULFATE 500 MG INJ|| 80001|J1850||1.44|0|1.44|0||KANAMYCIN SULFATE 75 MG INJ|| 80001|J1885||0.82|0|0.82|0||KETOROLAC TROMETHAMINE INJ|| 80001|J1885||0.73|0|0|0||KETOROLAC TROMETHAMINE INJ|| 80001|J1930||61.75|0|61.75|0||PROPIOMAZINE INJECTION|| 80001|J1930||67.99|0|0|0||PROPIOMAZINE INJECTION|| 80001|J1931||38.24|0|38.24|0||LARONIDASE INJECTION|| 80001|J1931||38.26|0|0|0||LARONIDASE INJECTION|| 80001|J1940||3.69|0|3.69|0||FUROSEMIDE INJECTION|| 80001|J1940||1.11|0|0|0||FUROSEMIDE INJECTION|| 80001|J1942||2.95|0|0|0||INJ - ARIPIPRAZOLE LAUROXIL - 1|| 80001|J1950||1222.36|0|1222.36|0||LEUPROLIDE ACETATE /3.75 MG|| 80001|J1950||1270.44|0|0|0||LEUPROLIDE ACETATE /3.75 MG|| 80001|J1953||0.2|0|0.2|0||LEVETIRACETAM INJECTION|| 80001|J1953||0.16|0|0|0||LEVETIRACETAM INJECTION|| 80001|J1955||23.7|0|23.7|0||INJ LEVOCARNITINE PER 1 GM|| 80001|J1955||25.43|0|0|0||INJ LEVOCARNITINE PER 1 GM|| 80001|J1956||2.42|0|2.42|0||LEVOFLOXACIN INJECTION|| 80001|J1956||1.63|0|0|0||LEVOFLOXACIN INJECTION|| 80001|J1980||33.87|0|33.87|0||HYOSCYAMINE SULFATE INJ|| 80001|J1980||34.26|0|0|0||HYOSCYAMINE SULFATE INJ|| 80001|J2001||0.02|0|0.02|0||LIDOCAINE INJECTION|| 80001|J2001||0.02|0|0|0||LIDOCAINE INJECTION|| 80001|J2010||14.46|0|14.46|0||LINCOMYCIN INJECTION|| 80001|J2010||16.06|0|0|0||LINCOMYCIN INJECTION|| 80001|J2020||19.94|0|19.94|0||LINEZOLID INJECTION|| 80001|J2020||19.09|0|0|0||LINEZOLID INJECTION|| 80001|J2060||1|0|1|0||LORAZEPAM INJECTION|| 80001|J2060||1.14|0|0|0||LORAZEPAM INJECTION|| 80001|J2150||2.44|0|2.44|0||MANNITOL INJECTION|| 80001|J2150||2.36|0|0|0||MANNITOL INJECTION|| 80001|J2175||6.39|0|6.39|0||MEPERIDINE HYDROCHL /100 MG|| 80001|J2175||6.82|0|0|0||MEPERIDINE HYDROCHL /100 MG|| 80001|J2185||1.92|0|1.92|0||MEROPENEM|| 80001|J2185||1.43|0|0|0||MEROPENEM|| 80001|J2210||9.19|0|9.19|0||METHYLERGONOVIN MALEATE INJ|| 80001|J2210||22.04|0|0|0||METHYLERGONOVIN MALEATE INJ|| 80001|J2248||1.18|0|1.18|0||MICAFUNGIN SODIUM INJECTION|| 80001|J2248||1.18|0|0|0||MICAFUNGIN SODIUM INJECTION|| 80001|J2250||0.16|0|0.16|0||INJ MIDAZOLAM HYDROCHLORIDE|| 80001|J2250||0.14|0|0|0||INJ MIDAZOLAM HYDROCHLORIDE|| 80001|J2260||4.29|0|4.29|0||INJ MILRINONE LACTATE / 5 MG|| 80001|J2260||2.19|0|0|0||INJ MILRINONE LACTATE / 5 MG|| 80001|J2270||1.5|0|1.5|0||MORPHINE SULFATE INJECTION|| 80001|J2270||2.06|0|0|0||MORPHINE SULFATE INJECTION|| 80001|J2274||10.68|0|10.68|0||IN MORPHINE PRESERVATIV FREE - || 80001|J2274||12.17|0|0|0||IN MORPHINE PRESERVATIV FREE - || 80001|J2278||9.11|0|9.11|0||ZICONOTIDE INJECTION|| 80001|J2278||9.16|0|0|0||ZICONOTIDE INJECTION|| 80001|J2280||11.75|0|11.75|0||INJ - MOXIFLOXACIN 100 MG|| 80001|J2280||10.6|0|0|0||INJ - MOXIFLOXACIN 100 MG|| 80001|J2300||2.95|0|2.95|0||INJ NALBUPHINE HYDROCHLORIDE|| 80001|J2300||3.2|0|0|0||INJ NALBUPHINE HYDROCHLORIDE|| 80001|J2310||42.24|0|42.24|0||INJ NALOXONE HYDROCHLORIDE|| 80001|J2310||33.41|0|0|0||INJ NALOXONE HYDROCHLORIDE|| 80001|J2315||4.07|0|4.07|0||NALTREXONE - DEPOT FORM|| 80001|J2315||4.06|0|0|0||NALTREXONE - DEPOT FORM|| 80001|J2323||22.38|0|22.38|0||NATALIZUMAB INJECTION|| 80001|J2323||24.28|0|0|0||NATALIZUMAB INJECTION|| 80001|J2353||208.52|0|208.52|0||OCTREOTIDE INJECTION - DEPOT|| 80001|J2353||228.24|0|0|0||OCTREOTIDE INJECTION - DEPOT|| 80001|J2354||1.3|0|1.3|0||OCTREOTIDE INJ - NON-DEPOT|| 80001|J2354||1.41|0|0|0||OCTREOTIDE INJ - NON-DEPOT|| 80001|J2355||560.59|0|560.59|0||OPRELVEKIN INJECTION|| 80001|J2355||584.02|0|0|0||OPRELVEKIN INJECTION|| 80001|J2357||38.92|0|38.92|0||OMALIZUMAB INJECTION|| 80001|J2357||41.99|0|0|0||OMALIZUMAB INJECTION|| 80001|J2358||3.65|0|3.65|0||OLANZAPINE LONG-ACTING INJ|| 80001|J2358||3.65|0|0|0||OLANZAPINE LONG-ACTING INJ|| 80001|J2360||5.6|0|5.6|0||ORPHENADRINE INJECTION|| 80001|J2360||7.55|0|0|0||ORPHENADRINE INJECTION|| 80001|J2400||29.74|0|29.74|0||CHLOROPROCAINE HCL INJECTION|| 80001|J2400||29.98|0|0|0||CHLOROPROCAINE HCL INJECTION|| 80001|J2405||0.11|0|0.11|0||ONDANSETRON HCL INJECTION|| 80001|J2405||0.12|0|0|0||ONDANSETRON HCL INJECTION|| 80001|J2407||30.87|0|30.87|0||INJECTION - ORITAVANCIN - 10 MG|| 80001|J2407||29.21|0|0|0||INJECTION - ORITAVANCIN - 10 MG|| 80001|J2410||3.59|0|3.59|0||OXYMORPHONE HCL INJECTION|| 80001|J2410||3.65|0|0|0||OXYMORPHONE HCL INJECTION|| 80001|J2425||22.33|0|22.33|0||PALIFERMIN INJECTION|| 80001|J2425||23.95|0|0|0||PALIFERMIN INJECTION|| 80001|J2426||11.32|0|11.32|0||PALIPERIDONE PALMITATE INJ|| 80001|J2426||12.45|0|0|0||PALIPERIDONE PALMITATE INJ|| 80001|J2430||15.94|0|15.94|0||PAMIDRONATE DISODIUM /30 MG|| 80001|J2430||11.75|0|0|0||PAMIDRONATE DISODIUM /30 MG|| 80001|J2469||28.04|0|28.04|0||PALONOSETRON HCL|| 80001|J2469||27.56|0|0|0||PALONOSETRON HCL|| 80001|J2501||3.88|0|3.88|0||PARICALCITOL|| 80001|J2501||1.46|0|0|0||PARICALCITOL|| 80001|J2503||1318.38|0|1318.38|0||PEGAPTANIB SODIUM INJECTION|| 80001|J2503||1318.38|0|0|0||PEGAPTANIB SODIUM INJECTION|| 80001|J2504||399.58|0|399.58|0||PEGADEMASE BOVINE - 25 IU|| 80001|J2504||431.54|0|0|0||PEGADEMASE BOVINE - 25 IU|| 80001|J2505||4983.62|0|4983.62|0||INJECTION - PEGFILGRASTIM 6MG|| 80001|J2505||5309.06|0|0|0||INJECTION - PEGFILGRASTIM 6MG|| 80001|J2507||1888.78|0|1888.78|0||PEGLOTICASE INJECTION|| 80001|J2507||2498.56|0|0|0||PEGLOTICASE INJECTION|| 80001|J2510||31.31|0|31.31|0||PENICILLIN G PROCAINE INJ|| 80001|J2510||33.46|0|0|0||PENICILLIN G PROCAINE INJ|| 80001|J2515||56.63|0|56.63|0||PENTOBARBITAL SODIUM INJ|| 80001|J2515||60.27|0|0|0||PENTOBARBITAL SODIUM INJ|| 80001|J2540||1.22|0|1.22|0||PENICILLIN G POTASSIUM INJ|| 80001|J2540||1.33|0|0|0||PENICILLIN G POTASSIUM INJ|| 80001|J2543||3.38|0|3.38|0||PIPERACILLIN/TAZOBACTAM|| 80001|J2543||3.68|0|0|0||PIPERACILLIN/TAZOBACTAM|| 80001|J2545||131.4|0|131.4|0||PENTAMIDINE ISETHIONTE/300MG|| 80001|J2545||147.57|0|0|0||PENTAMIDINE ISETHIONTE/300MG|| 80001|J2550||2.04|0|2.04|0||PROMETHAZINE HCL INJECTION|| 80001|J2550||3.63|0|0|0||PROMETHAZINE HCL INJECTION|| 80001|J2560||36.93|0|36.93|0||PHENOBARBITAL SODIUM INJ|| 80001|J2560||45.16|0|0|0||PHENOBARBITAL SODIUM INJ|| 80001|J2562||387.82|0|387.82|0||PLERIXAFOR INJECTION|| 80001|J2562||392.78|0|0|0||PLERIXAFOR INJECTION|| 80001|J2597||19|0|19|0||INJ DESMOPRESSIN ACETATE|| 80001|J2597||15.51|0|0|0||INJ DESMOPRESSIN ACETATE|| 80001|J2675||1.3|0|1.3|0||INJ PROGESTERONE PER 50 MG|| 80001|J2675||1.83|0|0|0||INJ PROGESTERONE PER 50 MG|| 80001|J2680||26.43|0|26.43|0||FLUPHENAZINE DECANOATE 25 MG|| 80001|J2680||23|0|0|0||FLUPHENAZINE DECANOATE 25 MG|| 80001|J2690||70.47|0|70.47|0||PROCAINAMIDE HCL INJECTION|| 80001|J2690||83.15|0|0|0||PROCAINAMIDE HCL INJECTION|| 80001|J2700||2.06|0|2.06|0||OXACILLIN SODIUM INJECITON|| 80001|J2700||1.89|0|0|0||OXACILLIN SODIUM INJECITON|| 80001|J2704||0.15|0|0.15|0||INJ - PROPOFOL - 10 MG|| 80001|J2704||0.14|0|0|0||INJ - PROPOFOL - 10 MG|| 80001|J2720||1.43|0|1.43|0||INJ PROTAMINE SULFATE/10 MG|| 80001|J2720||1.32|0|0|0||INJ PROTAMINE SULFATE/10 MG|| 80001|J2724||19.06|0|19.06|0||PROTEIN C CONCENTRATE|| 80001|J2724||18.96|0|0|0||PROTEIN C CONCENTRATE|| 80001|J2730||114.88|0|114.88|0||PRALIDOXIME CHLORIDE INJ|| 80001|J2760||198.75|0|198.75|0||PHENTOLAINE MESYLATE INJ|| 80001|J2765||0.87|0|0.87|0||METOCLOPRAMIDE HCL INJECTION|| 80001|J2765||1.12|0|0|0||METOCLOPRAMIDE HCL INJECTION|| 80001|J2770||474.82|0|474.82|0||QUINUPRISTIN/DALFOPRISTIN|| 80001|J2770||547.87|0|0|0||QUINUPRISTIN/DALFOPRISTIN|| 80001|J2778||478.25|0|478.25|0||RANIBIZUMAB INJECTION|| 80001|J2778||476.11|0|0|0||RANIBIZUMAB INJECTION|| 80001|J2780||1.32|0|1.32|0||RANITIDINE HYDROCHLORIDE INJ|| 80001|J2780||7.71|0|0|0||RANITIDINE HYDROCHLORIDE INJ|| 80001|J2783||305.63|0|305.63|0||RASBURICASE|| 80001|J2783||324.06|0|0|0||RASBURICASE|| 80001|J2785||67.23|0|67.23|0||REGADENOSON INJECTION|| 80001|J2785||69.22|0|0|0||REGADENOSON INJECTION|| 80001|J2788||32.23|0|32.23|0||RHO D IMMUNE GLOBULIN 50 MCG|| 80001|J2788||24.87|0|0|0||RHO D IMMUNE GLOBULIN 50 MCG|| 80001|J2790||102.17|0|102.17|0||RHO D IMMUNE GLOBULIN INJ|| 80001|J2790||98.8|0|0|0||RHO D IMMUNE GLOBULIN INJ|| 80001|J2791||6.01|0|6.01|0||RHOPHYLAC INJECTION|| 80001|J2791||5.98|0|0|0||RHOPHYLAC INJECTION|| 80001|J2792||26.45|0|26.45|0||RHO(D) IMMUNE GLOBULIN H - SD|| 80001|J2792||29.82|0|0|0||RHO(D) IMMUNE GLOBULIN H - SD|| 80001|J2794||9.7|0|9.7|0||RISPERIDONE - LONG ACTING|| 80001|J2794||10.67|0|0|0||RISPERIDONE - LONG ACTING|| 80001|J2795||0.09|0|0.09|0||ROPIVACAINE HCL INJECTION|| 80001|J2795||0.09|0|0|0||ROPIVACAINE HCL INJECTION|| 80001|J2796||76.91|0|76.91|0||ROMIPLOSTIM INJECTION|| 80001|J2796||83.22|0|0|0||ROMIPLOSTIM INJECTION|| 80001|J2800||49.38|0|49.38|0||METHOCARBAMOL INJECTION|| 80001|J2800||45.49|0|0|0||METHOCARBAMOL INJECTION|| 80001|J2805||118.77|0|118.77|0||SINCALIDE INJECTION|| 80001|J2805||128.67|0|0|0||SINCALIDE INJECTION|| 80001|J2810||0.37|0|0.37|0||INJ THEOPHYLLINE PER 40 MG|| 80001|J2810||0.38|0|0|0||INJ THEOPHYLLINE PER 40 MG|| 80001|J2820||44.12|0|44.12|0||SARGRAMOSTIM INJECTION|| 80001|J2820||47.28|0|0|0||SARGRAMOSTIM INJECTION|| 80001|J2850||43.48|0|43.48|0||INJ SECRETIN SYNTHETIC HUMAN|| 80001|J2850||43.48|0|0|0||INJ SECRETIN SYNTHETIC HUMAN|| 80001|J2916||2.91|0|2.91|0||NA FERRIC GLUCONATE COMPLEX|| 80001|J2916||2.88|0|0|0||NA FERRIC GLUCONATE COMPLEX|| 80001|J2920||4.16|0|4.16|0||METHYLPREDNISOLONE INJECTION|| 80001|J2920||5.43|0|0|0||METHYLPREDNISOLONE INJECTION|| 80001|J2930||6.21|0|6.21|0||METHYLPREDNISOLONE INJECTION|| 80001|J2930||7.54|0|0|0||METHYLPREDNISOLONE INJECTION|| 80001|J2993||2877.39|0|2877.39|0||RETEPLASE INJECTION|| 80001|J2997||99.86|0|99.86|0||ALTEPLASE RECOMBINANT|| 80001|J2997||104.35|0|0|0||ALTEPLASE RECOMBINANT|| 80001|J3000||16.66|0|16.66|0||STREPTOMYCIN INJECTION|| 80001|J3000||16.11|0|0|0||STREPTOMYCIN INJECTION|| 80001|J3010||0.54|0|0.54|0||FENTANYL CITRATE INJECITON|| 80001|J3010||0.54|0|0|0||FENTANYL CITRATE INJECITON|| 80001|J3060||50.61|0|50.61|0||INJ - TALIGLUCERACE ALFA 10 UNI|| 80001|J3060||50.47|0|0|0||INJ - TALIGLUCERACE ALFA 10 UNI|| 80001|J3070||180.64|0|180.64|0||PENTAZOCINE INJECTION|| 80001|J3070||92.66|0|0|0||PENTAZOCINE INJECTION|| 80001|J3090||1.59|0|1.59|0||INJ - TEDIZOLID PHOSPHATE - 1 MG|| 80001|J3090||1.66|0|0|0||INJ - TEDIZOLID PHOSPHATE - 1 MG|| 80001|J3095||6.24|0|6.24|0||TELEVANCIN INJECTION|| 80001|J3095||6.35|0|0|0||TELEVANCIN INJECTION|| 80001|J3101||127.26|0|127.26|0||TENECTEPLASE INJECTION|| 80001|J3101||137.55|0|0|0||TENECTEPLASE INJECTION|| 80001|J3105||3.94|0|3.94|0||TERBUTALINE SULFATE INJ|| 80001|J3105||3.06|0|0|0||TERBUTALINE SULFATE INJ|| 80001|J3121||0.06|0|0.06|0||INJ TESTOSTERO ENANTHATE 1MG|| 80001|J3121||0.05|0|0|0||INJ TESTOSTERO ENANTHATE 1MG|| 80001|J3230||28.93|0|28.93|0||CHLORPROMAZINE HCL INJECTION|| 80001|J3230||34.64|0|0|0||CHLORPROMAZINE HCL INJECTION|| 80001|J3240||1961.93|0|1961.93|0||THYROTROPIN INJECTION|| 80001|J3240||1955.32|0|0|0||THYROTROPIN INJECTION|| 80001|J3243||3.44|0|3.44|0||TIGECYCLINE INJECTION|| 80001|J3243||4.09|0|0|0||TIGECYCLINE INJECTION|| 80001|J3250||31.61|0|31.61|0||TRIMETHOBENZAMIDE HCL INJ|| 80001|J3250||36.84|0|0|0||TRIMETHOBENZAMIDE HCL INJ|| 80001|J3260||2.62|0|2.62|0||TOBRAMYCIN SULFATE INJECTION|| 80001|J3260||2.34|0|0|0||TOBRAMYCIN SULFATE INJECTION|| 80001|J3262||5.16|0|5.16|0||TOCILIZUMAB INJECTION|| 80001|J3262||5.46|0|0|0||TOCILIZUMAB INJECTION|| 80001|J3285||76.55|0|76.55|0||TREPROSTINIL INJECTION|| 80001|J3285||76.55|0|0|0||TREPROSTINIL INJECTION|| 80001|J3300||4.62|0|4.62|0||TRIAMCINOLONE A INJ PRS-FREE|| 80001|J3300||4.87|0|0|0||TRIAMCINOLONE A INJ PRS-FREE|| 80001|J3301||2.23|0|2.23|0||TRIAMCINOLONE ACETONIDE INJ|| 80001|J3301||2.36|0|0|0||TRIAMCINOLONE ACETONIDE INJ|| 80001|J3303||2.27|0|2.27|0||TRIAMCINOLONE HEXACETONL INJ|| 80001|J3315||490.07|0|490.07|0||TRIPTORELIN PAMOATE|| 80001|J3315||349.2|0|0|0||TRIPTORELIN PAMOATE|| 80001|J3357||209.66|0|209.66|0||USTEKINUMAB INJECTION|| 80001|J3357||229.07|0|0|0||USTEKINUMAB INJECTION|| 80001|J3360||11.61|0|11.61|0||DIAZEPAM INJECTION|| 80001|J3360||12.32|0|0|0||DIAZEPAM INJECTION|| 80001|J3370||3.55|0|3.55|0||VANCOMYCIN HCL INJECTION|| 80001|J3370||3.2|0|0|0||VANCOMYCIN HCL INJECTION|| 80001|J3380||21.28|0|21.28|0||INJ ISOXSUPRINE HCL TO 10 MG|| 80001|J3380||22.58|0|0|0||INJ ISOXSUPRINE HCL TO 10 MG|| 80001|J3385||428.89|0|428.89|0||VELAGLUCERASE ALFA|| 80001|J3385||427.73|0|0|0||VELAGLUCERASE ALFA|| 80001|J3396||13.65|0|13.65|0||VERTEPORFIN INJECTION|| 80001|J3396||13.45|0|0|0||VERTEPORFIN INJECTION|| 80001|J3410||2.6|0|2.6|0||HYDROXYZINE HCL INJECTION|| 80001|J3410||2.65|0|0|0||HYDROXYZINE HCL INJECTION|| 80001|J3411||4.11|0|4.11|0||THIAMINE HCL 100 MG|| 80001|J3411||3.81|0|0|0||THIAMINE HCL 100 MG|| 80001|J3415||11.64|0|11.64|0||PYRIDOXINE HCL 100 MG|| 80001|J3415||12.75|0|0|0||PYRIDOXINE HCL 100 MG|| 80001|J3420||5.99|0|5.99|0||VITAMIN B12 INJECTION|| 80001|J3420||3.14|0|0|0||VITAMIN B12 INJECTION|| 80001|J3430||4.22|0|4.22|0||VITAMIN K PHYTONADIONE INJ|| 80001|J3430||5.11|0|0|0||VITAMIN K PHYTONADIONE INJ|| 80001|J3465||5.11|0|5.11|0||INJECTION - VORICONAZOLE|| 80001|J3465||4.07|0|0|0||INJECTION - VORICONAZOLE|| 80001|J3471||0.44|0|0.44|0||OVINE - UP TO 999 USP UNITS|| 80001|J3471||0.48|0|0|0||OVINE - UP TO 999 USP UNITS|| 80001|J3473||0.45|0|0.45|0||HYALURONIDASE RECOMBINANT|| 80001|J3473||0.45|0|0|0||HYALURONIDASE RECOMBINANT|| 80001|J3475||0.29|0|0.29|0||INJ MAGNESIUM SULFATE|| 80001|J3475||0.68|0|0|0||INJ MAGNESIUM SULFATE|| 80001|J3480||0.17|0|0.17|0||INJ POTASSIUM CHLORIDE|| 80001|J3480||0.17|0|0|0||INJ POTASSIUM CHLORIDE|| 80001|J3485||1.88|0|1.88|0||ZIDOVUDINE|| 80001|J3485||1.9|0|0|0||ZIDOVUDINE|| 80001|J3486||22.17|0|22.17|0||ZIPRASIDONE MESYLATE|| 80001|J3486||27.1|0|0|0||ZIPRASIDONE MESYLATE|| 80001|J3489||23.06|0|23.06|0||INJ - ZOLEDRONIC ACID 1MG|| 80001|J3489||15.04|0|0|0||INJ - ZOLEDRONIC ACID 1MG|| 80001|J7030||2.53|0|2.53|0||NORMAL SALINE SOLUTION INFUS|| 80001|J7030||2.49|0|0|0||NORMAL SALINE SOLUTION INFUS|| 80001|J7040||1.26|0|1.26|0||NORMAL SALINE SOLUTION INFUS|| 80001|J7040||1.25|0|0|0||NORMAL SALINE SOLUTION INFUS|| 80001|J7042||0.89|0|0.89|0||5% DEXTROSE/NORMAL SALINE|| 80001|J7042||1.1|0|0|0||5% DEXTROSE/NORMAL SALINE|| 80001|J7050||0.63|0|0.63|0||NORMAL SALINE SOLUTION INFUS|| 80001|J7050||0.61|0|0|0||NORMAL SALINE SOLUTION INFUS|| 80001|J7060||2.24|0|2.24|0||5% DEXTROSE/WATER|| 80001|J7060||2.58|0|0|0||5% DEXTROSE/WATER|| 80001|J7070||4.39|0|4.39|0||D5W INFUSION|| 80001|J7070||5.03|0|0|0||D5W INFUSION|| 80001|J7120||2.48|0|2.48|0||RINGERS LACTATE INFUSION|| 80001|J7120||3|0|0|0||RINGERS LACTATE INFUSION|| 80001|J7180||10.24|0|10.24|0||FACTOR XIII ANTI-HEM FACTOR|| 80001|J7180||10.24|0|0|0||FACTOR XIII ANTI-HEM FACTOR|| 80001|J7182||1.69|0|1.69|0||FACTOR VIII RECOMB NOVOEIGHT P|| 80001|J7182||1.64|0|0|0||FACTOR VIII RECOMB NOVOEIGHT P|| 80001|J7183||1|0|1|0||WILATE INJECTION|| 80001|J7183||1.29|0|0|0||WILATE INJECTION|| 80001|J7185||1.55|0|1.55|0||XYNTHA INJ|| 80001|J7185||1.58|0|0|0||XYNTHA INJ|| 80001|J7186||1.21|0|1.21|0||ANTIHEMOPHILIC VIII/VWF COMP|| 80001|J7186||1.18|0|0|0||ANTIHEMOPHILIC VIII/VWF COMP|| 80001|J7187||1.29|0|1.29|0||INJ VONWILLEBRAND FACTOR IU|| 80001|J7187||1.36|0|0|0||INJ VONWILLEBRAND FACTOR IU|| 80001|J7189||2.38|0|2.38|0||FACTOR VIIA|| 80001|J7189||2.47|0|0|0||FACTOR VIIA|| 80001|J7190||1.22|0|1.22|0||FACTOR VIII|| 80001|J7190||1.23|0|0|0||FACTOR VIII|| 80001|J7192||1.5|0|1.5|0||FACTOR VIII RECOMBINANT|| 80001|J7192||1.53|0|0|0||FACTOR VIII RECOMBINANT|| 80001|J7193||1.39|0|1.39|0||FACTOR IX NON-RECOMBINANT|| 80001|J7193||1.41|0|0|0||FACTOR IX NON-RECOMBINANT|| 80001|J7194||1.6|0|1.6|0||FACTOR IX COMPLEX|| 80001|J7194||1.74|0|0|0||FACTOR IX COMPLEX|| 80001|J7195||1.89|0|1.89|0||FACTOR IX RECOMBINANT|| 80001|J7195||1.88|0|0|0||FACTOR IX RECOMBINANT|| 80001|J7197||4.52|0|4.52|0||ANTITHROMBIN III INJECTION|| 80001|J7197||4.03|0|0|0||ANTITHROMBIN III INJECTION|| 80001|J7198||2.41|0|2.41|0||ANTI-INHIBITOR|| 80001|J7198||2.42|0|0|0||ANTI-INHIBITOR|| 80001|J7200||1.56|0|1.56|0||FACTOR IX RECOMBINAN RIXUBIS P|| 80001|J7200||1.6|0|0|0||FACTOR IX RECOMBINAN RIXUBIS P|| 80001|J7201||3.52|0|3.52|0||FACTOR IX FC FUSION RECOMB - PE|| 80001|J7201||3.73|0|0|0||FACTOR IX FC FUSION RECOMB - PE|| 80001|J7205||2.37|0|2.37|0||FACTOR VIII FC FUSION RECOMB P|| 80001|J7205||2.53|0|0|0||FACTOR VIII FC FUSION RECOMB P|| 80001|J7297||65|0|0||%|LEVONORGESTREL IU 52 MG 3 YR D|| 80001|J7298||780|0|780|||LEVONORGESTREL IU 52 MG 5 YR D|| 80001|J7300||971|0|0|||INTRAUT COPPER CONTRACEPTIVE|| 80001|J7301||600.01|0|600.01|||SKYLA 13.5 MG|| 80001|J7307||715|0|715|||ETONOGESTREL IMPLANT SYSTEM|| 80001|J7308||409.27|0|409.27|0||AMINOLEVULINIC ACID HCL TOP|| 80001|J7308||459.76|0|0|0||AMINOLEVULINIC ACID HCL TOP|| 80001|J7310||21200|0|21200|0||GANCICLOVIR LONG ACT IMPLANT|| 80001|J7311||25173.26|0|25173.26|0||FLUOCINOLONE ACETONIDE IMPLT|| 80001|J7311||25179.06|0|0|0||FLUOCINOLONE ACETONIDE IMPLT|| 80001|J7312||247.26|0|247.26|0||DEXAMETHASONE INTRA IMPLANT|| 80001|J7312||250.95|0|0|0||DEXAMETHASONE INTRA IMPLANT|| 80001|J7313||613.68|0|613.68|0||FLUOCINOL ACET INTRAVIT IMP 0.|| 80001|J7313||613.68|0|0|0||FLUOCINOL ACET INTRAVIT IMP 0.|| 80001|J7316||1308.44|0|1308.44|0||SODIM HYALURONATE 5 MG ARTICLR|| 80001|J7316||1308.44|0|0|0||SODIM HYALURONATE 5 MG ARTICLR|| 80001|J7320||8.83|0|0|0||HYLAN G-F 20 INJECTION|| 80001|J7321||108.24|0|108.24|0||HYALGAN/SUPARTZ INJ PER DOSE|| 80001|J7321||106.92|0|0|0||HYALGAN/SUPARTZ INJ PER DOSE|| 80001|J7323||196.98|0|196.98|0||EUFLEXXA INJ PER DOSE|| 80001|J7323||190.41|0|0|0||EUFLEXXA INJ PER DOSE|| 80001|J7324||199.73|0|199.73|0||ORTHOVISC INJ PER DOSE|| 80001|J7324||178.4|0|0|0||ORTHOVISC INJ PER DOSE|| 80001|J7325||15.61|0|15.61|0||SYNVISC OR SYNVISC-ONE|| 80001|J7325||15.86|0|0|0||SYNVISC OR SYNVISC-ONE|| 80001|J7326||762.63|0|762.63|0||GEL-ONE|| 80001|J7326||697.66|0|0|0||GEL-ONE|| 80001|J7327||1138.42|0|1138.42|0||MONOVISC INJ PER DOSE|| 80001|J7327||1084.24|0|0|0||MONOVISC INJ PER DOSE|| 80001|J7336||3.72|0|3.72|0||CAPSAICIN 8% PATCH - PER SQ CM|| 80001|J7336||4|0|0|0||CAPSAICIN 8% PATCH - PER SQ CM|| 80001|J7500||0.4|0|0.4|0||AZATHIOPRINE ORAL 50MG|| 80001|J7500||0.41|0|0|0||AZATHIOPRINE ORAL 50MG|| 80001|J7502||4.29|0|4.29|0||CYCLOSPORINE ORAL 100 MG|| 80001|J7502||3.46|0|0|0||CYCLOSPORINE ORAL 100 MG|| 80001|J7503||1.35|0|1.35|0||CYCLOSPORINE PARENTERAL|| 80001|J7503||1.55|0|0|0||CYCLOSPORINE PARENTERAL|| 80001|J7504||1612.2|0|1612.2|0||LYMPHOCYTE IMMUNE GLOBULIN|| 80001|J7504||2193.33|0|0|0||LYMPHOCYTE IMMUNE GLOBULIN|| 80001|J7506||0.09|0|0.09|0||PREDNISONE ORAL|| 80001|J7507||1.02|0|1.02|0||TACROLIMUS ORAL PER 1 MG|| 80001|J7507||0.75|0|0|0||TACROLIMUS ORAL PER 1 MG|| 80001|J7508||0.49|0|0.49|0||TACROLIMUS ORAL PER 5 MG|| 80001|J7508||0.53|0|0|0||TACROLIMUS ORAL PER 5 MG|| 80001|J7509||0.39|0|0.39|0||METHYLPREDNISOLONE ORAL|| 80001|J7509||0.52|0|0|0||METHYLPREDNISOLONE ORAL|| 80001|J7510||0.15|0|0.15|0||PREDNISOLONE ORAL PER 5 MG|| 80001|J7510||0.08|0|0|0||PREDNISOLONE ORAL PER 5 MG|| 80001|J7511||845.25|0|845.25|0||ANTITHYMOCYTE GLOBULN RABBIT|| 80001|J7511||882.66|0|0|0||ANTITHYMOCYTE GLOBULN RABBIT|| 80001|J7512||0.01|0|0.01|0||PREDNISONE IR OR DR ORAL 1 MG|| 80001|J7512||0.01|0|0|0||PREDNISONE IR OR DR ORAL 1 MG|| 80001|J7515||1.16|0|1.16|0||CYCLOSPORINE ORAL 25 MG|| 80001|J7515||0.98|0|0|0||CYCLOSPORINE ORAL 25 MG|| 80001|J7516||54.78|0|54.78|0||CYCLOSPORIN PARENTERAL 250MG|| 80001|J7516||53.14|0|0|0||CYCLOSPORIN PARENTERAL 250MG|| 80001|J7517||1.41|0|1.41|0||MYCOPHENOLATE MOFETIL ORAL|| 80001|J7517||1.25|0|0|0||MYCOPHENOLATE MOFETIL ORAL|| 80001|J7518||3.82|0|3.82|0||MYCOPHENOLIC ACID|| 80001|J7518||3.39|0|0|0||MYCOPHENOLIC ACID|| 80001|J7520||9.84|0|9.84|0||SIROLIMUS - ORAL|| 80001|J7520||9.68|0|0|0||SIROLIMUS - ORAL|| 80001|J7525||204.63|0|204.63|0||TACROLIMUS INJECTION|| 80001|J7525||231.55|0|0|0||TACROLIMUS INJECTION|| 80001|J7527||9.62|0|9.62|0||ORAL EVEROLIMUS|| 80001|J7527||10.16|0|0|0||ORAL EVEROLIMUS|| 80001|J7605||10.96|0|10.96|0||ARFORMOTEROL NON-COMP UNIT|| 80001|J7605||11.61|0|0|0||ARFORMOTEROL NON-COMP UNIT|| 80001|J7606||13.05|0|13.05|0||FORMOTEROL FUMARATE - INH|| 80001|J7606||12.97|0|0|0||FORMOTEROL FUMARATE - INH|| 80001|J7608||5.86|0|5.86|0||ACETYLCYSTEINE INH SOL U D|| 80001|J7608||5.59|0|0|0||ACETYLCYSTEINE INH SOL U D|| 80001|J7611||0.14|0|0.14|0||ALBUTEROL CONCENTRATED FORM|| 80001|J7611||0.17|0|0|0||ALBUTEROL CONCENTRATED FORM|| 80001|J7612||0.29|0|0.29|0||LEVALBUTEROL CONCENTRATED|| 80001|J7612||0.26|0|0|0||LEVALBUTEROL CONCENTRATED|| 80001|J7613||0.06|0|0.06|0||ALBUTEROL UNIT DOSE|| 80001|J7613||0.06|0|0|0||ALBUTEROL UNIT DOSE|| 80001|J7614||0.09|0|0.09|0||LEVALBUTEROL UNIT DOSE|| 80001|J7614||0.07|0|0|0||LEVALBUTEROL UNIT DOSE|| 80001|J7620||0.21|0|0.21|0||ALBUTEROL NON-COMPOUNDED|| 80001|J7620||0.18|0|0|0||ALBUTEROL NON-COMPOUNDED|| 80001|J7626||5.36|0|5.36|0||BUDESONIDE - NON-COMPOUNDED|| 80001|J7626||4.59|0|0|0||BUDESONIDE - NON-COMPOUNDED|| 80001|J7631||1.02|0|1.02|0||CROMOLYN SODIUM INH SOL U D|| 80001|J7631||1.01|0|0|0||CROMOLYN SODIUM INH SOL U D|| 80001|J7639||52.87|0|52.87|0||DORNASE ALPHA INHAL SOL U D|| 80001|J7639||56.36|0|0|0||DORNASE ALPHA INHAL SOL U D|| 80001|J7644||0.26|0|0.26|0||IPRATROPIUM BROM INH SOL U D|| 80001|J7644||0.28|0|0|0||IPRATROPIUM BROM INH SOL U D|| 80001|J7665||0.84|0|0.84|0||ISOPROTERENOL HYDROCHLORIDE - 1|| 80001|J7674||0.65|0|0.65|0||METHACHOLINE CHLORIDE - NEB|| 80001|J7674||0.68|0|0|0||METHACHOLINE CHLORIDE - NEB|| 80001|J7682||64.22|0|64.22|0||TOBRAMYCIN INHALATION SOL|| 80001|J7682||56.69|0|0|0||TOBRAMYCIN INHALATION SOL|| 80001|J7686||633.04|0|633.04|0||TREPROSTINIL - NON-COMP UNIT|| 80001|J7686||664.1|0|0|0||TREPROSTINIL - NON-COMP UNIT|| 80001|J8501||13.8|0|13.8|0||ORAL APREPITANT|| 80001|J8501||11.87|0|0|0||ORAL APREPITANT|| 80001|J8510||29.31|0|29.31|0||ORAL BUSULFAN|| 80001|J8510||31.04|0|0|0||ORAL BUSULFAN|| 80001|J8520||5.79|0|5.79|0||CAPECITABINE - ORAL - 150 MG|| 80001|J8520||3.79|0|0|0||CAPECITABINE - ORAL - 150 MG|| 80001|J8521||18.45|0|18.45|0||CAPECITABINE - ORAL - 500 MG|| 80001|J8521||9.98|0|0|0||CAPECITABINE - ORAL - 500 MG|| 80001|J8530||4.06|0|4.06|0||CYCLOPHOSPHAMIDE ORAL 25 MG|| 80001|J8530||4.38|0|0|0||CYCLOPHOSPHAMIDE ORAL 25 MG|| 80001|J8540||0.02|0|0.02|0||ORAL DEXAMETHASONE|| 80001|J8540||0.11|0|0|0||ORAL DEXAMETHASONE|| 80001|J8560||83.41|0|83.41|0||ETOPOSIDE ORAL 50 MG|| 80001|J8560||92.6|0|0|0||ETOPOSIDE ORAL 50 MG|| 80001|J8600||14.05|0|14.05|0||MELPHALAN ORAL 2 MG|| 80001|J8600||14.65|0|0|0||MELPHALAN ORAL 2 MG|| 80001|J8610||1.26|0|1.26|0||METHOTREXATE ORAL 2.5 MG|| 80001|J8610||0.67|0|0|0||METHOTREXATE ORAL 2.5 MG|| 80001|J8655||581.13|0|581.13|0||NETUPITANT 300/PALONOSETRON 0.|| 80001|J8655||539.38|0|0|0||NETUPITANT 300/PALONOSETRON 0.|| 80001|J8700||3.6|0|3.6|0||TEMOZOLOMIDE|| 80001|J8700||2.34|0|0|0||TEMOZOLOMIDE|| 80001|J8705||129.77|0|129.77|0||TOPOTECAN ORAL|| 80001|J8705||129.72|0|0|0||TOPOTECAN ORAL|| 80001|J9000||3.3|0|3.3|0||DOXORUBIC HCL 10 MG VL CHEMO|| 80001|J9000||3.34|0|0|0||DOXORUBIC HCL 10 MG VL CHEMO|| 80001|J9017||81.4|0|81.4|0||ARSENIC TRIOXIDE|| 80001|J9017||88.67|0|0|0||ARSENIC TRIOXIDE|| 80001|J9019||498.07|0|498.07|0||ERWINAZE INJECTION|| 80001|J9019||503.43|0|0|0||ERWINAZE INJECTION|| 80001|J9020||80.7|0|80.7|0||ASPARAGINASE INJECTION|| 80001|J9025||3.54|0|3.54|0||AZACITIDINE INJECTION|| 80001|J9025||2.63|0|0|0||AZACITIDINE INJECTION|| 80001|J9027||188.3|0|188.3|0||CLOFARABINE INJECTION|| 80001|J9027||189.95|0|0|0||CLOFARABINE INJECTION|| 80001|J9031||154.24|0|154.24|0||BCG LIVE INTRAVESICAL VAC|| 80001|J9031||160.85|0|0|0||BCG LIVE INTRAVESICAL VAC|| 80001|J9032||41.73|0|41.73|0||INJECTION - BELINOSTAT - 10MG|| 80001|J9032||44.08|0|0|0||INJECTION - BELINOSTAT - 10MG|| 80001|J9033||30.93|0|30.93|0||BENDAMUSTINE INJECTION|| 80001|J9033||36.14|0|0|0||BENDAMUSTINE INJECTION|| 80001|J9034||29.43|0|0|0||INJECTION - BENDEKA 1 MG|| 80001|J9035||90.25|0|90.25|0||BEVACIZUMAB INJECTION|| 80001|J9035||93.55|0|0|0||BEVACIZUMAB INJECTION|| 80001|J9039||127.88|0|0|0||INJECTION - BLINATUMOMAB - 1 MIC|| 80001|J9040||26.87|0|26.87|0||BLEOMYCIN SULFATE INJECTION|| 80001|J9040||58.12|0|0|0||BLEOMYCIN SULFATE INJECTION|| 80001|J9041||58.2|0|58.2|0||BORTEZOMIB INJECTION|| 80001|J9041||58.55|0|0|0||BORTEZOMIB INJECTION|| 80001|J9042||161.61|0|161.61|0||BRENTUXIMAB VEDOTIN INJ|| 80001|J9042||174.69|0|0|0||BRENTUXIMAB VEDOTIN INJ|| 80001|J9043||187.64|0|187.64|0||CABAZITAXEL INJECTION|| 80001|J9043||196.15|0|0|0||CABAZITAXEL INJECTION|| 80001|J9045||4.53|0|4.53|0||CARBOPLATIN INJECTION|| 80001|J9045||4.27|0|0|0||CARBOPLATIN INJECTION|| 80001|J9047||39.74|0|39.74|0||INJECTION - CARFILZOMIB - 1 MG|| 80001|J9047||40.17|0|0|0||INJECTION - CARFILZOMIB - 1 MG|| 80001|J9050||4775.94|0|4775.94|0||CARMUS BISCHL NITRO INJ|| 80001|J9050||4828.1|0|0|0||CARMUS BISCHL NITRO INJ|| 80001|J9055||69.96|0|69.96|0||CETUXIMAB INJECTION|| 80001|J9055||71.86|0|0|0||CETUXIMAB INJECTION|| 80001|J9060||2.52|0|2.52|0||CISPLATIN 10 MG INJECTION|| 80001|J9060||2.51|0|0|0||CISPLATIN 10 MG INJECTION|| 80001|J9065||27.42|0|27.42|0||INJ CLADRIBINE PER 1 MG|| 80001|J9065||26.52|0|0|0||INJ CLADRIBINE PER 1 MG|| 80001|J9070||52.73|0|52.73|0||CYCLOPHOSPHAMIDE 100 MG INJ|| 80001|J9070||52.7|0|0|0||CYCLOPHOSPHAMIDE 100 MG INJ|| 80001|J9098||739.14|0|739.14|0||CYTARABINE LIPOSOME|| 80001|J9098||764.26|0|0|0||CYTARABINE LIPOSOME|| 80001|J9100||1.1|0|1.1|0||CYTARABINE HCL 100 MG INJ|| 80001|J9100||1.03|0|0|0||CYTARABINE HCL 100 MG INJ|| 80001|J9120||1572.54|0|1572.54|0||DACTINOMYCIN ACTINOMYCIN D|| 80001|J9120||1712.6|0|0|0||DACTINOMYCIN ACTINOMYCIN D|| 80001|J9130||4.95|0|4.95|0||DACARBAZINE 100 MG INJ|| 80001|J9130||4.89|0|0|0||DACARBAZINE 100 MG INJ|| 80001|J9145||60.77|0|0|0||INJECTION - DARATUMUMAB - 10 MG|| 80001|J9150||47.11|0|47.11|0||DAUNORUBICIN|| 80001|J9150||51.45|0|0|0||DAUNORUBICIN|| 80001|J9155||4.65|0|4.65|0||DEGARELIX INJECTION|| 80001|J9155||4.56|0|0|0||DEGARELIX INJECTION|| 80001|J9171||3.41|0|3.41|0||DOCETAXEL INJECTION|| 80001|J9171||2.25|0|0|0||DOCETAXEL INJECTION|| 80001|J9176||7.85|0|0|0||INJECTION - ELOTUZUMAB - 1 MG|| 80001|J9178||1.61|0|1.61|0||INJ - EPIRUBICIN HCL - 2 MG|| 80001|J9178||1.51|0|0|0||INJ - EPIRUBICIN HCL - 2 MG|| 80001|J9179||132.97|0|132.97|0||ERIBULIN MESYLATE INJECTION|| 80001|J9179||137.01|0|0|0||ERIBULIN MESYLATE INJECTION|| 80001|J9181||0.9|0|0.9|0||ETOPOSIDE 10 MG INJ|| 80001|J9181||0.73|0|0|0||ETOPOSIDE 10 MG INJ|| 80001|J9185||80.55|0|80.55|0||FLUDARABINE PHOSPHATE INJ|| 80001|J9185||96|0|0|0||FLUDARABINE PHOSPHATE INJ|| 80001|J9190||2.34|0|2.34|0||FLUOROURACIL INJECTION|| 80001|J9190||2.06|0|0|0||FLUOROURACIL INJECTION|| 80001|J9200||20.34|0|20.34|0||FLOXURIDINE INJECTION|| 80001|J9200||92.35|0|0|0||FLOXURIDINE INJECTION|| 80001|J9201||8.81|0|8.81|0||GEMCITABINE HCL|| 80001|J9201||7.71|0|0|0||GEMCITABINE HCL|| 80001|J9202||380.33|0|380.33|0||GOSERELIN ACETATE IMPLANT|| 80001|J9202||407.51|0|0|0||GOSERELIN ACETATE IMPLANT|| 80001|J9205||50.37|0|0|0||INJECTION - IRINOTECAN LIPOSOME|| 80001|J9206||5.26|0|5.26|0||IRINOTECAN INJECTION|| 80001|J9206||4.42|0|0|0||IRINOTECAN INJECTION|| 80001|J9207||96.13|0|96.13|0||IXABEPILONE INJECTION|| 80001|J9207||92.61|0|0|0||IXABEPILONE INJECTION|| 80001|J9208||36.48|0|36.48|0||IFOSFOMIDE INJECTION|| 80001|J9208||34.07|0|0|0||IFOSFOMIDE INJECTION|| 80001|J9209||4.05|0|4.05|0||MESNA INJECTION|| 80001|J9209||2.71|0|0|0||MESNA INJECTION|| 80001|J9211||32.46|0|32.46|0||IDARUBICIN HCL INJECTION|| 80001|J9211||49.1|0|0|0||IDARUBICIN HCL INJECTION|| 80001|J9214||31.58|0|31.58|0||INTERFERON ALFA-2B INJ|| 80001|J9214||35.55|0|0|0||INTERFERON ALFA-2B INJ|| 80001|J9217||274.85|0|274.85|0||LEUPROLIDE ACETATE SUSPNSION|| 80001|J9217||252.65|0|0|0||LEUPROLIDE ACETATE SUSPNSION|| 80001|J9218||20.94|0|20.94|0||LEUPROLIDE ACETATE INJECITON|| 80001|J9218||32.16|0|0|0||LEUPROLIDE ACETATE INJECITON|| 80001|J9225||3860.09|0|3860.09|0||HISTRELIN IMPLANT|| 80001|J9225||4003.89|0|0|0||HISTRELIN IMPLANT|| 80001|J9226||32705.14|0|32705.14|0||SUPPRELIN LA IMPLANT|| 80001|J9226||34686.33|0|0|0||SUPPRELIN LA IMPLANT|| 80001|J9228||175.79|0|175.79|0||IPILIMUMAB INJECTION|| 80001|J9228||180.84|0|0|0||IPILIMUMAB INJECTION|| 80001|J9230||332.93|0|332.93|0||MECHLORETHAMINE HCL INJ|| 80001|J9230||366.11|0|0|0||MECHLORETHAMINE HCL INJ|| 80001|J9245||2207.46|0|2207.46|0||INJ MELPHALAN HYDROCHL 50 MG|| 80001|J9245||1836.06|0|0|0||INJ MELPHALAN HYDROCHL 50 MG|| 80001|J9250||0.29|0|0.29|0||METHOTREXATE SODIUM INJ|| 80001|J9250||0.37|0|0|0||METHOTREXATE SODIUM INJ|| 80001|J9260||2.88|0|2.88|0||METHOTREXATE SODIUM INJ|| 80001|J9260||3.69|0|0|0||METHOTREXATE SODIUM INJ|| 80001|J9261||190.1|0|190.1|0||NELARABINE INJECTION|| 80001|J9261||190.01|0|0|0||NELARABINE INJECTION|| 80001|J9263||0.38|0|0.38|0||OXALIPLATIN|| 80001|J9263||0.22|0|0|0||OXALIPLATIN|| 80001|J9264||12.57|0|12.57|0||PACLITAXEL INJECTION|| 80001|J9264||13.44|0|0|0||PACLITAXEL INJECTION|| 80001|J9266||17844|0|17844|0||PEGASPARGASE/SINGL DOSE VIAL|| 80001|J9266||17393.88|0|0|0||PEGASPARGASE/SINGL DOSE VIAL|| 80001|J9267||0.18|0|0.18|0||PACLITAXEL INJECTION - 1 MG|| 80001|J9267||0.18|0|0|0||PACLITAXEL INJECTION - 1 MG|| 80001|J9268||2300.4|0|2300.4|0||PENTOSTATIN INJECTION|| 80001|J9268||2571.36|0|0|0||PENTOSTATIN INJECTION|| 80001|J9271||57.21|0|57.21|0||INJ PEMBROLIZUMAB - 1 MG|| 80001|J9271||58.97|0|0|0||INJ PEMBROLIZUMAB - 1 MG|| 80001|J9280||122.76|0|122.76|0||MITOMYCIN 5 MG INJ|| 80001|J9280||151.82|0|0|0||MITOMYCIN 5 MG INJ|| 80001|J9293||45.39|0|45.39|0||MITOXANTRONE HYDROCHL / 5 MG|| 80001|J9293||47.34|0|0|0||MITOXANTRONE HYDROCHL / 5 MG|| 80001|J9295||6.66|0|0|0||POLYESTRADIOL PHOSPHATE 40 MG|| 80001|J9299||32.12|0|32.12|0||INJECTION - NIVOLUMAB - 1 MG|| 80001|J9299||33.03|0|0|0||INJECTION - NIVOLUMAB - 1 MG|| 80001|J9301||70.37|0|70.37|0||OBINUTUZUMAB INJ - 10 MG|| 80001|J9301||73.48|0|0|0||OBINUTUZUMAB INJ - 10 MG|| 80001|J9302||64.95|0|64.95|0||OFATUMUMAB INJECTION|| 80001|J9302||68.55|0|0|0||OFATUMUMAB INJECTION|| 80001|J9303||131.91|0|131.91|0||PANITUMUMAB INJECTION|| 80001|J9303||136.75|0|0|0||PANITUMUMAB INJECTION|| 80001|J9305||78.68|0|78.68|0||PEMETREXED INJECTION|| 80001|J9305||80.93|0|0|0||PEMETREXED INJECTION|| 80001|J9306||13.32|0|13.32|0||INJECTION - PERTUZUMAB - 1 MG|| 80001|J9306||13.89|0|0|0||INJECTION - PERTUZUMAB - 1 MG|| 80001|J9307||287.42|0|287.42|0||PRALATREXATE INJECTION|| 80001|J9307||309.5|0|0|0||PRALATREXATE INJECTION|| 80001|J9308||70.19|0|70.19|0||INJECTION - RAMUCIRUMAB - 5 MG|| 80001|J9308||70.7|0|0|0||INJECTION - RAMUCIRUMAB - 5 MG|| 80001|J9310||989.25|0|989.25|0||RITUXIMAB CANCER TREATMENT|| 80001|J9310||1052.99|0|0|0||RITUXIMAB CANCER TREATMENT|| 80001|J9315||375.5|0|375.5|0||ROMIDEPSIN INJECTION|| 80001|J9315||399.31|0|0|0||ROMIDEPSIN INJECTION|| 80001|J9320||403.51|0|403.51|0||STREPTOZOCIN INJECTION|| 80001|J9320||398.8|0|0|0||STREPTOZOCIN INJECTION|| 80001|J9325||58.83|0|0|0||INJ TALIMOGENE LAHERPAREPVEC - || 80001|J9328||9.32|0|9.32|0||TEMOZOLOMIDE INJECTION|| 80001|J9328||10.99|0|0|0||TEMOZOLOMIDE INJECTION|| 80001|J9330||81.98|0|81.98|0||TEMSIROLIMUS INJECTION|| 80001|J9330||87.47|0|0|0||TEMSIROLIMUS INJECTION|| 80001|J9351||2.28|0|2.28|0||TOPOTECAN INJECTION|| 80001|J9351||1.36|0|0|0||TOPOTECAN INJECTION|| 80001|J9352||358.03|0|0|0||INJECTION - TRABECTEDIN - 0.1 MG|| 80001|J9354||36.52|0|36.52|0||INJ - ADO-TRASTUZUMAB EMT 1 MG|| 80001|J9354||37.24|0|0|0||INJ - ADO-TRASTUZUMAB EMT 1 MG|| 80001|J9355||114.66|0|114.66|0||TRASTUZUMAB|| 80001|J9355||120.79|0|0|0||TRASTUZUMAB|| 80001|J9357||1415.98|0|1415.98|0||VALRUBICIN - 200 MG|| 80001|J9357||1452.43|0|0|0||VALRUBICIN - 200 MG|| 80001|J9360||3.88|0|3.88|0||VINBLASTINE SULFATE INJ|| 80001|J9360||4.35|0|0|0||VINBLASTINE SULFATE INJ|| 80001|J9370||5.33|0|5.33|0||VINCRISTINE SULFATE 1 MG INJ|| 80001|J9370||6.14|0|0|0||VINCRISTINE SULFATE 1 MG INJ|| 80001|J9371||3116.26|0|3116.26|0||INJ - VINCRISTINE SUL LIP 1 MG|| 80001|J9371||3250.45|0|0|0||INJ - VINCRISTINE SUL LIP 1 MG|| 80001|J9390||13.07|0|13.07|0||VINORELBINE TARTRATE/10 MG|| 80001|J9390||11.79|0|0|0||VINORELBINE TARTRATE/10 MG|| 80001|J9395||117.6|0|117.6|0||INJECTION - FULVESTRANT|| 80001|J9395||120.23|0|0|0||INJECTION - FULVESTRANT|| 80001|J9400||10.09|0|10.09|0||INJ - ZIV-AFLIBERCEPT - 1 MG|| 80001|J9400||10.06|0|0|0||INJ - ZIV-AFLIBERCEPT - 1 MG|| 80001|K0001|RR|62.63|0|62.63|0||STANDARD WHEELCHAIR|| 80001|K0002|RR|92.64|0|92.64|0||STND HEMI (LOW SEAT) WHLCHR|| 80001|K0003|RR|117.83|0|117.83|0||LIGHTWEIGHT WHEELCHAIR|| 80001|K0004|RR|151.3|0|151.3|0||HIGH STRENGTH LTWT WHLCHR|| 80001|K0005|NU|2462.45|0|2462.45|0||ULTRALIGHTWEIGHT WHEELCHAIR|| 80001|K0005|RR|246.22|0|246.22|0||ULTRALIGHTWEIGHT WHEELCHAIR|| 80001|K0006|RR|167.05|0|167.05|0||HEAVY DUTY WHEELCHAIR|| 80001|K0007|RR|233.78|0|233.78|0||EXTRA HEAVY DUTY WHEELCHAIR|| 80001|K0009|RR|99.04|0|99.04|0||OTHER MANUAL WHEELCHAIR/BASE|| 80001|K0010|RR|482.28|0|482.28|0||STND WT FRAME POWER WHLCHR|| 80001|K0011|RR|682.3|0|682.3|0||STND WT PWR WHLCHR W CONTROL|| 80001|K0012|RR|419.77|0|419.77|0||LTWT PORTBL POWER WHLCHR|| 80001|K0015|NU|208.61|0|208.61|0||DETACH NON-ADJUS HGHT ARMRST|| 80001|K0015|RR|20.86|0|20.86|0||DETACH NON-ADJUS HGHT ARMRST|| 80001|K0017|NU|58.67|0|58.67|0||DETACH ADJUST ARMREST BASE|| 80001|K0017|RR|5.87|0|5.87|0||DETACH ADJUST ARMREST BASE|| 80001|K0018|NU|32.77|0|32.77|0||DETACH ADJUST ARMRST UPPER|| 80001|K0018|RR|3.26|0|3.26|0||DETACH ADJUST ARMRST UPPER|| 80001|K0019|NU|19.51|0|19.51|0||ARM PAD EACH|| 80001|K0019|RR|1.96|0|1.96|0||ARM PAD EACH|| 80001|K0020|NU|53.34|0|53.34|0||FIXED ADJUST ARMREST PAIR|| 80001|K0020|RR|5.34|0|5.34|0||FIXED ADJUST ARMREST PAIR|| 80001|K0037|NU|55.28|0|55.28|0||HIGH MOUNT FLIP-UP FOOTREST|| 80001|K0037|RR|4.93|0|4.93|0||HIGH MOUNT FLIP-UP FOOTREST|| 80001|K0038|NU|27.86|0|27.86|0||LEG STRAP EACH|| 80001|K0038|RR|2.78|0|2.78|0||LEG STRAP EACH|| 80001|K0039|NU|61.85|0|61.85|0||LEG STRAP H STYLE EACH|| 80001|K0039|RR|6.22|0|6.22|0||LEG STRAP H STYLE EACH|| 80001|K0040|NU|85.73|0|85.73|0||ADJUSTABLE ANGLE FOOTPLATE|| 80001|K0040|RR|8.56|0|8.56|0||ADJUSTABLE ANGLE FOOTPLATE|| 80001|K0041|NU|60.74|0|60.74|0||LARGE SIZE FOOTPLATE EACH|| 80001|K0041|RR|6.12|0|6.12|0||LARGE SIZE FOOTPLATE EACH|| 80001|K0042|NU|41.83|0|41.83|0||STANDARD SIZE FOOTPLATE EACH|| 80001|K0042|RR|4.18|0|4.18|0||STANDARD SIZE FOOTPLATE EACH|| 80001|K0043|NU|22.4|0|22.4|0||FTRST LOWER EXTENSION TUBE|| 80001|K0043|RR|2.23|0|2.23|0||FTRST LOWER EXTENSION TUBE|| 80001|K0044|NU|19.1|0|19.1|0||FTRST UPPER HANGER BRACKET|| 80001|K0044|RR|1.92|0|1.92|0||FTRST UPPER HANGER BRACKET|| 80001|K0045|NU|65|0|65|0||FOOTREST COMPLETE ASSEMBLY|| 80001|K0045|RR|6.7|0|6.7|0||FOOTREST COMPLETE ASSEMBLY|| 80001|K0046|NU|22.4|0|22.4|0||ELEVAT LEGRST LOW EXTENSION|| 80001|K0046|RR|2.23|0|2.23|0||ELEVAT LEGRST LOW EXTENSION|| 80001|K0047|NU|87.79|0|87.79|0||ELEVAT LEGRST UP HANGR BRACK|| 80001|K0047|RR|8.81|0|8.81|0||ELEVAT LEGRST UP HANGR BRACK|| 80001|K0050|NU|37.31|0|37.31|0||RATCHET ASSEMBLY|| 80001|K0050|RR|3.72|0|3.72|0||RATCHET ASSEMBLY|| 80001|K0051|NU|60.38|0|60.38|0||CAM RELESE ASSEM FTRST/LGRST|| 80001|K0051|RR|6.07|0|6.07|0||CAM RELESE ASSEM FTRST/LGRST|| 80001|K0052|NU|106.13|0|106.13|0||SWINGAWAY DETACH FOOTREST|| 80001|K0052|RR|10.61|0|10.61|0||SWINGAWAY DETACH FOOTREST|| 80001|K0053|NU|117.11|0|117.11|0||ELEVATE FOOTREST ARTICULATE|| 80001|K0053|RR|11.7|0|11.7|0||ELEVATE FOOTREST ARTICULATE|| 80001|K0056|NU|126.67|0|126.67|0||SEAT HT <17 OR >=21 LTWT WC|| 80001|K0056|RR|12.67|0|12.67|0||SEAT HT <17 OR >=21 LTWT WC|| 80001|K0065|NU|59.21|0|59.21|0||SPOKE PROTECTORS|| 80001|K0065|RR|5.93|0|5.93|0||SPOKE PROTECTORS|| 80001|K0069|NU|133.1|0|133.1|0||REAR WHL COMPLETE SOLID TIRE|| 80001|K0069|RR|13.86|0|13.86|0||REAR WHL COMPLETE SOLID TIRE|| 80001|K0070|NU|243.95|0|243.95|0||REAR WHL COMPL PNEUM TIRE|| 80001|K0070|RR|24.42|0|24.42|0||REAR WHL COMPL PNEUM TIRE|| 80001|K0071|NU|145.51|0|145.51|0||FRONT CASTR COMPL PNEUM TIRE|| 80001|K0071|RR|14.57|0|14.57|0||FRONT CASTR COMPL PNEUM TIRE|| 80001|K0072|NU|87.6|0|87.6|0||FRNT CSTR CMPL SEM-PNEUM TIR|| 80001|K0072|RR|8.76|0|8.76|0||FRNT CSTR CMPL SEM-PNEUM TIR|| 80001|K0073|NU|46.36|0|46.36|0||CASTER PIN LOCK EACH|| 80001|K0073|RR|4.64|0|4.64|0||CASTER PIN LOCK EACH|| 80001|K0077|NU|78.4|0|78.4|0||FRONT CASTER ASSEM COMPLETE|| 80001|K0077|RR|7.82|0|7.82|0||FRONT CASTER ASSEM COMPLETE|| 80001|K0098|NU|31.24|0|31.24|0||DRIVE BELT POWER WHEELCHAIR|| 80001|K0098|RR|3.13|0|3.13|0||DRIVE BELT POWER WHEELCHAIR|| 80001|K0105|NU|132.43|0|132.43|0||IV HANGER|| 80001|K0105|RR|13.24|0|13.24|0||IV HANGER|| 80001|K0195|RR|24.02|0|24.02|0||ELEVATING WHLCHAIR LEG RESTS|| 80001|K0455|RR|342.22|0|342.22|0||PUMP UNINTERRUPTED INFUSION|| 80001|K0552||3.53|0|3.53|0||SUPPLY/EXT INF PUMP SYR TYPE|| 80001|K0553||301.33|0|301.33|0||COMBINATION ORAL/NASAL MASK|| 80001|K0554|NU|298.76|0|298.76|0||REPL ORAL CUSHION COMBO MASK|| 80001|K0554|RR|29.88|0|29.88|0||REPL ORAL CUSHION COMBO MASK|| 80001|K0601|NU|1.48|0|1.48|0||REPL BATT SILVER OXIDE 1.5 V|| 80001|K0602|NU|8.46|0|8.46|0||REPL BATT SILVER OXIDE 3 V|| 80001|K0603|NU|0.76|0|0.76|0||REPL BATT ALKALINE 1.5 V|| 80001|K0604|NU|8.1|0|8.1|0||REPL BATT LITHIUM 3.6 V|| 80001|K0605|NU|19.45|0|19.45|0||REPL BATT LITHIUM 4.5 V|| 80001|K0607|RR|25.88|0|25.88|0||REPL BATT FOR AED|| 80001|K0608|NU|161.44|0|161.44|0||REPL GARMENT FOR AED|| 80001|K0608|RR|16.18|0|16.18|0||REPL GARMENT FOR AED|| 80001|K0609||1073.65|0|1073.65|0||REPL ELECTRODE FOR AED|| 80001|K0672||97.93|0|97.93|0||REMOVE SOFT INTERFACE - REPL|| 80001|K0730|RR|229.63|0|229.63|0||CTRL DOSE INH DRUG DELIV SYS|| 80001|K0733|NU|34.68|0|34.68|0||12-24HR SEALED LEAD ACID|| 80001|K0733|RR|3.49|0|3.49|0||12-24HR SEALED LEAD ACID|| 80001|K0738|RR|61.96|0|61.96|0||PORTABLE GAS OXYGEN SYSTEM|| 80001|K0800|NU|1484.1|0|1484.1|0||POV GROUP 1 STD UP TO 300 LBS|| 80001|K0800|RR|148.43|0|148.43|0||POV GROUP 1 STD UP TO 300 LBS|| 80001|K0801|NU|2392.69|0|2392.69|0||POV GROUP 1 HD 301-450 LBS|| 80001|K0801|RR|239.23|0|239.23|0||POV GROUP 1 HD 301-450 LBS|| 80001|K0802|NU|2707.76|0|2707.76|0||POV GROUP 1 VHD 451-600 LBS|| 80001|K0802|RR|270.77|0|270.77|0||POV GROUP 1 VHD 451-600 LBS|| 80001|K0806|NU|1795.36|0|1795.36|0||POV GROUP 2 STD UP TO 300LBS|| 80001|K0806|RR|179.53|0|179.53|0||POV GROUP 2 STD UP TO 300LBS|| 80001|K0807|NU|2724.28|0|2724.28|0||POV GROUP 2 HD 301-450 LBS|| 80001|K0807|RR|272.44|0|272.44|0||POV GROUP 2 HD 301-450 LBS|| 80001|K0808|NU|4215.01|0|4215.01|0||POV GROUP 2 VHD 451-600 LBS|| 80001|K0808|RR|421.5|0|421.5|0||POV GROUP 2 VHD 451-600 LBS|| 80001|K0813|RR|415.42|0|415.42|0||PWC GP 1 STD PORT SEAT/BACK|| 80001|K0814|RR|531.77|0|531.77|0||PWC GP 1 STD PORT CAP CHAIR|| 80001|K0815|RR|605.48|0|605.48|0||PWC GP 1 STD SEAT/BACK|| 80001|K0816|RR|579.88|0|579.88|0||PWC GP 1 STD CAP CHAIR|| 80001|K0820|RR|443.71|0|443.71|0||PWC GP 2 STD PORT SEAT/BACK|| 80001|K0821|RR|569.58|0|569.58|0||PWC GP 2 STD PORT CAP CHAIR|| 80001|K0822|RR|688.38|0|688.38|0||PWC GP 2 STD SEAT/BACK|| 80001|K0823|RR|692.9|0|692.9|0||PWC GP 2 STD CAP CHAIR|| 80001|K0824|RR|833.9|0|833.9|0||PWC GP 2 HD SEAT/BACK|| 80001|K0825|RR|763.44|0|763.44|0||PWC GP 2 HD CAP CHAIR|| 80001|K0826|RR|1079.62|0|1079.62|0||PWC GP2 VHD SEAT/BACK|| 80001|K0827|RR|917.98|0|917.98|0||PWC GP VHD CAP CHAIR|| 80001|K0828|RR|1189.6|0|1189.6|0||PWC GP 2 XTRA HD SEAT/BACK|| 80001|K0829|RR|1092.41|0|1092.41|0||PWC GP 2 XTRA HD CAP CHAIR|| 80001|K0835|RR|698.69|0|698.69|0||PWC GP2 STD SING POW OPT S/B|| 80001|K0836|RR|724.57|0|724.57|0||PWC GP2 STD SING POW OPT CAP|| 80001|K0837|RR|833.9|0|833.9|0||PWC GP 2 HD SING POW OPT S/B|| 80001|K0838|RR|746|0|746|0||PWC GP 2 HD SING POW OPT CAP|| 80001|K0839|RR|1079.62|0|1079.62|0||PWC GP2 VHD SING POW OPT S/B|| 80001|K0840|RR|1635.58|0|1635.58|0||PWC GP2 XHD SING POW OPT S/B|| 80001|K0841|RR|743.69|0|743.69|0||PWC GP2 STD MULT POW OPT S/B|| 80001|K0842|RR|743.69|0|743.69|0||PWC GP2 STD MULT POW OPT CAP|| 80001|K0843|RR|895.38|0|895.38|0||PWC GP2 HD MULT POW OPT S/B|| 80001|K0848|RR|909.97|0|909.97|0||PWC GP 3 STD SEAT/BACK|| 80001|K0849|RR|874.9|0|874.9|0||PWC GP 3 STD CAP CHAIR|| 80001|K0850|RR|1055.54|0|1055.54|0||PWC GP 3 HD SEAT/BACK|| 80001|K0851|RR|1014.9|0|1014.9|0||PWC GP 3 HD CAP CHAIR|| 80001|K0852|RR|1219.61|0|1219.61|0||PWC GP 3 VHD SEAT/BACK|| 80001|K0853|RR|1252.85|0|1252.85|0||PWC GP 3 VHD CAP CHAIR|| 80001|K0854|RR|1659.74|0|1659.74|0||PWC GP 3 XHD SEAT/BACK|| 80001|K0855|RR|1567.88|0|1567.88|0||PWC GP 3 XHD CAP CHAIR|| 80001|K0856|RR|976.76|0|976.76|0||PWC GP3 STD SING POW OPT S/B|| 80001|K0857|RR|996.34|0|996.34|0||PWC GP3 STD SING POW OPT CAP|| 80001|K0858|RR|1211.88|0|1211.88|0||PWC GP3 HD SING POW OPT S/B|| 80001|K0859|RR|1155.76|0|1155.76|0||PWC GP3 HD SING POW OPT CAP|| 80001|K0860|RR|1731.31|0|1731.31|0||PWC GP3 VHD SING POW OPT S/B|| 80001|K0861|RR|978.32|0|978.32|0||PWC GP3 STD MULT POW OPT S/B|| 80001|K0862|RR|1211.88|0|1211.88|0||PWC GP3 HD MULT POW OPT S/B|| 80001|K0863|RR|1731.31|0|1731.31|0||PWC GP3 VHD MULT POW OPT S/B|| 80001|K0864|RR|2060.28|0|2060.28|0||PWC GP3 XHD MULT POW OPT S/B|| 80001|L0112||1616.3|0|1616.3|0||CRANIAL CERVICAL ORTHOSIS|| 80001|L0113||329.34|0|329.34|0||CRANIAL CERVICAL TORTICOLLIS|| 80001|L0120||32.3|0|32.3|0||CERV FLEXIBLE NON-ADJUSTABLE|| 80001|L0130||233.63|0|233.63|0||FLEX THERMOPLASTIC COLLAR MO|| 80001|L0140||80.62|0|80.62|0||CERVICAL SEMI-RIGID ADJUSTAB|| 80001|L0150||134.44|0|134.44|0||CERV SEMI-RIG ADJ MOLDED CHN|| 80001|L0160||191.41|0|191.41|0||CERV SEMI-RIG WIRE OCC/MAND|| 80001|L0170||809.98|0|809.98|0||CERVICAL COLLAR MOLDED TO PT|| 80001|L0172||164.23|0|164.23|0||CERV COL THERMPLAS FOAM 2 PI|| 80001|L0174||295.03|0|295.03|0||CERV COL FOAM 2 PIECE W THOR|| 80001|L0180||401.23|0|401.23|0||CER POST COL OCC/MAN SUP ADJ|| 80001|L0190||604|0|604|0||CERV COLLAR SUPP ADJ CERV BA|| 80001|L0200||554.6|0|554.6|0||CERV COL SUPP ADJ BAR & THOR|| 80001|L0220||131.53|0|131.53|0||THOR RIB BELT CUSTOM FABRICA|| 80001|L0450||217.14|0|217.14|0||TLSO FLEX PREFAB THORACIC|| 80001|L0452||0|0|0|0||TLSO FLEX CUSTOM FAB THORACI|| 80001|L0454||400.51|0|400.51|0||TLSO FLEX PREFAB SACROCOC-T9|| 80001|L0455||400.51|0|400.51|0||TLSO FLEX TRNK SJ-T9 PRE OTS|| 80001|L0456||1148.56|0|1148.56|0||TLSO FLEX PREFAB|| 80001|L0457||1148.56|0|1148.56|0||TLSO FLEX TRNK SJ-SS PRE OTS|| 80001|L0458||1029.9|0|1029.9|0||TLSO 2MOD SYMPHIS-XIPHO PRE|| 80001|L0460||1159.25|0|1159.25|0||TLSO2MOD SYMPHYSIS-STERN PRE|| 80001|L0462||1441.9|0|1441.9|0||TLSO 3MOD SACRO-SCAP PRE|| 80001|L0464||1716.55|0|1716.55|0||TLSO 4MOD SACRO-SCAP PRE|| 80001|L0466||441.4|0|441.4|0||TLSO RIGID FRAME PRE SOFT AP|| 80001|L0467||441.4|0|441.4|0||TLSO R FRAM SOFT PRE OTS|| 80001|L0468||553.39|0|553.39|0||TLSO RIGID FRAME PREFAB PELV|| 80001|L0469||553.39|0|553.39|0||TLSO RIG FRAM PELVIC PRE OTS|| 80001|L0470||787.88|0|787.88|0||TLSO RIGID FRAME PRE SUBCLAV|| 80001|L0472||494.56|0|494.56|0||TLSO RIGID FRAME HYPEREX PRE|| 80001|L0480||1529.27|0|1529.27|0||TLSO RIGID PLASTIC CUSTOM FA|| 80001|L0482||1753.1|0|1753.1|0||TLSO RIGID LINED CUSTOM FAB|| 80001|L0484||2044.08|0|2044.08|0||TLSO RIGID PLASTIC CUST FAB|| 80001|L0486||2024.92|0|2024.92|0||TLSO RIGIDLINED CUST FAB TWO|| 80001|L0488||1159.25|0|1159.25|0||TLSO RIGID LINED PRE ONE PIE|| 80001|L0490||326.66|0|326.66|0||TLSO RIGID PLASTIC PRE ONE|| 80001|L0491||886.87|0|886.87|0||TLSO 2 PIECE RIGID SHELL|| 80001|L0492||574.79|0|574.79|0||TLSO 3 PIECE RIGID SHELL|| 80001|L0621||102.97|0|102.97|0||SIO FLEX PELVISACRAL PREFAB|| 80001|L0622||279.22|0|279.22|0||SIO FLEX PELVISACRAL CUSTOM|| 80001|L0623||0|0|0|0||SIO PANEL PREFAB|| 80001|L0624||0|0|0|0||SIO PANEL CUSTOM|| 80001|L0625||63.64|0|63.64|0||LO FLEXIBL L1-BELOW L5 PRE|| 80001|L0626||90.02|0|90.02|0||LO SAG STAYS/PANELS PRE-FAB|| 80001|L0627||474.71|0|474.71|0||LO SAGITT RIGID PANEL PREFAB|| 80001|L0628||96.85|0|96.85|0||LO FLEX W/O RIGID STAYS PRE|| 80001|L0629||0|0|0|0||LSO FLEX W/RIGID STAYS CUST|| 80001|L0630||187|0|187|0||LSO POST RIGID PANEL PRE|| 80001|L0631||1185.5|0|1185.5|0||LSO SAG-CORO RIGID FRAME PRE|| 80001|L0632||0|0|0|0||LSO SAG RIGID FRAME CUST|| 80001|L0633||331.15|0|331.15|0||LSO FLEXION CONTROL PREFAB|| 80001|L0634||0|0|0|0||LSO FLEXION CONTROL CUSTOM|| 80001|L0635||1227.98|0|1227.98|0||LSO SAGIT RIGID PANEL PREFAB|| 80001|L0636||1811.96|0|1811.96|0||LSO SAGITTAL RIGID PANEL CUS|| 80001|L0637||1572.12|0|1572.12|0||LSO SAG-CORONAL PANEL PREFAB|| 80001|L0638||1523.1|0|1523.1|0||LSO SAG-CORONAL PANEL CUSTOM|| 80001|L0639||1572.12|0|1572.12|0||LSO S/C SHELL/PANEL PREFAB|| 80001|L0640||1208.4|0|1208.4|0||LSO S/C SHELL/PANEL CUSTOM|| 80001|L0641||90.02|0|90.02|0||LO RIG POS PNL L1-L5 PRE OTS|| 80001|L0642||474.71|0|474.71|0||LO SAG RI AN/POS PNL PRE OTS|| 80001|L0643||187|0|187|0||LSO SAG CTR RIGI POS PRE OTS|| 80001|L0648||1185.5|0|1185.5|0||LSO SAG R AN/POS PNL PRE OTS|| 80001|L0649||331.15|0|331.15|0||LSO SC R POS/LAT PNL PRE OTS|| 80001|L0650||1572.12|0|1572.12|0||LSO SC R ANT/POS PNL PRE OTS|| 80001|L0651||1572.12|0|1572.12|0||LSO SAG-CO SHELL PNL PRE OTS|| 80001|L0700||2486.34|0|2486.34|0||CTLSO A-P-L CONTROL MOLDED|| 80001|L0710||2714|0|2714|0||CTLSO A-P-L CONTROL W/ INTER|| 80001|L0810||2883.23|0|2883.23|0||HALO CERVICAL INTO JCKT VEST|| 80001|L0820||2332.4|0|2332.4|0||HALO CERVICAL INTO BODY JACK|| 80001|L0830||3367.74|0|3367.74|0||HALO CERV INTO MILWAUKEE TYP|| 80001|L0859||1308.35|0|1308.35|0||MRI COMPATIBLE SYSTEM|| 80001|L0861||248.9|0|248.9|0||HALO REPL LINER/INTERFACE|| 80001|L0970||122.75|0|122.75|0||TLSO CORSET FRONT|| 80001|L0972||125.47|0|125.47|0||LSO CORSET FRONT|| 80001|L0974||256.37|0|256.37|0||TLSO FULL CORSET|| 80001|L0976||228.97|0|228.97|0||LSO FULL CORSET|| 80001|L0978||206.74|0|206.74|0||AXILLARY CRUTCH EXTENSION|| 80001|L0980||18.76|0|18.76|0||PERONEAL STRAPS PAIR|| 80001|L0982||20.44|0|20.44|0||STOCKING SUPP GRIPS SET OF F|| 80001|L0984||65.21|0|65.21|0||PROTECTIVE BODY SOCK EACH|| 80001|L1000||2180.41|0|2180.41|0||CTLSO MILWAUKE INITIAL MODEL|| 80001|L1001||0|0|0|0||CTLSO INFANT IMMOBILIZER|| 80001|L1005||3696.17|0|3696.17|0||TENSION BASED SCOLIOSIS ORTH|| 80001|L1010||87.8|0|87.8|0||CTLSO AXILLA SLING|| 80001|L1020||119.98|0|119.98|0||KYPHOSIS PAD|| 80001|L1025||136.36|0|136.36|0||KYPHOSIS PAD FLOATING|| 80001|L1030||91.09|0|91.09|0||LUMBAR BOLSTER PAD|| 80001|L1040||109.64|0|109.64|0||LUMBAR OR LUMBAR RIB PAD|| 80001|L1050||94.93|0|94.93|0||STERNAL PAD|| 80001|L1060||107.09|0|107.09|0||THORACIC PAD|| 80001|L1070||109.48|0|109.48|0||TRAPEZIUS SLING|| 80001|L1080||75.86|0|75.86|0||OUTRIGGER|| 80001|L1085||210.74|0|210.74|0||OUTRIGGER BIL W/ VERT EXTENS|| 80001|L1090||98.44|0|98.44|0||LUMBAR SLING|| 80001|L1100||173.77|0|173.77|0||RING FLANGE PLASTIC/LEATHER|| 80001|L1110||294.34|0|294.34|0||RING FLANGE PLAS/LEATHER MOL|| 80001|L1120||46.9|0|46.9|0||COVERS FOR UPRIGHT EACH|| 80001|L1200||1866.43|0|1866.43|0||FURNSH INITIAL ORTHOSIS ONLY|| 80001|L1210||281.02|0|281.02|0||LATERAL THORACIC EXTENSION|| 80001|L1220||237.92|0|237.92|0||ANTERIOR THORACIC EXTENSION|| 80001|L1230||610.5|0|610.5|0||MILWAUKEE TYPE SUPERSTRUCTUR|| 80001|L1240||105.06|0|105.06|0||LUMBAR DEROTATION PAD|| 80001|L1250||103.45|0|103.45|0||ANTERIOR ASIS PAD|| 80001|L1260||106.31|0|106.31|0||ANTERIOR THORACIC DEROTATION|| 80001|L1270||106.19|0|106.19|0||ABDOMINAL PAD|| 80001|L1280||94.66|0|94.66|0||RIB GUSSET (ELASTIC) EACH|| 80001|L1290||107.32|0|107.32|0||LATERAL TROCHANTERIC PAD|| 80001|L1300||1793.99|0|1793.99|0||BODY JACKET MOLD TO PATIENT|| 80001|L1310||1846.02|0|1846.02|0||POST-OPERATIVE BODY JACKET|| 80001|L1600||138.4|0|138.4|0||ABDUCT HIP FLEX FREJKA W CVR|| 80001|L1610||47.15|0|47.15|0||ABDUCT HIP FLEX FREJKA COVR|| 80001|L1620||155.26|0|155.26|0||ABDUCT HIP FLEX PAVLIK HARNE|| 80001|L1630||185.28|0|185.28|0||ABDUCT CONTROL HIP SEMI-FLEX|| 80001|L1640||495.56|0|495.56|0||PELV BAND/SPREAD BAR THIGH C|| 80001|L1650||262.81|0|262.81|0||HO ABDUCTION HIP ADJUSTABLE|| 80001|L1652||411.67|0|411.67|0||HO BI THIGHCUFFS W SPRDR BAR|| 80001|L1660||183.79|0|183.79|0||HO ABDUCTION STATIC PLASTIC|| 80001|L1680||1511.06|0|1511.06|0||PELVIC & HIP CONTROL THIGH C|| 80001|L1685||1594.43|0|1594.43|0||POST-OP HIP ABDUCT CUSTOM FA|| 80001|L1686||1069.66|0|1069.66|0||HO POST-OP HIP ABDUCTION|| 80001|L1690||2233.13|0|2233.13|0||COMBINATION BILATERAL HO|| 80001|L1700||1857.82|0|1857.82|0||LEG PERTHES ORTH TORONTO TYP|| 80001|L1710||2183.75|0|2183.75|0||LEGG PERTHES ORTH NEWINGTON|| 80001|L1720||1613.15|0|1613.15|0||LEGG PERTHES ORTHOSIS TRILAT|| 80001|L1730||1217.08|0|1217.08|0||LEGG PERTHES ORTH SCOTTISH R|| 80001|L1755||1771.48|0|1771.48|0||LEGG PERTHES PATTEN BOTTOM T|| 80001|L1810||139.81|0|139.81|0||KO ELASTIC WITH JOINTS|| 80001|L1812||139.81|0|139.81|0||KO ELASTIC W/JOINTS PRE OTS|| 80001|L1820||139.26|0|139.26|0||KO ELAS W/ CONDYLE PADS & JO|| 80001|L1830||116.48|0|116.48|0||KO IMMOBILIZER CANVAS LONGIT|| 80001|L1831||339.86|0|339.86|0||KNEE ORTH POS LOCKING JOINT|| 80001|L1832||870.59|0|870.59|0||KO ADJ JNT POS RIGID SUPPORT|| 80001|L1833||870.59|0|870.59|0||KO ADJ JNT POS R SUP PRE OTS|| 80001|L1834||1024.22|0|1024.22|0||KO W/0 JOINT RIGID MOLDED TO|| 80001|L1836||154.07|0|154.07|0||RIGID KO WO JOINTS|| 80001|L1840||1076.64|0|1076.64|0||KO DEROT ANT CRUCIATE CUSTOM|| 80001|L1843||1036.15|0|1036.15|0||KO SINGLE UPRIGHT CUSTOM FIT|| 80001|L1844||1795.43|0|1795.43|0||KO W/ADJ JT ROT CNTRL MOLDED|| 80001|L1845||1081.67|0|1081.67|0||KO W/ ADJ FLEX/EXT ROTAT CUS|| 80001|L1846||1372.44|0|1372.44|0||KO W ADJ FLEX/EXT ROTAT MOLD|| 80001|L1847||664.22|0|664.22|0||KO ADJUSTABLE W AIR CHAMBERS|| 80001|L1848||664.22|0|664.22|0||KO DBL UPRIGHT W/AIR PRE OTS|| 80001|L1850||309.13|0|309.13|0||KO SWEDISH TYPE|| 80001|L1860||1199.02|0|1199.02|0||KO SUPRACONDYLAR SOCKET MOLD|| 80001|L1900||324.82|0|324.82|0||AFO SPRNG WIR DRSFLX CALF BD|| 80001|L1902||88.22|0|88.22|0||AFO ANKLE GAUNTLET|| 80001|L1904||505.03|0|505.03|0||AFO MOLDED ANKLE GAUNTLET|| 80001|L1906||147.58|0|147.58|0||AFO MULTILIGAMENTUS ANKLE SU|| 80001|L1907||649.8|0|649.8|0||AFO SUPRAMALLEOLAR CUSTOM|| 80001|L1910||287.21|0|287.21|0||AFO SING BAR CLASP ATTACH SH|| 80001|L1920||375.47|0|375.47|0||AFO SING UPRIGHT W/ ADJUST S|| 80001|L1930||254.06|0|254.06|0||AFO PLASTIC|| 80001|L1932||1030.5|0|1030.5|0||AFO RIG ANT TIB PREFAB TCF/=|| 80001|L1940||574.14|0|574.14|0||AFO MOLDED TO PATIENT PLASTI|| 80001|L1945||1054.37|0|1054.37|0||AFO MOLDED PLAS RIG ANT TIB|| 80001|L1950||799.94|0|799.94|0||AFO SPIRAL MOLDED TO PT PLAS|| 80001|L1951||969.84|0|969.84|0||AFO SPIRAL PREFABRICATED|| 80001|L1960||595.28|0|595.28|0||AFO POS SOLID ANK PLASTIC MO|| 80001|L1970||880.46|0|880.46|0||AFO PLASTIC MOLDED W/ANKLE J|| 80001|L1971||541.28|0|541.28|0||AFO W/ANKLE JOINT - PREFAB|| 80001|L1980||394.15|0|394.15|0||AFO SING SOLID STIRRUP CALF|| 80001|L1990||506.44|0|506.44|0||AFO DOUB SOLID STIRRUP CALF|| 80001|L2000||1089.31|0|1089.31|0||KAFO SING FRE STIRR THI/CALF|| 80001|L2005||4732.12|0|4732.12|0||KAFO SNG/DBL MECHANICAL ACT|| 80001|L2010||993.01|0|993.01|0||KAFO SNG SOLID STIRRUP W/O J|| 80001|L2020||1254.02|0|1254.02|0||KAFO DBL SOLID STIRRUP BAND/|| 80001|L2030||1087.98|0|1087.98|0||KAFO DBL SOLID STIRRUP W/O J|| 80001|L2034||2371.19|0|2371.19|0||KAFO PLA SIN UP W/WO K/A CUS|| 80001|L2035||200.05|0|200.05|0||KAFO PLASTIC PEDIATRIC SIZE|| 80001|L2036||1992.56|0|1992.56|0||KAFO PLAS DOUB FREE KNEE MOL|| 80001|L2037||1836.26|0|1836.26|0||KAFO PLAS SING FREE KNEE MOL|| 80001|L2038||1535.5|0|1535.5|0||KAFO W/O JOINT MULTI-AXIS AN|| 80001|L2040||196.14|0|196.14|0||HKAFO TORSION BIL ROT STRAPS|| 80001|L2050||522.34|0|522.34|0||HKAFO TORSION CABLE HIP PELV|| 80001|L2060||670.38|0|670.38|0||HKAFO TORSION BALL BEARING J|| 80001|L2070||192.58|0|192.58|0||HKAFO TORSION UNILAT ROT STR|| 80001|L2080||410.69|0|410.69|0||HKAFO UNILAT TORSION CABLE|| 80001|L2090||506.22|0|506.22|0||HKAFO UNILAT TORSION BALL BR|| 80001|L2106||730.21|0|730.21|0||AFO TIB FX CAST PLASTER MOLD|| 80001|L2108||1147.49|0|1147.49|0||AFO TIB FX CAST MOLDED TO PT|| 80001|L2112||544.85|0|544.85|0||AFO TIBIAL FRACTURE SOFT|| 80001|L2114||623.36|0|623.36|0||AFO TIB FX SEMI-RIGID|| 80001|L2116||821.3|0|821.3|0||AFO TIBIAL FRACTURE RIGID|| 80001|L2126||1461.31|0|1461.31|0||KAFO FEM FX CAST THERMOPLAS|| 80001|L2128||1841.57|0|1841.57|0||KAFO FEM FX CAST MOLDED TO P|| 80001|L2132||866.35|0|866.35|0||KAFO FEMORAL FX CAST SOFT|| 80001|L2134||1038.72|0|1038.72|0||KAFO FEM FX CAST SEMI-RIGID|| 80001|L2136||1270.08|0|1270.08|0||KAFO FEMORAL FX CAST RIGID|| 80001|L2180||125.77|0|125.77|0||PLAS SHOE INSERT W ANK JOINT|| 80001|L2182||98.44|0|98.44|0||DROP LOCK KNEE|| 80001|L2184||177.38|0|177.38|0||LIMITED MOTION KNEE JOINT|| 80001|L2186||196.57|0|196.57|0||ADJ MOTION KNEE JNT LERMAN T|| 80001|L2188||428.86|0|428.86|0||QUADRILATERAL BRIM|| 80001|L2190||111.4|0|111.4|0||WAIST BELT|| 80001|L2192||382.93|0|382.93|0||PELVIC BAND & BELT THIGH FLA|| 80001|L2200||51.06|0|51.06|0||LIMITED ANKLE MOTION EA JNT|| 80001|L2210||82.86|0|82.86|0||DORSIFLEXION ASSIST EACH JOI|| 80001|L2220||95.14|0|95.14|0||DORSI & PLANTAR FLEX ASS/RES|| 80001|L2230||82.4|0|82.4|0||SPLIT FLAT CALIPER STIRR & P|| 80001|L2232||111.56|0|111.56|0||ROCKER BOTTOM - CONTACT AFO|| 80001|L2240||89.82|0|89.82|0||ROUND CALIPER AND PLATE ATTA|| 80001|L2250||381.61|0|381.61|0||FOOT PLATE MOLDED STIRRUP AT|| 80001|L2260||215.29|0|215.29|0||REINFORCED SOLID STIRRUP|| 80001|L2265||126.48|0|126.48|0||LONG TONGUE STIRRUP|| 80001|L2270||57.68|0|57.68|0||VARUS/VALGUS STRAP PADDED/LI|| 80001|L2275||140.34|0|140.34|0||PLASTIC MOD LOW EXT PAD/LINE|| 80001|L2280||521.35|0|521.35|0||MOLDED INNER BOOT|| 80001|L2300||294.29|0|294.29|0||ABDUCTION BAR JOINTED ADJUST|| 80001|L2310||132.12|0|132.12|0||ABDUCTION BAR-STRAIGHT|| 80001|L2320||220.97|0|220.97|0||NON-MOLDED LACER|| 80001|L2330||421.7|0|421.7|0||LACER MOLDED TO PATIENT MODE|| 80001|L2335||248.09|0|248.09|0||ANTERIOR SWING BAND|| 80001|L2340||585.41|0|585.41|0||PRE-TIBIAL SHELL MOLDED TO P|| 80001|L2350||956.96|0|956.96|0||PROSTHETIC TYPE SOCKET MOLDE|| 80001|L2360||55.56|0|55.56|0||EXTENDED STEEL SHANK|| 80001|L2370||275.69|0|275.69|0||PATTEN BOTTOM|| 80001|L2375||121.34|0|121.34|0||TORSION ANK & HALF SOLID STI|| 80001|L2380||132.22|0|132.22|0||TORSION STRAIGHT KNEE JOINT|| 80001|L2385||143.86|0|143.86|0||STRAIGHT KNEE JOINT HEAVY DU|| 80001|L2387||195.23|0|195.23|0||ADD LE POLY KNEE CUSTOM KAFO|| 80001|L2390||117.56|0|117.56|0||OFFSET KNEE JOINT EACH|| 80001|L2395||179.5|0|179.5|0||OFFSET KNEE JOINT HEAVY DUTY|| 80001|L2397||125.87|0|125.87|0||SUSPENSION SLEEVE LOWER EXT|| 80001|L2405||100.69|0|100.69|0||KNEE JOINT DROP LOCK EA JNT|| 80001|L2415||140.29|0|140.29|0||KNEE JOINT CAM LOCK EACH JOI|| 80001|L2425||165.53|0|165.53|0||KNEE DISC/DIAL LOCK/ADJ FLEX|| 80001|L2430||165.53|0|165.53|0||KNEE JNT RATCHET LOCK EA JNT|| 80001|L2492||109.51|0|109.51|0||KNEE LIFT LOOP DROP LOCK RIN|| 80001|L2500||338.81|0|338.81|0||THI/GLUT/ISCHIA WGT BEARING|| 80001|L2510||907.13|0|907.13|0||TH/WGHT BEAR QUAD-LAT BRIM M|| 80001|L2520||494.76|0|494.76|0||TH/WGHT BEAR QUAD-LAT BRIM C|| 80001|L2525||1697.4|0|1697.4|0||TH/WGHT BEAR NAR M-L BRIM MO|| 80001|L2526||914.92|0|914.92|0||TH/WGHT BEAR NAR M-L BRIM CU|| 80001|L2530||252.34|0|252.34|0||THIGH/WGHT BEAR LACER NON-MO|| 80001|L2540||454.06|0|454.06|0||THIGH/WGHT BEAR LACER MOLDED|| 80001|L2550||308.45|0|308.45|0||THIGH/WGHT BEAR HIGH ROLL CU|| 80001|L2570||682.06|0|682.06|0||HIP CLEVIS TYPE 2 POSIT JNT|| 80001|L2580||646.55|0|646.55|0||PELVIC CONTROL PELVIC SLING|| 80001|L2600||220.57|0|220.57|0||HIP CLEVIS/THRUST BEARING FR|| 80001|L2610||260.82|0|260.82|0||HIP CLEVIS/THRUST BEARING LO|| 80001|L2620||287.16|0|287.16|0||PELVIC CONTROL HIP HEAVY DUT|| 80001|L2622||329.34|0|329.34|0||HIP JOINT ADJUSTABLE FLEXION|| 80001|L2624||447.73|0|447.73|0||HIP ADJ FLEX EXT ABDUCT CONT|| 80001|L2627||1844.64|0|1844.64|0||PLASTIC MOLD RECIPRO HIP & C|| 80001|L2628||2166.86|0|2166.86|0||METAL FRAME RECIPRO HIP & CA|| 80001|L2630||265.94|0|265.94|0||PELVIC CONTROL BAND & BELT U|| 80001|L2640||360.91|0|360.91|0||PELVIC CONTROL BAND & BELT B|| 80001|L2650||128.88|0|128.88|0||PELV & THOR CONTROL GLUTEAL|| 80001|L2660||200.17|0|200.17|0||THORACIC CONTROL THORACIC BA|| 80001|L2670||183.2|0|183.2|0||THORAC CONT PARASPINAL UPRIG|| 80001|L2680||168.06|0|168.06|0||THORAC CONT LAT SUPPORT UPRI|| 80001|L2750||89.77|0|89.77|0||PLATING CHROME/NICKEL PR BAR|| 80001|L2755||150.92|0|150.92|0||CARBON GRAPHITE LAMINATION|| 80001|L2760||65.26|0|65.26|0||EXTENSION PER EXTENSION PER|| 80001|L2768||150.48|0|150.48|0||ORTHO SIDEBAR DISCONNECT|| 80001|L2780||77.2|0|77.2|0||NON-CORROSIVE FINISH|| 80001|L2785||45.38|0|45.38|0||DROP LOCK RETAINER EACH|| 80001|L2795||91.26|0|91.26|0||KNEE CONTROL FULL KNEECAP|| 80001|L2800||114.55|0|114.55|0||KNEE CAP MEDIAL OR LATERAL P|| 80001|L2810||83.88|0|83.88|0||KNEE CONTROL CONDYLAR PAD|| 80001|L2820||93.26|0|93.26|0||SOFT INTERFACE BELOW KNEE SE|| 80001|L2830||104.88|0|104.88|0||SOFT INTERFACE ABOVE KNEE SE|| 80001|L2840||58.54|0|58.54|0||TIBIAL LENGTH SOCK FX OR EQU|| 80001|L2850||66.49|0|66.49|0||FEMORAL LGTH SOCK FX OR EQUA|| 80001|L3000||362.77|0|362.77|0||FT INSERT UCB BERKELEY SHELL|| 80001|L3001||152.72|0|152.72|0||FOOT INSERT REMOV MOLDED SPE|| 80001|L3002||186.52|0|186.52|0||FOOT INSERT PLASTAZOTE OR EQ|| 80001|L3003||201.2|0|201.2|0||FOOT INSERT SILICONE GEL EAC|| 80001|L3010||201.2|0|201.2|0||FOOT LONGITUDINAL ARCH SUPPO|| 80001|L3020||229.12|0|229.12|0||FOOT LONGITUD/METATARSAL SUP|| 80001|L3030||88.14|0|88.14|0||FOOT ARCH SUPPORT REMOV PREM|| 80001|L3031||141.42|0|141.42|0||FOOT LAMIN/PREPREG COMPOSITE|| 80001|L3040||54.35|0|54.35|0||FT ARCH SUPRT PREMOLD LONGIT|| 80001|L3050||54.35|0|54.35|0||FOOT ARCH SUPP PREMOLD METAT|| 80001|L3060||85.18|0|85.18|0||FOOT ARCH SUPP LONGITUD/META|| 80001|L3070||36.72|0|36.72|0||ARCH SUPRT ATT TO SHO LONGIT|| 80001|L3080||36.72|0|36.72|0||ARCH SUPP ATT TO SHOE METATA|| 80001|L3090||47.02|0|47.02|0||ARCH SUPP ATT TO SHOE LONG/M|| 80001|L3100||49.91|0|49.91|0||HALLUS-VALGUS NGHT DYNAMIC S|| 80001|L3140||102.82|0|102.82|0||ABDUCTION ROTATION BAR SHOE|| 80001|L3150||94.01|0|94.01|0||ABDUCT ROTATION BAR W/O SHOE|| 80001|L3170||58.76|0|58.76|0||FOOT PLASTIC HEEL STABILIZER|| 80001|L3224||63.16|0|63.16|0||WOMAN'S SHOE OXFORD BRACE|| 80001|L3225||72.65|0|72.65|0||MAN'S SHOE OXFORD BRACE|| 80001|L3260||21.5|0|21.5|||AMBULATORY SURGICAL BOOT EAC|| 80001|L3300||60.2|0|60.2|0||SHO LIFT TAPER TO METATARSAL|| 80001|L3310||94.01|0|94.01|0||SHOE LIFT ELEV HEEL/SOLE NEO|| 80001|L3330||653.54|0|653.54|0||LIFTS ELEVATION METAL EXTENS|| 80001|L3332||85.18|0|85.18|0||SHOE LIFTS TAPERED TO ONE-HA|| 80001|L3334||44.05|0|44.05|0||SHOE LIFTS ELEVATION HEEL /I|| 80001|L3340||98.44|0|98.44|0||SHOE WEDGE SACH|| 80001|L3350||26.41|0|26.41|0||SHOE HEEL WEDGE|| 80001|L3360||41.12|0|41.12|0||SHOE SOLE WEDGE OUTSIDE SOLE|| 80001|L3370||57.29|0|57.29|0||SHOE SOLE WEDGE BETWEEN SOLE|| 80001|L3380||57.29|0|57.29|0||SHOE CLUBFOOT WEDGE|| 80001|L3390||57.29|0|57.29|0||SHOE OUTFLARE WEDGE|| 80001|L3400||47.02|0|47.02|0||SHOE METATARSAL BAR WEDGE RO|| 80001|L3410||107.24|0|107.24|0||SHOE METATARSAL BAR BETWEEN|| 80001|L3420||63.13|0|63.13|0||FULL SOLE/HEEL WEDGE BTWEEN|| 80001|L3430||185.05|0|185.05|0||SHO HEEL COUNT PLAST REINFOR|| 80001|L3440||88.14|0|88.14|0||HEEL LEATHER REINFORCED|| 80001|L3450||121.87|0|121.87|0||SHOE HEEL SACH CUSHION TYPE|| 80001|L3455||47.02|0|47.02|0||SHOE HEEL NEW LEATHER STANDA|| 80001|L3460||39.64|0|39.64|0||SHOE HEEL NEW RUBBER STANDAR|| 80001|L3465||67.56|0|67.56|0||SHOE HEEL THOMAS WITH WEDGE|| 80001|L3470||71.94|0|71.94|0||SHOE HEEL THOMAS EXTEND TO B|| 80001|L3480||71.94|0|71.94|0||SHOE HEEL PAD & DEPRESS FOR|| 80001|L3500||33.8|0|33.8|0||ORTHO SHOE ADD LEATHER INSOL|| 80001|L3510||33.8|0|33.8|0||ORTHOPEDIC SHOE ADD RUB INSL|| 80001|L3520||36.72|0|36.72|0||O SHOE ADD FELT W LEATH INSL|| 80001|L3530||36.72|0|36.72|0||ORTHO SHOE ADD HALF SOLE|| 80001|L3540||58.76|0|58.76|0||ORTHO SHOE ADD FULL SOLE|| 80001|L3550||10.3|0|10.3|0||O SHOE ADD STANDARD TOE TAP|| 80001|L3560||26.41|0|26.41|0||O SHOE ADD HORSESHOE TOE TAP|| 80001|L3570||98.44|0|98.44|0||O SHOE ADD INSTEP EXTENSION|| 80001|L3580||74.89|0|74.89|0||O SHOE ADD INSTEP VELCRO CLO|| 80001|L3590||61.69|0|61.69|0||O SHOE CONVERT TO SOF COUNTE|| 80001|L3595||48.46|0|48.46|0||ORTHO SHOE ADD MARCH BAR|| 80001|L3600||88.14|0|88.14|0||TRANS SHOE CALIP PLATE EXIST|| 80001|L3610||116.03|0|116.03|0||TRANS SHOE CALIPER PLATE NEW|| 80001|L3620||88.14|0|88.14|0||TRANS SHOE SOLID STIRRUP EXI|| 80001|L3630||116.03|0|116.03|0||TRANS SHOE SOLID STIRRUP NEW|| 80001|L3640||49.91|0|49.91|0||SHOE DENNIS BROWNE SPLINT BO|| 80001|L3650||62.9|0|62.9|0||SHLDER FIG 8 ABDUCT RESTRAIN|| 80001|L3660||108.01|0|108.01|0||ABDUCT RESTRAINER CANVAS&WEB|| 80001|L3670||150.55|0|150.55|0||ACROMIO/CLAVICULAR CANVAS&WE|| 80001|L3671||946.98|0|946.98|0||SO CAP DESIGN W/O JNTS CF|| 80001|L3674||1242.3|0|1242.3|0||SO AIRPLANE W/WO JOINT CF|| 80001|L3675||184.44|0|184.44|0||CANVAS VEST SO|| 80001|L3702||303.48|0|303.48|0||EO W/O JOINTS CF|| 80001|L3710||152.38|0|152.38|0||ELBOW ELASTIC WITH METAL JOI|| 80001|L3720||760.21|0|760.21|0||FOREARM/ARM CUFFS FREE MOTIO|| 80001|L3730||1000.73|0|1000.73|0||FOREARM/ARM CUFFS EXT/FLEX A|| 80001|L3740||1124.66|0|1124.66|0||CUFFS ADJ LOCK W/ ACTIVE CON|| 80001|L3760||525.58|0|525.58|0||EO WITHJOINT - PREFABRICATED|| 80001|L3761||532.93|0|532.93|0||EO - ADJ LOCK JOINT PREFAB OFF|| 80001|L3762||113.02|0|113.02|0||RIGID EO WO JOINTS|| 80001|L3763||834.42|0|834.42|0||EWHO RIGID W/O JNTS CF|| 80001|L3764||832.16|0|832.16|0||EWHO W/JOINT(S) CF|| 80001|L3765||1347.61|0|1347.61|0||EWHFO RIGID W/O JNTS CF|| 80001|L3766||1427.04|0|1427.04|0||EWHFO W/JOINT(S) CF|| 80001|L3806||477.4|0|477.4|0||WHFO W/JOINT(S) CUSTOM FAB|| 80001|L3807||262.81|0|262.81|0||WHFO - NO JOINT - PREFABRICATED|| 80001|L3808||351.04|0|351.04|0||WHFO - RIGID W/O JOINTS|| 80001|L3809||262.81|0|262.81|0||WHFO W/O JOINTS PRE OTS|| 80001|L3900||1641.82|0|1641.82|0||HINGE EXTENSION/FLEX WRIST/F|| 80001|L3901||1840.91|0|1840.91|0||HINGE EXT/FLEX WRIST FINGER|| 80001|L3904||3747.58|0|3747.58|0||WHFO ELECTRIC CUSTOM FITTED|| 80001|L3905||1042.25|0|1042.25|0||WHO W/NONTORSION JNT(S) CF|| 80001|L3906||443.35|0|443.35|0||WHO W/O JOINTS CF|| 80001|L3908||62.96|0|62.96|0||WRIST COCK-UP NON-MOLDED|| 80001|L3912||101|0|101|0||FLEX GLOVE W/ELASTIC FINGER|| 80001|L3913||284.66|0|284.66|0||HFO W/O JOINTS CF|| 80001|L3915||558.67|0|558.67|0||WHO W NONTOR JNT(S) PREFAB|| 80001|L3916||558.67|0|558.67|0||WHFO WRIST EXTENS W/ OUTRIGG|| 80001|L3917||111.02|0|111.02|0||PREFAB METACARPL FX ORTHOSIS|| 80001|L3918||111.02|0|111.02|0||HFO KNUCKLE BENDER|| 80001|L3919||284.66|0|284.66|0||HO W/O JOINTS CF|| 80001|L3921||337.56|0|337.56|0||HFO W/JOINT(S) CF|| 80001|L3923||91.42|0|91.42|0||HFO W/O JOINTS PF|| 80001|L3924||91.42|0|91.42|0||OPPENHEIMER|| 80001|L3925||55.52|0|55.52|0||FO PIP/DIP WITH JOINT/SPRING|| 80001|L3927||36.78|0|36.78|0||FO PIP/DIP W/O JOINT/SPRING|| 80001|L3929||88.48|0|88.48|0||HFO NONTORSION JOINT - PREFAB|| 80001|L3930||88.48|0|88.48|0||FINGER EXTENSION WITH WRIST|| 80001|L3931||214.03|0|214.03|0||WHFO NONTORSION JOINT PREFAB|| 80001|L3933||224.26|0|224.26|0||FO W/O JOINTS CF|| 80001|L3935||232.21|0|232.21|0||FO NONTORSION JOINT CF|| 80001|L3956||0|0|0|0||ADD JOINT UPPER EXT ORTHOSIS|| 80001|L3960||866.3|0|866.3|0||SEWHO AIRPLAN DESIG ABDU POS|| 80001|L3961||1765.78|0|1765.78|0||SEWHO CAP DESIGN W/O JNTS CF|| 80001|L3962||902.02|0|902.02|0||SEWHO ERBS PALSEY DESIGN ABD|| 80001|L3967||2084.77|0|2084.77|0||SEWHO AIRPLANE W/O JNTS CF|| 80001|L3971||1978.91|0|1978.91|0||SEWHO CAP DESIGN W/JNT(S) CF|| 80001|L3973||2084.77|0|2084.77|0||SEWHO AIRPLANE W/JNT(S) CF|| 80001|L3975||1765.78|0|1765.78|0||SEWHFO CAP DESIGN W/O JNT CF|| 80001|L3976||1765.78|0|1765.78|0||SEWHFO AIRPLANE W/O JNTS CF|| 80001|L3977||1978.91|0|1978.91|0||SEWHFO CAP DESGN W/JNT(S) CF|| 80001|L3978||2084.77|0|2084.77|0||SEWHFO AIRPLANE W/JNT(S) CF|| 80001|L3980||324.89|0|324.89|0||UPP EXT FX ORTHOSIS HUMERAL|| 80001|L3981||1057.87|0|1057.87|0||UE FX ORTH SHOUL CAP FOREARM|| 80001|L3982||401.4|0|401.4|0||UPPER EXT FX ORTHOSIS RAD/UL|| 80001|L3984||428.46|0|428.46|0||UPPER EXT FX ORTHOSIS WRIST|| 80001|L3995||35.95|0|35.95|0||SOCK FRACTURE OR EQUAL EACH|| 80001|L4000||1401.04|0|1401.04|0||REPL GIRDLE MILWAUKEE ORTH|| 80001|L4002||0|0|0|0||REPLACE STRAP - ANY ORTHOSIS|| 80001|L4010||788.42|0|788.42|0||REPLACE TRILATERAL SOCKET BR|| 80001|L4020||984.8|0|984.8|0||REPLACE QUADLAT SOCKET BRIM|| 80001|L4030||542.23|0|542.23|0||REPLACE SOCKET BRIM CUST FIT|| 80001|L4040||438.4|0|438.4|0||REPLACE MOLDED THIGH LACER|| 80001|L4045||352.3|0|352.3|0||REPLACE NON-MOLDED THIGH LAC|| 80001|L4050||443.39|0|443.39|0||REPLACE MOLDED CALF LACER|| 80001|L4055||287.1|0|287.1|0||REPLACE NON-MOLDED CALF LACE|| 80001|L4060||341.3|0|341.3|0||REPLACE HIGH ROLL CUFF|| 80001|L4070||325.63|0|325.63|0||REPLACE PROX & DIST UPRIGHT|| 80001|L4080||114.79|0|114.79|0||REPL MET BAND KAFO-AFO PROX|| 80001|L4090||101.62|0|101.62|0||REPL MET BAND KAFO-AFO CALF/|| 80001|L4100||114.6|0|114.6|0||REPL LEATH CUFF KAFO PROX TH|| 80001|L4110||91.07|0|91.07|0||REPL LEATH CUFF KAFO-AFO CAL|| 80001|L4130||626.83|0|626.83|0||REPLACE PRETIBIAL SHELL|| 80001|L4350||112.93|0|112.93|0||ANKLE CONTROL ORTHOSI PREFAB|| 80001|L4360||315.95|0|315.95|0||PNEUMATI WALKING BOOT PREFAB|| 80001|L4361||315.95|0|315.95|0||PNEUMA/VAC WALK BOOT PRE OTS|| 80001|L4370||202.75|0|202.75|0||PNEUMATIC FULL LEG SPLINT|| 80001|L4386||183.1|0|183.1|0||NON-PNEUM WALK BOOT PREFAB|| 80001|L4387||183.1|0|183.1|0||NON-PNEUM WALK BOOT PRE OTS|| 80001|L4392||27.19|0|27.19|0||REPLACE AFO SOFT INTERFACE|| 80001|L4394||19.85|0|19.85|0||REPLACE FOOT DROP SPINT|| 80001|L4396||193.84|0|193.84|0||STATIC AFO|| 80001|L4397||193.84|0|193.84|0||STATIC OR DYNAMI AFO PRE OTS|| 80001|L4398||89.21|0|89.21|0||FOOT DROP SPLINT RECUMBENT|| 80001|L5000||605.52|0|605.52|0||SHO INSERT W ARCH TOE FILLER|| 80001|L5010||1462.48|0|1462.48|0||MOLD SOCKET ANK HGT W/ TOE F|| 80001|L5020||2483.63|0|2483.63|0||TIBIAL TUBERCLE HGT W/ TOE F|| 80001|L5050||2747.34|0|2747.34|0||ANK SYMES MOLD SCKT SACH FT|| 80001|L5060||3160.25|0|3160.25|0||SYMES MET FR LEATH SOCKET AR|| 80001|L5100||2753.41|0|2753.41|0||MOLDED SOCKET SHIN SACH FOOT|| 80001|L5105||3974.84|0|3974.84|0||PLAST SOCKET JTS/THGH LACER|| 80001|L5150||4018.02|0|4018.02|0||MOLD SCKT EXT KNEE SHIN SACH|| 80001|L5160||4370.32|0|4370.32|0||MOLD SOCKET BENT KNEE SHIN S|| 80001|L5200||4185.19|0|4185.19|0||KNE SING AXIS FRIC SHIN SACH|| 80001|L5210||2776.45|0|2776.45|0||NO KNEE/ANKLE JOINTS W/ FT B|| 80001|L5220||3155.95|0|3155.95|0||NO KNEE JOINT WITH ARTIC ALI|| 80001|L5230||4352.68|0|4352.68|0||FEM FOCAL DEFIC CONSTANT FRI|| 80001|L5250||5936.66|0|5936.66|0||HIP CANAD SING AXI CONS FRIC|| 80001|L5270||5910.31|0|5910.31|0||TILT TABLE LOCKING HIP SING|| 80001|L5280||5865.06|0|5865.06|0||HEMIPELVECT CANAD SING AXIS|| 80001|L5301||3147.31|0|3147.31|0||BK MOLD SOCKET SACH FT ENDO|| 80001|L5312||4505.17|0|4505.17|0||KNEE DISART - SACH FT - ENDO|| 80001|L5321||4562.12|0|4562.12|0||AK OPEN END SACH|| 80001|L5331||5813.06|0|5813.06|0||HIP DISART CANADIAN SACH FT|| 80001|L5341||6051.42|0|6051.42|0||HEMIPELVECTOMY CANADIAN SACH|| 80001|L5400||1558.19|0|1558.19|0||POSTOP DRESS & 1 CAST CHG BK|| 80001|L5410||478.06|0|478.06|0||POSTOP DSG BK EA ADD CAST CH|| 80001|L5420||1909.51|0|1909.51|0||POSTOP DSG & 1 CAST CHG AK/D|| 80001|L5430||575.77|0|575.77|0||POSTOP DSG AK EA ADD CAST CH|| 80001|L5450||468.41|0|468.41|0||POSTOP APP NON-WGT BEAR DSG|| 80001|L5460||624.07|0|624.07|0||POSTOP APP NON-WGT BEAR DSG|| 80001|L5500||1469.51|0|1469.51|0||INIT BK PTB PLASTER DIRECT|| 80001|L5505||2032.37|0|2032.37|0||INIT AK ISCHAL PLSTR DIRECT|| 80001|L5510||1665.79|0|1665.79|0||PREP BK PTB PLASTER MOLDED|| 80001|L5520||1645.39|0|1645.39|0||PERP BK PTB THERMOPLS DIRECT|| 80001|L5530||1976.28|0|1976.28|0||PREP BK PTB THERMOPLS MOLDED|| 80001|L5535||1940.32|0|1940.32|0||PREP BK PTB OPEN END SOCKET|| 80001|L5540||2070.92|0|2070.92|0||PREP BK PTB LAMINATED SOCKET|| 80001|L5560||2223.82|0|2223.82|0||PREP AK ISCHIAL PLAST MOLDED|| 80001|L5570||2311.98|0|2311.98|0||PREP AK ISCHIAL DIRECT FORM|| 80001|L5580||2699.08|0|2699.08|0||PREP AK ISCHIAL THERMO MOLD|| 80001|L5585||3321.65|0|3321.65|0||PREP AK ISCHIAL OPEN END|| 80001|L5590||2750.54|0|2750.54|0||PREP AK ISCHIAL LAMINATED|| 80001|L5595||4859.21|0|4859.21|0||HIP DISARTIC SACH THERMOPLS|| 80001|L5600||5223.42|0|5223.42|0||HIP DISART SACH LAMINAT MOLD|| 80001|L5610||2368.91|0|2368.91|0||ABOVE KNEE HYDRACADENCE|| 80001|L5611||1843.48|0|1843.48|0||AK 4 BAR LINK W/FRIC SWING|| 80001|L5613||2882.22|0|2882.22|0||AK 4 BAR LING W/HYDRAUL SWIG|| 80001|L5614||1952.51|0|1952.51|0||4-BAR LINK ABOVE KNEE W/SWNG|| 80001|L5616||1557.53|0|1557.53|0||AK UNIV MULTIPLEX SYS FRICT|| 80001|L5617||647.39|0|647.39|0||AK/BK SELF-ALIGNING UNIT EA|| 80001|L5618||342.48|0|342.48|0||TEST SOCKET SYMES|| 80001|L5620||318.11|0|318.11|0||TEST SOCKET BELOW KNEE|| 80001|L5622||414.79|0|414.79|0||TEST SOCKET KNEE DISARTICULA|| 80001|L5624||415.98|0|415.98|0||TEST SOCKET ABOVE KNEE|| 80001|L5626||545.53|0|545.53|0||TEST SOCKET HIP DISARTICULAT|| 80001|L5628||583.31|0|583.31|0||TEST SOCKET HEMIPELVECTOMY|| 80001|L5629||363.61|0|363.61|0||BELOW KNEE ACRYLIC SOCKET|| 80001|L5630||513.5|0|513.5|0||SYME TYP EXPANDABL WALL SCKT|| 80001|L5631||502.73|0|502.73|0||AK/KNEE DISARTIC ACRYLIC SOC|| 80001|L5632||280.58|0|280.58|0||SYMES TYPE PTB BRIM DESIGN S|| 80001|L5634||348.05|0|348.05|0||SYMES TYPE POSTER OPENING SO|| 80001|L5636||291.54|0|291.54|0||SYMES TYPE MEDIAL OPENING SO|| 80001|L5637||330.54|0|330.54|0||BELOW KNEE TOTAL CONTACT|| 80001|L5638||575.8|0|575.8|0||BELOW KNEE LEATHER SOCKET|| 80001|L5639||1282.84|0|1282.84|0||BELOW KNEE WOOD SOCKET|| 80001|L5640||731.63|0|731.63|0||KNEE DISARTICULAT LEATHER SO|| 80001|L5642||708.9|0|708.9|0||ABOVE KNEE LEATHER SOCKET|| 80001|L5643||1780.85|0|1780.85|0||HIP FLEX INNER SOCKET EXT FR|| 80001|L5644||675.8|0|675.8|0||ABOVE KNEE WOOD SOCKET|| 80001|L5645||912.94|0|912.94|0||BK FLEX INNER SOCKET EXT FRA|| 80001|L5646||626.9|0|626.9|0||BELOW KNEE CUSHION SOCKET|| 80001|L5647||910.15|0|910.15|0||BELOW KNEE SUCTION SOCKET|| 80001|L5648||753.3|0|753.3|0||ABOVE KNEE CUSHION SOCKET|| 80001|L5649||2729.64|0|2729.64|0||ISCH CONTAINMT/NARROW M-L SO|| 80001|L5650||558.58|0|558.58|0||TOT CONTACT AK/KNEE DISART S|| 80001|L5651||1374.07|0|1374.07|0||AK FLEX INNER SOCKET EXT FRA|| 80001|L5652||498.84|0|498.84|0||SUCTION SUSP AK/KNEE DISART|| 80001|L5653||665.9|0|665.9|0||KNEE DISART EXPAND WALL SOCK|| 80001|L5654||379.46|0|379.46|0||SOCKET INSERT SYMES|| 80001|L5655||321.56|0|321.56|0||SOCKET INSERT BELOW KNEE|| 80001|L5656||431.38|0|431.38|0||SOCKET INSERT KNEE ARTICULAT|| 80001|L5658||416.02|0|416.02|0||SOCKET INSERT ABOVE KNEE|| 80001|L5661||696.29|0|696.29|0||MULTI-DUROMETER SYMES|| 80001|L5665||585.85|0|585.85|0||MULTI-DUROMETER BELOW KNEE|| 80001|L5666||80.09|0|80.09|0||BELOW KNEE CUFF SUSPENSION|| 80001|L5668||129.18|0|129.18|0||SOCKET INSERT W/O LOCK LOWER|| 80001|L5670||310.48|0|310.48|0||BK MOLDED SUPRACONDYLAR SUSP|| 80001|L5671||657.92|0|657.92|0||BK/AK LOCKING MECHANISM|| 80001|L5672||341.18|0|341.18|0||BK REMOVABLE MEDIAL BRIM SUS|| 80001|L5673||813.58|0|813.58|0||SOCKET INSERT W LOCK MECH|| 80001|L5676||414.62|0|414.62|0||BK KNEE JOINTS SINGLE AXIS P|| 80001|L5677||564.14|0|564.14|0||BK KNEE JOINTS POLYCENTRIC P|| 80001|L5678||45.43|0|45.43|0||BK JOINT COVERS PAIR|| 80001|L5679||677.95|0|677.95|0||SOCKET INSERT W/O LOCK MECH|| 80001|L5680||379.24|0|379.24|0||BK THIGH LACER NON-MOLDED|| 80001|L5681||1522.01|0|1522.01|0||INTL CUSTM CONG/LATYP INSERT|| 80001|L5682||715.56|0|715.56|0||BK THIGH LACER GLUT/ISCHIA M|| 80001|L5683||1522.01|0|1522.01|0||INITIAL CUSTOM SOCKET INSERT|| 80001|L5684||55.07|0|55.07|0||BK FORK STRAP|| 80001|L5685||148.2|0|148.2|0||BELOW KNEE SUS/SEAL SLEEVE|| 80001|L5686||58.45|0|58.45|0||BK BACK CHECK|| 80001|L5688||69.89|0|69.89|0||BK WAIST BELT WEBBING|| 80001|L5690||111.96|0|111.96|0||BK WAIST BELT PADDED AND LIN|| 80001|L5692||152.04|0|152.04|0||AK PELVIC CONTROL BELT LIGHT|| 80001|L5694||207.58|0|207.58|0||AK PELVIC CONTROL BELT PAD/L|| 80001|L5695||191.63|0|191.63|0||AK SLEEVE SUSP NEOPRENE/EQUA|| 80001|L5696||211.69|0|211.69|0||AK/KNEE DISARTIC PELVIC JOIN|| 80001|L5697||91.85|0|91.85|0||AK/KNEE DISARTIC PELVIC BAND|| 80001|L5698||150.2|0|150.2|0||AK/KNEE DISARTIC SILESIAN BA|| 80001|L5699||270.58|0|270.58|0||SHOULDER HARNESS|| 80001|L5700||3278.3|0|3278.3|0||REPLACE SOCKET BELOW KNEE|| 80001|L5701||3937|0|3937|0||REPLACE SOCKET ABOVE KNEE|| 80001|L5702||4980.88|0|4980.88|0||REPLACE SOCKET HIP|| 80001|L5703||2577.65|0|2577.65|0||SYMES ANKLE W/O (SACH) FOOT|| 80001|L5704||613.3|0|613.3|0||CUSTOM SHAPE COVER BK|| 80001|L5705||1095.85|0|1095.85|0||CUSTOM SHAPE COVER AK|| 80001|L5706||1074.22|0|1074.22|0||CUSTOM SHAPE CVR KNEE DISART|| 80001|L5707||1416.19|0|1416.19|0||CUSTOM SHAPE CVR HIP DISART|| 80001|L5710||427.91|0|427.91|0||KNE-SHIN EXO SNG AXI MNL LOC|| 80001|L5711||598.04|0|598.04|0||KNEE-SHIN EXO MNL LOCK ULTRA|| 80001|L5712||501.1|0|501.1|0||KNEE-SHIN EXO FRICT SWG & ST|| 80001|L5714||514.72|0|514.72|0||KNEE-SHIN EXO VARIABLE FRICT|| 80001|L5716||833.93|0|833.93|0||KNEE-SHIN EXO MECH STANCE PH|| 80001|L5718||1042.32|0|1042.32|0||KNEE-SHIN EXO FRCT SWG & STA|| 80001|L5722||1101.17|0|1101.17|0||KNEE-SHIN PNEUM SWG FRCT EXO|| 80001|L5724||1727.05|0|1727.05|0||KNEE-SHIN EXO FLUID SWING PH|| 80001|L5726||1990.38|0|1990.38|0||KNEE-SHIN EXT JNTS FLD SWG E|| 80001|L5728||2722.58|0|2722.58|0||KNEE-SHIN FLUID SWG & STANCE|| 80001|L5780||1309.99|0|1309.99|0||KNEE-SHIN PNEUM/HYDRA PNEUM|| 80001|L5781||4629.62|0|4629.62|0||LOWER LIMB PROS VACUUM PUMP|| 80001|L5782||4880.69|0|4880.69|0||HD LOW LIMB PROS VACUUM PUMP|| 80001|L5785||736.37|0|736.37|0||EXOSKELETAL BK ULTRALT MATER|| 80001|L5790||822.7|0|822.7|0||EXOSKELETAL AK ULTRA-LIGHT M|| 80001|L5795||1638|0|1638|0||EXOSKEL HIP ULTRA-LIGHT MATE|| 80001|L5810||557.06|0|557.06|0||ENDOSKEL KNEE-SHIN MNL LOCK|| 80001|L5811||834.47|0|834.47|0||ENDO KNEE-SHIN MNL LCK ULTRA|| 80001|L5812||646.8|0|646.8|0||ENDO KNEE-SHIN FRCT SWG & ST|| 80001|L5814||4297.19|0|4297.19|0||ENDO KNEE-SHIN HYDRAL SWG PH|| 80001|L5816||978.92|0|978.92|0||ENDO KNEE-SHIN POLYC MCH STA|| 80001|L5818||1098.79|0|1098.79|0||ENDO KNEE-SHIN FRCT SWG & ST|| 80001|L5822||1948.43|0|1948.43|0||ENDO KNEE-SHIN PNEUM SWG FRC|| 80001|L5824||1754.68|0|1754.68|0||ENDO KNEE-SHIN FLUID SWING P|| 80001|L5826||3613.38|0|3613.38|0||MINIATURE KNEE JOINT|| 80001|L5828||3231.1|0|3231.1|0||ENDO KNEE-SHIN FLUID SWG/STA|| 80001|L5830||2171.12|0|2171.12|0||ENDO KNEE-SHIN PNEUM/SWG PHA|| 80001|L5840||4014.43|0|4014.43|0||MULTI-AXIAL KNEE/SHIN SYSTEM|| 80001|L5845||2073.91|0|2073.91|0||KNEE-SHIN SYS STANCE FLEXION|| 80001|L5848||1244.2|0|1244.2|0||KNEE-SHIN SYS HYDRAUL STANCE|| 80001|L5850||146.38|0|146.38|0||ENDO AK/HIP KNEE EXTENS ASSI|| 80001|L5855||393.3|0|393.3|0||MECH HIP EXTENSION ASSIST|| 80001|L5856||27776.38|0|27776.38|0||ELEC KNEE-SHIN SWING/STANCE|| 80001|L5857||9856.07|0|9856.07|0||ELEC KNEE-SHIN SWING ONLY|| 80001|L5858||21504.32|0|21504.32|0||STANCE PHASE ONLY|| 80001|L5859||16788.25|0|16788.25|0||KNEE-SHIN PRO FLEX/EXT CONT|| 80001|L5910||414.4|0|414.4|0||ENDO BELOW KNEE ALIGNABLE SY|| 80001|L5920||607.09|0|607.09|0||ENDO AK/HIP ALIGNABLE SYSTEM|| 80001|L5925||512.6|0|512.6|0||ABOVE KNEE MANUAL LOCK|| 80001|L5930||3894.55|0|3894.55|0||HIGH ACTIVITY KNEE FRAME|| 80001|L5940||573.94|0|573.94|0||ENDO BK ULTRA-LIGHT MATERIAL|| 80001|L5950||897.38|0|897.38|0||ENDO AK ULTRA-LIGHT MATERIAL|| 80001|L5960||1103.04|0|1103.04|0||ENDO HIP ULTRA-LIGHT MATERIA|| 80001|L5961||5259.74|0|5259.74|0||ENDO POLY HIP - PNEU/HYD/ROT|| 80001|L5962||725.92|0|725.92|0||BELOW KNEE FLEX COVER SYSTEM|| 80001|L5964||1071.56|0|1071.56|0||ABOVE KNEE FLEX COVER SYSTEM|| 80001|L5966||1365.42|0|1365.42|0||HIP FLEXIBLE COVER SYSTEM|| 80001|L5968||4204.7|0|4204.7|0||MULTIAXIAL ANKLE W DORSIFLEX|| 80001|L5970||232.38|0|232.38|0||FOOT EXTERNAL KEEL SACH FOOT|| 80001|L5971||232.38|0|232.38|0||SACH FOOT - REPLACEMENT|| 80001|L5972||434.05|0|434.05|0||FLEXIBLE KEEL FOOT|| 80001|L5973||19906.97|0|19906.97|0||ANK-FOOT SYS DORS-PLANT FLEX|| 80001|L5974||266.63|0|266.63|0||FOOT SINGLE AXIS ANKLE/FOOT|| 80001|L5975||536.44|0|536.44|0||COMBO ANKLE/FOOT PROSTHESIS|| 80001|L5976||640.76|0|640.76|0||ENERGY STORING FOOT|| 80001|L5978||333.91|0|333.91|0||FT PROSTH MULTIAXIAL ANKL/FT|| 80001|L5979||2610.76|0|2610.76|0||MULTI-AXIAL ANKLE/FT PROSTH|| 80001|L5980||4242.3|0|4242.3|0||FLEX FOOT SYSTEM|| 80001|L5981||3427.2|0|3427.2|0||FLEX-WALK SYS LOW EXT PROSTH|| 80001|L5982||661.46|0|661.46|0||EXOSKELETAL AXIAL ROTATION U|| 80001|L5984||651.82|0|651.82|0||ENDOSKELETAL AXIAL ROTATION|| 80001|L5985||326.74|0|326.74|0||LWR EXT DYNAMIC PROSTH PYLON|| 80001|L5986||725.05|0|725.05|0||MULTI-AXIAL ROTATION UNIT|| 80001|L5987||8323.64|0|8323.64|0||SHANK FT W VERT LOAD PYLON|| 80001|L5988||2311.46|0|2311.46|0||VERTICAL SHOCK REDUCING PYLO|| 80001|L5990||2099.16|0|2099.16|0||USER ADJUSTABLE HEEL HEIGHT|| 80001|L6000||1520.27|0|1520.27|0||PAR HAND ROBIN-AIDS THUM REM|| 80001|L6010||1691.81|0|1691.81|0||HAND ROBIN-AIDS LITTLE/RING|| 80001|L6020||1577.34|0|1577.34|0||PART HAND ROBIN-AIDS NO FING|| 80001|L6026||5719.69|0|5719.69|0||PART HAND MYO EXCLU TERM DEV|| 80001|L6050||2173.51|0|2173.51|0||WRST MLD SCK FLX HNG TRI PAD|| 80001|L6055||3029.32|0|3029.32|0||WRST MOLD SOCK W/EXP INTERFA|| 80001|L6100||2202.11|0|2202.11|0||ELB MOLD SOCK FLEX HINGE PAD|| 80001|L6110||2335.7|0|2335.7|0||ELBOW MOLD SOCK SUSPENSION T|| 80001|L6120||2721.94|0|2721.94|0||ELBOW MOLD DOUB SPLT SOC STE|| 80001|L6130||2961.97|0|2961.97|0||ELBOW STUMP ACTIVATED LOCK H|| 80001|L6200||3121.43|0|3121.43|0||ELBOW MOLD OUTSID LOCK HINGE|| 80001|L6205||4166.62|0|4166.62|0||ELBOW MOLDED W/ EXPAND INTER|| 80001|L6250||3270.54|0|3270.54|0||ELBOW INTER LOC ELBOW FORARM|| 80001|L6300||4262.81|0|4262.81|0||SHLDER DISART INT LOCK ELBOW|| 80001|L6310||3680.74|0|3680.74|0||SHOULDER PASSIVE RESTOR COMP|| 80001|L6320||2010.7|0|2010.7|0||SHOULDER PASSIVE RESTOR CAP|| 80001|L6350||4481.69|0|4481.69|0||THORACIC INTERN LOCK ELBOW|| 80001|L6360||4030.57|0|4030.57|0||THORACIC PASSIVE RESTOR COMP|| 80001|L6370||2411.77|0|2411.77|0||THORACIC PASSIVE RESTOR CAP|| 80001|L6380||1397.57|0|1397.57|0||POSTOP DSG CAST CHG WRST/ELB|| 80001|L6382||2102.57|0|2102.57|0||POSTOP DSG CAST CHG ELB DIS/|| 80001|L6384||2908.68|0|2908.68|0||POSTOP DSG CAST CHG SHLDER/T|| 80001|L6386||459.49|0|459.49|0||POSTOP EA CAST CHG & REALIGN|| 80001|L6388||503|0|503|0||POSTOP APPLICAT RIGID DSG ON|| 80001|L6400||2654.96|0|2654.96|0||BELOW ELBOW PROSTH TISS SHAP|| 80001|L6450||3546.95|0|3546.95|0||ELB DISART PROSTH TISS SHAP|| 80001|L6500||3710.86|0|3710.86|0||ABOVE ELBOW PROSTH TISS SHAP|| 80001|L6550||4460.51|0|4460.51|0||SHLDR DISAR PROSTH TISS SHAP|| 80001|L6570||5007.95|0|5007.95|0||SCAP THORAC PROSTH TISS SHAP|| 80001|L6580||1911.92|0|1911.92|0||WRIST/ELBOW BOWDEN CABLE MOL|| 80001|L6582||1731.7|0|1731.7|0||WRIST/ELBOW BOWDEN CBL DIR F|| 80001|L6584||2715.74|0|2715.74|0||ELBOW FAIR LEAD CABLE MOLDED|| 80001|L6586||2541.5|0|2541.5|0||ELBOW FAIR LEAD CABLE DIR FO|| 80001|L6588||3339.48|0|3339.48|0||SHDR FAIR LEAD CABLE MOLDED|| 80001|L6590||3171.97|0|3171.97|0||SHDR FAIR LEAD CABLE DIRECT|| 80001|L6600||214.62|0|214.62|0||POLYCENTRIC HINGE PAIR|| 80001|L6605||211.92|0|211.92|0||SINGLE PIVOT HINGE PAIR|| 80001|L6610||203.51|0|203.51|0||FLEXIBLE METAL HINGE PAIR|| 80001|L6611||476.36|0|476.36|0||ADDITIONAL SWITCH - EXT POWER|| 80001|L6615||219.28|0|219.28|0||DISCONNECT LOCKING WRIST UNI|| 80001|L6616||81.25|0|81.25|0||DISCONNECT INSERT LOCKING WR|| 80001|L6620||350.82|0|350.82|0||FLEXION/EXTENSION WRIST UNIT|| 80001|L6621||2646.52|0|2646.52|0||FLEX/EXT WRIST W/WO FRICTION|| 80001|L6623||978.6|0|978.6|0||SPRING-ASS ROT WRST W/ LATCH|| 80001|L6624||4357.58|0|4357.58|0||FLEX/EXT/ROTATION WRIST UNIT|| 80001|L6625||695.32|0|695.32|0||ROTATION WRST W/ CABLE LOCK|| 80001|L6628||548.12|0|548.12|0||QUICK DISCONN HOOK ADAPTER O|| 80001|L6629||167.4|0|167.4|0||LAMINATION COLLAR W/ COUPLIN|| 80001|L6630||246.59|0|246.59|0||STAINLESS STEEL ANY WRIST|| 80001|L6632||85.64|0|85.64|0||LATEX SUSPENSION SLEEVE EACH|| 80001|L6635||201.53|0|201.53|0||LIFT ASSIST FOR ELBOW|| 80001|L6637||429.84|0|429.84|0||NUDGE CONTROL ELBOW LOCK|| 80001|L6638||2893.51|0|2893.51|0||ELEC LOCK ON MANUAL PW ELBOW|| 80001|L6640||381.86|0|381.86|0||SHOULDER ABDUCTION JOINT PAI|| 80001|L6641||183.55|0|183.55|0||EXCURSION AMPLIFIER PULLEY T|| 80001|L6642||248.8|0|248.8|0||EXCURSION AMPLIFIER LEVER TY|| 80001|L6645||459.24|0|459.24|0||SHOULDER FLEXION-ABDUCTION J|| 80001|L6646||3649.38|0|3649.38|0||MULTIPO LOCKING SHOULDER JNT|| 80001|L6647||600.79|0|600.79|0||SHOULDER LOCK ACTUATOR|| 80001|L6648||3763.8|0|3763.8|0||EXT PWRD SHLDER LOCK/UNLOCK|| 80001|L6650||476.81|0|476.81|0||SHOULDER UNIVERSAL JOINT|| 80001|L6655||93.71|0|93.71|0||STANDARD CONTROL CABLE EXTRA|| 80001|L6660||105.02|0|105.02|0||HEAVY DUTY CONTROL CABLE|| 80001|L6665||52.69|0|52.69|0||TEFLON OR EQUAL CABLE LINING|| 80001|L6670||58.26|0|58.26|0||HOOK TO HAND CABLE ADAPTER|| 80001|L6672||231.22|0|231.22|0||HARNESS CHEST/SHLDER SADDLE|| 80001|L6675||137.41|0|137.41|0||HARNESS FIGURE OF 8 SING CON|| 80001|L6676||158.83|0|158.83|0||HARNESS FIGURE OF 8 DUAL CON|| 80001|L6677||343.28|0|343.28|0||UE TRIPLE CONTROL HARNESS|| 80001|L6680||265.46|0|265.46|0||TEST SOCK WRIST DISART/BEL E|| 80001|L6682||293.51|0|293.51|0||TEST SOCK ELBW DISART/ABOVE|| 80001|L6684||398.83|0|398.83|0||TEST SOCKET SHLDR DISART/THO|| 80001|L6686||900.65|0|900.65|0||SUCTION SOCKET|| 80001|L6687||659.98|0|659.98|0||FRAME TYP SOCKET BEL ELBOW/W|| 80001|L6688||656|0|656|0||FRAME TYP SOCK ABOVE ELB/DIS|| 80001|L6689||785.96|0|785.96|0||FRAME TYP SOCKET SHOULDER DI|| 80001|L6690||856.48|0|856.48|0||FRAME TYP SOCK INTERSCAP-THO|| 80001|L6691||396.42|0|396.42|0||REMOVABLE INSERT EACH|| 80001|L6692||639.86|0|639.86|0||SILICONE GEL INSERT OR EQUAL|| 80001|L6693||3284.88|0|3284.88|0||LOCKINGELBOW FOREARM CNTRBAL|| 80001|L6694||813.58|0|813.58|0||ELBOW SOCKET INS USE W/LOCK|| 80001|L6695||677.95|0|677.95|0||ELBOW SOCKET INS USE W/O LCK|| 80001|L6696||1522.01|0|1522.01|0||CUS ELBO SKT IN FOR CON/ATYP|| 80001|L6697||1522.01|0|1522.01|0||CUS ELBO SKT IN NOT CON/ATYP|| 80001|L6698||657.92|0|657.92|0||BELOW/ABOVE ELBOW LOCK MECH|| 80001|L6703||415.96|0|415.96|0||TERM DEV - PASSIVE HAND MITT|| 80001|L6704||670.08|0|670.08|0||TERM DEV - SPORT/REC/WORK ATT|| 80001|L6706||399.23|0|399.23|0||TERM DEV MECH HOOK VOL OPEN|| 80001|L6707||1471.5|0|1471.5|0||TERM DEV MECH HOOK VOL CLOSE|| 80001|L6708||961.97|0|961.97|0||TERM DEV MECH HAND VOL OPEN|| 80001|L6709||1386.22|0|1386.22|0||TERM DEV MECH HAND VOL CLOSE|| 80001|L6711||777.9|0|777.9|0||PED TERM DEV - HOOK - VOL OPEN|| 80001|L6712||1432.3|0|1432.3|0||PED TERM DEV - HOOK - VOL CLOS|| 80001|L6713||1807.67|0|1807.67|0||PED TERM DEV - HAND - VOL OPEN|| 80001|L6714||1531.12|0|1531.12|0||PED TERM DEV - HAND - VOL CLOS|| 80001|L6715||3653.04|0|3653.04|0||TERMINAL DEVICE MODEL #5XA|| 80001|L6721||2721.4|0|2721.4|0||HOOK/HAND - HVY DTY - VOL OPEN|| 80001|L6722||2346.02|0|2346.02|0||HOOK/HAND - HVY DTY - VOL CLOS|| 80001|L6805||389.29|0|389.29|0||MODIFIER WRIST FLEXION UNIT|| 80001|L6810||220.66|0|220.66|0||PINCHER TOOL OTTO BOCK OR EQ|| 80001|L6880||27645.23|0|27645.23|0||HAND BOCK VO|| 80001|L6881||4730.35|0|4730.35|0||AUTOGRASP FEATURE UL TERM DV|| 80001|L6882||3588.23|0|3588.23|0||MICROPROCESSOR CONTROL UPLMB|| 80001|L6883||1815.68|0|1815.68|0||REPLC SOCKT BELOW E/W DISA|| 80001|L6884||2694.85|0|2694.85|0||REPLC SOCKT ABOVE ELBOW DISA|| 80001|L6885||4030.57|0|4030.57|0||REPLC SOCKT SHLDR DIS/INTERC|| 80001|L6890||194.6|0|194.6|0||PREFAB GLOVE FOR TERM DEVICE|| 80001|L6895||715.93|0|715.93|0||CUSTOM GLOVE FOR TERM DEVICE|| 80001|L6900||2043.07|0|2043.07|0||HAND RESTORAT THUMB/1 FINGER|| 80001|L6905||2031.46|0|2031.46|0||HAND RESTORATION MULTIPLE FI|| 80001|L6910||1737.1|0|1737.1|0||HAND RESTORATION NO FINGERS|| 80001|L6915||875.82|0|875.82|0||HAND RESTORATION REPLACMNT G|| 80001|L6920||7635.97|0|7635.97|0||WRIST DISARTICUL SWITCH CTRL|| 80001|L6925||10279.34|0|10279.34|0||WRIST DISART MYOELECTRONIC C|| 80001|L6930||7683.32|0|7683.32|0||BELOW ELBOW SWITCH CONTROL|| 80001|L6935||10438.87|0|10438.87|0||BELOW ELBOW MYOELECTRONIC CT|| 80001|L6940||10038.77|0|10038.77|0||ELBOW DISARTICULATION SWITCH|| 80001|L6945||12266.17|0|12266.17|0||ELBOW DISART MYOELECTRONIC C|| 80001|L6950||11410.48|0|11410.48|0||ABOVE ELBOW SWITCH CONTROL|| 80001|L6955||13665.59|0|13665.59|0||ABOVE ELBOW MYOELECTRONIC CT|| 80001|L6960||15479.71|0|15479.71|0||SHLDR DISARTIC SWITCH CONTRO|| 80001|L6965||16509.67|0|16509.67|0||SHLDR DISARTIC MYOELECTRONIC|| 80001|L6970||17203.34|0|17203.34|0||INTERSCAPULAR-THOR SWITCH CT|| 80001|L6975||18814.92|0|18814.92|0||INTERSCAP-THOR MYOELECTRONIC|| 80001|L7007||3937.21|0|3937.21|0||ADULT ELECTRIC HAND|| 80001|L7008||6196.75|0|6196.75|0||PEDIATRIC ELECTRIC HAND|| 80001|L7009||4017.2|0|4017.2|0||ADULT ELECTRIC HOOK|| 80001|L7040||3225.66|0|3225.66|0||PREHENSILE ACTUATOR HOSMER S|| 80001|L7045||1849.38|0|1849.38|0||ELECTRON HOOK CHILD MICHIGAN|| 80001|L7170||8515.25|0|8515.25|0||ELECTRONIC ELBOW HOSMER SWIT|| 80001|L7180||37377.18|0|37377.18|0||ELECTRONIC ELBOW SEQUENTIAL|| 80001|L7181||46361.38|0|46361.38|0||ELECTRONIC ELBO SIMULTANEOUS|| 80001|L7185||8408.92|0|8408.92|0||ELECTRON ELBOW ADOLESCENT SW|| 80001|L7186||10120.94|0|10120.94|0||ELECTRON ELBOW CHILD SWITCH|| 80001|L7190||8832.23|0|8832.23|0||ELBOW ADOLESCENT MYOELECTRON|| 80001|L7191||10575.79|0|10575.79|0||ELBOW CHILD MYOELECTRONIC CT|| 80001|L7259||3656.72|0|3656.72|0||ELECTRONIC WRIST ROTATOR ANY T|| 80001|L7360||273.01|0|273.01|0||SIX VOLT BAT OTTO BOCK/EQ EA|| 80001|L7362||286.67|0|286.67|0||BATTERY CHRGR SIX VOLT OTTO|| 80001|L7364||455.93|0|455.93|0||TWELVE VOLT BATTERY UTAH/EQU|| 80001|L7366||614.16|0|614.16|0||BATTERY CHRGR 12 VOLT UTAH/E|| 80001|L7367||450.46|0|450.46|0||REPLACEMNT LITHIUM IONBATTER|| 80001|L7368||583.97|0|583.97|0||LITHIUM ION BATTERY CHARGER|| 80001|L7400||354.64|0|354.64|0||ADD UE PROST BE/WD - ULTLITE|| 80001|L7401||397.01|0|397.01|0||ADD UE PROST A/E ULTLITE MAT|| 80001|L7402||428.7|0|428.7|0||ADD UE PROST S/D ULTLITE MAT|| 80001|L7403||426.12|0|426.12|0||ADD UE PROST B/E ACRYLIC|| 80001|L7404||643.08|0|643.08|0||ADD UE PROST A/E ACRYLIC|| 80001|L7405||841.08|0|841.08|0||ADD UE PROST S/D ACRYLIC|| 80001|L7700||130.94|0|130.94|0||PROS SOCKET INSERT GASKET/SEAL|| 80001|L8000||50.33|0|50.33|0||MASTECTOMY BRA|| 80001|L8001||145.13|0|145.13|0||BREAST PROSTHESIS BRA & FORM|| 80001|L8002||190.91|0|190.91|0||BRST PRSTH BRA & BILAT FORM|| 80001|L8010||54|0|54|||MASTECTOMY SLEEVE|| 80001|L8015||69.35|0|69.35|0||EXT BREASTPROSTHESIS GARMENT|| 80001|L8020||260.84|0|260.84|0||MASTECTOMY FORM|| 80001|L8030||377.32|0|377.32|0||BREAST PROSTHESIS SILICONE/E|| 80001|L8031||377.32|0|377.32|0||BREAST PROSTHESIS W ADHESIVE|| 80001|L8032||45.32|0|45.32|0||REUSABLE NIPPLE PROSTHESIS|| 80001|L8035||4239.06|0|4239.06|0||CUSTOM BREAST PROSTHESIS|| 80001|L8040||2796.83|0|2796.83|0||NASAL PROSTHESIS|| 80001|L8041||3371.05|0|3371.05|0||MIDFACIAL PROSTHESIS|| 80001|L8042||3787.68|0|3787.68|0||ORBITAL PROSTHESIS|| 80001|L8043||4242.2|0|4242.2|0||UPPER FACIAL PROSTHESIS|| 80001|L8044||4696.72|0|4696.72|0||HEMI-FACIAL PROSTHESIS|| 80001|L8045||2941.21|0|2941.21|0||AURICULAR PROSTHESIS|| 80001|L8046||3030.14|0|3030.14|0||PARTIAL FACIAL PROSTHESIS|| 80001|L8047||1552.93|0|1552.93|0||NASAL SEPTAL PROSTHESIS|| 80001|L8300||111.43|0|111.43|0||TRUSS SINGLE W/ STANDARD PAD|| 80001|L8310||171.34|0|171.34|0||TRUSS DOUBLE W/ STANDARD PAD|| 80001|L8320||74.84|0|74.84|0||TRUSS ADDITION TO STD PAD WA|| 80001|L8330||74.18|0|74.18|0||TRUSS ADD TO STD PAD SCROTAL|| 80001|L8400||21.68|0|21.68|0||SHEATH BELOW KNEE|| 80001|L8410||24.67|0|24.67|0||SHEATH ABOVE KNEE|| 80001|L8415||24.53|0|24.53|0||SHEATH UPPER LIMB|| 80001|L8417||87|0|87|0||PROS SHEATH/SOCK W GEL CUSHN|| 80001|L8420||28.68|0|28.68|0||PROSTHETIC SOCK MULTI PLY BK|| 80001|L8430||31.54|0|31.54|0||PROSTHETIC SOCK MULTI PLY AK|| 80001|L8435||28.3|0|28.3|0||PROS SOCK MULTI PLY UPPER LM|| 80001|L8440||59.99|0|59.99|0||SHRINKER BELOW KNEE|| 80001|L8460||83.48|0|83.48|0||SHRINKER ABOVE KNEE|| 80001|L8465||74.41|0|74.41|0||SHRINKER UPPER LIMB|| 80001|L8470||7.63|0|7.63|0||PROS SOCK SINGLE PLY BK|| 80001|L8480||10.54|0|10.54|0||PROS SOCK SINGLE PLY AK|| 80001|L8485||12.72|0|12.72|0||PROS SOCK SINGLE PLY UPPER L|| 80001|L8500||755.11|0|755.11|0||ARTIFICIAL LARYNX|| 80001|L8501||167.71|0|167.71|0||TRACHEOSTOMY SPEAKING VALVE|| 80001|L8507||48.47|0|48.47|0||TRACH-ESOPH VOICE PROS PT IN|| 80001|L8509||126.38|0|126.38|0||TRACH-ESOPH VOICE PROS MD IN|| 80001|L8510||292.4|0|292.4|0||VOICE AMPLIFIER|| 80001|L8511||84.16|0|84.16|0||INDWELLING TRACH INSERT|| 80001|L8512||2.54|0|2.54|0||GEL CAP FOR TRACH VOICE PROS|| 80001|L8513||6.02|0|6.02|0||TRACH PROS CLEANING DEVICE|| 80001|L8514||109.12|0|109.12|0||REPL TRACH PUNCTURE DILATOR|| 80001|L8515||73.02|0|73.02|0||GEL CAP APP DEVICE FOR TRACH|| 80001|L8600||714.48|0|714.48|0||IMPLANT BREAST SILICONE/EQ|| 80001|L8603||501.78|0|501.78|0||COLLAGEN IMP URINARY 2.5 ML|| 80001|L8605||828.73|0|828.73|0||TISSUE EXPANDER IMPLANT|| 80001|L8606||263.4|0|263.4|0||SYNTHETIC IMPLNT URINARY 1ML|| 80001|L8609||7538.81|0|7538.81|0||ARTIFICIAL CORNEA|| 80001|L8610||732.89|0|732.89|0||OCULAR IMPLANT|| 80001|L8612||772.98|0|772.98|0||AQUEOUS SHUNT PROSTHESIS|| 80001|L8613||346.07|0|346.07|0||OSSICULAR IMPLANT|| 80001|L8614||21905.1|0|21905.1|0||COCHLEAR DEVICE/SYSTEM|| 80001|L8615||521.86|0|521.86|0||COCH IMPLANT HEADSET REPLACE|| 80001|L8616||121.55|0|121.55|0||COCH IMPLANT MICROPHONE REPL|| 80001|L8617||106.19|0|106.19|0||COCH IMPLANT TRANS COIL REPL|| 80001|L8618||30.32|0|30.32|0||COCH IMPLANT TRAN CABLE REPL|| 80001|L8619||9396.47|0|9396.47|0||REPLACE COCHLEAR PROCESSOR|| 80001|L8621||0.71|0|0.71|0||REPL ZINC AIR BATTERY|| 80001|L8622||0.37|0|0.37|0||REPL ALKALINE BATTERY|| 80001|L8623||74.84|0|74.84|0||LITH ION BATT CID - NON-EARLVL|| 80001|L8624||186.55|0|186.55|0||LITH ION BATT CID - EAR LEVEL|| 80001|L8625||221.59|0|221.59|0||TRAPEZIUM IMPLANT|| 80001|L8627||7965.08|0|7965.08|0||LUNATE IMPLANT|| 80001|L8628||1431.4|0|1431.4|0||CARPUS IMPLANT|| 80001|L8629||207.18|0|207.18|0||SCAPHOID IMPLANT|| 80001|L8630||385.48|0|385.48|0||METACARPOPHALANGEAL IMPLANT|| 80001|L8631||2587|0|2587|0||MCP JOINT REPL 2 PC OR MORE|| 80001|L8641||418.38|0|418.38|0||METATARSAL JOINT IMPLANT|| 80001|L8642||343.43|0|343.43|0||HALLUX IMPLANT|| 80001|L8658||358.92|0|358.92|0||INTERPHALANGEAL JOINT SPACER|| 80001|L8659||2232.76|0|2232.76|0||INTERPHALANGEAL JOINT REPL|| 80001|L8670||636.91|0|636.91|0||VASCULAR GRAFT - SYNTHETIC|| 80001|L8679||9654.64|0|9654.64|0||IMP NEUROSTI PLS GN ANY TYPE|| 80001|L8681||1306.87|0|1306.87|0||PT PRGRM FOR IMPLT NEUROSTIM|| 80001|L8682||6898.04|0|6898.04|0||IMPLT NEUROSTIM RADIOFQ REC|| 80001|L8683||6071.83|0|6071.83|0||RADIOFQ TRSMTR FOR IMPLT NEU|| 80001|L8684||797.35|0|797.35|0||RADIOF TRSMTR IMPLT SCRL NEU|| 80001|L8689||1995.85|0|1995.85|0||EXTERNAL RECHARGING SYSTEM|| 80001|L8690||5504.35|0|5504.35|0||AUD OSSEO DEV - INT/EXT COMP|| 80001|L8691||3085.38|0|3085.38|0||AUD OSSEO DEV EXT SND PROCES|| 80001|L8693||1754.5|0|1754.5|0||AUD OSSEO DEV - ABUTMENT|| 80001|L8694||1108.03|0|1108.03|0||AOI TRANSDUCER/CCTUATOR REPL E|| 80001|L8695||19.27|0|19.27|0||EXTERNAL RECHARG SYS EXTERN|| 80001|L8696||250.81|0|250.81|0||EXT ANTENNA PHREN NERVE STIM|| 80001|P9041||14.15|0|14.15|0||ALBUMIN (HUMAN) - 5% - 50ML|| 80001|P9041||14.75|0|0|0||ALBUMIN (HUMAN) - 5% - 50ML|| 80001|P9045||68.4|0|68.4|0||ALBUMIN (HUMAN) - 5% - 250 ML|| 80001|P9045||68.4|0|0|0||ALBUMIN (HUMAN) - 5% - 250 ML|| 80001|P9046||28.11|0|28.11|0||ALBUMIN (HUMAN) - 25% - 20 ML|| 80001|P9046||28.11|0|0|0||ALBUMIN (HUMAN) - 25% - 20 ML|| 80001|P9047||66.8|0|66.8|0||ALBUMIN (HUMAN) - 25% - 50ML|| 80001|P9047||66.8|0|0|0||ALBUMIN (HUMAN) - 25% - 50ML|| 80001|Q0035||23.62|0|23.62|0||CARDIOKYMOGRAPHY|| 80001|Q0035|26|10.43|0|10.43|0||CARDIOKYMOGRAPHY|| 80001|Q0035|TC|13.18|0|13.18|0||CARDIOKYMOGRAPHY|| 80001|Q0081||0|0|0|0||INFUSION THER OTHER THAN CHE|| 80001|Q0083||0|0|0|0||CHEMO BY OTHER THAN INFUSION|| 80001|Q0084||0|0|0|0||CHEMOTHERAPY BY INFUSION|| 80001|Q0085||0|0|0|0||CHEMO BY BOTH INFUSION AND O|| 80001|Q0091||50.85|0|23.33|0||OBTAINING SCREEN PAP SMEAR|| 80001|Q0092||27.53|0|27.53|0||SET UP PORT XRAY EQUIPMENT|| 80001|Q0111||6.97|0|6.97|0||WET MOUNTS/ W PREPARATIONS|| 80001|Q0112||6.97|0|6.97|0||POTASSIUM HYDROXIDE PREPS|| 80001|Q0113||8.83|0|8.83|0||PINWORM EXAMINATIONS|| 80001|Q0114||11.69|0|11.69|0||FERN TEST|| 80001|Q0115||16.15|0|16.15|0||POST-COITAL MUCOUS EXAM|| 80001|Q0138||1.08|0|1.08|0||INJ - FERUMOXYTOL 1MG (NON-ESRD)|| 80001|Q0138||1.11|0|0|0||INJ - FERUMOXYTOL 1MG (NON-ESRD)|| 80001|Q0139||1.08|0|1.08|0||INJ - FERUMOXYTOL 1MG-ESRD/DIALY|| 80001|Q0139||1.11|0|0|0||INJ - FERUMOXYTOL 1MG-ESRD/DIALY|| 80001|Q0144||0|0|0|0||AZITHROMYCIN DIHYDRATE - ORAL|| 80001|Q0161||0|0|0|0||FACTOR IX RECOMBINANT|| 80001|Q0162||0.04|0|0.04|0||ONDANSETRON ORAL|| 80001|Q0162||0.04|0|0|0||ONDANSETRON ORAL|| 80001|Q0163||0.33|0|0.33|0||DIPHENHYDRAMINE HCL 50MG|| 80001|Q0163||0.34|0|0|0||DIPHENHYDRAMINE HCL 50MG|| 80001|Q0164||0.08|0|0.08|0||PROCHLORPERAZINE MALEATE 5MG|| 80001|Q0164||0.05|0|0|0||PROCHLORPERAZINE MALEATE 5MG|| 80001|Q0166||1.18|0|1.18|0||GRANISETRON HCL 1 MG ORAL|| 80001|Q0166||2.95|0|0|0||GRANISETRON HCL 1 MG ORAL|| 80001|Q0167||11.34|0|11.34|0||DRONABINOL 2.5MG ORAL|| 80001|Q0167||5.2|0|0|0||DRONABINOL 2.5MG ORAL|| 80001|Q0169||0.04|0|0.04|0||PROMETHAZINE HCL 12.5MG ORAL|| 80001|Q0169||0.05|0|0|0||PROMETHAZINE HCL 12.5MG ORAL|| 80001|Q0173||0|0|0|0||TRIMETHOBENZAMIDE HCL 250MG|| 80001|Q0174||0|0|0|0||THIETHYLPERAZINE MALEATE10MG|| 80001|Q0175||0|0|0|0||PERPHENAZINE 4MG ORAL|| 80001|Q0177||0|0|0|0||HYDROXYZINE PAMOATE 25MG|| 80001|Q0180||119.03|0|119.03|0||DOLASETRON MESYLATE ORAL|| 80001|Q0181||0|0|0|0||UNSPECIFIED ORAL ANTI-EMETIC|| 80001|Q0478||212.63|0|212.63|0||POWER ADAPTER - COMBO VAD|| 80001|Q0479||13974.72|0|13974.72|0||POWER MODULE COMBO VAD - REP|| 80001|Q0480||104210.65|0|104210.65|0||DRIVER PNEUMATIC VAD - REP|| 80001|Q0481||16813.19|0|16813.19|0||MICROPRCSR CU ELEC VAD - REP|| 80001|Q0482||5266.2|0|5266.2|0||MICROPRCSR CU COMBO VAD - REP|| 80001|Q0483||21694.38|0|21694.38|0||MONITOR ELEC VAD - REP|| 80001|Q0484||4212.98|0|4212.98|0||MONITOR ELEC OR COMB VAD REP|| 80001|Q0485||406.76|0|406.76|0||MONITOR CABLE ELEC VAD - REP|| 80001|Q0486||338.53|0|338.53|0||MON CABLE ELEC/PNEUM VAD REP|| 80001|Q0487||394.98|0|394.98|0||LEADS ANY TYPE VAD - REP ONLY|| 80001|Q0488||0|0|0|0||PWR PACK BASE ELEC VAD - REP|| 80001|Q0489||18807.84|0|18807.84|0||PWR PCK BASE COMBO VAD - REP|| 80001|Q0490||813.54|0|813.54|0||EMR PWR SOURCE ELEC VAD - REP|| 80001|Q0491||1278.94|0|1278.94|0||EMR PWR SOURCE COMBO VAD REP|| 80001|Q0492||103.07|0|103.07|0||EMR PWR CBL ELEC VAD - REP|| 80001|Q0493||293.35|0|293.35|0||EMR PWR CBL COMBO VAD - REP|| 80001|Q0494||248.26|0|248.26|0||EMR HD PMP ELEC/COMBO - REP|| 80001|Q0495||4833.18|0|4833.18|0||CHARGER ELEC/COMBO VAD - REP|| 80001|Q0496||1734.71|0|1734.71|0||BATTERY ELEC/COMBO VAD - REP|| 80001|Q0497||541.66|0|541.66|0||BAT CLPS ELEC/COMB VAD - REP|| 80001|Q0498||594.32|0|594.32|0||HOLSTER ELEC/COMBO VAD - REP|| 80001|Q0499||193.1|0|193.1|0||BELT/VEST ELEC/COMBO VAD REP|| 80001|Q0500||35.34|0|35.34|0||FILTERS ELEC/COMBO VAD - REP|| 80001|Q0501||590.9|0|590.9|0||SHWR COV ELEC/COMBO VAD - REP|| 80001|Q0502||752.29|0|752.29|0||MOBILITY CART PNEUM VAD - REP|| 80001|Q0503||1504.62|0|1504.62|0||BATTERY PNEUM VAD REPLACEMNT|| 80001|Q0504||793.93|0|793.93|0||PWR ADPT PNEUM VAD - REP VEH|| 80001|Q0506||988.27|0|988.27|0||LITH-ION BATT ELEC/PNEUM VAD|| 80001|Q0507||0|0|0|0||MISC SUP/ACC EXT VAD|| 80001|Q0508||0|0|0|0||MISC SUP/ACC IMP VAD|| 80001|Q0509||0|0|0|0||MIS SUP/AC IMP VAD NOPAY MED|| 80001|Q0510||0|0|0|0||DISPENS FEE IMMUNOSUPRESSIVE|| 80001|Q0511||0|0|0|0||SUP FEE ANTIEM - ANTICA - IMMUNO|| 80001|Q0512||0|0|0|0||PX SUP FEE ANTI-CAN SUB PRES|| 80001|Q0513||0|0|0|0||DISP FEE INHAL DRUGS/30 DAYS|| 80001|Q0514||0|0|0|0||DISP FEE INHAL DRUGS/90 DAYS|| 80001|Q0515||0|0|0|0||SERMORELIN ACETATE INJECTION|| 80001|Q1004||0|0|0|0||NTIOL CATEGORY 4|| 80001|Q1005||0|0|0|0||NTIOL CATEGORY 5|| 80001|Q2004||0|0|0|0||BLADDER CALCULI IRRIG SOL|| 80001|Q2009||0|0|0|0||FOSPHENYTOIN - 50 MG|| 80001|Q2017||0|0|0|0||TENIPOSIDE - 50 MG|| 80001|Q2026||0|0|0|0||RADIESSE INJECTION|| 80001|Q2028||0|0|0|0||INJ - SCULPTRA - 0.5 MG|| 80001|Q2034||0|0|0|0||AGRIFLU VACCINE|| 80001|Q2035||16.28|0|16.28|0||AFLURIA VACC - 3 YRS & > - IM|| 80001|Q2035||20.36|0|0|0||AFLURIA VACC - 3 YRS & > - IM|| 80001|Q2036||0|0|0|0||FLULAVAL VACC - 3 YRS & > - IM|| 80001|Q2037||19.79|0|19.79|0||FLUVIRIN VACC - 3 YRS & > - IM|| 80001|Q2037||20.36|0|0|0||FLUVIRIN VACC - 3 YRS & > - IM|| 80001|Q2038||15.06|0|15.06|0||FLUZONE VACC - 3 YRS & > - IM|| 80001|Q2039||0|0|0|0||NOS FLU VACC - 3 YRS & > - IM|| 80001|Q2043||47544.01|0|47544.01|0||SIPULEUCEL-T AUTO CD54+|| 80001|Q2043||49446.1|0|0|0||SIPULEUCEL-T AUTO CD54+|| 80001|Q2049||635.54|0|635.54|0||IMPORTED LIPODOX INJ|| 80001|Q2050||532.81|0|532.81|0||DOXORUBICIN INJ 10MG|| 80001|Q2050||479.78|0|0|0||DOXORUBICIN INJ 10MG|| 80001|Q2052||0|0|0|0||IVIG DEMO - SERVICES/SUPPLIES|| 80001|Q3001||0|0|0|0||BRACHYTHERAPY RADIOELEMENTS|| 80001|Q3014||0|0|0|0||TELEHEALTH FACILITY FEE|| 80001|Q3027||56|0|56|0||INJ BETA INTERFERON IM 1 MCG|| 80001|Q3027||62.83|0|0|0||INJ BETA INTERFERON IM 1 MCG|| 80001|Q3028||0|0|0|0||INJ BETA INTERFERON SQ 1 MCG|| 80001|Q3031||0|0|0|0||COLLAGEN SKIN TEST|| 80001|Q4001||58.28|0|58.28|0||CAST SUP BODY CAST PLASTER|| 80001|Q4002||220.24|0|220.24|0||CAST SUP BODY CAST FIBERGLAS|| 80001|Q4003||41.86|0|41.86|0||CAST SUP SHOULDER CAST PLSTR|| 80001|Q4004||144.89|0|144.89|0||CAST SUP SHOULDER CAST FBRGL|| 80001|Q4005||15.43|0|15.43|0||CAST SUP LONG ARM ADULT PLST|| 80001|Q4006||34.78|0|34.78|0||CAST SUP LONG ARM ADULT FBRG|| 80001|Q4007||7.73|0|7.73|0||CAST SUP LONG ARM PED PLSTER|| 80001|Q4008||17.38|0|17.38|0||CAST SUP LONG ARM PED FBRGLS|| 80001|Q4009||10.31|0|10.31|0||CAST SUP SHT ARM ADULT PLSTR|| 80001|Q4010||23.2|0|23.2|0||CAST SUP SHT ARM ADULT FBRGL|| 80001|Q4011||5.14|0|5.14|0||CAST SUP SHT ARM PED PLASTER|| 80001|Q4012||11.6|0|11.6|0||CAST SUP SHT ARM PED FBRGLAS|| 80001|Q4013||18.76|0|18.76|0||CAST SUP GAUNTLET PLASTER|| 80001|Q4014||31.63|0|31.63|0||CAST SUP GAUNTLET FIBERGLASS|| 80001|Q4015||9.4|0|9.4|0||CAST SUP GAUNTLET PED PLSTER|| 80001|Q4016||15.8|0|15.8|0||CAST SUP GAUNTLET PED FBRGLS|| 80001|Q4017||10.85|0|10.85|0||CAST SUP LNG ARM SPLINT PLST|| 80001|Q4018||17.28|0|17.28|0||CAST SUP LNG ARM SPLINT FBRG|| 80001|Q4019||5.44|0|5.44|0||CAST SUP LNG ARM SPLNT PED P|| 80001|Q4020||8.66|0|8.66|0||CAST SUP LNG ARM SPLNT PED F|| 80001|Q4021||8.03|0|8.03|0||CAST SUP SHT ARM SPLINT PLST|| 80001|Q4022||14.48|0|14.48|0||CAST SUP SHT ARM SPLINT FBRG|| 80001|Q4023||4.03|0|4.03|0||CAST SUP SHT ARM SPLNT PED P|| 80001|Q4024||7.25|0|7.25|0||CAST SUP SHT ARM SPLNT PED F|| 80001|Q4025||44.99|0|44.99|0||CAST SUP HIP SPICA PLASTER|| 80001|Q4026||140.48|0|140.48|0||CAST SUP HIP SPICA FIBERGLAS|| 80001|Q4027||22.51|0|22.51|0||CAST SUP HIP SPICA PED PLSTR|| 80001|Q4028||70.27|0|70.27|0||CAST SUP HIP SPICA PED FBRGL|| 80001|Q4029||34.4|0|34.4|0||CAST SUP LONG LEG PLASTER|| 80001|Q4030||90.58|0|90.58|0||CAST SUP LONG LEG FIBERGLASS|| 80001|Q4031||17.2|0|17.2|0||CAST SUP LNG LEG PED PLASTER|| 80001|Q4032||45.29|0|45.29|0||CAST SUP LNG LEG PED FBRGLS|| 80001|Q4033||32.1|0|32.1|0||CAST SUP LNG LEG CYLINDER PL|| 80001|Q4034||79.82|0|79.82|0||CAST SUP LNG LEG CYLINDER FB|| 80001|Q4035||16.04|0|16.04|0||CAST SUP LNGLEG CYLNDR PED P|| 80001|Q4036||39.92|0|39.92|0||CAST SUP LNGLEG CYLNDR PED F|| 80001|Q4037||19.57|0|19.57|0||CAST SUP SHRT LEG PLASTER|| 80001|Q4038||49.04|0|49.04|0||CAST SUP SHRT LEG FIBERGLASS|| 80001|Q4039||9.8|0|9.8|0||CAST SUP SHRT LEG PED PLSTER|| 80001|Q4040||24.52|0|24.52|0||CAST SUP SHRT LEG PED FBRGLS|| 80001|Q4041||23.81|0|23.81|0||CAST SUP LNG LEG SPLNT PLSTR|| 80001|Q4042||40.64|0|40.64|0||CAST SUP LNG LEG SPLNT FBRGL|| 80001|Q4043||11.92|0|11.92|0||CAST SUP LNG LEG SPLNT PED P|| 80001|Q4044||20.33|0|20.33|0||CAST SUP LNG LEG SPLNT PED F|| 80001|Q4045||13.82|0|13.82|0||CAST SUP SHT LEG SPLNT PLSTR|| 80001|Q4046||22.22|0|22.22|0||CAST SUP SHT LEG SPLNT FBRGL|| 80001|Q4047||6.89|0|6.89|0||CAST SUP SHT LEG SPLNT PED P|| 80001|Q4048||11.12|0|11.12|0||CAST SUP SHT LEG SPLNT PED F|| 80001|Q4049||2.52|0|2.52|0||FINGER SPLINT - STATIC|| 80001|Q4050||0|0|0|0||CAST SUPPLIES UNLISTED|| 80001|Q4051||0|0|0|0||SPLINT SUPPLIES MISC|| 80001|Q4074||151.59|0|151.59|0||ILOPROST NON-COMP UNIT DOSE|| 80001|Q4074||158.25|0|0|0||ILOPROST NON-COMP UNIT DOSE|| 80001|Q4081||1.56|0|1.56|0||EPOETIN ALFA - 100 UNITS ESRD|| 80001|Q4081||1.72|0|0|0||EPOETIN ALFA - 100 UNITS ESRD|| 80001|Q4082||0|0|0|0||DRUG/BIO NOC PART B DRUG CAP|| 80001|Q4100||0|0|0|0||SKIN SUBSTITUTE - NOS|| 80001|Q4101||38.78|0|38.78|0||APLIGRAF SKIN SUB|| 80001|Q4101||38.59|0|0|0||APLIGRAF SKIN SUB|| 80001|Q4102||13.57|0|13.57|0||OASIS WOUND MATRIX SKIN SUB|| 80001|Q4102||13.74|0|0|0||OASIS WOUND MATRIX SKIN SUB|| 80001|Q4103||0|0|0|0||OASIS BURN MATRIX SKIN SUB|| 80001|Q4104||48.48|0|48.48|0||INTEGRA BMWD SKIN SUB|| 80001|Q4105||37.28|0|37.28|0||INTEGRA DRT SKIN SUB|| 80001|Q4106||41.11|0|41.11|0||DERMAGRAFT SKIN SUB|| 80001|Q4106||41.34|0|0|0||DERMAGRAFT SKIN SUB|| 80001|Q4107||110.25|0|110.25|0||GRAFTJACKET SKIN SUB|| 80001|Q4107||116.66|0|0|0||GRAFTJACKET SKIN SUB|| 80001|Q4108||45.67|0|45.67|0||INTEGRA MATRIX SKIN SUB|| 80001|Q4110||60.14|0|60.14|0||PRIMATRIX SKIN SUB|| 80001|Q4111||8.76|0|8.76|0||GAMMAGRAFT SKIN SUB|| 80001|Q4111||9.21|0|0|0||GAMMAGRAFT SKIN SUB|| 80001|Q4112||309.18|0|309.18|0||CYMETRA ALLOGRAFT|| 80001|Q4112||250.06|0|0|0||CYMETRA ALLOGRAFT|| 80001|Q4113||309.18|0|309.18|0||GRAFTJACKET EXPRESS ALLOGRAF|| 80001|Q4113||250.06|0|0|0||GRAFTJACKET EXPRESS ALLOGRAF|| 80001|Q4114||1961.08|0|1961.08|0||INTEGRA FLOWABLE WOUND MATRI|| 80001|Q4115||13.48|0|13.48|0||ALLOSKIN SKIN SUB|| 80001|Q4115||9.43|0|0|0||ALLOSKIN SKIN SUB|| 80001|Q4116||40.38|0|40.38|0||ALLODERM SKIN SUB|| 80001|Q4116||39.29|0|0|0||ALLODERM SKIN SUB|| 80001|Q4117||0|0|0|0||HYALOMATRIX|| 80001|Q4118||0|0|0|0||MATRISTEM MICROMATRIX|| 80001|Q4119||0|0|0|0||MATRISTEM WOUND MATRIX|| 80001|Q4120||0|0|0|0||MATRISTEM BURN MATRIX|| 80001|Q4121||50.19|0|50.19|0||THERASKIN|| 80001|Q4121||52.33|0|0|0||THERASKIN|| 80001|Q4122||0|0|0|0||DERMACELL|| 80001|Q4123||31.17|0|31.17|0||ALLOSKIN|| 80001|Q4123||40.55|0|0|0||ALLOSKIN|| 80001|Q4124||0|0|0|0||OASIS TRI-LAYER WOUND MATRIX|| 80001|Q4125||0|0|0|0||ARTHROFLEX|| 80001|Q4126||0|0|0|0||MEMODERM|| 80001|Q4127||0|0|0|0||TALYMED|| 80001|Q4128||0|0|0|0||FLEXHD OR ALLOPATCH HD|| 80001|Q4129||0|0|0|0||UNITE BIOMATRIX|| 80001|Q4130||0|0|0|0||STRATTICE TM|| 80001|Q4131||222.88|0|222.88|0||EPIFIX|| 80001|Q4131||202.52|0|0|0||EPIFIX|| 80001|Q4132||0|0|0|0||GRAFIX CORE|| 80001|Q4132||171.08|0|0|0||GRAFIX CORE|| 80001|Q4133||0|0|0|0||GRAFIX PRIME|| 80001|Q4133||173.01|0|0|0||GRAFIX PRIME|| 80001|Q4134||0|0|0|0||HMATRIX|| 80001|Q4135||0|0|0|0||MEDISKIN|| 80001|Q4136||0|0|0|0||EZDERM|| 80001|Q4137||0|0|0|0||AMNIOEXCEL OR BIODEXCEL - 1 CM|| 80001|Q4138||0|0|0|0||BIODFENCE DRYFLEX - 1 CM|| 80001|Q4139||0|0|0|0||AMNIO OR BIODMATRIX - INJ 1CC|| 80001|Q4140||0|0|0|0||BIODFENCE 1 CM|| 80001|Q4141||0|0|0|0||ALLOSKIN AC - 1 CM|| 80001|Q4142||0|0|0|0||XCM BIOLOGIC TISS MATRIX 1 CM|| 80001|Q4143||0|0|0|0||REPRIZA - 1 CM|| 80001|Q4145||0|0|0|0||EPIFIX - INJ - 1 MG|| 80001|Q4146||0|0|0|0||TENSIX - 1 CM|| 80001|Q4147||0|0|0|0||ARCHITECT ECM - 1 CM|| 80001|Q4148||0|0|0|0||NEOX 1K - 1CM|| 80001|Q4149||0|0|0|0||EXCELLAGEN - 0.1 CC|| 80001|Q4150||0|0|0|0||ALLOWRAP DS OR DRY PER SQ CM|| 80001|Q4151||0|0|0|0||AMNIOBAND - GUARDIAN PER SQ CM|| 80001|Q4152||0|0|0|0||DERMAPURE PER SQUARE CM|| 80001|Q4153||0|0|0|0||DERMAVEST PER SQUARE CM|| 80001|Q4154||0|0|0|0||BIOVANCE PER SQUARE CM|| 80001|Q4155||0|0|0|0||NEOXFLO OR CLARIXFLO 1 MG|| 80001|Q4156||0|0|0|0||NEOX 100 PER SQUARE CM|| 80001|Q4157||0|0|0|0||REVITALON PER SQUARE CM|| 80001|Q4158||0|0|0|0||MARIGEN PER SQUARE CM|| 80001|Q4159||0|0|0|0||AFFINITY1 PER SQUARE CM|| 80001|Q4160||0|0|0|0||NUSHIELD PER SQUARE CM|| 80001|Q5001||0|0|0|0||HOSPICE IN PATIENT HOME|| 80001|Q5002||0|0|0|0||HOSPICE IN ASSISTED LIVING|| 80001|Q5003||0|0|0|0||HOSPICE IN LT/NON-SKILLED NF|| 80001|Q5004||0|0|0|0||HOSPICE IN SNF|| 80001|Q5005||0|0|0|0||HOSPICE - INPATIENT HOSPITAL|| 80001|Q5006||0|0|0|0||HOSPICE IN HOSPICE FACILITY|| 80001|Q5007||0|0|0|0||HOSPICE IN LTCH|| 80001|Q5008||0|0|0|0||HOSPICE IN INPATIENT PSYCH|| 80001|Q5009||0|0|0|0||HOSPICE CARE - NOS|| 80001|Q5010||0|0|0|0||HOSPICE HOME CARE IN HOSPICE|| 80001|Q5101||1.09|0|1.09|0||INJ FILGRASTIM G-CSF BIOSIM - 1|| 80001|Q5101||0.91|0|0|0||INJ FILGRASTIM G-CSF BIOSIM - 1|| 80001|Q5102||100.24|0|0|0||INJ - INFLIXIMAB BIOSIMILAR - 10|| 80001|Q9950||28.66|0|28.66|0||LOCM 350-399MG/ML IODINE - 1ML|| 80001|Q9950||26.36|0|0|0||LOCM 350-399MG/ML IODINE - 1ML|| 80001|Q9951||0|0|0|0||LOCM >= 400 MG/ML IODINE - 1ML|| 80001|Q9953||0|0|0|0||INJ FE-BASED MR CONTRAST - 1ML|| 80001|Q9954||0|0|0|0||ORAL MR CONTRAST - 100 ML|| 80001|Q9955||0|0|0|0||INJ PERFLEXANE LIP MICROS - ML|| 80001|Q9956||43.47|0|43.47|0||INJ OCTAFLUOROPROPANE MIC - ML|| 80001|Q9956||42.68|0|0|0||INJ OCTAFLUOROPROPANE MIC - ML|| 80001|Q9957||65.21|0|65.21|0||INJ PERFLUTREN LIP MICROS - ML|| 80001|Q9957||64.02|0|0|0||INJ PERFLUTREN LIP MICROS - ML|| 80001|Q9958||0.11|0|0.11|0||HOCM <=149 MG/ML IODINE - 1ML|| 80001|Q9958||0.11|0|0|0||HOCM <=149 MG/ML IODINE - 1ML|| 80001|Q9959||0|0|0|0||HOCM 150-199MG/ML IODINE - 1ML|| 80001|Q9960||0.23|0|0.23|0||HOCM 200-249MG/ML IODINE - 1ML|| 80001|Q9960||0.35|0|0|0||HOCM 200-249MG/ML IODINE - 1ML|| 80001|Q9961||0.26|0|0.26|0||HOCM 250-299MG/ML IODINE - 1ML|| 80001|Q9961||0.32|0|0|0||HOCM 250-299MG/ML IODINE - 1ML|| 80001|Q9962||0|0|0|0||HOCM 300-349MG/ML IODINE - 1ML|| 80001|Q9963||0.24|0|0.24|0||HOCM 350-399MG/ML IODINE - 1ML|| 80001|Q9963||0.24|0|0|0||HOCM 350-399MG/ML IODINE - 1ML|| 80001|Q9964||0|0|0|0||HOCM>= 400MG/ML IODINE - 1ML|| 80001|Q9965||1.01|0|1.01|0||LOCM 100-199MG/ML IODINE - 1ML|| 80001|Q9965||0.96|0|0|0||LOCM 100-199MG/ML IODINE - 1ML|| 80001|Q9966||0.22|0|0.22|0||LOCM 200-299MG/ML IODINE - 1ML|| 80001|Q9966||0.41|0|0|0||LOCM 200-299MG/ML IODINE - 1ML|| 80001|Q9967||0.16|0|0.16|0||LOCM 300-399MG/ML IODINE - 1ML|| 80001|Q9967||0.16|0|0|0||LOCM 300-399MG/ML IODINE - 1ML|| 80001|Q9975||2.38|0|2.38|0||FACTOR VIII FC FUSION RECOMB|| 80001|Q9979||2178.99|0|2178.99|0||INJECTION - ALEMTUZUMAB|| 80001|Q9989||16.1|0|0|0||USTEKINUMAB - IV INJ - 1 MG|| 80001|S2083||240|0|240|||ADJUSTMENT GASTRIC BAND|| 80001|S8420||340.92|0|0|0||CUSTOM GRADIENT SLEEV/GLOV|| 80001|S8421||103.87|0|0|0||READY GRADIENT SLEEV/GLOV|| 80001|S8422||130|0|0|0||CUSTOM GRAD SLEEVE MED|| 80001|S8423||89.6|0|0|0||CUSTOM GRAD SLEEVE HEAVY|| 80001|S8424||78|0|0|0||READY GRADIENT SLEEVE|| 80001|S8425||195|0|0|0||CUSTOM GRAD GLOVE MED|| 80001|S8426||180.7|0|0|0||CUSTOM GRAD GLOVE HEAVY|| 80001|S8427||112.77|0|0|0||READY GRADIENT GLOVE|| 80001|S8428||43.87|0|0|0||READY GRADIENT GAUNTLET|| 80001|S8990||28|0|28|||PT OR MANIP FOR MAINT|| 80001|V2020||96.35|0|0|||VISION SVCS FRAMES PURCHASES|| 80001|V2200||61.29|0|0|||LENS SPHER BIFOC PLANO 4.00D|| 80001|V2203||61.83|0|0|||LENS SPHCYL BIFOCAL 4.00D/.1|| 80001|V2781||75|0|75|||PROGRESSIVE LENS PER LENS||