TAX ID|SCHEDNO|NAME|SCH_NAME|CPTNO|CPT|MODIFIER|FULLAMT|PROFAMT|TECHAMT|ANESUNITS|BEGIN DATEDT
58-2102532|106|SH SH311|106-SH SH311|V2786|V2786 - OCCUPATIONAL MULTIFOCAL LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2784|V2784 - LENS POLYCARB OR EQUAL||55.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2783|V2783 - LENS -  >= 1.66 P/>=1.80 G||84.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2782|V2782 - LENS -  1.54-1.65 P/1.60-1.79G||75.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2781|V2781 - PROGRESSIVE LENS PER LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2780|V2780 - OVERSIZE LENS/ES||19.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2770|V2770 - OCCLUDER LENS/ES||23.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2762|V2762 - POLARIZATION -  ANY LENS||69.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2760|V2760 - SCRATCH RESISTANT COATING||18.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2755|V2755 - UV LENS/ES||21.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2750|V2750 - ANTI-REFLECTIVE COATING||29.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2745|V2745 - TINT -  ANY COLOR/SOLID/GRAD||14.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2744|V2744 - TINT PHOTOCHROMATIC LENS/ES||25.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2730|V2730 - SPECIAL BASE CURVE||24.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2718|V2718 - FRESNELL PRISM PRESS-ON LENS||32.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2715|V2715 - PRISM LENS/ES||13.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2710|V2710 - GLASS/PLASTIC SLAB OFF PRISM||73.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2702|V2702 - DELUXE LENS FEATURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2700|V2700 - BALANCE LENS||50.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2628|V2628 - FABRICATION & FITTING||377.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2627|V2627 - SCLERAL COVER SHELL||1651.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2626|V2626 - REDUCTION OF EYE PROSTHESIS||288.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2625|V2625 - ENLARGEMNT OF EYE PROSTHESIS||454.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2624|V2624 - POLISHING ARTIFICAL EYE||70.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2623|V2623 - PLASTIC EYE PROSTH CUSTOM||1035.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2531|V2531 - CONTACT LENS GAS PERMEABLE||631.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2530|V2530 - CONTACT LENS GAS IMPERMEABLE||257.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2523|V2523 - CNTCT LENS HYDROPHIL EXTEND||173.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2522|V2522 - CNTCT LENS HYDROPHIL BIFOCL||203.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2521|V2521 - CNTCT LENS HYDROPHILIC TORIC||209.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2520|V2520 - CONTACT LENS HYDROPHILIC||120.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2513|V2513 - CONTACT LENS EXTENDED WEAR||182.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2512|V2512 - CNTCT LENS GAS PERMBL BIFOCL||217.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2511|V2511 - CNTCT TORIC PRISM BALLAST||183.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2510|V2510 - CNTCT GAS PERMEABLE SPHERICL||127.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2503|V2503 - CNTCT LENS PMMA COLOR VISION||168.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2502|V2502 - CONTACT LENS PMMA BIFOCAL||175.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2501|V2501 - CNTCT LENS PMMA-TORIC/PRISM||142.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2500|V2500 - CONTACT LENS PMMA SPHERICAL||93.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2430|V2430 - LENS VARIABLE ASPHERICITY BI||134.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2410|V2410 - LENS VARIAB ASPHERICITY SING||103.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2321|V2321 - LENTICULAR LENS -  TRIFOCAL||180.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2320|V2320 - LENS TRIFOCAL ADD OVER 3.25D||60.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2319|V2319 - LENS TRIFOCAL SEG WIDTH > 28||57.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2318|V2318 - LENS ANISEIKONIC TRIFOCAL||169.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2315|V2315 - LENS LENTICULAR TRIFOCAL||183.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2314|V2314 - LENS SPHCYL TRIFOCAL OVER 12||165.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2313|V2313 - LENS SPHC TRIFO 7.25-12/4.25||150.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2312|V2312 - LENS SPHC TRIFO 7.25-12/2.25||110.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2311|V2311 - LENS SPHC TRIFO 7.25-12/.25-||125.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2310|V2310 - LENS SPHC TRIFOCAL 4.25-7/>6||131.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2309|V2309 - LENS SPHC TRIFOCAL 4.25-7/4.||119.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2308|V2308 - LENS SPHC TRIFOCAL 4.25-7/2.||102.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2307|V2307 - LENS SPHCY TRIFOCAL 4.25-7/.||95.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2306|V2306 - LENS SPHCYL TRIFOCAL 4.00/>6||96.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2305|V2305 - LENS SPHCY TRIFOCAL 4.0/4.25||103.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2304|V2304 - LENS SPHCY TRIFOCAL 4.0/2.25||84.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2303|V2303 - LENS SPHCY TRIFOCAL 4.0/.12-||80.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2302|V2302 - LENS SPHERE TRIFOCAL 7.12-20||97.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2301|V2301 - LENS SPHERE TRIFOCAL 4.12-7.||89.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2300|V2300 - LENS SPHERE TRIFOCAL 4.00D||76.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2221|V2221 - LENTICULAR LENS -  BIFOCAL||111.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2220|V2220 - LENS BIFOCAL ADD OVER 3.25D||41.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2219|V2219 - LENS BIFOCAL SEG WIDTH OVER||51.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2218|V2218 - LENS ANISEIKONIC BIFOCAL||116.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2215|V2215 - LENS LENTICULAR BIFOCAL||114.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2214|V2214 - LENS SPHCYL BIFOCAL OVER 12.||105.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2213|V2213 - LENS SPHCYL BIFO 7.25-12/4.2||98.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2212|V2212 - LENS SPHCYL BIFO 7.25-12/2.2||95.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2211|V2211 - LENS SPHCY BIFO 7.25-12/.25-||88.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2210|V2210 - LENS SPHCY BIFOCAL 4.25-7/OV||103.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2209|V2209 - LENS SPHCY BIFOCAL 4.25-7/4.||80.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2208|V2208 - LENS SPHCY BIFOCAL 4.25-7/2.||73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2207|V2207 - LENS SPHCY BIFOCAL 4.25-7D/.||72.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2206|V2206 - LENS SPHCY BIFOCAL 4.00D/OVE||86.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2205|V2205 - LENS SPHCY BIFOCAL 4.00D/4.2||70.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2204|V2204 - LENS SPHCY BIFOCAL 4.00D/2.1||64.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2203|V2203 - LENS SPHCYL BIFOCAL 4.00D/.1||59.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2202|V2202 - LENS SPHERE BIFOCAL 7.12-20.||75.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2201|V2201 - LENS SPHERE BIFOCAL 4.12-7.0||64.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2200|V2200 - LENS SPHER BIFOC PLANO 4.00D||59.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2121|V2121 - LENTICULAR LENS -  SINGLE||87.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2118|V2118 - LENS ANISEIKONIC SINGLE||84.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2115|V2115 - LENS LENTICULAR BIFOCAL||85.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2114|V2114 - SPHEROCYLINDER OVER 12.00D||78.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2113|V2113 - SPHEROCYLINDR 7.25D/4.25-6D||88.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2112|V2112 - SPHEROCYLINDR 7.25D/2.25-4D||64.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2111|V2111 - SPHEROCYLINDR 7.25D/.25-2.25||65.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2110|V2110 - SPHEROCYLINDER 4.25D/OVER 6D||73.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2109|V2109 - SPHEROCYLINDER 4.25D/4.25-6D||63.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2108|V2108 - SPHEROCYLINDER 4.25D/2.12-4D||55.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2107|V2107 - SPHEROCYLINDER 4.25D/12-2D||56.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2106|V2106 - SPHEROCYLINDER 4.00D/>6.00D||53.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2105|V2105 - SPHEROCYLINDER 4.00D/4.25-6D||53.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2104|V2104 - SPHEROCYLINDR 4.00D/2.12-4D||43.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2103|V2103 - SPHEROCYLINDR 4.00D/12-2.00D||39.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2102|V2102 - SINGL VISN SPHERE 7.12-20.00||67.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2101|V2101 - SINGLE VISN SPHERE 4.12-7.00||47.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2100|V2100 - LENS SPHER SINGLE PLANO 4.00||45.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2025|V2025 - EYEGLASSES DELUX FRAMES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|V2020|V2020 - VISION SVCS FRAMES PURCHASES||92.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9999|S9999 - SALES TAX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9996|S9996 - MEALS FOR CLINICAL TRIAL PAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9994|S9994 - LODGING COSTS (E.G. HOTEL CH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9992|S9992 - TRANSPORTATION COSTS TO AND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9991|S9991 - SERVICES PROVIDED AS PART OF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9990|S9990 - SERVICES PROVIDED AS PART OF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9989|S9989 - SERVICES OUTSIDE US||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9988|S9988 - SERV PART OF PHASE I TRIAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9986|S9986 - NOT MEDICALLY NECESSARY SVC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9982|S9982 - MED RECORD COPY PER PAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9981|S9981 - MED RECORD COPY ADMIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9977|S9977 - MEALS PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9976|S9976 - LODGING PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9975|S9975 - TRANSPLANT RELATED PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9970|S9970 - HEALTH CLUB MEMBERSHIP YR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9900|S9900 - CHRISTIAN SCI PRACT VISIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9810|S9810 - HT PHARM PER HOUR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9590|S9590 - HT IRRIGATION DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9562|S9562 - HT INJ PALIVIZUMAB DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9560|S9560 - HT INJ HORMONE DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9559|S9559 - HIT INJ INTERFERON DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9558|S9558 - HT INJ GROWTH HORM DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9542|S9542 - HT INJ NOC PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9538|S9538 - HIT BLOOD PRODUCTS DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9537|S9537 - HT HEM HORM INJ DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9529|S9529 - VENIPUNCTURE HOME/SNF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9504|S9504 - HIT ANTIBIOTIC Q4H DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9503|S9503 - HIT ANTIBIOTIC Q6H DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9502|S9502 - HIT ANTIBIOTIC Q8H DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9501|S9501 - HIT ANTIBIOTIC Q12H DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9500|S9500 - HIT ANTIBIOTIC Q24H DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9497|S9497 - HIT ANTIBIOTIC Q3H DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9494|S9494 - HIT ANTIBIOTIC TOTAL DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9490|S9490 - HIT CORTICOSTEROID/DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9485|S9485 - CRISIS INTERVENTION MENTAL H||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9484|S9484 - CRISIS INTERVENTION PER HOUR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9482|S9482 - FAMILY STABILIZATION 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9480|S9480 - INTENSIVE OUTPATIENT PSYCHIA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9476|S9476 - VESTIBULAR REHAB PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9475|S9475 - AMBULATORY SETTING SUBSTANCE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9474|S9474 - ENTEROSTOMAL THERAPY BY A RE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9473|S9473 - PULMONARY REHABILITATION PRO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9472|S9472 - CARDIAC REHABILITATION PROGR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9470|S9470 - NUTRITIONAL COUNSELING -  DIET||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9465|S9465 - DIABETIC MANAGEMENT PROGRAM - ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9460|S9460 - DIABETIC MANAGEMENT PROGRAM - ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9455|S9455 - DIABETIC MANAGEMENT PROGRAM - ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9454|S9454 - STRESS MGMT CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9453|S9453 - SMOKING CESSATION CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9452|S9452 - NUTRITION CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9451|S9451 - EXERCISE CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9449|S9449 - WEIGHT MGMT CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9447|S9447 - INFANT SAFETY CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9446|S9446 - PT EDUCATION NOC GROUP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9445|S9445 - PT EDUCATION NOC INDIVID||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9444|S9444 - PARENTING CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9443|S9443 - LACTATION CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9442|S9442 - BIRTHING CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9441|S9441 - ASTHMA EDUCATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9439|S9439 - VBAC CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9438|S9438 - CESAREAN BIRTH CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9437|S9437 - CHILDBIRTH REFRESHER CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9436|S9436 - LAMAZE CLASS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9435|S9435 - MEDICAL FOODS FOR INBORN ERR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9434|S9434 - MOD SOLID FOOD SUPPL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9433|S9433 - MEDICAL FOOD ORAL 100% NUTR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9430|S9430 - PHARMACY COMP/DISP SERV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9401|S9401 - ANTICOAG CLINIC PER SESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9381|S9381 - HIT HIGH RISK/ESCORT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9379|S9379 - HIT NOC PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9377|S9377 - HIT HYDRA OVER 3L DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9376|S9376 - HIT HYDRA 3 LITER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9375|S9375 - HIT HYDRA 2 LITER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9374|S9374 - HIT HYDRA 1 LITER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9373|S9373 - HIT HYDRA TOTAL DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9372|S9372 - HT INJ ANTICOAG DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9370|S9370 - HT INJ ANTIEMETIC DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9368|S9368 - HIT TPN OVER 3L DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9367|S9367 - HIT TPN 3 LITER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9366|S9366 - HIT TPN 2 LITER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9365|S9365 - HIT TPN 1 LITER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9364|S9364 - HIT TPN TOTAL DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9363|S9363 - HIT ANTI-SPASMOTIC DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9361|S9361 - HIT DIURETIC INFUS DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9359|S9359 - HIT ANTI-TNF PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9357|S9357 - HIT ENZYME REPLACE DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9355|S9355 - HIT CHELATION DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9353|S9353 - HIT CONT INSULIN DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9351|S9351 - HIT CONT ANTIEMETIC DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9349|S9349 - HIT TOCOLYSIS DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9348|S9348 - HIT SYMPATHOMIM DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9347|S9347 - HIT LONGTERM INFUSION DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9346|S9346 - HIT ALPHA-1-PROTEINAS DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9345|S9345 - HIT ANTI-HEMOPHIL DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9343|S9343 - HIT ENTERAL BOLUS NURS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9342|S9342 - HIT ENTERAL PUMP DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9341|S9341 - HIT ENTERAL GRAV DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9340|S9340 - HIT ENTERAL PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9339|S9339 - HIT PERITON DIALYSIS DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9338|S9338 - HIT IMMUNOTHERAPY DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9336|S9336 - HIT CONT ANTICOAG DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9335|S9335 - HT HEMODIALYSIS DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9331|S9331 - HIT INTERMIT CHEMO DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9330|S9330 - HIT CONT CHEM DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9329|S9329 - HIT CHEMO PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9328|S9328 - HIT PAIN IMP PUMP DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9327|S9327 - HIT INT PAIN PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9326|S9326 - HIT CONT PAIN PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9325|S9325 - HIT PAIN MGMT PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9214|S9214 - HM GEST DM PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9213|S9213 - HM PREECLAMP PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9212|S9212 - HM POSTPAR HYPER PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9211|S9211 - HOME MGMT GEST HYPERTENSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9209|S9209 - HOME MGMT PPROM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9208|S9208 - HOME MGMT PRETERM LABOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9152|S9152 - SPEECH THERAPY -  RE-EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9150|S9150 - EVALUATION BY OCULARIST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9145|S9145 - INSULIN PUMP INITIATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9141|S9141 - DIABETIC MANAGEMENT PROGRAM - ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9140|S9140 - DIABETIC MANAGEMENT PROGRAM - ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9131|S9131 - PT IN THE HOME PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9129|S9129 - OCCUPATIONAL THERAPY -  IN THE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9128|S9128 - SPEECH THERAPY -  IN THE HOME - ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9127|S9127 - SOCIAL WORK VISIT -  IN THE HO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9126|S9126 - HOSPICE CARE -  IN THE HOME -  P||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9125|S9125 - RESPITE CARE -  IN THE HOME -  P||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9124|S9124 - NURSING CARE -  IN THE HOME; B||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9123|S9123 - NURSING CARE IN HOME RN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9122|S9122 - HOME HEALTH AIDE OR CERTIFIE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9117|S9117 - BACK SCHOOL VISIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9109|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9098|S9098 - HOME PHOTOTHERAPY VISIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9097|S9097 - HOME VISIT WOUND CARE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9090|S9090 - VERTEBRAL AXIAL DECOMPRESSIO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9088|S9088 - SERVICES PROVIDED IN URGENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9083|S9083 - URGENT CARE CENTER GLOBAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9061|S9061 - MEDICAL SUPPLIES AND EQUIPME||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9056|S9056 - COMA STIMULATION PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9055|S9055 - PROCUREN OR OTHER GROWTH FAC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9034|S9034 - ESWL FOR GALLSTONES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9025|S9025 - OMNICARDIOGRAM/CARDIOINTEGRA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9024|S9024 - PARANASAL SINUS ULTRASOUND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9015|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9007|S9007 - ULTRAFILTRATION MONITOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S9001|S9001 - HOME UTERINE MONITOR WITH OR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8999|S8999 - RESUSCITATION BAG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8990|S8990 - PT OR MANIP FOR MAINT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8950|S8950 - COMPLEX LYMPHEDEMA THERAPY - ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8948|S8948 - LOW-LEVEL LASER TRMT 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8940|S8940 - HIPPOTHERAPY PER SESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8490|S8490 - 100 INSULIN SYRINGES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8460|S8460 - CAMISOLE POST-MAST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8452|S8452 - SPLINT ELBOW||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8451|S8451 - SPLINT WRIST OR ANKLE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8450|S8450 - SPLINT DIGIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8431|S8431 - COMPRESSION BANDAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8430|S8430 - PADDING FOR COMPRSSN BDG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8429|S8429 - GRADIENT PRESSURE WRAP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8428|S8428 - READY GRADIENT GAUNTLET||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8427|S8427 - READY GRADIENT GLOVE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8426|S8426 - CUSTOM GRAD GLOVE HEAVY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8425|S8425 - CUSTOM GRAD GLOVE MED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8424|S8424 - READY GRADIENT SLEEVE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8423|S8423 - CUSTOM GRAD SLEEVE HEAVY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8422|S8422 - CUSTOM GRAD SLEEVE MED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8421|S8421 - READY GRADIENT SLEEV/GLOV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8420|S8420 - CUSTOM GRADIENT SLEEV/GLOV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8415|S8415 - SUPPLIES FOR HOME DELIVERY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8301|S8301 - INFECT CONTROL SUPPLIES NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8270|S8270 - ENURESIS ALARM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8265|S8265 - HABERMAN FEEDER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8262|S8262 - MANDIBULAR ORTHOPEDIC REPOSITIONING DEVICE -  EACH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8210|S8210 - MUCUS TRAP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8189|S8189 - TRACH SUPPLY NOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8186|S8186 - SWIVEL ADAPTOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8185|S8185 - FLUTTER DEVICE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8131|S8131 - INTERFERENTIAL STIM 4 CHAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8130|S8130 - INTERFERENTIAL STIM 2 CHAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8121|S8121 - O2 CONTENTS LIQUID LB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8120|S8120 - O2 CONTENTS GAS CUBIC FT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8110|S8110 - PEAK EXPIRATORY FLOW RATE (P||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8101|S8101 - SPACER WITH MASK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8100|S8100 - SPACER WITHOUT MASK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8097|S8097 - ASTHMA KIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8096|S8096 - PORTABLE PEAK FLOW METER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8092|S8092 - ELECTRON BEAM COMPUTED TOMOG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8085|S8085 - FLUORINE-18 FLUORODEOXYGLUCO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8080|S8080 - SCINTIMAMMOGRAPHY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8055|S8055 - US GUIDANCE FETAL REDUCT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8049|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8042|S8042 - MRI LOW FIELD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8040|S8040 - TOPOGRAPHIC BRAIN MAPPING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8037|S8037 - MRCP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8035|S8035 - MAGNETIC SOURCE IMAGING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S8030|S8030 - TANTALUM RING APPLICATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5571|S5571 - INSULIN DISPOS PEN 3 ML||66.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5570|S5570 - INSULIN DISPOS PEN 1.5 ML||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5566|S5566 - INSULIN CARTRIDGE 300 U||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5565|S5565 - INSULIN CARTRIDGE 150 U||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5561|S5561 - INSULIN REUSE PEN 3 ML||75.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5560|S5560 - INSULIN REUSE PEN 1.5 ML||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5553|S5553 - INSULIN LONG ACTING 5 U||1.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5552|S5552 - INSULIN INTERMED 5 U||0.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5551|S5551 - INSULIN MOST RAPID 5 U||1.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5550|S5550 - INSULIN RAPID 5 U||0.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5523|S5523 - HIP MIDLINE CATH INSERT KIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5522|S5522 - HIT PICC INSERT NO SUPP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5521|S5521 - HIT MIDLINE CATH INSERT KIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5520|S5520 - HIT PICC INSERT KIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5518|S5518 - HIT CATH REPAIR KIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5517|S5517 - HIT DECLOTTING KIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5502|S5502 - HIT INTERIM CATH CARE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5501|S5501 - HIT COMPLEX CATH CARE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5498|S5498 - HIT SIMPLE CATH CARE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5497|S5497 - HIT CATH CARE NOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5199|S5199 - PERSONAL CARE ITEM NOS EACH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5190|S5190 - WELLNESS ASSESSMENT BY NONPH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5185|S5185 - MED REMINDER SERV PER MONTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5181|S5181 - HH RESPIRATORY THRPY NOS/DAY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5180|S5180 - HH RESPIRATORY THRPY IN EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5175|S5175 - LAUNDRY SERV - EXT - PROF - /ORDER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5170|S5170 - HOMEDELIVERED PREPARED MEAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5165|S5165 - HOME MODIFICATIONS PER SERV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5162|S5162 - EMER RSPNS SYSTEM PURCHASE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5161|S5161 - EMER RSPNS SYS SERV PERMONTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5160|S5160 - EMER RESPONSE SYS INSTAL&TST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5151|S5151 - UNSKILLED RESPITECARE /DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5150|S5150 - UNSKILLED RESPITE CARE /15M||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5146|S5146 - THER FOSTERCARE CHILD /MONTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5145|S5145 - CHILD FOSTERCARE TH PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5141|S5141 - ADULT FOSTER CARE PER MONTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5140|S5140 - ADULT FOSTER CARE PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5136|S5136 - ADULT COMPANIONCARE PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5135|S5135 - ADULT COMPANIONCARE PER 15M||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5131|S5131 - HOMEMAKER SERVICE NOS /DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5130|S5130 - HOMAKER SERVICE NOS PER 15M||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5126|S5126 - ATTENDANT CARE SERVICE /DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5125|S5125 - ATTENDANT CARE SERVICE /15M||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5121|S5121 - CHORE SERVICES PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5120|S5120 - CHORE SERVICES PER 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5116|S5116 - NONFAMILY HC TRAIN/SESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5115|S5115 - NONFAMILY HOMECARE TRAIN/15M||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5111|S5111 - FAMILY HOMECARE TRAIN/SESSIO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5110|S5110 - FAMILY HOMECARE TRAINING 15M||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5109|S5109 - HOMECARE TRAIN PT SESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5108|S5108 - HOMECARE TRAIN PT 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5105|S5105 - CENTERBASED DAY CARE PERDIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5102|S5102 - ADULT DAY CARE PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5101|S5101 - ADULT DAY CARE PER HALF DAY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5100|S5100 - ADULT DAYCARE SERVICES 15MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5036|S5036 - HIT DEVICE REPAIR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5035|S5035 - HIT ROUTINE DEVICE MAINT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5014|S5014 - D5W/0.45NS W KCL AND MGS04||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5013|S5013 - 5%DEXTROSE/0.45%SALINE1000ML||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5012|S5012 - 5% DEXTROSE WITH POTASSIUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5011|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5010|S5010 - 5% DEXTROSE AND 0.45% SALINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5001|S5001 - PRESCRIPTION DRUG - BRAND NAME||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S5000|S5000 - PRESCRIPTION DRUG -  GENERIC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4995|S4995 - SMOKING CESSATION GUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4993|S4993 - CONTRACEPTIVE PILLS FOR BC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4991|S4991 - NICOTINE PATCH NONLEGEND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4990|S4990 - NICOTINE PATCH LEGEND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4989|S4989 - CONTRACEPT IUD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4981|S4981 - INSERT LEVONORGESTREL IUS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4042|S4042 - OVULATION MGMT PER CYCLE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4040|S4040 - MONIT STORE CRYO EMBRYO 30 D||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4037|S4037 - CRYO EMBRYO TRANSF CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4035|S4035 - STIMULATED IUI CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4031|S4031 - SPERM PROCURE SUBS VISIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4030|S4030 - SPERM PROCURE INIT VISIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4028|S4028 - MICROSURG EPI SPERM ASP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4027|S4027 - STORE PREV FROZ EMBRYOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4026|S4026 - PROCURE DONOR SPERM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4025|S4025 - DONOR SERV IVF CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4023|S4023 - INCOMPL DONOR EGG CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4022|S4022 - ASST OOCYTE FERT CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4021|S4021 - IVF CANC P ASPIR CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4020|S4020 - IVF CANC A ASPIR CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4018|S4018 - F EMB TRNS CANC CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4017|S4017 - IVF CANC A STIM CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4016|S4016 - FROZEN IVF CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4015|S4015 - COMPLETE IVF NOS CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4014|S4014 - COMPL ZIFT CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4013|S4013 - COMPL GIFT CASE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4011|S4011 - IVF PACKAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S4005|S4005 - INTERIM LABOR FACILITY GLOBA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3904|S3904 - MASTERS TWO STEP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3902|S3902 - BALLISTOCARDIOGRAM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3900|S3900 - SURFACE EMG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3890|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3870|S3870 - CGH TEST DEVELOPMENTAL DELAY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3866|S3866 - SPEC GENE TEST HYP CARDIOMY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3865|S3865 - COMP GENET TEST HYP CARDIOMY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3862|S3862 - GENETC TEST FAM SPC ION CHNL TEST POSIT CARDI ION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3861|S3861 - GENETIC TEST BRUGADA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3860|S3860 - GENETC TEST COMP CARDIAC ION FAMLIL LONG QT SYND O||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3855|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3854|S3854 - GENE PROFILE PANEL BREAST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3853|S3853 - GENE TEST MYO MUSCLR DYST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3852|S3852 - DNA ANALYSIS APOE ALZHEIMER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3851|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3850|S3850 - GENE TEST SICKLE CELL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3849|S3849 - GENE TEST NIEMANN-PICK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3848|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3847|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3846|S3846 - GENE TEST BETA-THALASSEMIA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3845|S3845 - GENE TEST ALPHA-THALASSEMIA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3844|S3844 - DNA ANALYSIS DEAFNESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3843|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3842|S3842 - GENE TEST HIPPEL-LINDAU||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3841|S3841 - GENE TEST RETINOBLASTOMA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3840|S3840 - DNA ANALYSIS RET-ONCOGENE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3837|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3835|S3835 - COMP GENE SEQ ANAL CYST FIBROSIS GENE TEST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3834|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3833|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3831|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3830|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3829|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3828|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3823|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3822|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3820|S3820 - COMP GENE SEQ BRCA1/BRCA2||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3819|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3818|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3800|S3800 - GENETIC TESTING ALS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3722|S3722 - DOSE OPTIMIZATION AUC - 5FU||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3713|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3711|S3711 - CIRCULATING TUMOR CELL TEST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3708|S3708 - GASTROINTESTINAL FAT ABSORPT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3655|S3655 - ANTISPERM ANTIBODIES TEST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3652|S3652 - SALIVA TEST -  HORMONE LEVEL;||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3650|S3650 - SALIVA TEST -  HORMONE LEVEL;||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3645|S3645 - HIV-1 ANTIBODY TESTING OF OR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3630|S3630 - EOSINOPHIL BLOOD COUNT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3626|S3626 - MATERNAL SERUM QUAD MARKER SCR INC ALPHA-FETOPROTE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3625|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3620|S3620 - NEWBORN METABOLIC SCREENING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3601|S3601 - STAT LAB HOME/NF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3600|S3600 - STAT LAB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3005|S3005 - EVAL SELF-ASSESS DEPRESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S3000|S3000 - BILAT DIL RETINAL EXAM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2900|S2900 - ROBOTIC SURGICAL SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2411|S2411 - FETOSCOP LASER THER TTTS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2409|S2409 - FETAL SURG NOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2405|S2405 - FETAL SURG SACROCOC TERATOMA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2404|S2404 - FETAL SURG MYELOMENINGO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2403|S2403 - FETAL SURG PULMON SEQUEST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2402|S2402 - FETAL SURG CONG CYST MALF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2401|S2401 - FETAL SURG URIN TRAC OBSTR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2400|S2400 - FETAL SURG CONGEN HERNIA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2361|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2360|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2351|S2351 - DISKECTOMY -  ANTERIOR -  WITH D||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2350|S2350 - DISKECTOMY -  ANTERIOR -  WITH D||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2348|S2348 - DECOMPRESS DISC RF LUMBAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2342|S2342 - NASAL ENDOSCOP PO DEBRID||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2341|S2341 - CHEMODENERV ADDUCT VOCAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2340|S2340 - CHEMODENERVATION OF ABDUCTOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2325|S2325 - HIP CORE DECOMPRESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2300|S2300 - ARTHROSCOPY -  SHOULDER -  SURGI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2267|S2267 - INDUCED ABORTION 32 OR MORE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2266|S2266 - INDUCED ABORTION 29-31 WKS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2265|S2265 - INDUCED ABORTION 25-28 WKS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2260|S2260 - INDUCED ABORTION 17-24 WEEKS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2235|S2235 - IMPLANT AUDITORY BRAIN IMP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2230|S2230 - IMPLANT SEMI-IMP HEAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2225|S2225 - MYRINGOTOMY LASER-ASSIST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2209|S2209 - MINIMALLY INVASIVE DIRECT CO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2208|S2208 - MINIMALLY INVASIVE DIRECT CO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2207|S2207 - MINIMALLY INVASIVE DIRECT CO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2206|S2206 - MINIMALLY INVASIVE DIRECT CO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2205|S2205 - MINIMALLY INVASIVE DIRECT CO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2202|S2202 - ECHOSCLEROTHERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2152|S2152 - SOLID ORGAN TRANSPL PKG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2150|S2150 - BMT HARV/TRANSPL 28D PKG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2142|S2142 - CORD BLOOD-DERIVED STEM-CELL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2140|S2140 - CORD BLOOD HARVESTING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2120|S2120 - LOW DENSITY LIPOPROTEIN(LDL)||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2118|S2118 - TOTAL HIP RESURFACING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2117|S2117 - ARTHROEREISIS -  SUBTALAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2115|S2115 - PERIACETABULAR OSTEOTOMY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2112|S2112 - KNEE ARTHROSCP HARV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2107|S2107 - ADOPTIVE IMMUNOTHERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2103|S2103 - ADRENAL TISSUE TRANSPLANT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2102|S2102 - ISLET CELL TISSUE TRANSPLANT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2095|S2095 - TRANSCATH EMBOLIZ MICROSPHER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2083|S2083 - ADJUSTMENT GASTRIC BAND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2080|S2080 - LAUP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2079|S2079 - LAP ESOPHAGOMYOTOMY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2070|S2070 - CYSTO LASER TX URETERAL CALC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2068|S2068 - BREAST DIEP OR SIEA FLAP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2067|S2067 - BREAST 'STACKED' DIEP/GAP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2066|S2066 - BREAST GAP FLAP RECONST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2065|S2065 - SIMULT PANC KIDN TRANS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2061|S2061 - DONOR LOBECTOMY (LUNG)||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2060|S2060 - LOBAR LUNG TRANSPLANTATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2055|S2055 - HARVESTING OF DONOR MULTIVIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2054|S2054 - TRANSPLANTATION OF MULTIVISC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S2053|S2053 - TRANSPLANTATION OF SMALL INT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S1040|S1040 - CRANIAL REMOLDING ORTHOSIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S1031|S1031 - GLUC MONITOR RENTAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S1030|S1030 - GLUC MONITOR PURCHASE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S1016|S1016 - NON-PVC INTRAVENOUS ADMINIST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S1015|S1015 - IV TUBING EXTENSION SET||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S1002|S1002 - CUSTOM ITEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S1001|S1001 - DELUXE ITEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0812|S0812 - PHOTOTHERAP KERATECT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0810|S0810 - PHOTOREFRACTIVE KERATECTOMY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0800|S0800 - LASER IN SITU KERATOMILEUSIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0630|S0630 - REMOVAL OF SUTURES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0625|S0625 - RETINAL TELESCREENING BY DIGITAL IMAGING OF MULT D||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0622|S0622 - PHYS EXAM FOR COLLEGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0621|S0621 - ROUTINE OPHTHALMOLOGICAL EXA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0620|S0620 - ROUTINE OPHTHALMOLOGICAL EXA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0618|S0618 - AUDIOMETRY FOR HEARING AID||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0613|S0613 - ANN BREAST EXAM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0612|S0612 - ANNUAL GYNECOLOGICAL EXAMINA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0610|S0610 - ANNUAL GYNECOLOGICAL EXAMINA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0601|S0601 - SCREENING PROCTOSCOPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0595|S0595 - NEW LENSES IN PTS OLD FRAME||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0592|S0592 - COMP CONT LENS EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0590|S0590 - MISC INTEGRAL LENS SERV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0581|S0581 - NONSTND LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0580|S0580 - POLYCARB LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0518|S0518 - SUNGLASS FRAMES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0516|S0516 - SAFETY FRAMES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0515|S0515 - SCLERAL LENS LIQUID BANDAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0514|S0514 - COLOR CONT LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0512|S0512 - DAILY CONT LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0510|S0510 - NON-PRSCRP LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0508|S0508 - TRIFOC PRSCRP LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0506|S0506 - BIFOC PRSCP LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0504|S0504 - SINGL PRSCRP LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0500|S0500 - DISPOS CONT LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0400|S0400 - GLOBAL ESWL KIDNEY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0395|S0395 - IMPRESSION CASTING FT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0390|S0390 - ROUT FOOT CARE PER VISIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0342|S0342 - LIFESTYLE MOD 4TH STAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0341|S0341 - LIFESTYLE MOD 2 OR 3 STAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0340|S0340 - LIFESTYLE MOD 1ST STAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0320|S0320 - RN TELEPHONE CALLS TO DMP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0317|S0317 - DISEASE MGMT PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0316|S0316 - FOLLOW-UP/REASSESSMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0315|S0315 - DISEASE MANAGEMENT PROGRAM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0310|S0310 - HOSPITALIST VISIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0302|S0302 - COMPLETED EPSDT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0281|S0281 - MEDICAL HOME -  MAINTENANCE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0280|S0280 - MEDICAL HOME -  INITIAL PLAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0274|S0274 - NURSE PRACTR VISIT OUTS CAP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0273|S0273 - MD HOME VISIT OUTSIDE CAP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0272|S0272 - HOME EPISODIC CASE 30 DAYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0271|S0271 - HOME HOSPICE CASE 30 DAYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0270|S0270 - HOME STD CASE RATE 30 DAYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0265|S0265 - GENETIC COUNSEL 15 MINS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0260|S0260 - H&P FOR SURGERY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0257|S0257 - END OF LIFE COUNSELING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0255|S0255 - HOSPICE REFER VISIT NONMD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0250|S0250 - COMP GERIATR ASSMT TEAM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0221|S0221 - MEDICAL CONFERENCE -  60 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0220|S0220 - MEDICAL CONFERENCE BY PHYSIC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0215|S0215 - NONEMERG TRANSP MILEAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0209|S0209 - WC VAN MILEAGE PER MI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0208|S0208 - PARAMED INTRCEPT NONVOL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0207|S0207 - PARAMEDICINTERCEP NONHOSPALS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0201|S0201 - PARTIAL HOSPITALIZATION SERV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0199|S0199 - MED ABORTION INC ALL EX DRUG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0197|S0197 - PRENATAL VITAMINS 30 DAY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0195|||95.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0194|S0194 - VITAMIN SUPPL 100 CAPS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0191|S0191 - MISOPROSTOL -  ORAL -  200 MCG||2.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0190|S0190 - MIFEPRISTONE -  ORAL -  200 MG||78.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0189|S0189 - TESTOSTERONE PELLET 75 MG||120.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0187|S0187 - TAMOXIFEN 10 MG||2.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0183|S0183 - PROCHLORPERAZINE 5 MG||0.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0182|S0182 - PROCARBAZINE -  ORAL||49.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0179|S0179 - MEGESTROL 20 MG||0.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0178|S0178 - LOMUSTINE 10 MG||24.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0177|S0177 - LEVAMISOLE 50 MG||4.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0176|S0176 - HYDROXYUREA 500 MG||1.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0175|S0175 - FLUTAMIDE 125 MG||2.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0174|S0174 - DOLASETRON 50 MG||50.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0172|S0172 - CHLORAMBUCIL 2 MG||2.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0171|S0171 - BUMETANIDE 0.5 MG||1.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0170|S0170 - ANASTROZOLE 1 MG||7.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0169|S0169 - CALCITROL||1.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0166|S0166 - INJ OLANZAPINE 2.5MG||5.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0164|S0164 - INJECTION PANTROPRAZOLE||12.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0160|S0160 - DEXTROAMPHETAMINE||0.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0157|S0157 - BECAPLERMIN GEL 1% -  0.5 GM||16.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0156|S0156 - EXEMESTANE -  25 MG||8.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0155|S0155 - EPOPROSTENOL DILUTANT||16.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0148|S0148 - PEG INTERFERON ALFA-2B/10||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0145|S0145 - PEG INTERFERON ALFA-2A/180||962.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0142|S0142 - COLISTIMETHATE INH SOL MG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0140|S0140 - SAQUINAVIR -  200 MG||1.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0139|S0139 - MINOXIDIL -  10 MG||0.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0138|S0138 - FINASTERIDE -  5 MG||2.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0137|S0137 - DIDANOSINE -  25 MG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0136|S0136 - CLOZAPINE -  25 MG||1.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0132|S0132 - INJ GANIRELIX ACETAT 250 MCG||101.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0128|S0128 - INJ FOLLITROPIN BETA 75 IU||73.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0126|S0126 - INJ FOLLITROPIN ALFA 75 IU||77.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0122|S0122 - INJ MENOTROPINS 75 IU||67.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0119|S0119 - ONDANSETRON 4 MG||19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0117|S0117 - TRETINOIN TOPICAL 5 G||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0109|S0109 - METHADONE ORAL 5MG||0.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0108|S0108 - MERCAPTOPURINE 50 MG||3.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0106|S0106 - BUPROPION HCL SR 60 TABLETS||105.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0104|S0104 - ZIDOVUDINE -  ORAL -  100 MG||1.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0093|S0093 - MORPHINE 500 MG||229.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0092|S0092 - HYDROMORPHONE 250 MG||99.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0091|S0091 - GRANISETRON 1MG||78.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0090|S0090 - SILDENAFIL CITRATE -  25 MG||16.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0088|S0088 - IMATINIB 100 MG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0081|S0081 - INJECTION -  PIPERACILLIN SODI||1.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0080|S0080 - INJECTION -  PENTAMIDINE ISETH||66.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0078|S0078 - INJECTION -  FOSPHENYTOIN SODI||169.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0077|S0077 - INJECTION -  CLINDAMYCIN PHOSP||3.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0074|S0074 - INJECTION -  CEFOTETAN DISODIU||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0073|S0073 - INJECTION -  AZTREONAM -  500 MG||17.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0040|S0040 - INJECTION -  TICARCILLIN DISOD||13.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0039|S0039 - INJECTION -  SULFAMETHOXAZOLE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0034|S0034 - INJECTION -  OFLOXACIN -  400 MG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0032|S0032 - INJECTION -  NAFCILLIN SODIUM||21.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0030|S0030 - INJECTION -  METRONIDAZOLE||9.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0028|S0028 - INJECTION -  FAMOTIDINE -  20 MG||2.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0023|S0023 - INJECTION -  CIMETIDINE HYDROC||2.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0021|S0021 - INJECTION -  CEFOPERAZONE SOD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0020|S0020 - INJECTION -  BUPIVICAINE HYDRO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0017|S0017 - INJECTION -  AMINOCAPROIC ACID||6.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0014|S0014 - TACRINE HYDROCHLORIDE -  10 MG||2.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|S0012|S0012 - BUTORPHANOL TARTRATE -  NASAL||73.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9995|Q9995 - INJ. -  EMICIZUMAB-KXWH 0.5 MG||61.845|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|Q9993|Q9993 - INJ. -  TRIAMCINOLONE EXT REL||23.6013|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|Q9992|Q9992 - INJ -  BUPRENORPHINE XR OVER 100 MG||2093.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9991|Q9991 - INJ - BUPRENORPHINE XR 100 MG OR LESS||2093.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9989|Q9989 - USTEKINUMAB -  IV INJECT - 1 MG||16.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9975|||2.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9974|Q9974 - INJECTION - MORPHINE SULFATE - 10MG||12.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9970|Q9970 - INJECTION FERRIC CARBOXYMAL 1MG||1.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9967|Q9967 - LOCM 300-399MG/ML IODINE - 1ML||0.1388|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9966|Q9966 - LOCM 200-299MG/ML IODINE - 1ML||0.3937|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9965|Q9965 - LOCM 100-199MG/ML IODINE - 1ML||1.2112|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9963|Q9963 - HOCM 350-399MG/ML IODINE - 1ML||0.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9961|Q9961 - HOCM 250-299MG/ML IODINE - 1ML||0.3325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9960|Q9960 - HOCM 200-249MG/ML IODINE - 1ML||0.3013|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9958|Q9958 - HOCM <=149 MG/ML IODINE -  1ML||0.0838|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9957|Q9957 - INJ PERFLUTREN LIP MICROS - ML||60.7862|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9956|Q9956 - INJ OCTAFLUOROPROPANE MIC - ML||40.5237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9954|Q9954 - ORAL MR CONTRAST -  100 ML||11.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9953|Q9953 - INJ FE-BASED MR CONTRAST - 1ML||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q9950|Q9950 - INJ SULF HEXA LIPID MICROSPH||24.6687|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q5106|Q5106 - INJ RETACRIT NON-ESRD USE 1000 UN||12.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q5105|Q5105 - INJ RETACRIT ESRD ON DIALYSI 100 UN||1.273|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q5104|Q5104 - INJECTION -  RENFLEXIS -  10 MG||68.3113|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q5103|Q5103 - INJECTION -  INFLECTRA -  10 MG||64.155|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q5102|Q5102 - INJ. -  INFLIXIMAB BIOSIMILAR||100.24|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|Q5101|Q5101 - INJECTION -  ZARXIO -  1 MCG||0.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4172|Q4172 - PURAPLY OR PURAPLY AM||109.5825|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|Q4133|Q4133 - GRAFIX STRAVIX PRIME PL SQCM||200.1712|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4132|Q4132 - GRAFIX CORE -  GRAFIXPL CORE||164.2825|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4131|Q4131 - EPIFIX OR EPICORD||200.78|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|Q4123|Q4123 - ALLOSKIN||39.5187|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4121|Q4121 - THERASKIN||52.4525|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4116|Q4116 - ALLODERM||39.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4115|Q4115 - ALLOSKIN||11.375|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4114|Q4114 - INTEGRA FLOWABLE WOUND MATRI||1890.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4113|Q4113 - GRAFTJACKET XPRESS||1090.0975|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4112|Q4112 - CYMETRA INJECTABLE||1090.0975|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4111|Q4111 - GAMMAGRAFT||9.2212|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4110|Q4110 - PRIMATRIX||60.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4108|Q4108 - INTEGRA MATRIX||45.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4107|Q4107 - GRAFTJACKET||119.6513|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4106|Q4106 - DERMAGRAFT||40.9363|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4105|Q4105 - INTEGRA DRT OR OMNIGRAFT||37.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4104|Q4104 - INTEGRA BMWD||48.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4103|Q4103 - OASIS BURN MATRIX||9.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4102|Q4102 - OASIS WOUND MATRIX||14.9062|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4101|Q4101 - APLIGRAF||38.505|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4081|Q4081 - EPOETIN ALFA -  100 UNITS ESRD||1.4325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4074|Q4074 - ILOPROST NON-COMP UNIT DOSE||177.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4038|Q4038 - CAST SUP SHRT LEG FIBERGLASS||120.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4032|Q4032 - CAST SUP LNG LEG PED FBRGLS||52.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4030|Q4030 - CAST SUP LONG LEG FIBERGLASS||104.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q4010|Q4010 - CAST SUP SHT ARM ADULT FBRGL||58.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q3027|Q3027 - INJ BETA INTERFERON IM 1 MCG||67.3663|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q3025|Q3025 - INJECTION INTRFER BETA-1A 11 MCG IM USE||338.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2050|Q2050 - DOXORUBICIN INJ 10MG||436.6225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2049|Q2049 - IMPORTED LIPODOX INJ||635.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2048|||671.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2047|Q2047 - INJECTION -  PEGINESATIDE 0.1MG FOR ESRD ON DIALYSIS||14.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2046|||1225.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2043|Q2043 - SIPULEUCEL-T AUTO CD54+||55030.7463|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2038|Q2038 - FLUZONE VACC -  3 YRS & > -  IM||15.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2037|Q2037 - FLUVIRIN VACC -  3 YRS & > -  IM||22.1062|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2036|Q2036 - FLULAVAL VACC -  3 YRS & > -  IM||10.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2035|Q2035 - AFLURIA VACC -  3 YRS & > -  IM||22.795|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2017|Q2017 - TENIPOSIDE -  50 MG||401.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q2009|Q2009 - FOSPHENYTOIN INJ PE||0.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0515|Q0515 - SERMORELIN ACETATE INJECTION||2.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0506|Q0506 - LITH-ION BATT ELEC/PNEUM VAD||996.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0504|Q0504 - PWR ADPT PNEUM VAD -  REP VEH||800.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0503|Q0503 - BATTERY PNEUM VAD REPLACEMNT||1516.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0502|Q0502 - MOBILITY CART PNEUM VAD -  REP||758.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0501|Q0501 - SHWR COV ELEC/COMBO VAD -  REP||595.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0500|Q0500 - FILTERS ELEC/COMBO VAD -  REP||35.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0499|Q0499 - BELT/VEST ELEC/COMBO VAD REP||194.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0498|Q0498 - HOLSTER ELEC/COMBO VAD -  REP||599.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0497|Q0497 - BAT CLPS ELEC/COMB VAD -  REP||546.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0496|Q0496 - BATTERY ELEC/COMBO VAD -  REP||1748.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0495|Q0495 - CHARGER ELEC/COMBO VAD -  REP||4872.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0494|Q0494 - EMR HD PMP ELEC/COMBO -  REP||250.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0493|Q0493 - EMR PWR CBL COMBO VAD -  REP||295.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0492|Q0492 - EMR PWR CBL ELEC VAD -  REP||103.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0491|Q0491 - EMR PWR SOURCE COMBO VAD REP||1289.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0490|Q0490 - EMR PWR SOURCE ELEC VAD -  REP||820.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0489|Q0489 - PWR PCK BASE COMBO VAD -  REP||18959.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0487|Q0487 - LEADS ANY TYPE VAD -  REP ONLY||398.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0486|Q0486 - MON CABLE ELEC/PNEUM VAD REP||341.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0485|Q0485 - MONITOR CABLE ELEC VAD -  REP||410.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0484|Q0484 - MONITOR ELEC OR COMB VAD REP||4246.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0483|Q0483 - MONITOR ELEC VAD -  REP||21868.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0482|Q0482 - MICROPRCSR CU COMBO VAD -  REP||5308.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0481|Q0481 - MICROPRCSR CU ELEC VAD -  REP||16948.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0480|Q0480 - DRIVER PNEUMATIC VAD -  REP||105049.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0479|Q0479 - POWER MODULE COMBO VAD -  REP||14087.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0478|Q0478 - POWER ADAPTER -  COMBO VAD||214.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0180|Q0180 - DOLASETRON MESYLATE ORAL||119.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0170|Q0170 - PROMETHAZINE HCL 25 MG ORAL NOT >48 HR DOSE||0.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0169|Q0169 - PROMETHAZINE HCL 12.5MG ORAL||0.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0168|Q0168 - DRONABINOL 5 MG ORAL NOT>48 HR DOSE REGIMEN||11.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0167|Q0167 - DRONABINOL 2.5MG ORAL||0.9425|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0166|Q0166 - GRANISETRON HCL 1 MG ORAL||3.7575|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0165|Q0165 - PROCHLORPERAZINE MALEATE 10 MG ORL NOT>48HR DOSE||0.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0164|Q0164 - PROCHLORPERAZINE MALEATE 5MG||0.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0163|Q0163 - DIPHENHYDRAMINE HCL 50MG||0.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0162|Q0162 - ONDANSETRON ORAL||0.0338|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0139|Q0139 - FERUMOXYTOL -  ESRD USE||1.2463|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0138|Q0138 - FERUMOXYTOL -  NON-ESRD||1.2463|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0115|Q0115 - POST-COITAL MUCOUS EXAM||17.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0114|Q0114 - FERN TEST||12.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0113|Q0113 - PINWORM EXAMINATIONS||9.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0112|Q0112 - POTASSIUM HYDROXIDE PREPS||7.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0111|Q0111 - WET MOUNTS/ W PREPARATIONS||7.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0091|Q0091 - OBTAINING SCREEN PAP SMEAR||51.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|Q0035|Q0035 - CARDIOKYMOGRAPHY||21.4|13.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P9615|P9615 - URINE SPECIMEN COLLECT MULT||3.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P9612|P9612 - CATHETERIZE FOR URINE SPEC||3.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P9048|P9048 - PLASMAPROTEIN FRACT - 5% - 250ML||52.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P9047|P9047 - ALBUMIN (HUMAN) -  25% -  50ML||65.5625|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P9046|P9046 - ALBUMIN (HUMAN) -  25% -  20 ML||26.225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P9045|P9045 - ALBUMIN (HUMAN) -  5% -  250 ML||65.5625|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P9043|P9043 - PLASMA PROTEIN FRACT - 5% - 50ML||10.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P9041|P9041 - ALBUMIN (HUMAN) - 5% -  50ML||13.1125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P3001|P3001 - SCREENING PAP SMEAR BY PHYS||34.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P3000|P3000 - SCREEN PAP BY TECH W MD SUPV||18.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|P2038|P2038 - BLOOD MUCOPROTEIN||8.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8695|L8695 - EXTERNAL RECHARG SYS EXTERN||19.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8693|L8693 - AUD OSSEO DEV -  ABUTMENT||1768.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8691|L8691 - AOI SND PROC REPL EXCL ACTUA||3110.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8690|L8690 - AUD OSSEO DEV -  INT/EXT COMP||5548.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8689|L8689 - EXTERNAL RECHARG SYS INTERN||2011.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8688|L8688 - IMPLT NROSTM PLS GEN DUA NON||12665.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8687|L8687 - IMPLT NROSTM PLS GEN DUA REC||19849.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8686|L8686 - IMPLT NROSTM PLS GEN SNG NON||9732.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8685|L8685 - IMPLT NROSTM PLS GEN SNG REC||15252.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8684|L8684 - RADIOF TRSMTR IMPLT SCRL NEU||803.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8683|L8683 - RADIOFQ TRSMTR FOR IMPLT NEU||6120.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8682|L8682 - IMPLT NEUROSTIM RADIOFQ REC||6953.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8681|L8681 - PT PRGRM FOR IMPLT NEUROSTIM||1317.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8680|L8680 - IMPLT NEUROSTIM ELCTR EACH||535.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8670|L8670 - VASCULAR GRAFT -  SYNTHETIC||642.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8659|L8659 - INTERPHALANGEAL JOINT REPL||2250.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8658|L8658 - INTERPHALANGEAL JOINT SPACER||361.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8642|L8642 - HALLUX IMPLANT||346.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8641|L8641 - METATARSAL JOINT IMPLANT||421.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8631|L8631 - MCP JOINT REPL 2 PC OR MORE||2607.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8630|L8630 - METACARPOPHALANGEAL IMPLANT||388.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8629|L8629 - CID TRANSMIT COIL AND CABLE||208.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8628|L8628 - CID EXT CONTROLLER REPL||1442.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8627|L8627 - CID EXT SPEECH PROCESS REPL||8029.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8624|L8624 - LITH ION BATT CID -  EAR LEVEL||188.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8623|L8623 - LITH ION BATT CID - NON-EARLVL||75.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8622|L8622 - REPL ALKALINE BATTERY||0.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8621|L8621 - REPL ZINC AIR BATTERY||0.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8619|L8619 - COCH IMP EXT PROC/CONTR RPLC||9472.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8618|L8618 - COCH IMPLANT TRAN CABLE REPL||30.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8617|L8617 - COCH IMPLANT TRANS COIL REPL||107.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8616|L8616 - COCH IMPLANT MICROPHONE REPL||122.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8615|L8615 - COCH IMPLANT HEADSET REPLACE||526.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8614|L8614 - COCHLEAR DEVICE||22081.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8613|L8613 - OSSICULAR IMPLANT||348.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8612|L8612 - AQUEOUS SHUNT PROSTHESIS||779.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8610|L8610 - OCULAR IMPLANT||738.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8609|L8609 - ARTIFICIAL CORNEA||7599.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8606|L8606 - SYNTHETIC IMPLNT URINARY 1ML||265.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8603|L8603 - COLLAGEN IMP URINARY 2.5 ML||505.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8600|L8600 - IMPLANT BREAST SILICONE/EQ||720.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8515|L8515 - GEL CAP APP DEVICE FOR TRACH||73.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8514|L8514 - REPL TRACH PUNCTURE DILATOR||110|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8513|L8513 - TRACH PROS CLEANING DEVICE||6.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8512|L8512 - GEL CAP FOR TRACH VOICE PROS||2.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8511|L8511 - INDWELLING TRACH INSERT||84.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8510|L8510 - VOICE AMPLIFIER||294.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8509|L8509 - TRACH-ESOPH VOICE PROS MD IN||127.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8507|L8507 - TRACH-ESOPH VOICE PROS PT IN||48.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8501|L8501 - TRACHEOSTOMY SPEAKING VALVE||169.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8500|L8500 - ARTIFICIAL LARYNX||761.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8485|L8485 - PROS SOCK SINGLE PLY UPPER L||12.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8480|L8480 - PROS SOCK SINGLE PLY AK||10.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8470|L8470 - PROS SOCK SINGLE PLY BK||7.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8465|L8465 - SHRINKER UPPER LIMB||75.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8460|L8460 - SHRINKER ABOVE KNEE||84.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8440|L8440 - SHRINKER BELOW KNEE||60.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8435|L8435 - PROS SOCK MULTI PLY UPPER LM||28.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8430|L8430 - PROSTHETIC SOCK MULTI PLY AK||31.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8420|L8420 - PROSTHETIC SOCK MULTI PLY BK||28.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8417|L8417 - PROS SHEATH/SOCK W GEL CUSHN||87.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8415|L8415 - SHEATH UPPER LIMB||24.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8410|L8410 - SHEATH ABOVE KNEE||24.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8400|L8400 - SHEATH BELOW KNEE||21.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8330|L8330 - TRUSS ADD TO STD PAD SCROTAL||74.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8320|L8320 - TRUSS ADDITION TO STD PAD WA||75.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8310|L8310 - TRUSS DOUBLE W/ STANDARD PAD||172.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8300|L8300 - TRUSS SINGLE W/ STANDARD PAD||112.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8047|L8047 - NASAL SEPTAL PROSTHESIS||626.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8046|L8046 - PARTIAL FACIAL PROSTHESIS||1221.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8045|L8045 - AURICULAR PROSTHESIS||1185.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8044|L8044 - HEMI-FACIAL PROSTHESIS||1893.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8043|L8043 - UPPER FACIAL PROSTHESIS||1710.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8042|L8042 - ORBITAL PROSTHESIS||1527.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8041|L8041 - MIDFACIAL PROSTHESIS||1359.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8040|L8040 - NASAL PROSTHESIS||1127.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8035|L8035 - CUSTOM BREAST PROSTHESIS||4273.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8032|L8032 - REUSABLE NIPPLE PROSTHESIS||45.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8031|L8031 - BREAST PROSTHESIS W ADHESIVE||380.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8030|L8030 - BREAST PROSTHES W/O ADHESIVE||380.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8020|L8020 - MASTECTOMY FORM||262.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8015|L8015 - EXT BREASTPROSTHESIS GARMENT||69.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8002|L8002 - BRST PRSTH BRA & BILAT FORM||192.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8001|L8001 - BREAST PROSTHESIS BRA & FORM||146.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L8000|L8000 - MASTECTOMY BRA||50.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7900|L7900 - MALE VACUUM ERECTION SYSTEM||631.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7405|L7405 - ADD UE PROST S/D ACRYLIC||847.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7404|L7404 - ADD UE PROST A/E ACRYLIC||648.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7403|L7403 - ADD UE PROST B/E ACRYLIC||429.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7402|L7402 - ADD UE PROST S/D ULTLITE MAT||432.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7401|L7401 - ADD UE PROST A/E ULTLITE MAT||400.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7400|L7400 - ADD UE PROST BE/WD -  ULTLITE||357.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7368|L7368 - LITHIUM ION BATTERY CHARGER||588.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7367|L7367 - REPLACEMNT LITHIUM IONBATTER||454.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7366|L7366 - BATTERY CHRGR 12 VOLT UTAH/E||619.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7364|L7364 - TWELVE VOLT BATTERY UTAH/EQU||459.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7362|L7362 - BATTERY CHRGR SIX VOLT OTTO||288.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7360|L7360 - SIX VOLT BAT OTTO BOCK/EQ EA||275.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7261|L7261 - ELECTRONIC WRIST ROTATOR FOR UTAH ARM||4132.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7260|L7260 - ELECTRONIC WRIST ROTATOR OTTO BOCK OR EQUAL||2269.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7191|L7191 - ELBOW CHILD MYOELECTRONIC CT||10660.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7190|L7190 - ELBOW ADOLESCENT MYOELECTRON||8903.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7186|L7186 - ELECTRON ELBOW CHILD SWITCH||10202.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7185|L7185 - ELECTRON ELBOW ADOLESCENT SW||8476.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7181|L7181 - ELECTRONIC ELBO SIMULTANEOUS||46734.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7180|L7180 - ELECTRONIC ELBOW SEQUENTIAL||37677.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7170|L7170 - ELECTRONIC ELBOW HOSMER SWIT||8583.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7045|L7045 - PEDIATRIC ELECTRIC HOOK||1864.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7040|L7040 - PREHENSILE ACTUATOR||3251.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7009|L7009 - ADULT ELECTRIC HOOK||4049.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7008|L7008 - PEDIATRIC ELECTRIC HAND||6246.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L7007|L7007 - ADULT ELECTRIC HAND||3968.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6975|L6975 - INTERSCAP-THOR MYOELECTRONIC||18966.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6970|L6970 - INTERSCAPULAR-THOR SWITCH CT||17341.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6965|L6965 - SHLDR DISARTIC MYOELECTRONIC||16642.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6960|L6960 - SHLDR DISARTIC SWITCH CONTRO||15604.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6955|L6955 - ABOVE ELBOW MYOELECTRONIC CT||13775.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6950|L6950 - ABOVE ELBOW SWITCH CONTROL||11502.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6945|L6945 - ELBOW DISART MYOELECTRONIC C||12364.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6940|L6940 - ELBOW DISARTICULATION SWITCH||10119.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6935|L6935 - BELOW ELBOW MYOELECTRONIC CT||10522.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6930|L6930 - BELOW ELBOW SWITCH CONTROL||7745.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6925|L6925 - WRIST DISART MYOELECTRONIC C||10362.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6920|L6920 - WRIST DISARTICUL SWITCH CTRL||7697.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6915|L6915 - HAND RESTORATION REPLACMNT G||882.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6910|L6910 - HAND RESTORATION NO FINGERS||1751.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6905|L6905 - HAND RESTORATION MULTIPLE FI||2047.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6900|L6900 - HAND RESTORAT THUMB/1 FINGER||2059.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6895|L6895 - CUSTOM GLOVE FOR TERM DEVICE||721.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6890|L6890 - PREFAB GLOVE FOR TERM DEVICE||196.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6885|L6885 - REPLC SOCKT SHLDR DIS/INTERC||4063.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6884|L6884 - REPLC SOCKT ABOVE ELBOW DISA||2716.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6883|L6883 - REPLC SOCKT BELOW E/W DISA||1830.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6882|L6882 - MICROPROCESSOR CONTROL UPLMB||3617.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6881|L6881 - TERM DEV AUTO GRASP FEATURE||4768.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6880|L6880 - ELEC HAND IND ART DIGITS||28090.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6810|L6810 - TERM DEV PRECISION PINCH DEV||222.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6805|L6805 - TERM DEV MODIFIER WRIST UNIT||392.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6722|L6722 - HOOK/HAND -  HVY DTY -  VOL CLOS||2364.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6721|L6721 - HOOK/HAND -  HVY DTY -  VOL OPEN||2743.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6715|L6715 - TERM DEVICE -  MULTI ART DIGIT||3711.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6714|L6714 - PED TERM DEV -  HAND -  VOL CLOS||1543.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6713|L6713 - PED TERM DEV -  HAND -  VOL OPEN||1822.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6712|L6712 - PED TERM DEV -  HOOK -  VOL CLOS||1443.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6711|L6711 - PED TERM DEV -  HOOK -  VOL OPEN||784.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6709|L6709 - TERM DEV MECH HAND VOL CLOSE||1397.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6708|L6708 - TERM DEV MECH HAND VOL OPEN||969.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6707|L6707 - TERM DEV MECH HOOK VOL CLOSE||1483.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6706|L6706 - TERM DEV MECH HOOK VOL OPEN||402.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6704|L6704 - TERM DEV -  SPORT/REC/WORK ATT||675.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6703|L6703 - TERM DEV -  PASSIVE HAND MITT||419.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6698|L6698 - BELOW/ABOVE ELBOW LOCK MECH||663.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6697|L6697 - CUS ELBO SKT IN NOT CON/ATYP||1534.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6696|L6696 - CUS ELBO SKT IN FOR CON/ATYP||1534.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6695|L6695 - ELBOW SOCKET INS USE W/O LCK||683.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6694|L6694 - ELBOW SOCKET INS USE W/LOCK||820.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6693|L6693 - LOCKINGELBOW FOREARM CNTRBAL||3311.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6692|L6692 - SILICONE GEL INSERT OR EQUAL||645.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6691|L6691 - REMOVABLE INSERT EACH||399.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6690|L6690 - FRAME TYP SOCK INTERSCAP-THO||863.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6689|L6689 - FRAME TYP SOCKET SHOULDER DI||792.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6688|L6688 - FRAME TYP SOCK ABOVE ELB/DIS||661.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6687|L6687 - FRAME TYP SOCKET BEL ELBOW/W||665.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6686|L6686 - SUCTION SOCKET||907.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6684|L6684 - TEST SOCKET SHLDR DISART/THO||402.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6682|L6682 - TEST SOCK ELBW DISART/ABOVE||295.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6680|L6680 - TEST SOCK WRIST DISART/BEL E||267.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6677|L6677 - UE TRIPLE CONTROL HARNESS||346.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6676|L6676 - HARNESS FIGURE OF 8 DUAL CON||160.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6675|L6675 - HARNESS FIGURE OF 8 SING CON||138.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6672|L6672 - HARNESS CHEST/SHLDER SADDLE||233.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6670|L6670 - HOOK TO HAND CABLE ADAPTER||58.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6665|L6665 - TEFLON OR EQUAL CABLE LINING||53.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6660|L6660 - HEAVY DUTY CONTROL CABLE||105.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6655|L6655 - STANDARD CONTROL CABLE EXTRA||94.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6650|L6650 - SHOULDER UNIVERSAL JOINT||480.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6648|L6648 - EXT PWRD SHLDER LOCK/UNLOCK||3794.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6647|L6647 - SHOULDER LOCK ACTUATOR||605.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6646|L6646 - MULTIPO LOCKING SHOULDER JNT||3678.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6645|L6645 - SHOULDER FLEXION-ABDUCTION J||462.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6642|L6642 - EXCURSION AMPLIFIER LEVER TY||250.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6641|L6641 - EXCURSION AMPLIFIER PULLEY T||185.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6640|L6640 - SHOULDER ABDUCTION JOINT PAI||384.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6638|L6638 - ELEC LOCK ON MANUAL PW ELBOW||2916.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6637|L6637 - NUDGE CONTROL ELBOW LOCK||433.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6635|L6635 - LIFT ASSIST FOR ELBOW||203.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6632|L6632 - LATEX SUSPENSION SLEEVE EACH||86.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6630|L6630 - STAINLESS STEEL ANY WRIST||248.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6629|L6629 - LAMINATION COLLAR W/ COUPLIN||168.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6628|L6628 - QUICK DISCONN HOOK ADAPTER O||552.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6625|L6625 - ROTATION WRST W/ CABLE LOCK||700.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6624|L6624 - FLEX/EXT/ROTATION WRIST UNIT||4392.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6623|L6623 - SPRING-ASS ROT WRST W/ LATCH||986.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6621|L6621 - FLEX/EXT WRIST W/WO FRICTION||2667.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6620|L6620 - FLEXION/EXTENSION WRIST UNIT||353.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6616|L6616 - DISCONNECT INSERT LOCKING WR||81.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6615|L6615 - DISCONNECT LOCKING WRIST UNI||221.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6611|L6611 - ADDITIONAL SWITCH -  EXT POWER||480.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6610|L6610 - FLEXIBLE METAL HINGE PAIR||205.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6605|L6605 - SINGLE PIVOT HINGE PAIR||213.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6600|L6600 - POLYCENTRIC HINGE PAIR||216.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6590|L6590 - SHDR FAIR LEAD CABLE DIRECT||3197.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6588|L6588 - SHDR FAIR LEAD CABLE MOLDED||3366.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6586|L6586 - ELBOW FAIR LEAD CABLE DIR FO||2561.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6584|L6584 - ELBOW FAIR LEAD CABLE MOLDED||2737.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6582|L6582 - WRIST/ELBOW BOWDEN CBL DIR F||1745.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6580|L6580 - WRIST/ELBOW BOWDEN CABLE MOL||1927.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6570|L6570 - SCAP THORAC PROSTH TISS SHAP||5048.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6550|L6550 - SHLDR DISAR PROSTH TISS SHAP||4496.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6500|L6500 - ABOVE ELBOW PROSTH TISS SHAP||3740.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6450|L6450 - ELB DISART PROSTH TISS SHAP||3575.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6400|L6400 - BELOW ELBOW PROSTH TISS SHAP||2676.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6388|L6388 - POSTOP APPLICAT RIGID DSG ON||507.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6386|L6386 - POSTOP EA CAST CHG & REALIGN||463.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6384|L6384 - POSTOP DSG CAST CHG SHLDER/T||2932.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6382|L6382 - POSTOP DSG CAST CHG ELB DIS/||2119.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6380|L6380 - POSTOP DSG CAST CHG WRST/ELB||1408.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6370|L6370 - THORACIC PASSIVE RESTOR CAP||2431.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6360|L6360 - THORACIC PASSIVE RESTOR COMP||4063.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6350|L6350 - THORACIC INTERN LOCK ELBOW||4517.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6320|L6320 - SHOULDER PASSIVE RESTOR CAP||2026.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6310|L6310 - SHOULDER PASSIVE RESTOR COMP||3710.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6300|L6300 - SHLDER DISART INT LOCK ELBOW||4297.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6250|L6250 - ELBOW INTER LOC ELBOW FORARM||3296.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6205|L6205 - ELBOW MOLDED W/ EXPAND INTER||4200.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6200|L6200 - ELBOW MOLD OUTSID LOCK HINGE||3146.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6130|L6130 - ELBOW STUMP ACTIVATED LOCK H||2985.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6120|L6120 - ELBOW MOLD DOUB SPLT SOC STE||2743.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6110|L6110 - ELBOW MOLD SOCK SUSPENSION T||2354.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6100|L6100 - ELB MOLD SOCK FLEX HINGE PAD||2219.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6055|L6055 - WRST MOLD SOCK W/EXP INTERFA||3053.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6050|L6050 - WRST MLD SCK FLX HNG TRI PAD||2191|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6025|L6025 - TRANSCARPAL/MC/PART HND DISARTIC PROS DEVC||9333.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6020|L6020 - PART HAND NO FINGERS||1590.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6010|L6010 - PART HAND LITTLE/RING||1705.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L6000|L6000 - PART HAND THUMB REM||1532.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5990|L5990 - USER ADJUSTABLE HEEL HEIGHT||2116.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5988|L5988 - VERTICAL SHOCK REDUCING PYLO||2330.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5987|L5987 - SHANK FT W VERT LOAD PYLON||8390.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5986|L5986 - MULTI-AXIAL ROTATION UNIT||730.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5985|L5985 - LWR EXT DYNAMIC PROSTH PYLON||329.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5984|L5984 - ENDOSKELETAL AXIAL ROTATION||657.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5982|L5982 - EXOSKELETAL AXIAL ROTATION U||666.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5981|L5981 - FLEX-WALK SYS LOW EXT PROSTH||3454.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5980|L5980 - FLEX FOOT SYSTEM||4276.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5979|L5979 - MULTI-AXIAL ANKLE/FT PROSTH||2631.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5978|L5978 - FT PROSTH MULTIAXIAL ANKL/FT||336.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5976|L5976 - ENERGY STORING FOOT||645.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5975|L5975 - COMBO ANKLE/FOOT PROSTHESIS||540.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5974|L5974 - FOOT SINGLE AXIS ANKLE/FOOT||268.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5973|L5973 - ANK-FOOT SYS DORS-PLANT FLEX||20067.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5972|L5972 - FLEXIBLE KEEL FOOT||437.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5971|L5971 - SACH FOOT -  REPLACEMENT||234.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5970|L5970 - FOOT EXTERNAL KEEL SACH FOOT||234.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5968|L5968 - MULTIAXIAL ANKLE W DORSIFLEX||4238.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5966|L5966 - HIP FLEXIBLE COVER SYSTEM||1376.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5964|L5964 - ABOVE KNEE FLEX COVER SYSTEM||1080.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5962|L5962 - BELOW KNEE FLEX COVER SYSTEM||731.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5961|L5961 - ENDO POLY HIP -  PNEU/HYD/ROT||5302.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5960|L5960 - ENDO HIP ULTRA-LIGHT MATERIA||1111.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5950|L5950 - ENDO AK ULTRA-LIGHT MATERIAL||904.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5940|L5940 - ENDO BK ULTRA-LIGHT MATERIAL||578.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5930|L5930 - HIGH ACTIVITY KNEE FRAME||3925.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5925|L5925 - ABOVE KNEE MANUAL LOCK||516.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5920|L5920 - ENDO AK/HIP ALIGNABLE SYSTEM||611.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5910|L5910 - ENDO BELOW KNEE ALIGNABLE SY||417.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5858|L5858 - STANCE PHASE ONLY||21677.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5857|L5857 - ELEC KNEE-SHIN SWING ONLY||9935.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5856|L5856 - ELEC KNEE-SHIN SWING/STANCE||27999.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5855|L5855 - MECH HIP EXTENSION ASSIST||396.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5850|L5850 - ENDO AK/HIP KNEE EXTENS ASSI||147.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5848|L5848 - KNEE-SHIN SYS HYDRAUL STANCE||1254.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5845|L5845 - KNEE-SHIN SYS STANCE FLEXION||2090.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5840|L5840 - MULTI-AXIAL KNEE/SHIN SYSTEM||4046.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5830|L5830 - ENDO KNEE-SHIN PNEUM/SWG PHA||2188.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5828|L5828 - ENDO KNEE-SHIN FLUID SWG/STA||3257.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5826|L5826 - MINIATURE KNEE JOINT||3642.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5824|L5824 - ENDO KNEE-SHIN FLUID SWING P||1768.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5822|L5822 - ENDO KNEE-SHIN PNEUM SWG FRC||1964.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5818|L5818 - ENDO KNEE-SHIN FRCT SWG & ST||1107.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5816|L5816 - ENDO KNEE-SHIN POLYC MCH STA||986.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5814|L5814 - ENDO KNEE-SHIN HYDRAL SWG PH||4331.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5812|L5812 - ENDO KNEE-SHIN FRCT SWG & ST||652.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5811|L5811 - ENDO KNEE-SHIN MNL LCK ULTRA||841.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5810|L5810 - ENDOSKEL KNEE-SHIN MNL LOCK||561.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5795|L5795 - EXOSKEL HIP ULTRA-LIGHT MATE||1651.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5790|L5790 - EXOSKELETAL AK ULTRA-LIGHT M||829.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5785|L5785 - EXOSKELETAL BK ULTRALT MATER||742.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5782|L5782 - HD LOW LIMB PROS VACUUM PUMP||4919.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5781|L5781 - LOWER LIMB PROS VACUUM PUMP||4666.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5780|L5780 - KNEE-SHIN PNEUM/HYDRA PNEUM||1320.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5728|L5728 - KNEE-SHIN FLUID SWG & STANCE||2744.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5726|L5726 - KNEE-SHIN EXT JNTS FLD SWG E||2006.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5724|L5724 - KNEE-SHIN EXO FLUID SWING PH||1740.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5722|L5722 - KNEE-SHIN PNEUM SWG FRCT EXO||1110.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5718|L5718 - KNEE-SHIN EXO FRCT SWG & STA||1050.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5716|L5716 - KNEE-SHIN EXO MECH STANCE PH||840.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5714|L5714 - KNEE-SHIN EXO VARIABLE FRICT||518.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5712|L5712 - KNEE-SHIN EXO FRICT SWG & ST||505.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5711|L5711 - KNEE-SHIN EXO MNL LOCK ULTRA||602.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5710|L5710 - KNE-SHIN EXO SNG AXI MNL LOC||431.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5707|L5707 - CUSTOM SHAPE CVR HIP DISART||1427.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5706|L5706 - CUSTOM SHAPE CVR KNEE DISART||1082.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5705|L5705 - CUSTOM SHAPE COVER AK||1104.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5704|L5704 - CUSTOM SHAPE COVER BK||618.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5703|L5703 - SYMES ANKLE W/O (SACH) FOOT||2598.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5702|L5702 - REPLACE SOCKET HIP||5020.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5701|L5701 - REPLACE SOCKET ABOVE KNEE||3968.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5700|L5700 - REPLACE SOCKET BELOW KNEE||3304.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5699|L5699 - SHOULDER HARNESS||272.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5698|L5698 - AK/KNEE DISARTIC SILESIAN BA||151.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5697|L5697 - AK/KNEE DISARTIC PELVIC BAND||92.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5696|L5696 - AK/KNEE DISARTIC PELVIC JOIN||213.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5695|L5695 - AK SLEEVE SUSP NEOPRENE/EQUA||193.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5694|L5694 - AK PELVIC CONTROL BELT PAD/L||209.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5692|L5692 - AK PELVIC CONTROL BELT LIGHT||153.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5690|L5690 - BK WAIST BELT PADDED AND LIN||112.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5688|L5688 - BK WAIST BELT WEBBING||70.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5686|L5686 - BK BACK CHECK||58.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5685|L5685 - BELOW KNEE SUS/SEAL SLEEVE||149.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5684|L5684 - BK FORK STRAP||55.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5683|L5683 - INITIAL CUSTOM SOCKET INSERT||1534.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5682|L5682 - BK THIGH LACER GLUT/ISCHIA M||721.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5681|L5681 - INTL CUSTM CONG/LATYP INSERT||1534.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5680|L5680 - BK THIGH LACER NON-MOLDED||382.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5679|L5679 - SOCKET INSERT W/O LOCK MECH||683.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5678|L5678 - BK JOINT COVERS PAIR||45.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5677|L5677 - BK KNEE JOINTS POLYCENTRIC P||568.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5676|L5676 - BK KNEE JOINTS SINGLE AXIS P||417.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5673|L5673 - SOCKET INSERT W LOCK MECH||820.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5672|L5672 - BK REMOVABLE MEDIAL BRIM SUS||343.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5671|L5671 - BK/AK LOCKING MECHANISM||663.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5670|L5670 - BK MOLDED SUPRACONDYLAR SUSP||312.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5668|L5668 - BK MOLDED DISTAL CUSHION||130.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5666|L5666 - BELOW KNEE CUFF SUSPENSION||80.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5665|L5665 - MULTI-DUROMETER BELOW KNEE||590.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5661|L5661 - MULTI-DUROMETER SYMES||701.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5658|L5658 - SOCKET INSERT ABOVE KNEE||419.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5656|L5656 - SOCKET INSERT KNEE ARTICULAT||434.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5655|L5655 - SOCKET INSERT BELOW KNEE||324.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5654|L5654 - SOCKET INSERT SYMES||382.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5653|L5653 - KNEE DISART EXPAND WALL SOCK||671.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5652|L5652 - SUCTION SUSP AK/KNEE DISART||502.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5651|L5651 - AK FLEX INNER SOCKET EXT FRA||1385.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5650|L5650 - TOT CONTACT AK/KNEE DISART S||563.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5649|L5649 - ISCH CONTAINMT/NARROW M-L SO||2751.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5648|L5648 - ABOVE KNEE CUSHION SOCKET||759.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5647|L5647 - BELOW KNEE SUCTION SOCKET||917.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5646|L5646 - BELOW KNEE CUSHION SOCKET||631.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5645|L5645 - BK FLEX INNER SOCKET EXT FRA||920.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5644|L5644 - ABOVE KNEE WOOD SOCKET||681.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5643|L5643 - HIP FLEX INNER SOCKET EXT FR||1795.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5642|L5642 - ABOVE KNEE LEATHER SOCKET||714.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5640|L5640 - KNEE DISARTICULAT LEATHER SO||737.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5639|L5639 - BELOW KNEE WOOD SOCKET||1293.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5638|L5638 - BELOW KNEE LEATHER SOCKET||580.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5637|L5637 - BELOW KNEE TOTAL CONTACT||333.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5636|L5636 - SYMES TYPE MEDIAL OPENING SO||293.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5634|L5634 - SYMES TYPE POSTER OPENING SO||350.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5632|L5632 - SYMES TYPE PTB BRIM DESIGN S||282.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5631|L5631 - AK/KNEE DISARTIC ACRYLIC SOC||506.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5630|L5630 - SYME TYP EXPANDABL WALL SCKT||517.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5629|L5629 - BELOW KNEE ACRYLIC SOCKET||366.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5628|L5628 - TEST SOCKET HEMIPELVECTOMY||588.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5626|L5626 - TEST SOCKET HIP DISARTICULAT||549.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5624|L5624 - TEST SOCKET ABOVE KNEE||419.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5622|L5622 - TEST SOCKET KNEE DISARTICULA||418.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5620|L5620 - TEST SOCKET BELOW KNEE||320.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5618|L5618 - TEST SOCKET SYMES||345.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5617|L5617 - AK/BK SELF-ALIGNING UNIT EA||652.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5616|L5616 - AK UNIV MULTIPLEX SYS FRICT||1570.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5614|L5614 - 4-BAR LINK ABOVE KNEE W/SWNG||1968.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5613|L5613 - AK 4 BAR LING W/HYDRAUL SWIG||2905.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5611|L5611 - AK 4 BAR LINK W/FRIC SWING||1858.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5610|L5610 - ABOVE KNEE HYDRACADENCE||2387.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5600|L5600 - HIP DISART SACH LAMINAT MOLD||5265.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5595|L5595 - HIP DISARTIC SACH THERMOPLS||4898.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5590|L5590 - PREP AK ISCHIAL LAMINATED||2772.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5585|L5585 - PREP AK ISCHIAL OPEN END||3348.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5580|L5580 - PREP AK ISCHIAL THERMO MOLD||2720.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5570|L5570 - PREP AK ISCHIAL DIRECT FORM||2330.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5560|L5560 - PREP AK ISCHIAL PLAST MOLDED||2241.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5540|L5540 - PREP BK PTB LAMINATED SOCKET||2087.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5535|L5535 - PREP BK PTB OPEN END SOCKET||1955.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5530|L5530 - PREP BK PTB THERMOPLS MOLDED||1992.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5520|L5520 - PERP BK PTB THERMOPLS DIRECT||1658.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5510|L5510 - PREP BK PTB PLASTER MOLDED||1679.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5505|L5505 - INIT AK ISCHAL PLSTR DIRECT||2048.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5500|L5500 - INIT BK PTB PLASTER DIRECT||1481.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5460|L5460 - POSTOP APP NON-WGT BEAR DSG||629.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5450|L5450 - POSTOP APP NON-WGT BEAR DSG||472.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5430|L5430 - POSTOP DSG AK EA ADD CAST CH||580.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5420|L5420 - POSTOP DSG & 1 CAST CHG AK/D||1924.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5410|L5410 - POSTOP DSG BK EA ADD CAST CH||481.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5400|L5400 - POSTOP DRESS & 1 CAST CHG BK||1570.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5341|L5341 - HEMIPELVECTOMY CANADIAN SACH||6100.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5331|L5331 - HIP DISART CANADIAN SACH FT||5859.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5321|L5321 - AK OPEN END SACH||4598.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5312|L5312 - KNEE DISART -  SACH FT -  ENDO||4541.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5301|L5301 - BK MOLD SOCKET SACH FT ENDO||3172.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5280|L5280 - HEMIPELVECT CANAD SING AXIS||5912.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5270|L5270 - TILT TABLE LOCKING HIP SING||5957.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5250|L5250 - HIP CANAD SING AXI CONS FRIC||5984.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5230|L5230 - FEM FOCAL DEFIC CONSTANT FRI||4387.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5220|L5220 - NO KNEE JOINT WITH ARTIC ALI||3181.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5210|L5210 - NO KNEE/ANKLE JOINTS W/ FT B||2798.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5200|L5200 - KNE SING AXIS FRIC SHIN SACH||4218.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5160|L5160 - MOLD SOCKET BENT KNEE SHIN S||4405.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5150|L5150 - MOLD SCKT EXT KNEE SHIN SACH||4050.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5105|L5105 - PLAST SOCKET JTS/THGH LACER||4006.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5100|L5100 - MOLDED SOCKET SHIN SACH FOOT||2775.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5060|L5060 - SYMES MET FR LEATH SOCKET AR||3185.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5050|L5050 - ANK SYMES MOLD SCKT SACH FT||2769.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5020|L5020 - TIBIAL TUBERCLE HGT W/ TOE F||2503.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5010|L5010 - MOLD SOCKET ANK HGT W/ TOE F||1474.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L5000|L5000 - SHO INSERT W ARCH TOE FILLER||610.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4631|L4631 - AFO -  WALK BOOT TYPE -  CUS FAB||1737.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4398|L4398 - FOOT DROP SPLINT PRE OTS||89.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4396|L4396 - STATIC OR DYNAMI AFO PRE CST||195.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4394|L4394 - REPLACE FOOT DROP SPINT||20.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4392|L4392 - REPLACE AFO SOFT INTERFACE||27.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4386|L4386 - NON-PNEUM WALK BOOT PRE CST||184.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4370|L4370 - PNEUM FULL LEG SPLNT PRE OTS||204.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4360|L4360 - PNEUMAT WALKING BOOT PRE CST||318.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4350|L4350 - ANKLE CONTROL ORTHO PRE OTS||113.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4130|L4130 - REPLACE PRETIBIAL SHELL||631.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4110|L4110 - REPL LEATH CUFF KAFO-AFO CAL||91.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4100|L4100 - REPL LEATH CUFF KAFO PROX TH||115.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4090|L4090 - REPL MET BAND KAFO-AFO CALF/||102.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4080|L4080 - REPL MET BAND KAFO-AFO PROX||115.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4070|L4070 - REPLACE PROX & DIST UPRIGHT||328.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4060|L4060 - REPLACE HIGH ROLL CUFF||344.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4055|L4055 - REPLACE NON-MOLDED CALF LACE||289.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4050|L4050 - REPLACE MOLDED CALF LACER||446.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4045|L4045 - REPLACE NON-MOLDED THIGH LAC||355.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4040|L4040 - REPLACE MOLDED THIGH LACER||441.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4030|L4030 - REPLACE SOCKET BRIM CUST FIT||546.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4020|L4020 - REPLACE QUADLAT SOCKET BRIM||992.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4010|L4010 - REPLACE TRILATERAL SOCKET BR||794.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4002|L4002 - REPLACE STRAP -  ANY ORTHOSIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L4000|L4000 - REPL GIRDLE MILWAUKEE ORTH||1412.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3995|L3995 - SOCK FRACTURE OR EQUAL EACH||36.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3984|L3984 - UPPER EXT FX ORTHOSIS WRIST||431.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3982|L3982 - UPPER EXT FX ORTHOSIS RAD/UL||404.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3980|L3980 - UP EXT FX ORTHOS HUMERAL NOS||327.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3978|L3978 - SEWHFO AIRPLANE W/JNT(S) CF||2101.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3977|L3977 - SEWHFO CAP DESGN W/JNT(S) CF||1994.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3976|L3976 - SEWHFO AIRPLANE W/O JNTS CF||1779.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3975|L3975 - SEWHFO CAP DESIGN W/O JNT CF||1779.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3973|L3973 - SEWHO AIRPLANE W/JNT(S) CF||2101.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3971|L3971 - SEWHO CAP DESIGN W/JNT(S) CF||1994.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3967|L3967 - SEWHO AIRPLANE W/O JNTS CF||2101.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3962|L3962 - SEWHO ERBS PALSEY DESIGN ABD||909.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3961|L3961 - SEWHO CAP DESIGN W/O JNTS CF||1779.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3960|L3960 - SEWHO AIRPLAN DESIG ABDU POS||873.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3956|L3956 - ADD JOINT UPPER EXT ORTHOSIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3935|L3935 - FO NONTORSION JOINT CF||234.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3933|L3933 - FO W/O JOINTS CF||226.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3931|L3931 - WHFO NONTORSION JOINT PREFAB||215.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3929|L3929 - HFO NONTORSION JNTS PRE CST||89.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3927|L3927 - FO PIP DIP NO JT SPR PRE OTS||37.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3925|L3925 - FO PIP DIP JNT/SPRNG PRE OTS||55.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3923|L3923 - HFO WITHOUT JOINTS PRE CST||92.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3921|L3921 - HFO W/JOINT(S) CF||340.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3919|L3919 - HO W/O JOINTS CF||286.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3917|L3917 - METACARP FX ORTHOSIS PRE CST||111.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3915|L3915 - WHO NONTORSION JNTS PRE CST||563.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3913|L3913 - HFO W/O JOINTS CF||286.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3912|L3912 - HFO FLEXION GLOVE PRE OTS||101.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3908|L3908 - WHO COCK-UP NONMOLDE PRE OTS||63.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3906|L3906 - WHO W/O JOINTS CF||446.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3905|L3905 - WHO W/NONTORSION JNT(S) CF||1050.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3904|L3904 - WHFO ELECTRIC CUSTOM FITTED||3777.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3901|L3901 - HINGE EXT/FLEX WRIST FINGER||1855.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3900|L3900 - HINGE EXTENSION/FLEX WRIST/F||1655.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3808|L3808 - WHFO -  RIGID W/O JOINTS||353.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3807|L3807 - WHFO W/O JOINTS PRE CST||264.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3806|L3806 - WHFO W/JOINT(S) CUSTOM FAB||481.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3766|L3766 - EWHFO W/JOINT(S) CF||1438.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3765|L3765 - EWHFO RIGID W/O JNTS CF||1358.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3764|L3764 - EWHO W/JOINT(S) CF||838.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3763|L3763 - EWHO RIGID W/O JNTS CF||841.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3762|L3762 - EO RIGID W/O JOINTS PRE OTS||113.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3760|L3760 - EO ADJ JT PREFAB CUSTOM FIT||529.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3740|L3740 - CUFFS ADJ LOCK W/ ACTIVE CON||1133.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3730|L3730 - FOREARM/ARM CUFFS EXT/FLEX A||1008.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3720|L3720 - FOREARM/ARM CUFFS FREE MOTIO||766.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3710|L3710 - EO ELAS W/METAL JNTS PRE OTS||153.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3702|L3702 - EO W/O JOINTS CF||305.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3675|L3675 - SO VEST CANVAS/WEB PRE OTS||185.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3674|L3674 - SO AIRPLANE W/WO JOINT CF||1252.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3671|L3671 - SO CAP DESIGN W/O JNTS CF||954.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3670|L3670 - SO ACRO/CLAV CAN WEB PRE OTS||151.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3660|L3660 - SO 8 AB RSTR CAN/WEB PRE OTS||108.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3650|L3650 - SO 8 ABD RESTRAINT PRE OTS||63.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3640|L3640 - SHOE DENNIS BROWNE SPLINT BO||50.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3630|L3630 - TRANS SHOE SOLID STIRRUP NEW||116.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3620|L3620 - TRANS SHOE SOLID STIRRUP EXI||88.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3610|L3610 - TRANS SHOE CALIPER PLATE NEW||116.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3600|L3600 - TRANS SHOE CALIP PLATE EXIST||88.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3595|L3595 - ORTHO SHOE ADD MARCH BAR||48.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3590|L3590 - O SHOE CONVERT TO SOF COUNTE||62.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3580|L3580 - O SHOE ADD INSTEP VELCRO CLO||75.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3570|L3570 - O SHOE ADD INSTEP EXTENSION||99.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3560|L3560 - O SHOE ADD HORSESHOE TOE TAP||26.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3550|L3550 - O SHOE ADD STANDARD TOE TAP||10.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3540|L3540 - ORTHO SHOE ADD FULL SOLE||59.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3530|L3530 - ORTHO SHOE ADD HALF SOLE||37.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3520|L3520 - O SHOE ADD FELT W LEATH INSL||37.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3510|L3510 - ORTHOPEDIC SHOE ADD RUB INSL||34.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3500|L3500 - ORTHO SHOE ADD LEATHER INSOL||34.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3480|L3480 - SHOE HEEL PAD & DEPRESS FOR||72.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3470|L3470 - SHOE HEEL THOMAS EXTEND TO B||72.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3465|L3465 - SHOE HEEL THOMAS WITH WEDGE||68.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3460|L3460 - SHOE HEEL NEW RUBBER STANDAR||39.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3455|L3455 - SHOE HEEL NEW LEATHER STANDA||47.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3450|L3450 - SHOE HEEL SACH CUSHION TYPE||122.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3440|L3440 - HEEL LEATHER REINFORCED||88.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3430|L3430 - SHO HEEL COUNT PLAST REINFOR||186.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3420|L3420 - FULL SOLE/HEEL WEDGE BTWEEN||63.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3410|L3410 - SHOE METATARSAL BAR BETWEEN||108.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3400|L3400 - SHOE METATARSAL BAR WEDGE RO||47.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3390|L3390 - SHOE OUTFLARE WEDGE||57.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3380|L3380 - SHOE CLUBFOOT WEDGE||57.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3370|L3370 - SHOE SOLE WEDGE BETWEEN SOLE||57.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3360|L3360 - SHOE SOLE WEDGE OUTSIDE SOLE||41.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3350|L3350 - SHOE HEEL WEDGE||26.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3340|L3340 - SHOE WEDGE SACH||99.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3334|L3334 - SHOE LIFTS ELEVATION HEEL /I||44.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3332|L3332 - SHOE LIFTS TAPERED TO ONE-HA||85.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3330|L3330 - LIFTS ELEVATION METAL EXTENS||658.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3310|L3310 - SHOE LIFT ELEV HEEL/SOLE NEO||94.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3300|L3300 - SHO LIFT TAPER TO METATARSAL||60.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3260|L3260 - AMBULATORY SURGICAL BOOT EAC||15.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3225|L3225 - MAN'S SHOE OXFORD BRACE||73.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3224|L3224 - WOMAN'S SHOE OXFORD BRACE||63.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3170|L3170 - FOOT PLAS HEEL STABI PRE OTS||59.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3150|L3150 - ABDUCT ROTATION BAR W/O SHOE||94.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3140|L3140 - ABDUCTION ROTATION BAR SHOE||103.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3100|L3100 - HALLUS-VALGUS NT DYN PRE OTS||50.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3090|L3090 - ARCH SUPP ATT TO SHOE LONG/M||47.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3080|L3080 - ARCH SUPP ATT TO SHOE METATA||37.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3070|L3070 - ARCH SUPRT ATT TO SHO LONGIT||37.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3060|L3060 - FOOT ARCH SUPP LONGITUD/META||85.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3050|L3050 - FOOT ARCH SUPP PREMOLD METAT||54.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3040|L3040 - FT ARCH SUPRT PREMOLD LONGIT||54.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3031|L3031 - FOOT LAMIN/PREPREG COMPOSITE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3030|L3030 - FOOT ARCH SUPPORT REMOV PREM||88.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3020|L3020 - FOOT LONGITUD/METATARSAL SUP||230.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3010|L3010 - FOOT LONGITUDINAL ARCH SUPPO||202.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3003|L3003 - FOOT INSERT SILICONE GEL EAC||202.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3002|L3002 - FOOT INSERT PLASTAZOTE OR EQ||188.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3001|L3001 - FOOT INSERT REMOV MOLDED SPE||153.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L3000|L3000 - FT INSERT UCB BERKELEY SHELL||365.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2850|L2850 - FEMORAL LGTH SOCK FX OR EQUA||67.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2840|L2840 - TIBIAL LENGTH SOCK FX OR EQU||59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2830|L2830 - SOFT INTERFACE ABOVE KNEE SE||105.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2820|L2820 - SOFT INTERFACE BELOW KNEE SE||94.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2810|L2810 - KNEE CONTROL CONDYLAR PAD||84.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2800|L2800 - KNEE CAP MEDIAL OR LATERAL P||115.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2795|L2795 - KNEE CONTROL FULL KNEECAP||91.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2785|L2785 - DROP LOCK RETAINER EACH||45.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2780|L2780 - NON-CORROSIVE FINISH||77.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2768|L2768 - ORTHO SIDEBAR DISCONNECT||151.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2760|L2760 - EXTENSION PER EXTENSION PER||65.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2755|L2755 - CARBON GRAPHITE LAMINATION||152.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2750|L2750 - PLATING CHROME/NICKEL PR BAR||90.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2680|L2680 - THORAC CONT LAT SUPPORT UPRI||169.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2670|L2670 - THORAC CONT PARASPINAL UPRIG||184.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2660|L2660 - THORACIC CONTROL THORACIC BA||201.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2650|L2650 - PELV & THOR CONTROL GLUTEAL||129.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2640|L2640 - PELVIC CONTROL BAND & BELT B||363.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2630|L2630 - PELVIC CONTROL BAND & BELT U||268.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2628|L2628 - METAL FRAME RECIPRO HIP & CA||2184.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2627|L2627 - PLASTIC MOLD RECIPRO HIP & C||1859.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2624|L2624 - HIP ADJ FLEX EXT ABDUCT CONT||451.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2622|L2622 - HIP JOINT ADJUSTABLE FLEXION||332|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2620|L2620 - PELVIC CONTROL HIP HEAVY DUT||289.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2610|L2610 - HIP CLEVIS/THRUST BEARING LO||262.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2600|L2600 - HIP CLEVIS/THRUST BEARING FR||222.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2580|L2580 - PELVIC CONTROL PELVIC SLING||651.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2570|L2570 - HIP CLEVIS TYPE 2 POSIT JNT||687.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2550|L2550 - THIGH/WGHT BEAR HIGH ROLL CU||310.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2540|L2540 - THIGH/WGHT BEAR LACER MOLDED||457.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2530|L2530 - THIGH/WGHT BEAR LACER NON-MO||254.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2526|L2526 - TH/WGHT BEAR NAR M-L BRIM CU||922.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2525|L2525 - TH/WGHT BEAR NAR M-L BRIM MO||1711.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2520|L2520 - TH/WGHT BEAR QUAD-LAT BRIM C||498.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2510|L2510 - TH/WGHT BEAR QUAD-LAT BRIM M||914.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2500|L2500 - THI/GLUT/ISCHIA WGT BEARING||341.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2492|L2492 - KNEE LIFT LOOP DROP LOCK RIN||110.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2430|L2430 - KNEE JNT RATCHET LOCK EA JNT||166.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2425|L2425 - KNEE DISC/DIAL LOCK/ADJ FLEX||166.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2415|L2415 - KNEE JOINT CAM LOCK EACH JOI||141.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2405|L2405 - KNEE JOINT DROP LOCK EA JNT||101.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2397|L2397 - SUSPENSION SLEEVE LOWER EXT||126.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2395|L2395 - OFFSET KNEE JOINT HEAVY DUTY||180.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2390|L2390 - OFFSET KNEE JOINT EACH||118.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2387|L2387 - ADD LE POLY KNEE CUSTOM KAFO||196.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2385|L2385 - STRAIGHT KNEE JOINT HEAVY DU||145.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2380|L2380 - TORSION STRAIGHT KNEE JOINT||133.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2375|L2375 - TORSION ANK & HALF SOLID STI||122.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2370|L2370 - PATTEN BOTTOM||277.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2360|L2360 - EXTENDED STEEL SHANK||56.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2350|L2350 - PROSTHETIC TYPE SOCKET MOLDE||964.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2340|L2340 - PRE-TIBIAL SHELL MOLDED TO P||590.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2335|L2335 - ANTERIOR SWING BAND||250.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2330|L2330 - LACER MOLDED TO PATIENT MODE||425.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2320|L2320 - NON-MOLDED LACER||222.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2310|L2310 - ABDUCTION BAR-STRAIGHT||133.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2300|L2300 - ABDUCTION BAR JOINTED ADJUST||296.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2280|L2280 - MOLDED INNER BOOT||525.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2275|L2275 - PLASTIC MOD LOW EXT PAD/LINE||141.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2270|L2270 - VARUS/VALGUS STRAP PADDED/LI||58.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2265|L2265 - LONG TONGUE STIRRUP||127.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2260|L2260 - REINFORCED SOLID STIRRUP||217.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2250|L2250 - FOOT PLATE MOLDED STIRRUP AT||384.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2240|L2240 - ROUND CALIPER AND PLATE ATTA||90.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2232|L2232 - ROCKER BOTTOM -  CONTACT AFO||112.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2230|L2230 - SPLIT FLAT CALIPER STIRR & P||83.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2220|L2220 - DORSI & PLANTAR FLEX ASS/RES||95.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2210|L2210 - DORSIFLEXION ASSIST EACH JOI||83.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2200|L2200 - LIMITED ANKLE MOTION EA JNT||51.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2192|L2192 - PELVIC BAND & BELT THIGH FLA||386.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2190|L2190 - WAIST BELT||112.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2188|L2188 - QUADRILATERAL BRIM||432.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2186|L2186 - ADJ MOTION KNEE JNT LERMAN T||198.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2184|L2184 - LIMITED MOTION KNEE JOINT||178.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2182|L2182 - DROP LOCK KNEE||99.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2180|L2180 - PLAS SHOE INSERT W ANK JOINT||126.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2136|L2136 - KAFO FEMORAL FX CAST RIGID||1280.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2134|L2134 - KAFO FEM FX CAST SEMI-RIGID||1047.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2132|L2132 - KAFO FEMORAL FX CAST SOFT||873.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2128|L2128 - KAFO FEM FX CAST MOLDED TO P||1856.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2126|L2126 - KAFO FEM FX CAST THERMOPLAS||1473.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2116|L2116 - AFO TIBIAL FRACTURE RIGID||827.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2114|L2114 - AFO TIB FX SEMI-RIGID||628.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2112|L2112 - AFO TIBIAL FRACTURE SOFT||549.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2108|L2108 - AFO TIB FX CAST MOLDED TO PT||1156.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2106|L2106 - AFO TIB FX CAST PLASTER MOLD||736.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2090|L2090 - HKAFO UNILAT TORSION BALL BR||510.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2080|L2080 - HKAFO UNILAT TORSION CABLE||413.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2070|L2070 - HKAFO TORSION UNILAT ROT STR||194.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2060|L2060 - HKAFO TORSION BALL BEARING J||675.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2050|L2050 - HKAFO TORSION CABLE HIP PELV||526.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2040|L2040 - HKAFO TORSION BIL ROT STRAPS||197.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2038|L2038 - KAFO W/O JOINT MULTI-AXIS AN||1547.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2037|L2037 - KAFO PLAS SING FREE KNEE MOL||1851.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2036|L2036 - KAFO PLAS DOUB FREE KNEE MOL||2008.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2035|L2035 - KAFO PLASTIC PEDIATRIC SIZE||201.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2034|L2034 - KAFO PLA SIN UP W/WO K/A CUS||2390.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2030|L2030 - KAFO DBL SOLID STIRRUP W/O J||1096.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2020|L2020 - KAFO DBL SOLID STIRRUP BAND/||1264.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2010|L2010 - KAFO SNG SOLID STIRRUP W/O J||1001|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2005|L2005 - KAFO SNG/DBL MECHANICAL ACT||4770.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L2000|L2000 - KAFO SING FRE STIRR THI/CALF||1098.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1990|L1990 - AFO DOUB SOLID STIRRUP CALF||510.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1980|L1980 - AFO SING SOLID STIRRUP CALF||397.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1971|L1971 - AFO W/ANKLE JOINT -  PREFAB||545.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1970|L1970 - AFO PLASTIC MOLDED W/ANKLE J||887.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1960|L1960 - AFO POS SOLID ANK PLASTIC MO||600.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1951|L1951 - AFO SPIRAL PREFABRICATED||977.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1950|L1950 - AFO SPIRAL MOLDED TO PT PLAS||806.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1945|L1945 - AFO MOLDED PLAS RIG ANT TIB||1062.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1940|L1940 - AFO MOLDED TO PATIENT PLASTI||578.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1932|L1932 - AFO RIG ANT TIB PREFAB TCF/=||1038.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1930|L1930 - AFO PLASTIC||256.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1920|L1920 - AFO SING UPRIGHT W/ ADJUST S||378.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1910|L1910 - AFO SING BAR CLASP ATTACH SH||289.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1907|L1907 - AFO SUPRAMALLEOLAR CUSTOM||655.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1906|L1906 - AFO MULTILIG ANK SUP PRE OTS||148.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1904|L1904 - AFO MOLDED ANKLE GAUNTLET||509.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1902|L1902 - AFO ANKLE GAUNTLET PRE OTS||88.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1900|L1900 - AFO SPRNG WIR DRSFLX CALF BD||327.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1860|L1860 - KO SUPRACONDYLAR SOCKET MOLD||1208.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1850|L1850 - KO SWEDISH TYPE PRE OTS||311.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1847|L1847 - KO DBL UPRIGHT W/AIR PRE CST||669.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1846|L1846 - KO W ADJ FLEX/EXT ROTAT MOLD||1383.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1845|L1845 - KO DOUBLE UPRIGHT PRE CST||1090.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1844|L1844 - KO W/ADJ JT ROT CNTRL MOLDED||1809.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1843|L1843 - KO SINGLE UPRIGHT PRE CST||1044.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1840|L1840 - KO DEROT ANT CRUCIATE CUSTOM||1085.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1836|L1836 - KO RIGID W/O JOINTS PRE OTS||155.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1834|L1834 - KO W/0 JOINT RIGID MOLDED TO||1032.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1832|L1832 - KO ADJ JNT POS R SUP PRE CST||877.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1831|L1831 - KNEE ORTH POS LOCKING JOINT||342.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1830|L1830 - KO IMMOB CANVAS LONG PRE OTS||117.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1820|L1820 - KO ELAS W/ CONDYLE PADS & JO||140.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1810|L1810 - KO ELASTIC WITH JOINTS||140.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1755|L1755 - LEGG PERTHES PATTEN BOTTOM T||1785.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1730|L1730 - LEGG PERTHES ORTH SCOTTISH R||1226.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1720|L1720 - LEGG PERTHES ORTHOSIS TRILAT||1626.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1710|L1710 - LEGG PERTHES ORTH NEWINGTON||2201.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1700|L1700 - LEG PERTHES ORTH TORONTO TYP||1872.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1690|L1690 - COMBINATION BILATERAL HO||2251.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1686|L1686 - HO POST-OP HIP ABDUCTION||1078.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1685|L1685 - POST-OP HIP ABDUCT CUSTOM FA||1607.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1680|L1680 - PELVIC & HIP CONTROL THIGH C||1523.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1660|L1660 - HO ABDUCTION STATIC PLASTIC||185.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1652|L1652 - HO BI THIGHCUFFS W SPRDR BAR||414.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1650|L1650 - HO ABDUCTION HIP ADJUSTABLE||264.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1640|L1640 - PELV BAND/SPREAD BAR THIGH C||499.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1630|L1630 - ABDUCT CONTROL HIP SEMI-FLEX||186.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1620|L1620 - HO FLEX PAVLIK HARNS PRE CST||156.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1610|L1610 - HO FREJKA COV ONLY PRE CST||47.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1600|L1600 - HO FLEX FREJKA W/COV PRE CST||139.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1310|L1310 - POST-OPERATIVE BODY JACKET||1860.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1300|L1300 - BODY JACKET MOLD TO PATIENT||1808.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1290|L1290 - LATERAL TROCHANTERIC PAD||108.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1280|L1280 - RIB GUSSET (ELASTIC) EACH||95.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1270|L1270 - ABDOMINAL PAD||107.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1260|L1260 - ANTERIOR THORACIC DEROTATION||107.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1250|L1250 - ANTERIOR ASIS PAD||104.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1240|L1240 - LUMBAR DEROTATION PAD||105.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1230|L1230 - MILWAUKEE TYPE SUPERSTRUCTUR||615.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1220|L1220 - ANTERIOR THORACIC EXTENSION||239.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1210|L1210 - LATERAL THORACIC EXTENSION||283.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1200|L1200 - FURNSH INITIAL ORTHOSIS ONLY||1881.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1120|L1120 - COVERS FOR UPRIGHT EACH||47.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1110|L1110 - RING FLANGE PLAS/LEATHER MOL||296.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1100|L1100 - RING FLANGE PLASTIC/LEATHER||175.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1090|L1090 - LUMBAR SLING||99.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1085|L1085 - OUTRIGGER BIL W/ VERT EXTENS||212.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1080|L1080 - OUTRIGGER||76.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1070|L1070 - TRAPEZIUS SLING||110.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1060|L1060 - THORACIC PAD||107.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1050|L1050 - STERNAL PAD||95.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1040|L1040 - LUMBAR OR LUMBAR RIB PAD||110.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1030|L1030 - LUMBAR BOLSTER PAD||91.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1025|L1025 - KYPHOSIS PAD FLOATING||137.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1020|L1020 - KYPHOSIS PAD||120.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1010|L1010 - CTLSO AXILLA SLING||88.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1005|L1005 - TENSION BASED SCOLIOSIS ORTH||3725.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1001|L1001 - CTLSO INFANT IMMOBILIZER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L1000|L1000 - CTLSO MILWAUKE INITIAL MODEL||2197.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0984|L0984 - PROTECT BODY SOCK EA PRE OTS||65.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0982|L0982 - STOCKING SUP GRIPS 4 PRE OTS||20.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0980|L0980 - PERONEAL STRAPS PAIR PRE OTS||18.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0978|L0978 - AXILLARY CRUTCH EXTENSION||208.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0976|L0976 - LSO FULL CORSET||230.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0974|L0974 - TLSO FULL CORSET||258.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0972|L0972 - LSO CORSET FRONT||126.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0970|L0970 - TLSO CORSET FRONT||123.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0861|L0861 - HALO REPL LINER/INTERFACE||250.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0859|L0859 - MRI COMPATIBLE SYSTEM||1318.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0830|L0830 - HALO CERV INTO MILWAUKEE TYP||3394.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0820|L0820 - HALO CERVICAL INTO BODY JACK||2351.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0810|L0810 - HALO CERVICAL INTO JCKT VEST||2906.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0710|L0710 - CTLSO A-P-L CONTROL W/ INTER||2735.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0700|L0700 - CTLSO A-P-L CONTROL MOLDED||2506.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0640|L0640 - LSO S/C SHELL/PANEL CUSTOM||1218.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0639|L0639 - LSO S/C SHELL/PANEL PREFAB||1584.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0638|L0638 - LSO SAG-CORONAL PANEL CUSTOM||1535.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0637|L0637 - LSO SC R ANT/POS PNL PRE CST||1584.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0636|L0636 - LSO SAGITTAL RIGID PANEL CUS||1826.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0635|L0635 - LSO SAGIT RIGID PANEL PREFAB||1237.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0634|L0634 - LSO FLEXION CONTROL CUSTOM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0633|L0633 - LSO SC R POS/LAT PNL PRE CST||333.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0632|L0632 - LSO SAG RIGID FRAME CUST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0631|L0631 - LSO SAG R AN/POS PNL PRE CST||1195.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0630|L0630 - LSO R POST PNL SJ-T9 PRE CST||188.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0629|L0629 - LSO FLEX W/RIGID STAYS CUST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0628|L0628 - LSO FLEX NO RI STAYS PRE OTS||97.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0627|L0627 - LO SAG RI AN/POS PNL PRE CST||478.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0626|L0626 - LO SAG RIG PNL STAYS PRE CST||90.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0625|L0625 - LO FLEX L1-BELOW L5 PRE OTS||64.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0624|L0624 - SIO PANEL CUSTOM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0623|L0623 - SIO RIG PNL PELV/SAC PRE OTS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0622|L0622 - SIO FLEX PELVISACRAL CUSTOM||281.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0621|L0621 - SIO FLEX PELVIC/SACR PRE OTS||103.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0492|L0492 - TLSO 3 PIECE RIGID SHELL||579.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0491|L0491 - TLSO 2 PIECE RIGID SHELL||894.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0490|L0490 - TLSO RIGID PLASTIC PRE ONE||329.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0488|L0488 - TLSO RIGID LINED PRE ONE PIE||1168.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0486|L0486 - TLSO RIGIDLINED CUST FAB TWO||2041.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0484|L0484 - TLSO RIGID PLASTIC CUST FAB||2060.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0482|L0482 - TLSO RIGID LINED CUSTOM FAB||1767.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0480|L0480 - TLSO RIGID PLASTIC CUSTOM FA||1541.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0472|L0472 - TLSO RIGID FRAME HYPEREX PRE||498.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0470|L0470 - TLSO RIGID FRAME PRE SUBCLAV||794.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0468|L0468 - TLSO RIG FRAM PELVIC PRE CST||557.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0466|L0466 - TLSO R FRAM SOFT ANT PRE CST||444.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0464|L0464 - TLSO 4MOD SACRO-SCAP PRE||1730.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0462|L0462 - TLSO 3MOD SACRO-SCAP PRE||1453.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0460|L0460 - TLSO 2 SHL SYMPHYS-STERN CST||1168.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0458|L0458 - TLSO 2MOD SYMPHIS-XIPHO PRE||1038.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0456|L0456 - TLSO FLEX TRNK SJ-SS PRE CST||1157.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0454|L0454 - TLSO TRNK SJ-T9 PRE CST||403.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0452|L0452 - TLSO FLEX CUSTOM FAB THORACI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0450|L0450 - TLSO FLEX TRUNK/THOR PRE OTS||218.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0430|L0430 - TLSO ANT-POST-LAT W/INTERFACE-CUST              ED||1619.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0220|L0220 - THOR RIB BELT CUSTOM FABRICA||132.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0200|L0200 - CERV COL SUPP ADJ BAR & THOR||559.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0190|L0190 - CERV COLLAR SUPP ADJ CERV BA||608.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0180|L0180 - CER POST COL OCC/MAN SUP ADJ||404.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0174|L0174 - CERV SR 2PC THOR EXT PRE OTS||297.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0172|L0172 - CERV COL SR FOAM 2PC PRE OTS||165.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0170|L0170 - CERVICAL COLLAR MOLDED TO PT||816.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0160|L0160 - CERV SR WIRE OCC/MAN PRE OTS||192.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0150|L0150 - CERV SEMI-RIG ADJ MOLDED CHN||135.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0140|L0140 - CERVICAL SEMI-RIGID ADJUSTAB||81.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0130|L0130 - FLEX THERMOPLASTIC COLLAR MO||235.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0120|L0120 - CERV FLEX N/ADJ FOAM PRE OTS||32.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0113|L0113 - CRANIAL CERVICAL TORTICOLLIS||331.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|L0112|L0112 - CRANIAL CERVICAL ORTHOSIS||1629.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0864|K0864 - PWC GP3 XHD MULT POW OPT S/B||2076.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0863|K0863 - PWC GP3 VHD MULT POW OPT S/B||1745.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0862|K0862 - PWC GP3 HD MULT POW OPT S/B||1221.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0861|K0861 - PWC GP3 STD MULT POW OPT S/B||0|986.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0860|K0860 - PWC GP3 VHD SING POW OPT S/B||1745.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0859|K0859 - PWC GP3 HD SING POW OPT CAP||1165.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0858|K0858 - PWC GP3 HD SING POW OPT S/B||1221.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0857|K0857 - PWC GP3 STD SING POW OPT CAP||1004.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0856|K0856 - PWC GP3 STD SING POW OPT S/B||984.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0855|K0855 - PWC GP 3 XHD CAP CHAIR||1580.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0854|K0854 - PWC GP 3 XHD SEAT/BACK||1673.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0853|K0853 - PWC GP 3 VHD CAP CHAIR||1262.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0852|K0852 - PWC GP 3 VHD SEAT/BACK||1229.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0851|K0851 - PWC GP 3 HD CAP CHAIR||1023.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0850|K0850 - PWC GP 3 HD SEAT/BACK||1064.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0849|K0849 - PWC GP 3 STD CAP CHAIR||881.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0848|K0848 - PWC GP 3 STD SEAT/BACK||917.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0843|K0843 - PWC GP2 HD MULT POW OPT S/B||902.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0842|K0842 - PWC GP2 STD MULT POW OPT CAP||749.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0841|K0841 - PWC GP2 STD MULT POW OPT S/B||749.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0840|K0840 - PWC GP2 XHD SING POW OPT S/B||1648.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0839|K0839 - PWC GP2 VHD SING POW OPT S/B||1088.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0838|K0838 - PWC GP 2 HD SING POW OPT CAP||752.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0837|K0837 - PWC GP 2 HD SING POW OPT S/B||840.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0836|K0836 - PWC GP2 STD SING POW OPT CAP||730.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0835|K0835 - PWC GP2 STD SING POW OPT S/B||704.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0829|K0829 - PWC GP 2 XTRA HD CAP CHAIR||1101.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0828|K0828 - PWC GP 2 XTRA HD SEAT/BACK||1199.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0827|K0827 - PWC GP VHD CAP CHAIR||925.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0826|K0826 - PWC GP 2 VHD SEAT/BACK||1088.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0825|K0825 - PWC GP 2 HD CAP CHAIR||769.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0824|K0824 - PWC GP 2 HD SEAT/BACK||840.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0823|K0823 - PWC GP 2 STD CAP CHAIR||698.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0822|K0822 - PWC GP 2 STD SEAT/BACK||693.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0821|K0821 - PWC GP 2 STD PORT CAP CHAIR||574.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0820|K0820 - PWC GP 2 STD PORT SEAT/BACK||447.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0816|K0816 - PWC GP 1 STD CAP CHAIR||584.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0815|K0815 - PWC GP 1 STD SEAT/BACK||610.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0814|K0814 - PWC GP 1 STD PORT CAP CHAIR||536.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0813|K0813 - PWC GP 1 STD PORT SEAT/BACK||418.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0808|K0808 - POV GROUP 2 VHD 451-600 LBS||4248.94|424.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0807|K0807 - POV GROUP 2 HD 301-450 LBS||2746.19|274.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0806|K0806 - POV GROUP 2 STD UP TO 300LBS||1809.81|180.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0802|K0802 - POV GROUP 1 VHD 451-600 LBS||2729.55|272.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0801|K0801 - POV GROUP 1 HD 301-450 LBS||2411.94|241.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0800|K0800 - POV GROUP 1 STD UP TO 300LBS||1496.05|149.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0738|K0738 - PORTABLE GAS OXYGEN SYSTEM||64.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0733|K0733 - 12-24HR SEALED LEAD ACID||34.96|3.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0730|K0730 - CTRL DOSE INH DRUG DELIV SYS||2314.76|231.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0672|K0672 - REMOVABLE SOFT INTERFACE LE||98.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0609|K0609 - REPL ELECTRODE FOR AED||1201.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0608|K0608 - REPL GARMENT FOR AED||162.74|16.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0607|K0607 - REPL BATT FOR AED||260.79|26.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0606|K0606 - AED GARMENT W ELEC ANALYSIS||3381.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0605|K0605 - REPL BATT LITHIUM 4.5 V||19.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0604|K0604 - REPL BATT LITHIUM 3.6 V||8.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0603|K0603 - REPL BATT ALKALINE 1.5 V||0.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0602|K0602 - REPL BATT SILVER OXIDE 3 V||8.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0601|K0601 - REPL BATT SILVER OXIDE 1.5 V||1.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0552|K0552 - SUP/EXT NON-INS INF PUMP SYR||3.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0455|K0455 - PUMP UNINTERRUPTED INFUSION||344.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0195|K0195 - ELEVATING WHLCHAIR LEG RESTS||0|24.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0105|K0105 - IV HANGER||133.5|13.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0098|K0098 - DRIVE BELT FOR PWC -  REPL||31.5|3.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0077|K0077 - FR CSTR ASMB SOL TIRE REP EA||79.01|7.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0073|K0073 - CASTER PIN LOCK EACH||46.73|4.68||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0072|K0072 - FR CSTR SEMI-PNE TIRE REP EA||88.3|8.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0071|K0071 - FR CSTR COMP PNE TIRE REP EA||146.69|14.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0070|K0070 - RR WHL COMPL PNE TIRE REP EA||245.93|24.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0069|K0069 - RR WHL COMPL SOL TIRE REP EA||134.17|13.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0065|K0065 - SPOKE PROTECTORS||59.69|5.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0056|K0056 - SEAT HT <17 OR >=21 LTWT WC||127.69|12.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0053|K0053 - ELEVATE FOOTREST ARTICULATE||118.05|11.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0052|K0052 - SWINGAWAY DETACH FTREST REPL||106.99|10.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0051|K0051 - CAM REL ASM FT/LEGRST REP EA||60.88|6.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0050|K0050 - RATCHET ASSEMBLY REPLACEMENT||37.61|3.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0047|K0047 - ELEV LEGRST UPR HANGR REP EA||88.5|8.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0046|K0046 - ELEV LGRST LWR EXTEN REPL EA||22.59|2.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0045|K0045 - FTRST COMPL ASSEMBLY REPL EA||65.52|6.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0044|K0044 - FTRST UPR HANGER BRAC REP EA||19.25|1.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0043|K0043 - FTRST LOWR EXTEN TUBE REP EA||22.59|2.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0042|K0042 - STANDARD SIZE FTPLATE REP EA||42.16|4.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0041|K0041 - LARGE SIZE FOOTPLATE EACH||61.24|6.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0040|K0040 - ADJUSTABLE ANGLE FOOTPLATE||86.41|8.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0039|K0039 - LEG STRAP H STYLE EACH||62.35|6.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0038|K0038 - LEG STRAP EACH||28.09|2.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0037|K0037 - HI MOUNT FLIP-UP FOOTREST EA||55.73|4.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0020|K0020 - FIXED ADJUST ARMREST PAIR||53.78|5.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0019|K0019 - ARM PAD REPL -  EACH||19.66|1.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0018|K0018 - DETACH ADJUST ARMRST UPPER||33.04|3.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0017|K0017 - DETACH ADJUST ARMREST BASE||59.14|5.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0015|K0015 - DETACH NON-ADJ HT ARMRST REP||210.28|21.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0012|K0012 - LTWT PORTBL POWER WHLCHR||423.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0011|K0011 - STND WT PWR WHLCHR W CONTROL||0|687.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0010|K0010 - STND WT FRAME POWER WHLCHR||486.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0007|K0007 - EXTRA HEAVY DUTY WHEELCHAIR||235.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0006|K0006 - HEAVY DUTY WHEELCHAIR||168.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0005|K0005 - ULTRALIGHTWEIGHT WHEELCHAIR||248.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0004|K0004 - HIGH STRENGTH LTWT WHLCHR||152.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0003|K0003 - LIGHTWEIGHT WHEELCHAIR||118.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0002|K0002 - STND HEMI (LOW SEAT) WHLCHR||93.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|K0001|K0001 - STANDARD WHEELCHAIR||63.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9400|J9400 - INJ -  ZIV-AFLIBERCEPT -  1 MG||10.5275|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9395|J9395 - INJECTION -  FULVESTRANT||123.4725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9390|J9390 - VINORELBINE TARTRATE INJ||11.0563|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9371|J9371 - INJ -  VINCRISTINE SUL LIP 1 MG||3787.9662|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9370|J9370 - VINCRISTINE SULFATE 1 MG INJ||5.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9360|J9360 - VINBLASTINE SULFATE INJ||3.8688|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9357|J9357 - VALRUBICIN INJECTION||1730.1762|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9355|J9355 - TRASTUZUMAB INJECTION||133.7188|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9354|J9354 - INJ -  ADO-TRASTUZUMAB EMT 1 MG||39.1075|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9352|J9352 - INJECTION TRABECTEDIN 0.1MG||388.5462|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9351|J9351 - TOPOTECAN INJECTION||1.2675|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9340|J9340 - THIOTEPA INJECTION||525.5325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9330|J9330 - TEMSIROLIMUS INJECTION||72.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9328|J9328 - TEMOZOLOMIDE INJECTION||12.9937|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9325|J9325 - INJ TALIMOGENE LAHERPAREPVEC||63.8725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9320|J9320 - STREPTOZOCIN INJECTION||431.0538|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9315|J9315 - ROMIDEPSIN INJECTION||388.1875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9310|J9310 - RITUXIMAB INJECTION||1144.12|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|J9308|J9308 - INJECTION -  RAMUCIRUMAB||72.9925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9307|J9307 - PRALATREXATE INJECTION||358.1612|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9306|J9306 - INJECTION -  PERTUZUMAB -  1 MG||15.3125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9305|J9305 - PEMETREXED INJECTION||86.9288|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9303|J9303 - PANITUMUMAB INJECTION||147.195|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9302|J9302 - OFATUMUMAB INJECTION||74.7475|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9301|J9301 - OBINUTUZUMAB INJ||79.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9300|J9300 - GEMTUZUMAB OZOGAMICIN INJ||108.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9299|J9299 - INJECTION -  NIVOLUMAB||34.755|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9295|J9295 - INJECTION -  NECITUMUMAB -  1 MG||7.1788|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9293|J9293 - MITOXANTRONE HYDROCHL / 5 MG||34.085|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9285|J9285 - INJ -  OLARATUMAB -  10 MG||65.0737|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9280|J9280 - MITOMYCIN INJECTION||125.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9271|J9271 - INJ PEMBROLIZUMAB||61.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9268|J9268 - PENTOSTATIN INJECTION||2525.3775|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9267|J9267 - PACLITAXEL INJECTION||0.1688|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9266|J9266 - PEGASPARGASE INJECTION||20537.5787|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9265|J9265 - PACLITAXEL 30 MG||4.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9264|J9264 - PACLITAXEL PROTEIN BOUND||15.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9263|J9263 - OXALIPLATIN||0.1575|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9261|J9261 - NELARABINE INJECTION||190.4038|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9260|J9260 - METHOTREXATE SODIUM INJ||3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9250|J9250 - METHOTREXATE SODIUM INJ||0.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9245|J9245 - INJ MELPHALAN HYDROCHL 50 MG||795.1675|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9230|J9230 - MECHLORETHAMINE HCL INJ||403.3238|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9228|J9228 - IPILIMUMAB INJECTION||191.3237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9226|J9226 - SUPPRELIN LA IMPLANT||43743.1138|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9225|J9225 - VANTAS IMPLANT||4871.745|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9218|J9218 - LEUPROLIDE ACETATE INJECITON||67.4614|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9217|J9217 - LEUPROLIDE ACETATE SUSPNSION||286.8975|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9214|J9214 - INTERFERON ALFA-2B INJ||42.4875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9211|J9211 - IDARUBICIN HCL INJECTION||40.6813|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9209|J9209 - MESNA INJECTION||1.835|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9208|J9208 - IFOSFAMIDE INJECTION||32.115|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9207|J9207 - IXABEPILONE INJECTION||111.8175|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9206|J9206 - IRINOTECAN INJECTION||3.4213|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9205|J9205 - INJ IRINOTECAN LIPOSOME 1 MG||62.2325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9203|J9203 - GEMTUZUMAB OZOGAMICIN 0.1 MG||241.445|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9202|J9202 - GOSERELIN ACETATE IMPLANT||625.3075|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9201|J9201 - GEMCITABINE HCL INJECTION||5.5775|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9200|J9200 - FLOXURIDINE INJECTION||93.5412|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9190|J9190 - FLUOROURACIL INJECTION||2.295|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9185|J9185 - FLUDARABINE PHOSPHATE INJ||74.6562|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9181|J9181 - ETOPOSIDE INJECTION||0.7775|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9179|J9179 - ERIBULIN MESYLATE INJECTION||144.7025|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9178|J9178 - INJ -  EPIRUBICIN HCL -  2 MG||1.1562|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9176|J9176 - INJECTION -  ELOTUZUMAB -  1 MG||8.1137|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9175|J9175 - ELLIOTTS B SOLUTION PER ML||54.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9171|J9171 - DOCETAXEL INJECTION||1.0675|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9160|J9160 - DENILEUKIN DIFTITOX INJ||77.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9155|J9155 - DEGARELIX INJECTION||4.8788|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9150|J9150 - DAUNORUBICIN INJECTION||58.925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9145|J9145 - INJECTION -  DARATUMUMAB 10 MG||67.1887|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9130|J9130 - DACARBAZINE 100 MG INJ||5.0725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9120|J9120 - DACTINOMYCIN INJECTION||1367.7238|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9100|J9100 - CYTARABINE HCL 100 MG INJ||0.7288|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9098|J9098 - CYTARABINE LIPOSOME INJ||785.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9070|J9070 - CYCLOPHOSPHAMIDE 100 MG INJ||43.4087|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9065|J9065 - INJ CLADRIBINE PER 1 MG||24.6588|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9060|J9060 - CISPLATIN 10 MG INJECTION||2.3638|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9055|J9055 - CETUXIMAB INJECTION||77.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9050|J9050 - CARMUSTINE INJECTION||4418.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9047|J9047 - INJECTION -  CARFILZOMIB -  1 MG||46.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9045|J9045 - CARBOPLATIN INJECTION||3.6125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9043|J9043 - CABAZITAXEL INJECTION||216.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9042|J9042 - BRENTUXIMAB VEDOTIN INJ||203.8325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9041|J9041 - INJ. -  VELCADE 0.1 MG||55.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9040|J9040 - BLEOMYCIN SULFATE INJECTION||34.5463|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9039|J9039 - INJECTION -  BLINATUMOMAB||141.1962|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9035|J9035 - BEVACIZUMAB INJECTION||101.6025|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9034|J9034 - INJ. -  BENDEKA 1 MG||29.7512|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9033|J9033 - INJ. -  TREANDA 1 MG||36.0962|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9032|J9032 - INJECTION -  BELINOSTAT -  10MG||49.3013|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9031|J9031 - BCG LIVE INTRAVESICAL VAC||172.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9027|J9027 - CLOFARABINE INJECTION||71.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9025|J9025 - AZACITIDINE INJECTION||1.5925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9023|J9023 - INJECTION -  AVELUMAB -  10 MG||103.4287|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9022|J9022 - INJ -  ATEZOLIZUMAB - 10 MG||96.4725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9020|J9020 - ASPARAGINASE -  NOS||80.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9019|J9019 - ERWINAZE INJECTION||518.5312|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9017|J9017 - ARSENIC TRIOXIDE INJECTION||64.0362|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9015|J9015 - ALDESLEUKIN INJECTION||2638.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9010|J9010 - ALEMTUZUMAB 10 MG||0.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J9000|J9000 - DOXORUBICIN HCL INJECTION||3.6175|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8705|J8705 - TOPOTECAN ORAL||129.625|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8700|J8700 - TEMOZOLOMIDE||0.9563|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8670|J8670 - ROLAPITANT -  ORAL -  1 MG||2.7725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8655|J8655 - ORAL NETUPITANT -  PALONOSETRO||312.7488|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8610|J8610 - METHOTREXATE ORAL 2.5 MG||0.1875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8600|J8600 - MELPHALAN ORAL 2 MG||14.9995|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8562|J8562 - ORAL FLUDARABINE PHOSPHATE||6.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8560|J8560 - ETOPOSIDE ORAL 50 MG||93.2638|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8540|J8540 - ORAL DEXAMETHASONE||0.0063|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8530|J8530 - CYCLOPHOSPHAMIDE ORAL 25 MG||4.9013|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8521|J8521 - CAPECITABINE -  ORAL -  500 MG||4.555|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8520|J8520 - CAPECITABINE -  ORAL -  150 MG||1.5163|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8510|J8510 - ORAL BUSULFAN||30.3475|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J8501|J8501 - ORAL APREPITANT||6.1613|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7686|J7686 - TREPROSTINIL -  NON-COMP UNIT||766.1962|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7682|J7682 - TOBRAMYCIN NON-COMP UNIT||54.9813|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7674|J7674 - METHACHOLINE CHLORIDE -  NEB||0.8363|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7669|J7669 - METAPROTERENOL NON-COMP UNIT||4.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7665|J7665 - MANNITOL FOR INHALER||0.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7644|J7644 - IPRATROPIUM BROMIDE NON-COMP||0.2463|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7639|J7639 - DORNASE ALFA NON-COMP UNIT||59.725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7631|J7631 - CROMOLYN SODIUM NONCOMP UNIT||6.6338|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7626|J7626 - BUDESONIDE NON-COMP UNIT||2.8175|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7620|J7620 - ALBUTEROL IPRATROP NON-COMP||0.1663|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7614|J7614 - LEVALBUTEROL NON-COMP UNIT||0.0825|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7613|J7613 - ALBUTEROL NON-COMP UNIT||0.0537|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7612|J7612 - LEVALBUTEROL NON-COMP CON||0.2612|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7611|J7611 - ALBUTEROL NON-COMP CON||0.2075|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7608|J7608 - ACETYLCYSTEINE NON-COMP UNIT||7.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7606|J7606 - FORMOTEROL FUMARATE -  INH||14.4325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7605|J7605 - ARFORMOTEROL NON-COMP UNIT||12.7875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7527|J7527 - ORAL EVEROLIMUS||11.1312|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7525|J7525 - TACROLIMUS INJECTION||264.725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7520|J7520 - SIROLIMUS -  ORAL||8.695|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7518|J7518 - MYCOPHENOLIC ACID||3.7237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7517|J7517 - MYCOPHENOLATE MOFETIL ORAL||0.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7516|J7516 - CYCLOSPORIN PARENTERAL 250MG||66.5637|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7515|J7515 - CYCLOSPORINE ORAL 25 MG||0.8313|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7513|J7513 - DACLIZUMAB -  PARENTERAL||244.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7512|J7512 - PREDNISONE IR OR DR ORAL 1 MG||0.0187|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7511|J7511 - ANTITHYMOCYTE GLOBULN RABBIT||951.4038|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7510|J7510 - PREDNISOLONE ORAL PER 5 MG||0.1013|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7509|J7509 - METHYLPREDNISOLONE ORAL||0.3013|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7508|J7508 - TACROL ASTAGRAF EX REL ORAL||0.5988|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7507|J7507 - TACROLIMUS IMME REL ORAL 1MG||0.5925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7506|J7506 - PREDNISONE ORAL PER 5 MG||0.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7505|J7505 - MONOCLONAL ANTIBODIES||501.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7504|J7504 - LYMPHOCYTE IMMUNE GLOBULIN||2590.2938|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7503|J7503 - TACROL ENVARSUS EX REL ORAL||1.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7502|J7502 - CYCLOSPORINE ORAL 100 MG||2.7225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7501|J7501 - AZATHIOPRINE PARENTERAL||271.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7500|J7500 - AZATHIOPRINE ORAL 50MG||1.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7336|J7336 - CAPSAICIN 8% PATCH||3.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7335|J7335 - CAPSAICIN 8% PATCH PER 10 SQ CENTIMETERS||33.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7330|J7330 - CULTURED CHONDROCYTES IMPLNT||1.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7327|J7327 - MONOVISC INJ PER DOSE||995.7025|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7326|J7326 - GEL-ONE||636.685|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7325|J7325 - SYNVISC OR SYNVISC-ONE||14.235|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7324|J7324 - ORTHOVISC INJ PER DOSE||175.4263|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7323|J7323 - EUFLEXXA INJ PER DOSE||179.1137|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7321|J7321 - HYALGAN SUPARTZ VISCO-3 DOSE||93.5662|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7320|J7320 - GENVISC 850 -  INJ -  1 MG||7.815|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7316|J7316 - INJ -  OCRIPLASMIN -  0.125 MG||1308.6587|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7313|J7313 - FLUOCINOL ACET INTRAVIT IMP||613.6762|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7312|J7312 - DEXAMETHASONE INTRA IMPLANT||249.7612|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7311|J7311 - FLUOCINOLONE ACETONIDE IMPLT||25157.2887|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7310|J7310 - GANCICLOVIR LONG ACT IMPLANT||21200|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7309|J7309 - METHYL AMINOLEVULINATE -  TOP||1.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7308|J7308 - AMINOLEVULINIC ACID HCL TOP||501.7312|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7205|J7205 - FACTOR VIII FC FUSION RECOMB||2.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7201|J7201 - FACTOR IX ALPROLIX RECOMB||3.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7200|J7200 - FACTOR IX RECOMBINAN RIXUBIS||1.7488|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7198|J7198 - ANTI-INHIBITOR||2.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7197|J7197 - ANTITHROMBIN III INJECTION||4.2588|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7195|J7195 - FACTOR IX RECOMBINANT NOS||1.8837|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7194|J7194 - FACTOR IX COMPLEX||1.7938|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7193|J7193 - FACTOR IX NON-RECOMBINANT||1.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7192|J7192 - FACTOR VIII RECOMBINANT NOS||1.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7190|J7190 - FACTOR VIII||1.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7189|J7189 - FACTOR VIIA||2.6662|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7187|J7187 - HUMATE-P -  INJ||1.4525|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7186|J7186 - ANTIHEMOPHILIC VIII/VWF COMP||1.3075|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7185|J7185 - XYNTHA INJ||1.5637|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7183|J7183 - WILATE INJECTION||1.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7182|J7182 - FACTOR VIII RECOMB NOVOEIGHT||1.6212|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7180|J7180 - FACTOR XIII ANTI-HEM FACTOR||10.5875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7120|J7120 - RINGERS LACTATE INFUSION||2.9588|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7100|J7100 - DEXTRAN 40 INFUSION||22.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7070|J7070 - D5W INFUSION||4.8675|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7060|J7060 - 5% DEXTROSE/WATER||2.4475|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7050|J7050 - NORMAL SALINE SOLUTION INFUS||0.775|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7042|J7042 - 5% DEXTROSE/NORMAL SALINE||1.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7040|J7040 - NORMAL SALINE SOLUTION INFUS||1.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J7030|J7030 - NORMAL SALINE SOLUTION INFUS||3.0987|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3489|J3489 - ZOLEDRONIC ACID 1MG||14.4988|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3486|J3486 - ZIPRASIDONE MESYLATE||23.0663|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3485|J3485 - ZIDOVUDINE||1.8912|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3480|J3480 - INJ POTASSIUM CHLORIDE||0.225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3475|J3475 - INJ MAGNESIUM SULFATE||0.855|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3473|J3473 - HYALURONIDASE RECOMBINANT||0.4475|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3471|J3471 - OVINE -  UP TO 999 USP UNITS||0.5312|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3470|J3470 - HYALURONIDASE INJECTION||3.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3465|J3465 - INJECTION -  VORICONAZOLE||2.8925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3430|J3430 - VITAMIN K PHYTONADIONE INJ||5.2363|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3420|J3420 - VITAMIN B12 INJECTION||2.2925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3415|J3415 - PYRIDOXINE HCL 100 MG||11.2575|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3411|J3411 - THIAMINE HCL 100 MG||3.205|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3410|J3410 - HYDROXYZINE HCL INJECTION||9.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3396|J3396 - VERTEPORFIN INJECTION||13.8125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3385|J3385 - VELAGLUCERASE ALFA||431.4238|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3380|J3380 - INJECTION -  VEDOLIZUMAB||25.1638|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3370|J3370 - VANCOMYCIN HCL INJECTION||4.5587|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3360|J3360 - DIAZEPAM INJECTION||12.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3358|J3358 - USTEKINUMAB -  IV INJECT -  1 MG||14.995|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3357|J3357 - USTEKINUMAB SUB CU INJ -  1 MG||238.3837|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3355|J3355 - UROFOLLITROPIN -  75 IU||2.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3315|J3315 - TRIPTORELIN PAMOATE||310.4887|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3303|J3303 - TRIAMCINOLONE HEXACETONL INJ||2.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3302|J3302 - TRIAMCINOLONE DIACETATE INJ||1.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3301|J3301 - TRIAMCINOLONE ACET INJ NOS||1.9837|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3300|J3300 - TRIAMCINOLONE A INJ PRS-FREE||4.815|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3285|J3285 - TREPROSTINIL INJECTION||81.1438|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3262|J3262 - TOCILIZUMAB INJECTION||6.1662|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3260|J3260 - TOBRAMYCIN SULFATE INJECTION||3.6725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3250|J3250 - TRIMETHOBENZAMIDE HCL INJ||45.6875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3246|J3246 - TIROFIBAN HCL||2.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3243|J3243 - TIGECYCLINE INJECTION||2.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3240|J3240 - THYROTROPIN INJECTION||2112.8788|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3230|J3230 - CHLORPROMAZINE HCL INJECTION||41.4963|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3130|J3130 - INJECTION TESTOSTERONE ENANTHATE UP TO 200 MG||11.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3121|J3121 - INJ TESTOSTERO ENANTHATE 1MG||0.0638|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3120|J3120 - INJECTION TESTOSTERONE ENANTHATE UP TO 100 MG||9.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3105|J3105 - TERBUTALINE SULFATE INJ||3.1988|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3101|J3101 - TENECTEPLASE INJECTION||152.2325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3095|J3095 - TELAVANCIN INJECTION||7.3062|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3090|J3090 - INJ TEDIZOLID PHOSPHATE||1.8538|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3070|J3070 - PENTAZOCINE INJECTION||135.4813|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3060|J3060 - INJ -  TALIGLUCERASE ALFA 10 U||50.4225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3010|J3010 - FENTANYL CITRATE INJECTION||1.0075|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J3000|J3000 - STREPTOMYCIN INJECTION||39.4713|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2997|J2997 - ALTEPLASE RECOMBINANT||109.6075|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2993|J2993 - RETEPLASE INJECTION||2877.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2930|J2930 - METHYLPREDNISOLONE INJECTION||7.7112|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2920|J2920 - METHYLPREDNISOLONE INJECTION||5.6113|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2916|J2916 - NA FERRIC GLUCONATE COMPLEX||2.1612|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2850|J2850 - INJ SECRETIN SYNTHETIC HUMAN||43.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2820|J2820 - SARGRAMOSTIM INJECTION||52.995|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2810|J2810 - INJ THEOPHYLLINE PER 40 MG||0.5194|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2805|J2805 - SINCALIDE INJECTION||135.0662|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2800|J2800 - METHOCARBAMOL INJECTION||15.6487|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2796|J2796 - ROMIPLOSTIM INJECTION||91.8812|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2795|J2795 - ROPIVACAINE HCL INJECTION||0.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2794|J2794 - RISPERIDONE -  LONG ACTING||12.4425|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2792|J2792 - RHO(D) IMMUNE GLOBULIN H -  SD||37.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2791|J2791 - RHOPHYLAC INJECTION||5.9462|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2790|J2790 - RHO D IMMUNE GLOBULIN INJ||98.415|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2788|J2788 - RHO D IMMUNE GLOBULIN 50 MCG||29.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2785|J2785 - REGADENOSON INJECTION||74.0875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2783|J2783 - RASBURICASE||359.555|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2780|J2780 - RANITIDINE HYDROCHLORIDE INJ||5.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2778|J2778 - RANIBIZUMAB INJECTION||446.6788|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2770|J2770 - QUINUPRISTIN/DALFOPRISTIN||522.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2765|J2765 - METOCLOPRAMIDE HCL INJECTION||1.5625|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2760|J2760 - PHENTOLAINE MESYLATE INJ||490.1875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2730|J2730 - PRALIDOXIME CHLORIDE INJ||114.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2724|J2724 - PROTEIN C CONCENTRATE||18.8225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2720|J2720 - INJ PROTAMINE SULFATE/10 MG||1.4925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2704|J2704 - INJ -  PROPOFOL -  10 MG||0.1288|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2700|J2700 - OXACILLIN SODIUM INJECITON||1.8525|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2690|J2690 - PROCAINAMIDE HCL INJECTION||87.6812|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2680|J2680 - FLUPHENAZINE DECANOATE 25 MG||14.3187|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2675|J2675 - INJ PROGESTERONE PER 50 MG||2.8287|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2597|J2597 - INJ DESMOPRESSIN ACETATE||14.9575|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2590|J2590 - OXYTOCIN INJECTION||26.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2562|J2562 - PLERIXAFOR INJECTION||434.0537|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2560|J2560 - PHENOBARBITAL SODIUM INJ||51.7825|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2550|J2550 - PROMETHAZINE HCL INJECTION||3.0388|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2545|J2545 - PENTAMIDINE NON-COMP UNIT||119.9788|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2543|J2543 - PIPERACILLIN/TAZOBACTAM||2.2812|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2540|J2540 - PENICILLIN G POTASSIUM INJ||1.2725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2515|J2515 - PENTOBARBITAL SODIUM INJ||47.5538|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2510|J2510 - PENICILLIN G PROCAINE INJ||37.2763|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2507|J2507 - PEGLOTICASE INJECTION||3106.5525|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2505|J2505 - INJECTION -  PEGFILGRASTIM 6MG||5660.3888|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2504|J2504 - PEGADEMASE BOVINE -  25 IU||459.9513|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2503|J2503 - PEGAPTANIB SODIUM INJECTION||900.835|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2501|J2501 - PARICALCITOL||0.8188|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2469|J2469 - PALONOSETRON HCL||11.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2430|J2430 - PAMIDRONATE DISODIUM /30 MG||15.5838|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2426|J2426 - PALIPERIDONE PALMITATE INJ||14.3438|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2425|J2425 - PALIFERMIN INJECTION||26.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2410|J2410 - OXYMORPHONE HCL INJECTION||3.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2407|J2407 - INJECTION -  ORITAVANCIN||30.1725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2405|J2405 - ONDANSETRON HCL INJECTION||0.1537|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2400|J2400 - CHLOROPROCAINE HCL INJECTION||33.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2370|J2370 - PHENYLEPHRINE HCL INJECTION||4.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2360|J2360 - ORPHENADRINE INJECTION||8.0162|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2358|J2358 - OLANZAPINE LONG-ACTING INJ||3.6462|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2357|J2357 - OMALIZUMAB INJECTION||46.315|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2355|J2355 - OPRELVEKIN INJECTION||533.6437|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2354|J2354 - OCTREOTIDE INJ -  NON-DEPOT||1.0187|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2353|J2353 - OCTREOTIDE INJECTION -  DEPOT||255.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2350|J2350 - INJECTION -  OCRELIZUMAB -  1 MG||71.7713|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2325|J2325 - NESIRITIDE INJECTION||8.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2323|J2323 - NATALIZUMAB INJECTION||25.365|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2315|J2315 - NALTREXONE -  DEPOT FORM||4.0425|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2310|J2310 - INJ NALOXONE HYDROCHLORIDE||21.8238|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2300|J2300 - INJ NALBUPHINE HYDROCHLORIDE||3.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2280|J2280 - INJ -  MOXIFLOXACIN 100 MG||11.8325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2278|J2278 - ZICONOTIDE INJECTION||9.8912|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2275|J2275 - INJECTION MORPHINE SULFATE PER 10 MG||5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2274|J2274 - INJ MORPHINE PF EPID ITHC||14.6375|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2271|J2271 - INJECTION MORPHINE SULFATE 100 MG||2.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2270|J2270 - MORPHINE SULFATE INJECTION||5.9112|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2260|J2260 - INJ MILRINONE LACTATE / 5 MG||2.5312|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2250|J2250 - INJ MIDAZOLAM HYDROCHLORIDE||0.1413|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2248|J2248 - MICAFUNGIN SODIUM INJECTION||1.2975|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2210|J2210 - METHYLERGONOVIN MALEATE INJ||21.5188|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2185|J2185 - MEROPENEM||1.225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2175|J2175 - MEPERIDINE HYDROCHL /100 MG||6.7188|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2150|J2150 - MANNITOL INJECTION||2.6388|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2060|J2060 - LORAZEPAM INJECTION||0.7988|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2020|J2020 - LINEZOLID INJECTION||8.6412|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2010|J2010 - LINCOMYCIN INJECTION||16.4475|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J2001|J2001 - LIDOCAINE INJECTION||0.0438|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1980|J1980 - HYOSCYAMINE SULFATE INJ||36.9363|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1956|J1956 - LEVOFLOXACIN INJECTION||1.3538|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1955|J1955 - INJ LEVOCARNITINE PER 1 GM||25.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1953|J1953 - LEVETIRACETAM INJECTION||0.1325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1950|J1950 - LEUPROLIDE ACETATE /3.75 MG||1584.7137|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1945|J1945 - LEPIRUDIN||9.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1942|J1942 - ARIPIPRAZOLE LAUROXIL 1MG||3.3213|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1940|J1940 - FUROSEMIDE INJECTION||0.9663|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1931|J1931 - LARONIDASE INJECTION||39.9363|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1930|J1930 - LANREOTIDE INJECTION||79.015|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1885|J1885 - KETOROLAC TROMETHAMINE INJ||0.8288|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1850|J1850 - KANAMYCIN SULFATE 75 MG INJ||1.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1840|J1840 - KANAMYCIN SULFATE 500 MG INJ||9.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1817|J1817 - INSULIN FOR INSULIN PUMP USE||13.735|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1815|J1815 - INSULIN INJECTION||1.1288|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1800|J1800 - PROPRANOLOL INJECTION||1.5388|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1790|J1790 - DROPERIDOL INJECTION||2.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1786|J1786 - IMUGLUCERASE INJECTION||53.5813|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1756|J1756 - IRON SUCROSE INJECTION||0.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1750|J1750 - INJ IRON DEXTRAN||18.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1745|J1745 - INFLIXIMAB NOT BIOSIMIL 10MG||81.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1743|J1743 - IDURSULFASE INJECTION||678.6125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1742|J1742 - IBUTILIDE FUMARATE INJECTION||191.0725|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1740|J1740 - IBANDRONATE SODIUM INJECTION||57.1587|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1720|J1720 - HYDROCORTISONE SODIUM SUCC I||16.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1670|J1670 - TETANUS IMMUNE GLOBULIN INJ||523.5488|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1652|J1652 - FONDAPARINUX SODIUM||2.1813|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1650|J1650 - INJ ENOXAPARIN SODIUM||1.0437|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1645|J1645 - DALTEPARIN SODIUM||16.4413|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1644|J1644 - INJ HEPARIN SODIUM PER 1000U||0.2538|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1642|J1642 - INJ HEPARIN SODIUM PER 10 U||0.2075|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1640|J1640 - HEMIN -  1 MG||29.7012|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1631|J1631 - HALOPERIDOL DECANOATE INJ||20.8087|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1630|J1630 - HALOPERIDOL INJECTION||1.415|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1627|J1627 - INJ -  GRANISETRON -  XR -  0.1 MG||3.815|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1626|J1626 - GRANISETRON HCL INJECTION||0.3762|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1610|J1610 - GLUCAGON HYDROCHLORIDE/1 MG||250.3288|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1602|J1602 - GOLIMUMAB FOR IV USE 1MG||27.3575|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1600|J1600 - GOLD SODIUM THIOMALEATE INJ||49.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1580|J1580 - GARAMYCIN GENTAMICIN INJ||2.2812|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1575|J1575 - HYQVIA 100MG IMMUNEGLOBULIN||17.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1573|J1573 - HEPAGAM B INTRAVENOUS -  INJ||38.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1572|J1572 - FLEBOGAMMA INJECTION||44.8212|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1571|J1571 - HEPAGAM B IM INJECTION||75.4375|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1570|J1570 - GANCICLOVIR SODIUM INJECTION||58.8375|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1569|J1569 - GAMMAGARD LIQUID INJECTION||51.2087|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1568|J1568 - OCTAGAM INJECTION||48.3438|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1566|J1566 - IMMUNE GLOBULIN -  POWDER||77.7738|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1561|J1561 - GAMUNEX-C/GAMMAKED||48.3038|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1560|J1560 - GAMMA GLOBULIN > 10 CC INJ||506.6975|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1559|J1559 - HIZENTRA INJECTION||12.7363|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1557|J1557 - GAMMAPLEX INJECTION||57.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1556|J1556 - INJ -  IMM GLOB BIVIGAM -  500 MG||88.145|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1555|J1555 - INJ CUVITRU -  100 MG||17.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1460|J1460 - GAMMA GLOBULIN 1 CC INJ||50.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1459|J1459 - INJ IVIG PRIVIGEN 500 MG||50.7538|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1458|J1458 - GALSULFASE INJECTION||487.5838|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1453|J1453 - FOSAPREPITANT INJECTION||2.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1451|J1451 - FOMEPIZOLE -  15 MG||285.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1450|J1450 - FLUCONAZOLE||6.465|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1447|J1447 - INJ TBO FILGRASTIM 1 MICROG||0.7237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1446|J1446 - INJ TBO-FILGRASTIM 5 MCG||4.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1442|J1442 - INJ FILGRASTIM EXCL BIOSIMIL||1.2237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1441|J1441 - INJECTION FILGRASTIM 480 MCG||156.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1440|J1440 - INJECTION FILGRASTIM 300 MCG||11.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1439|J1439 - INJ FERRIC CARBOXYMALTOS 1 MG||1.3638|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1438|J1438 - ETANERCEPT INJECTION||514.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1430|J1430 - ETHANOLAMINE OLEATE 100 MG||555.1237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1410|J1410 - INJ ESTROGEN CONJUGATE 25 MG||386.6638|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1380|J1380 - ESTRADIOL VALERATE 10 MG INJ||11.6762|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1364|J1364 - ERYTHRO LACTOBIONATE /500 MG||98.584|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1335|J1335 - ERTAPENEM INJECTION||55.7825|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1327|J1327 - EPTIFIBATIDE INJECTION||1.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1325|J1325 - EPOPROSTENOL INJECTION||20.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1300|J1300 - ECULIZUMAB INJECTION||288.0987|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1290|J1290 - ECALLANTIDE INJECTION||600.685|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1270|J1270 - INJECTION -  DOXERCALCIFEROL||0.2925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1267|J1267 - DORIPENEM INJECTION||1.1062|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1265|J1265 - DOPAMINE INJECTION||0.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1260|J1260 - DOLASETRON MESYLATE||7.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1250|J1250 - INJ DOBUTAMINE HCL/250 MG||10.6562|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1245|J1245 - DIPYRIDAMOLE INJECTION||1.7888|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1240|J1240 - DIMENHYDRINATE INJECTION||9.3362|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1230|J1230 - METHADONE INJECTION||22.685|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1212|J1212 - DIMETHYL SULFOXIDE 50% 50 ML||698.585|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1205|J1205 - CHLOROTHIAZIDE SODIUM INJ||63.3012|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1200|J1200 - DIPHENHYDRAMINE HCL INJECTIO||1.0775|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1190|J1190 - DEXRAZOXANE HCL INJECTION||243.3938|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1170|J1170 - HYDROMORPHONE INJECTION||5.2438|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1165|J1165 - PHENYTOIN SODIUM INJECTION||0.9425|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1162|J1162 - DIGOXIN IMMUNE FAB (OVINE)||4725.3237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1160|J1160 - DIGOXIN INJECTION||6.5175|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1120|J1120 - ACETAZOLAMID SODIUM INJECTIO||19.3837|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1110|J1110 - INJ DIHYDROERGOTAMINE MESYLT||71.6088|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1100|J1100 - DEXAMETHASONE SODIUM PHOS||0.155|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1080|J1080 - INJECTION TESTOSTERONE CYPIONATE 1 CC 200 MG||6.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1071|J1071 - INJ TESTOSTERONE CYPIONATE||0.0338|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1070|J1070 - INJECTION TESTOSTERONE CYPIONATE UP TO 100 MG||6.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1050|J1050 - MEDROXYPROGESTERONE ACETATE||0.7062|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1040|J1040 - METHYLPREDNISOLONE 80 MG INJ||15.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1030|J1030 - METHYLPREDNISOLONE 40 MG INJ||7.7975|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1020|J1020 - METHYLPREDNISOLONE 20 MG INJ||4.5762|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J1000|J1000 - DEPO-ESTRADIOL CYPIONATE INJ||27.4475|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0897|J0897 - DENOSUMAB INJECTION||23.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0895|J0895 - DEFEROXAMINE MESYLATE INJ||10.2562|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0894|J0894 - DECITABINE INJECTION||9.3238|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0888|J0888 - EPOETIN BETA NON ESRD||2.0625|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0887|J0887 - EPOETIN BETA ESRD USE||2.0625|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0886|J0886 - INJ -  EPOETIN ALFA -  1000 UNITS FOR ESRD ON DIALYSIS||15.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0885|J0885 - EPOETIN ALFA -  NON-ESRD||14.3275|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0882|J0882 - DARBEPOETIN ALFA -  ESRD USE||4.7837|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0881|J0881 - DARBEPOETIN ALFA -  NON-ESRD||4.7837|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0878|J0878 - DAPTOMYCIN INJECTION||0.4375|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0875|J0875 - INJECTION -  DALBAVANCIN||18.2688|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0850|J0850 - CYTOMEGALOVIRUS IMM IV /VIAL||1411.4425|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0840|J0840 - CROTALIDAE POLY IMMUNE FAB||4046.2563|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0834|J0834 - INJ. -  COSYNTROPIN -  0.25 MG||55.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0800|J0800 - CORTICOTROPIN INJECTION||4952.7125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0795|J0795 - CORTICORELIN OVINE TRIFLUTAL||11.3063|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0780|J0780 - PROCHLORPERAZINE INJECTION||12.9238|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0775|J0775 - COLLAGENASE -  CLOST HIST INJ||58.8612|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0770|J0770 - COLISTIMETHATE SODIUM INJ||24.0512|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0744|J0744 - CIPROFLOXACIN IV||1.6362|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0743|J0743 - CILASTATIN SODIUM INJECTION||7.3125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0740|J0740 - CIDOFOVIR INJECTION||804.1163|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0735|J0735 - CLONIDINE HYDROCHLORIDE||14.4613|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0725|J0725 - CHORIONIC GONADOTROPIN/1000U||27.9625|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0720|J0720 - CHLORAMPHENICOL SODIUM INJEC||47.9162|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0718|J0718 - INJECTION -  CERTOLIZUMAB PEGOL -  1 MG||5.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0717|J0717 - CERTOLIZUMAB PEGOL INJ 1MG||10.165|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0713|J0713 - INJ CEFTAZIDIME PER 500 MG||2.505|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0712|J0712 - CEFTAROLINE FOSAMIL INJ||3.9525|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0706|J0706 - CAFFEINE CITRATE INJECTION||0.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0702|J0702 - BETAMETHASONE ACET&SOD PHOSP||8.6375|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0698|J0698 - CEFOTAXIME SODIUM INJECTION||2.915|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0697|J0697 - STERILE CEFUROXIME INJECTION||2.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0696|J0696 - CEFTRIAXONE SODIUM INJECTION||0.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0694|J0694 - CEFOXITIN SODIUM INJECTION||6.2038|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0692|J0692 - CEFEPIME HCL FOR INJECTION||2.345|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0690|J0690 - CEFAZOLIN SODIUM INJECTION||0.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0670|J0670 - INJ MEPIVACAINE HCL/10 ML||2.5025|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0641|J0641 - LEVOLEUCOVORIN INJECTION||0.205|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0640|J0640 - LEUCOVORIN CALCIUM INJECTION||3.7738|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0638|J0638 - CANAKINUMAB INJECTION||138.765|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0637|J0637 - CASPOFUNGIN ACETATE||12.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0636|J0636 - INJ CALCITRIOL PER 0.1 MCG||0.9043|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0630|J0630 - CALCITONIN SALMON INJECTION||3309.0775|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0610|J0610 - CALCIUM GLUCONATE INJECTION||4.3875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0600|J0600 - EDETATE CALCIUM DISODIUM INJ||6993.0275|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0598|J0598 - C-1 ESTERASE -  CINRYZE||71.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0597|J0597 - C-1 ESTERASE -  BERINERT||64.1925|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0596|J0596 - INJECTION -  RUCONEST||34.7713|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0595|J0595 - BUTORPHANOL TARTRATE 1 MG||2.8287|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0594|J0594 - BUSULFAN INJECTION||7.2225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0592|J0592 - BUPRENORPHINE HYDROCHLORIDE||5.4488|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0588|J0588 - INCOBOTULINUMTOXIN A||6.3138|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0587|J0587 - INJ -  RIMABOTULINUMTOXINB||15.0237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0586|J0586 - ABOBOTULINUMTOXINA||10.5237|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0585|J0585 - INJECTION - ONABOTULINUMTOXINA||7.655|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0583|J0583 - BIVALIRUDIN||0.665|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0570|J0570 - BUPRENORPHINE IMPLANT 74.2MG||1577.3388|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0561|J0561 - PENICILLIN G BENZATHINE INJ||17.3063|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0558|J0558 - PENG BENZATHINE/PROCAINE INJ||13.7737|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0515|J0515 - INJ BENZTROPINE MESYLATE||24.8675|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0500|J0500 - DICYCLOMINE INJECTION||87.4675|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0490|J0490 - BELIMUMAB INJECTION||56.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0485|J0485 - BELATACEPT INJECTION||4.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0480|J0480 - BASILIXIMAB||4737.0325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0476|J0476 - BACLOFEN INTRATHECAL TRIAL||63.0513|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0475|J0475 - BACLOFEN 10 MG INJECTION||216.7363|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0470|J0470 - DIMECAPROL INJECTION||67.8462|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0461|J0461 - ATROPINE SULFATE INJECTION||0.0838|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0456|J0456 - AZITHROMYCIN||3.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0401|J0401 - INJ ARIPIPRAZOLE EXT REL 1MG||6.8112|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0400|J0400 - ARIPIPRAZOLE INJECTION||0.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0365|J0365 - APROTONIN -  10 - 000 KIU||3.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0364|J0364 - APOMORPHINE HYDROCHLORIDE||38.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0360|J0360 - HYDRALAZINE HCL INJECTION||5.0838|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0348|J0348 - ANIDULAFUNGIN INJECTION||0.6863|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0295|J0295 - AMPICILLIN SULBACTAM 1.5 GM||4.1463|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0290|J0290 - AMPICILLIN 500 MG INJ||1.1513|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0289|J0289 - AMPHOTERICIN B LIPOSOME INJ||22.9062|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0288|J0288 - AMPHO B CHOLESTERYL SULFATE||17.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0287|J0287 - AMPHOTERICIN B LIPID COMPLEX||8.9025|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0285|J0285 - AMPHOTERICIN B||50.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0280|J0280 - AMINOPHYLLIN 250 MG INJ||9.1675|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0278|J0278 - AMIKACIN SULFATE INJECTION||1.5125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0257|J0257 - GLASSIA INJECTION||6.1087|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0256|J0256 - ALPHA 1 PROTEINASE INHIBITOR||5.6337|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0221|J0221 - LUMIZYME INJECTION||212.6012|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0220|J0220 - ALGLUCOSIDASE ALFA INJECTION||258.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0215|J0215 - ALEFACEPT||52.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0210|J0210 - METHYLDOPATE HCL INJECTION||53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0207|J0207 - AMIFOSTINE||1221.6375|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0202|J0202 - INJECTION -  ALEMTUZUMAB||2397.9325|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0180|J0180 - AGALSIDASE BETA INJECTION||228.0362|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0178|J0178 - AFLIBERCEPT INJECTION||1196.7038|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0171|J0171 - ADRENALIN EPINEPHRINE INJECT||1.0775|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0153|J0153 - ADENOSINE INJ 1MG||0.7888|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0152|J0152 - INJECTION ADENOSINE 30MG||136.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0151|J0151 - INJECTION ADENOSINE DIAG 1 MG||2.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0150|J0150 - INJECTION ADENOSINE 6 MG||7.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0135|J0135 - ADALIMUMAB INJECTION||1061.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0133|J0133 - ACYCLOVIR INJECTION||0.0488|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0132|J0132 - ACETYLCYSTEINE INJECTION||1.6338|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0130|J0130 - ABCIXIMAB INJECTION||1786.3385|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0129|J0129 - ABATACEPT INJECTION||67.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|J0120|J0120 - TETRACYCLIN INJECTION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2037|H2037 - DEV DELAY PREV DP CH -  15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2036|H2036 - A/D TX PROGRAM -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2035|H2035 - A/D TX PROGRAM -  PER HOUR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2034|H2034 - A/D HALFWAY HOUSE -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2033|H2033 - MULTISYS THER/JUVENILE 15MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2032|H2032 - ACTIVITY THERAPY -  PER 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2031|H2031 - MH CLUBHOUSE SVC -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2030|H2030 - MH CLUBHOUSE SVC -  PER 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2029|H2029 - SEX OFFEND TX SVC -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2028|H2028 - SEX OFFEND TX SVC -  15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2027|H2027 - PSYCHOED SVC -  PER 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2026|H2026 - SUPP MAINT EMPLOY -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2025|H2025 - SUPP MAINT EMPLOY -  15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2024|H2024 - SUPPORTED EMPLOY -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2023|H2023 - SUPPORTED EMPLOY -  PER 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2022|H2022 - COM WRAP-AROUND SV -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2021|H2021 - COM WRAP-AROUND SV -  15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2020|H2020 - THER BEHAV SVC -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2019|H2019 - THER BEHAV SVC -  PER 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2018|H2018 - PSYSOC REHAB SVC -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2017|H2017 - PSYSOC REHAB SVC -  PER 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2016|H2016 - COMP COMM SUPP SVC -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2015|H2015 - COMP COMM SUPP SVC -  15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2014|H2014 - SKILLS TRAIN AND DEV -  15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2013|H2013 - PSYCH HLTH FAC SVC -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2012|H2012 - BEHAV HLTH DAY TREAT -  PER HR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2011|H2011 - CRISIS INTERVEN SVC -  15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2010|H2010 - COMPREHENSIVE MED SVC 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2001|H2001 - REHABILITATION PROGRAM 1/2 D||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H2000|H2000 - COMP MULTIDISIPLN EVALUATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H1011|H1011 - FAMILY ASSESSMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H1010|H1010 - NONMED FAMILY PLANNING ED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H1005|H1005 - PRENATALCARE ENHANCED SRV PK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H1004|H1004 - FOLLOW UP HOME VISIT/PRENTAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H1003|H1003 - PRENATAL AT RISK EDUCATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H1002|H1002 - CARECOORDINATION PRENATAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H1001|H1001 - ANTEPARTUM MANAGEMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H1000|H1000 - PRENATAL CARE ATRISK ASSESSM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0050|H0050 - ALCOHOL/DRUG SERVICE 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0049|H0049 - ALCOHOL/DRUG SCREENING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0048|H0048 - SPEC COLL NON-BLOOD:A/D TEST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0047|H0047 - ALCOHOL/DRUG ABUSE SVC NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0046|H0046 - MENTAL HEALTH SERVICE -  NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0045|H0045 - RESPITE NOT-IN-HOME PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0044|H0044 - SUPPORTED HOUSING -  PER MONTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0043|H0043 - SUPPORTED HOUSING -  PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0042|H0042 - FOS C CHLD NON-THER PER MON||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0041|H0041 - FOS C CHLD NON-THER PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0040|H0040 - ASSERT COMM TX PGM PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0039|H0039 - ASSER COM TX FACE-FACE/15MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0038|H0038 - SELF-HELP/PEER SVC PER 15MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0037|H0037 - COMM PSY SUP TX PGM PER DIEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0036|H0036 - COMM PSY FACE-FACE PER 15MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0035|H0035 - MH PARTIAL HOSP TX UNDER 24H||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0034|H0034 - MED TRNG & SUPPORT PER 15MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0033|H0033 - ORAL MED ADM DIRECT OBSERVE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0032|H0032 - MH SVC PLAN DEV BY NON-MD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0031|H0031 - MH HEALTH ASSESS BY NON-MD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0030|H0030 - ALCOHOL AND/OR DRUG HOTLINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0029|H0029 - ALCOHOL AND/OR DRUG PREVENTI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0028|H0028 - ALCOHOL AND/OR DRUG PREVENTI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0027|H0027 - ALCOHOL AND/OR DRUG PREVENTI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0026|H0026 - ALCOHOL AND/OR DRUG PREVENTI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0025|H0025 - ALCOHOL AND/OR DRUG PREVENTI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0024|H0024 - ALCOHOL AND/OR DRUG PREVENTI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0023|H0023 - ALCOHOL AND/OR DRUG OUTREACH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0022|H0022 - ALCOHOL AND/OR DRUG INTERVEN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0021|H0021 - ALCOHOL AND/OR DRUG TRAINING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0020|H0020 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0019|H0019 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0018|H0018 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0017|H0017 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0016|H0016 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0015|H0015 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0014|H0014 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0013|H0013 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0012|H0012 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0011|H0011 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0010|H0010 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0009|H0009 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0008|H0008 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0007|H0007 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0006|H0006 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0005|H0005 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0004|H0004 - ALCOHOL AND/OR DRUG SERVICES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0003|H0003 - ALCOHOL AND/OR DRUG SCREENIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0002|H0002 - ALCOHOL AND/OR DRUG SCREENIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|H0001|H0001 - ALCOHOL AND/OR DRUG ASSESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9156|G9156 - EVALUATION FOR WHEELCHAIR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9147|G9147 - OUTPT IV INSULIN TX ANY MEA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9143|G9143 - WARFARIN RESPON GENETIC TEST||216.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9142|G9142 - INFLUENZA A (H1N1) IMMUNE ADMIN INC PHYS COUNSL||30.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9141|G9141 - INFLUENZA A (H1N1) VAC ANY ROUTE OF ADMIN||30.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9140|G9140 - FRONTIER EXTENDED STAY DEMO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9139|G9139 - ONC DX CML DX STATUS UNKNOWN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9138|G9138 - ONC DX NHL STG UNKNOWN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9137|G9137 - ONC DX NHL RELAPSE/REFRACTOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9136|G9136 - ONC DX NHL TRANS TO LG BCELL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9135|G9135 - ONC DX NHL STG 3-4 NOT RELAP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9134|G9134 - ONC NHLSTG 1-2 NO RELAP NO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9133|G9133 - ONC DX PROSTATE CLINICAL MET||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9132|G9132 - ONC DX PROSTATE METS NO CAST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9131|G9131 - ONC DX BRST UNKNOWN NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9130|G9130 - ONC DX MULTI MYELOMA UNKNOWN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9129|G9129 - ONC DX MULT MYELOMA STG2 HIG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9128|G9128 - ONC DX MULTI MYELOMA STAGE I||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9126|G9126 - ONC DX CML REMISSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9125|G9125 - ONC DX CML BLAST PHASE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9124|G9124 - ONC DX CML ACCELER PHASE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9123|G9123 - ONC DX CML CHRONIC PHASE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9117|G9117 - ONC DX OVARIAN UNKNOWN NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9116|G9116 - ONC DX OVARIAN RECURRENCE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9115|G9115 - ONC DX OVARIAN STG3/4 NOPROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9114|G9114 - ONC DX OVARIAN STG1A-B OR 2||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9113|G9113 - ONC DX OVARIAN STG1A-B NO PR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9112|G9112 - ONC DX HEAD/NECK EXT UNKNOWN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9111|G9111 - ONC DX HEAD/NECK M1 METS REC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9110|G9110 - ONC DX HEAD/NECK T3-4 NOPROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9109|G9109 - ONC DX HEAD/NECK T1-T2NO PRG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9108|G9108 - ONC DX PANCREATIC UNKNWN NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9107|G9107 - ONC DX PANCREATIC UNRESECTAB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9106|G9106 - ONC DX PANCREATC P R1/R2 NO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9105|G9105 - ONC DX PANCREATC P R0 RES NO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9104|G9104 - ONC DX GASTRIC UNKNOWN NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9103|G9103 - ONC DX GASTRIC RECURRENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9102|G9102 - ONC DX GASTRIC UNRESECTABLE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9101|G9101 - ONC DX GASTRIC P R1-R2NOPROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9100|G9100 - ONC DX GASTRIC NO RECURRENCE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9099|G9099 - ONC DX ESOPHAGEAL UNKNOWN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9098|G9098 - ONC DX ESOPHAGEAL METS RECUR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9097|G9097 - ONC DX ESOPHAGEAL T4 NO PROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9096|G9096 - ONC DX ESOPHAG T1-T3 NOPROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9095|G9095 - ONC DX RECTAL EXTENT UNKNWN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9094|G9094 - ONC DX RECTAL M1 W/METS PROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9093|G9093 - ONC DX RECTAL T4 - N - M0 NO PRG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9092|G9092 - ONC DX RECTAL T1-3 - N1-2NOPRG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9091|G9091 - ONC DX RECTAL T3 N0 NO PROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9090|G9090 - ONC DX RECTAL T1-2 NO PROGR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9089|G9089 - ONC DX COLON EXTENT UNKNOWN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9088|G9088 - ONC DX COLON METAS NOEVID DX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9087|G9087 - ONC DX COLON METAS EVID DX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9086|G9086 - ONC DX COLON T1-4 NO DX PROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9085|G9085 - ONC DX COLON T4 -  N0 W/O PROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9084|G9084 - ONC DX COLON T1-3 - N1-2 - NO PR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9083|G9083 - ONC DX PROSTATE UNKNWN NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9080|G9080 - ONC DX PROSTATE W/RISE PSA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9079|G9079 - ONC DX PROSTATE T3B-T4NOPROG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9078|G9078 - ONC DX PROSTATE T2NO PROGRES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9077|G9077 - ONC DX PROSTATE T1NO PROGRES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9075|G9075 - ONC DX BRST METASTIC/ RECUR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9074|G9074 - ONC DX BRST STG3-NOPROGRESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9073|G9073 - ONC DX BRST STG3-HR -  NO PRO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9072|G9072 - ONC DX BRST STG1-2 NOPROGRES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9071|G9071 - ONC DX BRST STG1-2B HR - NOPRO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9070|G9070 - ONC DX SCLC/NSCLC EXT UNKNWN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9069|G9069 - ONC DX SCLC/NSCLC EXT AT DX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9068|G9068 - ONC DX SCLC/NSCLC LIMITED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9067|G9067 - ONC DX NSCLC DX UNKNOWN NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9066|G9066 - ONC DX NSCLC STG3B-4 METASTA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9065|G9065 - ONC DX NSCLC STG3A NO PROGRE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9064|G9064 - ONC DX NSCLC STG2 NO PROGRES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9063|G9063 - ONC DX NSCLC STGI NO PROGRES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9062|G9062 - ONC PRAC GUIDE DIFFERS NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9061|G9061 - ONC PRAC COND NOADD BY GUIDE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9060|G9060 - ONC PRAC MGMT DIF PT COMORB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9059|G9059 - ONC PRAC MGMT PT OPT ALTERNA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9058|G9058 - ONC PRAC MGMT DISAGREE W/GUI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9057|G9057 - ONC PRACT MGMT DIFFERS TRIAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9056|G9056 - ONC PRAC MGMT ADHERES GUIDE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9055|G9055 - ONC VISIT UNSPECIFIED NOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9054|G9054 - ONC SUPERVISION PALLIATIVE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9053|G9053 - ONC EXPECTANT MANAGEMENT PT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9052|G9052 - ONC SURVEILLANCE FOR DISEASE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9051|G9051 - ONCOLOGY TX DECISION-MGMT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9050|G9050 - ONCOLOGY WORK-UP EVALUATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9036|G9036 - RIMANTADINE HCL -  BRAND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9035|G9035 - OSELTAMIVIR PHOSP -  BRAND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9034|G9034 - ZANAMIVIR -  INH PWDR -  BRAND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9033|G9033 - AMANTADINE HCL ORAL BRAND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9020|G9020 - RIMANTADINE HCL 100MG ORAL||2.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9019|G9019 - OSELTAMIVIR PHOSPHATE 75MG||7.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9018|G9018 - ZANAMIVIR - INHALATION PWD 10M||6.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9017|G9017 - AMANTADINE HCL 100MG ORAL||1.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9016|G9016 - DEMO-SMOKING CESSATION COUN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9014|G9014 - ESRD DEMO BUNDLE-LEVEL II||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9013|G9013 - ESRD DEMO BUNDLE LEVEL I||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9012|G9012 - OTHER SPECIFIED CASE MGMT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9011|G9011 - MCCD -  RISK ADJ -  LEVEL 5||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9010|G9010 - MCCD -  RISK ADJ -  LEVEL 4||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9009|G9009 - MCCD -  RISK ADJ -  LEVEL 3||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9008|G9008 - MCCD - PHYS COOR-CARE OVRSGHT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9007|G9007 - MCCD -  SCH TEAM CONF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9006|G9006 - MCCD -  HOME MONITORING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9005|G9005 - MCCD -  RISK ADJ -  MAINTENANCE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9004|G9004 - MCCD -  RISK ADJ LO -  INITIAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9003|G9003 - MCCD -  RISK ADJ HI -  INITIAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9002|G9002 - MCCD - MAINTENANCE RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G9001|G9001 - MCCD -  INITIAL RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8906|G8906 - CATARACT MEASURES GROUP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8905|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8904|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8903|G8903 - PARKINSON'S DISEASE MG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8902|G8902 - DEMENTIA MEASURES GROUP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8901|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8900|G8900 - OBSTRUCTIVE SLEEP APNEA MG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8899|G8899 - INFLAMMATORY BOWEL DIS MG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8898|G8898 - COPD MEASURES GROUP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8897|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8896|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8895|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8894|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8893|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8892|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8891|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8890|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8889|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8888|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8887|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8886|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8885|G8885 - NO REV -  COMM -  TRACK BIOPSY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8884|G8884 - DOC REAS BIOPSY NOT REVIEW||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8883|G8883 - REV -  COMM -  TRACK -  DOC BIOPSY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8882|G8882 - NO SENT LYMPH NODE BIOPSY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8881|G8881 - BRST CNCR STAGE > T1N0M0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8880|G8880 - SEN LYM P NODE BIOP NOT PERF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8879|G8879 - NODE NEG INV BRST CNCR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8878|G8878 - SENT LYMPH NODE BIOPSY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8877|G8877 - NO BRST CNCR DX MIN INVASIVE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8876|G8876 - DOC REAS NO MIN INV DX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8875|G8875 - BREAST CANCER DX MIN INVSIVE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8874|G8874 - TISSUE NOT IMAGE INTRAOP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8873|G8873 - SPECIMEN NOT INTRAOP IMAGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8872|G8872 - INTRAOP IMAGE CONFIRM EXCISE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8871|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8870|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8869|G8869 - DOC IMMUNE HEP B ANTITNF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8868|G8868 - 1ST COURSE ANTITNF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8867|G8867 - NO PNEUMOCOCCAL ADMIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8866|G8866 - DOC PT REAS NO PNEUMOCOCCAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8865|G8865 - DOC MED REAS NO PNEUMOCOCCAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8864|G8864 - PNEUMOCOCCAL VACCINE ADMIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8863|G8863 - NO ASSESS BONE LOSS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8862|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8861|G8861 - DXA ORDERED FOR OSTEO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8860|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8859|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8858|G8858 - NOT REF FOR OTO EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8857|G8857 - NO ELIG REF FOR OTO EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8856|G8856 - REF FOR OTO EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8855|G8855 - POS AIR PRESS ADHERE NO PERF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8854|G8854 - REAS NO ADHERE POS AIR PRES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8853|G8853 - POS AIR PRESS NOT PRESCRIBE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8852|G8852 - POS AIR PRESS PRESCRIBE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8851|G8851 - ADHERE POS AIR PRESS THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8850|G8850 - NO PAP PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8849|G8849 - DOC REAS NO POS AIR PRESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8848|G8848 - MILD OSA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8847|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8846|G8846 - MOD OR SEVERE OSA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8845|G8845 - POS AIRWAY PRESS PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8844|G8844 - NO AHI OR RDI INITIAL DX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8843|G8843 - DOC REAS NO AHI OR RDI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8842|G8842 - AHI OR RDI INITIAL DX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8841|G8841 - NO SLEEP APNEA ASSESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8840|G8840 - DOC REAS NO SLEEP APNEA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8839|G8839 - SLEEP APNEA ASSESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8838|G8838 - NOT DISCH HOME BY DAY #2||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8837|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8836|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8835|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8834|G8834 - PT DISCH HOME DAY #2 CEA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8833|G8833 - PT NOT DISCH HOME DAY#2 EVAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8832|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8831|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8830|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8829|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8828|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8827|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8826|G8826 - PT DISCH HOME DAY #2 EVAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8825|G8825 - PT NOT DISCH TO HOME DAY#7||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8824|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8823|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8822|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8821|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8820|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8819|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8818|G8818 - PT DISCH TO HOME BY DAY#7||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8817|G8817 - DOC REAS NO STATIN MED DISCH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8816|G8816 - STATIN MED PRES AT DISCH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8815|G8815 - DOC REAS NO STATIN THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8814|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8813|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8812|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8811|G8811 - NO RH-IMMUNOGLOBULIN ORDER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8810|G8810 - DOC REAS NO RH-IMMUNO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8809|G8809 - RH-IMMUNOGLOBULIN ORDER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8808|G8808 - ULTRASOUND NOT PERF -  RNG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8807|G8807 - NO TA TV ULTRASND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8806|G8806 - PERF ULTRSND TO LCT PREG DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8805|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8803|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8802|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8801|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8800|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8799|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8798|G8798 - SPECIMEN SITE NOT PROSTATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8797|G8797 - SPECIMEN SITE NOT ESOPHAGUS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8796|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8795|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8794|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8793|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8792|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8791|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8790|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8789|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8788|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8787|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8786|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8785|G8785 - BP SCRN NO PERF AT INTERVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8784|G8784 - PT NO ELIG FOR BP ASSESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8783|G8783 - BP SCRN PERF REC INTERVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8782|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8781|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8780|G8780 - COUNSELING FOR DIET AND PHYSICAL ACTIVITY PERFORME||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8779|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8778|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8777|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8776|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8775|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8774|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8773|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8772|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8771|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8770|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8769|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8768|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8767|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8765|G8765 - CATARACT MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8764|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8763|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8762|G8762 - PD MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8761|G8761 - DEMENTIA MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8760|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8759|G8759 - OSA MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8758|G8758 - IBD MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8757|G8757 - COPD MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8756|G8756 - NO BP MEASURE DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8755|G8755 - DIAS BP > OR = 90||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8754|G8754 - DIAS BP LESS 90||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8753|G8753 - SYS BP > OR = 140||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8752|G8752 - SYS BP LESS 140||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8751|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8750|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8749|G8749 - NO SIGNS MELANOMA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8748|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8747|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8746|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8745|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8744|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8743|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8742|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8741|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8740|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8739|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8738|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8737|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8736|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8735|G8735 - ELD MAL SCRN POS NO PLAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8734|G8734 - DOC NEG ELDER MAL NO PLAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8733|G8733 - DOC POS ELDER MAL SCRN PLAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8732|G8732 - NO DOC OF PAIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8731|G8731 - PAIN NEG NO PLAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8730|G8730 - PAIN DOC POS AND PLAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8728|G8728 - LIPID PROFILE NOT PERF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8727|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8726|G8726 - DOC REAS NO LIPID PROFILE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8725|G8725 - LIPID PROFILE PERF DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8724|G8724 - PT -  PN -  HIST GRADE NOT DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8723|G8723 - SPEC SIT NOT PRIM TUMOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8722|G8722 - MED REAS PT -  PN -  NOT DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8721|G8721 - PT -  PN -  HIST GRADE DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8720|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8718|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8717|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8716|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8715|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8714|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8713|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8712|G8712 - NOT PRES ANTIBIOTIC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8711|G8711 - PRES ANTIBIOTIC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8710|G8710 - PT PRES ANTIBIOTIC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8709|G8709 - PT PRESC DOC MED RSN ID URI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8708|G8708 - ANTIBIOTIC NOT PRES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8707|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8706|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8705|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8704|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8703|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8702|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8701|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8700|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8699|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8698|G8698 - ANTITHROMB NO PRESC NO REAS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8697|G8697 - ANTITHROMB NO PRESC DOC REAS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8696|G8696 - ANTITHROMB THX PRESC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8695|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8694|G8694 - LVEF <40%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8685|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8683|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8682|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8674|G8674 - RAFSCRS NECK -  NO MSR/NO FOTO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8673|G8673 - RAFSCRS GOI NO SCOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8672|G8672 - RAFSCRS GOI SCOR < 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8671|G8671 - RAFSCRS GOI SCOR >= 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8670|G8670 - RAFSCRS EWH NO SCOR NO SURV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8669|G8669 - RAFSCRS HAND -  NO MSR/SURV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8668|G8668 - RAFSCRS EWH SCOR < 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8667|G8667 - RAFSCRS EWH SCOR >= 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8666|G8666 - RAFSCRS SI NO SCOR NO SURV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8665|G8665 - RAFSCRS SI NO SCOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8664|G8664 - RAFSCRS SI SCOR < 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8663|G8663 - RAFSCRS SI SCOR >= 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8662|G8662 - RAFSCRS LBI NO SCOR NO SURV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8661|G8661 - RAFSCRS LBI NO SCOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8660|G8660 - RAFSCRS LBI SCOR < 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8659|G8659 - RAFSCRS LBI SCOR >= 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8658|G8658 - RAFSCRS LLFAI NO SCOR + SURV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8657|G8657 - RAFSCRS LLFAI NO SCOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8656|G8656 - RAFSCRS LLFAI SCOR < 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8655|G8655 - RAFSCRS LLFAI SCOR >= 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8654|G8654 - RAFSCRS HI NO SCOR NO SURV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8653|G8653 - RAFSCRS HI NO SCOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8652|G8652 - RAFSCRS HI SCOR < 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8651|G8651 - RAFSCRS HI SCOR >=0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8650|G8650 - RAFSCRS KI NO SCOR NO SURV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8649|G8649 - RAFSCRS KI NO SCOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8648|G8648 - RAFSCRS KI SCOR < 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8647|G8647 - RAFSCRS KI SCOR >= 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8646|G8646 - ASTHMA MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8645|G8645 - ASTHMA MEASURES GRP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8644|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8643|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8642|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8635|G8635 - NO PHARM THER OSTEO RX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8634|G8634 - PT NO ELG PHAR THER OSTEO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8633|G8633 - PHARM THER OSTEO RX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8632|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8631|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8630|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8629|G8629 - DOC ANTIOBIOTIC ORDER B/4 SURGERY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8628|G8628 - NO SURG PROC W/IN 30 DAYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8627|G8627 - SURG PROC W/IN 30 DAYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8626|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8625|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8624|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8623|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8622|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8621|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8620|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8619|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8618|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8617|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8616|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8615|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8614|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8613|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8612|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8611|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8610|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8609|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8608|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8607|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8606|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8605|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8604|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8603|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8602|G8602 - NO TPA INIT W/IN 3 HRS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8601|G8601 - NO ELIG TPA INIT W/IN 3 HRS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8600|G8600 - TPA INITI W/IN 3 HRS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8599|G8599 - NO ASA/ANTIPLAT THER USE RNG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8598|G8598 - ASA/ANTIPLAT THER USED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8597|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8596|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8595|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8594|G8594 - LIPID PROFILE NOT PERFORMED -  REASON NOT GIVEN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8593|G8593 - LIPID PROFILE RESULTS DOCUMENTED AND REVIEWED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8592|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8591|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8590|G8590 - MOST RECENT DIASTOLIC BLOOD PRESSURE <90 MMHG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8589|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8588|G8588 - MOST RECENT SYSTOLIC BLOOD PRESSURE <140 MMHG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8587|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8586|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8585|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8584|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8583|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8582|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8581|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8580|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8579|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8578|G8578 - NO REOP REQ BLD GRFT OTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8577|G8577 - REOP REQ BLD GRFT OTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8576|G8576 - NO POSTOP REN FAIL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8575|G8575 - POSTOP REN FAIL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8574|G8574 - NO STRK CABG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8573|G8573 - STK CABG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8572|G8572 - NO STER WD IFX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8571|G8571 - STER WD IFX 30 D POSTOP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8570|G8570 - NO PROL INTUB REQ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8569|G8569 - PROL INTUBATION REQ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8568|G8568 - PT NO REF OTOLO NO SPEC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8567|G8567 - PT NO DOC HEAR LOSS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8566|G8566 - PT INELIG REF OTO EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8565|G8565 - VER DOC HEAR LOSS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8564|G8564 - PT REF OTO EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8563|G8563 - PT NO REF OTO REAS NO SPEC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8562|G8562 - PT NO HX ACT DRAIN 90 D||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8561|G8561 - PT INELIG FOR REF OTO EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8560|G8560 - PT HX ACT DRAIN PREV 90 DAYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8559|G8559 - PT REF DOC OTO EVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8558|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8557|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8556|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8553|G8553 - ONE OR MORE RX CREATD DUR ENCNTR WAS GNRTD/TRNS EL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8552|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8551|G8551 - HF MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8550|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8549|G8549 - HEPC MG QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8548|G8548 - HF MEASURES GRP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8547|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8546|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8545|G8545 - HEPC MEASURES GRP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8544|G8544 - CABG MEASURES GRP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8543|G8543 - CUR FUNCT ASSES; NO CARE PLN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8542|G8542 - DOC FUNCT NO DEFICIENCIES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8541|G8541 - NO DOC CUR FUNCT ASSESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8540|G8540 - FOA NOT DOC AS BEING PERF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8539|G8539 - DOC FUNCT AND CARE PLAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8536|G8536 - NO DOC ELDER MAL SCRN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8535|G8535 - ELD MALTREATMENT NOT DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8532|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8531|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8530|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8526|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8525|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8524|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8511|G8511 - SCR DEP POS -  NO PLAN DOC RNG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8510|G8510 - SCR DEP NEG -  NO PLAN REQD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8509|G8509 - POS PAIN ASSESS NO F/U DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8506|G8506 - PT REC ACE/ARB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8502|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8501|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8500|G8500 - HIV MEAS QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8499|G8499 - RA MEAS QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8498|G8498 - CAD MEAS QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8497|G8497 - CABG MEAS QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8496|G8496 - PREV CARE MG QUAL ACT PERFRM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8495|G8495 - CKD MEAS QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8494|G8494 - DM MEAS QUAL ACT PERFORM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8493|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8492|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8491|G8491 - HIV/AIDS MEASURES GRP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8490|G8490 - RA MEASURES GRP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8489|G8489 - CAD MEASURES GRP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8487|G8487 - REPORT CKD MEASURES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8486|G8486 - REPORT -  PREV CARE MEASURES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8485|G8485 - REPORT -  DIABETES MEASURES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8484|G8484 - FLU IMMUNIZE NO ADMIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8483|G8483 - FLU IMM NO ADMIN DOC REA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8482|G8482 - FLU IMMUNIZE ORDER/ADMIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8478|G8478 - BP NOT PERFORMED/DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8477|G8477 - BP SYS>=140 AND/OR DIAS >=90||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8476|G8476 - BP SYS <140 AND DIAS <90||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8475|G8475 - ACE/ARB THXPY NOT RX'D||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8474|G8474 - ACE/ARB NOT RX'D; DOC REAS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8473|G8473 - ACE/ARB THXPY RX'D||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8472|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8471|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8470|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8469|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8468|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8465|G8465 - HIGH RISK RECURRENCE PRO CA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8464|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8463|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8462|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8461|G8461 - PT REC ANTIVIR TREAT HEP C||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8460|G8460 - PT INELIG RNA NO ANTVIR TX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8459|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8458|G8458 - PT INELIG GENO NO ANTVIR TX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8452|G8452 - PT W/ABN LVEF B-BLOC NO RX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8451|G8451 - PT W/ABN LVEF INELIG B-BLOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8450|G8450 - BETA-BLOC RX PT W/ABN LVEF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8448|G8448 - PT ENCNTR DOCUMENTED USING QUAL EHR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8447|G8447 - PT ENCNTR DOCUMENTED USING CCHIT CERT EMR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8442|G8442 - DOC PAIN AS NT PERF -  NOT ELG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8433|G8433 - SCR FOR DEP NOT CPT DOC RSN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8432|G8432 - DEP SCR NOT DOC -  RNG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8431|G8431 - POS CLIN DEPRES SCRN F/U DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8430|G8430 - EC AT DOC MEDREC PT NOT ELIG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8428|G8428 - CUR MEDS NOT DOCUMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8427|G8427 - DOCREV CUR MEDS BY ELIG CLIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8422|G8422 - PT INELIG BMI CALCULATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8421|G8421 - BMI NOT CALCULATED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8420|G8420 - CALC BMI NORM PARAMETERS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8419|G8419 - CALC BMI OUT NRM PARAM NOF/U||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8418|G8418 - CALC BMI BLW LOW PARAM F/U||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8417|G8417 - CALC BMI ABV UP PARAM F/U||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8416|G8416 - PT INELIG FOOTWEAR EVALUATIO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8415|G8415 - EVAL ON FOOT NOT PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8410|G8410 - EVAL ON FOOT DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8406|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8405|G8405 - LOW EXTEMITY NEUR NOT PERFOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8404|G8404 - LOW EXTEMITY NEUR EXAM DOCUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8401|G8401 - PT INELIG OSTEO SCREEN MEASU||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8400|G8400 - PT W/DXA NO RESULTS DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8399|G8399 - PT W/DXA RESULTS DOCUMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8398|G8398 - DIL MACULAR/FUNDUS NOT PERFO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8397|G8397 - DIL MACULA/FUNDUS EXAM/W DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8396|G8396 - LVEF NOT PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8395|G8395 - LVEF>=40% DOC NORMAL OR MILD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8128|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8127|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G8126|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G3001|G3001 - ADMIN + SUPPLY -  TOSITUMOMAB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0922|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0921|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0920|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0919|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0918|G0918 - NO SATISFY WITH CARE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0917|G0917 - SATISFY SURVEY NOT COMPLETE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0916|G0916 - SATISFY WITH CARE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0915|G0915 - NO IMPROVE VISUAL FUNCT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0914|G0914 - SURVEY NOT COMPLETE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0913|G0913 - IMPROVE VISUAL FUNCT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0912|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0911|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0910|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0909|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0908|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0455|G0455 - FECAL MICROBIOTA PREP INSTIL||130.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0454|G0454 - MD DOCUMENT VISIT BY NPP||10.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0453|G0453 - CONT INTRAOP NEURO MONITOR||31.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0451|G0451 - DEVLOPMENT TEST INTERPT&REP||11.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0448|G0448 - PLACE PERM PACING CARDIOVERT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0447|G0447 - BEHAVIOR COUNSEL OBESITY 15M||30.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0446|G0446 - INTENS BEHAVE THER CARDIO DX||30.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0445|G0445 - HIGH INTEN BEH COUNS STD 30M||30.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0444|G0444 - DEPRESSION SCREEN ANNUAL||20.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0443|G0443 - BRIEF ALCOHOL MISUSE COUNSEL||30.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0442|G0442 - ANNUAL ALCOHOL SCREEN 15 MIN||20.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0439|G0439 - PPPS -  SUBSEQ VISIT||131.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0438|G0438 - PPPS -  INITIAL VISIT||197.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0437|G0437 - SMOK/TBCO CESS COUNSEL VST >10 MIN||33.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0436|G0436 - SMOK/TBCO CESS COUNSELING VST ASYMPTO PT INTERMED||16.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0435|G0435 - ORAL HIV-1/HIV-2 SCREEN||21.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0434|G0434 - DRUG SCRN OTH THN CHROMATOGRAPH ANY # DRUG CLS BY||26.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0433|G0433 - ELISA HIV-1/HIV-2 SCREEN||24.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0432|G0432 - EIA HIV-1/HIV-2 SCREEN||24.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0431|G0431 - DRUG SCRN QUAL SNGL CLASS METH EACH||123.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0429|G0429 - DERMAL FILLER INJECTION(S)||89.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0428|G0428 - COLLAGEN MENISCUS IMPLANT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0427|G0427 - INPT/ED TELECONSULT70||239.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0426|G0426 - INPT/ED TELECONSULT50||162.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0425|G0425 - INPT/ED TELECONSULT30||120.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0424|G0424 - PULMONARY REHAB W EXER||17.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0423|G0423 - INTENS CARDIAC REHAB NO EXER||83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0422|G0422 - INTENS CARDIAC REHAB W/EXERC||83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0421|G0421 - ED SVC CKD GRP PER SESSION||29.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0420|G0420 - ED SVC CKD IND PER SESSION||128.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0419|||3034.95|1108.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0418|||2557.36|960.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0417|||1490.61|553.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0416|G0416 - PROSTATE BIOPSY -  ANY MTHD||766.63|287.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0415|G0415 - OPEN TX POST PELVIC FXCTURE||1641.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0414|G0414 - PELVIC RING FX TREAT INT FIX||1197.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0413|G0413 - PELVIC RING FRACTURE UNI/BIL||1262.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0412|G0412 - OPEN TX ILIAC SPINE UNI/BIL||861.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0411|G0411 - INTER ACTIVE GRP PSYCH PARTI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0410|G0410 - GRP PSYCH PARTIAL HOSP 45-50||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0409|G0409 - CORF RELATED SERV 15 MINS EA||11.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0408|G0408 - INPT/TELE FOLLOW UP 35||121.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0407|G0407 - INPT/TELE FOLLOW UP 25||84.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0406|G0406 - INPT/TELE FOLLOW UP 15||46.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0405|G0405 - EKG INTERPRET & REPORT PREVE||10.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0404|G0404 - EKG TRACING FOR INITIAL PREV||11.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0403|G0403 - EKG FOR INITIAL PREVENT EXAM||22.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0402|G0402 - INITIAL PREVENTIVE EXAM||185.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0400|G0400 - HOME SLEEP TEST/TYPE 4 PORTA||189.05|99.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0399|G0399 - HOME SLEEP TEST/TYPE 3 PORTA||189.05|99.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0398|G0398 - HOME SLEEP TEST/TYPE 2 PORTA||189.05|99.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0397|G0397 - ALCOHOL/SUBS INTERV >30 MIN||81.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0396|G0396 - ALCOHOL/SUBS INTERV 15-30MN||41.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0389|G0389 - ULTRASOUND EXAM AAA SCREEN||128.65|45.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0379|G0379 - DIRECT REFER HOSPITAL OBSERV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0378|G0378 - HOSPITAL OBSERVATION PER HR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0372|G0372 - MD SERVICE REQUIRED FOR PMD||10.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0365|G0365 - VESSEL MAPPING HEMO ACCESS||249.86|19.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0364|G0364 - BONE MARROW ASPIRATE &BIOPSY||10.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0343|G0343 - LAPAROTOMY ISLET CELL TRANSP||1358.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0342|G0342 - LAPAROSCOPY ISLET CELL TRANS||786|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0341|G0341 - PERCUTANEOUS ISLET CELLTRANS||393.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0340|G0340 - ROBT LIN-RADSURG FRACTX 2-5||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0339|G0339 - ROBOT LIN-RADSURG COM -  FIRST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0337|G0337 - HOSPICE EVALUATION PREELECTI||86.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0333|G0333 - DISPENSE FEE INITIAL 30 DAY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0329|G0329 - ELECTROMAGNTIC TX FOR ULCERS||11.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0328|G0328 - FECAL BLOOD SCRN IMMUNOASSAY||28.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0307|G0307 - CBC WITHOUT PLATELET||11.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0306|G0306 - CBC/DIFFWBC W/O PLATELET||13.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0305|G0305 - POST OP SERVICE LVRS MIN 6||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0304|G0304 - PRE-OP SERVICE LVRS 1-9 DOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0303|G0303 - PRE-OP SERVICE LVRS 10-15DOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0302|G0302 - PRE-OP SERVICE LVRS COMPLETE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0295|G0295 - ELECTROMAGNETIC THERAPY ONC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0294|G0294 - NON-COV PROC -  CLINICAL TRIAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0293|G0293 - NON-COV SURG PROC - CLIN TRIAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0291|G0291 - TRNSCATH PLCMT RX ELUTING INTRACOR STNT; EA ADD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0290|G0290 - TRNSCATH PLCMT RX ELUTING INTRACOR STNT; 1 VES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0289|G0289 - ARTHRO -  LOOSE BODY + CHONDRO||105.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0288|G0288 - RECON -  CTA FOR SURG PLAN||70.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0283|G0283 - ELEC STIM OTHER THAN WOUND||15.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0282|G0282 - ELECT STIM WOUND CARE NOT PD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0281|G0281 - ELEC STIM UNATTEND FOR PRESS||15.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0278|G0278 - ILIAC ART ANGIO - CARDIAC CATH||15.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0275|G0275 - RENL ART ANGIO PRFRM AT CARD CATH RAD SUP&INTEPR||15.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0271|G0271 - GROUP MNT 2 OR MORE 30 MINS||17.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0270|G0270 - MNT SUBS TX FOR CHANGE DX||32.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0269|G0269 - OCCLUSIVE DEVICE IN VEIN ART||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0268|G0268 - REMOVAL OF IMPACTED WAX MD||38.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0260|G0260 - INJ FOR SACROILIAC JT ANESTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0259|G0259 - INJECT FOR SACROILIAC JOINT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0257|G0257 - UNSCHED DIALYSIS ESRD PT HOS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0255|G0255 - CURRENT PERCEP THRESHOLD TST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0252|G0252 - PET IMAGING INITIAL DX||95.62|121.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0251|G0251 - LINR STEREOTAC RADIOSURG TX ALL LES MAX 5 SESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0250|G0250 - MD INR TEST REVIE INTER MGMT||11.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0249|G0249 - PROVIDE INR TEST MATER/EQUIP||128.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0248|G0248 - DEMONSTRATE USE HOME INR MON||139.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0247|G0247 - ROUTINE FOOTCARE PT W LOPS||28.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0246|G0246 - FOLLOWUP EVAL OF FOOT PT LOP||25.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0245|G0245 - INITIAL FOOT EXAM PT LOPS||51.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0239|G0239 - OTH RESP PROC -  GROUP||14.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0238|G0238 - OTH RESP PROC -  INDIV||12.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0237|G0237 - THERAPEUTIC PROCD STRG ENDUR||11.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0235|G0235 - PET NOT OTHERWISE SPECIFIED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0219|G0219 - PET IMG WHOLBOD MELANO NONCO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0206|G0206 - DX MAMMO INCL CAD UNI||152.87|55.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0204|G0204 - DX MAMMO INCL CAD BI||193.36|69.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0202|G0202 - SCR MAMMO BI INCL CAD||160.13|55.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0186|G0186 - DSTRY EYE LESN - FDR VSSL TECH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0182|G0182 - HOSPICE CARE SUPERVISION||126.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0181|G0181 - HOME HEALTH CARE SUPERVISION||125.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0180|G0180 - MD CERTIFICATION HHA PATIENT||62.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0179|G0179 - MD RECERTIFICATION HHA PT||47.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0177|G0177 - OPPS/PHP; TRAIN & EDUC SERV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0176|G0176 - OPPS/PHP;ACTIVITY THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0175|G0175 - OPPS SERVICE - SCHED TEAM CONF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0173|G0173 - STEREOTAC RADIOSURG COMPLETE COURSE TX 1 SESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0168|G0168 - WOUND CLOSURE BY ADHESIVE||31.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0166|G0166 - EXTRNL COUNTERPULSE -  PER TX||191.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0164|G0164 - HHC LIS NURSE TRAIN EA 15||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0163|G0163 - HHC LPN/RN OBS/ASSES EA 15||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0162|G0162 - HHC RN E&M PLAN SVS -  15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0161|G0161 - HHC SLP EA 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0160|G0160 - HHC OCCUP THERAPY EA 15||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0159|G0159 - HHC PT MAINT EA 15 MIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0158|G0158 - HHC OT ASSISTANT EA 15||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0157|G0157 - HHC PT ASSISTANT EA 15||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0148|G0148 - SCR C/V CYTO -  AUTOSYS -  RESCR||27.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0147|G0147 - SCR C/V CYTO -  AUTOMATED SYS||20.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0145|G0145 - SCR C/V CYTO - THINLAYER - RESCR||47.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0144|G0144 - SCR C/V CYTO - THINLAYER - RESCR||38.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0143|G0143 - SCR C/V CYTO - THINLAYER - RESCR||36.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0141|G0141 - SCR C/V CYTO - AUTOSYS AND MD||34.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0130|G0130 - SINGLE ENERGY X-RAY STUDY||39.19|17.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0128|G0128 - CORF SKILLED NURSING SERVICE||11.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0127|G0127 - TRIM NAIL(S)||9.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0124|G0124 - SCREEN C/V THIN LAYER BY MD||34.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0123|G0123 - SCREEN CERV/VAG THIN LAYER||33.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0122|G0122 - COLON CA SCRN; BARIUM ENEMA||325.3|78.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0121|G0121 - COLON CA SCRN NOT HI RSK IND||264.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0120|G0120 - COLON CA SCRN; BARIUM ENEMA||251.17|75.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0118|G0118 - GLAUCOMA SCRN HGH RISK DIREC||41.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0117|G0117 - GLAUCOMA SCRN HGH RISK DIREC||60.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0109|G0109 - DIAB MANAGE TRN IND/GROUP||19.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0108|G0108 - DIAB MANAGE TRN  PER INDIV||63.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0106|G0106 - COLON CA SCREEN;BARIUM ENEMA||251.17|75.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0105|G0105 - COLORECTAL SCRN; HI RISK IND||264.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0104|G0104 - CA SCREEN;FLEXI SIGMOIDSCOPE||76.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0103|G0103 - PSA SCREENING||33.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|G0102|G0102 - PROSTATE CA SCREENING; DRE||22.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2633|E2633 - MOBILE ARM SUPPORT SUPINATOR||192.93|11.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2632|E2632 - OFFSET/LAT ROCKER ARM W/ELA||30.54|30.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2631|E2631 - ELEVAT PROXIMAL ARM SUPPORT||191.4|19.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2630|E2630 - MONOSUSPENSION ARM/HAND SUPP||225.65|22.56||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2629|E2629 - FRICTION DAMPENING ARM SUPP||354.87|35.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2628|E2628 - MOBILE ARM SUPPORTS RECLININ||887.15|88.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2627|E2627 - ARM SUPP ATT TO WC RANCHO TY||1268.63|126.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2626|E2626 - SEO MOBILE ARM SUP ATT TO WC||1002.49|100.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2625|E2625 - ADJ SKIN PRO/POS WC CUS>=22||998.04|83.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2624|E2624 - ADJ SKIN PRO/POS CUS<22IN||489.59|48.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2623|E2623 - ADJ SKIN PRO WC CUS WD>=22IN||386.74|38.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2622|E2622 - ADJ SKIN PRO W/C CUS WD<22IN||488.1|48.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2621|E2621 - WC PLANAR BACK CUSH WD>=22IN||383.59|38.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2620|E2620 - WC PLANAR BACK CUSH WD <22IN||665.14|66.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2619|E2619 - REPLACE COVER W/C SEAT CUSH||633.81|63.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2616|E2616 - POS BACK POST/LAT WDTH>=22IN||59.38|5.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2615|E2615 - POS BACK POST/LAT WDTH <22IN||704.27|70.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2614|E2614 - POSITION BACK CUSH WD>=22IN||523.44|52.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2613|E2613 - POSITION BACK CUSH WD <22IN||629.46|62.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2612|E2612 - GEN USE BACK CUSH WDTH>=22IN||454.84|45.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2611|E2611 - GEN USE BACK CUSH WDTH <22IN||488.99|48.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2608|E2608 - SKIN PRO/POS WC CUS WD>=22IN||361.47|36.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2607|E2607 - SKIN PRO/POS WC CUS WD <22IN||402.81|40.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2606|E2606 - POSITION WC CUSH WDTH>=22 IN||335.42|33.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2605|E2605 - POSITION WC CUSH WDTH <22 IN||485.96|48.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2604|E2604 - SKIN PROTECT WC CUS WD>=22IN||311.5|31.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2603|E2603 - SKIN PROTECT WC CUS WD <22IN||218.04|21.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2602|E2602 - GEN W/C CUSHION WDTH >=22 IN||175.42|17.56||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2601|E2601 - GEN W/C CUSHION WDTH < 22 IN||138.18|13.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2512|E2512 - SGD ACCESSORY -  MOUNTING SYS||61.57|8.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2511|E2511 - SGD SFTWRE PRGRM FOR PC/PDA||82.12|7.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2510|E2510 - SGD W MULTI METHODS MSG/ACCS||11450.16|1145.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2508|E2508 - SGD SPELLING PHYS CONTACT||6050.7|605.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2506|E2506 - SGD PREREC MSG > 40 MIN||9087.42|908.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2504|E2504 - SGD PREREC MSG>20MIN <=40MIN||4802.15|480.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2502|E2502 - SGD PREREC MSG >8MIN <=20MIN||3105.51|310.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2500|E2500 - SGD DIGITIZED PRE-REC <=8MIN||2117.92|211.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2402|E2402 - NEG PRESS WOUND THERAPY PUMP||0|1204.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2397|E2397 - PWC ACC -  LITH-BASED BATTERY||1605.54|160.56||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2396|E2396 - CASTER FORK||556.05|52.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2395|E2395 - CASTER WHEEL EXCLUDES TIRE||76.96|8.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2394|E2394 - DRIVE WHEEL EXCLUDES TIRE||63.12|6.32||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2392|E2392 - SOLID CASTER TIRE -  INTEGRATE||88.82|8.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2391|E2391 - SOLID CASTER TIRE||62.35|6.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2390|E2390 - SOLID DRIVE WHEEL TIRE||23.71|2.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2389|E2389 - FOAM CASTER TIRE||49.51|4.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2388|E2388 - FOAM DRIVE WHEEL TIRE||31.66|3.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2387|E2387 - FOAM FILLED CASTER TIRE||58.3|5.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2386|E2386 - FOAM FILLED DRIVE WHEEL TIRE||78.1|7.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2385|E2385 - TUBE -  PNEUMATIC CASTER TIRE||174.17|17.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2384|E2384 - PNEUMATIC CASTER TIRE||57.29|5.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2383|E2383 - INSERT -  PNEUM WHEEL DRIVE||93.64|9.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2382|E2382 - TUBE -  PNEUM WHEEL DRIVE TIRE||175.76|17.59||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2381|E2381 - PNEUM DRIVE WHEEL TIRE||24.04|2.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2378|E2378 - PW ACTUATOR REPLACEMENT||76.73|10.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2377|E2377 - EXPANDABLE CONTROLLER -  INITL||421.58|8.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2376|E2376 - EXPANDABLE CONTROLLER -  REPL||1165.01|56.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2375|E2375 - NON-EXPANDABLE CONTROLLER||1553.33|115||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2374|E2374 - HAND/CHIN CTRL STD JOYSTICK||991.25|71.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2373|E2373 - HAND/CHIN CTRL SPEC JOYSTICK||707.9|61.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2372|E2372 - GR27 NON-SEALED LEADACID||1456.21|943.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2371|E2371 - GR27 SEALED LEADACID BATTERY||164.86|20.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2370|E2370 - PWR WC DR WH MOTOR/GEAR COMB||696.81|17.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2369|E2369 - PWR WC DRIVEWHEEL GEAR REPL||929.08|60.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2368|E2368 - PWR WC DRIVEWHEEL MOTOR REPL||520.69|52.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2367|E2367 - BATTERY CHARGER -  DUAL MODE||597.8|56.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2366|E2366 - BATTERY CHARGER -  SINGLE MODE||484.98|30.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2365|E2365 - U1 SEALED LEADACID BATTERY||259.31|15.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2364|E2364 - U1NONSEALED LEADACID BATTERY||150.6|12.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2363|E2363 - GR24 SEALED LEADACID BATTERY||161.44|12.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2362|E2362 - GR24 NONSEALED LEADACID||249.72|21.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2361|E2361 - 22NF SEALED LEADACID BATTERY||123.5|12.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2360|E2360 - 22NF NONSEALED LEADACID||187.25|16.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2359|E2359 - GR34 SEALED LEADACID BATTERY||128.21|12.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2351|E2351 - ELECTRONIC SGD INTERFACE||606.35|23.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2343|E2343 - W/C DPTH 22-25 IN SEAT FRAME||938.02|80.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2342|E2342 - W/C DPTH 20-21 IN SEAT FRAME||962.39|96.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2341|E2341 - W/C WDTH 24-27 IN SEAT FRAME||601.49|60.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2340|E2340 - W/C WDTH 20-23 IN SEAT FRAME||721.79|72.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2330|E2330 - HEAD CONTROL PROXIMITY SWITC||2970.15|48.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2329|E2329 - HEAD CONTROL NONPROPORTIONAL||3960.17|237.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2328|E2328 - HEAD/EXTREMITY CONTROL INTER||4300.89|204.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2327|E2327 - HEAD CONTROL INTERFACE MECH||3444.69|302.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2326|E2326 - BREATH TUBE KIT||3507.54|46.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2325|E2325 - SIP AND PUFF INTERFACE||1168.97|40.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2324|E2324 - CHIN CUP INTERFACE||1558.6|5.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2323|E2323 - SPECIAL JOYSTICK HANDLE||60.03|5.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2322|E2322 - MULT MECH SWITCHES||1224.1|8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2321|E2321 - HAND INTERFACE JOYSTICK||1893.64|183.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2313|E2313 - PWC HARNESS -  EXPAND CONTROL||2995.47|1838.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2312|E2312 - MINI-PROP REMOTE JOYSTICK||2030.85|43.01||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2311|E2311 - ELECTRO CONNECT BTW 2 SYS||2707.75|270.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2310|E2310 - ELECTRO CONNECT BTW CONTROL||2741.75|157.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2231|E2231 - SOLID SEAT SUPPORT BASE||1571.22|135.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2228|E2228 - MWC ACC -  WHEELCHAIR BRAKE||206.34|20.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2227|E2227 - GEAR REDUCTION DRIVE WHEEL||1257.07|125.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2226|E2226 - CASTER FORK REPLACEMENT ONLY||2511.64|251.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2225|E2225 - CASTER WHEEL EXCLUDES TIRE||50.95|5.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2224|E2224 - PROPULSION WHL EXCL TIRE REP||23.36|2.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2222|E2222 - SOLID CASTER INTEG WHL -  REPL||111.91|11.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2221|E2221 - SOLID CASTER TIRE REPL -  EACH||28.28|2.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2220|E2220 - SOLID PROPULS TIRE -  REPL -  EA||34.3|3.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2219|E2219 - FOAM CASTER TIRE ANY SIZE EA||38.3|3.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2218|E2218 - FOAM PROPULSION TIRE EACH||56.19|6.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2217|E2217 - FOAM FILLED CASTER TIRE EACH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2216|E2216 - FOAM FILLED PROPULSION TIRE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2215|E2215 - PNEUMATIC CASTER TIRE TUBE||16.23|1.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2214|E2214 - PNEUMATIC CASTER TIRE EACH||12.89|1.27||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2213|E2213 - PNEUMATIC PROP TIRE INSERT||41.09|4.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2212|E2212 - PNEUMATIC PROP TIRE TUBE||40.84|4.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2211|E2211 - PNEUMATIC PROPULSION TIRE||7.89|0.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2210|E2210 - WHEELCHAIR BEARINGS||34.56|0.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2209|E2209 - ARM TROUGH EACH||93.01|0.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2208|E2208 - CYLINDER TANK CARRIER||124.01|12.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2207|E2207 - CRUTCH AND CANE HOLDER||159.49|13.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2206|E2206 - MAN WC WHL LOCK COMP REPL EA||58.2|5.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2205|E2205 - MANUAL WC ACCESSORY -  HANDRIM||54.61|5.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2204|E2204 - FRAME DEPTH 22 TO 25 IN||43.86|4.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2203|E2203 - FRAME DEPTH LESS THAN 22 IN||1092.13|109.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2202|E2202 - SEAT WIDTH 24-27 IN||643.2|64.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2201|E2201 - MAN W/CH ACC SEAT W>=20''<24''||636.39|63.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2120|E2120 - PULSE GEN SYS TX ENDOLYMP FL||375.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2101|E2101 - BLD GLUCOSE MONITOR W LANCE||500.95|50.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2100|E2100 - BLD GLUCOSE MONITOR W VOICE||253.17|25.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E2000|E2000 - GASTRIC SUCTION PUMP HME MDL||550.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1841|E1841 - STATIC STR SHLDR DEV ROM ADJ||73.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1840|E1840 - ADJ SHOULDER EXT/FLEX DEVICE||734.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1831|E1831 - STATIC STR TOE DEV EXT/FLEX||67.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1830|E1830 - ADJUST TOE EXT/FLEX DEVICE||608.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1825|E1825 - ADJUST FINGER EXT/FLEX DEVC||496.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1821|E1821 - REPLACEMENT INTERFACE SPSD||144.19|88.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1820|E1820 - SOFT INTERFACE MATERIAL||141.31|14.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1818|E1818 - SPS FOREARM DEVICE||82.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1816|E1816 - SPS ANKLE DEVICE||10.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1815|E1815 - ADJUST ANKLE EXT/FLEX DEVICE||109.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1812|E1812 - KNEE EXT/FLEX W ACT RES CTRL||181.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1811|E1811 - SPS KNEE DEVICE||177.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1810|E1810 - ADJUST KNEE EXT/FLEX DEVICE||144.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1806|E1806 - SPS WRIST DEVICE||115.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1805|E1805 - ADJUST WRIST EXT/FLEX DEVICE||174.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1802|E1802 - ADJST FOREARM PRO/SUP DEVICE||142.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1801|E1801 - SPS ELBOW DEVICE||137.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1800|E1800 - ADJUST ELBOW EXT/FLEX DEVICE||144.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1702|E1702 - REPL MEASR SCALES JAW MOTION||438.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1701|E1701 - REPL CUSHIONS FOR JAW MOTION||168.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1700|E1700 - JAW MOTION REHAB SYSTEM||139.8|13.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1406|E1406 - O2/WATER VAPOR ENRICH W/O HE||347.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1405|E1405 - O2/WATER VAPOR ENRICH W/HEAT||45.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1392|E1392 - PORTABLE OXYGEN CONCENTRATOR||463|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1391|E1391 - OXYGEN CONCENTRATOR -  DUAL||241.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1390|E1390 - OXYGEN CONCENTRATOR||260.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1372|E1372 - OXY SUPPL HEATER FOR NEBULIZ||220.07|64.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1355|E1355 - OXYGEN SUPPLIES STAND/RACK||137.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1353|E1353 - OXYGEN SUPPLIES REGULATOR||27.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1310|E1310 - WHIRLPOOL NON-PORTABLE||186.05|28.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1298|E1298 - WHEELCHAIR SPEC SEAT DEPTH/W||2883.23|246.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1297|E1297 - WHEELCHAIR SPECIAL SEAT DEPT||568.82|58.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1296|E1296 - WHEELCHAIR SPECIAL SEAT HEIG||140.45|15.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1295|E1295 - WHEELCHAIR HEAVY DUTY FIXED||495.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1280|E1280 - WHCHR H-DUTY DET ARM LEG RES||67.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1270|E1270 - WHEELCHAIR LIGHTWEIGHT LEG R||660.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1240|E1240 - WHCHR LITWT DET ARM LEG REST||163.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1238|E1238 - FLD PED WC ADJSTABL W/O SEAT||153.5|106||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1237|E1237 - RGD PED WC ADJSTABL W/O SEAT||2200.25|220.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1236|E1236 - FOLDING PED WC ADJUSTABLE||2219.47|221.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1235|E1235 - RIGID PED WC ADJUSTABLE||2200.25|220.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1234|E1234 - FLD PED WC TLTNSPC W/O SEAT||2493.89|249.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1233|E1233 - RIG PED WC TLTNSPC W/O SEAT||2589.91|259.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1232|E1232 - FOLDING PED WC TILT-IN-SPACE||2974.96|297.5||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1231|E1231 - RIGID PED W/C TILT-IN-SPACE||2871.14|287.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1230|E1230 - POWER OPERATED VEHICLE||3826.39|376.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1228|E1228 - WHEELCHAIR SPEC SZ SPEC HT B||2299.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1227|E1227 - WHEELCHAIR SPEC SZ SPEC HT A||3036.81|31.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1226|E1226 - MANUAL FULLY RECLINING BACK||372.6|37.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1225|E1225 - MANUAL SEMI-RECLINING BACK||549.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1224|E1224 - WHEELCHAIR SPEC SIZE W/ LEG||75.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1223|E1223 - WHEELCHAIR SPEC SIZE W FOOT||732.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1222|E1222 - WHEELCHAIR SPEC SIZE W/ LEG||54.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1221|E1221 - WHEELCHAIR SPEC SIZE W FOOT||108.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1200|E1200 - WHEELCHAIR AMPUTEE FIXED ARM||99.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1195|E1195 - WHEELCHAIR AMPUTEE HEAVY DUT||90.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1190|E1190 - WHEELCHAIR AMPUTEE W/ LEG RE||63.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1180|E1180 - WHEELCHAIR AMPUTEE W/ FOOT R||99.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1172|E1172 - WHEELCHAIR AMPUTEE DETACH AR||143.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1171|E1171 - WHEELCHAIR AMPUTEE W/O LEG R||133.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1170|E1170 - WHLCHR AMPU FXD ARM LEG REST||115.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1161|E1161 - MANUAL ADULT WC W TILTINSPAC||131.53|95.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1160|E1160 - WHEELCHAIR FIXED ARMS||2382.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1150|E1150 - WHEELCHAIR STANDARD W/ LEG R||317.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1110|E1110 - WHEELCHAIR SEMI-RECL DETACH||3176.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1100|E1100 - WHCHR S-RECL FXD ARM LEG RES||71.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1093|E1093 - WHEELCHAIR WIDE W/ FOOT REST||100.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1092|E1092 - WHEELCHAIR WIDE W/ LEG RESTS||116.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1088|E1088 - WHEELCHAIR LIGHTWEIGHT DET A||118.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1087|E1087 - WHEELCHAIR LIGHTWT FIXED ARM||126.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1084|E1084 - HEMI-WHEELCHAIR DETACHABLE A||172.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1083|E1083 - HEMI-WHEELCHAIR FIXED ARMS||184.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1070|E1070 - WHEELCHAIR DETACHABLE FOOT R||144.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1060|E1060 - WHEELCHAIR DETACHABLE ARMS||131.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1050|E1050 - WHELCHR FXD FULL LENGTH ARMS||89.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1039|E1039 - TRANSPORT CHAIR PT WT >300LB||125|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1038|E1038 - TRANSPORT CHAIR PT WT<=300LB||143.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1037|E1037 - TRANSPORT CHAIR -  PED SIZE||116.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1036|E1036 - PATIENT TRANSFER SYSTEM >300||45.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1035|E1035 - PATIENT TRANSFER SYSTEM <300||24.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1031|E1031 - ROLLABOUT CHAIR WITH CASTERS||145.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1030|E1030 - W/C VENT TRAY GIMBALED||1154.21|57.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1029|E1029 - W/C VENT TRAY FIXED||1348.5|49.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1028|E1028 - W/C MANUAL SWINGAWAY||427.65|27.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1020|E1020 - RESIDUAL LIMB SUPPORT SYSTEM||245.11|23.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1018|E1018 - HD SHCK ABSRBER FOR HD POWWC||326.81|28.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1017|E1017 - HD SHCK ABSRBR FOR HD MAN WC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1016|E1016 - SHOCK ABSORBER FOR POWER W/C||143.59|17.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1015|E1015 - SHOCK ABSORBER FOR MAN W/C||176.31|15.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1014|E1014 - RECLINING BACK ADD PED W/C||154.01|15.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1011|E1011 - PED WC MODIFY WIDTH ADJUSTM||490.26|49.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1010|E1010 - ADD PWR LEG ELEVATION||1250.84|153.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1009|E1009 - ADD MECH LEG ELEVATION||1535.71|132.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1008|E1008 - PWR SEAT COMBO PWR SHEAR||9560.28|1173.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1007|E1007 - PWR SEAT COMBO W/SHEAR||10116.67|1011.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1006|E1006 - PWR SEAT COMBO W/O SHEAR||10115.76|866.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1005|E1005 - PWR SEAT RECLINE PWR||7470.81|707.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1004|E1004 - PWR SEAT RECLINE MECH||6099.09|609.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1003|E1003 - PWR SEAT RECLINE||5634.66|563.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E1002|E1002 - PWR SEAT TILT||5081.8|508.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0995|E0995 - WC CALF REST -  PAD REPLACEMNT||4690.55|4.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0994|E0994 - WHEELCHAIR ARM REST||40.82|3.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0992|E0992 - WHEELCHAIR SOLID SEAT INSERT||20.11|2.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0990|E0990 - WHEELCHAIR ELEVATING LEG RES||108.6|10.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0988|E0988 - LEVER-ACTIVATED WHEEL DRIVE||13.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0986|E0986 - MAN W/C PUSH-RIM POWR SYSTEM||401.93|135.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0985|E0985 - W/C SEAT LIFT MECHANISM||6531|653.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0984|E0984 - ADD PWR TILLER||272.36|27.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0983|E0983 - ADD PWR JOYSTICK||0|1979.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0982|E0982 - BACK UPHOLSTERY -  REPLACEMENT||326.15|6.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0981|E0981 - SEAT UPHOLSTERY -  REPLACEMENT||59.63|5.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0980|E0980 - WHEELCHAIR SAFETY VEST||61.21|5.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0978|E0978 - W/C ACC - SAF BELT PELV STRAP||37.73|3.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0974|E0974 - W/CH ACCESS ANTI-ROLLBACK||57.35|4.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0973|E0973 - W/CH ACCESS DET ADJ ARMREST||105.28|11.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0971|E0971 - WHEELCHAIR ANTI-TIPPING DEVI||154.36|12.68||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0969|E0969 - WHEELCHAIR NARROWING DEVICE||58.25|5.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0968|E0968 - WHEELCHAIR COMMODE SEAT||157.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0967|E0967 - MAN WC RIM/PROJECTION REP EA||210.3|20.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0966|E0966 - WHEELCHAIR HEAD REST EXTENSI||88.19|8.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0961|E0961 - WHEELCHAIR BRAKE EXTENSION||88.02|8.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0960|E0960 - W/C SHOULDER HARNESS/STRAPS||78.98|3.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0959|E0959 - AMPUTEE ADAPTER||122.15|10.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0958|E0958 - WHLCHR ATT- CONV 1 ARM DRIVE||0|38.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0957|E0957 - W/C MEDIAL THIGH SUPPORT||119.71|5.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0956|E0956 - W/C LATERAL TRUNK/HIP SUPPOR||159.62|13.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0955|E0955 - CUSHIONED HEADREST||175.48|11.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0952|E0952 - TOE LOOP/HOLDER -  EACH||233.97|2.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0951|E0951 - LOOP HEEL||19.1|1.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0950|E0950 - TRAY||76.69|2.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0948|E0948 - FRACTURE FRAME ATTACHMNTS CE||118.64|10.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0947|E0947 - FRACTURE FRAME ATTACHMNTS PE||721.35|72.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0946|E0946 - FRACTURE FRAME DUAL W CROSS||0|541||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0945|E0945 - BELT/HARNESS EXTREMITY||721.35|67.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0944|E0944 - PELVIC BELT/HARNESS/BOOT||50.59|5.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0942|E0942 - CERVICAL HEAD HARNESS/HALTER||60.16|6.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0941|E0941 - GRAVITY ASSISTED TRACTION DE||17.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0940|E0940 - TRAPEZE BAR FREE STANDING||2.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0935|E0935 - CONT PAS MOTION EXERCISE DEV||23.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0930|E0930 - FRACTURE FRAME FREE STANDING||58.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0920|E0920 - FRACTURE FRAME ATTACHED TO B||34.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0912|E0912 - HD TRAPEZE BAR FREE STANDING||25.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0911|E0911 - HD TRAPEZE BAR ATTACH TO BED||52.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0910|E0910 - TRAPEZE BAR ATTACHED TO BED||0|55.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0900|E0900 - TRAC STAND FREE STAND PELVIC||132.48|21.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0890|E0890 - TRACTION FRAME ATTACH PELVIC||146.24|31.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0880|E0880 - TRAC STAND FREE STAND EXTREM||137.41|43.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0870|E0870 - TRACT FRAME ATTACH FOOTBOARD||143.28|22.5||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0860|E0860 - TRACT EQUIP CERVICAL TRACT||132.75|15.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0856|E0856 - CERVIC COLLAR W AIR BLADDERS||48.59|7.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0855|E0855 - CERVICAL TRACTION EQUIPMENT||206.81|20.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0850|E0850 - TRACTION STAND FREE STANDING||674.85|67.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0849|E0849 - CERVICAL PNEUM TRAC EQUIP||119.89|16.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0840|E0840 - TRACT FRAME ATTACH HEADBOARD||691.89|69.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0791|E0791 - PARENTERAL INFUSION PUMP STA||71.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0786|E0786 - IMPLANTABLE PUMP REPLACEMENT||360.86|21.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0785|E0785 - REPLACEMENT IMPL PUMP CATHET||8041.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0784|E0784 - EXT AMB INFUSN PUMP INSULIN||1072.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0783|E0783 - PROGRAMMABLE INFUSION PUMP||10722.23|560.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0782|E0782 - NON-PROGRAMBLE INFUSION PUMP||10992.2|1099.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0781|E0781 - EXTERNAL AMBULATORY INFUS PU||4323.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0780|E0780 - MECH AMB INFUSION PUMP <8HRS||576.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0779|E0779 - AMB INFUSION PUMP MECHANICAL||5764.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0776|E0776 - IV POLE||344.98|13.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0765|E0765 - NERVE STIMULATOR FOR TX N&V||163.37|21.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0764|E0764 - FUNCTIONAL NEUROMUSCULARSTIM||112.96|11.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0762|E0762 - TRANS ELEC JT STIM DEV SYS||14858.92|1485.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0760|E0760 - OSTEOGEN ULTRASOUND STIMLTOR||1476.34|147.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0749|E0749 - ELEC OSTEOGEN STIM IMPLANTED||3255.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0748|E0748 - ELEC OSTEOGEN STIM SPINAL||4340.95|324.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0747|E0747 - ELEC OSTEOGEN STIM NOT SPINE||5223.88|522.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0745|E0745 - NEUROMUSCULAR STIM FOR SHOCK||3906.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0744|E0744 - NEUROMUSCULAR STIM FOR SCOLI||522.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0740|E0740 - NON-IMPLANT PELV FLR E-STIM||5257.94|120.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0731|E0731 - CONDUCTIVE GARMENT FOR TENS/||526.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0730|E0730 - TENS FOUR LEAD||70.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0720|E0720 - TENS TWO LEAD||702.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0705|E0705 - TRANSFER DEVICE||497.54|478.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0694|E0694 - UVL MD CABINET SYS 6 FT||74.01|7.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0693|E0693 - UVL SYS PANEL 6 FT||5944.4|594.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0692|E0692 - UVL SYS PANEL 4 FT||1867.61|186.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0691|E0691 - UVL PNL 2 SQ FT OR LESS||1515.03|151.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0675|E0675 - PNEUMATIC COMPRESSION DEVICE||0|904.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0673|E0673 - PRESSURE PNEUM APPL HALF LEG||1206.5|120.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0672|E0672 - PRESSURE PNEUM APPL FULL ARM||360.06|36.01||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0671|E0671 - PRESSURE PNEUM APPL FULL LEG||433.31|43.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0670|E0670 - SEG PNEUM INT LEGS/TRUNK||557.68|55.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0669|E0669 - SEG PNEUMATIC APPLI HALF LEG||243.05|24.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0668|E0668 - SEG PNEUMATIC APPL FULL ARM||593.29|58.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0667|E0667 - SEG PNEUMATIC APPL FULL LEG||434.71|49.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0666|E0666 - PNEUMATIC APPLIANCE HALF LEG||185.4|19.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0665|E0665 - PNEUMATIC APPLIANCE FULL ARM||179.97|18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0660|E0660 - PNEUMATIC APPLIANCE FULL LEG||214.49|21.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0657|E0657 - SEGMENTAL PNEUMATIC CHEST||728.71|72.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0656|E0656 - SEGMENTAL PNEUMATIC TRUNK||775.66|77.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0655|E0655 - PNEUMATIC APPLIANCE HALF ARM||126.75|14.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0652|E0652 - PNEUM COMPRES W/CAL PRESSURE||7118.01|703.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0651|E0651 - PNEUM COMPRESSOR SEGMENTAL||1233.12|125.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0650|E0650 - PNEUMA COMPRESOR NON-SEGMENT||821.95|107.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0636|E0636 - PT SUPPORT & POSITIONING SYS||1415.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0635|E0635 - PATIENT LIFT ELECTRIC||164.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0630|E0630 - PATIENT LIFT HYDRAULIC||123.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0629|E0629 - SEAT LIFT MECH -  NON-ELECTRIC||444.04|44.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0628|E0628 - SEAT LIFT FOR PT FURN-ELECTR||452.91|45.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0627|E0627 - SEAT LIFT MECH -  ELECTRIC ANY||452.91|45.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0621|E0621 - PATIENT LIFT SLING OR SEAT||109.55|10.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0620|E0620 - CAP BLD SKIN PIERCING LASER||1174|117.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0619|E0619 - APNEA MONITOR W RECORDER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0618|E0618 - APNEA MONITOR||376.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0617|E0617 - AUTOMATIC EXT DEFIBRILLATOR||0|408.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0615|E0615 - PACEMAKER MONITR DIGITAL/VIS||642.89|78.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0610|E0610 - PACEMAKER MONITR AUDIBLE/VIS||282.5|28.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0607|E0607 - BLOOD GLUCOSE MONITOR HOME||89.71|8.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0606|E0606 - DRAINAGE BOARD POSTURAL||30.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0605|E0605 - VAPORIZER ROOM TYPE||30.16|3.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0602|E0602 - MANUAL BREAST PUMP||39.64|3.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0601|E0601 - CONT AIRWAY PRESSURE DEVICE||129.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0600|E0600 - SUCTION PUMP PORTAB HOM MODL||54.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0585|E0585 - NEBULIZER W/ COMPRESSOR & HE||40.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0580|E0580 - NEBULIZER FOR USE W/ REGULAT||155.12|15.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0575|E0575 - NEBULIZER ULTRASONIC||135.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0574|E0574 - ULTRASONIC GENERATOR W SVNEB||52.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0572|E0572 - AEROSOL COMPRESSOR ADJUST PR||49.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0570|E0570 - NEBULIZER WITH COMPRESSION||21.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0565|E0565 - COMPRESSOR AIR POWER SOURCE||81.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0562|E0562 - HUMIDIFIER HEATED USED W PAP||348.59|34.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0561|E0561 - HUMIDIFIER NONHEATED W PAP||123.82|12.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0560|E0560 - HUMIDIFIER SUPPLEMENTAL W/ I||168.71|21.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0550|E0550 - HUMIDIF EXTENS SUPPLE W IPPB||67.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0500|E0500 - IPPB ALL TYPES||125.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0486|E0486 - ORAL DEVICE/APPLIANCE CUSFAB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0485|E0485 - ORAL DEVICE/APPLIANCE PREFAB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0484|E0484 - NON-ELEC OSCILLATORY PEP DVC||49.57|4.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0483|E0483 - HI FREQ CHEST WALL OSCIL SYS||1427.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0482|E0482 - COUGH STIMULATING DEVICE||560.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0480|E0480 - PERCUSSOR ELECT/PNEUM HOME M||58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0472|E0472 - RAD W BACKUP INVASIVE INTRFC||743.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0471|E0471 - RAD W/BACKUP NON INV INTRFC||743.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0470|E0470 - RAD W/O BACKUP NON-INV INTFC||296.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0464|E0464 - PRESR SUPP VENT W VOL CONTR MODE USED W NONINVA IN||1888.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0463|E0463 - PRESSURE SUPPORT VENT INVASIVE INT||1888.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0462|E0462 - ROCKING BED W/ OR W/O SIDE R||391.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0461|E0461 - VOL VENT BACKUP RATE FEATUR NON-INVASV INTERFCE||1281.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0460|E0460 - NEG PRESSURE VENTILATOR; PORTABLE/STATIONARY    AR||984.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0459|E0459 - CHEST WRAP||64.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0457|E0457 - CHEST SHELL||825.07|82.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0450|E0450 - VOL VENT STATION/PRTBLE W/BACKUP RATE FEATUR||1281.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0444|E0444 - PORTABLE 02 CONTENTS -  LIQUID||96.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0443|E0443 - PORTABLE 02 CONTENTS -  GAS||96.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0442|E0442 - STATIONARY O2 CONTENTS -  LIQ||96.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0441|E0441 - STATIONARY O2 CONTENTS -  GAS||96.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0439|E0439 - STATIONARY LIQUID 02||220.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0434|E0434 - PORTABLE LIQUID 02||36.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0433|E0433 - PORTABLE LIQUID OXYGEN SYS||64.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0431|E0431 - PORTABLE GASEOUS 02||36.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0424|E0424 - STATIONARY COMPRESSED GAS 02||220.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0373|E0373 - NONPOWERED PRESSURE MATTRESS||693.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0372|E0372 - POWERED AIR MATTRESS OVERLAY||605.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0371|E0371 - NONPOWER MATTRESS OVERLAY||498.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0326|E0326 - URINAL FEMALE JUG-TYPE||12.37|1.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0325|E0325 - URINAL MALE JUG-TYPE||11.54|1.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0316|E0316 - BED SAFETY ENCLOSURE||244.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0310|E0310 - RAILS BED SIDE FULL LENGTH||224.66|25.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0305|E0305 - RAILS BED SIDE HALF LENGTH||17.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0304|E0304 - HOSP BED XTRA HVY DTY X WIDE||891.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0303|E0303 - HOSP BED HVY DTY XTRA WIDE||341.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0302|E0302 - EX HD HOSP BED > 600 LBS||827.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0301|E0301 - HD HOSP BED -  350-600 LBS||303.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0300|E0300 - ENCLOSED PED CRIB HOSP GRADE||3284.96|328.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0297|E0297 - HOSP BED TOTAL ELECT W/O MAT||138.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0296|E0296 - HOSP BED TOTAL ELECT W/ MATT||161.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0295|E0295 - HOSP BED SEMI-ELECT W/O MATT||125.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0294|E0294 - HOSP BED SEMI-ELECT W/ MATTR||128.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0293|E0293 - HOSP BED VAR HT NO SR NO MAT||70.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0292|E0292 - HOSP BED VAR HT NO SR W/MATT||82.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0291|E0291 - HOSP BED FX HT W/O RAIL W/O||53.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0290|E0290 - HOSP BED FX HT W/O RAILS W/M||73.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0280|E0280 - BED CRADLE||44.21|4.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0277|E0277 - POWERED PRES-REDU AIR MATTRS||814.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0276|E0276 - BED PAN FRACTURE||17.88|2.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0275|E0275 - BED PAN STANDARD||20.56|2.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0272|E0272 - MATTRESS FOAM RUBBER||234.19|24.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0271|E0271 - MATTRESS INNERSPRING||234.97|23.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0266|E0266 - HOSP BED TOTAL ELEC W/O MATT||174.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0265|E0265 - HOSP BED TOTAL ELECTR W/ MAT||196.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0261|E0261 - HOSP BED SEMI-ELECTR W/O MAT||134.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0260|E0260 - HOSP BED SEMI-ELECTR W/ MATT||162.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0256|E0256 - HOSPITAL BED VAR HT W/O MATT||81.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0255|E0255 - HOSPITAL BED VAR HT W/ MATTR||116.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0251|E0251 - HOSP BED FIXD HT W/O MATTRES||73.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0250|E0250 - HOSP BED FIXED HT W/ MATTRES||98.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0249|E0249 - PAD WATER CIRCULATING HEAT U||133.74|14.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0239|E0239 - HYDROCOLLATOR UNIT PORTABLE||603.96|60.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0236|E0236 - PUMP FOR WATER CIRCULATING P||52.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0235|E0235 - PARAFFIN BATH UNIT PORTABLE||23.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0225|E0225 - HYDROCOLLATOR UNIT||521.81|51.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0217|E0217 - WATER CIRC HEAT PAD W PUMP||662.95|66.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0215|E0215 - ELECTRIC HEAT PAD MOIST||80.85|8.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0210|E0210 - ELECTRIC HEAT PAD STANDARD||39.11|3.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0205|E0205 - HEAT LAMP WITH STAND||260.56|28.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0202|E0202 - PHOTOTHERAPY LIGHT W/ PHOTOM||71.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0200|E0200 - HEAT LAMP WITHOUT STAND||106.45|14.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0199|E0199 - DRY PRESSURE PAD FOR MATTRES||43.04|4.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0198|E0198 - WATER PRESSURE PAD FOR MATTR||252.89|26.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0197|E0197 - AIR PRESSURE PAD FOR MATTRES||252.89|34.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0196|E0196 - GEL PRESSURE MATTRESS||37.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0194|E0194 - AIR FLUIDIZED BED||3714.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0193|E0193 - POWERED AIR FLOTATION BED||986.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0191|E0191 - PROTECTOR HEEL OR ELBOW||11.4|1.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0189|E0189 - LAMBSWOOL SHEEPSKIN PAD||69.77|7.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0188|E0188 - SYNTHETIC SHEEPSKIN PAD||35.49|4.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0187|E0187 - WATER PRESSURE MATTRESS||26.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0186|E0186 - AIR PRESSURE MATTRESS||23.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0185|E0185 - GEL PRESSURE MATTRESS PAD||389.76|51.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0184|E0184 - DRY PRESSURE MATTRESS||261.42|30.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0182|E0182 - REPLACE PUMP -  ALT PRESS PAD||29.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0181|E0181 - PRESS PAD ALTERNATING W/ PUM||34.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0175|E0175 - COMMODE CHAIR FOOT REST||88.92|8.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0171|E0171 - COMMODE CHAIR NON-ELECTRIC||38.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0170|E0170 - COMMODE CHAIR ELECTRIC||215.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0168|E0168 - HEAVYDUTY/WIDE COMMODE CHAIR||202.64|20.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0167|E0167 - COMMODE CHAIR PAIL OR PAN||13.7|1.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0165|E0165 - COMMODE CHAIR WITH DETACHARM||0|24.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0163|E0163 - COMMODE CHAIR WITH FIXED ARM||148.07|31.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0162|E0162 - SITZ BATH CHAIR||166.29|17.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0161|E0161 - SITZ BATH/EQUIPMENT W/FAUCET||35.21|4.07||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0160|E0160 - SITZ TYPE BATH OR EQUIPMENT||37.73|4.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0159|E0159 - BRAKE FOR WHEELED WALKER||20.68|2.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0158|E0158 - WALKER LEG EXTENDERS SET OF4||37.24|4.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0157|E0157 - WALKER CRUTCH ATTACHMENT||83.74|8.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0156|E0156 - WALKER SEAT ATTACHMENT||30.59|3.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0155|E0155 - WALKER WHEEL ATTACHMENT - PAIR||35.41|3.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0154|E0154 - WALKER PLATFORM ATTACHMENT||81.6|8.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0153|E0153 - FOREARM CRUTCH PLATFORM ATTA||81.06|8.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0149|E0149 - HEAVY DUTY WHEELED WALKER||258.3|25.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0148|E0148 - HEAVYDUTY WALKER NO WHEELS||147.04|14.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0147|E0147 - WALKER VARIABLE WHEEL RESIST||665.19|66.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0144|E0144 - ENCLOSED WALKER W REAR SEAT||368.53|36.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0143|E0143 - WALKER FOLDING WHEELED W/O S||128.94|21.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0141|E0141 - RIGID WHEELED WALKER ADJ/FIX||128.94|22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0140|E0140 - WALKER W TRUNK SUPPORT||417.43|41.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0135|E0135 - WALKER FOLDING ADJUST/FIXED||87.45|19.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0130|E0130 - WALKER RIGID ADJUST/FIXED HT||81.27|19.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0117|E0117 - UNDERARM SPRINGASSIST CRUTCH||258.75|25.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0116|E0116 - CRUTCH UNDERARM EACH NO WOOD||31.66|6.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0114|E0114 - CRUTCH UNDERARM PAIR NO WOOD||53.86|9.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0113|E0113 - CRUTCH UNDERARM EACH WOOD||24.12|5.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0112|E0112 - CRUTCH UNDERARM PAIR WOOD||42.22|11.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0111|E0111 - CRUTCH FOREARM EACH||66.05|9.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0110|E0110 - CRUTCH FOREARM PAIR||88.55|18.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0105|E0105 - CANE ADJUST/FIXED QUAD/3 PRO||65.95|10.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|E0100|E0100 - CANE ADJUST/FIXED WITH TIP||28.29|6.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|CMMT|||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP23|||21.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP22|||21.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP21|||20.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP20|||20.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP19|||19.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP18|||18.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP16|||18.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP12|||15.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP11|||15.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP10|||15.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP09|||15.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP08|||14.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP07|||14.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP06|||13.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP05|||13.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP04|||12.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP03|||11.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ATP02|||9.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|ANEST|||67.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9606|A9606 - RADIUM RA223 DICHLORIDE THER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9585|A9585 - GADOBUTROL INJECTION||0.4675|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9583|A9583 - GADOFOSVESET TRISODIUM INJ||22.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9581|A9581 - GADOXETATE DISODIUM INJ||18.4275|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9579|A9579 - GAD-BASE MR CONTRAST NOS - 1ML||1.9512|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9578|A9578 - INJ MULTIHANCE MULTIPACK||2.4075|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9577|A9577 - INJ MULTIHANCE||2.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9576|A9576 - INJ PROHANCE MULTIPACK||1.7588|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9575|A9575 - INJ GADOTERATE MEGLUMI 0.1ML||0.2487|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9505|A9505 - TL201 THALLIUM||114.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9503|A9503 - TC99M MEDRONATE||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9502|A9502 - TC99M TETROFOSMIN||144.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9500|A9500 - TC99M SESTAMIBI||152.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A9150|A9150 - MISC/EXPER NON-PRESCRIPT DRU||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A8004|A8004 - REPL SOFT INTERFACE -  HELMET||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A8003|A8003 - HARD PROTECT HELMET CUSTOM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A8002|A8002 - SOFT PROTECT HELMET CUSTOM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A8001|A8001 - HARD PROTECT HELMET PREFAB||205.9|20.59||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A8000|A8000 - SOFT PROTECT HELMET PREFAB||205.9|20.59||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7527|A7527 - TRACH/LARYN TUBE PLUG/STOP||4.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7526|A7526 - TRACHEOSTOMY TUBE COLLAR||4.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7525|A7525 - TRACHEOSTOMY MASK||2.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7524|A7524 - TRACHEOSTOMA STENT/STUD/BTTN||103.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7522|A7522 - TRACH/LARYN TUBE STAINLESS||60.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7521|A7521 - TRACH/LARYN TUBE CUFFED||63.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7520|A7520 - TRACH/LARYN TUBE NON-CUFFED||63.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7509|A7509 - HEAT & MOISTURE EXCHANGE SYS||1.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7508|A7508 - HOUSING & INTEGRATED ADHESIV||3.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7507|A7507 - INTEGRATED FILTER & HOLDER||3.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7506|A7506 - HMES/TRACHVALVE ADHESIVEDISK||0.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7505|A7505 - HMES OR TRACH VALVE HOUSING||6.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7504|A7504 - TRACHEOSTOMA HMES FILTER||0.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7503|A7503 - HMES FILTER HOLDER OR CAP||15.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7502|A7502 - REPLACEMENT DIAPHRAGM/FPLATE||67.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7501|A7501 - TRACHEOSTOMA VALVE W DIAPHRA||141.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7046|A7046 - REPL WATER CHAMBER -  PAP DEV||22.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7045|A7045 - REPL EXHALATION PORT FOR PAP||22.53|2.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7044|A7044 - PAP ORAL INTERFACE||139.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7043|A7043 - VACUUM DRAIN BOTTLE&TUBING USE W/IMPL CATHETER||38.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7042|A7042 - IMPLANTED PLEURAL CATHETER EACH||243.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7041|A7041 - WATER SEAL DRAIN CONTAINER||102.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7040|A7040 - ONE WAY CHEST DRAIN VALVE||54.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7039|A7039 - FILTER -  NON DISPOSABLE W PAP||15.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7038|A7038 - POS AIRWAY PRESSURE FILTER||6.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7037|A7037 - POS AIRWAY PRESSURE TUBING||46.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7036|A7036 - POS AIRWAY PRESS CHINSTRAP||17.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7035|A7035 - POS AIRWAY PRESS HEADGEAR||41.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7034|A7034 - NASAL APPLICATION DEVICE||136.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7033|A7033 - REPLACEMENT NASAL PILLOWS||32.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7032|A7032 - REPLACEMENT NASAL CUSHION||46.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7031|A7031 - REPLACEMENT FACEMASK INTERFA||80.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7030|A7030 - CPAP FULL FACE MASK||218.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7029|A7029 - REPL NASAL PILLOW COMB MASK||27.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7028|A7028 - REPL ORAL CUSHION COMBO MASK||66.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7027|A7027 - COMBINATION ORAL/NASAL MASK||250.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7026|A7026 - REPLACE CHST CMPRSS SYS HOSE||38.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7025|A7025 - REPLACE CHEST COMPRESS VEST||583.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7020|A7020 - INTERFACE -  COUGH STIM DEVICE||19.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7018|A7018 - WATER DISTILLED W/NEBULIZER||0.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7017|A7017 - NEBULIZER NOT USED W OXYGEN||179.96|18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7016|A7016 - NEBULIZER DOME & MOUTHPIECE||9.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7015|A7015 - AEROSOL MASK USED W NEBULIZE||2.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7014|A7014 - COMPRESSOR NONDISPOS FILTER||6.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7013|A7013 - DISPOSABLE COMPRESSOR FILTER||0.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7012|A7012 - NEBULIZER WATER COLLEC DEVIC||5.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7010|A7010 - DISPOSABLE CORRUGATED TUBING||26.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7009|A7009 - NEBULIZER RESERVOIR BOTTLE||54.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7008|A7008 - DISPOSABLE NEBULIZER PREFILL||12.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7007|A7007 - LG VOL NEBULIZER DISPOSABLE||5.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7006|A7006 - FILTERED NEBULIZER ADMIN SET||12.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7005|A7005 - NONDISPOSABLE NEBULIZER SET||35.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7004|A7004 - DISPOSABLE NEBULIZER SML VOL||2.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7003|A7003 - NEBULIZER ADMINISTRATION SET||3.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7002|A7002 - TUBING USED W SUCTION PUMP||4.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7001|A7001 - NONDISPOSABLE PUMP CANISTER||38.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A7000|A7000 - DISPOSABLE CANISTER FOR PUMP||10.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6550|A6550 - NEG PRES WOUND THER DRSG SET||31.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6545|A6545 - GRAD COMP NON-ELASTIC BK||114.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6532|A6532 - COMPRESSION STOCKING BK40-50||81.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6531|A6531 - COMPRESSION STOCKING BK30-40||58.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6513|A6513 - COMPRESS BURN MASK FACE/NECK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6511|A6511 - COMPRES BURN GARMENT PANTY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6510|A6510 - COMPRES BURN GARMENT LEOTARD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6509|A6509 - COMPRES BURN GARMENT JACKET||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6508|A6508 - CMPRS BURNGARMENT FOOT-THIGH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6507|A6507 - CMPRS BURNGARMENT FOOT-KNEE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6506|A6506 - CMPRSBURNGRMNT GLOVE-AXILLA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6505|A6505 - CMPRSBURNGARMENT GLOVE-ELBOW||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6504|A6504 - CMPRSBURNGARMENT GLOVE-WRIST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6503|A6503 - COMPRES BURNGARMENT FACEHOOD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6502|A6502 - COMPRES BURNGARMENT CHINSTRP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6501|A6501 - COMPRES BURNGARMENT BODYSUIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6457|A6457 - TUBULAR DRESSING||1.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6456|A6456 - ZINC PASTE BAND W >=3''<5''/YD||1.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6455|A6455 - SELF-ADHER BAND >=5''/YD||1.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6454|A6454 - SELF-ADHER BAND W>=3'' <5''/YD||1.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6453|A6453 - SELF-ADHER BAND W <3''/YD||0.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6452|A6452 - HIGH COMPRES BAND W>=3''<5''YD||7.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6451|A6451 - MOD COMPRES BAND W>=3''<5''/YD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6450|A6450 - LT COMPRES BAND >=5''/YD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6449|A6449 - LT COMPRES BAND >=3'' <5''/YD||2.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6448|A6448 - LT COMPRES BAND <3''/YD||1.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6447|A6447 - CONFORM BAND S W >=5''/YD||0.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6446|A6446 - CONFORM BAND S W>=3'' <5''/YD||0.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6445|A6445 - CONFORM BAND S W <3''/YD||0.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6444|A6444 - CONFORM BAND N/S W>=5''/YD||0.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6443|A6443 - CONFORM BAND N/S W>=3''<5''/YD||0.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6442|A6442 - CONFORM BAND N/S W<3''/YD||0.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6441|A6441 - PAD BAND W>=3'' <5''/YD||0.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6411|A6411 - NON-STERILE EYE PAD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6410|A6410 - STERILE EYE PAD||0.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6407|A6407 - PACKING STRIPS -  NON-IMPREG||2.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6403|A6403 - STERILE GAUZE>16 <= 48 SQ IN||0.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6402|A6402 - STERILE GAUZE <= 16 SQ IN||0.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6266|A6266 - IMPREG GAUZE NO H20/SAL/YARD||2.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6259|A6259 - TRANSPARENT FILM > 48 SQ IN||14.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6258|A6258 - TRANSPARENT FILM >16<=48 IN||5.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6257|A6257 - TRANSPARENT FILM <= 16 SQ IN||2.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6255|A6255 - ABSORPT DRG >16<=48 IN W/BDR||4.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6254|A6254 - ABSORPT DRG <=16 SQ IN W/BDR||1.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6253|A6253 - ABSORPT DRG > 48 SQ IN W/O B||8.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6252|A6252 - ABSORPT DRG >16 <=48 W/O BDR||4.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6251|A6251 - ABSORPT DRG <=16 SQ IN W/O B||2.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6248|A6248 - HYDROGEL DRSG GEL FILLER||21.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6247|A6247 - HYDROGEL DRG > 48 SQ IN W/B||31.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6246|A6246 - HYDROGEL DRG >16<=48 IN W/B||13.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6245|A6245 - HYDROGEL DRG <= 16 IN W/BDR||9.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6244|A6244 - HYDROGEL DRG >48 IN W/O BDR||52.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6243|A6243 - HYDROGEL DRG >16<=48 W/O BDR||16.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6242|A6242 - HYDROGEL DRG <=16 IN W/O BDR||8.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6241|A6241 - HYDROCOLLOID DRG FILLER DRY||3.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6240|A6240 - HYDROCOLLD DRG FILLER PASTE||16.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6238|A6238 - HYDROCOLLD DRG >16<=48 W/BDR||30.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6237|A6237 - HYDROCOLLD DRG <=16 IN W/BDR||10.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6236|A6236 - HYDROCOLLD DRG > 48 IN W/O B||36.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6235|A6235 - HYDROCOLLD DRG >16<=48 W/O B||22.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6234|A6234 - HYDROCOLLD DRG <=16 W/O BDR||8.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6233|A6233 - HYDROGEL DRESSING >48 SQ IN||25.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6232|A6232 - HYDROGEL DSG>16<=48 SQ IN||9.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6231|A6231 - HYDROGEL DSG<=16 SQ IN||6.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6229|A6229 - GAUZE >16<=48 SQ IN WATR/SAL||4.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6224|A6224 - GAUZE > 48 IN NO W/SAL W/O B||4.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6223|A6223 - GAUZE >16<=48 NO W/SAL W/O B||3.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6222|A6222 - GAUZE <=16 IN NO W/SAL W/O B||2.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6220|A6220 - GAUZE >16 <=48 SQ IN W/BORDR||3.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6219|A6219 - GAUZE <= 16 SQ IN W/BORDER||1.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6217|A6217 - NON-STERILE GAUZE>16<=48 SQ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6216|A6216 - NON-STERILE GAUZE<=16 SQ IN||0.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6214|A6214 - FOAM DRG > 48 SQ IN W/BORDER||13.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6212|A6212 - FOAM DRG <=16 SQ IN W/BORDER||13.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6211|A6211 - FOAM DRG > 48 SQ IN W/O BRDR||39.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6210|A6210 - FOAM DRG >16<=48 SQ IN W/O B||26.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6209|A6209 - FOAM DRSG <=16 SQ IN W/O BDR||10.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6207|A6207 - CONTACT LAYER >16<= 48 SQ IN||9.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6204|A6204 - COMPOSITE DRSG >16<=48 SQ IN||8.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6203|A6203 - COMPOSITE DRSG <= 16 SQ IN||4.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6199|A6199 - ALGINATE DRSG WOUND FILLER||7.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6197|A6197 - ALGINATE DRSG >16 <=48 SQ IN||22.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6196|A6196 - ALGINATE DRESSING <=16 SQ IN||9.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6154|A6154 - WOUND POUCH EACH||19.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6024|A6024 - COLLAGEN DSG WOUND FILLER||8.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6023|A6023 - COLLAGEN DRESSING >48 SQ IN||255.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6022|A6022 - COLLAGEN DRSG>16<=48 SQ IN||28.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6021|A6021 - COLLAGEN DRESSING <=16 SQ IN||28.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6011|A6011 - COLLAGEN GEL/PASTE WOUND FIL||3.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A6010|A6010 - COLLAGEN BASED WOUND FILLER||41.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5513|A5513 - MULTI DEN INSERT CUSTOM MOLD||51.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5512|A5512 - MULTI DEN INSERT DIRECT FORM||34.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5507|A5507 - MODIFICATION DIABETIC SHOE||41.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5506|A5506 - DIABETIC SHOE W/OFF SET HEEL||41.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5505|A5505 - DIAB SHOE W/METATARSAL BAR||41.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5504|A5504 - DIABETIC SHOE WITH WEDGE||41.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5503|A5503 - DIABETIC SHOE W/ROLLER/ROCKR||41.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5501|A5501 - DIABETIC CUSTOM MOLDED SHOE||256.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5500|A5500 - DIAB SHOE FOR DENSITY INSERT||85.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5200|A5200 - PERCUTANEOUS CATHETER ANCHOR||15.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5131|A5131 - APPLIANCE CLEANER||21.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5126|A5126 - DISK/FOAM PAD +OR- ADHESIVE||1.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5122|A5122 - SOLID SKIN BARRIER 8X8||17.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5121|A5121 - SOLID SKIN BARRIER 6X6||8.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5120|A5120 - SKIN BARRIER -  WIPE OR SWAB||0.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5114|A5114 - FOAM/FABRIC LEG STRAP||10.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5113|A5113 - LATEX LEG STRAP||6.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5112|A5112 - URINARY LEG BAG||46.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5105|A5105 - URINARY SUSPENSORY||54.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5102|A5102 - BEDSIDE DRAIN BTL W/WO TUBE||30.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5093|A5093 - OSTOMY ACCESSORY CONVEX INSE||2.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5083|A5083 - STOMA ABSORPTIVE COVER||0.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5082|A5082 - CONTINENT STOMA CATHETER||15.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5081|A5081 - STOMA PLUG OR SEAL -  ANY TYPE||3.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5073|A5073 - URINARY POUCH ON BARR W/FLNG||4.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5072|A5072 - URINARY POUCH W/O BARRIER||4.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5071|A5071 - URINARY POUCH W/BARRIER||8.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5063|A5063 - DRAIN OSTOMY POUCH W/FLANGE||3.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5062|A5062 - DRNBLE OSTOMY POUCH W/O BARR||2.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5061|A5061 - POUCH DRAINABLE W BARRIER AT||4.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5057|A5057 - 1 PC OST POU W BUILT-IN CONV||12.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5056|A5056 - 1 PC OST POUCH W FILTER||6.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5055|A5055 - STOMA CAP||1.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5054|A5054 - CLSD OSTOMY POUCH W/FLANGE||2.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5053|A5053 - CLSD OSTOMY POUCH FACEPLATE||2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5052|A5052 - CLSD OSTOMY POUCH W/O BARR||2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A5051|A5051 - POUCH CLSD W BARR ATTACHED||2.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4927|A4927 - NON-STERILE GLOVES||3.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4640|A4640 - ALTERNATING PRESSURE PAD||85.01|8.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4639|A4639 - INFRARED HT SYS REPLCMNT PAD||385.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4638|A4638 - REPL BATT PULSE GEN SYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4637|A4637 - REPL TIP CANE/CRUTCH/WALKER||2.1|0.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4636|A4636 - HANDGRIP FOR CANE ETC||4.15|0.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4635|A4635 - UNDERARM CRUTCH PAD||5.85|0.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4633|A4633 - UVL REPLACEMENT BULB||55.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4630|A4630 - REPL BAT T.E.N.S. OWN BY PT||7.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4629|A4629 - TRACHEOSTOMY CARE KIT||6.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4628|A4628 - OROPHARYNGEAL SUCTION CATH||5.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4626|A4626 - TRACHEOSTOMY CLEANING BRUSH||4.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4625|A4625 - TRACH CARE KIT FOR NEW TRACH||9.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4624|A4624 - TRACHEAL SUCTION TUBE||3.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4623|A4623 - TRACHEOSTOMY INNER CANNULA||8.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4620|A4620 - VARIABLE CONCENTRATION MASK||0.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4619|A4619 - FACE TENT||2.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4618|A4618 - BREATHING CIRCUITS||10.99|1.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4617|A4617 - MOUTH PIECE||4.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4616|A4616 - TUBING (OXYGEN) PER FOOT||0.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4615|A4615 - CANNULA NASAL||0.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4614|A4614 - HAND-HELD PEFR METER||31.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4613|A4613 - BATTERY CHARGER||164.59|16.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4612|A4612 - BATTERY CABLES||102.69|10.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4611|A4611 - HEAVY DUTY BATTERY||224.2|23.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4608|A4608 - TRANSTRACHEAL OXYGEN CATH||67.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4605|A4605 - TRACH SUCTION CATH CLOSE SYS||22.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4604|A4604 - TUBING WITH HEATING ELEMENT||77.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4595|A4595 - TENS SUPPL 2 LEAD PER MONTH||38.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4590|A4590 - SPECIAL CASTING MATERIAL||33.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4570|A4570 - SPLINT||15.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4565|A4565 - SLINGS||6.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4562|A4562 - PESSARY -  NON RUBBER -  ANY TYPE||68.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4561|A4561 - PESSARY RUBBER -  ANY TYPE||27.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4559|A4559 - COUPLING GEL OR PASTE||0.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4558|A4558 - CONDUCTIVE GEL OR PASTE||7.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4557|A4557 - LEAD WIRES -  PAIR||28.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4556|A4556 - ELECTRODES -  PAIR||16.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4550|A4550 - SURGICAL TRAYS||25.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4483|A4483 - MOISTURE EXCHANGER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4481|A4481 - TRACHEOSTOMA FILTER||0.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4466|A4466 - ELASTIC GARMENT/COVERING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4463|A4463 - SURGICAL DRESS HOLDER REUSE||17.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4461|A4461 - SURGICL DRESS HOLD NON-REUSE||4.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4456|A4456 - ADHESIVE REMOVER -  WIPES||0.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4455|A4455 - ADHESIVE REMOVER PER OUNCE||1.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4452|A4452 - WATERPROOF TAPE||0.54|0.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4450|A4450 - NON-WATERPROOF TAPE||0.15|0.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4434|A4434 - OST PCH URINE W LOCK FLNG/FT||5.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4433|A4433 - URINE OST PCH BAR W LOCK FLN||4.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4432|A4432 - OS PCH URINE W BAR/FANGE/TAP||4.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4431|A4431 - OST PCH URINE W BARRIER/TAPV||8.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4430|A4430 - OST URINE PCH W B/BLTIN CONV||11.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4429|A4429 - URINE OST POUCH W BLTINCONV||11.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4428|A4428 - URINE OST POUCH W FAUCET/TAP||8.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4427|A4427 - OST PCH DRAIN/BARR LK FLNG/F||3.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4426|A4426 - OST PCH DRAIN 2 PIECE SYSTEM||3.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4425|A4425 - OST PCH DRAIN FOR BARRIER FL||4.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4424|A4424 - OST PCH DRAIN W BAR & FILTER||6.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4423|A4423 - OST PCH FOR BAR W LK FL/FLTR||2.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4422|A4422 - OST POUCH ABSORBENT MATERIAL||0.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4420|A4420 - OST PCH CLSD FOR BAR W LK FL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4419|A4419 - OST PCH FOR BAR W FLANGE/FLT||2.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4418|A4418 - OST PCH CLSD W/O BAR W FILTR||2.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4417|A4417 - OST PCH W BAR/BLTINCONV/FLTR||5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4416|A4416 - OST PCH CLSD W BARRIER/FILTR||3.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4415|A4415 - OST SKN BARR W/O CONV >4 SQI||8.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4414|A4414 - OST SKNBAR W/O CONV<=4 SQ IN||6.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4413|A4413 - 2 PC DRAINABLE OST POUCH||7.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4412|A4412 - OST POUCH DRAIN HIGH OUTPUT||3.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4411|A4411 - OST SKN BARR EXTND =4SQ||6.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4410|A4410 - OST SKN BARR EXTND >4 SQ||12.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4409|A4409 - OST SKN BARR CONVEX <=4 SQ I||8.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4408|A4408 - EXT WEAR OST SKN BARR >4SQ''||13.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4407|A4407 - EXT WEAR OST SKN BARR <=4SQ''||11.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4406|A4406 - PECTIN BASED OSTOMY PASTE||7.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4405|A4405 - NONPECTIN BASED OSTOMY PASTE||4.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4404|A4404 - OSTOMY RING EACH||2.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4402|A4402 - LUBRICANT PER OUNCE||1.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4400|A4400 - OSTOMY IRRIGATION SET||55.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4399|A4399 - OSTOMY IRRIG CONE/CATH W BRS||14.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4398|A4398 - OSTOMY IRRIGATION BAG||17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4397|A4397 - IRRIGATION SUPPLY SLEEVE||5.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4396|A4396 - PERISTOMAL HERNIA SUPPRT BLT||54.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4395|A4395 - OSTOMY POUCH SOLID DEODORANT||0.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4394|A4394 - OSTOMY POUCH LIQ DEODORANT||3.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4393|A4393 - URINE PCH W EX WEAR BAR CONV||12.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4392|A4392 - URINARY POUCH W ST WEAR BARR||10.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4391|A4391 - URINARY POUCH W EX WEAR BARR||9.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4390|A4390 - DRAINABLE PCH EX WEAR CONVEX||12.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4389|A4389 - DRAINABLE PCH W ST WEAR BARR||8.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4388|A4388 - DRAINABLE PCH W EX WEAR BARR||5.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4387|A4387 - OST CLSD POUCH W ATT ST BARR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4385|A4385 - OST SKN BARRIER SLD EXT WEAR||6.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4384|A4384 - OSTOMY FACEPLT/SILICONE RING||12.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4383|A4383 - URINARY RUBBER POUCH W/O FP||37.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4382|A4382 - URINARY HVY PLSTC PCH W/O FP||33.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4381|A4381 - URINARY PLASTIC POUCH W/O FP||6.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4380|A4380 - URINARY RUBBER POUCH W FCPLT||50.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4379|A4379 - URINARY PLASTIC POUCH W FCPL||20.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4378|A4378 - DRAINABLE RUBBER PCH W/O FP||41.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4377|A4377 - DRAINABLE PLSTIC PCH W/O FP||5.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4376|A4376 - DRAINABLE RUBBER PCH W FCPLT||63.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4375|A4375 - DRAINABLE PLASTIC PCH W FCPL||23.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4373|A4373 - SKIN BARRIER WITH FLANGE||8.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4372|A4372 - SKIN BARRIER SOLID 4X4 EQUIV||5.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4371|A4371 - SKIN BARRIER POWDER PER OZ||4.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4369|A4369 - SKIN BARRIER LIQUID PER OZ||3.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4368|A4368 - OSTOMY FILTER||0.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4367|A4367 - OSTOMY BELT||9.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4366|A4366 - OSTOMY VENT||1.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4364|A4364 - ADHESIVE -  LIQUID OR EQUAL||3.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4363|A4363 - OSTOMY CLAMP -  REPLACEMENT||2.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4362|A4362 - SOLID SKIN BARRIER||3.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4361|A4361 - OSTOMY FACE PLATE||21.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4360|A4360 - DISPOSABLE EXT URETHRAL DEV||0.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4358|A4358 - URINARY LEG OR ABDOMEN BAG||8.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4357|A4357 - BEDSIDE DRAINAGE BAG||11.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4356|A4356 - EXT URETH CLMP OR COMPR DVC||61.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4355|A4355 - BLADDER IRRIGATION TUBING||10.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4354|A4354 - CATH INSERTION TRAY W/BAG||13.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4353|A4353 - INTERMITTENT URINARY CATH||9.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4352|A4352 - COUDE TIP URINARY CATHETER||8.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4351|A4351 - STRAIGHT TIP URINE CATHETER||2.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4349|A4349 - DISPOSABLE MALE EXTERNAL CAT||2.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4346|A4346 - CATH INDW FOLEY 3 WAY||22.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4344|A4344 - CATH INDW FOLEY 2 WAY SILICN||18.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4340|A4340 - INDWELLING CATHETER SPECIAL||36.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4338|A4338 - INDWELLING CATHETER LATEX||13.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4336|A4336 - URETHRAL INSERT||1.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4334|A4334 - URINARY CATH LEG STRAP||6.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4333|A4333 - URINARY CATH ANCHOR DEVICE||2.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4332|A4332 - LUBE STERILE PACKET||0.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4331|A4331 - EXTENSION DRAINAGE TUBING||4.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4330|A4330 - STOOL COLLECTION POUCH||9.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4328|A4328 - FEM URINARY COLLECT POUCH||13.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4327|A4327 - FEM URINARY COLLECT DEV CUP||59.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4326|A4326 - MALE EXTERNAL CATHETER||14.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4322|A4322 - IRRIGATION SYRINGE||3.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4321|A4321 - CATH THERAPEUTIC IRRIG AGENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4320|A4320 - IRRIGATION TRAY||6.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4316|A4316 - CATH W/DRAINAGE 3-WAY||38.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4315|A4315 - CATH W/DRAINAGE 2-WAY SILCNE||30.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4314|A4314 - CATH W/DRAINAGE 2-WAY LATEX||31.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4313|A4313 - CATHETER W/BAG 3-WAY||21.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4312|A4312 - CATH W/O BAG 2-WAY SILICONE||20.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4311|A4311 - CATHETER W/O BAG 2-WAY LATEX||19.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4310|A4310 - INSERT TRAY W/O BAG/CATH||9.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4280|A4280 - BRST PRSTHS ADHSV ATTCHMNT||7.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4265|A4265 - PARAFFIN||4.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4259|A4259 - LANCETS PER BOX||13.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4258|A4258 - LANCET DEVICE EACH||20.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4257|A4257 - REPLACE LENSSHIELD CARTRIDGE||17.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4256|A4256 - CALIBRATOR SOLUTION/CHIPS||11.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4255|A4255 - GLUCOSE MONITOR PLATFORMS||5.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4253|A4253 - BLOOD GLUCOSE/REAGENT STRIPS||41.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4236|A4236 - SILVR OXIDE BATT GLUCOSE MON||1.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4235|A4235 - LITHIUM BATT FOR GLUCOSE MON||2.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4234|A4234 - J-CELL BATT FOR GLUCOSE MON||4.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4233|A4233 - ALKALIN BATT FOR GLUCOSE MON||0.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4222|A4222 - INFUSION SUPPLIES WITH PUMP||62.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4221|A4221 - SUPP NON-INSULIN INF CATH/WK||30.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4217|A4217 - STERILE WATER/SALINE -  500 ML||4.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4216|A4216 - STERILE WATER/SALINE -  10 ML||0.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|A4208|A4208 - 3 CC STERILE SYRINGE&NEEDLE||0.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99496|99496 - TRANSITIONAL CARE MANAGE SRVC 7 DAY DISCHARGE||282.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99495|99495 - TRANSITIONAL CARE MANAGE SRVC 14 DAY DISCHARGE||192.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99480|99480 - SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS||136|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99479|99479 - SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS||144.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99478|99478 - SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS||156.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99477|99477 - INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL||393.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99476|99476 - SUBSEQUENT PED CRITICAL CARE 2 THRU 5 YEARS||386.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99475|99475 - INITIAL PED CRITICAL CARE 2 THRU 5 YEARS||637.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99474|99474 - SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD||10.54||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99473|99473 - SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION||11.98||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99472|99472 - SUBSQ PED CRITICAL CARE 29 DAYS THRU 24 MO||455.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99471|99471 - INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS||896.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99469|99469 - SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<||470.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99468|99468 - 1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<||1048.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99467|99467 - CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN||138.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99466|99466 - CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN||308.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99465|99465 - DELIVERY/BIRTHING ROOM RESUSCITATION||168.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99464|99464 - ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN||83.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99463|99463 - 1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT||127.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99462|99462 - SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN||48.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99461|99461 - 1ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER||106.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99460|99460 - 1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB||108.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99458|99458 - REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO||38.18||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99443|99443 - PHYS/QHP TELEPHONE EVALUATION 21-30 MIN||45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99442|99442 - PHYS/QHP TELEPHONE EVALUATION 11-20 MIN||30.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99441|99441 - PHYS/QHP TELEPHONE EVALUATION 5-10 MIN||15.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99429|99429 - UNLISTED PREVENTIVE MEDICINE SERVICE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99423|99423 - ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES||50.77||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99422|99422 - ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES||31.88||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99421|99421 - ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES||15.53||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99420|99420 - HEALTH RISK ASSESSMENT TEST||11.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99412|99412 - PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M||23.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99411|99411 - PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M||17.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99409|99409 - ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN||77.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99408|99408 - ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN||39.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99407|99407 - TOBACCO USE CESSATION INTENSIVE >10 MINUTES||30.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99406|99406 - TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES||15.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99404|99404 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN||126.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99403|99403 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN||98.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99402|99402 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN||70.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99401|99401 - PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN||40.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99397|99397 - PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER||150.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99396|99396 - PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS||139.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99395|99395 - PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS||130.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99394|99394 - PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS||127.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99393|99393 - PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS||116.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99392|99392 - PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS||117.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99391|99391 - PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y||109.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99387|99387 - INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>||184.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99386|99386 - INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS||170.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99385|99385 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS||146.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99384|99384 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR||150.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99383|99383 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS||133.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99382|99382 - INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS||128.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99381|99381 - INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR||122.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99380|99380 - SUPERVISION NURS FACILITY PATIENT MONTH 30 MIN/>||118.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99379|99379 - SUPERVISION NURS FACILITY PATIENT MO 15-29 MIN||78.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99378|99378 - SUPERVISION HOSPICE PATIENT/MONTH 30 MINUTES/>||120.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99377|99377 - SUPERVISION HOSPICE PATIENT/MONTH 15-29 MIN||78.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99375|99375 - SUPERVISION PT HOME HEALTH AGENCY MONTH 30 MIN/>||119.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99374|99374 - SUPVJ PT HOME HEALTH AGENCY MO 15-29 MINUTES||78.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99368|99368 - TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN||41.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99367|99367 - TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN||64.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99366|99366 - TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN||47.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99364|99364 - ANTICOAGULANT MGMT OUTPATIENT EA SBSQ 90 DAYS||36.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99363|99363 - ANTICOAGULANT MGMT OUTPATIENT INIT 90 DAYS||96.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99360|99360 - PHYS STANDBY SVC PROLNG PHYS ATTN EA 30 MINUTES||70.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99359|99359 - PROLNG E/M BEFORE&/AFTER DIR CARE EA 30 MINUTES||60|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99358|99358 - PROLNG E/M SVC BEFORE&/AFTER DIR PT CARE 1ST HR||124.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99357|99357 - PROLONGED SVC I/P REQ UNIT/FLOOR TIME EA 30 MIN||102.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99356|99356 - PROLONGED SERVICE I/P REQ UNIT/FLOOR TIME 1ST HR||102.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99355|99355 - PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON ADDL 30||109.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99354|99354 - PROLNG E&M/PSYCTX SVC OFFICE O/P DIR CON 1ST HR||111.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99350|99350 - HOME VST EST PT UNSTABLE/SIGNIF NEW PROB 60 MINS||198.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99349|99349 - HOME VISIT EST PT MOD-HI SEVERITY 40 MINUTES||142.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99348|99348 - HOME VISIT EST PT LOW-MOD SEVERITY 25 MINUTES||95.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99347|99347 - HOME VISIT EST PT SELF LIMITED/MINOR 15 MINUTES||62.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99345|99345 - HOME VISIT NEW PT UNSTABL/SIGNIF NEW PROB 75 MIN||244.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99344|99344 - HOME VISIT NEW PATIENT HI SEVERITY 60 MINUTES||204.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99343|99343 - HOME VST NEW PATIENT MOD-HI SEVERITY 45 MINUTES||149.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99342|99342 - HOME VISIT NEW PATIENT MOD SEVERITY 30 MINUTES||91.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99341|99341 - HOME VISIT NEW PATIENT LOW SEVERITY 20 MINUTES||62.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99340|99340 - INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>||122.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99339|99339 - INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 15-29 MIN||87.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99337|99337 - DOM/R-HOME E/M EST PT SIGNIF NEW PROB 60 MINUTES||215.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99336|99336 - DOM/R-HOME E/M EST PT MOD HI SEVERITY 40 MINUTES||149.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99335|99335 - DOM/R-HOME E/M EST PT LW MOD SEVERITY 25 MINUTES||105.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99334|99334 - DOM/R-HOME E/M EST PT SELF-LMTD/MINOR 15 MINUTES||67.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99328|99328 - DOM/R-HOME E/M NEW PT SIGNIF NEW PROB 75 MINUTES||241.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99327|99327 - DOMICIL/REST HOME NEW PT VISIT HI SEVER 60 MIN||207.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99326|99326 - DOMICIL/REST HOME NEW PT HI-MOD SEVER 45 MINUTES||156.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99325|99325 - DOMICIL/REST HOME NEW PT VISIT MOD SEVER 30 MIN||91.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99324|99324 - DOMICIL/REST HOME NEW PT VISIT LOW SEVER 20 MIN||63.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99318|99318 - E/M ANNUAL NURSING FACILITY ASSESS STABLE 30 MIN||106.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99316|99316 - NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES||115.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99315|99315 - NURSING FACILITY DISCHARGE MANAGEMENT 30 MINUTES||80.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99310|99310 - SBSQ NURS FACIL CARE/DAY UNSTABL/NEW PROB 35 MIN||148.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99309|99309 - SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN||100.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99308|99308 - SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN||76.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99307|99307 - SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN||49.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99306|99306 - INITIAL NURSING FACILITY CARE/DAY 45 MINUTES||186.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99305|99305 - INITIAL NURSING FACILITY CARE/DAY 35 MINUTES||146.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99304|99304 - INITIAL NURSING FACILITY CARE/DAY 25 MINUTES||103.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99292|99292 - CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN||126.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99291|99291 - CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN||253.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99288|99288 - PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99285|99285 - EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ||328.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99284|99284 - EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY||224.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99283|99283 - EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY||117.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99282|99282 - EMERGENCY DEPARTMENT VISIT LOW/MODER SEVERITY||78.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99281|99281 - EMERGENCY DEPARTMENT VISIT LIMITED/MINOR PROB||39.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99255|99255 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 110 MIN||225.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99254|99254 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 80 MIN||186.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99253|99253 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 55 MIN||129.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99252|99252 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 40 MIN||84.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99251|99251 - INITIAL INPATIENT CONSULT NEW/ESTAB PT 20 MIN||55.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99245|99245 - OFFICE CONSULTATION NEW/ESTAB PATIENT 80 MIN||249.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99244|99244 - OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN||203.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99243|99243 - OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN||137.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99242|99242 - OFFICE CONSULTATION NEW/ESTAB PATIENT 30 MIN||100.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99241|99241 - OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN||53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99239|99239 - HOSPITAL DISCHARGE DAY MANAGEMENT > 30 MIN||119.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99238|99238 - HOSPITAL DISCHARGE DAY MANAGEMENT 30 MIN/<||80.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99236|99236 - OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES||246.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99235|99235 - OBSERVATION/INPATIENT HOSPITAL CARE 50 MINUTES||191.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99234|99234 - OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES||152.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99233|99233 - SBSQ HOSPITAL CARE/DAY 35 MINUTES||116.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99232|99232 - SBSQ HOSPITAL CARE/DAY 25 MINUTES||81.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99231|99231 - SBSQ HOSPITAL CARE/DAY 15 MINUTES||44.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99226|99226 - SBSQ OBSERVATION CARE/DAY 35 MINUTES||117.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99225|99225 - SBSQ OBSERVATION CARE/DAY 25 MINUTES||81.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99224|99224 - SBSQ OBSERVATION CARE/DAY 15 MINUTES||45.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99223|99223 - INITIAL HOSPITAL CARE/DAY 70 MINUTES||226.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99222|99222 - INITIAL HOSPITAL CARE/DAY 50 MINUTES||154.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99221|99221 - INITIAL HOSPITAL CARE/DAY 30 MINUTES||114.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99220|99220 - INITIAL OBSERVATION CARE/DAY 70 MINUTES||206.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99219|99219 - INITIAL OBSERVATION CARE/DAY 50 MINUTES||150.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99218|99218 - INITIAL OBSERVATION CARE/DAY 30 MINUTES||109.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99217|99217 - OBSERVATION CARE DISCHARGE MANAGEMENT||80.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99215|99215 - OFFICE OUTPATIENT VISIT 40 MINUTES||159.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99214|99214 - OFFICE OUTPATIENT VISIT 25 MINUTES||118.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99213|99213 - OFFICE OUTPATIENT VISIT 15 MINUTES||80.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99212|99212 - OFFICE OUTPATIENT VISIT 10 MINUTES||47.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99211|99211 - OFFICE OUTPATIENT VISIT 5 MINUTES||22.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99205|99205 - OFFICE OUTPATIENT NEW 60 MINUTES||228.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99204|99204 - OFFICE OUTPATIENT NEW 45 MINUTES||183.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99203|99203 - OFFICE OUTPATIENT NEW 30 MINUTES||119.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99202|99202 - OFFICE OUTPATIENT NEW 20 MINUTES||82.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99201|99201 - OFFICE OUTPATIENT NEW 10 MINUTES||47.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99195|99195 - PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE||104.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99183|99183 - PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION||144.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99175|99175 - IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED||21.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99174|99174 - INSTRUMENT BASED OCULAR SCR BI W/RMT ANAL & RPT||32.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99173|99173 - SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT||3.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99170|99170 - ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG||158.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99150|99150 - MOD SED DIFF PHYS/QHP ADD ON||23.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99149|99149 - MOD SED DIFF PHYS/QHP 5/>YRS||44.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99148|99148 - MOD SED DIFF PHYS/QHP<5 YRS||44.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99145|99145 - MOD SEDAT PHYS/QHP EA 15 MIN||23.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99144|99144 - MOD SEDAT PHYS/QHP 5YRS/>||44.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99143|99143 - MOD SEDAT PHYS/QHP <5 YRS||44.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|99091|99091 - COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D||66.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98968|98968 - NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN||46.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98967|98967 - NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN||31.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98966|98966 - NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN||16.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98962|98962 - EDUCATION&TRAINING SELF-MGMT NONPHYS 5-8 PTS||11.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98961|98961 - EDUCATION&TRAINING SELF-MGMT NONPHYS 2-4 PTS||14.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98960|98960 - EDUCATION&TRAINING SELF-MGMT NONPHYS 1 PT||30.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98943|98943 - CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION||28.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98942|98942 - CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS||55.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98941|98941 - CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS||43.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98940|98940 - CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS||31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98929|98929 - OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS||100.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98928|98928 - OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS||84.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98927|98927 - OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS||68.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98926|98926 - OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS||52.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|98925|98925 - OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS||36.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97814|97814 - ACUP 1/> NDLS W/ELEC STIMJ EA 15 MIN W/RE-INSJ||36.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97813|97813 - ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN||45.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97811|97811 - ACUPUNCTURE 1/> NDLS W/O ELEC STIMJ EA 15 MIN||32.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97810|97810 - ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN||42.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97804|97804 - MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI||18.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97803|97803 - MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M||33.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97802|97802 - MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI||39.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97762|97762 - CHECKOUT ORTHOTIC/PROSTHETIC ESTAB PT EA 15 MIN||52.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97761|97761 - PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS||39.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97760|97760 - ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS||44.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97755|97755 - ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN||43.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97750|97750 - PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN||39.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97606|97606 - NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM||37.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97605|97605 - NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM||33.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97598|97598 - DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM||14.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97597|97597 - DEBRIDEMENT OPEN WOUND 20 SQ CM/<||30.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97542|97542 - WHEELCHAIR MGMT EA 15 MIN||36.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97537|97537 - COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN||35.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97535|97535 - SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES||40.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97533|97533 - SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES||34.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97532|97532 - DEVELOPMENT OF COGNITIVE SKILLS EACH 15 MINUTES||31.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97530|97530 - THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN||41.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97150|97150 - THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97140|97140 - MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES||35.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97139|97139 - UNLISTED THERAPEUTIC PROCEDURE SPECIFY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97130|97130 - THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES||29.71||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97129|97129 - THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES||30.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97124|97124 - THER PX 1/> AREAS EACH 15 MINUTES MASSAGE||52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97116|97116 - THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR||33.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97113|97113 - THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS||49.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97112|97112 - THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA||39.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97110|97110 - THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES||37.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97039|97039 - UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97036|97036 - APPL MODALITY 1/> AREAS HUBBARD TANK EA 15 MIN||37.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97035|97035 - APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN||15.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97034|97034 - APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN||20.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97033|97033 - APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN||36.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97032|97032 - APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN||22.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97028|97028 - APPL MODALITY 1/> AREAS ULTRAVIOLET||8.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97026|97026 - APPLICATION MODALITY 1/> AREAS INFRARED||7.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97024|97024 - APPLICATION MODALITY 1/> AREAS DIATHERMY||7.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97022|97022 - APPLICATION MODALITY 1/> AREAS WHIRLPOOL||26.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97018|97018 - APPL MODALITY 1/> AREAS PARAFFIN BATH||12.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97016|97016 - APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES||22.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97014|97014 - APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED||18.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97012|97012 - APPL MODALITY 1/> AREAS TRACTION MECHANICAL||19.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97010|97010 - APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS||7.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97006|97006 - ATHLETIC TRAIN REEVAL||38.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97005|97005 - ATHLETIC TRAIN EVAL||77.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97004|97004 - OT RE-EVALUATION||61.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97003|97003 - OT EVALUATION||101.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97002|97002 - PT RE-EVALUATION||50.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|97001|97001 - PT EVALUATION||91.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96999|96999 - UNLISTED SPECIAL DERMATOLOGICAL SERVICE/PROCED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96922|96922 - LASER SKIN DISEASE PSORIASIS >500 SQ CM||144.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96921|96921 - LASER SKIN DISEASE PSORIASIS 250-500 SQ CM||80.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96920|96920 - LASER SKIN DISEASE PSORIASIS TOT AREA <250 SQ CM||79.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96913|96913 - PHOTOCHEMOTHERAPY DERMATOSES 4-8 HRS SUPERVISION||144.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96912|96912 - PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA||103.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96910|96910 - PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB||81.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96904|96904 - WHOLE BODY INTEGUMENTARY PHOTOGRAPHY||79.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96902|96902 - MCRSCP XM HAIR PLUCK/CLIP FOR CNTS/STRUCT ABNORM||25.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96900|96900 - ACTINOTHERAPY ULTRAVIOLET LIGHT||24.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96571|96571 - PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN||32.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96570|96570 - PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN||69.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96567|96567 - PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY||153.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96549|96549 - UNLISTED CHEMOTHERAPY PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96542|96542 - CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT||50.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96523|96523 - IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST||28.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96522|96522 - REFILL&MAINTENANCE PUMP DRUG DLVR SYSTEMIC||125.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96521|96521 - REFILLING & MAINTENANCE PORTABLE PUMP||154.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96450|96450 - CHEMOTX ADMN CNS REQ SPINAL PUNCTURE||98.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96446|96446 - CHEMOTX ADMN PRTL CAVITY PORT/CATH||25.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96440|96440 - CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS||169.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96425|96425 - CHEMOTX ADMN IA NFS >8 HR PRTBLE IMPLTBL PMP||203.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96423|96423 - CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR||89.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96422|96422 - CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR||193.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96420|96420 - CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ||121.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96417|96417 - CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR||80.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96416|96416 - CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP||156.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96415|96415 - CHEMOTHERAPY ADMN IV INFUSION TQ EA HR||35.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96413|96413 - CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG||156.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96411|96411 - CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG||70.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96409|96409 - CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG||125.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96406|96406 - CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7||53.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96405|96405 - CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7||36.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96402|96402 - CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO||38.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96401|96401 - CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO||83.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96379|96379 - UNLISTED THERAPEUTIC PROPH/DX IV/IA NJX/NFS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96376|96376 - THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC||16.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96375|96375 - THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG||25.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96374|96374 - THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG||63.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96373|96373 - THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL||22.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96372|96372 - THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM||27.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96371|96371 - SUBQ INFUSION ADDITIONAL PUMP INFUSION SITE||96.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96370|96370 - SUBCUTANEOUS INFUSION EACH ADDITIONAL HOUR||18.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96369|96369 - SUBCUTANEOUS INFUSION INITIAL 1 HR W/PUMP SET-UP||211.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96368|96368 - IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS||22.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96367|96367 - IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR||37.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96366|96366 - IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR||24.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96365|96365 - IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR||82.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96361|96361 - IV INFUSION HYDRATION EACH ADDITIONAL HOUR||17.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96360|96360 - IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR||64.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96171|96171 - HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15||71.79||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96170|96170 - HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN||18.19||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96168|96168 - HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN||28.91||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96167|96167 - HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN||81.43||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96165|96165 - HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN||4.91||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96164|96164 - HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN||11.13||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96159|96159 - HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN||26.25||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96158|96158 - HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN||76.06||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96156|96156 - HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT||111.59||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96155|96155 - HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/O PT||26.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96154|96154 - HLTH&BEHAVIOR IVNTJ EA 15 MIN FAM W/PT||22.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96153|96153 - HLTH&BEHAVIOR IVNTJ EA 15 MIN GRP 2/>PTS||5.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96152|96152 - HLTH&BEHAVIOR IVNTJ EA 15 MIN INDIV||22.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96151|96151 - HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT RE-ASSMT||23.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96150|96150 - HLTH&BEHAVIOR ASSMT EA 15 MIN W/PT 1ST ASSMT||24.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96146|96146 - PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT||2.51||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96137|96137 - PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN||24.52|0|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96136|96136 - PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN||31.09|0|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96133|96133 - NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR||103.83||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96132|96132 - NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR||135.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96125|96125 - STANDARDIZED COGNITIVE PERFORMANCE TESTING||118.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96121|96121 - NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR||97.91||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96120|96120 - NEUROPSYCHOLOG TESTING COMPUTER W/PROF I&R||29.38|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|96119|96119 - NEUROPSYC TSTG W/PROF I&R ADMN BY TECH PR HR||27.62|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|96118|96118 - NUROPSYC TESTING PR HR W/PT & INTERPJ TIME||92.98|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|96116|96116 - NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR||101.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96113|96113 - DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN||72.65||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96112|96112 - DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR||158.95||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96111|96111 - DEVELOPMENTAL TESTING W/INTERP & REPORT||144.83|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|96110|96110 - DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM||11.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96105|96105 - ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR||121.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96103|96103 - PSYCHOLOGICAL TESTING COMPUTER W/PROF I&R||29.38|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|96102|96102 - PSYCHOLOGICAL TESTING ADMN BY TECH PR HR||27.42|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|96101|96101 - PSYCHOLOGICAL TESTING PR HR WITH PATIENT||93.75|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|96040|96040 - MEDICAL GENETICS COUNSELING EACH 30 MINUTES||52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96020|96020 - TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP||0|274.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96004|96004 - PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR||139.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96003|96003 - DYN FINE WIRE EMG WALKG/FUNCJAL ACTV 1 MUSC||23.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96002|96002 - DYN SURF EMG WALKG/FUNCJAL ACTV 1-12 MUSC||26.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96001|96001 - COMPRE CPTR MTN ALYS W/DYN PLNTR PRES MEAS WALKG||125.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|96000|96000 - COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS||119.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95999|95999 - UNLIS NEUROLOGICAL/NEUROMUSCULAR DX PX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95992|95992 - CANALITH REPOSITIONING PROCEDURE||47.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95991|95991 - RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP||48.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95990|95990 - REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN||100.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95984|95984 - ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN||57.51||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95983|95983 - ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN||65.77||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95982|95982 - ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG||43.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95981|95981 - ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG||21.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95980|95980 - ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG||57.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95979|95979 - ELEC ALYS NSTIM PLS GEN CPLX DP BRN EA 30 MIN||106.93|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|95978|95978 - ELEC ALYS NSTIM PLS GEN CPLX DP BRN 1ST HR||231.27|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|95977|95977 - ELEC ALYS IMPLT CPLX CN NPGT PRGRMG||69.34||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95976|95976 - ELEC ALYS IMPLT SMPL CN NPGT PRGRMG||52.04||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95975|95975 - ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV EA 30 MIN||109.55|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|95974|95974 - ELEC ALYS NSTIM PLS GEN CPLX CRNL NRV 1ST HR||193.49|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|95973|95973 - ANALYZE NEUROSTIM COMPLEX||60.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95972|95972 - ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG||97.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95971|95971 - ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG||50.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95970|95970 - ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING||29.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95967|95967 - MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL||1020.36|287.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95966|95966 - MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY||1161.85|330.01||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95965|95965 - MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY||2536.53|661.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95962|95962 - FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR||290.45|258.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95961|95961 - FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR||329.9|241.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95958|95958 - WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG||597.63|340.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95957|95957 - DIGITAL ANALYSIS ELECTROENCEPHALOGRAM||460.48|159.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95956|95956 - MNTR SEIZURE CMPTR 16CHAN EEG ATND EA 24 HR||1393.16|283.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95955|95955 - EEG NONINTRACRANIAL SURGERY||231.12|81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95954|95954 - RX/PHYSICAL EEG ACTIVAJ PHYS/QHP ATTENDANCE||484.9|188.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95953|95953 - LOCALIZE CEREBRAL SEIZURE CPTR PORTABLE EEG||515.6|248.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95951|95951 - LOCALIZE CEREBRAL SEIZURE CABLE/RADIO EEG/VIDEO||0|493.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95950|95950 - MONITOR ID& LATERALIZATION SEIZURE FOCUS EEG||355.03|121.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95940|95940 - IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES||50.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95939|95939 - CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI||550.76|183.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95938|95938 - SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB||349.28|69.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95937|95937 - NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH||84.06|52.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95936|95936 - H-REFLEX TEST||0|44.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95934|95934 - H-REFLEX TEST||0|40.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95933|95933 - ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST||97.29|47.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95930|95930 - VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R||178.03|28.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95929|95929 - CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS||309.29|121.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95928|95928 - CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS||304.52|121.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95927|95927 - SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD||193.19|42.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95926|95926 - SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS||190.84|43.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95925|95925 - SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS||196.77|42.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95923|95923 - TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION||188.5|72.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95922|95922 - TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ||127.57|76.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95921|95921 - TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP||102.26|71.27||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95920|95920 - INTRAOP NERVE TEST ADD-ON||0|170.08||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95913|95913 - NERVE CONDUCTION STUDIES 13/> STUDIES||369.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95912|95912 - NERVE CONDUCTION STUDIES 11-12 STUDIES||318.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95911|95911 - NERVE CONDUCTION STUDIES 9-10 STUDIES||271.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95910|95910 - NERVE CONDUCTION STUDIES 7-8 STUDIES||224.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95909|95909 - NERVE CONDUCTION STUDIES 5-6 STUDIES||170.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95908|95908 - NERVE CONDUCTION STUDIES 3-4 STUDIES||141.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95907|95907 - NERVE CONDUCTION STUDIES 1-2 STUDIES||115.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95905|95905 - MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB||78.93|4.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95904|95904 - SENSE NERVE CONDUCTION TEST||0|27.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95903|95903 - MOTOR NERVE CONDUCTION TEST||0|48.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95900|95900 - MOTOR NERVE CONDUCTION TEST||0|34.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95887|95887 - NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION||94.33|59.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95886|95886 - NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE||106.33|75.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95885|95885 - NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED||66.77|28.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95875|95875 - ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB||135.38|88.59||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95874|95874 - NEEDLE EMG GUID W/CHEMODENERVATION||75.6|30.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95873|95873 - ELECTRICAL STIMULATION GUID W/CHEMODENERVATION||79.58|31.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95872|95872 - NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER||229.32|229.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95870|95870 - NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI||77.99|29.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95869|95869 - NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12||81.17|29.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95868|95868 - NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI||148.44|94.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95867|95867 - NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI||110.51|63.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95866|95866 - NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM||135.66|101.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95865|95865 - NEEDLE ELECTROMYOGRAPHY LARYNX||152.19|128.08||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95864|95864 - NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS||222.47|161.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95863|95863 - NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS||205.63|151.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95861|95861 - NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS||169.95|125.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95860|95860 - NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS||116.44|78.68||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95857|95857 - CHOLINESTERASE INHIBITOR CHALLENGE TEST||35.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95852|95852 - ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID||7.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95851|95851 - ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI||9.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95836|95836 - ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS||144.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95834|95834 - MUSC TSTG MNL W/REPRT TOTAL EVAL BODY W/HANDS||37.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95833|95833 - MUSC TSTG MNL W/REPRT TOTAL EVAL BODY EX HANDS||27.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95832|95832 - MUSC TSTG MNL W/REPRT HAND W/WO CMPRSN NRML SIDE||19.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95831|95831 - MUSC TSTG MNL W/REPRT XTR EX HAND/TRNK||18.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95830|95830 - INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP||108.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95829|95829 - ELECTROCORTICOGRAM SURGERY SPX||1981.26|493.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95827|95827 - ELECTROENCEPHALOGRAM ALL NIGHT RECORDING||788.63|86.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95824|95824 - ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY||120.69|60.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95822|95822 - ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY||412.26|86.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95819|95819 - ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP||451.59|86.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95816|95816 - ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY||398.36|86.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95813|95813 - EEG EXTENDED MONITORING 61-119 MINUTES||504.25|138.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95812|95812 - ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN||433.32|86.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95811|95811 - POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND||836.95|202.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95810|95810 - POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND||785.21|194.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95808|95808 - POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND||792.06|139.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95807|95807 - SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN||587.7|99.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95806|95806 - SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT||220.32|99.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95805|95805 - MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG||493.08|94.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95803|95803 - ACTIGRAPHY TESTING RECORDING ANALYSIS I&R||197.24|70.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95801|95801 - SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL||105.51|76.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95800|95800 - SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME||192.75|80.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95783|95783 - POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM||175.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95782|95782 - POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND||160.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95726|95726 - EEG COMPLETE STD PHYS/QHP>84 HR W/VEEG||525.93||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95725|95725 - EEG COMPLETE STD PHYS/QHP>84 HR W/O VID||377.95||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95724|95724 - EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG||416.2||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95723|95723 - EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO||332.2||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95722|95722 - EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG||326.42||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95721|95721 - EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO||268.33||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95720|95720 - EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR W/VEEG||267.5||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95719|95719 - EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR WO VID||204.3||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95718|95718 - EEG PHYS/QHP 2-12 HR WITH VEEG||172.77||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95717|95717 - EEG PHYS/QHP 2-12 HR WITHOUT VIDEO||131.94||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95251|95251 - CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R||52.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95250|95250 - CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPTMENT||184.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95199|95199 - UNLISTED ALLERGY/CLINICAL IMMUNOLOGIC SRVC/PX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95180|95180 - RAPID DESENSITIZATION PROCEDURE EACH HOUR||127.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95170|95170 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE||3.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95165|95165 - PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN||4.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95149|95149 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT||3.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95148|95148 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT||3.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95147|95147 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT||3.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95146|95146 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT||3.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95145|95145 - PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT||3.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95144|95144 - PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO||3.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95117|95117 - PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS||13.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95115|95115 - PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX||11.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95079|95079 - INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES||83.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95076|95076 - INGESTION CHALLENGE TEST INITIAL 120 MINUTES||90.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95071|95071 - INHLJ BRNCL CHALLENGE TSTG W/AGS/GASES||79.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95070|95070 - INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL||40.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95065|95065 - DIRECT NASAL MUCOUS MEMBRANE TEST||29.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95060|95060 - OPHTHALMIC MUCOUS MEMBRANE TESTS||37.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95056|95056 - PHOTO TESTS||51.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95052|95052 - PHOTO PATCH TEST SPECIFY NUMBER TSTS||7.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95044|95044 - PATCH/APPLICATION TEST SPECIFY NUMBER TESTS||7.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95028|95028 - IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING||15.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95027|95027 - INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE||6.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95024|95024 - INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS||1.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95012|95012 - NITRIC OXIDE EXPIRED GAS DETERMINATION||23.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|95004|95004 - PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS||7.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94799|94799 - UNLISTED PULMONARY SERVICE/PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94781|94781 - CAR SEAT/BED TEST INFT THRU 12 MO EA ADDL 30 MIN||10.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94780|94780 - CAR SEAT/BED TEST INFT THRU 12 MO 60 MIN||29.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94777|94777 - PEDIATRIC APNEA MONITOR PHYS/QHP REVIEW||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94776|94776 - PEDIATRIC APNEA MONITOR ANALYSES COMPUTER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94775|94775 - PEDIATRIC APNEA MONITOR ATTACHMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94774|94774 - PEDIATRIC APNEA MONITOR ATTACHMENT PHYS I&R||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94772|94772 - CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94770|94770 - CARBON DIOXIDE EXP GAS DETER INFRARED ANALYZER||19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94762|94762 - NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR||17.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94761|94761 - NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER||5.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94760|94760 - NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER||3.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94750|94750 - PULMONARY COMPLIANCE STUDY||94.44|17.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94729|94729 - CO DIFFUSING CAPACITY||63.18|13.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94728|94728 - AIRWAY RESISTANCE BY OSCILLOMETRY||50.47|19.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94727|94727 - GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V||50.47|19.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94726|94726 - PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST||64|19.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94720|94720 - MONOXIDE DIFFUSING CAPACITY||70.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94690|94690 - O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX||61.14|5.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94681|94681 - O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC||64.11|15.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94680|94680 - O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP||70.74|20.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94668|94668 - MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ||27.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94667|94667 - MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL||28.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94664|94664 - DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP||19.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94662|94662 - CONTINUOUS NEGATIVE PRESSURE VENTJ INITIAT&MGM||45.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94660|94660 - CPAP VENTILATION CPAP INITIATION&MGMT||46.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94645|94645 - CONTINUOUS INHALATION TREATMENT EA ADDL HR||16.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94644|94644 - CONTINUOUS INHALATION TREATMENT 1ST HR||50.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94642|94642 - PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH||54.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94640|94640 - PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT||20.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94621|94621 - CARDIOPULMONARY EXERCISE TESTING||197.62|109.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94620|94620 - PULMONARY STRESS TESTING SIMPLE||72.88|48.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94610|94610 - INTRAPULMONARY SURFACTANT ADMINISTJ PHYS/QHP||74.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94453|94453 - HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION||94.42|29.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94452|94452 - HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT||69.37|22.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94450|94450 - BREATHING RESPONSE TO HYPOXIA||76.53|30.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94400|94400 - BREATHING RESPONSE TO CO2||68.19|30.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94375|94375 - RESPIRATORY FLOW VOLUME LOOP||47.12|23.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94370|94370 - BREATH AIRWAY CLOSING VOLUME||73.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94360|94360 - MEASURE AIRFLOW RESISTANCE||73.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94350|94350 - LUNG NITROGEN WASHOUT CURVE||73.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94260|94260 - THORACIC GAS VOLUME||72.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94250|94250 - EXPIRED GAS COLLECTION QUANT 1 PROCEDURE SPX||31.52|8.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94240|94240 - RESIDUAL LUNG CAPACITY||70.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94200|94200 - MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ||29.93|8.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94150|94150 - VITAL CAPACITY TOTAL SEPARATE PROCEDURE||29.75|5.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94070|94070 - BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT||73.89|45.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94060|94060 - BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN||72.33|20.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94016|94016 - PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY||30.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94015|94015 - PATIENT-INITIATED SPIROMETRIC RECORDING||27.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94014|94014 - PT-INITIATE SPIROMETRIC RECORDING PHYS/QHP R&I||57.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94013|94013 - MEASUREMENT LUNG VOLUMES INFANT/CHILD/2 YRS||41.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94012|94012 - MEAS SPIRO FRCD EXP FLO PRE&POST BRONCH INF/2YRS||199.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94011|94011 - MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT&/2 Y||126.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94010|94010 - SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ||42.91|13.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94005|94005 - HOME VENTILATOR MGMT CARE OVERSIGHT 30 MIN/>||113.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94004|94004 - VENTILATION ASSIST & MGMT NURSING FAC PR DAY||60.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94003|94003 - VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA||83.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|94002|94002 - VENTILATION ASSIST & MGMT INPATIENT 1ST DAY||116.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93998|93998 - UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93990|93990 - DUPLEX SCAN HEMODIALYSIS ACCESS||322.27|20.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93986|93986 - DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD||162.4|32.59|129.81||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93985|93985 - DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD||318.8|50.47|268.33||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93982|93982 - IMPLANT WIRELESS PRESS SENSOR STUDY ANEURYSM SAC||66.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93981|93981 - DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD||176.58|34.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93980|93980 - DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL||264.51|98.56||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93979|93979 - DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD||254.77|34.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93978|93978 - DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE||365.47|51.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93976|93976 - DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT||330.36|94.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93975|93975 - DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM||575.45|142.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93971|93971 - DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY||232.64|35.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93970|93970 - DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY||390.86|53.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93965|93965 - EXTREMITY STUDY||190.69|27.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93931|93931 - DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY||251.49|24.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93930|93930 - DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY||378.45|36.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93926|93926 - DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY||309.48|31.07||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93925|93925 - DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY||473.99|45.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93924|93924 - N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI||304.04|39.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93923|93923 - NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS||241.72|35.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93922|93922 - NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL||155.79|19.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93893|93893 - TRANSCRAN DOPPLER INTRACRAN ART MICROBUBBLE INJ||495.89|90.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93892|93892 - TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT||491.35|90.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93890|93890 - TRANSCRANIAL DOPPLER INTRACRAN ART VASOREAC STDY||427.94|78.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93888|93888 - TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD||326.41|49.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93886|93886 - TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL||533.51|74.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93882|93882 - DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY||267.17|32.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93880|93880 - DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY||377.23|47.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93799|93799 - UNLISTED CARDIOVASCULAR SERVICE/PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93798|93798 - OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING||40.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93797|93797 - OUTPATIENT CARDIAC REHAB W/O CONT ECG MONITOR||26.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93790|93790 - AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R||54.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93788|93788 - AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R||23.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93786|93786 - AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY||84.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93784|93784 - AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R||162.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93770|93770 - DERMINATION OF VENOUS PRESSUE||25.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93750|93750 - INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS||128.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93745|93745 - 1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93740|93740 - TEMPRATURE GRADIENT STUDY||26.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93724|93724 - ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM||806.08|388.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93701|93701 - BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS||69.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93668|93668 - PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION||51.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93662|93662 - INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I||0|227.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93660|93660 - CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR||445.41|150.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93657|93657 - ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN||1191.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93656|93656 - EPHYS EVL TRNSPTL TX ATRIAL FIB ISOLAT PULM VEIN||3975.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93655|93655 - ICAR CATHETER ABLATION ARRHYTHMIA ADD ON||1489.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93654|93654 - EPHYS EVAL W/ABLATION VENTRICULAR TACHYCARDIA||3974.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93653|93653 - EPHYS EVAL W/ABLATION SUPRAVENT ARRHYTHMIA||2978.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93651|93651 - ABLATE HEART DYSRHYTHM FOCUS||2625.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93650|93650 - ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION||1722.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93642|93642 - EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS||1134.42|389.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93641|93641 - EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN||1709.37|526.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93640|93640 - EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE||1323.36|311.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93631|93631 - INTRAOP EPICAR& ENDOCAR PACG& MAPG||1537.05|660.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93624|93624 - ELECTROPHYSIOLOGIC FOLLOW-UP W/PAC/REC W/ARRHYT||954.51|428.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93623|93623 - PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS||593.7|253.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93622|93622 - COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC||644.1|275.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93621|93621 - COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC||436.8|186.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93620|93620 - COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION||2405.91|1030.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93619|93619 - COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION||1971.39|652.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93618|93618 - INDUCTION ARRHYTHMIA ELECTRICAL PACING||1092.63|377.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93616|93616 - ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG||246.93|107.57||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93615|93615 - ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS||172.77|78.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93613|93613 - INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING||1131.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93612|93612 - INTRAVENTRICULAR PACING||645.06|266.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93610|93610 - INTRA-ATRIAL PACING||623.94|267.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93609|93609 - INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA||1077.75|443.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93603|93603 - RIGHT VENTRICULAR RECORDING||516.87|187.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93602|93602 - INTRA-ATRIAL RECORDING||456.3|187.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93600|93600 - BUNDLE OF HIS RECORDING||544.41|187.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93581|93581 - PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT||3935.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93580|93580 - PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT||2939.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93572|93572 - IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL||421.74|116.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93571|93571 - IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL||692.58|145.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93568|93568 - NJX PULMONARY ANGIO HRT CATH W/S&I||127.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93567|93567 - NJX SUPRAVALV AORTOG HRT CATH W/S&I||139.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93566|93566 - NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I||123.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93565|93565 - NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I||124.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93564|93564 - NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I||164.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93563|93563 - NJX SEL HRT ART CONGENITAL HRT CATH W/S&I||160.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93562|93562 - INDIC DIL STD ARTL&/OR VEN CATHJ SBSQ OUTP MEA||54.93|12.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93561|93561 - INDIC DIL STD ARTL&/OR VEN CATHJ W/OUTP MEAS||124.59|39.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93533|93533 - CMBN R HRT T-SEPTAL L HRT CATHJ SEPTAL OPNG CGEN||4933.92|590.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93532|93532 - CMBN R HRT T-SEPTAL L HRT CATHJ NTC SEPTUM CGEN||5910.72|880.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93531|93531 - CMBN R HRT & RETROGRADE L HRT CATHJ CGEN ANOMA||4938|736.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93530|93530 - R HRT CATHETERIZATION CONGENITAL CARDIAC ANOMALY||2400.66|374.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93505|93505 - ENDOMYOCARDIAL BIOPSY||2226.88|381.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93503|93503 - INSERTION FLOW DIRECTED CATHETER FOR MONITORING||392.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93464|93464 - PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU||738.76|149.59||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93463|93463 - MEDICATION ADMIN & HEMODYNAMIC MEASURMENT||309.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93462|93462 - LEFT HEART CATH BY TRANSEPTAL PUNCTURE||584.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93461|93461 - R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I||4095.28|696.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93460|93460 - R & L HRT CATH WINJX HRT ART& L VENTR IMG||3573.38|631.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93459|93459 - CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I||3339.5|567.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93458|93458 - CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I||3023.16|503.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93457|93457 - CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I||3552.72|592.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93456|93456 - CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I||3134.61|528.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93455|93455 - CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I||2923.4|476.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93454|93454 - CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I||2504.3|412.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93453|93453 - R & L HRT CATH W/NJX L VENTRICULOG IMG S&I||3182.44|536.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93452|93452 - L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I||2430.52|409.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93451|93451 - RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT||2190.62|233.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93356|93356 - MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH||15.52||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93352|93352 - USE OF ECHO CONTRAST AGENT DURING STRESS ECHO||96.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93351|93351 - ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG||672.27|139.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93350|93350 - ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST||574.74|116.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93325|93325 - DOP ECHOCARD COLOR FLOW VELOCITY MAPPING||76.9|5.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93321|93321 - DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD||74.06|11.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93320|93320 - DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY||149.82|29.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93318|93318 - ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ||318.99|179.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93317|93317 - ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT||513.27|148.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93316|93316 - ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY||128.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93315|93315 - ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R||761.69|225.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93314|93314 - ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY||785.33|97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93313|93313 - ECHO R-T 2D W/PROBE PLACEMENT ONLY||122.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93312|93312 - ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R||873.25|170.07||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93308|93308 - ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD||279.76|41.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93307|93307 - ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP||366.41|73.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93306|93306 - ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D||587.72|103.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93304|93304 - F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY||371.06|58.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93303|93303 - COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY||573.96|102.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93299|93299 - REM INTERROG ICPMS/SCRMS <30 D TECH REVIEW||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93298|93298 - REM INTERROG SCRMS <30 D PHYS/QHP||77.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93297|93297 - REM INTERROG ICPMS <30 D PHYS/QHP||73.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93296|93296 - REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW||79.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93295|93295 - INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB||189.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93294|93294 - REM INTERROG PM/LDLS PM <90 D PHYS/QHP||95.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93293|93293 - TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL||150.11|24.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93292|93292 - INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR||92.57|34.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93291|93291 - INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON||102.66|34.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93290|93290 - INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON||85.23|32.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93289|93289 - INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB||186.68|72.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93288|93288 - INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON||107.24|34.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93287|93287 - PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB||97.36|34.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93286|93286 - PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON||72.88|22.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93285|93285 - PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON||119.18|41.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93284|93284 - PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB||256.17|100.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93283|93283 - PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB||231.29|91.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93282|93282 - PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB||179.53|67.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93281|93281 - PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER||193.81|71.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93280|93280 - PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER||167.7|61.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93279|93279 - PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP||143.52|52.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93278|93278 - SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG||91.61|20.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93272|93272 - XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS||72.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93271|93271 - XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS||541.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93270|93270 - XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS||33.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93268|93268 - XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS||647.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93264|93264 - REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D||46.68||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93230|93230 - ECG MONITOR/REPORT -  24 HRS||300.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93229|93229 - XTRNL MOBILE CV TELEMETRY W/TECHNICAL SUPPORT||1869.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93228|93228 - XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS||74.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93227|93227 - XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS||76.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93226|93226 - EXTERNAL ECG SCANNING ANALYSIS REPORT||116.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93225|93225 - XTRNL ECG & 48 HR RECORDING||78.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93224|93224 - XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I||272.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93042|93042 - RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON||20.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93041|93041 - RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R||15.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93040|93040 - RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT||36.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93025|93025 - MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS||494.85|59.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93024|93024 - ERGONOVINE PROVOCATION TST||320.44|92.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93018|93018 - CV STRS TST XERS&/OR RX CONT ECG I&R ONLY||43.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93017|93017 - CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY||138.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93016|93016 - CV STRS TST XERS&/OR RX CONT ECG W/O I&R||64.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93015|93015 - CV STRS TST XERS&/OR RX CONT ECG W/SI&R||246.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93010|93010 - ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY||24.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93005|93005 - ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R||28.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|93000|93000 - ECG ROUTINE ECG W/LEAST 12 LDS W/I&R||53.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92998|92998 - PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL||963.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92997|92997 - PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL||1930.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92995|92995 - CORONARY ATHERECTOMY||1975.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92993|92993 - ATRIAL SEPTECT/SEPTOSTOMY BLADE METHOD||2372.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92992|92992 - ATRIAL SEPTECT/SEPTOST TRANSVENOUS BALLOON||2999.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92990|92990 - PRQ BALLOON VALVULOPLASTY PULMONARY VALVE||3212.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92987|92987 - PRQ BALLOON VALVULOPLASTY MITRAL VALVE||4111.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92986|92986 - PRQ BALLOON VALVULOPLASTY AORTIC VALVE||3989|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92979|92979 - ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL||428.13|117.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92978|92978 - ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL||695.36|146.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92977|92977 - THROMBOLYSIS CORONARY INTRAVENOUS INFUSION||329.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92975|92975 - THROMBOLYSIS INTRACORONARY NFS SLCTV ANGRPH||1173.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92974|92974 - TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX||485.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92973|92973 - PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY||530.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92971|92971 - CARDIOASSIST-METH CIRCULATORY ASSIST EXTERNAL||274.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92970|92970 - CARDIOASSIST-METH CIRCULATORY ASSIST INTERNAL||513.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92961|92961 - CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX||712.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92960|92960 - CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL||356.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92953|92953 - TEMPORARY TRANSCUTANEOUS PACING||31.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92950|92950 - CARDIOPULMONARY RESUSCITATION||536.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92943|92943 - PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL||850.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92941|92941 - PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL||850.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92937|92937 - PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL||758.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92933|92933 - PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH||849.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92928|92928 - PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH||759.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92924|92924 - PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH||812.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92920|92920 - PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH||683.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92700|92700 - UNLISTED OTORHINOLARYNGOLOGICAL SERVICE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92640|92640 - ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR||124.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92633|92633 - AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92630|92630 - AUDITORY REHABILITATION PRELINGUAL HEARING LOSS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92627|92627 - EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15||22.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92626|92626 - EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR||95.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92625|92625 - ASSESSMENT TINNITUS||75.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92621|92621 - EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN||22.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92620|92620 - EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN||99.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92618|92618 - EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV ADD 30 MIN||40.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92617|92617 - FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V I&R||52.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92616|92616 - FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC||124.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92615|92615 - FLEXIBLE ENDOSCOPIC EVAL LARYN SENS C/V REC I&R||42.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92614|92614 - FLEXIBLE ENDOSCOPIC EVAL LARYN SENSORY C/V REC||85.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92613|92613 - FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC I&R||47.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92612|92612 - FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC||84.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92611|92611 - MOTION FLUOR EVAL SWLNG FUNCJ C/V REC||120.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92610|92610 - EVAL ORAL&PHARYNGEAL SWLNG FUNCJ||84.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92609|92609 - THER SP-GENRATJ DEV PRGRMG&MODIFICAJ||124.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92608|92608 - RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN||56.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92607|92607 - RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR||174.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92606|92606 - THER SVC N-SP-GENRATJ DEV PRGRMG&MODIFICAJ||87.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92605|92605 - EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV F2F 1ST HR||109.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92604|92604 - ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG||85.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92603|92603 - ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG||153.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92602|92602 - ANALYSIS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG||89.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92601|92601 - ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG||156.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92597|92597 - EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC||102.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92596|92596 - EAR PROTECTOR ATTENUATION MEASUREMENTS||50.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92595|92595 - ELECTROACOUS EVAL HEARING AID BINAURAL||53.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92594|92594 - ELECTROACOUS EVAL HEARING AID MONAURAL||24.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92593|92593 - HEARING AID CHECK BINAURAL||43.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92592|92592 - HEARING AID CHECK MONAURAL||25.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92591|92591 - HEARING AID EXAMINATION & SELECTION BINAURAL||82.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92590|92590 - HEARING AID EXAMINATION & SELECTION MONAURAL||64.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92588|92588 - DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL||52.59|45.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92587|92587 - DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD||34.61|28.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92586|92586 - AUDITORY EVOKED POTENTIALS LIMITED||93.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92585|92585 - AUDITORY EVOKED POTENTIALS COMPREHENSIVE||147.32|40.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92584|92584 - ELECTROCOCHLEOGRAPHY||83.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92583|92583 - SELECT PICTURE AUDIOMETRY||54.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92582|92582 - CONDITIONING PLAY AUDIOMETRY||74.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92579|92579 - VISUAL REINFORCEMENT AUDIOMETRY||47.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92577|92577 - STENGER TEST SPEECH||20.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92576|92576 - SYNTHETIC SENTENCE IDENTIFICATION TEST||39.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92575|92575 - SENSORINEURAL ACUITY LEVEL||76.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92572|92572 - STAGGERED SPONDAIC WORD||36.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92571|92571 - FILTERED SPEECH TEST||28.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92570|92570 - ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY||37.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92568|92568 - ACOUSTIC REFLEX THRESHOLD||20|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92567|92567 - TYMPANOMETRY||14.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92565|92565 - STENGER TEST PURE TONE||18.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92564|92564 - SHORT INCREMENT SENSITIVITY INDEX||29.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92563|92563 - TONE DECAY TEST||34.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92562|92562 - LOUDNESS BALANCE BINAURAL/MONAURAL||45.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92561|92561 - BEKESY AUDIOMETRY DIAGNOSTIC||42.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92560|92560 - BEKESY AUDIOMETRY SCREENING||24.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92559|92559 - AUDIOMETRIC TESTING GROUPS||34.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92558|92558 - EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS||11.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92557|92557 - COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ||42.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92556|92556 - SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ||39.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92555|92555 - SPEECH AUDIOMETRY THRESHOLD||25.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92553|92553 - PURE TONE AUDIOMETRY AIR & BONE||42.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92552|92552 - PURE TONE AUDIOMETRY AIR ONLY||34.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92551|92551 - SCREENING TEST PURE TONE AIR ONLY||13.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92550|92550 - TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS||25.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92549|92549 - CDP-SOT 6 CONDITIONS W/I&R W/MCT & ADT||79.74|58.01|21.74||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92548|92548 - CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT||125.46|40.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92547|92547 - USE VERTICAL ELECTRODES||6.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92546|92546 - SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING||119.75|23.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92545|92545 - OSCILLATING TRACKING TEST W/RECORDING||33.65|18.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92544|92544 - OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC||36.17|21.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92543|92543 - CALORIC VESTIBULAR TEST||23.13|8.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92542|92542 - POSITIONAL NYSTAGMUS TEST||43.64|27.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92541|92541 - SPONTANEOUS NYSTAGMUS TEST||45.54|32.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92540|92540 - VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRK||123.66|124.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92534|92534 - OPTOKINETIC NYSTAGMUS TEST||24.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92533|92533 - CALORIC VESTIBULAR TEST EACH IRRIGATION||32.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92532|92532 - POSITIONAL NYSTAGMUS TEST||22.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92531|92531 - SPONTANEOUS NYSTAGMUS W/GAZE||20.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92526|92526 - TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING||103.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92520|92520 - LARYNGEAL FUNCTION STUDIES||50.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92516|92516 - FACIAL NERVE FUNCTION STUDIES||29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92512|92512 - NASAL FUNCTION STUDIES||35.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92511|92511 - NASOPHARYNGOSCOPY W/ENDOSCOPE SPX||60.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92508|92508 - TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV||27.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92507|92507 - TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND||93.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92506|92506 - SPEECH/HEARING EVALUATION||197.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92504|92504 - BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE||11.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92502|92502 - OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA||120.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92499|92499 - UNLISTED OPHTHALMOLOGICAL SERVICE/PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92371|92371 - RPR&REFITG SPECTACLE PROSTHESIS APHAKIA||14.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92370|92370 - RPR&REFITG SPECTACLES EXCEPT APHAKIA||20.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92358|92358 - PROSTHESIS SERVICE APHAKIA TEMPORARY||15.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92355|92355 - FITTING SPECTACLE MOUNTED LW VIS AID TLSCP||35.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92354|92354 - FITTING SPECTACLE MOUNTED LW VIS AID 1 ELMNT||40.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92353|92353 - FITTING SPECTACLE PROSTH APHAKIA MULTIFOCAL||31.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92352|92352 - FITTING SPECTACLE PROSTH APHAKIA MONOFOCAL||23.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92342|92342 - FITTING SPECTACLES XCPT APHAKIA MULTIFOCAL||33.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92341|92341 - FITTING SPECTACLES XCPT APHAKIA BIFOCAL||29.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92340|92340 - FITTING SPECTACLES XCPT APHAKIA MONOFOCAL||23.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92326|92326 - REPLACEMENT CONTACT LENS||41.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92325|92325 - MODIFICAJ CONTACT LENX SPX SUPVJ ADAPTATION||43.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92317|92317 - RX CONTACT CORNEOSCLERAL LENS||26.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92316|92316 - RX CONTACT CORNEAL LENS APHAKIA BOTH EYES||48.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92315|92315 - RX CONTACT CORNEAL LENS APHAKIA 1 EYE||29.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92314|92314 - RX&FTG CONTACT CORNEAL LENS EYES XCPT APHAKIA||43.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92313|92313 - RX&FITG CORNEOSCLERAL LENS||62.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92312|92312 - RX&FITG CONTACT CORNEAL LENS APHAKIA BOTH EYES||80.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92311|92311 - RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE||70.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92310|92310 - RX&FITG C-LENS SUPVJ CRNL LENS OU XCPT APHK||74.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92287|92287 - ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R||56.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92286|92286 - ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY||146.05|55.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92285|92285 - XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE||28.86|5.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92284|92284 - DARK ADAPTATION XM W/INTERPRETATION & REPORT||72.24|19.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92283|92283 - COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV||61.99|14.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92275|92275 - ELECTRORETINOGRAPY W/INTERPRETATION & REPORT||181.45|89.57||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|92274|92274 - MULTIFOCAL ELECTRORETINOGRAPHY W/I&R||110.87|54.02|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92273|92273 - FULL FIELD ELECTRORETINOGRAPHY W/I&R||162.64|60.91|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92270|92270 - ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT||110.99|65.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92265|92265 - NEEDLE OCULOGRAPHY 1/ XOC MUSC 1/BOTH EYE W/I&R||99.44|70.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92260|92260 - OPHTHALMODYNAMOMETRY||13.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92250|92250 - FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT||91.42|36.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92240|92240 - INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI||295.09|97.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92235|92235 - FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI||163.84|72.27||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92230|92230 - FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT||40.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92228|92228 - REMOTE IMAGING MGT RETINAL DISEASE W/I&R UNI/B||41.83|32.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92227|92227 - REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/B||14.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92226|92226 - OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R SBS||22.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92225|92225 - OPHTHALMOSCPY EXTENDED RETINAL DRAWING I&R 1ST||26.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92202|92202 - OPSCPY EXTND OPTIC NRV/MACULA DRAWING I&R UNI/BI||18.92||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92201|92201 - OPSCPY EXTND RTA DRAWING & SCL DEPRSN I&R UNI/BI||29.29||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92140|92140 - GLAUCOMA PROVOCATIVE TESTS||32.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92136|92136 - OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL||104.19|47.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92134|92134 - COMPUTERIZED OPHTHALMIC IMAGING RETINA||54.76|45.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92133|92133 - COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE||54.76|45.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92132|92132 - CMPTR OPHTHALMIC DX IMG ANT SEGMT W/I&R UNI/BI||44.94|32.32||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92100|92100 - SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES||61.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92083|92083 - VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM||106.81|43.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92082|92082 - VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM||83.33|35.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92081|92081 - VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM||58.63|26.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92072|92072 - FITTING CONTACT LENS FOR MNGT OF KERATOCONUS||120.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92071|92071 - FIT CONTACT LENS TX OCULAR SURFACE DISEASE||41.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92070|92070 - FITTING OF CONTACT LENS||48.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92065|92065 - ORTHOPTIC &/PLEOPTIC TRAINING W/MEDICAL DIRECTJ||62.09|28.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92060|92060 - SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX||76.28|59.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92025|92025 - COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI||44.12|30.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92020|92020 - GONIOSCOPY SEPARATE PROCEDURE||25.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92019|92019 - OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD||84.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92018|92018 - OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL||174.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92015|92015 - DETERMINATION REFRACTIVE STATE||24.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92014|92014 - OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>||97.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92012|92012 - OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT||64.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92004|92004 - OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST||122.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|92002|92002 - OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT||59.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91299|91299 - UNLISTED DIAGNOSTIC GASTROENTEROLOGY PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91133|91133 - ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG||211.54|57.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91132|91132 - ELECTROGASTROGRAPHY DX TRANSCUTANEOUS||181.88|44.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91122|91122 - ANORECTAL MANOMETRY||262.28|141.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91120|91120 - RECTAL SESATION TONE & COMPLIANCE TEST||462.81|80.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91117|91117 - COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R||180.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91112|91112 - GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP||1341.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91111|91111 - GASTROINTESTINAL TRACT IMAGING ESOPHAGUS W/I&R||864.07|85.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91110|91110 - GI IMAG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R||1071.3|310.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91065|91065 - BREATH HYDROGEN/METHANE TEST||101|16.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91040|91040 - ESOPHGL BALO DISTENSION DX STD W/PROVOCATION||363.41|76.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91038|91038 - ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG||454.93|93.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91037|91037 - GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD||193.06|83.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91035|91035 - GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD||572.09|134.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91034|91034 - GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT||228.55|81.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91030|91030 - ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS||165.63|77.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91022|91022 - DUODENAL MOTILITY MANOMETRIC STUDY||211.12|122.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91020|91020 - GASTRIC MOTILITY MANOMETRIC STUDIES||281.83|122.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91013|91013 - ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION||27.93|15.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|91010|91010 - ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT||215.8|108.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90999|90999 - UNLISTED DIALYSIS PROCEDURE INPATIENT/OUTPATIENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90997|90997 - HEMOPERFUSION||128.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90993|90993 - DIALYSIS TRAINING PATIENT PER TRAINING SESSION||108.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90989|90989 - DIALYSIS TRAINING PATIENT COMPLETED COURSE||500.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90970|90970 - ESRD RELATED SVC <FULL MONTH 20/>YR OLD||11.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90969|90969 - ESRD RELATED SVC <FULL MONTH 12-19 YR OLD||21.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90968|90968 - ESRD RELATED SVC <FULL MONTH 2-11 YR OLD||21.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90967|90967 - ESRD RELATED SVC <FULL MONTH <2 YR OLD||26.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90966|90966 - ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD||337.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90965|90965 - ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD||640.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90964|90964 - ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD||672.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90963|90963 - ESRD SVC HOME DIALYSIS FULL MONTH <2YR OLD||781.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90962|90962 - ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT||257.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90961|90961 - ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS||338.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90960|90960 - ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS||407.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90959|90959 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT||418.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90958|90958 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS||623.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90957|90957 - ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS||921.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90956|90956 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT||449.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90955|90955 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS||651.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90954|90954 - ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS||1154.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90953|90953 - ESRD RELATED SVC MONTHLY <2 YR OLD 1 VISIT||666.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90952|90952 - ESRD RELATED SVC MONTHLY <2 YR OLD 2/3 VISITS||1000.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90951|90951 - ESRD RELATED SVC MONTHLY & <2 YR OLD 4/> VISITS||1351.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90947|90947 - DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS||178.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90945|90945 - DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL||120.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90940|90940 - HEMODIALYSIS ACCESS FLOW STUDY||31.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90937|90937 - HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX||151|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90935|90935 - HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION||105.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90913|90913 - BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT||31.94||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90912|90912 - BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT||57.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90911|90911 - BIOFDBK TRNG PERINL MUSC ANORECT/URO SPHX W/EMG||54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90901|90901 - BIOFEEDBACK TRAINING ANY MODALITY||24.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90899|90899 - UNLISTED PSYCHIATRIC SERVICE/PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90889|90889 - PREP REPORT PT PSYCH STATUS AGENCY/PAYER||75.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90887|90887 - INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY||86.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90885|90885 - PSYCHIATRIC EVAL HOSPITAL RECORDS DX PURPOSES||56.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90880|90880 - HYPNOTHERAPY||106.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90876|90876 - INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN||110.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90875|90875 - INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN||70.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90870|90870 - ELECTROCONVULSIVE THERAPY||125.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90869|90869 - REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN||137.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90868|90868 - THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG||27.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90867|90867 - REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M||201.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90865|90865 - NARCOSYNTHESIS PSYC DX&THER PURPOSES||145.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90863|90863 - PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90853|90853 - GROUP PSYCHOTHERAPY||33.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90849|90849 - MULTIPLE FAMILY GROUP PSYCHOTHERAPY||32.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90847|90847 - FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS||110.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90846|90846 - FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS||92.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90845|90845 - PSYCHOANALYSIS||88.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90840|90840 - PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90839|90839 - PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90838|90838 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN||127.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90837|90837 - PSYCHOTHERAPY W/PATIENT 60 MINUTES||131.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90836|90836 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN||79.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90834|90834 - PSYCHOTHERAPY W/PATIENT 45 MINUTES||87.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90833|90833 - PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN||48.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90832|90832 - PSYCHOTHERAPY W/PATIENT 30 MINUTES||58.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90792|90792 - PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES||142.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90791|90791 - PSYCHIATRIC DIAGNOSTIC EVALUATION||137.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90785|90785 - PSYCHOTHERAPY COMPLEX INTERACTIVE||5.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90756|90756 - CCIIV4 VACCINE ANTIBIOTIC FREE 0.5 ML DOS IM USE||28.4913|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90748|90748 - HIB-HEPB VACCINE FOR INTRAMUSCULAR USE||65.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90747|90747 - HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM||167.6513|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90746|90746 - HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE||83.8263|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90744|90744 - HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM||33.6225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90743|90743 - HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM||32.6688|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90740|90740 - HEPB VACCINE DIALYSIS/IMMUNSUP PAT 3 DOSE IM||167.6513|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90739|90739 - HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE||163.875|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90738|90738 - JAPANESE ENCEPHALITIS VACCINE INACTIVATED IM||76.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90736|90736 - ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE||244.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90735|90735 - ENCEPHALITIS VACCINE SC||127.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90734|90734 - MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE||83.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90733|90733 - MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE||133.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90732|90732 - PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE||142.7637|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90723|90723 - DTAP-HEPB-IPV VACCINE INTRAMUSCULAR||64.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90721|90721 - DTAP/HIB VACCINE IM||23.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90717|90717 - YELLOW FEVER VACCINE LIVE SUBQ||89.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90716|90716 - VAR VACCINE LIVE FOR SUBCUTANEOUS USE||64.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90715|90715 - TDAP VACCINE 7 YRS/> IM||41.0513|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90714|90714 - TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE||29.5225|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90713|90713 - POLIOVIRUS VACCINE INACTIVATED SUBQ/IM||25.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90710|90710 - MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ||117.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90707|90707 - MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ||44.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90706|90706 - RUBELLA VACCINE SC||30.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90705|90705 - MEASLES VACCINE SC||30.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90704|90704 - MUMPS VACCINE SC||29.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90703|90703 - TETANUS VACCINE IM||53.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90702|90702 - DT VACCINE YOUNGER THAN 7 YRS FOR IM USE||55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90700|90700 - DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM||22.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90698|90698 - DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE||66.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90691|90691 - TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM||112.1663|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90690|90690 - TYPHOID VACCINE LIVE ORAL||83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90688|90688 - IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE||22.2941|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90687|90687 - IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE||11.7538|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90686|90686 - IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE||23.7904|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90685|90685 - IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE||27.2662|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90682|90682 - RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM||66.7163|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90681|90681 - RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE||66.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90680|90680 - RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE||66.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90675|90675 - RABIES VACCINE INTRAMUSCULAR||368.1625|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90674|90674 - CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE||30.0587|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90673|90673 - RIV3 VACCINE PRESERVATIVE FREE FOR IM USE||50.7662|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90672|90672 - LAIV4 VACCINE FOR INTRANASAL USE||33.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90670|90670 - PCV13 VACCINE FOR INTRAMUSCULAR USE||269.1662|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90669|90669 - PCV7 VACCINE IM||119.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90662|90662 - IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM||66.7163|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90661|90661 - CCIIV3 VACCINE PRESERVATIVE FREE 0.5 ML IM USE||27.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90660|90660 - LAIV3 VACCINE LIVE FOR INTRANASAL USE||27.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90658|90658 - IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE||13.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90657|90657 - IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE||7.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90656|90656 - IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE||24.7162|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90655|90655 - IIV3 VACC PRESRV FREE 0.25 ML DOSAGE IM USE||19.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90654|90654 - INFLUENZA VACC IIV3 SPLIT VIRUS PRSRV FREE ID||23.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90653|90653 - IIV ADJUVANTED VACCINE FOR INTRAMUSCULAR USE||68.3413|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90649|90649 - 4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE||111.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90648|90648 - HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE||23.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90647|90647 - HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE||25.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90646|90646 - HIB VACCINE PRP-D IM||30.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90645|90645 - HIB VACCINE HBOC IM||30.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90644|90644 - HIB-MENCY VACC 4 DOSE SCHED 6 WKS-18 MONTHS IM||30.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90636|90636 - HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM||137.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90634|90634 - HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE||40.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90633|90633 - HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE||29.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90632|90632 - HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE||74.5362|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90630|90630 - INFLUENZA VACC IIV4 SPLIT VIRUS PRSRV FREE ID||25.4288|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90586|90586 - BACILLUS CALMETTE-GUERIN VACCINE INTRAVESICAL||176.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90585|90585 - BACILLUS CALMETTE-GUERIN VACC FOR TB LIVE PERQ||176.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90581|90581 - ANTHRAX VACCINE SUBCUTANEOUS/IM USE||160.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90474|90474 - IM ADM INTRANSL/ORAL EA VACCINE||13.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90473|90473 - IM ADM INTRANSL/ORAL 1 VACCINE||25.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90472|90472 - IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE||14.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90471|90471 - IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE||27.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90468|90468 - IMMUNE ADMIN O/N -  ADDL < 8 Y||34.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90467|90467 - IMMUNE ADMIN O OR N -  < 8 YRS||33.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90466|90466 - IMMUNE ADMIN ADDL INJ -  < 8 Y||32.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90465|90465 - IMMUNE ADMIN 1 INJ -  < 8 YRS||30.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90461|90461 - IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT||14.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90460|90460 - IM ADM THRU 18YR ANY RTE 1ST/ONLY COMPT VAC/TOX||28.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90396|90396 - VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM||173.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90389|90389 - TETANUS IMMUNE GLOBULIN TIG HUMAN IM||157.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90386|90386 - RHO(D) IMMUNE GLOBULIN HUMAN IV||38.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90385|90385 - RHO(D) IMMUNE GLOBULIN HUMAN MINI-DOSE IM||43.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90384|90384 - RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM||103.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90378|90378 - RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E||1720.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90376|90376 - RABIES IG HEAT-TREATED HUMAN IM/SUBQ||357.0687|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90375|90375 - RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ||377.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90371|90371 - HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM||147.7488|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90296|90296 - DIPHTHERIA ANTITOXIN EQUINE ANY ROUTE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90291|90291 - CYTOMEGALOVIRUS IMMUNE GLOBULIN HUMAN IV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90288|90288 - BOTULISM IMMUNE GLOBULIN HUMAN INTRAVENOUS USE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90287|90287 - BOTULINUM ANTITOXIN EQUINE ANY ROUTE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90284|90284 - IMMUNE GLOBULIN HUMAN SUBQ INFUSION 100 MG EA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90283|90283 - IMMUNE GLOBULIN IGIV HUMAN IV USE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|90281|90281 - IMMUNE GLOBULIN IG HUMAN IM USE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89331|89331 - SPERM EVALUATION RETROGRADE EJACULATION URINE||36.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89330|89330 - SPERM EVALUATION CERVICAL MUCOUS PENETRATION||23.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89329|89329 - SPERM EVALUATION HAMSTER PENETRATION TEST||49.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89325|89325 - SPERM ANTIBODIES||24.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89322|89322 - SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA||26.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89321|89321 - SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM||13.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89320|89320 - SEMEN ANALYSIS VOLUME COUNT MOTILITY DIFFERENT||13.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89310|89310 - SEMEN ALYS MOTILITY&CNT X W/HUHNER TST||20.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89300|89300 - SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER||20.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89230|89230 - SWEAT COLLECTION IONTOPHORESIS||4.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89220|89220 - SPUTUM OBTAINING SPEC AEROSOL INDUCED TX SPX||24.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89190|89190 - NASAL SMEAR EOSINOPHILS||11.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89160|89160 - MEAT FIBERS FECES||8.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89125|89125 - FAT STAIN FECES URINE/RESPIR SECRETIONS||10.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89060|89060 - CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID||16.71|30.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89055|89055 - LEUKOCYTE ASSMT FECAL QUAL/SEMIQUANTITATIVE||5.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89051|89051 - CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT||4.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89050|89050 - CELL COUNT MISCELLANEOUS BODY FLUIDS||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|89049|89049 - CAFFEINE HALOTHANE CONTRACTURE TEST||104.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88741|88741 - HEMOGLOBIN QUANTITATIVE TC PER DAY METHEMOGLOBIN||11.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88740|88740 - HEMOGLOBIN QUAN TC PER DAY CARBOXYHEMOGLOBIN||11.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88738|88738 - HGB QUANTITATIVE TRANSCUTANEOUS||11.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88720|88720 - BILIRUBIN TOTAL TRANSCUTANEOUS||11.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88399|88399 - UNLISTED SURGICAL PATHOLOGY PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88388|88388 - MACR EXM DISS&PRP NONMICR IMPRNT/CONSLT/FRZ SE||48|35.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88387|88387 - MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA||55.03|45.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88386|88386 - EVAL MOLECUL PROBES 251-500||0|134.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88385|88385 - EVAL MOLECUL PROBES 51-250||0|100.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88384|88384 - EVAL MOLECULAR PROBES 11-50||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88381|88381 - MICRODISSECTION PREP IDENTIFIED TARGET MANUAL||245.88|81.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88380|88380 - MICRODISSECTION PREP IDENTIFIED TARGET LASER||279.34|119.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88375|88375 - OPTICAL ENDOMICROSCOPIC IMAGE INTERP & REPORT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88372|88372 - PROTEIN ALYS WSTRN BLOT I&R IMMUNOLOGICAL EA||53.16|26.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88371|88371 - PROTEIN ANAL TISSUE WESTERN BLOT W/INTERP&REPO||51.94|29.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88368|88368 - M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL||335.92|98.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88367|88367 - M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN||398.91|96.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88365|88365 - IN SITU HYBRIDIZATION 1ST PROBE STAIN||252.55|90.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88363|88363 - EXAM & SELECT ARCHIVE TISSUE MOLECULAR ANALYSI||25.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88362|88362 - NERVE TEASING PREPARATIONS||460.52|171.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88361|88361 - M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST||231.27|89.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88360|88360 - M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL||184.9|82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88358|88358 - MORPHOMETRIC ANALYSIS TUMOR||117.47|67.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88356|88356 - MORPHOMETRIC ANALYSIS NERVE||421.58|205.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88355|88355 - MORPHOMETRIC ANALYSIS SKELETAL MUSCLE||298.17|132.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88349|88349 - SCANNING ELECTRON MICROSCOPY||586.47|61.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88348|88348 - ELECTRON MICROSCOPY DIAGNOSTIC||1050.81|115.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88347|88347 - IMMUNOFLUORESCENT STUDY||114.4|59.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88346|88346 - IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN||158.28|65.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88342|88342 - IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE||161.28|65.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88334|88334 - PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE||93.52|58.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88333|88333 - PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE||150.69|95.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88332|88332 - PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION||63.93|46.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88331|88331 - PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC||144.03|94.08||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88329|88329 - PATHOLOGY CONSULTATION DURING SURGERY||54.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88325|88325 - CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL||199.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88323|88323 - CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES||213.81|131.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88321|88321 - CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE||129.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88319|88319 - SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS||148.35|41.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88314|88314 - SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU||121.13|34.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88313|88313 - SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT||98.75|18.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88312|88312 - SPECIAL STAIN GROUP 1 MICROORGANISMS I&R||141.82|41.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88311|88311 - DECALCIFICATION PROCEDURE||29.65|19.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88309|88309 - LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||542.75|221.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88307|88307 - LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||356.68|126.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88305|88305 - LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||161.18|57.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88304|88304 - LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||93.08|17.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88302|88302 - LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM||83.49|10.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88300|88300 - LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY||42.35|7.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88291|88291 - CYTOGENETICS&MOLEC CYTOGENETICS INTERP&REP||46.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88289|88289 - CHRMSM ANALYSIS ADDL HIGH RESOLUTION STUDY||80.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88285|88285 - CHRMSM ANALYSIS ADDL CELLS COUNTED EACH STUDY||44.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88283|88283 - CHRMSM ANALYSIS ADDL SPECIALIZED BANDING||83.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88280|88280 - CHRMSM ANALYSIS ADDL KARYOTYP EACH STUDY||58.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88275|88275 - MOLEC CYTG INTERPHASE ISH ANALYZE 100-300 CLL||93.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88274|88274 - MOLECULAR CYTOGENETICS INTERPHASE ISH 25-99 CLL||81.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88273|88273 - MOLECULAR CYTOGENETICS CHRMOML ISH 10-30 CLL||75.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88272|88272 - MOLECULAR CYTOGENETICS CHRMOML ISH 3-5 CELLS||62.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88271|88271 - MOLECULAR CYTOGENETICS DNA PROBE EACH||50.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88269|88269 - CHRMSM SITU AMNIOTIC CLL 6-12 COLONIES 1KARYOTYP||388.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88267|88267 - CHRMSM ALYS AMNIOTIC/VILLUS 15 CELL 1KARYOTYPE||420.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88264|88264 - CHRMSM ANALYZE 20-25 CELLS||291.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88263|88263 - CHRMSM COUNT 45 CELL MOSAICISM 2KARYOTYPE||351.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88262|88262 - CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING||291.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88261|88261 - CHRMSM COUNT 5 CELL 1KARYOTYPE BANDING||413.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88249|88249 - CHRMSM BREAKAGE SYNDS SCORE 100 CLL||404.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88248|88248 - CHRMSM BREAKAGE BASELINE BREAKAGE 50-100 CLL||404.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88245|88245 - CHRMSM BREAKAGE BASELINE SISTER 20-25 CLL||347.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88241|88241 - THAWING&EXPANSION FROZEN CELLS EACH ALIQUOT||19.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88240|88240 - CRYOPRSRV FRZING&STORAGE CELLS EA CELL LINE||19.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88239|88239 - TISS CUL NEO DISORDERS SOLID TUMOR||344.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88237|88237 - TISS CUL NEO DISORDERS BONE MARROW BLOOD CELLS||206.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88235|88235 - TISS CUL NON-NEO DISORDERS AMNIOTIC/CHORNC CELLS||344.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88233|88233 - TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX||328.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88230|88230 - TISS CUL NON-NEO DISORDERS LYMPHOCYTE||272.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88199|88199 - UNLISTED CYTOPATHOLOGY PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88189|88189 - FLOW CYTOMETRY INTERPRETATION 16/> MARKERS||164.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88188|88188 - FLOW CYTOMETRY INTERPJ 9-15 MARKERS||133.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88187|88187 - FLOW CYTOMETRY INTERPJ 2-8 MARKERS||106.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88185|88185 - FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY EA||74.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88184|88184 - FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST||122.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88182|88182 - FLOW CYTOMETRY CELL CYCLE/DNA ANALYSIS||155.81|54.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88177|88177 - CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL||43.29|33.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88175|88175 - CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS||61.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88174|88174 - CYTP C/V AUTO THIN LYR PREPJ SCR SYS PHYS||49.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88173|88173 - CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT||213.82|108.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88172|88172 - CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST||82.16|53.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88167|88167 - CYTP SLIDES C/V MNL SCR&CPTR RESCR CELL S&I||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88166|88166 - CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS SUPV||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88165|88165 - CYTP SLIDES C/V MNL SCR&RESCR PHYS SUPV||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88164|88164 - CYTP SLIDES CERV/VAG MNL SCRN PHYSICIAN SUPV||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88162|88162 - CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES||131.51|60.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88161|88161 - CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ||87.63|38.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88160|88160 - CYTP SMRS ANY OTH SRC SCR&INTERPJ||85.61|38.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88155|88155 - CYTP SLIDES C/V DEFINITIVE HORMONAL EVAL||14.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88154|88154 - CYTP SLIDES C/V MNL SCR&CPTR-RESCR CELL S&I||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88153|88153 - CYTP SLIDES C/V MNL SCR&RESCR PHYS||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88152|88152 - CYTP SLIDES C/V MNL SCR&CPTR RESCR PHYS||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88150|88150 - CYTP SLIDES C/V MNL SCR UNDER PHYS||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88148|88148 - CYTP SMRS C/V SCR AUTO SYS MNL RESCR PHYS||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88147|88147 - CYTP SMRS C/V SCR AUTOMATED SYSTEM PHYS SUPV||24.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88143|88143 - CYTP C/V FLU AUTO THIN MNL SCR&RESCR PHYS||47.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88142|88142 - CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN||47.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88141|88141 - CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN||45.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88140|88140 - SEX CHROMATIN IDENTJ PERIPHERAL BLOOD SMEAR||18.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88130|88130 - SEX CHROMATIN IDENTIFICATION BARR BODIES||35.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88125|88125 - CYTOPATHOLOGY FORENSIC||34.3|20.67||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88121|88121 - CYTP INSITU HYBRID URNE SPEC 3-5 PROBES CPTR EA||610.49|73.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88120|88120 - CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL||708.51|83.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88112|88112 - CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V||158.65|90.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88108|88108 - CYTP CONCENTRATION SMEARS & INTERPRETATION||107.46|34.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88106|88106 - CYTP FLU BR/WA XCPT C/V FILTER METH ONLY INTERPJ||110.08|29.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|88104|88104 - CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ||103.6|43.57||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87912|87912 - NFCT AGENT GENOTYPE HEPATITIS B VIRUS||394.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87910|87910 - NFCT AGT GENOTYPE NUCLEIC ACID CYTOMEGALOVIRUS||394.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87906|87906 - NFCT GEXYP DNA/RNA HIV 1 OTHER REGION||80.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87905|87905 - INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS||22.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87904|87904 - NFCT PHEXYP RESIST TISS CUL HIV EA ADDL DRUG||40.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87903|87903 - NFCT PHEXYP RESIST TISS CUL HIV FIRST 1-10 DRUGS||622.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87902|87902 - NFCT AGNT GENOTYP NUCLEIC ACID HEPATITIS C VIRUS||160.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87901|87901 - NFCT GEXYP NUCLEIC ACID HIV REV TRNSCR&PROTEAS||160.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87900|87900 - NFCT AGT DRUG SUSCEPT PHENOTYPE PREDICTION||203.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87899|87899 - IAADIADOO NOT OTHERWISE SPECIFIED||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87880|87880 - IAADIADOO STREPTOCOCCUS GROUP A||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87850|87850 - IAADIADOO NEISSERIA GONORRHOEAE||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87810|87810 - CHLAMYDIA TRACHOMATIS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87809|87809 - INFECTIOUS AGENT IMMUNOASSAY OPTICAL ADENOVIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87808|87808 - IAADIADOO TRICHOMONAS VAGINALIS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87807|87807 - IAADIADOO RESPIRATORY SYNCTIAL VIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87804|87804 - IAADIADOO INFLUENZA||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87803|87803 - IAADIADOO CLOSTRIDIUM DIFFICILE TOXIN||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87802|87802 - IAADIADOO STREPTOCOCCUS GROUP B||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87801|87801 - IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ||72.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87800|87800 - IADNA MULTIPLE ORGANISMS DIRECT PROBE TQ||72.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87799|87799 - IADNA NOS QUANTIFICATION EACH ORGANISM||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87798|87798 - IADNA NOS AMPLIFIED PROBE TQ EACH ORGANISM||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87797|87797 - IADNA NOS DIRECT PROBE TQ EACH ORGANISM||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87660|87660 - IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87653|87653 - IADNA STREPTOCOCCUS GROUP B AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87652|87652 - IADNA STREPTOCOCCUS GROUP A QUANTIFICATION||76.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87651|87651 - IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87650|87650 - IADNA STREPTOCOCCUS GROUP A DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87641|87641 - IADNA S AUREUS METHICILLIN RESIST AMP PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87640|87640 - IADNA S AUREUS AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87633|87633 - IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET||641.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87632|87632 - IADNA RESPIRATRY PROBE & REV TRNSCR 6-11 TARGETS||319.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87631|87631 - IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS||189.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87622|87622 - HPV DNA QUANT||76.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87621|87621 - HPV DNA AMP PROBE||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87620|87620 - HPV DNA DIR PROBE||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87592|87592 - IADNA NEISSERIA GONORRHOEAE QUANTIFICATION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87591|87591 - IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87590|87590 - IADNA NEISSERIA GONORRHOEAE DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87582|87582 - IADNA MYCOPLSM PNEUMONIAE QUANTIFICATION||76.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87581|87581 - IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87580|87580 - IADNA MYCOPLSM PNEUMONIAE DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87563|87563 - IADNA MYCOPLASMA GENITALIUM AMPLIFIED PROBE TECH||57.9||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87562|87562 - IADNA MYCOBACTERIA AVIUM-INTRACELLULARE QUANT||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87561|87561 - IADNA MYCOBACTERIA AVIUM-INTRACLRE AMP PRB||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87560|87560 - IADNA MYCOBACTERIA AVIUM-INTRACLRE DIR PRB||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87557|87557 - IADNA MYCOBACTERIA TUBERCULOSIS QUANTIFICATION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87556|87556 - IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87555|87555 - IADNA MYCOBACTERIA TUBERCULOSIS DIR PRB||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87552|87552 - IADNA MYCOBACTERIA SPECIES QUANTIFICATION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87551|87551 - IADNA MYCOBACTERIA SPECIES AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87550|87550 - IADNA MYCOBACTERIA SPECIES DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87542|87542 - IADNA LEGIONELLA PNEUMOPHILA QUANTIFICATION||76.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87541|87541 - IADNA LEGIONELLA PNEUMOPHILA AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87540|87540 - IADNA LEGIONELLA PNEUMOPHILA DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87539|87539 - IADNA HIV-2 QUANT & REVERSE TRANSCRIPTION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87538|87538 - IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIPJ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87537|87537 - IADNA HIV-2 DIRECT PROBE TECHNIQUE||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87536|87536 - IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION||95.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87535|87535 - IADNA HIV-1 AMPLIFIED PROBE & REVERSE TRANSCRPJ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87534|87534 - IADNA HIV-1 DIRECT PROBE TECHNIQUE||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87533|87533 - IADNA HERPES VIRUS-6 QUANTIFICATION||76.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87532|87532 - IADNA HERPES VIRUS-6 AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87531|87531 - IADNA HERPES VIRUS-6 DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87530|87530 - IADNA HERPES SOMPLX VIRUS QUANTIFICATION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87529|87529 - IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87528|87528 - IADNA HERPES SIMPLX VIRUS DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87527|87527 - IADNA HEPATITIS G QUANTIFICATION||76.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87526|87526 - IADNA HEPATITIS G AMPLIFIED PROBE TECHNIQUE||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87525|87525 - IADNA HEPATITIS G DIRECT PROBE TECHNIQUE||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87522|87522 - IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87521|87521 - IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87520|87520 - IADNA HEPATITIS C DIRECT PROBE TECHNIQUE||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87517|87517 - IADNA HEPATITIS B VIRUS QUANTIFICATION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87516|87516 - IADNA HEPATITIS B VIRUS AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87515|87515 - IADNA HEPATITIS B VIRUS DIRECT PROBE TECHNIQUE||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87512|87512 - IADNA GARDNERELLA VAGINALIS QUANTIFICATION||76.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87511|87511 - IADNA GARDNERELLA VAGINALIS AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87510|87510 - IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87503|87503 - NFCT AGENT DNA/RNA INFLUENZA >2 TYPES EA ADDL||14.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87502|87502 - INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES||95.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87501|87501 - INFECTIOUS AGENT DNA/RNA INFLUENZA EA TYPE||59.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87500|87500 - INFECTIOUS AGENT DNA/RNA VANCOMYCIN RESISTANCE||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87498|87498 - IADNA ENTEROVIRUS AMPLIF PROBE & REVRSE TRNSCRIP||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87497|87497 - IADNA CYTOMEGALOVIRUS QUANTIFICATION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87496|87496 - IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87495|87495 - IADNA CYTOMEGALOVIRUS DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87493|87493 - INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87492|87492 - IADNA CHLAMYDIA TRACHOMATIS QUANTIFICATION||64.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87491|87491 - IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87490|87490 - IADNA CHLAMYDIA TRACHOMATIS DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87487|87487 - IADNA CHLAMYDIA PNEUMONIAE QUANTIFICATION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87486|87486 - IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87485|87485 - IADNA CHLAMYDIA PNEUMONIAE DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87482|87482 - IADNA CANDIDA SPECIES QUANTIFICATION||76.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87481|87481 - IADNA CANDIDA SPECIES AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87480|87480 - IADNA CANDIDA SPECIES DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87477|87477 - IADNA BORRELIA BURGDORFERI QUANTIFICATION||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87476|87476 - IADNA BORRELIA BURGDORFERI AMPLIFIED PROBE TQ||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87475|87475 - IADNA BORRELIA BURGDORFERI DIRECT PROBE TQ||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87472|87472 - IADNA BARTONELLA HENSELAE&QUINTANA QUANTJ||78.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87471|87471 - IADNA BARTONELLA AMPLIFIED PROBE TECHNIQUE||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87470|87470 - IADNA BARTONELLA DIRECT PROBE TECHNIQUE||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87451|87451 - IAAD IA POLYV MLT ORGANISMS EA POLYV ANTISERUM||17.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87450|87450 - IAAD IA SINGLE STEP METHOD NOS EA ORGANISM||17.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87449|87449 - IAAD IA MULT STEP METHOD NOS EACH ORGANISM||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87430|87430 - IAAD IA STREPTOCOCCUS GROUP A||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87427|87427 - IAAD IA SHIGA-LIKE TOXIN||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87425|87425 - IAAD IA ROTAVIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87420|87420 - IAAD IA RESPIRATORY SYNCTIAL VIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87400|87400 - IAAD IA INFLUENZA A/B EACH||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87391|87391 - IAAD IA HIV-2||32.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87390|87390 - IAAD IA HIV-1||32.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87389|87389 - IAAD IA HIV-1 AG W/HIV-1 & HIV-2 ANTBDY SINGLE||44.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87385|87385 - IAAD IA HISTOPLASM CAPSULATUM||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87380|87380 - IAAD IA HEPATITIS DELTA ANTIGEN||30.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87350|87350 - IAAD IA HEPATITIS BE ANTIGEN||21.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87341|87341 - IAAD IA HEPATITIS B SURFACE AG NEUTRALIZATION||19.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87340|87340 - IAAD IA HEPATITIS B SURFACE ANTIGEN||19.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87339|87339 - IAAD IA HPYLORI||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87338|87338 - IAAD IA HPYLORI STOOL||26.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87337|87337 - IAAD IA ENTAMOEBA HISTOLYTICA GRP||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87336|87336 - IAAD IA ENTAMOEBA HISTOLYTICA DISPAR GRP||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87335|87335 - IAAD IA ESCHERICHIA COLI 0157||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87332|87332 - IAAD IA CYTOMEGALOVIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87329|87329 - IAAD IA GIARDIA||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87328|87328 - IAAD IA CRYPTOSPORIDIUM||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87327|87327 - IAAD IA CRYPTOCOCCUS NEOFORMANS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87324|87324 - IAAD IA CLOSTRIDIUM DIFFICILE TOXIN||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87320|87320 - IAAD IA CHLAMYDIA TRACHOMATIS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87305|87305 - IAAD IA QUAL/SEMIQUAN MULTIPLE STEP ASPERGILLUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87301|87301 - IAAD IA ADENOVIRUS ENTERIC TYP 40/41||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87300|87300 - IAADI POLYV MLT ORGANISMS EA POLYV ANTISERUM||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87299|87299 - IAADI NOT OTHERWISE SPECIFIED EACH ORGANISM||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87290|87290 - IAADI VARICELLA ZOSTER VIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87285|87285 - IAADI TREPONEMA PALLIDUM||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87283|87283 - IAADI RUBEOLA||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87281|87281 - IAADI PNEUMOCUSTIS CARINII||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87280|87280 - IAADI RESPIRATORY SYNCTIAL VIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87279|87279 - IAADI PARAINFLUENZA VIRUS EACH TYPE||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87278|87278 - IAADI LEGIONELLA PNEUMOPHILA||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87277|87277 - IAADI LEGIONELLA MICDADEI||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87276|87276 - IAADI INFFLUENZA A VIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87275|87275 - IAADI INFLUENZA B VIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87274|87274 - IAADI HERPES SMPLX VIRUS TYPE 1||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87273|87273 - IAADI HERPES SMPLX VIRUS TYPE 2||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87272|87272 - IAADI CRYPTOSPORIDIUM||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87271|87271 - IAADI CYTOMEGALOVIRUS DIR FLUORESCENT ANTIBODY||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87270|87270 - IAADI CHLAMYDIA TRACHOMATIS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87269|87269 - IAADI GIARDIA||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87267|87267 - IAADI ENTEROVIRUS DIRECT FLUORESCENT ANTIBODY||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87265|87265 - IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87260|87260 - IAADI ADENOVIRUS||22.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87255|87255 - VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC||55.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87254|87254 - VIRUS CENTRIFUGE ENHNCD ID IMFLUOR STAIN EA||36.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87253|87253 - VIRUS TISSUE CULTURE ADDL STDY/ID EACH ISOLATE||29.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87252|87252 - VIRUS TISS CUL INOCULATION CYTOPATHIC EFFECT||40.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87250|87250 - VIRUS INOCULATION EGGS/SM ANIMAL OBS&DSJ||36.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87230|87230 - TOXIN/ANTITOXIN ASSAY TISSUE CULTURE||36.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87220|87220 - TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT||7.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87210|87210 - SMR PRIM SRC WET MOUNT NFCT AGT||7.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87209|87209 - SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS||33.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87207|87207 - SMR PRIM SRC SPEC STAIN BODIES/PARASITS||11.04|30.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87206|87206 - SMR PRIM SRC FLUORESCENT&/AFS BCT FNGI PARASIT||9.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87205|87205 - SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL||4.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87197|87197 - SERUM BACTERICIDAL TITER||27.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87190|87190 - SUSCEPTIBLTY STDY ANTMCRB MYCOBACT PROPORJ MTHD||10.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87188|87188 - SC STD ANTMCRB AGT MACROBROTH DIL METH EA AGT||12.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87187|87187 - SUSCEPTIBLTY STDY ANTMCRB MICRO/AGAR DILUTJ EA||19.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87186|87186 - SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ||15.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87185|87185 - SUSCEPTIBILITY STUDY ANTIMICROBIAL ENZYME DETCJ||8.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87184|87184 - SUSCEPTIBILITY STUDY ANTIMICROBIAL DISK METHOD||12.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87181|87181 - SUSCEPTBILTY STDY ANTIMICRBIAL AGNT AGAR DILUTJ||8.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87177|87177 - OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID||16.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87176|87176 - HOMOGENIZATION TISSUE CULTURE||10.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87172|87172 - PINWORM EXAMINATION||7.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87169|87169 - MACROSCOPIC EXAMINATION PARASITE||7.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87168|87168 - MACROSCOPIC EXAMINATION ARTHROPOD||7.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87166|87166 - DARK FIELD EXAM ANY SOURCE W/O SPECIMEN COLLECT||20.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87164|87164 - DARK FIELD EXAM ANY SOURCE W/SPECIMEN COLLECTION||16.11|30.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87158|87158 - CULTURE TYPING OTHER METHODS||9.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87153|87153 - CULTYP NUCLEIC ACID SEQUENCING METH EA ISOLATE||130.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87152|87152 - CULTURE TYPING IDENTIFJ PULSE FIELD GEL TYPING||9.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87150|87150 - CULTYP NUC ACID AMP PRB CULT/ISOLATE EA ORGNISM||36.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87149|87149 - CULTURE TYPING NUCLEIC ACID PROBE DIR EA ORGANSM||36.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87147|87147 - CULTURE TYPING IMMUNOLOGIC OTH/THN IMMUNOFLUORES||8.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87143|87143 - CULTURE TYPING GAS/HIGH PRES LIQ CHROMATOGRAPHY||23.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87140|87140 - CULTURE TYPING IMMUNOFLUORESCENT EACH ANTISERUM||10.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87118|87118 - CULTURE MYCOBACTERIAL DEFINITIVE ID EA ISOL||20.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87116|87116 - CULTURE TUBERCLE/OTH ACID-FAST BACILLI ANY ISOL||13.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87110|87110 - CULTURE CHLAMYDIA ANY SOURCE||36.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87109|87109 - CULTURE MYCOPLASMA ANY SOURCE||28.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87107|87107 - CULTURE FUNGI DEFINITIVE ID EACH ORGANISM MOLD||19.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87106|87106 - CULTURE FUNGI DEFINITIVE ID EACH ORGANISM YEAST||19.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87103|87103 - CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD||16.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87102|87102 - CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD||15.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87101|87101 - CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL||14.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87088|87088 - CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE||14.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87086|87086 - CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE||14.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87084|87084 - CUL PRSMPTV PTHGNC ORGANISMS SCR DNS CHART||15.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87081|87081 - CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ||12.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87077|87077 - CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL||14.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87076|87076 - CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL||14.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87075|87075 - CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID||17.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87073|87073 - CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL||17.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87071|87071 - CUL BACT QUAN AEROBIC ISOL XCPT UR BLOOD/STOOL||17.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87070|87070 - CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL||15.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87046|87046 - CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA||17.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87045|87045 - CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL||17.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87040|87040 - CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES||19.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87015|87015 - CONCENTRATION INFECTIOUS AGENTS||12.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87003|87003 - ANIMAL INOCULATION SMALL ANIMAL W/OBS&DSJ||30.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|87001|87001 - SMALL ANIMAL INOCULATION||24.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86941|86941 - HEMOLYSINS&AGGLUTININS INCUBATED||22.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86940|86940 - HEMOLYSINS&AGGLUTININS AUTO SCREEN EACH||15.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86906|86906 - BLOOD TYPING SEROLOGIC RH PHENOTYPING COMPLETE||14.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86905|86905 - BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH||7.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86904|86904 - BLOOD TYPING ANTIGEN SCREEN PATIENT SERUM/UNIT||17.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86902|86902 - BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EACH||7.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86901|86901 - BLOOD TYPING SEROLOGIC RH (D)||5.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86900|86900 - BLOOD TYPING SEROLOGIC ABO||5.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86886|86886 - ANTIHUMAN GLOBULIN INDIRECT EACH ANTIBODY TITER||8.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86885|86885 - ANTIHUMAN GLOBULIN INDIR QUAL EA REAGENT CELL||10.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86880|86880 - ANTIHUMAN GLOBULIN DIRECT EACH ANTISERUM||9.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86850|86850 - ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE||21.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86835|86835 - ANTIBODY HLA CLASS II SEMIQUANTITATIVE PANEL||577.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86834|86834 - ANTIBODY HLA CLASS I SEMIQUANTITATIVE PANEL||638.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86833|86833 - ANTIBODY HLA CLASS II HIGH DEFINITION PANEL QUAL||206.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86832|86832 - ANTIBODY HLA CLASS I HIGH DEFINITION PANEL QUAL||226.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86831|86831 - ANTIBODY HLA CLASS II PHENOTYPE PANEL QUAL||123.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86830|86830 - ANTIBODY HLA CLASS I PHENOTYPE PANEL QUALITATIVE||144.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86829|86829 - ANTIBODY HLA CLASS I OR CLASS II ANTIGENS QUAL||51.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86828|86828 - ANTIBODY HLA CLASS I & CLASS II ANTIGENS QUAL||57.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86826|86826 - HLA CROSSMATCH NONCYTOTOXIC ADDL SERUM/DILUTION||48.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86825|86825 - HLA CROSSMATCH NONCYTOTOXIC 1ST SERUM/DILUTION||144.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86822|86822 - HLA TYPING LYMPHOCYTE CULTURE PRIMED||67.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86821|86821 - HLA TYPING LYMPHOCYTE CULTURE MIXED||103.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86817|86817 - HLA TYPING DR/DQ MULTIPLE ANTIGENS||118.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86816|86816 - HLA TYPING DR/DQ SINGLE ANTIGEN||51.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86813|86813 - HLA TYPING A/B/C MULTIPLE ANTIGENS||106.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86812|86812 - HLA TYPING A/B/C SINGLE ANTIGEN||47.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86808|86808 - SERUM SCREENING % REACTIVE ANTIBODY QUICK METH||54.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86807|86807 - SERUM SCREENING % REACTIVE ANTIBODY STANDRD METH||72.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86806|86806 - LMPHOCYTOTOXICITY ASSAY VIS CROSSMTCH W/O TITRAT||87.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86805|86805 - LYMPHOCYTOTOXICITY ASSAY VIS CROSSMATCH TITRATJ||96.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86804|86804 - HEPATITIS C ANTIBODY CONFIRMATORY TEST||28.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86803|86803 - HEPATITIS C ANTIBODY||26.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86800|86800 - THYROGLOBULIN ANTIBODY||29.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86793|86793 - ANTIBODY YERSINIA||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86790|86790 - ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED||23.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86789|86789 - ANTIBODY WEST NILE VIRUS||21.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86788|86788 - ANTIBODY WEST NILE VIRUS IGM||31.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86787|86787 - ANTIBODY VARICELLA-ZOSTER||23.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86784|86784 - ANTIBODY TRICHINELLA||23.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86780|86780 - ANTIBODY TREPONEMA PALLIDUM||24.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86778|86778 - ANTIBODY TOXOPLASMA IGM||26.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86777|86777 - ANTIBODY TOXOPLASMA||21.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86774|86774 - ANTIBODY TETANUS||27.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86771|86771 - ANTIBODY SHIGELLA||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86768|86768 - ANTIBODY SALMONELLA||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86765|86765 - ANTIBODY RUBEOLA||23.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86762|86762 - ANTIBODY RUBELLA||21.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86759|86759 - ANTIBODY ROTAVIRUS||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86757|86757 - ANTIBODY RICKETTSIA||35.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86756|86756 - ANTIBODY RESPIRATORY SYNCTIAL VIRUS||23.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86753|86753 - ANTIBODY PROTOZOA NES||22.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86750|86750 - ANTIBODY PLASMODIUM MALARIA||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86747|86747 - ANTIBODY PARVOVIRUS||27.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86744|86744 - ANTIBODY NOCARDIA||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86741|86741 - ANTIBODY NEISSERIA MENINGITIDIS||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86738|86738 - ANTIBODY MYCOPLSM||24.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86735|86735 - ANTIBODY MUMPS||24.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86732|86732 - ANTIBODY MUCORMYCOSIS||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86729|86729 - ANTIBODY LYMPHOGRANULOMA VENEREUM||22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86727|86727 - ANTIBODY LYMPHOCYTIC CHORIOMENINGITIS||23.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86723|86723 - ANTIBODY LISTERIA MONOCYTOGENES||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86720|86720 - ANTIBODY LEPTOSPIRA||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86717|86717 - ANTIBODY LEISHMANIA||22.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86713|86713 - ANTIBODY LEGIONELLA||28.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86711|86711 - ANTIBODY JOHN CUNNINGHAM VIRUS||25.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86710|86710 - ANTIBODY INFLUENZA VIRUS||24.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86709|86709 - HEPATITIS ANTIBODY HAAB IGM ANTIBODY||20.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86708|86708 - HEPATITIS A ANTIBODY HAAB||22.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86707|86707 - HEPATITIS BE ANTIBODY HBEAB||21.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86706|86706 - HEPATITIS B SURF ANTIBODY HBSAB||19.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86705|86705 - HEPATITIS B CORE ANTIBODY HBCAB IGM ANTIBODY||21.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86704|86704 - HEPATITIS B CORE ANTIBODY HBCAB TOTAL||22.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86703|86703 - ANTIBODY HIV-1&HIV-2 SINGLE RESULT||25.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86702|86702 - ANTIBODY HIV-2||24.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86701|86701 - ANTIBODY HIV-1||16.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86698|86698 - ANTIBODY HISTOPLASMA||23.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86696|86696 - ANTIBODY HERPES SMPLX TYPE 2||35.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86695|86695 - ANTIBODY HERPES SMPLX TYPE 1||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86694|86694 - ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST||21.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86692|86692 - ANTIBODY HEP DELTA AGENT||31.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86689|86689 - ANTIBODY HTLV/HIV ANTIBODY CONFIRMATORY TEST||35.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86688|86688 - ANTIBODY HTLV-II||25.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86687|86687 - ANTIBODY HTLV-I||15.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86684|86684 - ANTIBODY HAEMOPHILUS INFLUENZA||29.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86682|86682 - ANTIBODY HELMINTH NOT ELSEWHERE SPECIFIED||23.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86677|86677 - ANTIBODY HELICOBACTER PYLORI||26.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86674|86674 - ANTIBODY GIARDIA LAMBLIA||27.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86671|86671 - ANTIBODY FUNGUS NOT ELSEWHERE SPECIFIED||22.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86668|86668 - ANTIBODY FRANCISELLA TULARENSIS||19.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86666|86666 - ANTIBODY EHRLICHIA||18.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86665|86665 - ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA||33.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86664|86664 - ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA||28.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86663|86663 - ANTIBODY EPSTEIN-BARR EB VIRUS EARLY ANTIGEN EA||24.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86658|86658 - ANTIBODY ENTEROVIRUS||24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86654|86654 - ANTIBODY ENCEPHALITIS WESTRN EQUINE||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86653|86653 - ANTIBODY ENCEPHALITIS ST. LOUIS||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86652|86652 - ANTIBODY ENCEPHALITIS EASTERN EQUINE||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86651|86651 - ANTIBODY ENCEPHALITIS CALIFORNIA LA CROSSE||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86648|86648 - ANTIBODY DIPHTHERIA||28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86645|86645 - ANTIBODY CYTOMEGALOVIRUS CMV IGM||31.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86644|86644 - ANTIBODY CYTOMEGALOVIRUS CMV||21.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86641|86641 - ANTIBODY CRYPTOCOCCUS||26.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86638|86638 - ANTIBODY COXIELLA BURNETII Q FEVER||22.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86635|86635 - ANTIBODY COCCIDIOIDES||21.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86632|86632 - ANTIBODY CHLAMYDIA IGM||23.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86631|86631 - ANTIBODY CHLAMYDIA||21.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86628|86628 - ANTIBODY CANDIDA||22.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86625|86625 - ANTIBODY CAMPYLOBACTER||24.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86622|86622 - ANTIBODY BRUCELLA||16.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86619|86619 - ANTIBODY BORRELIA RELAPSING FEVER||24.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86618|86618 - ANTIBODY BORRELIA BURGDORFERI LYME DISEASE||31.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86617|86617 - ANTIBODY BORRELIA BURGDORFERI CONFIRMATORY TST||28.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86615|86615 - ANTIBODY BORDETELLA||24.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86612|86612 - ANTIBODY BLASTOMYCES||23.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86611|86611 - ANTIBODY BARTONELLA||18.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86609|86609 - ANTIBODY BACTERIUM NOT ELSEWHERE SPECIFIED||23.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86606|86606 - ANTIBODY ASPERGILLUS||27.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86603|86603 - ANTIBODY ADENOVIRUS||23.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86602|86602 - ANTIBODY ACTINOMYCES||18.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86593|86593 - SYPHILIS TEST QUANTITATIVE||8.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86592|86592 - SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL||7.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86590|86590 - STREPTOKINASE ANTIBODY||20.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86580|86580 - SKIN TEST TUBERCULOSIS INTRADERMAL||9.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86510|86510 - SKIN TEST HISTOPLASMOSIS||7.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86490|86490 - SKIN TEST COCCIDIOIDOMYCOSIS||7.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86486|86486 - SKIN TEST UNLISTED ANTIGEN EACH||6.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86481|86481 - TB ANTIGEN RESPONSE GAMMA INTERFERON T-CELL SUSP||137.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86480|86480 - TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON||114.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86431|86431 - RHEUMATOID FACTOR QUANTITATIVE||10.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86430|86430 - RHEUMATOID FACTOR QUALITATIVE||10.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86406|86406 - PARTICLE AGGLUTINATION TITER EACH ANTIBODY||19.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86403|86403 - PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY||18.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86386|86386 - NUCLEAR MATRIX PROTEIN 22 NMP22 QUALITATIVE||29.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86384|86384 - NITROBLUE TETRAZOLIUM DYE TEST NTD||20.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86382|86382 - NEUTRALIZATION TEST VIRAL||31.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86378|86378 - MIGRATION INHIBITORY FACTOR TEST MIF||36.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86376|86376 - MICROSOMAL ANTIBODIES EACH||26.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86367|86367 - STEM CELLS TOTAL COUNT||43.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86361|86361 - T CELLS ABSOLUTE CD4 COUNT||48.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86360|86360 - T CELLS ABSOLUTE CD4&CD8 COUNT RATIO||86.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86359|86359 - T CELLS TOTAL COUNT||43.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86357|86357 - NATURAL KILLER CELLS TOTAL COUNT||43.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86356|86356 - MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA||48.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86355|86355 - B CELLS TOTAL COUNT||43.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86353|86353 - LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS||90.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86352|86352 - CELLULAR FUNCTION ASSAY STIMUL&DETECT BIOMARKE||250.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86344|86344 - LEUKOCYTE PHAGOCYTOSIS||14.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86343|86343 - LEUKOCYTE HISTAMINE RELEASE TEST LHR||22.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86341|86341 - ISLET CELL ANTIBODY||36.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86340|86340 - INTRINSIC FACTOR ANTIBODIES||27.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86337|86337 - INSULIN ANTIBODIES||39.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86336|86336 - INHIBIN A||23.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86335|86335 - IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS||54.04|30.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86334|86334 - IMMUNOFIXJ ELECTROPHORESIS SERUM||41.13|30.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86332|86332 - IMMUNE COMPLEX ASSAY||44.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86331|86331 - IMMUNODIFFUSION GEL DIFFUSION QUAL EA AG/ANTBDY||22.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86329|86329 - IMMUNODIFFUSION NOT ELSEWHERE SPECIFIED||25.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86327|86327 - IMMUNOELECTROPHORESIS CROSSED||41.78|34.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86325|86325 - IMMUNOELECTROPHORESIS OTHER FLUIDS CONCENTRATION||41.17|29.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86320|86320 - IMMUNOELECTROPHORESIS SERUM||41.27|29.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86318|86318 - IMMUNOASSAY NFCT AGT ANTB QUAL/SEMIQUAN 1 STEP||23.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86317|86317 - IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUAN NOS||22.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86316|86316 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE||38.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86310|86310 - HETEROPHILE ANTIBODIES TITER AFTER ABSORPTION||13.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86309|86309 - HETEROPHILE ANTIBODIES TITER||11.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86308|86308 - HETEROPHILE ANTIBODIES SCREEN||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86305|86305 - HUMAN EPIDIDYMIS PROTEIN 4 (HE4)||38.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86304|86304 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125||38.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86301|86301 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9||38.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86300|86300 - IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3||38.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86294|86294 - IMMUNOASSAY TUMOR ANTIGEN QUAL/SEMIQUANTITATIVE||21.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86280|86280 - HEMAGGLUTINATION INHIBITION TEST HAI||15.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86277|86277 - GROWTH HORMONE HUMAN ANTIBODY||28.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86256|86256 - FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY||22.19|29.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86255|86255 - FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY||22.19|30.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86243|86243 - FC RECEPTOR||37.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86235|86235 - EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD||33.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86226|86226 - DNA ANTIBODY SINGLE STRANDED||22.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86225|86225 - DNA ANTIBODY NATIVE/DOUBLE STRANDED||25.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86215|86215 - DEOXYRIBONUCLEASE ANTIBODY||24.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86200|86200 - CYCLIC CITRULLINATED PEPTIDE ANTIBODY||23.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86185|86185 - CNTERIMMUNOELECTROPHORESIS EACH ANTIGEN||16.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86171|86171 - COMPLEMENT FIXATION TESTS EACH ANTIGEN||12.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86162|86162 - COMPLEMENT TOTAL HEMOLYTIC||37.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86161|86161 - COMPLEMENT FUNCTIONAL ACTIVITY EACH COMPONENT||22.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86160|86160 - COMPLEMENT ANTIGEN EACH COMPONENT||22.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86157|86157 - COLD AGGLUTININ TITER||14.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86156|86156 - COLD AGGLUTININ SCREEN||12.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86155|86155 - CHEMOTAXIS ASSAY SPECIFY METHOD||29.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86153|86153 - CELL ENUMERATION IMMUNE SELECTJ & ID PHYS INTERP||42.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86152|86152 - CELL ENUMERATION IMMUNE SELECTJ & ID FLUID SPEC||42.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86148|86148 - ANTI-PHOSPHATIDYLSERINE ANTIBODY||29.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86147|86147 - CARDIOLIPIN ANTIBODY EACH IG CLASS||46.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86146|86146 - BETA 2 GLYCOPROTEIN I ANTIBODY EACH||46.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86141|86141 - C-REACTIVE PROTEIN HIGH SENSITIVITY||23.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86140|86140 - C-REACTIVE PROTEIN||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86079|86079 - BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT||60.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86078|86078 - BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT||60.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86077|86077 - BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP||59.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86063|86063 - ANTISTREPTOLYSIN O SCREEN||10.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86060|86060 - ANTISTREPTOLYSIN O TITER||12.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86039|86039 - ANTINUCLEAR ANTIBODIES ANA TITER||20.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86038|86038 - ANTINUCLEAR ANTIBODIES ANA||22.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86023|86023 - ANTIBODY IDENTIFICATION PLATELET IMMUNOGL ASSAY||22.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86022|86022 - ANTIBODY IDENTIFICATION PLATELET ANTIBODIES||33.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86021|86021 - ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES||27.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86005|86005 - ALLERGEN SPEC IGE QUAL MULTIALLERGEN SCREEN||10.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86003|86003 - ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH||9.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86001|86001 - ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA ALLERGEN||9.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|86000|86000 - AGGLUTININS FEBRILE EACH ANTIGEN||12.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85810|85810 - VISCOSITY||21.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85732|85732 - THROMBOPLASTIN TIME PRTL SUBSTIT PLASMA FRCTJ EA||11.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85730|85730 - THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85705|85705 - THROMBOPLASTIN INHIBITION TISSUE||17.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85675|85675 - THROMBIN TIME TITER||11.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85670|85670 - THROMBIN TIME PLASMA||10.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85660|85660 - SICKLING RBC REDUCTION||10.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85652|85652 - SEDIMENTATION RATE RBC AUTOMATED||4.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85651|85651 - SEDIMENTATION RATE RBC NON-AUTOMATED||6.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85635|85635 - REPTILASE TEST||18.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85613|85613 - RUSSELL VIPER VENOM TIME DILUTED||17.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85612|85612 - RUSSELL VIPER VENON TIME UNDILUTED||17.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85611|85611 - PROTHROMBIN TIME SUBSTITUTION PLASMA FRCTJ EACH||7.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85610|85610 - PROTHROMBIN TIME||7.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85598|85598 - PHOSPHOLIPID NEUTRALIZATION HEXAGONAL||33.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85597|85597 - PHOSPHOLIPID NEUTRALIZATION PLATELET||33.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85576|85576 - PLATELET AGGREGATION IN VITRO EACH AGENT||39.56|30.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85557|85557 - OSMOTIC FRAGILITY RBC INCUBATED||24.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85555|85555 - OSMOTIC FRAGILITY RBC UNINCUBATED||12.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85549|85549 - MURAMIDASE||34.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85547|85547 - MECHANICAL FRAGILITY RBC||11.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85540|85540 - WBC ALKALINE PHOSPHATASE COUNT||11.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85536|85536 - IRON STAIN PERIPHERAL BLOOD||11.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85530|85530 - HEPARIN-PROTAMINE TOLERANCE TST||26.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85525|85525 - HEPARIN NEUTRALIZATION||21.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85520|85520 - HEPARIN ASSAY||24.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85475|85475 - HEMOLYSIN ACID||9.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85461|85461 - HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE||12.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85460|85460 - HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS||4.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85445|85445 - HEINZ BODIES INDUCED ACETYL PHENYLHYDRAZINE||12.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85441|85441 - HEINZ BODIES DIRECT||7.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85421|85421 - FBRNLYC FACTORS&INHIBITORS PLSMNG AGIC ASSAY||18.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85420|85420 - FBRNLYC FACTORS&INHIBITRS PLSMNG XCPT AGIC ASS||12.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85415|85415 - FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR||31.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85410|85410 - FBRNLYC FACTORS&INHIBITORS ALPHA-2 ANTIPLASMIN||14.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85400|85400 - FIBRINOLYTIC FACTORS & INHIBITORS PLASMIN||16.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85397|85397 - COAGJ&FIBRINOLYSIS FUNCTIONAL ACTV NOS EA ANAL||42.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85396|85396 - COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY||23.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85390|85390 - FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR||9.52|30.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85385|85385 - FIBRINOGEN ANTIGEN||15.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85384|85384 - FIBRINOGEN ACTIVITY||15.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85380|85380 - FIBRIN DGRADJ PRODUCTS D-DIMER ULTRASENSITIVE||18.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85379|85379 - FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE||18.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85378|85378 - FIBRIN DGRADJ PRODUCTS D-DIMER QUAL/SEMIQUAN||13.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85370|85370 - FIBRIN DGRADJ SPLT PRODUCTS QUANTITATIVE||20.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85366|85366 - FIBRIN DGRADJ SPLT PRODUXS PARACOAGJ||15.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85362|85362 - FIBRIN DGRADJ SPLT PRODUXS AGGLUJ SLIDE SEMIQUAN||12.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85360|85360 - EUGLOBULIN LYSIS||15.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85348|85348 - COAGULATION TIME OTHER METHODS||6.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85347|85347 - COAGULATION TIME ACTIVATED||7.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85345|85345 - COAGULATION TIME LEE AND WHITE||6.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85337|85337 - THROMBOMODULIN||19.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85335|85335 - FACTOR INHIBITOR TEST||23.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85307|85307 - ACTIVATED PROTEIN C APC RESISTANCE ASSAY||28.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85306|85306 - CLOTTING INHIBITORS PROTEIN S FREE||28.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85305|85305 - CLOTTING INHIBITORS PROTEIN S TOTAL||21.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85303|85303 - CLOTTING INHIBITORS PROTEIN C ACTIVITY||25.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85302|85302 - CLOTTING INHIBITORS PROTEIN C ANTIGEN||22.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85301|85301 - CLOTTING INHIBITRS ANTITHROMBN III ANTIGEN ASSAY||19.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85300|85300 - CLOTTING INHIBITORS ANTITHROMBIN III ACTIVITY||21.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85293|85293 - CLOTTING HI MOLEC WEIGHT KININOGEN ASSAY||34.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85292|85292 - CLOTTING PREKALLIKREIN ASSAY FLETCHER FACT ASSAY||34.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85291|85291 - CLOTTING FACTOR XIII FIBRN STABILIZ SCREEN SOLUB||16.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85290|85290 - CLOTTING FACTOR XIII FIBRIN STABILIZING||30.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85280|85280 - CLOTTING FACTOR XII HAGEMAN||35.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85270|85270 - CLOTTING FACTOR XI PTA||32.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85260|85260 - CLOTTING FACTOR X STUART-PROWER||32.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85250|85250 - CLOTTING FACTOR IX PTC/CHRISTMAS||35.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85247|85247 - CLOTTING FACTOR VIII MULTIMETRIC ANALYSIS||42.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85246|85246 - CLOTTING FACTOR VIII VW FACTOR ANTIGEN||42.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85245|85245 - CLOTTING FACTOR VIII VW FACTOR RISTOCETIN COFACT||42.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85244|85244 - CLOTTING FACTOR VIII RELATED ANTIGEN||37.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85240|85240 - CLOTTING FACTOR VIII AHG 1 STAGE||32.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85230|85230 - CLOTTING FACTOR VII PROCONVERTIN STABLE FACTOR||32.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85220|85220 - CLOTTING FACTOR V ACG/PROACCELERIN LABILE FACTOR||32.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85210|85210 - CLOTTING FACTOR II PROTHROMBIN SPECIFIC||23.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85175|85175 - CLOT LYSIS TIME WHOLE BLOOD DILUTION||8.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85170|85170 - BLOOD CLOT RETRACTION||6.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85130|85130 - CHROMOGENIC SUBSTRATE ASSAY||21.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85097|85097 - BONE MARROW SMEAR INTERPRETATION||58.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85060|85060 - BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT||29.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85055|85055 - RETICULATED PLATELET ASSAY||48.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85049|85049 - BLOOD COUNT PLATELET AUTOMATED||8.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85048|85048 - BLOOD COUNT LEUKOCYTE WBC AUTOMATED||4.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85046|85046 - BLOOD COUNT RETICULOCYTES AUTO 1/> CELL MEAS||10.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85045|85045 - BLOOD COUNT RETICULOCYTE AUTOMATED||7.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85044|85044 - BLOOD COUNT RETICULOCYTE AUTOMATED||7.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85041|85041 - BLOOD COUNT RED BLOOD CELL AUTOMATED||5.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85032|85032 - BLOOD COUNT MANUAL CELL COUNT EACH||7.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85027|85027 - BLOOD COUNT COMPLETE AUTOMATED||11.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85025|85025 - BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC||14.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85018|85018 - BLOOD COUNT HEMOGLOBIN||4.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85014|85014 - BLOOD COUNT HEMATOCRIT||4.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85013|85013 - BLOOD COUNT SPUN MICROHEMATOCRIT||4.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85009|85009 - BLOOD COUNT MANUAL DIFRNTL WBC COUNT BUFFY COAT||6.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85008|85008 - BLD COUNT SMEAR MCRSCP W/O MNL DIFRNTL WBC COUNT||6.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85007|85007 - BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT||6.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85004|85004 - BLOOD COUNT AUTOMATED DIFFERENTIAL WBC COUNT||11.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|85002|85002 - BLEEDING TIME TEST||8.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84830|84830 - OVULATION TEST VISUAL COLOR COMPARISON HLH||18.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84704|84704 - GONADOTROPIN CHORIONIC HCG FREE BETA CHAIN||11.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84703|84703 - GONADOTROPIN CHORIONIC QUALITATIVE||11.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84702|84702 - GONADOTROPIN CHORIONIC QUANTITATIVE||11.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84681|84681 - ASSAY OF C-PEPTIDE||29.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84630|84630 - ASSAY OF ZINC||20.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84620|84620 - XYLOSE ABSORPTION TEST BLOOD &/URINE||21.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84600|84600 - ASSAY OF VOLATILES||29.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84597|84597 - ASSAY OF VITAMIN K||25.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84591|84591 - ASSAY OF VITAMIN NOT OTHERWISE SPECIFIED||21.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84590|84590 - ASSAY OF VITAMIN A||21.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84588|84588 - ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE||62.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84586|84586 - ASSAY OF VASOACTIVE INTESTINAL PEPTIDE||65.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84585|84585 - ASSAY OF VANILLYLMANDELIC ACID URINE||28.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84583|84583 - ASSAY OF UROBILINOGEN URINE SEMIQUANTITATIVE||9.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84580|84580 - UROBILINOGEN URINE QUANTITATIVE TIMED SPECIMEN||13.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84578|84578 - ASSAY OF UROBILINOGEN URINE QUALITATIVE||5.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84577|84577 - ASSAY OF UROBILINOGEN FECES QUANTITATIVE||12.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84560|84560 - ASSAY OF URIC ACID OTHER SOURCE||8.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84550|84550 - ASSAY OF BLOOD/URIC ACID||8.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84545|84545 - UREA NITROGEN CLEARANCE||12.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84540|84540 - ASSAY OF UREA NITROGEN URINE||8.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84525|84525 - ASSAY OF UREA NITROGEN SEMIQUANTITATIVE||4.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84520|84520 - ASSAY OF UREA NITROGEN QUANTITATIVE||7.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84512|84512 - ASSAY OF TROPONIN QUALITATIVE||13.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84510|84510 - ASSAY OF TYROSINE||19.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84490|84490 - TRYPSIN FECES QUANTITATIVE 24-HR COLLECTION||14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84488|84488 - ASSAY OF TRYPSIN FECES QUALITATIVE||13.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84485|84485 - ASSAY OF TRYPSIN DUODENAL FLUID||13.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84484|84484 - ASSAY OF TROPONIN QUANTITATIVE||18.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84482|84482 - TRIIODOTHYRONINE T3 REVERSE||29.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84481|84481 - ASSAY OF TRIIODOTHYRONINE T3 FREE||31.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84480|84480 - ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3||23.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84479|84479 - THYROID HORM UPTK/THYROID HORMONE BINDING RATIO||11.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84478|84478 - ASSAY OF TRIGLYCERIDES||10.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84466|84466 - ASSAY OF L7383TRANSFERRIN||23.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84460|84460 - TRANSFERASE ALANINE AMINO ALT SGPT||9.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84450|84450 - TRANSFERASE ASPARTATE AMINO AST SGOT||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84449|84449 - ASSAY OF TRANSCORTIN CORTISOL BINDING GLOBULIN||33.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84446|84446 - ASSAY OF TOCOPHEROL ALPHA VITAMIN E||26.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84445|84445 - THYROID STIMULATING IMMUNE GLOBULINS TSI||15.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84443|84443 - ASSAY OF THYROID STIMULATING HORMONE TSH||30.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84442|84442 - ASSAY OF THYROXINE BINDING GLOBULIN||21.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84439|84439 - ASSAY OF FREE THYROXINE||16.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84437|84437 - ASSAY OF THYROXINE REQUIRING ELUTION||11.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84436|84436 - ASSAY OF THYROXINE TOTAL||12.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84432|84432 - ASSAY OF THYROGLOBULIN||29.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84431|84431 - THROMBOXANE METABOLITE W/WO THROMBOXANE URINE||30.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84430|84430 - ASSAY OF THIOCYANATE||10.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84425|84425 - ASSAY OF THIAMINE-VITAMIN B-1||39.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84403|84403 - ASSAY OF TESTOSTERONE TOTAL||47.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84402|84402 - ASSAY OF TESTOSTERONE FREE||46.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84392|84392 - ASSAY OF SULFATE URINE||8.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84379|84379 - SUGARS MONO DI&OLIGOS MLT QUANTITATIVE EA SPEC||21.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84378|84378 - SUGARS MONO DI&OLIGOS 1 QUANTITATIVE EACH SPEC||21.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84377|84377 - SUGARS MONO DI&OLIGOS MLT QUALITATIVE EACH SPE||10.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84376|84376 - SUGARS MONO DI&OLIGOS 1 QUALITATAIVE EACH SPEC||10.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84375|84375 - SUGARS CHROMATOGRAPHIC TLC/PAPER CHROMATOGRAPHY||36.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84315|84315 - SPECIFIC GRAVITY EXCEPT URINE||4.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84311|84311 - SPECTROPHOTOMETRY ANALYT NOT ELSEWHERE SPECIFIED||12.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84307|84307 - ASSAY OF SOMATOSTATIN||33.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84305|84305 - ASSAY OF SOMATOMEDIN||39.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84302|84302 - ASSAY OF SODIUM OTHER SOURCE||6.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84300|84300 - ASSAY OF URINE SODIUM||6.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84295|84295 - SODIUM SERUM PLASMA OR WHOLE BLOOD||8.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84285|84285 - ASSAY OF SILICA||43.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84275|84275 - ASSAY OF SIALIC ACID||24.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84270|84270 - ASSAY OF SEX HORMONE BINDING GLOBULIN||40.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84260|84260 - ASSAY OF SEROTONIN||57.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84255|84255 - ASSAY OF SELENIUM||47.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84252|84252 - ASSAY OF RIBOFLAVIN-VITAMIN B-2||37.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84244|84244 - ASSAY OF RENIN||40.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84238|84238 - RECEPTOR ASSAY NON-ENDOCRINE SPECIFY RECEPTOR||67.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84235|84235 - RECEPTOR ASSAY ENDOCRINE OTH/THN ESTRGN/PROGST||96.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84234|84234 - ASSAY OF RECEPTOR ASSAY PROGESTERONE||119.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84233|84233 - ASSAY OF RECEPTOR ASSAY ESTROGEN||118.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84228|84228 - ASSAY OF QUININE||21.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84220|84220 - ASSAY OF PYRUVATE KINASE||17.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84210|84210 - ASSAY OF PYRUVATE||19.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84207|84207 - ASSAY OF PYRIDOXAL PHOSPHATE||51.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84206|84206 - ASSAY OF PROINSULIN||32.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84203|84203 - PROTOPORPHYRIN RBC SCREEN||15.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84202|84202 - PROTOPORPHYRIN RBC QUANTITATIVE||26.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84182|84182 - PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL||33.14|28.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84181|84181 - PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID||31.36|30.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84166|84166 - PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI||32.84|30.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84165|84165 - PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM||19.77|30.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84163|84163 - PREGNANCY-ASSOCIATED PLASMA PROTEIN-A||11.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84160|84160 - PROTEIN TOTAL REFRACTOMETRY ANY SRC||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84157|84157 - PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC||6.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84156|84156 - PROTEIN TOTAL XCPT REFRACTOMETRY URINE||6.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84155|84155 - PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD||6.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84154|84154 - ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE||33.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84153|84153 - ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL||33.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84152|84152 - ASSAY OF PROSTATE SPECIFIC ANTIGEN COMPLEXED||33.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84150|84150 - ASSAY OF PROSTAGLNDIN EACH||45.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84146|84146 - ASSAY OF PROLACTIN||35.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84145|84145 - PROCALCITONIN (PCT)||49.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84144|84144 - ASSAY OF PROGESTERONE||37.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84143|84143 - 17-HYDROXYPREGNENOLONE||42.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84140|84140 - PREGNENOLONE||38.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84138|84138 - PREGNANETRIOL||34.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84135|84135 - PREGNANEDIOL||35.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84134|84134 - PREALBUMIN||26.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84133|84133 - POTASSIUM URINE||7.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84132|84132 - POTASSIUM SERUM PLASMA/WHOLE BLOOD||8.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84127|84127 - ASSAY OF FECES PORPHYRINS||21.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84126|84126 - PORPHYRINS FECES QUANTITATIVE||46.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84120|84120 - PORPHYRINS URINE QUANTITATION & FRACTIONATION||27.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84119|84119 - PORPHYRINS URINE QUALITATAIVE||15.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84112|84112 - EVAL C/V AMNIOTIC FLUID PROTEIN QUAL EA SPECIMEN||118.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84110|84110 - ASSAY OF PORPHOBILINOGEN URINE QUANTITATIVE||15.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84106|84106 - PORPHOBILINOGEN URINE QUALITATIVE||7.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84105|84105 - ASSAY OF PHOSPHORUS INORGANIC URINE||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84100|84100 - ASSAY OF PHOSPHORUS INORGANIC||8.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84087|84087 - ASSAY OF PHOSPHOHEXOSE ISOMERASE||19.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84085|84085 - PHOSPHOGLUCONATE 6-DEHYD RBC||12.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84081|84081 - PHOSPHATIDYLGLYCEROL||30.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84080|84080 - ASSAY OF PHOSPHATASE ALKALINE ISOENZYMES||27.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84078|84078 - ASSAY OF PHOSPHATASE ALKALINE HEAT STABLE||13.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84075|84075 - ASSAY OF PHOSPHATASE ALKALINE||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84066|84066 - ASSAY OF PHOSPHATASE ACID PROSTATIC||17.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84061|84061 - PHOSPHATASE ACID FORENSIC EXAMINATION||14.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84060|84060 - ASSAY OF PHOSPHATASE ACID TOTAL||13.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84035|84035 - ASSAY OF PHENYLKETONES QUALITATIVE||6.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84030|84030 - ASSAY OF PHENYLALANINE BLOOD||10.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|84022|84022 - ASSAY OF PHENOTHIAZINE||28.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83993|83993 - ASSAY OF CALPROTECTIN FECAL||36.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83992|83992 - ASSAY OF PHENCYCLIDINE||27.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83987|83987 - PH EXHALED BREATH CONDENSATE||29.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83986|83986 - PH BODY FLUID NOT ELSEWHERE SPECIFIED||6.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83970|83970 - ASSAY OF PARATHORMONE||76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83951|83951 - ONCOPROTEIN DES-GAMMA-CARBOXY-PROTHROMBIN DCP||118.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83950|83950 - ONCOPROTEIN HER-2/NEU||118.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83945|83945 - ASSAY OF OXALATE||23.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83937|83937 - ASSAY OF OSTEOCALCIN||54.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83935|83935 - ASSAY OF OSMOLALITY URINE||12.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83930|83930 - ASSAY OF OSMOLALITY BLOOD||12.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83925|83925 - ASSAY OF OPIATES||35.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83921|83921 - ORGANIC ACID 1 QUANTITATIVE||30.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83919|83919 - ORGANIC ACIDS QUALITATIVE EACH SPECIMEN||30.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83918|83918 - ORGANIC ACIDS TOTAL QUANTITATIVE EACH SPECIMEN||30.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83916|83916 - OLIGOCLONAL IMMUNE||37.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83915|83915 - ASSAY OF NUCLEOTIDASE 5'-||20.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83912|83912 - GENETIC EXAMINATION||0|29.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83887|83887 - ASSAY OF NICOTINE||43.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83885|83885 - ASSAY OF NICKEL||45.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83883|83883 - ASSAY OF NEPHELOMETRY EACH ANALYTE NES||25.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83880|83880 - NATRIURETIC PEPTIDE||62.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83876|83876 - MYELOPEROXIDASE MPO||62.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83874|83874 - MYOGLOBIN||23.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83873|83873 - MYELIN BASIC PROTEIN CEREBROSPINAL FLUID||31.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83872|83872 - MUCIN SYNOVIAL FLUID ROPES TEST||10.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83866|83866 - MUCOPOLYSACCHARIDES SCREEN||18.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83864|83864 - MUCOPOLYSACCHARIDES ACID QUANTITATIVE||36.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83861|83861 - MICROFLUIDIC ANALYSIS TEAR OSMOLARITY||30.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83858|83858 - ASSAY OF METHSUXIMIDE||27.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83857|83857 - METHEMALBUMIN||19.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83840|83840 - ASSAY OF METHADONE||30.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83835|83835 - METANEPHRINES||31.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83825|83825 - ASSAY OF MERCURY QUANTITATIVE||29.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83805|83805 - ASSAY OF MEPROBAMATE||32.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83789|83789 - MASS SPECT&TANDEM MASS SPECT NONDRG ANAL NES EA||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83788|83788 - MASS SPECTROMETRY QUAL||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83785|83785 - ASSAY OF MANGANESE||45.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83775|83775 - ASSAY OF MALATE DEHYDROGENASE||13.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83735|83735 - ASSAY OF MAGNESIUM||12.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83727|83727 - LUTEINIZING RELEASING FACTOR||31.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83722|83722 - DIR MEAS LIPOPROTEIN SMALL DENSE LDL CHOLESTEROL||57.85||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83721|83721 - LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL||17.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83719|83719 - LIPOPROTEIN DIRECT MEASUREMENT VLDL CHOLESTEROL||21.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83718|83718 - LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL||15.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83704|83704 - LIPOPROTEIN BLOOD QUAN NUMBERS & SUBCLASSES||58.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83701|83701 - LIPOPROTEIN BLOOD HIGH RESOLTJ&QUANTJ SUBCLASS||45.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83700|83700 - LIPOPROTEIN BLOOD ELECTROPHORECTIC SEP&QUAN||16.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83698|83698 - LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2||62.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83695|83695 - LIPOPROTEIN (A)||23.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83690|83690 - ASSAY OF LIPASE||12.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83670|83670 - LEUCINE AMINOPEPTIDASE LAP||16.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83664|83664 - FETAL LUNG MATURITY LAMELLAR BODY DENSITY||34.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83663|83663 - FETAL LUNG MATURITY FLUORESCENCE POLARIZATION||34.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83662|83662 - FETAL LUNG MATURITY FOAM STABILITY TEST||34.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83661|83661 - FETAL LUNG MATURITY LECITHIN SPHINGOMYELIN RATIO||40.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83655|83655 - ASSAY OF LEAD||22.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83634|83634 - ASSAY OF URINE FOR LACTOSE||21.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83633|83633 - LACTOSE URINE QUALITATIVE||10.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83632|83632 - LACTOGEN HPL HUMAN CHORIONIC SOMATOMAMMOTROPIN||37.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83631|83631 - LACTOFERRIN FECAL QUANTITATIVE||36.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83630|83630 - LACTOFERRIN FECAL QUALITATIVE||36.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83625|83625 - LACTATE DEHYDROGENASE ISOENZYMES SEP&QUAN||21.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83615|83615 - LACTATE DEHYDROGENASE LDH||11.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83605|83605 - ASSAY OF LACTATE||19.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83593|83593 - KETOSTEROIDS 17- FRACTIONATION||48.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83586|83586 - ASSAY OF KETOSTEROIDS 17- TOTAL||23.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83582|83582 - ASSAY OF KETOGENIC STEROIDS FRACTIONATION||26.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83570|83570 - ISOCITRIC DEHYDROGENASE||16.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83550|83550 - IRON BINDING CAPACITY||16.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83540|83540 - ASSAY OF IRON||11.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83528|83528 - ASSAY OF INTRINSIC FACTOR||29.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83527|83527 - ASSAY OF INSULIN FREE||23.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83525|83525 - ASSAY OF INSULIN TOTAL||21.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83520|83520 - IMMUNOASSAY ANALYTE QUANTITATIVE NOS||23.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83519|83519 - IMMUNOASSAY ANALYTE QUANT RADIOIMMUNOASSAY||24.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83518|83518 - IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP||15.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83516|83516 - IMMUNOASSAY ANALYTE QUAL/SEMIQUAL MULTIPLE STEP||19.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83505|83505 - ASSAY OF HYDROXYPROLINE TOTAL||44.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83500|83500 - ASSAY OF HYDROXYPROLINE FREE||41.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83499|83499 - ASSAY OF HYDROXYPROGESTERONE 20-||46.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83498|83498 - ASSAY OF HYDROXYPROGESTERONE 17-D||50.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83497|83497 - ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA||23.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83491|83491 - HYDROXYCORTICOSTEROIDS 17||32.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83150|83150 - ASSAY OF HOMOVANILLIC ACID||35.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83090|83090 - ASSAY OF HOMOCYSTEINE||31.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83088|83088 - ASSAY OF HISTAMINE||54.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83080|83080 - ASSAY OF B-HEXOSAMINIDASE EACH ASSAY||31.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83071|83071 - ASSAY OF HEMOSIDERIN QUANT||12.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83070|83070 - ASSAY OF HEMOSIDERIN QUALITATIVE||8.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83069|83069 - ASSAY OF HEMOGLOBIN URINE||7.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83068|83068 - HEMOGLOBIN UNSTABLE SCREEN||15.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83065|83065 - HEMOGLOBIN THERMOLABILE||12.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83060|83060 - HEMOGLOBIN SULFHEMOGLOBIN QUANTITATIVE||15.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83055|83055 - BLOOD SULFHEMOGLOBIN TEST||4.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83051|83051 - ASSAY OF HEMOGLOBIN PLASMA||13.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83050|83050 - HEMOGLOBIN METHEMOGLOBIN QUANTITATIVE||13.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83045|83045 - HEMOGLOBIN METHEMOGLOBIN QUALITATIVE||7.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83037|83037 - HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE||17.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83036|83036 - HEMOGLOBIN GLYCOSYLATED A1C||17.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83033|83033 - HEMOGLOBIN F FETAL QUALITATIVE||10.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83030|83030 - HEMOGLOBIN F FETAL CHEMICAL||15.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83026|83026 - HEMOGLOBIN COPPER SULFATE METHOD NON-AUTOMATED||4.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83021|83021 - HEMOGLOBIN FRACTJ/QUANTJ CHROMOTOGRAPHY||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83020|83020 - HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS||18.01|30.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83018|83018 - HEAVY METAL QUANTIATIVE EACH NES||40.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83015|83015 - HEAVY METAL QUALITATIVE ANY ANALYTES||34.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83014|83014 - HPYLORI DRUG ADMINISTRATION||14.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83013|83013 - HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE||124.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83012|83012 - ASSAY OF HAPTOGLOBIN PHENOTYPES||31.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83010|83010 - ASSAY OF HAPTOGLOBIN QUANTITATIVE||6.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83009|83009 - HPYLORI BLOOD ANAL UREASE ACT NON-RADACT ISOTOPE||24.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83008|83008 - ASSAY OF GUANOSINE||30.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83003|83003 - ASSAY OF GROWTH HORMONE HUMAN||26.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83002|83002 - GONADOTROPIN LUTEINIZING HORMONE||34.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|83001|83001 - GONADOTROPIN FOLLICLE STIMULATING HORMONE||34.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82985|82985 - ASSAY OF GLYCATED PROTEIN||27.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82980|82980 - ASSAY OF GLUTETHIMIDE||33.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82979|82979 - ASSAY OF GLUTATHIONE REDUCTASE RBC||12.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82978|82978 - ASSAY OF GLUTATHIONE||26.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82977|82977 - ASSAY OF GLUTAMYLTRASE GAMMA||13.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82975|82975 - ASSAY OF GLUTAMINE||29.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82965|82965 - ASSAY OF GLUTAMATE DEHYDROGENASE||14.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82963|82963 - ASSAY OF GLUCOSIDASE BETA||39.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82962|82962 - GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE||4.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82960|82960 - GLUC-6-PHOSPHATE DEHYDROGENASE SCREEN||11.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82955|82955 - GLUC-6-PHOSPHATE DEHYDROGENASE QUANTITATIVE||14.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82953|82953 - GLUCOSE-TOLBUTAMIDE TEST||27.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82952|82952 - GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS||7.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82951|82951 - GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS||23.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82950|82950 - GLUCOSE POST GLUCOSE DOSE||8.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82948|82948 - GLUCOSE BLOOD REAGENT STRIP||5.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82947|82947 - GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP||7.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82946|82946 - GLUCOSE TOLERANCE TEST||27.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82945|82945 - GLUCOSE BODY FLUID OTHER THAN BLOOD||7.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82943|82943 - ASSAY OF GLUCAGON||26.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82941|82941 - ASSAY OF GASTRIN||32.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82938|82938 - GASTRIN AFTER SECRETIN STIMULATION||32.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82930|82930 - GASTRIC ACID ANALYIS W/PH EACH SPECIMEN||10.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82820|82820 - HGB-O2 AFFINITY PO2 50% SATURATION OXYGEN||18.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82810|82810 - GASES BLOOD O2 SATURATION ONLY DIRECT MEAS||16.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82805|82805 - GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY||52.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82803|82803 - BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3||35.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82800|82800 - GASES BLOOD PH ONLY||15.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82787|82787 - GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES||14.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82785|82785 - ASSAY OF GAMMAGLOBULIN IGE||30.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82784|82784 - ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH||17.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82777|82777 - GALECTIN-3||23.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82776|82776 - GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE SCREEN||15.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82775|82775 - GALACTOSE-1-PHOSPHATE URIDYL TRANSFERASE QUAN||38.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82760|82760 - ASSAY OF GALACTOSE||20.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82759|82759 - ASSAY OF GALACTOKINASE RBC||39.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82757|82757 - ASSAY OF FRUCTOSE SEMEN||31.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82747|82747 - ASSAY OF FOLIC ACID RBC||31.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82746|82746 - ASSAY OF FOLIC ACID SERUM||27.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82742|82742 - ASSAY OF FLURAZEPAM||36.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82735|82735 - ASSAY OF FLUORIDE||34.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82731|82731 - FTL FIBRONECTIN CERVICOVAG SECRETIONS SEMI-QUAN||118.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82728|82728 - ASSAY OF FERRITIN||25.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82726|82726 - VERY LONG CHAIN FATTY ACIDS||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82725|82725 - FATTY ACIDS NONESTERIFIED||24.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82715|82715 - FAT DIFFIAL FECES QUANTITATIVE||31.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82710|82710 - FAT/LIPIDS FECES QUANTITATIVE||30.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82705|82705 - FAT/LIPIDS FECES QUALITATIVE||9.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82696|82696 - ASSAY OF ETIOCHOLANOLONE||43.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82693|82693 - ASSAY OF ETHYLENE GLYCOL||27.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82690|82690 - ASSAY OF ETHCHLORVYNOL||31.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82679|82679 - ASSAY OF ESTRONE||45.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82677|82677 - ASSAY OF ESTRIOL||44.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82672|82672 - ASSAY OF ESTROGENS TOTAL||30.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82671|82671 - ASSAY OF ESTROGENS FRACTIONATED||59.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82670|82670 - ASSAY OF ESTRADIOL||51.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82668|82668 - ASSAY OF ERYTHROPOIETIN||34.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82666|82666 - ASSAY OF EPIANDROSTERONE||39.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82664|82664 - ELCTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED||63.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82658|82658 - NZYM ACTV BLOOD CELLS/TISS RADACT SUBSTRATE EA||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82657|82657 - NZYM ACTIV BLD CELLS/TISS NONRADACT SUBSTRATE EA||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82656|82656 - ELASTASE PANCREATIC FECAL QUAL/SEMI-QUAN||19.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82654|82654 - ASSAY OF DIMETHADIONE||25.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82652|82652 - 1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED||70.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82651|82651 - ASSAY OF DIHYDROTESTOSTERONE||47.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82649|82649 - ASSAY OF DIHYDROMORPHINONE||47.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82646|82646 - ASSAY OF DIHYDROCODEINONE||38.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82642|82642 - DIHYDROTESTOSTERONE (DHT)||53.67||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82638|82638 - ASSAY OF DIBUCAINE NUMBER||22.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82634|82634 - DEOXYCORTISOL 11-||53.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82633|82633 - DESOXYCORTICOSTERONE 11-||57.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82627|82627 - DEHYDROEPIANDROSTERONE-SULFATE||40.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82626|82626 - DEHYDROEPIANDROSTERONE||46.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82615|82615 - CSTINE&HOMOCSTINE URINE QUALITATIVE||15.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82610|82610 - CYSTATIN C||25.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82608|82608 - CYANOCOBALAMIN VIT B-12 UNSAT BINDING CAPACITY||26.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82607|82607 - CYANOCOBALAMIN VITAMIN B-12||27.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82600|82600 - ASSAY OF CYANIDE||35.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82595|82595 - CRYOGLOBULIN QUALITATIVE/SEMI-QUANTITATIVE||11.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82585|82585 - ASSAY OF CRYOFIBRN||15.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82575|82575 - CREATININE CLEARANCE||17.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82570|82570 - CREATININE OTHER SOURCE||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82565|82565 - CREATININE BLOOD||9.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82554|82554 - CREATINE KINASE ISOFORMS||21.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82553|82553 - CREATINE KINASE MB FRACTION ONLY||21.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82552|82552 - CREATINE KINASE ISOENZYMES||24.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82550|82550 - CREATINE KINASE TOTAL||12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82544|82544 - COLUMN CHROMOTOGRAPH/ISOTOPE||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82543|82543 - COLUMN CHROMOTOGRAPH/ISOTOPE||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82542|82542 - COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82541|82541 - COLUMN CHROMOTOGRAPHY QUAL||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82540|82540 - ASSAY OF CREATINE||8.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82533|82533 - CORTISOL TOTAL||30.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82530|82530 - CORTISOL FREE||30.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82528|82528 - CORTICOSTERONE||41.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82525|82525 - ASSAY OF COPPER||22.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82523|82523 - COLLAGEN CROSS LINKS ANY METHOD||34.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82520|82520 - ASSAY OF COCAINE||17.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82507|82507 - ASSAY OF CITRATE||51.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82495|82495 - ASSAY OF CHROMIUM||37.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82492|82492 - CHROMOTOGRAPHY QUANT MULT||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82491|82491 - CHROMOTOGRAPHY QUANT SING||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82489|82489 - THIN LAYER CHROMATOGRAPHY||34.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82488|82488 - PAPER CHROMATOGRAPHY||39.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82487|82487 - PAPER CHROMATOGRAPHY||29.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82486|82486 - GAS/LIQUID CHROMATOGRAPHY||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82485|82485 - CHONDROITIN B SULFATE QUANTITATIVE||38.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82482|82482 - CHOLINESTERASE RBC||14.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82480|82480 - CHOLINESTERASE SERUM||14.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82465|82465 - CHOLESTEROL SERUM/WHOLE BLOOD TOTAL||8.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82441|82441 - CHLORINATED HYDROCARBONS SCREEN||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82438|82438 - CHLORIDE OTHER SOURCE||9.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82436|82436 - CHLORIDE URINE||9.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82435|82435 - CHLORIDE BLD||8.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82415|82415 - CHLORAMPHENICOL||23.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82397|82397 - CHEMILUMINESCENT ASSAY||26.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82390|82390 - CERULOPLASMIN||19.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82387|82387 - CATHEPSIN-D||38.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82384|82384 - CATECHOLAMINES FRACTIONATED||46.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82383|82383 - CATECHOLAMINES BLOOD||46.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82382|82382 - CATECHOLAMINES TOTAL URINE||31.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82380|82380 - CAROTENE||16.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82379|82379 - CARNITINE QUANTITATIVE EACH SPECIMEN||31.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82378|82378 - CARCINOEMBRYONIC ANTIGEN CEA||34.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82376|82376 - CARBOXYHEMOGLOBIN QUALITATIVE||11.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82375|82375 - CARBOXYHEMOGLOBIN QUANTITATIVE||5.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82374|82374 - CARBON DIOXIDE BICARBONATE||9.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82373|82373 - CARBOHYDRATE DEFICIENT TRANSFERRIN||11.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82370|82370 - CALCULUS XRAY DIFFRACTION||23.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82365|82365 - CALCULUS INFRARED SPECTROSCOPY||23.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82360|82360 - CALCULUS QUANTITATIVE CHEMICAL||23.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82355|82355 - CALCULUS QUALITATIVE ANALYSIS||21.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82340|82340 - CALCIUM URINE QUANTITATIVE TIMED SPECIMEN||11.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82331|82331 - CALCIUM AFTER CALCIUM INFUSION TEST||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82330|82330 - CALCIUM IONIZED||25.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82310|82310 - CALCIUM TOTAL||9.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82308|82308 - CALCITONIN||49.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82306|82306 - 25 HYDROXY INCLUDES FRACTIONS IF PERFORMED||54.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82300|82300 - CADMIUM||42.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82286|82286 - BRADYKININ||12.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82274|82274 - BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3||29.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82272|82272 - BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC||5.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82271|82271 - BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES||5.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82270|82270 - BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER||5.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82261|82261 - BIOTINIDASE EACH SPECIMEN||31.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82252|82252 - BILIRUBIN FECES QUALITATIVE||8.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82248|82248 - BILIRUBIN DIRECT||9.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82247|82247 - BILIRUBIN TOTAL||9.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82240|82240 - BILE ACIDS CHOLYLGLYCINE||48.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82239|82239 - BILE ACIDS TOTAL||31.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82232|82232 - BETA-2 MICROGLOBULIN||29.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82205|82205 - ASSAY OF BARBITURATES||21.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82190|82190 - ATOMIC ABSRPJ SPECTROSCOPY EA ANALYTE||27.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82180|82180 - ASSAY OF ASCORBIC ACID BLOOD||16.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82175|82175 - ASSAY OF ARSENIC||34.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82172|82172 - APOLIPOPROTEIN EACH||28.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82164|82164 - ANGIOTENSIN I-CONVERTING ENZYME||26.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82163|82163 - ANGIOTENSIN II||37.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82160|82160 - ANDROSTERONE||46.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82157|82157 - ANDROSTENEDIONE||53.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82154|82154 - ANDROSTANEDIOL GLUCURONIDE||53.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82150|82150 - ASSAY OF AMYLASE||11.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82145|82145 - ASSAY OF AMPHETAMINES||28.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82143|82143 - AMNIOTIC FLU SCAN||12.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82140|82140 - ASSAY OF AMMONIA||18.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82139|82139 - AMINO ACIDS 6/> AMINO ACIDS QUANTITATIVE EA SPE||31.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82136|82136 - AMINO ACIDS 2-5 AMINO ACIDS QUANTITATIVE EA SPEC||31.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82135|82135 - AMINOLEVULINIC ACID DELTA||30.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82131|82131 - AMINO ACIDS 1 QUANTITATIVE EACH SPECIMEN||31.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82128|82128 - AMINO ACIDS MULTIPLE QUALITATIVE EACH SPECIMEN||25.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82127|82127 - AMINO ACIDS 1 QUALITATIVE EACH SPECIMEN||25.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82120|82120 - AMINES VAGINAL FLUID QUALITATIVE||4.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82108|82108 - ASSAY OF ALUMINUM||31.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82107|82107 - AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO||118.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82106|82106 - ALPHA-FETOPROTEIN AMNIOTIC FLUID||30.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82105|82105 - ALPHA-FETOPROTEIN SERUM||30.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82104|82104 - ALPHA-1-ANTITRYPSIN PHENOTYPE||26.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82103|82103 - ALPHA-1-ANTITRYPSIN TOTAL||24.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82101|82101 - ASSAY OF URINE ALKALOIDS||55.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82088|82088 - ASSAY OF ALDOSTERONE||75.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82085|82085 - ASSAY OF ALDOLASE||17.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82075|82075 - ASSAY OF ALCOHOL BREATH||22.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82055|82055 - ASSAY OF ETHANOL||19.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82045|82045 - ALBUMIN ISCHEMIA MODIFIED||62.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82044|82044 - URINE ALBUMIN SEMIQUANTITATIVE||8.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82043|82043 - URINE ALBUMIN QUANTITATIVE||10.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82042|82042 - OTHER SOURCE ALBUMIN QUANTITATIVE EACH SPECIMEN||9.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82040|82040 - ALBUMIN SERUM PLASMA/WHOLE BLOOD||5.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82030|82030 - ADENOSINE 5-MONOPHOSPHATE CYCLIC||47.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82024|82024 - ADRENOCORTICOTROPIC HORMONE ACTH||71.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82017|82017 - ACYLCARNITINES QUANTIATIVE EACH SPECIMEN||31.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82016|82016 - ACYLCARNITINES QUALITATIVE EACH SPECIMEN||25.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82013|82013 - ASSAY OF ACETYLCHOLINESTERASE||20.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82010|82010 - KETONE BODIES SERUM QUANTITATIVE||15.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82009|82009 - KETONE BODIES SERUM QUALITATIVE||6.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82003|82003 - ASSAY OF ACETAMINOPHEN||37.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|82000|82000 - ASSAY OF BLOOD ACETALDEHYDE||22.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81596|81596 - NFCT DS CHRNC HCV 6 BIOCHEM ASSAY SRM ALG LVR||119.11||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81522|81522 - ONCOLOGY BREAST MRNA GENE XPRSN PRFL 12 GENES||6390.45||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81518|81518 - ONCOLOGY BREAST MRNA GENE EXPRESSION 11 GENES||6390.45||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81443|81443 - GENETIC TESTING FOR SEVERE INHERITED CONDITIONS||4040.12||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81345|81345 - TERT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS||305.58||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81344|81344 - TBP GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81343|81343 - PPP2R2B GENE ANALYSIS EVAL DETC ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81337|81337 - SMN1 GENE ANALYSIS KNOWN FAMILIAL SEQ VARIANTS||305.58||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81336|81336 - SMN1 GENE ANALYSIS FULL GENE SEQUENCE||497.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81333|81333 - TGFBI GENE ANALYSIS COMMON VARIANTS||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81329|81329 - SMN1 GENE ANALYSIS DOSAGE/DELET ALYS W/SMN2 ALYS||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81322|81322 - PTEN GENE ANALYSIS KNOWN FAMILIAL VARIANT||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81321|81321 - PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81320|81320 - PLCG2 GENE ANALYSIS COMMON VARIANTS||480.74||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81312|81312 - PABPN1 GENE ANALYSIS EVAL DETC ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81309|81309 - PIK3CA GENE ANALYSIS TARGETED SEQUENCE ANALYSIS||453.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81308|81308 - PALB2 GENE ANALYSIS KNOWN FAMILIAL VARIANT||497.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81307|81307 - PALB2 GENE ANALYSIS FULL GENE SEQUENCE||466.75||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81306|81306 - NUDT15 GENE ANALYSIS COMMON VARIANTS||480.74||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81305|81305 - MYD88 GENE ANALYSIS P.LEU265 (L265P) VARIANT||289.41||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81289|81289 - FXN GENE ANALYSIS KNOWN FAMILIAL VARIANTS||305.58||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81286|81286 - FXN GENE ANALYSIS FULL GENE SEQUENCE||453.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81285|81285 - FXN GENE ANALYSIS CHARACTERIZATION ALLELES||453.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81284|81284 - FXN GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81277|81277 - CYTOGENOMIC NEOPLASIA MIRCROARRAY ANALYSIS||1914||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81274|81274 - HTT GENE ANALYSIS CHARACTERIZATION ALLELES||453.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81271|81271 - HTT GENE ANALYSIS DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81254|81254 - GJB6 GENE ANALYSIS COMMON VARIANTS||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81253|81253 - GJB2 GENE ANALYSIS KNOWN FAMILIAL VARIANTS||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81252|81252 - GJB2 GENE ANALYSIS FULL GENE SEQUENCE||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81239|81239 - DMPK GENE ANALYSIS CHARACTERIZATION OF ALLELES||453.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81237|81237 - EZH2 GENE ANALYSIS COMMON VARIANTS||289.41||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81236|81236 - EZH2 GENE ANALYSIS FULL GENE SEQUENCE||466.75||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81235|81235 - EGFR GENE ANALYSIS COMMON VARIANTS||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81234|81234 - DMPK GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81233|81233 - BTK GENE ANALYSIS COMMON VARIANTS||289.41||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81204|81204 - AR GENE ANALYSIS CHARACTERIZATION OF ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81203|81203 - APC GENE ANALYSIS DUPLICATION/DELETION VARIANTS||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81202|81202 - APC GENE ANALYSIS KNOWN FAMILIAL VARIANTS||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81201|81201 - APC GENE ANALYSIS FULL GENE SEQUENCE||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81200|81200 - ASPA GENE ANALYSIS COMMON VARIANTS||159.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81190|81190 - CSTB GENE ANALYSIS KNOWN FAMILIAL VARIANTS||305.58||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81189|81189 - CSTB GENE ANALYSIS FULL GENE SEQUENCE||453.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81188|81188 - CSTB GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81187|81187 - CNBP GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81186|81186 - CACNA1A GENE ANALYSIS KNOWN FAMILIAL VARIANT||305.58||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81185|81185 - CACNA1A GENE ANALYSIS FULL GENE SEQUENCE||1396.35||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81184|81184 - CACNA1A GENE ANALYSIS EVAL DETECT ABNOR ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81183|81183 - ATXN10 GENE ANALYSIS EVAL DETC ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81182|81182 - ATXN8OS GENE ANALYSIS EVAL DETECT ABNOR ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81181|81181 - ATXN7 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81180|81180 - ATXN3 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81179|81179 - ATXN2 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81178|81178 - ATXN1 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81177|81177 - ATN1 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81174|81174 - AR GENE ANALYSIS KNOWN FAMILIAL VARIANT||305.58||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81173|81173 - AR GENE ANALYSIS FULL GENE SEQUENCE||497.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81172|81172 - AFF2 GENE ANALYSIS CHARACTERIZATION OF ALLELES||453.47||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81171|81171 - AFF2 GENE ANALYSIS EVAL DETECT ABNORMAL ALLELES||226.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81167|81167 - BRCA2 GENE ANALYSIS FULL DUP/DEL ANALYSIS||466.75||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81166|81166 - BRCA1 GENE ANALYSIS FULL DUP/DEL ANALYSIS||497.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81165|81165 - BRCA1 GENE ANALYSIS FULL SEQUENCE ANALYSIS||466.75||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81164|81164 - BRCA1 BRCA2 GENE ANALYSIS FULL DUP/DEL ANALYSIS||963.98||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81163|81163 - BRCA1 BRCA2 GENE ANALYSIS FULL SEQUENCE ANALYSIS||772.2||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81099|81099 - UNLISTED URINALYSIS PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81050|81050 - VOLUME MEASUREMENT TIMED COLLECTION EACH||5.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81025|81025 - URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS||11.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81020|81020 - URINALYSIS 2/3 GLASS TEST||6.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81015|81015 - URINALYSIS MICROSCOPIC ONLY||5.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81007|81007 - URINALYSIS BACTERIURIA SCR XCPT CULTURE/DIPSTICK||4.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81005|81005 - URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS||3.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81003|81003 - URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY||4.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81002|81002 - URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP||4.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81001|81001 - URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY||5.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|81000|81000 - URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY||5.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80502|80502 - CLINICAL PATHOLOGY CONSULTATION COMPREHENSIVE||77.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80500|80500 - CLINICAL PATHOLOGY CONSULTATION LIMITED||22.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80440|80440 - TRH STIMULATION PANEL||107.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80439|80439 - THYROTROPIN RELEASING HORMONE STMLJ PANEL 2 HR||123.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80438|80438 - THYROTROPIN RELEASING HORMONE STMLJ PANEL 1 HR||92.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80436|80436 - METYRAPONE PANEL||167.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80435|80435 - INSULIN TOLERANCE PANEL GROWTH HORM DEFNCY||167.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80434|80434 - INSULIN TOLERANCE PANEL ACTH INSUFFICIENCY||186.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80432|80432 - INSULIN-INDUCED C-PEPTIDE SUPRESSION PANEL||203.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80430|80430 - GROWTH HORMONE SUPRJ PANEL GLUCOSE ADMN||126.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80428|80428 - GROWTH HORMONE STIMULATION PANEL||104.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80426|80426 - GONADOTROPIN RELEASING HORMONE STIMJ PANEL||273.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80424|80424 - GLUCOSE TOLERANCE PANEL PHEOCHROMOCYTOMA||92.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80422|80422 - GLUCOSE TOLERANCE PANEL INSULINOMA||84.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80420|80420 - DEXMETHASONE SUPPRESSION PANEL 48 HR||132.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80418|80418 - COMBINED RAPID ANT PITUITARY EVALUATION PANEL||1049.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80417|80417 - PERIPHERAL VEIN RENIN STIMULATION PANEL||80.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80416|80416 - RENAL VEIN RENIN STIMULATION PANEL||242.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80415|80415 - CHORNC GONAD STIMJ PANEL ESTRADIOL RESPONSE||102.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80414|80414 - CHORNC GONAD STIMJ PANEL TSTOSTERONE RESPONSE||95.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80412|80412 - CORTICOTROPIC RELEASING HORM STIMJ PANEL||606.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80410|80410 - CALCITONIN STIMULATION PANEL||147.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80408|80408 - ALDOSTERONE SUPPRESSION EVALUATION PANEL||231.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80406|80406 - ACTH STIMJ PANEL 3 BETA-HYDROXYDEHYD DEFNCY||144.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80402|80402 - ACTH STIMULATION PANEL 21 HYDROXYLASE DEFICIENCY||160.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80400|80400 - ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY||60.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80299|80299 - QUANTITATION DRUG NOT ELSEWHERE SPECIFIED||22.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80285|80285 - DRUG ASSAY VORICONAZOLE||44.73||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80280|80280 - DRUG ASSAY VEDOLIZUMAB||63.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80235|80235 - DRUG ASSAY LACOSAMIDE||44.73||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80230|80230 - DRUG ASSAY INFLIXIMAB||63.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80202|80202 - DRUG SCREEN QUANTITATIVE VANCOMYCIN||20.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80201|80201 - DRUG SCREEN QUANTITATIVE TOPIRAMATE||21.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80200|80200 - DRUG SCREEN QUANTITATIVE TOBRAMYCIN||27.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80198|80198 - DRUG SCREEN QUANTITATIVE THEOPHYLLINE||26.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80197|80197 - DRUG SCREEN QUANTITATIVE TACROLIMUS||25.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80196|80196 - ASSAY OF SALICYLATE||13.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80195|80195 - DRUG SCREEN QUANTITATIVE SIROLIMUS||25.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80194|80194 - DRUG SCREEN QUANTITATIVE QUINIDINE||26.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80192|80192 - DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE||30.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80190|80190 - DRUG SCREEN QUANTITATIVE PROCAINAMIDE||30.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80188|80188 - DRUG SCREEN QUANTITATIVE PRIMIDONE||30.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80187|80187 - DRUG ASSAY POSACONAZOLE||44.73||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80186|80186 - DRUG SCREEN QUANTITATIVE PHENYTOIN FREE||25.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80185|80185 - DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL||24.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80184|80184 - DRUG SCREEN QUANTITATIVE PHENOBARBITAL||21.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80182|80182 - ASSAY OF NORTRIPTYLINE||20.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80178|80178 - DRUG SCREEN QUANTITATIVE LITHIUM||12.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80176|80176 - DRUG SCREEN QUANTITATIVE LIDOCAINE||27.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80174|80174 - ASSAY OF IMIPRAMINE||31.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80173|80173 - DRUG SCREEN QUANTITATIVE HALOPRIDOL||26.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80172|80172 - ASSAY OF GOLD||26.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80170|80170 - DRUG SCREEN QUANTITATIVE GENTAMICIN||30.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80168|80168 - DRUG SCREEN QUANTITATIVE ETHOSUXIMIDE||30.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80166|80166 - ASSAY OF DOXEPIN||28.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80164|80164 - DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL||20.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80162|80162 - DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL||24.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80160|80160 - ASSAY OF DESIPRAMINE||31.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80158|80158 - DRUG ASSAY CYCLOSPORINE||10.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80157|80157 - DRUG ASSAY CARBAMAZEPINE FREE||24.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80156|80156 - DRUG ASSAY CARBAMAZEPINE TOTAL||26.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80154|80154 - ASSAY OF BENZODIAZEPINES||34.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80152|80152 - ASSAY OF AMITRIPTYLINE||32.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80150|80150 - DRUG SCREEN QUANTITATIVE AMIKACIN||27.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80145|80145 - DRUG ASSAY ADALIMUMAB||63.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80104|80104 - DRUG SCRN 1+ CLASS NONCHROMO||45.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80102|80102 - DRUG CONFIRMATION||24.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80101|80101 - DRUG SCREEN SINGLE||35.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80100|80100 - DRUG SCREEN QUALITATE/MULTI||42.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80076|80076 - HEPATIC FUNCTION PANEL||15.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80074|80074 - ACUTE HEPATITIS PANEL||87.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80069|80069 - RENAL FUNCTION PANEL||15.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80061|80061 - LIPID PANEL||24.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80055|80055 - OBSTETRIC PANEL||75.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80053|80053 - COMPREHENSIVE METABOLIC PANEL||19.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80051|80051 - ELECTROLYTE PANEL||12.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80050|80050 - GENERAL HEALTH PANEL||52.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80048|80048 - BASIC METABOLIC PANEL CALCIUM TOTAL||15.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|80047|80047 - BASIC METABOLIC PANEL CALCIUM IONIZED||15.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|79999|79999 - RP THERAPY UNLISTED PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|79445|79445 - RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN||318.8|186.57||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|79440|79440 - RP THERAPY INTRA-ARTICULAR ADMINISTRATION||243.5|158.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|79403|79403 - RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS||299.08|172.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|79300|79300 - RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN||205.13|133.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|79200|79200 - RP THERAPY INRACAVITARY ADMINISTRATION||255.2|156.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|79101|79101 - RP THERAPY INTRAVENOUS ADMINISTRATION||241.34|159.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|79005|79005 - RP THERAPY ORAL ADMINISTRATION||213.69|137.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78999|78999 - UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78835|78835 - RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA||159.46|37.11|122.35||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78832|78832 - RP LOCLZJ TUM SPECT CT 2AREA 1D IMG/1 AR IMG>2+D||1416.89|168.07|1248.82||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78831|78831 - RP LOCLZJ TUM SPECT 2 AREA 1D IMG/1 AREA IMG>2+D||1090.34|144.33|946.01||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78830|78830 - RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING||755.34|118.21|637.15||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78816|78816 - PET IMAGING FOR CT ATTENUATION WHOLE BODY||1487.36|194.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78815|78815 - PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH||1474.39|192.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78814|78814 - PET IMAGING CT FOR ATTENUATION LIMITED AREA||1334.16|173.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78813|78813 - PET IMAGING WHOLE BODY||1206.76|158.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78812|78812 - PET IMAGING SKULL BASE TO MID-THIGH||1159.87|151.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78811|78811 - PET IMAGING LIMITED AREA CHEST HEAD/NECK||956.24|124.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78808|78808 - NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS||64.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78807|78807 - RP LOCLZJ INFLAMMATORY PROCESS TOMOG SPECT||531.88|81.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78806|78806 - RP LOCLZJ INFLAMMATORY PROCESS WHOLE BODY||513.92|65.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78805|78805 - RP LOCLZJ INFLAMMATORY PROCESS LIMITED AREA||280.68|56.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78804|78804 - RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING||880.82|81.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78803|78803 - RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING||530.38|81.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78802|78802 - RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING||497.28|65.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78801|78801 - RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D||377.35|61.08||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78800|78800 - RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING||289.86|51.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78799|78799 - UNLISTED GENITOURINARY PX DX NUCLEAR MEDICINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78761|78761 - TESTICULAR IMAGING WITH VASCULAR FLOW||325.95|55.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78740|78740 - URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM||351.36|45.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78730|78730 - URINARY BLADDER RESIDUAL STUDY||116.39|12.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78725|78725 - KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY||159.6|28.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78710|78710 - KIDNEY IMAGING MORPHOLOGY TOMOGRAPHIC||325.11|48.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78709|78709 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE||565.54|108.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78708|78708 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX||266.29|92.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78707|78707 - KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX||360.67|73.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78701|78701 - KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW||326.69|38.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78700|78700 - KIDNEY IMAGING MORPHOLOGY||269.98|35.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78699|78699 - UNLISTED NERVOUS SYSTEM PX DX NUCLEAR MEDICINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78660|78660 - RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY||283.55|42.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78650|78650 - CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO||505.93|46.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78647|78647 - CEREBROSPINAL FLUID FLOW W/O MATL TOMOG SPECT||525.26|68.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78645|78645 - CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ||489.55|43.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78635|78635 - CEREBROSPINAL FLUID FLOW W/O MATL VENTRICLGRAPHY||506.89|46.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78630|78630 - CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY||521.95|52.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78610|78610 - BRAIN IMAGING VASCULAR FLOW ONLY||269.59|23.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78609|78609 - BRAIN IMAGING PET PERFUSION EVALUATION||120.22|120.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78608|78608 - BRAIN IMAGING PET METABOLIC EVALUATION||879.66|115.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78607|78607 - BRAIN IMAGING TOMOGRAPHIC SPECT||557.41|92.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78606|78606 - BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW||506.56|48.57||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78605|78605 - BRAIN IMAGING MINIMUM 4 STATIC VIEWS||302.71|41.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78601|78601 - BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW||326.3|39.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78600|78600 - BRAIN IMAGING <4 STATIC VIEWS||276.44|33.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78599|78599 - UNLISTED RESPIRATORY PX DX NUCLEAR MEDICINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78598|78598 - QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN||452.82|62.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78597|78597 - QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING||295.87|55.27||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78582|78582 - PULMONARY VENTILATION & PERFUSION IMAGING||483.37|80.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78580|78580 - PULMONARY PERFUSION IMAGING PARTICULATE||338.21|56.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78579|78579 - PULMONARY VENTILATION IMAGING||261.62|37.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78499|78499 - UNLISTED CARDIOVASCULAR PX DX NUCLEAR MEDICINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78496|78496 - CARD BL POOL GATED 1 STDY REST RT VENT EJCT FRCT||97.21|39.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78494|78494 - CARD BL POOL GATED SPECT REST WAL MOTN EJCT FRCT||379.13|92.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78492|78492 - MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS||834.8|148.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78491|78491 - MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS||671.6|117.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78483|78483 - CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT||416.56|115.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78481|78481 - CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT||305.26|77.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78473|78473 - CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT||483.14|114.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78472|78472 - CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS||373.39|76.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78469|78469 - MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ||370.51|71.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78468|78468 - MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ||326.45|63.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78466|78466 - MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN||269.33|53.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78459|78459 - MYOCRD IMG PET METAB EVAL SINGLE STUDY||620.6|116.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78458|78458 - VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL||291.25|66.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78457|78457 - VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL||310.66|59.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78456|78456 - ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE||577.24|79.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78454|78454 - MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES||666.49|101.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78453|78453 - MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS||466.83|75.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78452|78452 - MYOCARDIAL SPECT MULTIPLE STUDIES||755.34|122.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78451|78451 - MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS||542.64|104.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78445|78445 - NONCARDIAC VASCULAR FLOW IMAGING||264.62|36.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78434|78434 - AQMBF PET REST AND PHARMACOLOGIC STRESS|||50.87|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78433|78433 - MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT|||176.93|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78432|78432 - MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER|||161.85|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78431|78431 - MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT|||151.73|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78430|78430 - MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT|||130.5|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78429|78429 - MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT|||137.46|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78428|78428 - CARDIAC SHUNT DETECTION||289.52|60.5||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78414|78414 - CARD-VASC HEMODYNAM W/WO PHARM/EXER 1/MLT DETERM||113.67|36.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78399|78399 - UNLISTED MUSCULOSKELETAL PX DX NUCLEAR MEDICINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78351|78351 - BONE DENSTY 1/> SITES DUAL PHOTON ABSORPTIOMETR||23.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78350|78350 - BONE DENSITY 1/> SITES 1 PHOTON ABSORPTIOMETRY||50.72|17.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78320|78320 - BONE &/JOINT IMAGING TOMOGRAPHIC SPECT||361.14|79.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78315|78315 - BONE &/JOINT IMAGING 3 PHASE STUDY||532.5|78.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78306|78306 - BONE &/JOINT IMAGING WHOLE BODY||386.83|66.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78305|78305 - BONE &/JOINT IMAGING MULTIPLE AREAS||359.42|63.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78300|78300 - BONE &/JOINT IMAGING LIMITED AREA||272.46|47.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78299|78299 - UNLISTED GASTROINTESTINAL PX DX NUCLEAR MEDICINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78291|78291 - PERITONEAL-VENOUS SHUNT PATENCY TEST||388.97|67.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78290|78290 - INTESTINE IMAGING||503.31|52.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78282|78282 - GASTROINTESTINAL PROTEIN LOSS||113.27|29.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78278|78278 - ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING||532.84|76.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78272|78272 - VITAMIN B-12 ABSRPJ STDY W/WO INTRINSIC FACT||136.78|20.73||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|78271|78271 - VITAMIN B-12 ABSRPJ STUDY W/INTRINSIC FACTOR||134.32|15.79||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|78270|78270 - VITAMIN B-12 ABSRPJ STUDY W/O INTRINSIC FACTOR||125.25|15.79||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|78268|78268 - UREA BREATH TEST C-14 ISOTOPIC ANALYSIS||31.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78267|78267 - UREA BREATH TEST C-14 ISOTOPIC ACQUISJ ANALYSIS||18.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78264|78264 - GASTRIC EMPTYING IMAGING STUDY||441.96|61.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78262|78262 - GASTROESOPHAGEAL REFLUX STUDY||381.71|51.32||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78261|78261 - GASTRIC MUCOSA IMAGING||384.84|53.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78258|78258 - ESOPHAGEAL MOTILITY||354.85|57.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78232|78232 - SALIVARY GLAND FUNCTION STUDY||162.67|33.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78231|78231 - SALIVARY GLAND IMAGING SERIAL IMAGES||192.68|39.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78230|78230 - SALIVARY GLAND IMAGING||259.39|35.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78227|78227 - HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ||671.52|67.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78226|78226 - HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER||491.04|56.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78216|78216 - LIVER & SPLEEN IMAGING W/VASCULAR FLOW||191.48|43.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78215|78215 - LIVER & SPLEEN IMAGING STATIC ONLY||295.42|38.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78206|78206 - LIVER IMAGING SPECT W/VASCULAR FLOW||529.12|73.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78205|78205 - LIVER IMAGING SPECT||336.04|54.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78202|78202 - LIVER IMAGING W/VASCULAR FLOW||313.66|37.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78201|78201 - LIVER IMAGING STATIC ONLY||282.04|33.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78199|78199 - UNLIS HEMATOP RET/ENDO&LYMPHATIC DX NUC MED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78195|78195 - LYMPHATICS & LYMPH NODES IMAGING||546.68|92.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78191|78191 - PLATELET SURVIVAL STUDY||253.28|47.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78190|78190 - KINETICS PLATELET W/WO DIFFRNTL ORGAN/TIS LOCLZJ||624.17|86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78185|78185 - SPLEEN IMAGING ONLY W/WO VASCULAR FLOW||316.06|30.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78140|78140 - LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE||206.86|47.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78135|78135 - RBC SURVIVAL STUDY DIFFERNTL ORGAN/TISS KINETICS||546.45|50.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78130|78130 - RED CELL SURVIVAL STUDY||237.14|48.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78122|78122 - WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU||156.47|33.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78121|78121 - RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS||149.17|24.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78120|78120 - RED CELL VOLUME DETERMINATION SPX 1 SAMPLING||133.52|17.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78111|78111 - PLASMA VOL RADIOPHARM VOL DILUTE SPX MULT SMPLES||126.4|15.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78110|78110 - PLASMA VOL RADIOPHARM VOL DILUTION SPX 1 SAMPLE||128.75|14.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78104|78104 - BONE MARROW IMAGING WHOLE BODY||378.41|61.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78103|78103 - BONE MARROW IMAGING MULTIPLE AREAS||338.28|56.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78102|78102 - BONE MARROW IMAGING LIMITED AREA||256.43|42.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78099|78099 - UNLISTED ENDOCRINE PX DX NUCLEAR MEDICINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78075|78075 - ADRENAL IMAGING CORTEX &/MEDULLA||646.9|55.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78072|78072 - PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT||0|125.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78071|78071 - PARATHYROID PLANAR IMAGING W/WO SUBTRACTION||678.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78070|78070 - PARATHYROID PLANAR IMAGING||243.87|62.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78020|78020 - THYROID CARCINOMA METASTASES UPTAKE||129.59|44.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78018|78018 - THYROID CARCINOMA METASTASES IMG WHOLE BODY||483.66|65.01||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78016|78016 - THYROID CARCINOMA METASTASES IMG ADDL STUDY||454.16|57.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78015|78015 - THYROID CARCINOMA METASTASES IMG LMTD AREA||332.28|51.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78014|78014 - THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS||362.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78013|78013 - THYROID IMAGING WITH VASCULAR FLOW||313.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78012|78012 - THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT||124.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78011|78011 - THYROID IMAGING WITH FLOW||0|35.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78010|78010 - THYROID IMAGING||0|29.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78007|78007 - THYROID IMAGE MULT UPTAKES||0|38.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78006|78006 - THYROID IMAGING WITH UPTAKE||0|38.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78003|78003 - THYROID SUPPRESS/STIMUL||0|25.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78001|78001 - THYROID MULTIPLE UPTAKES||0|20.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|78000|78000 - THYROID SINGLE UPTAKE||0|14.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77799|77799 - UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77790|77790 - SUPERVISION HANDLING LOADING RADIATION SOURCE||140.76|81.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77789|77789 - SURFACE APPLIC LOW DOSE RATE RADIONUCLIDE SOURCE||172.05|89.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77787|77787 - HDR BRACHYTX OVER 12 CHAN||1407.94|387.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77786|77786 - HDR BRACHYTX 2-12 CHANNEL||851.12|254.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77785|77785 - HDR BRACHYTX 1 CHANNEL||354.28|112.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77778|77778 - INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX||1299.6|891.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77777|77777 - APPLY INTERSTIT RADIAT INTER||883.71|600.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77776|77776 - APPLY INTERSTIT RADIAT SIMPL||645.34|373.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77763|77763 - INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX||1080.32|681.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77762|77762 - INTRACAVITARY RADIATION SOURCE APPLIC INTERMED||760.84|454.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77761|77761 - INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE||568.15|302.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77750|77750 - NFS/INSTLJ RADIOELMNT SLN 3 MO FOLLOW-UP CARE||548.09|394.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77620|77620 - HYPERTHERMIA INTRACAVITARY PROBES||821.05|120.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77615|77615 - HYPERTHERMIA INTERSTIAL PROBE 5/> APPLICATORS||1479.37|164.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77610|77610 - HYPERTHERMIA INTERSTITIAL PROBE 5/< APPLICATORS||991.55|121.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77605|77605 - HYPERTHERMIA EXTERNAL GENERATED DEEP||1057.14|177.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77600|77600 - HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL||626.41|122.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77525|77525 - PROTON TX DELIVERY COMPLEX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77523|77523 - PROTON TX DELIVERY INTERMEDIATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77522|77522 - PROTON TX DELIVERY SIMPLE W/COMPENSATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77520|77520 - PROTON TX DELIVERY SIMPLE W/O COMPENSATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77499|77499 - UNLISTED PROCEDURE THERAPEUTIC RADIOLOGY TX MGMT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77470|77470 - SPECIAL TREATMENT PROCEDURE||269.37|164.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77469|77469 - INTRAOPERATIVE RADIATION TREATMENT MANAGEMENT||474.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77435|77435 - STEREOTACTIC BODY RADIATION MANAGEMENT||958.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77432|77432 - STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION||639.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77431|77431 - RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY||154.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77427|77427 - RADIATION TREATMENT MANAGEMENT 5 TREATMENTS||282.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77425|77425 - INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77424|77424 - INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77423|77423 - HIGH ENERGY NEUTRON RADJ TX DLVR 1/> ISOCENTER||387.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77422|77422 - HIGH ENERGY NEUTRON RADJ TX DLVR 1 TX AREA||374.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77421|77421 - STEREOSCOPIC X-RAY GUIDANCE||130.37|29.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77418|77418 - RADIATION TX DELIVERY IMRT||705.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77417|77417 - THERAPEUTIC RADIOLOGY PORT IMAGES(S)||21.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77416|77416 - RADIATION TREATMENT DELIVERY||402.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77414|77414 - RADIATION TREATMENT DELIVERY||400.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77413|77413 - RADIATION TREATMENT DELIVERY||357.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77412|77412 - RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX||360.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77411|77411 - RADIATION TREATMENT DELIVERY||300.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77409|77409 - RADIATION TREATMENT DELIVERY||302.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77408|77408 - RADIATION TREATMENT DELIVERY||271.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77407|77407 - RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE||374.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77406|77406 - RADIATION TREATMENT DELIVERY||225.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77404|77404 - RADIATION TREATMENT DELIVERY||221.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77403|77403 - RADIATION TREATMENT DELIVERY||198.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77402|77402 - RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE||271.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77401|77401 - RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTA||32.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77399|77399 - UNLIS MEDICAL RADJ DOSIM TX DEV SPEC SVCS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77373|77373 - STEREOTACTIC BODY RADIATION DELIVERY||2364.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77372|77372 - RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR||1241.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77371|77371 - RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT||1991.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77370|77370 - SPEC MEDICAL RADJ PHYSICS CONSLTJ||168.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77338|77338 - MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN||753.29|337.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77336|77336 - CONTINUING MEDICAL PHYSICS CONSLTJ PR WK||69.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77334|77334 - TX DEVICES DESIGN & CONSTRUCTION COMPLEX||227.09|96.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77333|77333 - TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE||85.59|65.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77332|77332 - TX DEVICES DESIGN & CONSTRUCTION SIMPLE||117.64|42.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77331|77331 - SPEC DOSIM ONLY PRESCRIBED TREATING PHYS||96.86|68.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77328|77328 - BRACHYTX ISODOSE PLAN COMPL||414.67|164.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77327|77327 - BRACHYTX ISODOSE CALC INTERM||308.21|109.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77326|77326 - BRACHYTX ISODOSE CALC SIMP||218.78|72.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77321|77321 - SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY||151.28|74.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77315|77315 - TELETX ISODOSE PLAN COMPLEX||212.82|122.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77310|77310 - TELETX ISODOSE PLAN INTERMED||137.75|82.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77305|77305 - TELETX ISODOSE PLAN SIMPLE||96.37|55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77301|77301 - NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS||2987.61|629.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77300|77300 - BASIC RADIATION DOSIMETRY CALCULATION||103.98|48.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77299|77299 - UNLIS PX THER RADIOL CLINICAL TX PLANNING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77295|77295 - 3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS||767.46|359.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77290|77290 - THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX||803.4|122.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77285|77285 - THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED||496.83|82.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77280|77280 - THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE||281.97|55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77263|77263 - THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX||252.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77262|77262 - THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE||170.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77261|77261 - THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE||113.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77084|77084 - BONE MARROW BLOOD SUPPLY||738.12|125.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77082|77082 - DXA BONE DENSITY VERT FX||41.68|10.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77081|77081 - DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL||44.16|17.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77080|77080 - DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL||146.3|17.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77078|77078 - CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE||222.87|19.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77077|77077 - JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS||64.9|26.56||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77076|77076 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT||166.49|55.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77075|77075 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL||160.01|42.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77074|77074 - RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED||107.55|35.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77073|77073 - BONE LENGTH STUDIES||60.13|23.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77072|77072 - BONE AGE STUDIES||35.92|14.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77071|77071 - MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS||77.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77059|77059 - MRI BREAST BILATERAL||1071.65|127.02||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|77058|77058 - MRI BREAST UNILATERAL||1051.98|127.52||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|77057|77057 - MAMMOGRAM SCREENING||124.63|55.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77056|77056 - MAMMOGRAM BOTH BREASTS||171.52|68.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77055|77055 - MAMMOGRAM ONE BREAST||134.21|55.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77054|77054 - MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE||131.25|35.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77053|77053 - MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE||96.41|27.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77052|77052 - COMP SCREEN MAMMOGRAM ADD-ON||16.52|4.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77051|77051 - COMPUTER DX MAMMOGRAM ADD-ON||16.52|4.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77049|77049 - MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL||624.26|189.43|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77048|77048 - MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL||610.12|173.16|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77047|77047 - MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL||396.08|132.43|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77046|77046 - MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL||384.92|119.66|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77032|77032 - GUIDANCE FOR NEEDLE BREAST||83.46|43.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77031|77031 - STEREOTACT GUIDE FOR BRST BX||225.69|125.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77022|77022 - MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION||1013.13|334.59||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77021|77021 - MRI GUIDANCE NEEDLE PLACEMENT RS&I||626.62|118.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77014|77014 - CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT||217.78|66.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77013|77013 - CT GUIDANCE &MONITORING VISC TISS ABLATION||827.89|318.01||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77012|77012 - CT GUIDANCE NEEDLE PLACEMENT||224.6|88.92||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77011|77011 - CT GUIDANCE STEREOTACTIC LOCALIZATION||542.12|95.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77003|77003 - FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON||99.33|47.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77002|77002 - FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON||119.16|43.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|77001|77001 - FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT||179.27|29.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76999|76999 - UNLISTED US PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76998|76998 - ULTRASONIC GUIDANCE INTRAOPERATIVE||102.09|103.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76983|76983 - ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION||92.59|41.8|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76982|76982 - ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION||149.47|49.4|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76981|76981 - ULTRASOUND ELASTOGRAPHY PARENCHYMA||166.57|49.4|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76979|76979 - ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES||338.67|36|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76978|76978 - ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION||501.62|133.72|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76977|76977 - US BONE DENSITY MEAS & INTERP PERIPH ANY METHO||13.43|4.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76975|76975 - GI ENDOSCOPIC US S&I||161.21|68.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76970|76970 - US STUDY FOLLOW UP||155.19|32.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76965|76965 - US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION||161.15|106.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76950|76950 - ECHO GUIDANCE RADIOTHERAPY||85.09|45.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76948|76948 - US GUIDANCE ASPIRATION OVA IMG S&I||55.7|30.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76946|76946 - US GUIDANCE AMNIOCENTESIS IMG S&I||54.66|29.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76945|76945 - US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I||144.19|54.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76942|76942 - US GUIDANCE NEEDLE PLACEMENT IMG S&I||310.05|52.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76941|76941 - US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I||196.55|106.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76940|76940 - US &MNTR PARENCHYMAL TISSUE ABLATION||257.6|165.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76937|76937 - US VASC ACCESS SITS VSL PATENCY NDL ENTRY||54.24|23.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76936|76936 - US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL||461.67|159.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76932|76932 - US ENDOMYOCARDIAL BIOPSY RS&I||133.6|53.83||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76930|76930 - US GUIDANCE PERICARDIOCENTESIS RS&I||133.49|52.27||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76886|76886 - US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ||160.94|46.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76885|76885 - US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ||229.26|58.27||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76882|76882 - US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG||54.33|38.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76881|76881 - US COMPL JOINT R-T W/IMAGE DOCUMENTATION||186.26|48.56||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76873|76873 - US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX||270.78|121.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76872|76872 - US TRANSRECTAL||210.31|54.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76870|76870 - US SCROTUM & CONTENTS||191.87|50.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76857|76857 - US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U||152.03|30.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76856|76856 - US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE||193.15|53.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76831|76831 - SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER||197.35|57.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76830|76830 - US TRANSVAGINAL||195.16|53.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76828|76828 - DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT||73.34|43.57||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76827|76827 - DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE||99.68|45.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76826|76826 - ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD||200|65.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76825|76825 - ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING||341.5|130.67||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76821|76821 - DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART||151.34|56.01||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76820|76820 - DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY||68.46|39.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76819|76819 - FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING||142.16|60.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76818|76818 - FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING||192.18|83.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76817|76817 - US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG||160.2|58.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76816|76816 - US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS||185.49|67.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76815|76815 - US PREGNANT UTERUS LIMITED 1/> FETUSES||141.95|50.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76814|76814 - US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION||127.79|78.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76813|76813 - US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION||196.47|93.07||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76812|76812 - US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT||326.01|140.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76811|76811 - US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION||297.45|150.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76810|76810 - US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO||153.45|76.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76805|76805 - US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION||231.68|77.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76802|76802 - US PREG UTERUS 14 WK TRANSABDL EACH GESTATION||107.71|64.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76801|76801 - US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT||200.92|77.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76800|76800 - ULTRASOUND SPINAL CANAL & CONTENTS||205.27|86.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76776|76776 - US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN||235.93|58.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76775|76775 - US RETROPERITONEAL REAL TIME W/IMAGE LIMITED||169.82|45.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76770|76770 - US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE||206.06|57.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76705|76705 - US ABDOMINAL REAL TIME W/IMAGE LIMITED||166.35|45.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76700|76700 - US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION||217.55|63.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76645|76645 - US EXAM BREAST(S)||150.44|42.5||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76604|76604 - US CHEST REAL TIME W/IMAGE DOCUMENTATION||135.86|42.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76536|76536 - US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM||185.84|43.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76529|76529 - OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION||117.82|51.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76519|76519 - OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL||124.2|48.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76516|76516 - OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN||115.09|46.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76514|76514 - OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI||22.69|15.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76513|76513 - OPH US DX ANT SGM US IMMERSION B-SCAN/HR BIOM||139.99|54.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76512|76512 - OPHTHALMIC ULTRASOUND DX B-SCAN W/WO A-SCAN||143.15|83.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76511|76511 - OPHTHALMIC ULTRASOUND DX QUAN A-SCAN ONLY||155.21|81.56||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76510|76510 - OPH US DX B-SCAN&QUAN A-SCAN SM PT ENCTR||265.03|148.01||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76506|76506 - ECHOENCEPHALOGRAPHY REAL TIME IMAGING||190.8|49.57||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76499|76499 - UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76498|76498 - UNLISTED MAGNETIC RESONANCE PROCEDURE||0|343.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76497|76497 - UNLISTED COMPUTED TOMOGRAPHY PROCEDURE||0|103.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76496|76496 - UNLISTED FLUOROSCOPIC PROCEDURE||0|81.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76391|76391 - MAGNETIC RESONANCE ELASTOGRAPHY||363.37|91.69|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76390|76390 - MRI SPECTROSCOPY||726.8|109.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76380|76380 - CT LIMITED/LOCALIZED FOLLOW UP STUDY||274|76.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76377|76377 - 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION||134.22|61.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76376|76376 - 3D RENDERING W/INTERP & POSTPROCESS SUPERVISION||100.03|15.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76140|76140 - CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT||90.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76125|76125 - CINERADIOGRAPY/VIDRADIOGRAPY ROUTINE EXAMINATION||68.23|22.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76120|76120 - CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC||117.74|29.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76102|76102 - RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY BI||338.39|54.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76101|76101 - RADEX CPLX MOTION BDY SCTJ OTH/THN UROGRAPY UNI||251.61|54.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76100|76100 - RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY||172.38|49.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76098|76098 - RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN||28.69|12.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76080|76080 - RADEX ABSCESS/FISTULA/SINUS TRACT RS&I||94.95|41.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76010|76010 - RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD||41.92|14.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|76001|76001 - FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME||211.93|55.92||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|76000|76000 - FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME||98.34|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75989|75989 - RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I||203.1|91.63||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75984|75984 - CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I||175.68|56.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75982|75982 - CONTRAST XRAY EXAM BILE DUCT||461.22|113.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75980|75980 - CONTRAST XRAY EXAM BILE DUCT||408.19|113.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75978|75978 - REPAIR VENOUS BLOCKAGE||275|41.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75970|75970 - TRANSCATHETER BIOPSY RS&I||666.78|65.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75968|75968 - REPAIR ARTERY BLOCKAGE EACH||168.02|27.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75966|75966 - REPAIR ARTERIAL BLOCKAGE||331.93|102.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75964|75964 - REPAIR ARTERY BLOCKAGE EACH||174.12|28.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75962|75962 - REPAIR ARTERIAL BLOCKAGE||268.95|41.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75961|75961 - RETRIEVAL BROKEN CATHETER||0|329.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75960|75960 - TRANSCATH IV STENT RS&I||243.35|63.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75959|75959 - PLMT DSTL XTN PRSTH EVASC DESC THORAC AORTA RS&I||282.58|290.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75958|75958 - PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I||324.74|331.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75957|75957 - EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I||487.08|498.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75956|75956 - EVASC RPR DESCND THORCIC AORTA SUBCLAV ORIG RS&I||570.82|582.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75954|75954 - EVASC RPR ILIAC ART W/ILIO-ILIAC PROSTH RS&I||181.45|185.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75953|75953 - PLMT XTN PROSTH EVASC RPR INFRARENAL RS&I||110.58|113.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75952|75952 - EVASC RPR INFRARENAL AAA/DISSECTION RS&I||363.41|371.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75946|75946 - INTRAVASCULAR US ADD-ON||268.47|32.67||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75945|75945 - INTRAVASCULAR US||263.9|32.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75902|75902 - MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I||118.82|31.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75901|75901 - MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I||264.12|38.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75900|75900 - INTRAVASCULAR CATH EXCHANGE||0|38.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75898|75898 - ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS||193.38|134.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75896|75896 - X-RAYS TRANSCATH THERAPY||1213.46|106.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75894|75894 - TRANSCATHETER EMBOLIZATION ANY METH RS&I||1392.73|106.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75893|75893 - VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&||231.59|40.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75891|75891 - HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I||281.02|88.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75889|75889 - HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I||280.52|88.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75887|75887 - PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP||302.88|110.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75885|75885 - PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I||302.93|112.28||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75880|75880 - VENOGRAPHY ORBITAL RS&I||202.8|54.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75872|75872 - VENOGRAPHY EPIDURAL RS&I||419.72|96.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75870|75870 - VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I||280.01|89.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75860|75860 - VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I||283.06|90.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75842|75842 - VENOGRAPHY ADRENAL BILATERAL SELECTIVE RS&I||333.98|116.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75840|75840 - VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I||286.86|97.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75833|75833 - VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I||329.44|113.57||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75831|75831 - VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I||288.88|97.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75827|75827 - VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I||279.51|87.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75825|75825 - VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I||274.48|88.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75822|75822 - VENOGRAPHY EXTREMITY BILATERAL RS&I||240.72|82.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75820|75820 - VENOGRAPHY EXTREMITY UNILATERAL RS&I||194.73|55.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75810|75810 - SPLENOPORTOGRAPY RS&I||764|91.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75809|75809 - SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I||158.6|37.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75807|75807 - LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I||435.95|93.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75805|75805 - LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I||402.06|64.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75803|75803 - LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I||397.06|93.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75801|75801 - LYMPHANGIOGRAPHY EXTREMITY ONLY UNILATERAL RS&I||394.15|71.01||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75791|75791 - AV DIALYSIS SHUNT IMAGING||514.32|129.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75774|75774 - ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I||198.32|28.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75756|75756 - ANGIOGRAPHY INTERNAL MAMMARY RS&I||332.72|98.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75746|75746 - ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I||303.72|89.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75743|75743 - ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I||334.99|129.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75741|75741 - ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I||293.11|101.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75736|75736 - ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I||310.24|87.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75733|75733 - ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I||364.69|103.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75731|75731 - ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I||304.17|89.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75726|75726 - ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I||314.83|89.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75716|75716 - ANGIOGRAPHY EXTREMITY BILATERAL RS&I||371.85|102.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75710|75710 - ANGIOGRAPHY EXTREMITY UNILATERAL RS&I||315.79|87.81||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75705|75705 - ANGIOGRAPHY SPINAL SELECTIVE RS&I||414.07|170.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75685|75685 - ARTERY X-RAYS SPINE||0|104.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75680|75680 - ARTERY X-RAYS NECK||0|131.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75676|75676 - ARTERY X-RAYS NECK||0|105.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75671|75671 - ARTERY X-RAYS HEAD & NECK||0|131.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75665|75665 - ARTERY X-RAYS HEAD & NECK||0|105.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75662|75662 - ARTERY X-RAYS HEAD & NECK||0|131.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75660|75660 - ARTERY X-RAYS HEAD & NECK||0|102.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75658|75658 - ANIOGRAPHY BRACHIAL RETROGRADE RS&I||323.87|100.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75650|75650 - ARTERY X-RAYS HEAD & NECK||0|117.14||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75635|75635 - CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP||758.9|187.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75630|75630 - AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I||337.75|139.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75625|75625 - AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I||285.61|89.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75605|75605 - AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I||283.04|89.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75600|75600 - AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I||366.5|39.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75574|75574 - CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST||701.81|182.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75573|75573 - CT HRT CONTRST CARDIAC STRUCT&MORPH CONG HRT D||652.24|193.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75572|75572 - CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH||474.62|132.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75571|75571 - CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM||172.81|43.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75565|75565 - CARDIAC MRI FOR VELOCITY FLOW MAPPING||99.31|19.1||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75563|75563 - CARDIAC MRI W/W/O CONTRAST W/STRESS||1013.45|237.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75561|75561 - CARDIAC MRI W/WO CONTRAST & FURTHER SEQ||843.72|204.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75559|75559 - CARDIAC MRI W/O CONTRAST W/STRESS IMAGING||888.1|232.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|75557|75557 - CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST||628.43|184.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74775|74775 - PERINEOGRAM||129.8|49.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74742|74742 - TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I||131.76|48.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74740|74740 - HYSTEROSALPINGOGRAPHY RS&I||122.24|29.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74710|74710 - PELVIMETRY W/WOPLACENTAL LOCALIZATION||58.97|26.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74485|74485 - DILATION URETERS/URETHRA RS&I||162.03|41.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74480|74480 - X-RAY CONTROL CATH INSERT||162.53|41.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74475|74475 - X-RAY CONTROL CATH INSERT||162.03|41.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74470|74470 - RADEX RENAL CYST STUDY TRANSLUMBAR RS&I||111.16|42.5||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74455|74455 - URETHROCYSTOGRAPHY VOIDING RS&I||135.57|25.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74450|74450 - URETHROCYSTOGRAPHY RETROGRADE RS&I||107.44|26.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74445|74445 - CORPORA CAVERNOSOGRAPY RS&I||151.98|91.93||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74440|74440 - VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I||127.82|29.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74430|74430 - CYSTOGRAPHY MINIMUM 3 VIEWS RS&I||78.02|24.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74425|74425 - UROGRAPHY ANTEGRADE RS&I||97.52|28.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74420|74420 - X-RAY URINARY TRACT EXAM WITH CONTRAST MATERIAL||177.29|28.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74415|74415 - UROGRAPY INFUSION DRIP &/BOLUS TECHQ W/WO TOMO||210.66|38.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74410|74410 - UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE||174.85|38.67||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74400|74400 - UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY||172.84|38.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74363|74363 - PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I||186.86|70.24||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74360|74360 - INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I||177.8|46.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74355|74355 - PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I||211.91|62.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74340|74340 - INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I||160.64|42.5||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74330|74330 - CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I||180.28|72.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74329|74329 - ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I||153.98|56.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74328|74328 - ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I||177.21|56.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74327|74327 - X-RAY BILE STONE REMOVAL||214.03|58.68||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74320|74320 - CONTRAST X-RAY OF BILE DUCTS||160.01|41.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74305|74305 - X-RAY BILE DUCTS/PANCREAS||90.29|33.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74301|74301 - CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS||46.17|17.39||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74300|74300 - CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I||28.33|28.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74291|74291 - CONTRAST X-RAYS GALLBLADDER||102.55|15.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74290|74290 - CHOLECYSTOGRAPHY ORAL CONTRST||107.27|24.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74283|74283 - THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ||318.31|154.89||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74280|74280 - RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY||332.58|76.87||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74270|74270 - RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY||240.07|53.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74263|74263 - CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING||1212.08|181.21||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74262|74262 - CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST||950.12|195.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74261|74261 - CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST||815.86|183.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74260|74260 - DUODENOGRAPY HYPOTONIC||489.11|39.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74251|74251 - RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY||588.56|53.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74250|74250 - RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY||166.67|37.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74249|74249 - RADEX GI UPR W/WO GLUCOSE W/SM INTEST FOLLW-THRU||296.82|70.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74248|74248 - RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY||127.63|57.22|70.41||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74247|74247 - RADEX UPPER GI W/WO GLUCAGON/DELAY IMAGES W/KUB||219.89|53.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74246|74246 - RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY||198.21|53.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74245|74245 - RADEX GI TRACT UPR W/SM INT W/MULT SERIAL IMAGES||275.13|70.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74241|74241 - RADEX GI TRACT UPPER W/WO DELAYED IMAGES W/KUB||185.08|53.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74240|74240 - RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY||177.02|54.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74235|74235 - RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I||284.05|103.31||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74230|74230 - RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY||142.3|41.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74221|74221 - RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY||166.85|57.22|109.64||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74220|74220 - RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY||139.88|35.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74210|74210 - RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY||121.62|27.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74190|74190 - PERITONEOGRAM RS&I||90.11|38.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74185|74185 - MRA ABDOMEN W/WO CONTRAST MATERIAL||783.64|140.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74183|74183 - MRI ABDOMEN W/O & W/CONTRAST MATERIAL||1015.28|175.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74182|74182 - MRI ABDOMEN W/CONTRAST MATERIAL||876.54|135.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74181|74181 - MRI ABDOMEN W/O CONTRAST MATERIAL||644.48|113.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74178|74178 - CT ABDOMEN & PELVIS W/O CONTRST 1/> BODY RE||685.02|154.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74177|74177 - CT ABDOMEN & PELVIS W/CONTRAST MATERIAL||540.67|139.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74176|74176 - CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL||345.54|133.7||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74175|74175 - CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST||735.33|148.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74174|74174 - CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG||846.02|169.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74170|74170 - CT ABDOMEN W/O & W/CONTRAST MATERIAL||629.51|109.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74160|74160 - CT ABDOMEN W/CONTRAST MATERIAL||476.44|99.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74150|74150 - CT ABDOMEN W/O CONTRAST MATERIAL||351.41|93.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74022|74022 - RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES||74.49|24.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74020|74020 - RADEX ABDOMEN COMPL W/DCBTS&/ERC VIEWS||62.1|20.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74010|74010 - RADEX ABD ANTEROPOST&ADDL OBLQ&CONE VIEWS||59.35|17.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|74000|74000 - RADEX ABDOMEN 1 ANTEROPOSTERIOR VIEW||38.39|14.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73725|73725 - MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL||786.78|141.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73723|73723 - MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL||952.11|167.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73722|73722 - MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL||757.92|127.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73721|73721 - MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL||697.85|107.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73720|73720 - MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR||1011.12|167.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73719|73719 - MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL||792.7|126.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73718|73718 - MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL||706.89|105.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73706|73706 - CT ANGIOGRAPHY LOWER EXTREMITY||678.83|148.75||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73702|73702 - CT LOWER EXTREMITY W/O & W/CONTRAST MATRL||548.28|95.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73701|73701 - CT LOWER EXTREMITY W/CONTRAST MATERIAL||432.94|90.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73700|73700 - CT LOWER EXTREMITY W/O CONTRAST MATERIAL||350.32|78.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73660|73660 - RADEX TOE MINIMUM 2 VIEWS||46.17|10.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73650|73650 - RADEX CALCANEUS MINIMUM 2 VIEWS||43.82|12.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73630|73630 - RADEX FOOT COMPLETE MINIMUM 3 VIEWS||48.92|13.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73620|73620 - RADIOLOGIC EXAMINATION FOOT 2 VIEWS||42.31|12.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73615|73615 - RADEX ANKLE ARTHROGRAPHY RS&I||167.59|45.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73610|73610 - RADEX ANKLE COMPLETE MINIMUM 3 VIEWS||51.44|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73600|73600 - RADIOLOGIC EXAMINATION ANKLE 2 VIEWS||44.83|13.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73592|73592 - RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS||49.87|13.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73590|73590 - RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS||42.87|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73580|73580 - RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I||208.46|46.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73565|73565 - RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST||55.01|15.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73564|73564 - RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS||67.4|18.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73562|73562 - RADIOLOGIC EXAMINATION KNEE 3 VIEWS||57.58|15.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73560|73560 - RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS||48.45|15.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73550|73550 - X-RAY EXAM OF THIGH||44.41|14.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73540|73540 - X-RAY EXAM OF PELVIS & HIPS||68.29|17.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73530|73530 - X-RAY EXAM OF HIP||51.17|23.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73525|73525 - RADEX HIP ARTHROGRAPHY RS&I||161.03|45.02||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73520|73520 - X-RAY EXAM OF HIPS||64.09|21.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73510|73510 - X-RAY EXAM OF HIP||60.78|17.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73500|73500 - X-RAY EXAM OF HIP||42.4|14.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73225|73225 - MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL||783.7|132.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73223|73223 - MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL||951.1|167.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73222|73222 - MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL||741.26|126.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73221|73221 - MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL||682.72|107.26||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73220|73220 - MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS||1006.58|167.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73219|73219 - MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL||790.68|126.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73218|73218 - MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL||715.95|105.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73206|73206 - CT ANGIOGRAPHY UPPER EXTREMITY||613.2|140.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73202|73202 - CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL||548.28|95.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73201|73201 - CT UPPER EXTREMITY W/CONTRAST MATERIAL||428.4|90.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73200|73200 - CT UPPER EXTREMITY W/O CONTRAST MATERIAL||349.82|79.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73140|73140 - RADEX FINGR MINIMUM 2 VIEWS||50.71|10.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73130|73130 - RADEX HAND MINIMUM 3 VIEWS||49.93|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73120|73120 - RADEX HAND 2 VIEWS||43.31|13.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73115|73115 - RADEX WRIST ARTHROGRAPHY RS&I||174.65|44.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73110|73110 - RADEX WRIST COMPLETE MINIMUM 3 VIEWS||57.49|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73100|73100 - RADEX WRIST 2 VIEWS||49.4|14.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73092|73092 - RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS||43.31|12.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73090|73090 - RADEX FOREARM 2 VIEWS||42.81|12.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73085|73085 - RADEX ELBOW ARTHROGRAPHY RS&I||155.97|44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73080|73080 - RADEX ELBOW COMPLETE MINIMUM 3 VIEWS||52.45|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73070|73070 - RADEX ELBOW 2 VIEWS||44.27|12.48||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73060|73060 - RADEX HUMERUS MINIMUM 2 VIEWS||45.39|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73050|73050 - RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ||62.24|17.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73040|73040 - RADEX SHOULDER ARTHROGRAPHY RS&I||167.09|43.51||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73030|73030 - RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS||48|15.71||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73020|73020 - RADEX SHOULDER 1 VIEW||37.21|11.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73010|73010 - RADEX SCAPULA COMPLETE||48.95|15.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|73000|73000 - RADEX CLAVICLE COMPLETE||44.83|13.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72295|72295 - DISKOGRAPY LUMBAR RS&I||181.86|67.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72292|72292 - PERQ VERTE/SACROPLSTY CT||475.66|116.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72291|72291 - PERQ VERTE/SACROPLSTY FLUOR||466.7|114.29||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72285|72285 - DISKOGRAPY CERVICAL/THORACIC RS&I||206.97|93.47||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72275|72275 - EPIDUROGRAPY RS&I||182.97|61.41||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72270|72270 - MYELOGRAPY 2/MORE REGIONS RS&I||319.43|104.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72265|72265 - MYELOGRAPY LUMBOSACRAL RS&I||204.05|64.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72255|72255 - MYELOGRAPHY THORACIC RS&I||201.99|70.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72240|72240 - MYELOGRAPHY CERVICAL RS&I||212.6|71.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72220|72220 - RADEX SACRUM & COCCYX MINIMUM 2 VIEWS||44.88|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72202|72202 - RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS||53.57|14.72||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72200|72200 - RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS||46.4|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72198|72198 - MRA PELVIS W/WO CONTRAST MATERIAL||784.65|140.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72197|72197 - MRI PELVIS W/O & W/CONTRAST MATERIAL||1012.76|175.54||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72196|72196 - MRI PELVIS W/CONTRAST MATERIAL||803.41|135.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72195|72195 - MRI PELVIS W/O CONTRAST MATERIAL||722.69|114.95||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72194|72194 - CT PELVIS W/O & W/CONTRAST MATERIAL||533.65|95.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72193|72193 - CT PELVIS W/CONTRAST MATERIAL||417.31|90.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72192|72192 - CT PELVIS W/O CONTRAST MATERIAL||343.75|84.5||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72191|72191 - CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST||691.94|142.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72190|72190 - RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS||66.33|17.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72170|72170 - RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS||41.39|14.64||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72159|72159 - MRA SPINAL CANAL W/WO CONTRAST MATERIAL||814.86|138.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72158|72158 - MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL||972.55|185.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72157|72157 - MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL||927.86|201.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72156|72156 - MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL||989.38|201.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72149|72149 - MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL||806.24|140||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72148|72148 - MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL||648.66|116.57||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72147|72147 - MRI SPINAL CANAL THORACIC W/CONTRAST MATRL||738.96|150.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72146|72146 - MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL||657.93|125.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72142|72142 - MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL||826.71|150.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72141|72141 - MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL||652.88|125.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72133|72133 - CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL||531.41|99.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72132|72132 - CT LUMBAR SPINE W/CONTRAST MATERIAL||440.35|95.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72131|72131 - CT LUMBAR SPINE W/O CONTRAST MATERIAL||354.33|78.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72130|72130 - CT THORACIC SPINE W/O & W/CONTRAST MATERIAL||532.42|99.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72129|72129 - CT THORACIC SPINE W/CONTRAST MATERIAL||441.36|95.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72128|72128 - CT THORACIC SPINE W/O CONTRAST MATERIAL||355.33|78.44||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72127|72127 - CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL||528.39|98.68||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72126|72126 - CT CERVICAL SPINE W/CONTRAST MATERIAL||441.36|95.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72125|72125 - CT CERVICAL SPINE W/O CONTRAST MATERIAL||361.28|83.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72120|72120 - RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS||67.9|18.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72114|72114 - RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6||101.78|27.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72110|72110 - RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS||78|25.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72100|72100 - RADEX SPINE LUMBOSACRAL 2/3 VIEWS||57.31|18.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72090|72090 - X-RAY EXAM SCLOIOSIS ERECT||78.35|23.86||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72080|72080 - RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS||56.8|18.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72074|72074 - RADEX SPINE THORACIC MINIMUM 4 VIEWS||68.37|16.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72072|72072 - RADEX SPINE THORACIC 3 VIEWS||57.78|16.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72070|72070 - RADEX SPINE THORACIC 2 VIEWS||52.23|17.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72069|72069 - X-RAY EXAM TRUNK SPINE STAND||58.82|18.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72052|72052 - RADEX SPINE CERVICAL 6 OR MORE VIEWS||105.52|29.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72050|72050 - RADEX SPINE CERVICAL 4 OR 5 VIEWS||82.54|25.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72040|72040 - RADEX SPINE CERVICAL 2 OR 3 VIEWS||61.34|18.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72020|72020 - RADEX SPINE 1 VIEW SPECIFY LEVEL||36.7|11.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|72010|72010 - X-RAY EXAM SPINE AP&LAT||119.65|36.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71555|71555 - MRA CHEST W/O & W/CONTRAST MATERIAL||784.2|141.66||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71552|71552 - MRI CHEST W/O & W/CONTRAST MATERIAL||1150.44|176.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71551|71551 - MRI CHEST W/CONTRAST MATERIAL||895.71|135.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71550|71550 - MRI CHEST W/O CONTRAST MATERIAL||799.82|113.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71275|71275 - CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST||672.89|149.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71270|71270 - CT THORAX W/O & W/CONTRAST MATERIAL||538.6|107.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71260|71260 - CT THORAX W/CONTRAST MATERIAL||440.97|96.99||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71250|71250 - CT THORAX W/O CONTRAST MATERIAL||355.45|80.06||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71130|71130 - RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS||57.78|17.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71120|71120 - RADEX STERNUM MINIMUM 2 VIEWS||49.09|15.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71111|71111 - RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS||82.06|25.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71110|71110 - RADEX RIBS BILATERAL 3 VIEWS||63.11|21.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71101|71101 - RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS||61.09|20.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71100|71100 - RADEX RIBS UNILATERAL 2 VIEWS||50.72|17.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71060|71060 - CONTRAST X-RAY OF BRONCHI||0|57.77||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71040|71040 - CONTRAST X-RAY OF BRONCHI||0|43.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71035|71035 - RADEX CHEST SPECIAL VIEWS||55.03|14.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71034|71034 - RADEX CHEST COMPLETE MINIMUM 4 VIEWS W/FLUORO||134.3|35.94||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71030|71030 - RADEX CHEST COMPLETE MINIMUM 4 VIEWS||71.41|23.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71023|71023 - RADEX CH 2 VIEWS FRONTAL & LATERAL W/FLUORO||104.59|29.43||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71022|71022 - RADEX CH 2 VIEWS FRONTAL & LATERAL OBLIQUE PRJCJ||73.43|24.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71021|71021 - RADEX CH 2 VIEWS FRNT & LAT APICAL LORDOTIC PX||58.57|21.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71020|71020 - RADIOLOGIC EXAM CHEST 2 VIEWS FRONTAL&LATERAL||47.19|16.91||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71015|71015 - RADIOLOGIC EXAMINATION CHEST STERO FRONTAL||47.13|16.35||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|71010|71010 - RADIOLOGIC EXAMINATION CHEST SINGLE VIEW FRONTAL||36.37|14.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70559|70559 - MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST||2167.04|258.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70558|70558 - MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL||2161.99|256.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70557|70557 - MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL||2313|274.08||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70555|70555 - MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION||1116.47|204.58||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70554|70554 - MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION||814.7|165.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70553|70553 - MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL||989.16|184.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70552|70552 - MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL||813.3|139.49||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70551|70551 - MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL||727.31|115.03||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70549|70549 - MRA NECK W/O &W/CONTRAST MATERIAL||1190.64|140.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70548|70548 - MRA NECK W/CONTRAST MATERIAL||815.46|93.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70547|70547 - MRA NECK W/O CONTRST MATERIAL||772.09|93.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70546|70546 - MRA HEAD W/O & W/CONTRAST MATERIAL||1187.63|140.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70545|70545 - MRA HEAD W/CONTRAST MATERIAL||760.49|93.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70544|70544 - MRA HEAD W/O CONTRST MATERIAL||773.6|93.74||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70543|70543 - MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL||990.95|166.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70542|70542 - MRI ORBIT FACE & NECK W/CONTRAST MATERIAL||783.12|126.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70540|70540 - MRI ORBIT FACE &/NECK W/O CONTRAST||696.81|105.2||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70498|70498 - CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST||865.06|136.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70496|70496 - CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST||842.87|136.78||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70492|70492 - CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL||533.98|112.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70491|70491 - CT SOFT TISSUE NECK W/CONTRAST MATERIAL||445.3|107.88||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70490|70490 - CT SOFT TISSUE NECK W/O CONTRAST MATERIAL||370.08|100.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70488|70488 - CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL||549.44|110.65||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70487|70487 - CT MAXILLOFACIAL W/CONTRAST MATERIAL||454.93|101.37||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70486|70486 - CT MAXILLOFACIAL W/O CONTRAST MATERIAL||378.33|88.82||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70482|70482 - CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR||590.97|112.84||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70481|70481 - CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL||528.53|107.9||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70480|70480 - CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL||456.33|100.25||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70470|70470 - CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL||389.19|99.18||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70460|70460 - CT HEAD/BRAIN W/CONTRAST MATERIAL||363.64|87.76||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70450|70450 - CT HEAD/BRAIN W/O CONTRAST MATERIAL||278.3|65.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70390|70390 - SIALOGRAPHY RS&I||157.08|29.97||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70380|70380 - RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS||62.03|14.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70373|70373 - CONTRAST X-RAY OF LARYNX||123.09|33.3||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70371|70371 - CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC||146.09|65.38||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70370|70370 - RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ||131.99|25.05||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70360|70360 - RADIOLOGIC EXAMINATION NECK SOFT TISSUE||41.86|13.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70355|70355 - ORTHOPANTOGRAM||32.95|16.8||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70350|70350 - CEPHALOGRAM ORTHODONTIC||33.28|15.11||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70336|70336 - MRI TEMPOROMANDIBULAR JOINT||623.41|114.52||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70332|70332 - TEMPOROMANDBLE JT ARTHROGRAPHY RS&I||116.64|41.98||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70330|70330 - RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT||75.04|19.55||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70328|70328 - RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT||47.97|14.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70320|70320 - RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH||78.96|18.42||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70310|70310 - RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH||57.94|13.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70300|70300 - RADIOLOGIC EXAMINATION TEETH 1 VIEW||22.8|9.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70260|70260 - RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS||73.6|26.68||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|7025F|7025F - INFO SYSTEM ANALYSIS ABNORMAL INTERPRATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70250|70250 - RADIOLOGIC EXAMINATION SKULL 4/> VIEWS||57.39|19.04||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70240|70240 - RADIOLOGIC EXAMINATION SELLA TURCICA||46.51|15.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70220|70220 - RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS||60.98|19.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70210|70210 - RADEX SINUSES PARANASAL <3 VIEWS||48.42|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|7020F|7020F - MAMMO ASSESSMENT CAT IN DATABASE FOR RATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70200|70200 - RADEX ORBITS COMPLETE MINIMUM 4 VIEWS||67.71|21.79||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70190|70190 - RADEX OPTIC FORAMINA||55.7|16.85||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70170|70170 - DACRYOCSTOGRAPY NASOLACRIMAL DUCT RS&I||78.47|23.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70160|70160 - RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS||51.44|13.6||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70150|70150 - RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS||66.08|20.17||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70140|70140 - RADEX FACIAL BONES < 3 VIEWS||47.02|15.73||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70134|70134 - RADEX INTERNAL AUDITORY MEATI COMPLETE||86.71|28.19||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70130|70130 - RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE||88.22|26.68||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70120|70120 - RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE||56.04|14.67||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70110|70110 - RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS||61.48|19.61||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|7010F|7010F - PT INFORMATION ENTERED INTO RECALL SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70100|70100 - RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS||53.01|14.16||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70030|70030 - RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY||44.38|13.09||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70015|70015 - CISTERNOGRAPHY POSITIVE CONTRAST RS&I||238.95|94.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|70010|70010 - MYELOGRAPY POST FOSSA RS&I||147.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69990|69990 - MICROSURG TQS REQ USE OPERATING MICROSCOPE||315.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69979|69979 - UNLISTED PROCEDURE TEMPORAL BONE MIDDLE FOSSA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69970|69970 - REMOVAL TUMOR TEMPORAL BONE||3131.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69960|69960 - DECOMPRESSION INTERNAL AUDITORY CANAL||2811.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69955|69955 - TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR||2888.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69950|69950 - VESTIBULAR NRV SECTION TRANSCRANIAL APPROACH||2613.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69949|69949 - UNLISTED PROCEDURE INNER EAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69930|69930 - COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY||1788.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69915|69915 - VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR||2245.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69910|69910 - LABYRINTHECTOMY W/MASTOIDECTOMY||1481.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69905|69905 - LABYRINTHECTOMY TRANSCANAL||1332.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69840|69840 - REVISION FENESTRATION OPERATION||1284.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69820|69820 - FENESTRATION SEMICIRCULAR CANAL||1245.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69806|69806 - ENDOLYMPHATIC SAC SHUNT||1373.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69805|69805 - ENDOLYMPHATIC SAC W/O SHUNT||1534.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69801|69801 - LABYRINTHOTOMY TRANSCANAL||301.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69799|69799 - UNLISTED PROCEDURE MIDDLE EAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69745|69745 - SUTR NRV ITPRL W/WO GRF/DCMPRN MEDIAL GENICULATE||1809.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69740|69740 - SUTR NRV ITPRL W/WO GRF/DCMPRN LAT GENICULATE||1699.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69725|69725 - DCMPRN NRV INTRATEMPORAL MEDIAL GENICULATE||2742.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69720|69720 - DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION||1718.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69718|69718 - RPLMCT OSSEOINTEGRATE IMPLNT W/MASTOIDECTOMY||1957.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69717|69717 - RPLMCT OSSEOINTEGRATE IMPLNT W/O MASTOIDECTOMY||1647.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69715|69715 - IMPLJ OSSEOINTEGRATED TEMPORAL BONE W/O MASTOID||1936.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69714|69714 - IMPLTJ OSSEOINTEGRATED TEMPORAL BONE W/MASTOID||1561.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69711|69711 - RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE||1252.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69710|69710 - IMPLTJ/RPLCMT EMGNT BONE CNDJ DEV TEMPORAL BONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69700|69700 - CLOSURE POSTAURICULAR FISTULA MASTOID SPX||996.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69676|69676 - TYMPANIC NEURECTOMY||1204.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69670|69670 - MASTOID OBLITERATION SEPARATE PROCEDURE||1368.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69667|69667 - REPAIR ROUND WINDOW FISTULA||1169.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69666|69666 - REPAIR OVAL WINDOW FISTULA||1166.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69662|69662 - REVISION STAPEDECTOMY/STAPEDOTOMY||1680.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69661|69661 - STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT||1753.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69660|69660 - STAPEDECTOMY/STAPEDOTOMY||1346.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69650|69650 - STAPES MOBILIZATION||1161.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69646|69646 - TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR||2231.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69645|69645 - TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR||2101.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69644|69644 - TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR||2141.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69643|69643 - TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR||1774.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69642|69642 - TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ||1939.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69641|69641 - TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ||1510.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69637|69637 - TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP||1988.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69636|69636 - TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ||1994.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69635|69635 - TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ||1765.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69633|69633 - TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP||1508.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69632|69632 - TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ||1561.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69631|69631 - TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ||1278.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69620|69620 - MYRINGOPLASTY||707|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69610|69610 - TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH||426.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69605|69605 - REVJ MASTOIDECTOMY W/APICECTOMY||2260.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69604|69604 - REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY||1617.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69603|69603 - REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY||1825.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69602|69602 - REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC||1579.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69601|69601 - REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY||1518.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69554|69554 - EXCISION AURAL GLOMUS TUMOR EXTENDED||3654.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69552|69552 - EXCISION AURAL GLOMUS TUMOR TRANSMASTOID||2277.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69550|69550 - EXCISION AURAL GLOMUS TUMOR TRANSCANAL||1504.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69540|69540 - EXCISION AURAL POLYP||184.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69535|69535 - RESCJ TEMPORAL BONE EXTERNAL APPROACH||3880.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69530|69530 - PETROUS APICECTOMY RADICAL MASTOIDECTOMY||2396.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69511|69511 - MASTOIDECTOMY RADICAL||1783.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69505|69505 - MASTOIDECTOMY MODIFIED RADICAL||1739.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69502|69502 - MASTOIDECTOMY COMPLETE||1409.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69501|69501 - TRANSMASTOID ANTROTOMY||1060.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69450|69450 - TYMPANOLYSIS TRANSCANAL||784.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69440|69440 - MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC||995.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69436|69436 - TYMPANOSTOMY GENERAL ANESTHESIA||234.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69433|69433 - TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA||189.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69424|69424 - VENTILATING TUBE RMVL REQUIRING GENERAL ANES||90.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69421|69421 - MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES||216.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69420|69420 - MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ||174.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69405|69405 - CATHETERIZE MIDDLE EAR CANAL||279.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69401|69401 - INFLATE MIDDLE EAR CANAL||71.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69400|69400 - INFLATE MIDDLE EAR CANAL||89.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69399|69399 - UNLISTED PROCEDURE EXTERNAL EAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69320|69320 - RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG||2211.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69310|69310 - RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX||1564.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69300|69300 - OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ||689.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69222|69222 - DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX||198.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69220|69220 - DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE||89.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69210|69210 - REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT||72.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69205|69205 - RMVL FB XTRNL AUDITORY CANAL ANES||145.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69200|69200 - RMVL FB XTRNL AUDITORY CANAL W/O ANES||83.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69155|69155 - RAD EXC XTRNL AUDITORY CANAL LES NCK DSJ||2428.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69150|69150 - RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ||1517.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69145|69145 - EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL||359.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69140|69140 - EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL||1260.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69120|69120 - EXCISION EXTERNAL EAR COMPLETE AMPUTATION||577.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69110|69110 - EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR||467.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69105|69105 - BIOPSY EXTERNAL AUDITORY CANAL||92.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69100|69100 - BIOPSY EXTERNAL EAR||71.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69090|69090 - EAR PIERCING||46.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69020|69020 - DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS||206.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69005|69005 - DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX||228.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|69000|69000 - DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE||171.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68899|68899 - UNLISTED PROCEDURE LACRIMAL SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68850|68850 - INJECTION CONTRAST MEDIUM DACRYOCYSTOGRAPY||63.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68840|68840 - PROBE LACRIMAL CANALICULI W/WO IRRIGATION||136.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68816|68816 - PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION||299.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68815|68815 - PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT||306.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68811|68811 - PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES||245.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68810|68810 - PROBE NASOLACRIMAL DUCT W/WO IRRIGATION||222.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68801|68801 - DILATION LACRIMAL PUNCTUM W/WO IRRGATION||124.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68770|68770 - CLOSURE LACRIMAL FISTULA SPX||745.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68761|68761 - CLSR LACRIMAL PUNCTUM PLUG EACH||139.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68760|68760 - CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER||173.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68750|68750 - CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT||942.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68745|68745 - CONJUNCTIVORHINOSTOMY W/O TUBE||911.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68720|68720 - DACRYOCSTORHINOSTOMY||896.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68705|68705 - CORRECTION EVERTED PUNCTUM CAUTERY||198.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68700|68700 - PLASTIC REPAIR CANALICULI||723.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68550|68550 - EXC LACRIMAL GLAND TUMOR W/OSTEOTOMY||1144.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68540|68540 - EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH||1081.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68530|68530 - RMVL FB/DACRYOLITH LACRIMAL PASSAGES||312.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68525|68525 - BIOPSY LACRIMAL SAC||326.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68520|68520 - EXCISION LACRIMAL SAC||802.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68510|68510 - BIOPSY LACRIMAL GLAND||358.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68505|68505 - EXCISION LACRIMAL GLAND XCPT TUMOR PRTL||1165.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68500|68500 - EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL||1187.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68440|68440 - SNIP INCISION LACRIMAL PUNCTUM||116.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68420|68420 - INCISION DRAINAGE LACRIMAL SAC||198.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68400|68400 - INCISION DRAINAGE LACRIMAL GLAND||159.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68399|68399 - UNLISTED PROCEDURE CONJUNCTIVA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68371|68371 - HARVESTING CONJUNCIVAL ALLOGRAPHY LIVING DONOR||467.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68362|68362 - CONJUNCTIVAL FLAP TOTAL||786.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68360|68360 - CONJUNCTIVAL FLAP BRIDGE/PARTIAL SPX||491.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68340|68340 - RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE||476.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68335|68335 - RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB||776.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68330|68330 - RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT||550.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68328|68328 - CONJUNCTPL CUL-DE-SAC W/BUCCAL MUC MEMB GRAFT||853.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68326|68326 - CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT||773.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68325|68325 - CONJUNCTIVOPLASTY W/BUCCAL MUC MEMB GRAFT||790.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68320|68320 - CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT||641.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68200|68200 - SUBCONJUNCTIVAL INJECTION||41.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68135|68135 - DESTRUCTION LESION CONJUNCTIVA||176.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68130|68130 - EXCISION LESION CONJUNCTIVA ADJACENT SCLERA||466.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68115|68115 - EXCISION LESION CONJUNCTIVA > 1 CM||214.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68110|68110 - EXCISION LESION CONJUNCTIVA </1 CM||176.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68100|68100 - BIOPSY CONJUNCTIVA||115.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68040|68040 - EXPRESSION CONJUNCTIVAL FOLLICLES||64.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|68020|68020 - INCISION CONJUNCTIVA DRAINAGE OF CYST||129.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67999|67999 - UNLISTED PROCEDURE EYELIDS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67975|67975 - RCNSTJ EYELID FULL THICKNESS SECOND STAGE||826.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67974|67974 - RCNSTJ EYELID FULL THICKNESS UPPER EYELID 1 STG||1126.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67973|67973 - RCNSTJ EYELID FULL THICKNESS LOWER EYELID 1 STG||1128.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67971|67971 - RCNSTJ EYELID FULL THICKNESS </TWO-THIRDS 1 STG||874.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67966|67966 - EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN||787.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67961|67961 - EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN||544.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67950|67950 - CANTHOPLASTY||553.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67938|67938 - REMOVAL EMBEDDED FOREIGN BODY EYELID||136.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67935|67935 - SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK||537.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67930|67930 - SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK||294.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67924|67924 - REPAIR ENTROPION EXTENSIVE||537.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67923|67923 - REPAIR ENTROPION EXCISION TARSAL WEDGE||556.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67922|67922 - REPAIR ENTROPION THERMOCAUTERIZATION||286.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67921|67921 - REPAIR ENTROPION SUTURE||324.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67917|67917 - REPAIR ECTROPION EXTENSIVE||567.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67916|67916 - REPAIR ECTROPION EXCISION TARSAL WEDGE||512.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67915|67915 - REPAIR ECTROPION THERMOCAUTERIZATION||298.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67914|67914 - REPAIR ECTROPION SUTURE||343.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67912|67912 - CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD||578.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67911|67911 - CORRECTION LID RETRACTION||670.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67909|67909 - REDUCTION OVERCORRECTION PTOSIS||525.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67908|67908 - RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ||509.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67906|67906 - RPR BLEPHAROPTOSIS SUPERIOR RECTUS FASCIAL SLING||578.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67904|67904 - RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL||714.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67903|67903 - RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL||583.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67902|67902 - RPR BLEPHAROPT FRONTALIS MUSC AUTOL FASCAL SLING||867.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67901|67901 - RPR BLEPHAROPTOSIS FRONTALIS MUSC SUTR/OTH MATRL||690.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67900|67900 - REPAIR BROW PTOSIS||608.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67882|67882 - CONSTJ INTERMARGIN ADHES/TARSOR/CANTHOR W/TRPOS||564.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67880|67880 - CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY||436.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67875|67875 - TEMPORARY CLOSURE EYELIDS SUTURE||116.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67850|67850 - DESTRUCTION LESION LID MARGIN </ 1 CM||161.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67840|67840 - EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE||187.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67835|67835 - CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF||526.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67830|67830 - CORRECTION TRICHIASIS INCCISION LID MARGIN||165.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67825|67825 - CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS||144.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67820|67820 - CORRECTION TRICHIASIS EPILATION FORCEPS ONLY||63.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67810|67810 - INCISIONAL BIOPSY EYELID SKIN & LID MARGIN||108.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67808|67808 - EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT||438.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67805|67805 - EXCISION CHALAZION MULTIPLE DIFFERENT LIDS||198.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67801|67801 - EXCISION CHALAZION MULTIPLE SAME LID||161.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67800|67800 - EXCISION CHALAZION SINGLE||123.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67715|67715 - CANTHOTOMY SEPARATE PROCEDURE||130.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67710|67710 - SEVERING TARSORRHAPHY||115.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67700|67700 - BLEPHAROTOMY DRAINAGE ABSCESS EYELID||136.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67599|67599 - UNLISTED PROCEDURE ORBIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67570|67570 - OPTIC NERVE DECOMPRESSION||1456.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67560|67560 - ORBITAL IMPLANT REMOVAL/REVISION||1145.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67550|67550 - ORBITAL IMPLANT INSERTION||1151.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67515|67515 - INJECTION MEDICATION/OTHER SUBST TENON CAPSULE||107.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67505|67505 - RETROBULBAR INJECTION ALCOHOL||99.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67500|67500 - RETROBULBAR INJECTION MEDICATION SPX||89.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67450|67450 - ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX||1453.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67445|67445 - ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN||1685.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67440|67440 - ORBITOTOMY BONE FLAP/WINDOW LATERAL W/DRG||1398.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67430|67430 - ORBITOTOMY BONE FLAP/WINDOW LATERAL RMVL FB||1411.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67420|67420 - ORBITOTOMY BONE FLAP/WINDOW LAT RMVL LESION||1944.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67415|67415 - FINE NEEDLE ASPIRATION ORBITAL CONTENTS||125.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67414|67414 - ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN||1542.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67413|67413 - ORBITOTOMY W/O BONE FLAP W/RMVL FOREIGN BODY||1018.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67412|67412 - ORBITOTOMY W/O BONE FLAP W/REMOVAL LESION||1009.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67405|67405 - ORBITOTOMY W/O BONE FLAP EXPL W/DRAINAGE ONLY||917.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67400|67400 - ORBITOTOMY W/O BONE FLAP EXPL W/WO BIOPSY||1103.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67399|67399 - UNLISTED PROCEDURE EXTRAOCULAR MUSCLE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67346|67346 - BIOPSY EXTRAOCULAR MUSCLE||244.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67345|67345 - CHEMODENERVATION EXTRAOCULAR MUSCLE||263.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67343|67343 - RLS XTNSV SCAR TISS W/O DETACHING EO MUSC SPX||780.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67340|67340 - STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC||412.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67335|67335 - PLACEMENT ADJUSTABLE SUTURE STRABISMUS||180.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67334|67334 - STRABISMUS POST FIXJ SUTR TQ W/WO MUSC RECESSION||346.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67332|67332 - STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY||403.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67331|67331 - STRABISMUS PREVIOUS EYE X INVOLVE EO MUSC||371.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67320|67320 - TRANSPOSITION PROCEDURE EXTRAOCULAR MUSC||371.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67318|67318 - STRABISMUS ANY SUPERIOR OBLIQUE MUSCLE||797.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67316|67316 - STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC||964.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67314|67314 - STRABISMUS RECESSION/RESCJ 1 VER MUSC||796.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67312|67312 - STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC||857.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67311|67311 - STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC||707.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67299|67299 - UNLISTED PROCEDURE POSTERIOR SEGMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67255|67255 - SCLERAL REINFORCEMENT SPX W/GRAFT||1001.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67250|67250 - SCLERAL REINFORCEMENT SPX W/O GRAFT||920.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67229|67229 - EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT||1276.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67228|67228 - TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION||1148.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67227|67227 - DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY||646.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67225|67225 - DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION||32.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67221|67221 - DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY||255.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67220|67220 - DSTRJ LESION CHOROID PC 1/> SESS||636.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67218|67218 - DSTRJ LESION RETINA 1/> SESS RADJ IMPLTJ||1577.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67210|67210 - DSTRJ LOCLZD LESION RETINA 1/> SESS PC||594.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67208|67208 - DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM||654.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67145|67145 - PROPH RTA DTCHMNT W/O DRG 1/> SESS||579.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67141|67141 - PROPH RTA DTCHMNT W/O DRG 1/> SESS CRTX DTHRM||577.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67121|67121 - RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR||1081.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67120|67120 - RMVL IMPLNT MATL POSTERIOR SEGMENT EXTRAOCULAR||666.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67115|67115 - RELEASE ENCIRCLING MATERIAL POSTERIOR SEGMENT||577.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67113|67113 - RPR COMPLEX RETINA DETACH VITRECT &MEMBRANE PEEL||2052.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67112|67112 - REREPAIR DETACHED RETINA||1557.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67110|67110 - RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS||901.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67108|67108 - RPR RETINAL DTCHMNT W/VITRECTOMY ANY METH||1887.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67107|67107 - REPAIR RETINAL DETACHMENT SCLERAL BUCKLING||1450.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67105|67105 - RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID PC||752.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67101|67101 - RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID CRTX||800.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67043|67043 - VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE||1907.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67042|67042 - VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA||1782.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67041|67041 - VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE||1558.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67040|67040 - VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC||1666.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67039|67039 - VITRECTOMY MCHNL PARS PLNA FOCAL ENDOLASER PC||1472.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67036|67036 - VITRECTOMY MECHANICAL PARS PLANA||1125.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67031|67031 - SEVERING VITREOUS STRANS LASER 1/> STAGES||414.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67030|67030 - DISCISSION VITREOUS STRANS PARS PLANA APPROACH||597.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67028|67028 - INTRAVITREAL NJX PHARMACOLOGIC AGT SPX||123.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67027|67027 - IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS||1015.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67025|67025 - INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX||749.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67015|67015 - ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL||675.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67010|67010 - RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT||633.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|67005|67005 - RMVL VITREOUS ANT APPR PARTIAL REMOVAL||566.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66999|66999 - UNLISTED PROCEDURE ANTERIOR SEGMENT EYE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66990|66990 - USE OPHTHALMIC ENDOSCOPE||104.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66986|66986 - EXCHANGE INTRAOCULAR LENS||1061.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66985|66985 - INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL||895.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66984|66984 - XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP||901.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66983|66983 - ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG||850.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66982|66982 - XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX WO ECP||1251.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66940|66940 - REMOVAL LENS MATERIAL EXTRACAPSULAR||926.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66930|66930 - REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS||972.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66920|66920 - RMVL LENS MATERIAL INTRACAPSULAR||855.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66852|66852 - RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY||1006.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66850|66850 - RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR||927.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66840|66840 - RMVL LENS MATERIAL ASPIR TQ 1/> STAGES||834.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66830|66830 - RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ||808.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66825|66825 - REPOSITIONING IO LENS PROSTHESIS REQ INC SPX||879.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66821|66821 - POST-CATARACT LASER SURGERY||360.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66820|66820 - DISCISSION SECONDARY MEMBRANOUS CATARACT||457.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66770|66770 - DSTRJ CYST/LESION IRIS/CILIARY BODY||545.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66762|66762 - IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS||493.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66172|66172 - FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING||1753.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66170|66170 - FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO||1390.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66165|66165 - GLAUCOMA SURGERY||968.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66160|66160 - FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT||1116.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66155|66155 - FSTLJ SCLERA GLAUCOMA THERMOCAUT IRRIDEC||987.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66150|66150 - FSTLJ SCLERA GLAUCOMA TREPHIN W/IRIDECTOMY||988.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66130|66130 - EXCISION LESION SCLERA||691.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66030|66030 - INJX ANTERIOR CHAMBER EYE MEDICATION SPX||128.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66020|66020 - INJX ANTERIOR CHAMBER EYE AIR/LIQUID SPX||148.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65930|65930 - RMVL BLOOD CLOT ANTERIOR SEGMENT EYE||758.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65920|65920 - RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE||914.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65900|65900 - RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE||1093.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65880|65880 - SEVERING ADS ANT SEG INCAL SPX CORNEOVITREAL||750.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65875|65875 - SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE||733.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65870|65870 - SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE||699.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65865|65865 - SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE||534.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65860|65860 - SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX||331.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65855|65855 - TRABECULOPLASTY BY LASER SURGERY||352.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65850|65850 - TRABECULOTOMY AB EXTERNO||1001.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65820|65820 - GONIOTOMY||845.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65815|65815 - PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN||564.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65810|65810 - PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX||543.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65800|65800 - PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX||154.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65782|65782 - OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT||1386.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65781|65781 - OCULAR SURFACE RECONSTRUCTION LIMBAL ALLOGRAFT||1518.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65780|65780 - OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE||1030.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65779|65779 - PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED||341.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65778|65778 - PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES||87.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65775|65775 - CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM||624.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65772|65772 - CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM||470.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65771|65771 - RADIAL KERATOTOMY||800.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65770|65770 - KERATOPROSTHESIS||1825.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65767|65767 - EPIKERATOPLASTY||1966.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65765|65765 - KERATOPHAKIA||2112.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65760|65760 - KERATOMILEUSIS||1456.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65757|65757 - BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT||171.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65756|65756 - KERATOPLASTY ENDOTHELIAL||1347.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65755|65755 - KERATOPLASTY PENETRATING PSEUDOPHAKIA||1440.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65750|65750 - KERATOPLASTY PENETRAING APHAKIA||1442.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65730|65730 - KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA||1436.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65710|65710 - KERATOPLASTY ANTERIOR LAMELLAR||1293.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65600|65600 - MULTIPLE PUNCTURES ANTERIOR CORNEA||400.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65450|65450 - DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION||370.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65436|65436 - RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT||440.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65435|65435 - RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION||82.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65430|65430 - CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE||122.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65426|65426 - EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG||557.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65420|65420 - EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT||434.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65410|65410 - BIOPSY CORNEA||126.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65400|65400 - EXCISION LESION CORNEA XCP PTERYGIUM||701.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66761|66761 - IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION||299.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66740|66740 - CILIARY BODY DESTRUCTION CYCLODIALYSIS||445.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66720|66720 - CILIARY BODY DESTRUCTION CRYOTHERAPY||488.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66711|66711 - ECP CILIARY BODY DSTRJ W/O RMVL CRYSTALLINE LENS||720.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66710|66710 - CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL||471.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66700|66700 - CILIARY BODY DESTRUCTION DIATHERMY||450.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66682|66682 - SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE||752.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66680|66680 - REPAIR IRIS CILIARY BODY||619.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66635|66635 - IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX||650.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66630|66630 - IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX||672.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66625|66625 - IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX||499.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66605|66605 - IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY||1198.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66600|66600 - IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES||938.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66505|66505 - IRIDOTOMY STAB INC SPX TRANSFIXION||436.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66500|66500 - IRIDOTOMY STAB INC SPX XCP TRANSFIXION||397.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66250|66250 - REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT||665.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66225|66225 - REPAIR SCLERAL STAPHYLOMA W/GRAFT||1120.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66220|66220 - REPAIR SCLERAL STAPHYLOMA W/O GRAFT||861.9|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|66185|66185 - REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT||887.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66180|66180 - AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT||1363.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66175|66175 - TRLUML DILAT AQUEOUS CANAL W/DEVICE/STENT||1309.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|66174|66174 - TRLUML DILAT AQUEOUS CANAL W/O DEVICE/STENT||1155.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65140|65140 - INSJ OC IMPLT AFTER ENCL MUSC ATTACHED||933.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65135|65135 - INSJ OC IMPLT AFTER ENCL MUSC X ATTACHED||879.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65130|65130 - INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL||866.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65290|65290 - RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU||589.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65286|65286 - RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA||579.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65285|65285 - RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T||1313.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65280|65280 - RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS||805.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65275|65275 - RPR LAC CORNEA NONPERFOR W/WO RMVL FOREIGN BODY||539.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65273|65273 - RPR LAC CJNC MOBLJ & REARGMT W/HOSPIZATION||432.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65272|65272 - RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION||397.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65270|65270 - RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR||165.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65265|65265 - RMVL FB IO FROM POST SEG NONMAGNETIC XTRJ||1305.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65260|65260 - RMVL FB IO FROM POST SEG MAG XTRJ ANT/POST ROUTE||1085.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65235|65235 - RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS||825.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65222|65222 - RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP||69.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65220|65220 - RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP||50.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65210|65210 - RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR||63.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65205|65205 - REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL||51.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65175|65175 - REMOVAL OCULAR IMPLANT||757.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65155|65155 - REINSERTION OCULAR IMPLT RNFCMT &/ ATTACH MUSCLE||1005.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65150|65150 - REINSERTION OCULAR IMPLT W/WO CONJUNCTIVAL GRAFT||651.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65125|65125 - MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX||345.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65114|65114 - EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP||1731.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65112|65112 - EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE||1650.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65110|65110 - EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY||1415.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65105|65105 - ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT||1006.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65103|65103 - ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT||911.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65101|65101 - ENUCLEATION OF EYE W/O IMPLANT||872.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65093|65093 - EVISCERATION OCULAR CONTENTS W/IMPLANT||744.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|65091|65091 - EVISCERATION OCULAR CONTENTS W/O IMPLANT||750.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64999|64999 - UNLISTED PROCEDURE NERVOUS SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64911|64911 - NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE||1477.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64910|64910 - NERVE REPAIR W/CONDUIT EACH NERVE||1181.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64907|64907 - NERVE PEDICAL TRANSFER SECOND STAGE||1609.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64905|64905 - NERVE PEDICLE TRANSFER FIRST STAGE||1490.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64902|64902 - NERVE GRAFT EACH NERVE MULTIPLE STRANDS||1056.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64901|64901 - NERVE GRAFT EACH NERVE 1 STRAND||914.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64898|64898 - NERVE GRAFT MLT STRANDS ARM/LEG >4 CM||2044.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64897|64897 - NERVE GRAFT MLT STRANDS ARM/LEG </4 CM||1884.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64896|64896 - NERVE GRAFT MLT STRANDS HAND/FOOT > 4 CM||2300.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64895|64895 - NERVE GRAFT MLT STRANDS HAND/FOOT </4 CM||1968.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64893|64893 - NERVE GRAFT 1 STRAND ARM/LEG >4 CM||1657.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64892|64892 - NERVE GRAFT 1 STRAND ARM/LEG <4 CM||1556.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64891|64891 - NRV GRF 1 STRAND HAND/FOOT >4 CM||1605.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64890|64890 - NERVE GRAFT 1 STRAND HAND/FOOT </4 CM||1602.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64886|64886 - NERVE GRAFT HEAD/NECK >4 CM||1868.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64885|64885 - NERVE GRAFT HEAD/NECK </ 4 CM||1597.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64876|64876 - SUTURE NERVE REQ SHORTENING BONE EXTREMITY||267.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64874|64874 - SUTURE NERVE REQ XTNSV MOBIL/TRPOS NERVE||244.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64872|64872 - SUTURE NERVE REQ SECONDARY/DELAYED SUTURE||170.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64870|64870 - FUSION OF FACIAL/OTHER NERVE||1520.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64868|64868 - ANASTOMOSIS FACIAL HYPOGLOSSAL||1486.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64866|64866 - ANASTOMOSIS FACIAL-SPINAL ACCESSORY||1640.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64865|64865 - SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT||1625.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64864|64864 - SUTURE FACIAL NERVE EXTRACRANIAL||1263.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64862|64862 - SUTURE LUMBAR PLEXUS||2184.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64861|64861 - SUTURE BRACHIAL PLEXUS||1909.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64859|64859 - SUTURE EACH ADDITIONAL PERIPHERAL NERVE||381.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64858|64858 - SUTURE SCIATIC NERVE||1569.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64857|64857 - SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS||1514.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64856|64856 - SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS||1455.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64840|64840 - SUTURE POSTERIOR TIBIAL NERVE||1259.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64837|64837 - SUTURE EACH ADDITIONAL NERVE HAND/FOOT||513.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64836|64836 - SUTURE 1 NERVE ULNAR MOTOR||1157.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64835|64835 - SUTURE 1 NERVE MEDIAN MOTOR THENAR||1157.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64834|64834 - SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE||1058.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64832|64832 - SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV||494.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64831|64831 - SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE||974.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64823|64823 - SYMPATHECTOMY SUPERFICIAL PALMAR ARCH||1112.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64822|64822 - SYMPATHECTOMY ULNAR ARTERY||977.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64821|64821 - SYMPATHECTOMY RADIAL ARTERY||1003.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64820|64820 - SYMPATHECTOMY DIGITAL ARTERIES EACH DIGIT||1083.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64818|64818 - SYMPATHECTOMY LUMBAR||970.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64809|64809 - SYMPATHECTOMY THORACOLUMBAR||1077.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64804|64804 - SYMPATHECTOMY CERVICOTHORACIC||1158.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64802|64802 - SYMPATHECTOMY CERVICAL||785.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64795|64795 - BIOPSY NERVE||279.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64792|64792 - EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV||1690.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64790|64790 - EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV||1189.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64788|64788 - EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV||564|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64787|64787 - IMPLANTATION NERVE END BONE/MUSCLE||354.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64786|64786 - EXCISION NEUROMA SCIATIC NERVE||1540.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64784|64784 - EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC||1049.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64783|64783 - EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT||314.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64782|64782 - EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE||645.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64778|64778 - EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT||264.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64776|64776 - EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT||557.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64774|64774 - EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE||594.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64772|64772 - TRANSECTION/AVULSION OTH SPINAL NRV XDRL||827.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64771|64771 - TRANSECTION/AVULSION OTH CRANIAL NRV XDRL||850.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64766|64766 - TRNSXJ/AVLSN OBTURAT NRV INPELV W/WO TENOTOMY||846.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64763|64763 - TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY||741.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64761|64761 - INCISION OF PELVIS NERVE||657.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64760|64760 - TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL||723.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64755|64755 - TRANSECTION/AVULSION VAGUS NERVES||1310.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64752|64752 - INCISION OF VAGUS NERVE||746.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64746|64746 - TRANSECTION/AVULSION PHRENIC NERVE||630.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64744|64744 - TRANSECTION/AVULSION GREATER OCCIPITAL NERVE||684.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64742|64742 - TRANSECTION/AVULSION FACIAL NRV DIFFERENT/CMPL||665.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64740|64740 - TRANSECTION/AVULSION LINGUAL NERVE||659.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64738|64738 - TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO||716.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64736|64736 - TRANSECTION/AVULSION MENTAL NERVE||666.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64734|64734 - TRANSECTION/AVULSION INFRAORBITAL NERVE||632.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64732|64732 - TRANSECTION/AVULSION SUPRAORBITAL NERVE||616.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64727|64727 - INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE||267.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64726|64726 - DECOMPRESSION PLANTAR DIGITAL NERVE||388.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64722|64722 - DECOMPRESSION UNSPECIFIED NERVE||508.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64721|64721 - NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE||600.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64719|64719 - NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST||563.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64718|64718 - NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW||836.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64716|64716 - NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE||765.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64714|64714 - NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS||957.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64713|64713 - NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS||1089.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64712|64712 - NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV||795.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64708|64708 - NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC||701.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64704|64704 - NEUROPLASTY NERVE HAND/FOOT||451.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64702|64702 - NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT||704.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64681|64681 - DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS||288.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64680|64680 - DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS||238.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64653|64653 - CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY||76.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64650|64650 - CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE||57.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64640|64640 - DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE||243.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64636|64636 - DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL||88.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64635|64635 - DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL||331.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64634|64634 - DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA||101.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64633|64633 - DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA||337.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64632|64632 - DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE||100.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64630|64630 - DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE||273.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64625|64625 - RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN||291.12||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64624|64624 - DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG||219.89||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64620|64620 - DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE||248.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64615|64615 - CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE||185.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64614|64614 - DESTROY NERVE EXTREM MUSC||222.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64613|64613 - DESTROY NERVE NECK MUSCLE||213.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64612|64612 - CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL||227.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64611|64611 - CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS||128.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64610|64610 - DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR||699.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64605|64605 - DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH||483.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64600|64600 - DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH||315.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64595|64595 - REVISION/RMVL PERIPHERAL/GASTRIC NPGR||185.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64590|64590 - INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR||234.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64585|64585 - REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE||211.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64581|64581 - INC IMPLTJ NEUROSTIMULATOR ELTRD SACRAL NERVE||987.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64580|64580 - INC IMPLTJ NSTIM ELTRD NEUROMUSCULAR||434.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64575|64575 - INC IMPLTJ PERIPH NERVE NEUROSTIMULATOR ELTRD||427.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64570|64570 - REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATO||813.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64569|64569 - REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV||1004.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64568|64568 - INC IMPLTJ CRNL NRV NSTIM ELTRDS & PULSE GENER||908.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64566|64566 - POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE||43.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64565|64565 - PRQ IMPLTJ NSTIM ELTRD NEUROMUSCULAR||180.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64561|64561 - PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING||580.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64555|64555 - PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV||211|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64553|64553 - PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE||237.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64550|64550 - APPLICATION OF SURFACE NEUROSTIMULATOR||12.87|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|64530|64530 - INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG||133.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64520|64520 - INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC||115.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64517|64517 - INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS||180.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64510|64510 - NJX ANES STELLATE GANGLION CRV SYMPATHETIC||104.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64508|64508 - INJECTION ANESTHETIC AGENT CAROTID SINUS SPX||109.82|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|64505|64505 - INJECTION ANES AGENT SPHENOPALATINE GANGLION||120.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64495|64495 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL||77.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64494|64494 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL||75.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64493|64493 - NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL||133.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64492|64492 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL||90.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64491|64491 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL||89.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64490|64490 - NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL||159.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64488|64488 - TAP BLOCK BILATERAL BY INJECTION(S)||118.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64486|64486 - TAP BLOCK UNILATERAL BY INJECTION(S)||76.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64484|64484 - NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC EA LV||76.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64483|64483 - NJX ANES&/STRD W/IMG TFRML EDRL LMBR/SAC 1 LVL||336.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64480|64480 - NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC EA LV||96.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64479|64479 - NJX ANES&/STRD W/IMG TFRML EDRL CRV/THRC 1 LVL||192.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64455|64455 - NJX ANES&/STEROID PLANTAR COMMON DIGITAL NERVE||52.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64454|64454 - INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG||123.53||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64451|64451 - INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG||120.15||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64450|64450 - INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH||148.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64449|64449 - INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH||123.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64448|64448 - INJECTION AA&/STRD FEMORAL NERVE CONT NFS CATH||106.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64447|64447 - INJECTION AA&/STRD FEMORAL NERVE||97.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64446|64446 - INJECTION AA&/STRD SCIATIC NERVE CONT NFS CATH||119.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64445|64445 - INJECTION AA&/STRD SCIATIC NERVE||107.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64435|64435 - INJECTION AA&/STRD PARACERVICAL NERVE||121.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64430|64430 - INJECTION AA&/STRD PUDENDAL NERVE||119.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64425|64425 - INJECTION AA&/STRD ILIOINGUINAL IH NERVES||137.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64421|64421 - INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL||136.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64420|64420 - INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL||98.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64418|64418 - INJECTION AA&/STRD SUPRASCAPULAR NERVE||107.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64417|64417 - INJECTION AA&/STRD AXILLARY NERVE||103.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64416|64416 - INJECTION AA&/STRD BRACHIAL PLEXUS CONT NFS CATH||118.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64415|64415 - INJECTION AA&/STRD BRACHIAL PLEXUS||97.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64413|64413 - INJECTION ANESTHETIC AGENT CERVICAL PLEXUS||115.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64412|64412 - N BLOCK INJ SPINAL ACCESSOR||106.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64410|64410 - INJECTION ANESTHETIC AGENT PHRENIC NERVE||125.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64408|64408 - INJECTION AA&/STRD VAGUS NERVE||113.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64405|64405 - INJECTION AA&/STRD GREATER OCCIPITAL NERVE||135.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64402|64402 - INJECTION ANESTHETIC AGENT FACIAL NERVE||107.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|64400|64400 - INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH||97.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63746|63746 - RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT||850.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63744|63744 - RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT||965.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63741|63741 - CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM||905.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63740|63740 - CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM||1355.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63710|63710 - DURAL GRAFT SPINAL||1586.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63709|63709 - RPR DURAL/CSF LEAK/PSEUDOMENINGOCELE W/LAM||1579.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63707|63707 - RPR DURAL/CEREBROSPINAL FLUID LEAK X REQ LAM||1307.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63706|63706 - REPAIR MYELOMENINGOCELE > 5 CM DIAMETER||2630.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63704|63704 - REPAIR MYELOMENINGOCELE < 5 CM DIAMETER||2346.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63702|63702 - REPAIR MENINGOCELE > 5 CM DIAMETER||2040.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63700|63700 - REPAIR MENINGOCELE < 5 CM DIAMETER||1852.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63688|63688 - REVJ/RMVL IMPLANTED SPINAL NEUROSTIM GENERATOR||525.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63685|63685 - INSJ/RPLCMT SPI NPGR DIR/INDUXIVE COUPLING||517.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63664|63664 - REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR||1147.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63663|63663 - REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR||681.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63662|63662 - RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR||1119.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63661|63661 - RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR||465.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63655|63655 - LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL||1184.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63650|63650 - PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL||613.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63621|63621 - STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION||361.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63620|63620 - STEREOTACTIC RADIOSURGERY 1 SPINAL LESION||1561.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63615|63615 - STRTCTC BX ASPIRAT/EXC LESION SPINAL CORD||1765.39|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|63610|63610 - STRTCTC STIMJ SPI CORD PRQ SPX N/FLWD OTH SURG||631.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63600|63600 - CREATION LES SPINAL CORD STEREOTACTIC METHOD PRQ||1327.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63308|63308 - VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG||466.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63307|63307 - VCRPEC LES 1 SEG IDRL LMBR/SAC TRANSPRTL/RPR||3459.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63306|63306 - VERTEBRL CORPECT LES 1 SEG IDRL THRC THORACOLMBR||3199.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63305|63305 - VERTEBRAL CORPECTOMY LES 1 SEG IDRL THRC TTHRC||3576.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63304|63304 - VERTEBRAL CORPECTOMY EXC LES 1 SEG IDRL CERVICAL||3380.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63303|63303 - VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR||3201.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63302|63302 - VCRPEC LES 1 SEG XDRL THRC THORACOLMBR||3116.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63301|63301 - VCRPEC LES 1 SGM XDRL THORACIC TTHRC||3153.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63300|63300 - VCRPEC LES 1 SGM XDRL CERVICAL||2645.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63295|63295 - OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX||481.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63290|63290 - LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL||4024.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63287|63287 - LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR||3956.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63286|63286 - LAM BX/EXC ISPI NEO IDRL IMED THORACIC||3698.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63285|63285 - LAM BX/EXC ISPI NEO IDRL IMED CERVICAL||3765.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63283|63283 - LAM BX/EXC ISPI NEO IDRL SACRAL||2729.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63282|63282 - LAM BX/EXC ISPI NEO IDRL XMED LUMBAR||2839.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63281|63281 - LAM BX/EXC ISPI NEO IDRL XMED THORACIC||3018.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63280|63280 - LAM BX/EXC ISPI NEO IDRL XMED CERVICAL||3042.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63278|63278 - LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL||2277.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63277|63277 - LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR||2234.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63276|63276 - LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC||2569.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63275|63275 - LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL||2588.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63273|63273 - LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL||2669.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63272|63272 - LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR||2743.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63271|63271 - LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC||2981.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63270|63270 - LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL||2988.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63268|63268 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL||2083.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63267|63267 - LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR||1981.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63266|63266 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC||2477.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63265|63265 - LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL||2402.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63252|63252 - LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR||4376.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63251|63251 - LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC||4377.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63250|63250 - LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL||4279.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63200|63200 - LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR||2196.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63199|63199 - LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES THORACIC||2715.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63198|63198 - LAM CORDOTOMY SCTJ BOTH TRACTS 2 STAGES CERVICAL||2300.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63197|63197 - LAM CORDOTOMY SCTJ BOTH SPINOTHALMIC TRACT THRC||2460.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63196|63196 - LAM CORDOTOMY SCTJ BOTH SPINOTHALMIC TRACTS CRV||2011.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63195|63195 - LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT THORACIC||2205.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63194|63194 - LAM CORDOTOMY SCTJ 1 SPINOTHALMIC TRACT CERVICAL||1834.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63191|63191 - LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE||1778.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63190|63190 - LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS||1816.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63185|63185 - LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS||1704.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63182|63182 - LAM&SCTJ DENTATE LIG W/WO DURAL GRF CRV >2 SEG||2305.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63180|63180 - LAM&SCTJ DENTATE LIG W/WO DURAL GRF CRV 1/2 SEG||2118.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63173|63173 - LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL||2484.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63172|63172 - LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID||2024.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63170|63170 - LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR||2281.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63103|63103 - VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG||424.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63102|63102 - VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG||3226.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63101|63101 - VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG||3343.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63091|63091 - VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG||259.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63090|63090 - VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG||2832.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63088|63088 - VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG||374.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63087|63087 - VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG||3445.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63086|63086 - VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG||278.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63085|63085 - VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG||2736.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63082|63082 - VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG||391.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63081|63081 - VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG||2550.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63078|63078 - DISCECTOMY ANT DCMPRN CORD THORACIC EA NTRSPC||281.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63077|63077 - DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC||2156.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63076|63076 - DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC||363.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63075|63075 - DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC||1978.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63066|63066 - COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG||300.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63064|63064 - COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG||2548.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63057|63057 - TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR||467.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63056|63056 - TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR||2131.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63055|63055 - TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC||2341.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63051|63051 - LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ||2467.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63050|63050 - LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG||2232.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63048|63048 - LAM FACETECTOMY&FORAMTOMY 1 SGM EA CRV THRC/LMBR||309.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63047|63047 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR||1581.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63046|63046 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT THORACIC||1739.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63045|63045 - LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT CERVICAL||1830.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63044|63044 - LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR||805.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63043|63043 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV||848.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63042|63042 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR||1869.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63040|63040 - LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL||2023.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63035|63035 - LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR||279.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63030|63030 - LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR||1387.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63020|63020 - LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC||1678.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63017|63017 - LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR||1792.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63016|63016 - LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC||2180.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63015|63015 - LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL||2133.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63012|63012 - LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR||1711.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63011|63011 - LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL||1557.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63005|63005 - LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR||1690.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63003|63003 - LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC||1780.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|63001|63001 - LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG CRV||1777.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62370|62370 - ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP||68.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62369|62369 - ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL||50.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62368|62368 - ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG||49.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62367|62367 - ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL||36.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62365|62365 - RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS||418.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62362|62362 - IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP||555.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62361|62361 - IMPLTJ/RPLCMT FS NON-PRGRBL PUMP||499.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62360|62360 - IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR||440.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62355|62355 - RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH||371.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62351|62351 - IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM||1247.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62350|62350 - IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM||570.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62329|62329 - THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT||171.42||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62326|62326 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN||234.71|0|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62323|62323 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN||373.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62322|62322 - NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN||238.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62321|62321 - NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN||380.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62320|62320 - NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN||204.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62319|62319 - INJECT SPINE W/CATH LMB/SCRL||140.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62318|62318 - INJECT SPINE W/CATH CRV/THRC||147.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62311|62311 - INJECT SPINE LUMBAR/SACRAL||289.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62310|62310 - INJECT SPINE CERV/THORACIC||154.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62294|62294 - NJX ARTERIAL OCCLUSION ARVEN MALFRMJ SPINAL||1160.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62292|62292 - INJECTION PX CHEMONUCLEOLYSIS 1/MLT LUMBAR||820.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62291|62291 - INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC||239.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62290|62290 - INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR||248.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62287|62287 - DCMPRN PERQ NUCLEUS PULPOSUS 1/> LEVELS LUMBAR||802.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62284|62284 - INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR||123.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62282|62282 - INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL||204.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62281|62281 - INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC||220.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62280|62280 - INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID||240.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62273|62273 - INJECTION EPIDURAL BLOOD/CLOT PATCH||164.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62272|62272 - THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF||122.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62270|62270 - DIAGNOSTIC LUMBAR SPINAL PUNCTURE||112.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62269|62269 - BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE||383.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62268|62268 - PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX||375.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62267|62267 - PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS||228.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62264|62264 - PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY||345.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62263|62263 - PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS||485.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62258|62258 - RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT||1617.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62256|62256 - RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT||854.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62252|62252 - REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT||126.19|73.23||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62230|62230 - RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS||1209.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62225|62225 - RPLCMT/IRRIGATION VENTRICULAR CATHETER||742.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62223|62223 - CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS||1513.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62220|62220 - CRTJ SHUNT VENTRICULO-ATR-JUG-AUR||1467.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62201|62201 - VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC||1723.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62200|62200 - VENTRICULOCISTERNOSTOMY 3RD VENTRICLE||1979.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62194|62194 - RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER||594.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62192|62192 - CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH||1401.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62190|62190 - CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR||1322.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62180|62180 - VENTRICULOCISTERNOSTOMY||2303.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62165|62165 - NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID||2240.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62164|62164 - NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY||2996.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62163|62163 - NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY||1758.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62162|62162 - NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG||2722.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62161|62161 - NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS||2178.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62160|62160 - NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS||275.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62148|62148 - INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT||183.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62147|62147 - CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER||2101.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62146|62146 - CRANIOPLASTY W/AUTOGRAFT </ 5 CM DIAMETER||1788.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62145|62145 - CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG||2035.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62143|62143 - RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL||1495.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62142|62142 - RMVL BONE FLAP/PROSTHETIC PLATE SKULL||1275.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62141|62141 - CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER||1644.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62140|62140 - CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER||1498.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62121|62121 - CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE||2416.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62120|62120 - RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY||2445.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62117|62117 - RDCTJ CRANIOMEGALIC CRANIO&RECNSTJ W/WO GRAFT||2309.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62116|62116 - REDUCTION OF SKULL DEFECT||2552.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62115|62115 - RDCTJ CRANIOMEGALIC SKULL W/O GRAFT/CRANIOPLASTY||1791.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62100|62100 - CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA||2313.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62010|62010 - ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN||2198.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62005|62005 - ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL||1821.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|62000|62000 - ELEVATION DEPRESSED SKULL FX SIMPLE EXTRADURAL||1282.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61888|61888 - REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR||557.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61886|61886 - INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS||1203.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61885|61885 - INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR||754.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61880|61880 - REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS||810.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61875|61875 - IMPLANT NEUROELECTRODES||1485.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61870|61870 - CRNEC IMPLTJ NSTIM ELTRD CEREBELLAR CORTICAL||1703.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61868|61868 - STRTCTC IMPLTJ NSTIM ELTRD W/RECORD EA ARRAY||728.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61867|61867 - STRTCTC IMPLTJ NSTIM ELTRD W/RECORD 1ST ARRAY||3292.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61864|61864 - STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD EA ARRAY||413.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61863|61863 - STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY||2160.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61860|61860 - CRNEC/CRX IMPLTJ NSTIM ELTRD CERE CORTICAL||2253.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61850|61850 - TWIST/BURR HOLE IMPLTJ NSTIM ELTRD CORTICAL||1410.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61800|61800 - APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY||218.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61799|61799 - STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX||434.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61798|61798 - STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES||1921.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61797|61797 - STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE||314.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61796|61796 - STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES||1420.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61791|61791 - CREATE LES STRTCTC PRQ NEUROLYTIC TRIGEMINAL TRC||1596.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61790|61790 - CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN||1245.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61783|61783 - STEREOTACTIC COMPUTER ASSISTED PX SPINAL||341.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61782|61782 - STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL||280.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61781|61781 - STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL||341.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61770|61770 - STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC||2316.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61760|61760 - STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING||2262.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61751|61751 - STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR||1973.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61750|61750 - STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES||2020.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61735|61735 - CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN||2262.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61720|61720 - CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS||1807.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61711|61711 - ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES||3761.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61710|61710 - ARYSM VASC MALFRMJ IA EMBOLIZATION||2861.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61708|61708 - ARYSM VASC MALFRMJ/ICRA ELECTROTHROMBOSIS||2996.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61705|61705 - ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART||3742.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61703|61703 - ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART||1953.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61702|61702 - SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ||5800.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61700|61700 - SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION||4940.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61698|61698 - CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ||6676.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61697|61697 - COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION||6094.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61692|61692 - INTRACRANIAL ARVEN MALFRMJ DURAL CMPL||5286.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61690|61690 - INTRACRANIAL ARVEN MALFRMJ DURAL SMPL||3146.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61686|61686 - INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL||6509.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61684|61684 - INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL||4095.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61682|61682 - INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL||6060.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61680|61680 - INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL||3259.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61642|61642 - PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER||633.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61641|61641 - PERQ BALO DILA IC VSPSM EA VSL SM VASC TER||316.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61640|61640 - BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL||900.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61635|61635 - TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD||1993.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61630|61630 - BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS||1819.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61626|61626 - TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS||1244.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61624|61624 - TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS||1601.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61623|61623 - EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK||807.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61619|61619 - SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP||2138.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61618|61618 - SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT||1873.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61616|61616 - RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL||4779.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61615|61615 - RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL||3323.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61613|61613 - OBLTRJ CAROTID ARYSM ARTVEN CAROTID FISTULA DSJ||4709.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61612|61612 - TRNSXJ/LIG CRTD ART PETROUS CANAL RPR ANAST/GRF||2057.58|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|61611|61611 - TRNSXJ/LIG CAROTID ARTERY PETROUS CANAL W/O RPR||551.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61610|61610 - TRNSXJ/LIG CAROTID ARTERY SINUS W/RPR ANAST/GRFT||2601.5|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|61609|61609 - TRANSECT ARTERY SINUS||862.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61608|61608 - RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL||4667.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61607|61607 - RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL||4152.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61606|61606 - RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR||4316.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61605|61605 - RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL||3168.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61601|61601 - RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF||3437.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61600|61600 - RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL||3079.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61598|61598 - TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM||4012.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61597|61597 - TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL||4185.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61596|61596 - TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART||3598.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61595|61595 - TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV||3408.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61592|61592 - ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE||4554.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61591|61591 - INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI||4488.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61590|61590 - INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN||4429.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61586|61586 - BICORONAL TRANSZYGMTC&/LEFORT I W/O BONE GRFT||3440.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61585|61585 - ORBITOCRANIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ||4607.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61584|61584 - ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ||4096.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61583|61583 - CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE||4160.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61582|61582 - CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT||4332.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61581|61581 - CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ||3894.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61580|61580 - CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ||3563.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61576|61576 - TRNSRL SKUL BSE/BR STM/CORD BX/DCMP/ SPLT TONGUE||5369.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61575|61575 - TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES||3596.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61571|61571 - CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN||2865.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61570|61570 - CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN||2682.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61567|61567 - CRANIOTOMY MULTIPLE SUBPIAL TRANSECTIONS W/ECOG||3700.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61566|61566 - CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY||3243.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61564|61564 - EXC BENIGN TUM CRANIAL BONE W/OPTIC NRV DCMPRN||3469|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61563|61563 - EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN||2852.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61559|61559 - XTN CRNEC MLT SUTR CRANIOSYNOSTOSIS W/BONE GRAFT||2706.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61558|61558 - XTN CRANIECT MULTIPLE SUTURE CRANIOSYNOSTOSIS||2702.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61557|61557 - CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP||2419.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61556|61556 - CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP||2441.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61552|61552 - CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES||1841.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61550|61550 - CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE||1462.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61548|61548 - HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL||2248.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61546|61546 - CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR||3323.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61545|61545 - CRANIOTOMY EXCISION CRANIOPHARYNGIOMA||4588.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61544|61544 - CRANIOTOMY EXCISION/COAGULATION CHOROID PLEXUS||2703.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61543|61543 - CRANIOTOMY PARTIAL/SUBTOTAL HEMISPHERECTOMY||3120.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61542|61542 - REMOVAL OF BRAIN TISSUE||3171.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61541|61541 - CRANIOTOMY TRANSECTION CORPUS CALLOSUM||3094.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61540|61540 - CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG||3146.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61539|61539 - CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/ECOG||3398.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61538|61538 - CRANIOT LOBEC TEMPORAL LOBE W/ELECTROCORTCOGRPHY||3838.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61537|61537 - CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY||3541.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61536|61536 - CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY||3722.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61535|61535 - CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX||1431.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61534|61534 - CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY||2365.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61533|61533 - CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING||2190.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61531|61531 - SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING||1752.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61530|61530 - CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA||4351.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61526|61526 - CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM||5249.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61524|61524 - CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST||2995.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61522|61522 - CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS||3152.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61521|61521 - CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL||4592.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61520|61520 - CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM||5423.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61519|61519 - CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA||4254.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61518|61518 - CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA||3977.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61517|61517 - IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT||126.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61516|61516 - CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR||2672.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61514|61514 - CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR||2743.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61512|61512 - CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR||3680.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61510|61510 - CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR||3144.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6150F|6150F - PT NOT RCVNG 1ST COURSE OF ANTI-TNF THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61501|61501 - CRANIECTOMY OSTEOMYELITIS||1662.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61500|61500 - CRANIECTOMY W/EXCISION TUMOR/LESION SKULL||1922.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61490|61490 - INCISE SKULL FOR SURGERY||2729.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61480|61480 - CRNEC SUBOCPTL MESENCEPHAL TRCOTOMY/PEDUNCULOTMY||2379.17|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|61470|61470 - INCISE SKULL FOR SURGERY||2578.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61460|61460 - CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NR||3022.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61458|61458 - CRNEC SOPL EXPL/DCMPRN CRNL NRV||2890.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61450|61450 - CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION||2767.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61440|61440 - INCISE SKULL FOR SURGERY||2883.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61345|61345 - OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA||2938.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61343|61343 - CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD||3162.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61340|61340 - SUBTEMPORAL CRANIAL DECOMPRESSION||2075.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61334|61334 - EXPLORE ORBIT/REMOVE OBJECT||1782.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61333|61333 - EXPL ORBIT TRANSCRANIAL APPROACH W/RMVL LESION||2956.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61332|61332 - EXPLORATION ORBIT TRANSCRANIAL APPROACH W/BIOPSY||2888.98|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|61330|61330 - DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH||2584.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61323|61323 - CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY||3437.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61322|61322 - CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY||3412.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61321|61321 - CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL||3060.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61320|61320 - CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL||2742.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61316|61316 - INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF||127.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61315|61315 - CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL||2981.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61314|61314 - CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL||2629.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61313|61313 - CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL||2855.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61312|61312 - CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL||2997|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61305|61305 - CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL||2892.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61304|61304 - CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL||2361.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61253|61253 - BURR HOLE/TREPHINE INFRATENTORIAL UNI/BI||1201.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61250|61250 - BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG||1238.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61215|61215 - INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH||719.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61210|61210 - BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE||535.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61156|61156 - BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL||1789.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61154|61154 - BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL||1820.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61151|61151 - BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST||1424.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61150|61150 - BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST||1945.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61140|61140 - BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION||1809.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61120|61120 - BURR HOLE VENTRICULAR PUNCTURE||1063.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6110F|6110F - COUNSELING PROV RE RISKS DRIVING ALT TO DRIVING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61108|61108 - TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA||1293.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61107|61107 - TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE||458.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61105|61105 - TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE||656.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61070|61070 - PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX||120.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61055|61055 - CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION||194.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61050|61050 - CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX||148.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6102F|6102F - SAFETY COUNSELING DEMENTIA ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61026|61026 - VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ||184.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61020|61020 - VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX||195.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6101F|6101F - SAFETY COUNSELING DEMENTIA PROVIDED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6100F|6100F - VERIFY CORRECT PT SITE PXD DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61001|61001 - SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI SBSQ||166.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|61000|61000 - SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT||156.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6090F|6090F - PATIENT SAFETY COUNSEL DISEASE STAGE APPROPRIATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6080F|6080F - PATIENT QUERIED ABOUT FALLS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6070F|6070F - PATIENT QUERIED COUNSELED RE AED SIDE EFFECTS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60699|60699 - UNLISTED PROCEDURE ENDOCRINE SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60659|60659 - UNLISTED LAPAROSCOPY PROCEDURE ENDOCRINE SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60650|60650 - LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL||1717.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60605|60605 - EXC CAROTID BODY TUMOR W EXC CAROTID ARTERY||2382.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60600|60600 - EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY||2085.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60545|60545 - ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR||1748.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60540|60540 - ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX||1522.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60522|60522 - THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX||2020.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60521|60521 - THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX||1661.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60520|60520 - THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX||1490.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60512|60512 - PARATHYROID AUTOTRANSPLANTATION ADD-ON||352.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60505|60505 - PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC||2021.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60502|60502 - PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR||1842.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60500|60500 - PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS||1387.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6045F|6045F - RAD EXPOS/TIME IN LAST RPRT FLUORO PRXD DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6040F|6040F - USE APPROP RAD DOSE RDXN DEV/MAN TECHS DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6030F|6030F - ALL ELEM OF MAX STERILE BARRIER TECHNQ FLWD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60300|60300 - ASPIRATION AND/OR INJECTION THYROID CYST||71.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60281|60281 - EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT||854.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60280|60280 - EXCISION THYROGLOSSAL DUCT CYST/SINUS||639.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60271|60271 - THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH||1528.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60270|60270 - THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC||1982.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60260|60260 - THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL||1584.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60254|60254 - THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT||2421.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60252|60252 - THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT||1902.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60240|60240 - THYROIDECTOMY TOTAL/COMPLETE||1328.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60225|60225 - TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC||1339.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60220|60220 - TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY||1024.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60212|60212 - PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC||1460.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60210|60210 - PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY||1020.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6020F|6020F - NOTHING BY MOUTH ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60200|60200 - EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS||950.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6015F|6015F - PATIENT OK FOR PER ORAL INTAKE (FOOD/MEDICATION)||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6010F|6010F - DYSPHAGIA SCREENING PRIOR ORAL INTAKE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60100|60100 - BIOPSY THYROID PERCUTANEOUS CORE NEEDLE||114.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|6005F|6005F - RATIONALE FOR LEVEL OF CARE DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|60000|60000 - I&D THYROGLOSSAL DUCT CYST INFECTED||209.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59899|59899 - UNLISTED PROCEDURE MATERNITY CARE & DELIVERY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59898|59898 - UNLISTED LAPAROSCOPY PX MATERNITY CARE&DELIVERY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59897|59897 - UNLISTED FETAL INVASIVE PX W/ULTRASOUND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59871|59871 - REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA||197.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59870|59870 - UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE||689.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59866|59866 - MULTIFETAL PREGNANCY REDUCTION||310.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59857|59857 - INDUCED ABORT 1/> VAG SUPPOS DLVR FETUS HYSTOT||744.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59856|59856 - INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC||717.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59855|59855 - INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS||608.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59852|59852 - INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS HYSTOTM||720.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59851|59851 - INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS D&C||584.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59850|59850 - INDUCED ABORTION 1/> AMNIOTIC INJX W/D&C/EVACJ||498.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59841|59841 - INDUCED ABORTION DILATION & EVACUATION||528.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59840|59840 - INDUCED ABORTION DILATION AND CURETTAGE||301.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59830|59830 - TX SEPTIC ABORTION SURGICAL||639.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59821|59821 - TX MISSED ABORTION SECOND TRIMESTER SURGICAL||521.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59820|59820 - TX MISSED ABORTION FIRST TRIMESTER SURGICAL||517.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59812|59812 - TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL||431.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59622|59622 - CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA||1907.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59620|59620 - CESAREAN DELIVERY ATTEMPTED VBAC||1410.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59618|59618 - ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC||3422.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59614|59614 - VAGINAL DELIVERY & POSTPARTUM CARE VBAC||1675.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59612|59612 - VAGINAL DELIVERY AFTER CESAREAN DELIVERY||1354.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59610|59610 - ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB||3192.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59525|59525 - STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY||719.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59515|59515 - CESAREAN DELIVERY ONLY W/POSTPARTUM CARE||1850.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59514|59514 - CESAREAN DELIVERY ONLY||1359.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59510|59510 - OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM||3368.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59430|59430 - POSTPARTUM CARE ONLY SEPARATE PROCEDURE||206.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59426|59426 - ANTEPARTUM CARE ONLY 7/> VISITS||928.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59425|59425 - ANTEPARTUM CARE ONLY 4-6 VISITS||526.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59414|59414 - DELIVERY PLACENTA SEPARATE PROCEDURE||135.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59412|59412 - EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS||152.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59410|59410 - VAGINAL DELIVERY ONLY W/POSTPARTUM CARE||1529.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59409|59409 - VAGINAL DELIVERY ONLY||1204.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59400|59400 - OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM||3037.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59350|59350 - HYSTERORRHAPHY RUPTURED UTERUS||415.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59325|59325 - CERCLAGE CERVIX PREGNANCY ABDOMINAL||317.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59320|59320 - CERCLAGE CERVIX PREGNANCY VAGINAL||224.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59300|59300 - EPISIOTOMY/VAG RPR OTH/THN ATTENDING||217.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59200|59200 - INSERTION CERVICAL DILATOR SEPARATE PROCEDURE||66.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59160|59160 - CURETTAGE POSTPARTUM||256.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59151|59151 - LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY||1101.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59150|59150 - LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY||1130.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59140|59140 - TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION||523.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59136|59136 - TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER||1284.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59135|59135 - TX ECTOPIC PREGNANCY NTRSTL REQ TOT HYST||1219.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59130|59130 - TX ECTOPIC PREGNANCY ABDL PREGNANCY||1201.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59121|59121 - TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY||1169.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59120|59120 - TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR||1168.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59100|59100 - HYSTEROTOMY ABDOMINAL||1224.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59076|59076 - FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE||765.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59074|59074 - FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE||468.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59072|59072 - FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE||768.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59070|59070 - TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE||461.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59051|59051 - FETAL MONITR LABOR PHYS WRTTN REPRT INTERPJ ONLY||62.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59050|59050 - FETAL MONITORING LABOR PHYS WRITTEN REPORT||75.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59030|59030 - FETAL SCALP BLOOD SAMPLING||143.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59025|59025 - FETAL NONSTRESS TEST||68.06|47.62||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59020|59020 - FETAL CONTRACTION STRESS TEST||99.98|59.53||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59015|59015 - CHORIONIC VILLUS SAMPLING||195.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59012|59012 - CORDOCENTESIS INTRAUTERINE||296.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59001|59001 - AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID||267.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|59000|59000 - AMNIOCENTESIS DIAGNOSIC||119.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58999|58999 - UNLISTED PX FEMALE GENITAL SYSTEM NONOBSTETRICAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58976|58976 - GAMETE ZYGOTE/EMBRYO FALLOPIAN TRANSFER ANY METH||299.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58974|58974 - EMBRYO TRANSFER INTRAUTERINE||211.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58970|58970 - FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD||277.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58960|58960 - LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK||1355.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58958|58958 - RESECTION RECRT MAL W/OMENTECTOMY PEL LMPHADEC||2437.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58957|58957 - RESECJ RECUR OVARIAN/TUBAL/PERITONEAL MALIGNANCY||2217.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58956|58956 - BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC||1939.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58954|58954 - BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY||3081.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58953|58953 - BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION||2842.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58952|58952 - RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING||2296.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58951|58951 - RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD||2033.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58950|58950 - RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO||1580.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58943|58943 - OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY||1654.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58940|58940 - OOPHORECTOMY PARTIAL/TOTAL UNI/BI||752.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58925|58925 - OVARIAN CYSTECTOMY UNI/BI||1079.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58920|58920 - WEDGE RESCJ/BISCTJ OVARY UNI/BI||1022.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58900|58900 - BIOPSY OVARY UNI/BI SEPARATE PROCEDURE||641.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58825|58825 - TRANSPOSITION OVARY||1033.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58823|58823 - DRAIN PELVIC ABSCESS PERCUT||248.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58822|58822 - DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH||1074.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58820|58820 - DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN||453.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58805|58805 - DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL||586.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58800|58800 - DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR||434.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58770|58770 - SALPINGOSTOMY||1242.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58760|58760 - FIMBRIOPLASTY||1186.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58752|58752 - TUBOUTERINE IMPLANTATION||1248.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58750|58750 - TUBOTUBAL ANASTATOMOSIS||1320.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58740|58740 - LYSIS OF ADHESIONS SALPINX/OVARY||1280.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58720|58720 - SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX||1053.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58700|58700 - SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX||1130.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58679|58679 - UNLISTED LAPAROSCOPY PROCEDURE OVIDUCT/OVARY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58673|58673 - LAPAROSCOPY SALPINGOSTOMY||1172.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58672|58672 - LAPAROSCOPY FIMBRIOPLASTY||1078.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58671|58671 - LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS||532.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58670|58670 - LAPAROSCOPY FULGURATION OVIDUCTS||532.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58662|58662 - LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE||1031.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58661|58661 - LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES||942.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58660|58660 - LAPAROSCOPY W/LYSIS OF ADHESIONS||983.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58615|58615 - OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR||357.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58611|58611 - LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG||113.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58605|58605 - LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX||479.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58600|58600 - LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI||531.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58579|58579 - UNLISTED HYSTEROSCOPY PROCEDURE UTERUS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58578|58578 - UNLISTED LAPAROSCOPY PROCEDURE UTERUS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58573|58573 - LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR||1932.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58572|58572 - LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM||1689.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58571|58571 - LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY||1507.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58570|58570 - LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<||1355.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58565|58565 - HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS||633.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58563|58563 - HYSTEROSCOPY ENDOMETRIAL ABLATION||503.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58562|58562 - HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY||425.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58561|58561 - HYSTEROSCOPY REMOVAL LEIOMYOMATA||804.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58560|58560 - HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM||568.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58559|58559 - HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS||504.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58558|58558 - HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C||391.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58555|58555 - HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE||278.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58554|58554 - LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR||1924.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58553|58553 - LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS||1663.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58552|58552 - LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES||1434.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58550|58550 - LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<||1291.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58548|58548 - LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY||2639.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58546|58546 - LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS||1652.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58545|58545 - LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<||1309.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58544|58544 - LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY||1551.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58543|58543 - LAPS SUPRACERVICAL HYSTERECTOMY >250||1432.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58542|58542 - LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR||1408.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58541|58541 - LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<||1260.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58540|58540 - HYSTEROPLASTY RPR UTERINE ANOMALY||1329.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58520|58520 - HYSTERORRHAPHY REPAIR RUPT UTERUS NONOBSTETRICAL||1180.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58410|58410 - UTERINE SUSP W/WO SHORT LIGAMNTS W/SYMPATHECTOMY||1175.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58400|58400 - UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX||639|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58356|58356 - ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR||510.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58353|58353 - ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID||1446.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58350|58350 - CHROMOTUBATION OVIDUCT W/MATERIALS||114|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58346|58346 - INSERTION HEYMAN CAPSULES CLINICAL BRACHYTHERAPY||646|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58345|58345 - TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING||408.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58340|58340 - CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI||83.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58323|58323 - SPERM WASHING ARTIFICIAL INSEMINATION||18.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58322|58322 - ARTIFICIAL INSEMINATION INTRA-UTERINE||86.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58321|58321 - ARTIFICIAL INSEMINATION INTRA-CERVICAL||67.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58301|58301 - REMOVAL INTRAUTERINE DEVICE IUD||100.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58300|58300 - INSERTION INTRAUTERINE DEVICE IUD||100.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58294|58294 - VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE||1787.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58293|58293 - VAG HYST >250 GM COLPOURTCSTOPEXY W/WO NDSC CTR||2005.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58292|58292 - VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE||1929.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58291|58291 - VAG HYST > 250 GM RMVL TUBE&/OVARY||1827.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58290|58290 - VAGINAL HYSTERECTOMY UTERUS > 250 GM||1686.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58285|58285 - VAGINAL HYSTERECTOMY RADICAL SCHAUTA OPERATION||1923.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58280|58280 - VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE||1542.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58275|58275 - VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY||1441.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58270|58270 - VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE||1290.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58267|58267 - VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY||1546.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58263|58263 - VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL||1451.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58262|58262 - VAG HYST 250 GM/< W/RMVL TUBE&/OVARY||1349.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58260|58260 - VAGINAL HYSTERECTOMY UTERUS 250 GM/<||1209.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58240|58240 - PEL EXNTJ GYNECOLOGIC MAL||4092.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58210|58210 - RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY||2578.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58200|58200 - TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM||1924.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58180|58180 - SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY||1399.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58152|58152 - TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY||1826.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58150|58150 - TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY||1457.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58146|58146 - MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA||1692.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58145|58145 - MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR||793.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58140|58140 - MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR||1343.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58120|58120 - DILATION & CURETTAGE DX&/THER NONOBSTETRIC||317.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58110|58110 - ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY||60.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|58100|58100 - ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX||128.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57800|57800 - DILATION CERVICAL CANAL INSTRUMENTAL SPX||70.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57720|57720 - TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG||446.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57700|57700 - CERCLAGE UTERINE CERVIX NONOBSTETRICAL||449.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57558|57558 - DILATION & CURETTAGE CERVICAL STUMP||165.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57556|57556 - EXC CRV STUMP VAG APPR W/RPR NTRCL||823.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57555|57555 - EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR||876.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57550|57550 - EXCISION CERVICAL STUMP VAGINAL APPROACH||594.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57545|57545 - EXC CERVICAL STUMP ABDL APPR W/PELVIC FLOOR RPR||1202.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57540|57540 - EXCISION CERVICAL STUMP ABDOMINAL APPROACH||1139.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57531|57531 - RAD TRACHELECTOMY W/BI PEL LMPHADEC||2528.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57530|57530 - TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX||500.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57522|57522 - CONIZATION CERVIX W/WO D&C RPR ELTRD EXC||353.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57520|57520 - CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER||395.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57513|57513 - CAUTERY CERVIX LASER ABLATION||192.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57511|57511 - CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT||191.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57510|57510 - CAUTERY CERVIX ELECTRO/THERMAL||168.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57505|57505 - ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C||132.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57500|57500 - BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX||110.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57461|57461 - COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX||276.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57460|57460 - COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX||239.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57456|57456 - COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE||151.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57455|57455 - COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX||162.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57454|57454 - COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE||198.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57452|57452 - COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA||133.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57426|57426 - REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC||1244.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57425|57425 - LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX||1418.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57423|57423 - PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH||1346.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57421|57421 - COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX||179.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57420|57420 - COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT||131.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57415|57415 - REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL||231.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57410|57410 - PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL||155.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57400|57400 - DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL||194.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57335|57335 - VAGINOPLASTY INTERSEX STATE||1648.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57330|57330 - CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR||1067.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57320|57320 - CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH||771.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57311|57311 - CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL||755.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57310|57310 - CLOSURE URETHROVAGINAL FISTULA||663.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57308|57308 - CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ||933.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57307|57307 - CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST||1523.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57305|57305 - CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH||1336.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57300|57300 - CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR||801.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57296|57296 - REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR||1392.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57295|57295 - REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP||697.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57292|57292 - CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT||1199.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57291|57291 - CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT||886.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57289|57289 - PEREYRA PX W/ANTERIOR COLPORRHAPHY||1047.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57288|57288 - SLING OPERATION STRESS INCONTINENCE||1035.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57287|57287 - RMVL/REVJ SLING STRESS INCONTINENCE||987.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57285|57285 - PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH||983.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57284|57284 - PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR||1194.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57283|57283 - COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH||1007.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57282|57282 - COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH||727.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57280|57280 - COLPOPEXY ABDOMINAL APPROACH||1394.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57270|57270 - REPAIR ENTEROCELE ABDOMINAL APPROACH SPX||1165.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57268|57268 - REPAIR ENTEROCELE VAGINAL APPROACH SPX||700.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57267|57267 - INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE||378.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57265|57265 - CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR||1331.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57260|57260 - CMBND ANTERPOST COLPORRAPHY W/CYSTO||1212.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57250|57250 - POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY||982|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57240|57240 - ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO||970.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57230|57230 - PLASTIC REPAIR URETHROCELE||579.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57220|57220 - PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH||463.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57210|57210 - COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU||531.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57200|57200 - COLPORRHAPHY SUTURE INJURY VAGINA||431.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57180|57180 - INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX||153.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57170|57170 - DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS||70.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57160|57160 - FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI||69.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57156|57156 - INSERTION VAGINAL RADIATION DEVICE||205.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57155|57155 - INSERTION UTERINE TANDEM&/VAGINAL OVOIDS||404.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57150|57150 - IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE||42.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57135|57135 - EXCISION VAGINAL CYST/TUMOR||250.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57130|57130 - EXCISION VAGINAL SEPTUM||232.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57120|57120 - COLPOCLEISIS LE FORT TYPE||743.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57112|57112 - VAGNC COMPL RMVL VAG WALL TOT PEL LMPHADEC BX||2391.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57111|57111 - VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS||2356.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57110|57110 - VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL||1312.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57109|57109 - VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC||2350.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57107|57107 - VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T||2053.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57106|57106 - VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL||699.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57105|57105 - BIOPSY VAGINAL MUCOSA EXTENSIVE||180.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57100|57100 - BIOPSY VAGINAL MUCOSA SIMPLE||96.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57065|57065 - DESTRUCTION VAGINAL LESIONS EXTENSIVE||248.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57061|57061 - DESTRUCTION VAGINAL LESIONS SIMPLE||141.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57023|57023 - I&D VAGINAL HEMATOMA NON-OBSTETRICAL||454.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57022|57022 - I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM||244.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57020|57020 - COLPOCENTESIS SEPARATE PROCEDURE||120.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57010|57010 - COLPOTOMY W/DRAINAGE PELVIC ABSCESS||632.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|57000|57000 - COLPOTOMY W/EXPLORATION||269.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56821|56821 - COLPOSCOPY VULVA W/BIOPSY||168|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56820|56820 - COLPOSCOPY VULVA||125.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56810|56810 - PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX||378.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56805|56805 - CLITOROPLASTY INTERSEX STATE||1680.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56800|56800 - PLASTIC REPAIR INTROITUS||350.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56740|56740 - EXC BARTHOLINS GLAND/CYST||433.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56700|56700 - PRTL HYMENECTOMY/REVJ HYMENAL RING||272.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56640|56640 - VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY||2091.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56637|56637 - VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY||2096.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56634|56634 - VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY||1786.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56633|56633 - VULVECTOMY RADICAL COMPLETE||1685.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56632|56632 - VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY||1909.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56631|56631 - VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY||1643.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56630|56630 - VULVECTOMY RADICAL PARTIAL||1295.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56625|56625 - VULVECTOMY SIMPLE COMPLETE||877.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56620|56620 - VULVECTOMY SIMPLE PARTIAL||730.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56606|56606 - BIOPSY VULVA/PERINEUM EACH ADDL LESION||42.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56605|56605 - BIOPSY VULVA/PERINEUM 1 LESION SPX||88.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56515|56515 - DESTRUCTION LESIONS VULVA EXTENSIVE||288.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56501|56501 - DESTRUCTION LESIONS VULVA SIMPLE||165.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56442|56442 - HYMENOTOMY SIMPLE INCISION||69.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56441|56441 - LYSIS LABIAL ADHESIONS||199.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56440|56440 - MARSUPIALIZATION BARTHOLINS GLAND CYST||266.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56420|56420 - I&D OF BARTHOLINS GLAND ABSCESS||133.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|56405|56405 - I&D VULVA/PERINEAL ABSCESS||156.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55980|55980 - INTERSEX SURG FEMALE MALE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55970|55970 - INTERSEX SURG MALE FEMALE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55920|55920 - PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL||631.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55899|55899 - UNLISTED PROCEDURE MALE GENITAL SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55876|55876 - PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT||145.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55875|55875 - TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ||1106.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55873|55873 - CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI||1162.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55870|55870 - ELECTROEJACULATION||208.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55866|55866 - LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT||2527.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55865|55865 - EXPOS PROSTATE INSJ RADIOAC SBST W/BI PELV LYMPH||1944.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55862|55862 - EXPOS PROSTATE INSJ RADIOACT SBST W/LYMPH BX||1597.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55860|55860 - EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST||1271.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55845|55845 - PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM||2385.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55842|55842 - PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX||2088.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55840|55840 - PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING||1948.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55831|55831 - PROSTATECTOMY RETROPUBIC SUBTOTAL||1375.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55821|55821 - PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES||1271.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55815|55815 - PROSTATECTOMY PERINEAL RAD W/BI PELVIC LYMPH EXC||2570.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55812|55812 - PROSTATECTOMY PERINEAL RADICAL W/LYMPH NODE BX||2344.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55810|55810 - PROSTATECTOMY PERINEAL RADICAL||1918.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55801|55801 - PROSTATECTOMY PERINEAL SUBTOTAL||1587.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55725|55725 - PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED||858.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55720|55720 - PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE||654.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55706|55706 - BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID||536.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55705|55705 - BIOPSY PROSTATE INCISIONAL ANY APPROACH||387.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55700|55700 - PROSTATE NEEDLE BIOPSY ANY APPROACH||202.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55680|55680 - EXCISION MULLERIAN DUCT CYST||497.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55650|55650 - VESICULECTOMY ANY APPROACH||1039.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55605|55605 - VESICULOTOMY COMPLICATED||747.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55600|55600 - VESICULOTOMY||610.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55559|55559 - UNLISTED LAPROSCOPY PROCEDURE SPERMATIC CORD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55550|55550 - LAPS LIGATION SPERMATIC VEINS VARICOCELE||617.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55540|55540 - EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR||767.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55535|55535 - EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL||621.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55530|55530 - EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX||512.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55520|55520 - EXC LESION SPERMATIC CORD SEPARATE PROCEDURE||642.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55500|55500 - EXC HYDROCELE SPRMATIC CORD UNI SPX||571.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55450|55450 - LIGATION PRQ VAS DEFERENS UNI/BI SPX||371.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55400|55400 - VASOVASOSTOMY VASOVASORRHAPHY||724.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55300|55300 - VASOTOMY VASOGRAMS UNI/BI||270|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55250|55250 - VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS||327.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55200|55200 - VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX||401.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55180|55180 - SCROTOPLASTY COMPLICATED||1006.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55175|55175 - SCROTOPLASTY SIMPLE||525.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55150|55150 - RESECTION SCROTUM||711.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55120|55120 - REMOVAL FOREIGN BODY SCROTUM||519.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55110|55110 - SCROTAL EXPLORATION||562.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55100|55100 - DRAINAGE SCROTAL WALL ABSCESS||239.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55060|55060 - RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE||550.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55041|55041 - EXCISION HYDROCELE BILATERAL||739.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55040|55040 - EXCISION HYDROCELE UNILATERAL||490.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|55000|55000 - PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED||122.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54901|54901 - EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI||1514.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54900|54900 - EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI||1127.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54865|54865 - EXPLORATION EPIDIDYMIS W/WO BIOPSY||517.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54861|54861 - EPIDIDYMECTOMY BILATERAL||819.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54860|54860 - EPIDIDYMECTOMY UNILATERAL||606.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54840|54840 - EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY||465.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54830|54830 - EXCISION LOCAL LESION EPIDIDYMIS||539.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54800|54800 - BIOPSY EPIDIDYMIS NEEDLE||190.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54700|54700 - I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE||309.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54699|54699 - UNLISTED LAPAROSCOPY PROCEDURE TESTIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54692|54692 - LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS||1104.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54690|54690 - LAPAROSCOPY SURGICAL ORCHIECTOMY||1056.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54680|54680 - TRANSPLANTATION TESTIS TO THIGH||1139.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54670|54670 - SUTURE/REPAIR TESTICULAR INJURY||585.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54660|54660 - INSJ TESTICULAR PROSTH SEPARATE PROCEDURE||514.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54650|54650 - ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS||1029.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54640|54640 - ORCHIOPEXY INGUINAL OR SCROTAL APPROACH||691.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54620|54620 - FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE||435.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54600|54600 - RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS||655.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54560|54560 - EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL||1042.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54550|54550 - EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA||712.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54535|54535 - ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL||1076.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54530|54530 - ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH||733.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54522|54522 - ORCHIECTOMY PARTIAL||851.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54520|54520 - ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH||473.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54512|54512 - EXC XTRPARENCHYMAL LESION TESTIS||783.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54505|54505 - BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE||304.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54500|54500 - BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE||108.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54450|54450 - FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING||83.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54440|54440 - PLASTIC OPERATION PENIS INJURY||792.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54435|54435 - CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM||603.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54430|54430 - CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI||930.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54420|54420 - CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI||1025.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54417|54417 - RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD||1306.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54416|54416 - RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI||1030.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54415|54415 - RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT||766.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54411|54411 - RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL||1490.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54410|54410 - RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS||1250|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54408|54408 - RPR COMPONENT INFLATABLE PENILE PROSTHESIS||1148.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54406|54406 - RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH||1061.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54405|54405 - INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH||1176.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54401|54401 - INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED||949.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54400|54400 - INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID||769.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54390|54390 - PLASTIC RPR PENIS EPISPADIAS W/EXSTROPHY BLADDER||1826.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54385|54385 - PLASTIC PENIS EPISPADIAS DSTL SPHNCTR W/INCONT||1442.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54380|54380 - PLASTIC RPR PENIS EPISPADIAS DSTL SPHNCTR||1279.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54360|54360 - PLASTIC RPR PENIS CORRECT ANGULATION||1050.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54352|54352 - RPR HYPOSPADIAS CRIPPLE W/DSJ & EXC & GRFS/FLAP||2070.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54348|54348 - RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF||1457.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54344|54344 - RPR HYPOSPADIAS COMPLCTJS MOBLJ FLAPS & URTP||1382.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54340|54340 - RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE||824.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54336|54336 - 1 STG PERINEAL HYPOSPADIAS RPR W/GRF&/FLAP||1711.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54332|54332 - 1 STAGE PROX PENILE/PENOSCROTAL HYPOSPADIAS RPR||1478.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54328|54328 - 1 STAGE DSTL HYPOSPADIAS RPR W/EXTENSIVE DSJ||1365.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54326|54326 - 1 STG DSTL HYPOSPADIAS RPR URTP SKN FLAPS||1366.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54324|54324 - 1 STG DSTL HYPOSPADIAS RPR W/URTP SKIN FLAPS||1413.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54322|54322 - 1 STG DSTL HYPOSPADIAS RPR W/SMPL MEATAL ADVMNT||1139.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54318|54318 - URETHROPLASTY 3RD STG HYPOSPADIAS RPR RLS PENIS||1018.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54316|54316 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR SKIN GRF||1491.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54312|54312 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR > 3 CM||1192.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54308|54308 - URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR <3 CM||1068.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54304|54304 - PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR||1092.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54300|54300 - PENIS STRAIGHTENING CHORDEE||934.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54250|54250 - NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST||175.93|176.36||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54240|54240 - PENILE PLETHYSMOGRAPHY||141.76|103.46||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54235|54235 - NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT||106.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54231|54231 - DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS||169.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54230|54230 - INJECTION CORPORA CAVERNOSOGRAPY||115.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54220|54220 - IRRIGATION CORPORA CAVERNOSA PRIAPISM||196.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54205|54205 - NJX PEYRONIE W/SURG EXPOS PLAQUE||773.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54200|54200 - INJECTION PEYRONIE DISEASE||120.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54164|54164 - FRENULOTOMY PENIS||278.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54163|54163 - REPAIR INCOMPLETE CIRCUMCISION||315.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54162|54162 - LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS||287.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54161|54161 - CIRCUMCISION AGE >28 DAYS||286.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54160|54160 - CIRCUMCISION NEONATE||208.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54150|54150 - CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK||144.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54135|54135 - AMPUTATION PENIS RADICAL W/LYMPH NODES||2257.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54130|54130 - AMPUTATION PENIS RADW/BI INGUINOFEMORAL LMPHADE||1737.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54125|54125 - AMPUTATION PENIS COMPLETE||1182.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54120|54120 - AMPUTATION PENIS PARTIAL||917.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54115|54115 - REMOVAL FOREIGN BODY DEEP PENILE TISSUE||613.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54112|54112 - EXC PENILE PLAQUE GRAFT > 5 CM LENGTH||1365.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54111|54111 - EXC PENILE PLAQUE GRAFT &/5 CM LENGTH||1164.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54110|54110 - EXCISION OF PENILE PLAQUE||905.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54105|54105 - BIOPSY PENIS DEEP STRUCTURES||308.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54100|54100 - BIOPSY PENIS SEPARATE PROCEDURE||181.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54065|54065 - DSTRJ LESION PENIS EXTENSIVE||246.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54060|54060 - DSTRJ LESION PENIS SIMPLE SURG EXCISION||188.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54057|54057 - DSTRJ LESION PENIS SIMPLE LASER||134.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54056|54056 - DSTRJ LESION PENIS SIMPLE CRYOSURGERY||157.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54055|54055 - DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION||131.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54050|54050 - DSTRJ LESION PENIS SIMPLE CHEMICAL||148.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54015|54015 - I&D PENIS DEEP||446.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54001|54001 - SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN||200.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|54000|54000 - SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN||154.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53899|53899 - UNLISTED PROCEDURE URINARY SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53860|53860 - TRURL RF FEMALE BLADDER NECK STRS URIN INCONT||337.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53855|53855 - INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT||118.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53854|53854 - TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY||568.11||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53852|53852 - TRURL DSTRJ PRSTATE TISS RF THERMOTH||903.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53850|53850 - TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH||826.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53665|53665 - DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES||56.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53661|53661 - DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ||58.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53660|53660 - DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI||60.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53621|53621 - DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ||104.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53620|53620 - DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST||127.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53605|53605 - DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES||93.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53601|53601 - DILAT URETHRAL STRIX DILATOR MALE SBSQ||77.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53600|53600 - DILAT URETHRAL STRIX DILATOR MALE 1ST||93.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53520|53520 - CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX||806.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53515|53515 - URTORR SUTR URETHRAL WND/INJ PROSTATOMEMBRANOUS||1154.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53510|53510 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL||916.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53505|53505 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE||704.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53502|53502 - URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE||703.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53500|53500 - URETHROLSS TRVG SEC OPN W/CSTO||1092.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53460|53460 - URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM||662.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53450|53450 - URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT||591.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53449|53449 - RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER||888.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53448|53448 - RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD||1863.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53447|53447 - RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC||1176.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53446|53446 - REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER||932.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53445|53445 - INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER||1109.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53444|53444 - INSERTION TANDEM CUFF||1153.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53442|53442 - RMVL/REVJ SLING MALE URINARY INCONTINENCE||1132.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53440|53440 - SLING OPRATION CORRJ MALE URINARY INCONTINENCE||1112.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53431|53431 - URTP W/TUBULARIZATION POST URT&/LWR BLDR||1678.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53430|53430 - URETHROPLASTY RCNSTJ FEMALE URETHRA||1406.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53425|53425 - URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE||1365.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53420|53420 - URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE||1208.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53415|53415 - URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT||1646.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53410|53410 - URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA||1422.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53405|53405 - URETHROPLASTY 2ND STAGE W/URINARY DIVERSION||1271.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53400|53400 - URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX||1167.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53275|53275 - EXCISION/FULGURATION URETHRAL PROLAPSE||382.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53270|53270 - EXCISION OR FULGURATION SKENES GLANDS||274.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53265|53265 - EXC/FULGURATION URETHRAL CARUNCLE||270.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53260|53260 - EXC/FULGURATION URETHRAL POLYP DSTL URETHRA||262.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53250|53250 - EXCISION OF BULBOURETHRAL GLAND||610.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53240|53240 - MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE||616.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53235|53235 - EXC URETHRAL DIVERTICULUM SPX MALE||919.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53230|53230 - EXC URETHRAL DIVERTICULUM SPX FEMALE||885.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53220|53220 - EXC/FULGURATION CARCINOMA URETHRA||659.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53215|53215 - URETHRECTOMY TOT W/CYSTOST MALE||1350.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53210|53210 - URETHRECTOMY TOT W/CYSTOST FEMALE||1124.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53200|53200 - BIOPSY URETHRA||206.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53085|53085 - DRG PERINEAL URINARY XTRVASATION COMPLIC||943.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53080|53080 - DRG PERINEAL URINARY XTRVASATION UNCOMP SPX||613.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53060|53060 - DRG OF SKENE'S GLAND ABSCESS OR CYST||243.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53040|53040 - DRAINAGE DEEP PERIURETHRAL ABSCESS||567.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53025|53025 - MEATOTOMY CUTTING MEATUS SPX INFANT||98.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53020|53020 - MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT||141.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53010|53010 - URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA||424.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|53000|53000 - URTT/URTS XTRNL SPX PENDULOUS URETHRA||214.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52700|52700 - TRURL DRAINAGE PROSTATIC ABSCESS||641.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52649|52649 - LASER ENUCLEATION PROSTATE W/MORCELLATION||1210.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52648|52648 - LASER VAPORIZATION OF PROSTATE FOR URINE FLOW||1002.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52647|52647 - LASER COAGULATION OF PROSTATE FOR URINE FLOW||938.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52640|52640 - TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE||448.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52630|52630 - TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS||579.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52601|52601 - TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE||1223.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5250F|5250F - ASTHMA DISCHARGE PLAN PRESENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52500|52500 - TRANSURETHRAL RESECTION BLADDER NECK||707.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52450|52450 - TRANSURETHRAL INCISION PROSTATE||679.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52402|52402 - CSTO W/TRURL RESCJ/INC EJACULATORY DUXS||390.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52400|52400 - CYSTO INC FULG/RESCJ URTL VALVES/FOLDS||697.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52355|52355 - CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR||682.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52354|52354 - CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION||572.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52353|52353 - CYSTO W/URETEROSCOPY W/LITHOTRIPSY||618.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52352|52352 - CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES||538.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52351|52351 - CYSTO W/URTROSCOPY&/PYELOSCOPY DX||458.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52346|52346 - CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE||669.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52345|52345 - CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX||591.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52344|52344 - CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE||555.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52343|52343 - CYSTO W/TX INTRA-RENAL STRICTURE||511.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52342|52342 - CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE||459.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52341|52341 - CYSTO W/TX URETERAL STRICTURE||422.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52334|52334 - CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR||375.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52332|52332 - CYSTO W/INSERT URETERAL STENT||226.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52330|52330 - CYSTO MANJ W/O RMVL URETERAL STONE||385.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52327|52327 - CYSTO W/SUBURTRIC NJX IMPLT MATRL||385.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52325|52325 - CYSTO FRAGMENTATION URETERAL STONE||469.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52320|52320 - CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS||360.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52318|52318 - LITHOLAPAXY COMP/LG > 2.5 CM||693.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52317|52317 - LITHOLAPAXY SMPL/SM <2.5 CM||508.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52315|52315 - CYSTO W/COMPLEX REMOVAL STONE & STENT||401.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52310|52310 - CYSTO W/SIMPLE REMOVAL STONE & STENT||221.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52305|52305 - CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT||408.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52301|52301 - CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI||427.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52300|52300 - CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI||415.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52290|52290 - CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI||356.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52287|52287 - CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER||240.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52285|52285 - CYSTOURETHROSCOPY TX FEMALE URETHRAL SYNDROME||286.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52283|52283 - CYSTOURETHROSCOPY W/STEROID INJECTION STRICTURE||293.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52282|52282 - CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT||494.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52281|52281 - CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS||222.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52277|52277 - CYSTOURETHROSCOPY W/RESECJ EXTERNAL SPHINCTER||476.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52276|52276 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE||388.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52275|52275 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE||363.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52270|52270 - CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY FEMALE||265.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52265|52265 - CYSTOURETHROSCOPY W/DIL BLADDER LOCAL ANESTHESIA||238.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52260|52260 - CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH||307.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52250|52250 - CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG||354.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52240|52240 - CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE||737.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52235|52235 - CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM||421.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52234|52234 - CYSTO W/REMOVAL OF TUMORS SMALL||359.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52224|52224 - CYSTO W/REMOVAL OF LESIONS SMALL||246.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52214|52214 - CYSTO W/DESTRUCTION OF LESIONS||295.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52204|52204 - CYSTOURETHROSCOPY WITH BIOPSY||206.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52010|52010 - CYSTO W/EJACULATORY DUCT CATHETERIZATION||239.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5200F|5200F - CONSID NEURO EVAL APPROP SURG THXPY EPIL 3YRS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52007|52007 - CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS||241.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52005|52005 - CYSTO BLADDER W/URETERAL CATHETERIZATION||193.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52001|52001 - CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS||419.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|52000|52000 - CYSTOURETHROSCOPY||291.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51999|51999 - UNLISTED LAPAROSCOPY PROCEDURE BLADDER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51992|51992 - LAPAROSCOPY SLING OPERATION STRESS INCONT||1244.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51990|51990 - LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT||1103.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51980|51980 - CUTANEOUS VESICOSTOMY||1033.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51960|51960 - ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS||2025.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51940|51940 - CLOSURE EXSTROPHY BLADDER||2372.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51925|51925 - CLSR VESICOUTERINE FISTULA W/HYSTERECTOMY||1481.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51920|51920 - CLOSURE VESICOUTERINE FISTULA||1100.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51900|51900 - CLSR VESICOVAGINAL FISTUL AABDL APPROACH||1202.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51880|51880 - CLOSURE CYSTOSTOMY SEPARATE PROCEDURE||680.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51865|51865 - CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED||1302.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51860|51860 - CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE||1084.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51845|51845 - ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL||857.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51841|51841 - ANT VESICOURETHROPEXY/URETHROPEXY COMP||1145.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51840|51840 - ANT VESICOURETHROPEXY/URETHROPEXY SMPL||963.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51820|51820 - CSTOURTP W/UNI/BI URTRONEOCSTOST||1561.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51800|51800 - CSTOPLASTY/CSTOURTP PLSTC ANY||1519.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51798|51798 - MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP||26.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51797|51797 - VOID PRESSURE STUDIES INTRAABDOMINAL||170.69|64.68||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51792|51792 - STIMULUS EVOKED RESPONSE||308.5|89.69||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51785|51785 - NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ||329.57|124.96||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51784|51784 - EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL||279.59|123.45||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51741|51741 - COMPLEX UROFLOMETRY||34.84|19.15||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51736|51736 - SIMPLE UROFLOMETRY||30.26|16.12||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51729|51729 - COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL||475.61|203.4||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51728|51728 - COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES||434.92|167.22||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51727|51727 - COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE||436.82|173.34||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51726|51726 - BLADDER PRESSURE MEASUREMENT DURING FILLING||403.92|138.13||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51725|51725 - SIMPLE CYSTOMETROGRAM||277.19|122.33||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51720|51720 - BLADDER INSTILLATION ANTICARCINOGENIC AGENT||117.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51715|51715 - NDSC NJX IMPLT MATRL URT&/BLDR NCK||291.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51710|51710 - CHANGE CYSTOSTOMY TUBE COMPLICATED||113.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51705|51705 - CHANGE CYSTOSTOMY TUBE SIMPLE||74.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51703|51703 - INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED||118.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51702|51702 - INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE||43.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51701|51701 - INSJ NON-NDWELLG BLADDER CATHETER||39.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51700|51700 - BLDR IRRIGATION SMPL LAVAGE &/INSTLJ||64.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51610|51610 - NJX RETROGRADE URETHROCSTOGRAPY||92.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51605|51605 - NJX & PLACEMENT CHAIN CONTRAST&/URETHROCSTOGRAPY||55.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51600|51600 - NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY||64.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51597|51597 - PELVIC EXENTERATION COMPLETE MALIGNANCY||3343.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51596|51596 - CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR||3430.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51595|51595 - CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC||3194.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51590|51590 - CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST||2818.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51585|51585 - CYSTECTOMY W/URETEROSIGMOID BI PELV LYMPH NODES||3078.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51580|51580 - CYSTECTOMY W/URETEROSIGMOIDOSTOMY W/NODES||2763.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51575|51575 - CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY||2654.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51570|51570 - CYSTECTOMY COMPLETE SEPARATE PROCEDURE||2149.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51565|51565 - CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST||1883.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51555|51555 - CYSTECTOMY PARTIAL COMPLICATED||1848.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51550|51550 - CYSTECTOMY PARTIAL SIMPLE||1405.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51535|51535 - CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE||1127.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51530|51530 - CYSTOTOMY EXCISION BLADDER TUMOR||1139.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51525|51525 - CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE||1250.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51520|51520 - CYSTOTOMY SIMPLE EXCISION VESICAL NECK||857.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51500|51500 - EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR||968.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51102|51102 - ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER||213.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51101|51101 - ASPIRATION BLADDER TROCAR/INTRACATHETER||77.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51100|51100 - ASPIRATION BLADDER NEEDLE||56.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51080|51080 - DRG PRIVESICAL/PREVESICAL SPACE ABSC||589.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51065|51065 - CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO||838.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51060|51060 - TRANSVESICAL URETROLITHOTOMY||843.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51050|51050 - CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS||684.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51045|51045 - CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX||707.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51040|51040 - CYSTOSTOMY CYSTOTOMY W/DRAINAGE||418.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51030|51030 - CSTOTOMY/CSTOST CRYOSURG DSTRJ INTRAVESICAL LES||672.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|51020|51020 - CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL||679.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5100F|5100F - FX RISK REF PHYS/QHP COMMJ 24 HRS IMAGING STUDY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50980|50980 - NDSC URETEROTOMY RMVL FB/CALCULUS||521.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50976|50976 - URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX||682.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50974|50974 - URETERAL ENDOSCOPY VIA URETEROT W/O IMAGING W/BX||692.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50972|50972 - NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER||524.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50970|50970 - URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING||542.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50961|50961 - URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE||464.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50957|50957 - URETERAL ENDOSCOPY W/DEST&/INC W/WO BIOPSY||518.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50955|50955 - URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY||533.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50953|50953 - URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER||495.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50951|50951 - URETERAL ENDOSCOPY VIA URETEROSTOMY||448.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50949|50949 - UNLISTED LAPAROSCOPY PROCEDURE URETER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50948|50948 - LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT||1860.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50947|50947 - LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT||2011.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50945|50945 - LAPAROSCOPY URTROLITHOTOMY||1416.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50940|50940 - DELIGATION URETER||1286.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50930|50930 - CLOSURE URETEROCUTANEOUS FISTULA W/VISC RPR||1769.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50920|50920 - CLOSURE URETEROCUTANEOUS FISTULA||1280.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50900|50900 - URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE||1227.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50860|50860 - URETEROSTOMY TRANSPLANTATION URETER SKIN||1372.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50845|50845 - CUTANANEOUS APPENDICO-VESICOSTOMY||1815.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50840|50840 - RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST||1787.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50830|50830 - URINARY UNIDIVERSION||2618.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50825|50825 - CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN||2415.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50820|50820 - URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS||1915.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50815|50815 - URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS||1776.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50810|50810 - URETEROSIGMOIDOSTOMY W/SIGMOID BLADDER & COLOSTO||2001.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50800|50800 - URETEROENTEROSTOMY ANAST URETER INTESTINE||1344.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50785|50785 - URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP||1761.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50783|50783 - URETERONEOCYSTOSTOMY W/URETERAL TAILORING||1625.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50782|50782 - URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR||1665.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50780|50780 - URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER||1608.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50770|50770 - TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR||1665.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50760|50760 - URETEROURETEROSTOMY||1636.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50750|50750 - URETEROCALYCOSTOMY ANAST URETER RENAL CALYX||1680.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50740|50740 - EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR||1758.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50728|50728 - REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA||1008.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50727|50727 - REVJ URINARY-CUTANEOUS ANASTAMOSIS||732.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50725|50725 - URTROLSS RETROCAVAL URTR W/REANAST||1594.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50722|50722 - URETEROLYSIS FOR OVARIAN VEIN SYNDROME||1524.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50715|50715 - URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS||1714.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50700|50700 - URETEROPLASTY PLASTIC OPERATION URETER||1344.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50690|50690 - NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG||100.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50688|50688 - CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL||114.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50686|50686 - MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH||132.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50684|50684 - INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH||71.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50660|50660 - URETERECTOMY TOT ECTOPIC URETER CMBN APPR||1661.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50650|50650 - URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE||1506.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50630|50630 - URTROLITHOTOMY LOWER ONE-THIRD URETER||1294.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5062F|5062F - DOC DIRECT COMM DIAG MAMMO FNDNGS-PHONE/PERSON||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50620|50620 - URTROLITHOTOMY MIDDLE ONE-THIRD URETER||1314.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50610|50610 - URTROLITHOTOMY UPPER ONE-THIRD URETER||1374.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5060F|5060F - FINDNGS DIAG MAM TO MNGNG PRACT 3 DAYS INTERP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50605|50605 - URETEROTOMY INSERTION INDWELLING STENT ALL TYPES||1408.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50600|50600 - URTROTOMY W/EXPL/DRG SEPARATE PROCEDURE||1363.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50593|50593 - ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY||695.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50592|50592 - ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY||526.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50590|50590 - LITHOTRIPSY XTRCORP SHOCK WAVE||819.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50580|50580 - RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS||890.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50576|50576 - RNL NDSC NFROT FULGURATION &/INCISION W/WO BX||826.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50575|50575 - RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY||1047.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50574|50574 - RENAL NDSC NEPHROTOMY W/BIOPSY||829.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50572|50572 - RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER||779.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50570|50570 - RENAL NDSC NEPHROTOMY W/WO IRRIGATION||719.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50562|50562 - RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR||850.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50561|50561 - RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS||577.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50557|50557 - RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI||506.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50555|50555 - RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY||499.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50553|50553 - RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA||461.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50551|50551 - RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION||430.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50549|50549 - UNLISTED LAPAROSCOPY PROCEDURE RENAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50548|50548 - LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY||1965.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50547|50547 - LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR||2303.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50546|50546 - LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT||1748.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50545|50545 - LAPAROSCOPY RADICAL NEPHRECTOMY||1957.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50544|50544 - LAPAROSCOPY SURG PYELOPLASTY||1819.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50543|50543 - LAPAROSCOPY SURG PARTIAL NEPHRECTOMY||2169.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50542|50542 - LAPS ABLTJ RENAL MASS LESION W/INTRAOP US||1698.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50541|50541 - LAPAROSCOPY SURG ABLATION RENAL CYSTS||1339.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50540|50540 - SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI||1661.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50526|50526 - CLSR NEPHROVISCERAL FISTULA W/VISC RPR THRC APPR||2049.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50525|50525 - CLSR NEPHROVISCERAL FISTULA W/VISC RPR ABDL APPR||2041.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50520|50520 - CLOSURE NEPHROCUTANEOUS/PYELOCUTANEOUS FISTULA||1504.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5050F|5050F - TX COMMUN PROVIDERS CONTINUING CARE 1 MO DX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50500|50500 - NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY||1835.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50437|50437 - PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS||385||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50436|50436 - PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG||230.09||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50405|50405 - PYELOPLASTY COMPLICATED||2033.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50400|50400 - PYELOPLASTY SIMPLE||1684.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50398|50398 - CHANGE KIDNEY TUBE||106.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50396|50396 - MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH||169.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50395|50395 - INTRO GUIDE PELVIS&/URETER W/DILAT NFROS TRACT||262.89|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|50394|50394 - INJECTION FOR KIDNEY X-RAY||71.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50393|50393 - INSERT URETERAL TUBE||317|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50392|50392 - INSERT KIDNEY DRAIN||260.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50391|50391 - INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB||144.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50390|50390 - ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ||142.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50389|50389 - RMVL NFROS TUBE REQ FLUORO GUIDANCE||79.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50387|50387 - RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH||145.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50386|50386 - REMOVE INT DWELL URETERAL STENT TRANSURETHRAL||257.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50385|50385 - REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL||341.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50384|50384 - REMOVAL INDWELLING URETERAL STENT PRQ||365.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50382|50382 - RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ||401.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50380|50380 - RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY||2864.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50370|50370 - RMVL TRNSPLED RENAL ALLOGRAFT||1704.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50365|50365 - RENAL ALTRNSPLJ IMPLTJ GRF W/RCP NEPHRECTOMY||4106.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50360|50360 - RENAL ALTRNSPLJ IMPLTJ GRF W/O RCP NEPHRECTOMY||3658.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50340|50340 - RECIPIENT NEPHRECTOMY SEPARATE PROCEDURE||1343.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50329|50329 - BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA||254.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50328|50328 - BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA||273.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50327|50327 - BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA||312.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50325|50325 - BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT||389.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50323|50323 - BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT||268.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50320|50320 - DONOR NEPHRECTOMY OPEN LIVING DONOR||2049.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50300|50300 - DONOR NEPHRECTOMY CADAVER DONOR UNI/BILATERAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50290|50290 - EXCISION PERINEPHRIC CYST||1291.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50280|50280 - EXCISION/UNROOFING CYST KIDNEY||1387.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50250|50250 - OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND||1777.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50240|50240 - NEPHRECTOMY PARTIAL||1926.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50236|50236 - NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN||2134.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50234|50234 - NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC||1894.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50230|50230 - NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD||1866.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50225|50225 - NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL||1739.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50220|50220 - NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ||1516.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5020F|5020F - TX SUMM RPRT COMMUN PHYS&PT 1 MO COMPLETE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50205|50205 - RENAL BIOPSY SURG EXPOSURE KIDNEY||1077.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50200|50200 - RENAL BIOPSY PRQ TROCAR/NEEDLE||209.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5015F|5015F - DOCD CONTACT THAT FX EXISTED & PT TSTED/TXD OP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50135|50135 - PYELOTOMY COMPLICATED||1631.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50130|50130 - PYELOTOMY W/REMOVAL CALCULUS||1502.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50125|50125 - PYELOTOMY W/DRAINAGE PYELOSTOMY||1490.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50120|50120 - PYELOTOMY W/EXPLORATION||1377.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5010F|5010F - DILATED MACULAR/FUNDUS XM COMMUNJ TX PHYS/QHP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50100|50100 - TRNSXJ/REPOSITIONING ABERRANT RENAL VESSEL SPX||1311.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50081|50081 - PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY > 2 CM||1860.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50080|50080 - PRQ NEPHROSTOLITHOTOMY/PYELOSTOLITHOTOMY </2 CM||1266.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50075|50075 - NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1||2124.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50070|50070 - NEPHROLITHOTOMY COMP CGEN KDN ABNORMALITY||1769.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50065|50065 - NEPHROLITHOTOMY SECONDARY FOR CALCULUS||1754.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50060|50060 - NEPHROLITHOTOMY REMOVAL STAGE 1||1658.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|5005F|5005F - COUNSEL NEW/CHANGING MOLES SELF-EXAMINATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50045|50045 - NEPHROTOMY W/EXPLORATION||1351.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50040|50040 - NEPHROSTOMY/NEPHROTOMY W/DRAINAGE||1345.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50021|50021 - RENAL ABSCESS PERCUT DRAIN||244.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50020|50020 - DRAINAGE PERIRENAL/RENAL ABSCESS OPEN||1516.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|50010|50010 - RNL EXPL X NECESSITATING OTH SPEC PX||1060.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49999|49999 - UNLISTED PROCEDURE ABDOMEN PERITONEUM & OMENTUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49906|49906 - FREE OMENTAL FLAP W/MICROVASCULAR ANAST||6013.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49905|49905 - OMENTAL FLAP INTRA-ABDOMINAL||509.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49904|49904 - OMENTAL FLAP EXTRA-ABDOMINAL||2094.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49900|49900 - SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN||1159.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49659|49659 - UNLIS LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49657|49657 - LAPS RPR RECURRENT INCAL HRNA NCRC8/STRANGULATED||1741.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49656|49656 - LAPS RPR RECURRENT INCISIONAL HERNIA REDUCIBLE||1211.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49655|49655 - LAPS RPR INCISIONAL HERNIA NCRC8/STRANGULATED||1366.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49654|49654 - LAPAROSCOPY REPAIR INCISIONAL HERNIA REDUCIBLE||1119.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49653|49653 - LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRANGULATED||1229.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49652|49652 - LAPS REPAIR HERNIA EXCEPT INCAL/INGUN REDUCIBLE||984.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49651|49651 - LAPS SURG RPR RECURRENT INGUINAL HERNIA||790.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49650|49650 - LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA||606.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49611|49611 - RPR OMPHALOCELE GROSS TYP OPRATION 2ND STG||780.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49610|49610 - RPR OMPHALOCELE GROSS TYP OPRATION 1ST STG||979.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49606|49606 - RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH||1620.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49605|49605 - RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH||7110.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49600|49600 - RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE||1042.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49590|49590 - RPR SPIGELIAN HERNIA||813.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49587|49587 - RPR UMBILICAL HERNIA AGE 5 YRS/> INCARCERATED||676.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49585|49585 - RPR UMBILICAL HRNA 5 YRS/> REDUCIBLE||629.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49582|49582 - RPR UMBILICAL HERNIA < 5 YRS INCARCERATED||682.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49580|49580 - RPR UMBILICAL HERNIA < 5 YRS REDUCIBLE||467.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49572|49572 - RPR EPIGASTRIC HERNIA INCARCERATED||730.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49570|49570 - RPR EPIGASTRIC HERNIA REDUCIBLE SPX||589.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49568|49568 - IMPLANT MESH OPN HERNIA RPR/DEBRIDEMENT CLOSURE||385.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49566|49566 - RPR RECRT INCAL/VNT HERNIA INCARCERATED||1343.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49565|49565 - RPR RECRT INCAL/VNT HERNIA REDUCIBLE||1095.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49561|49561 - RPR 1ST INCAL/VNT HERNIA INCARCERATED||1328.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49560|49560 - REPAIR FIRST ABDOMINAL WALL HERNIA||1051.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49557|49557 - RPR RECRT FEM HRNA INCARCERATED||1030.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49555|49555 - RPR RECRT FEM HERNIA REDUCIBLE||852.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49553|49553 - RPR 1ST FEM HERNIA ANY AGE INCARCERATED||898.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49550|49550 - RPR 1ST FEM HRNA ANY AGE REDUCIBLE||819.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49540|49540 - REPAIR LUMBAR HERNIA||957.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49525|49525 - RPR INGUN HERNIA SLIDING ANY AGE||815.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49521|49521 - RPR RECRT INGUN HERNIA ANY AGE INCARCERATED||1022.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49520|49520 - RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE||899.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49507|49507 - RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED||836.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49505|49505 - RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE||738.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49501|49501 - RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED||859.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49500|49500 - RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE||579.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49496|49496 - RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER||854.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49495|49495 - RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC||578.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49492|49492 - RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED||1362.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49491|49491 - RPR 1ST INGUN HRNA PRETERM INFT RDC||1099.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49465|49465 - CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE||44.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49460|49460 - OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE||70.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49452|49452 - REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS||207.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49451|49451 - REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ||135.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49450|49450 - REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS||98.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49446|49446 - CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ||240.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49442|49442 - INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS||313.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49441|49441 - INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ||373.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49440|49440 - INSERT GASTROSTOMY TUBE PERCUTANEOUS||328.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49436|49436 - DELAYED CREATION EXIT SITE EMBEDDED CATHETER||264.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49435|49435 - INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER||174.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49429|49429 - RMVL PERITONEAL-VENOUS SHUNT||640.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49428|49428 - LIGATION PERITONEAL-VENOUS SHUNT||684.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49427|49427 - INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT||65.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49426|49426 - REVIS PERITONEAL-VENOUS SHUNT||909.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49425|49425 - INSERTION PERITONEAL-VENOUS SHUNT||1081.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49424|49424 - CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX||56.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49423|49423 - EXCHNG ABSC/CST DRG CATH RAD GID SPX||106.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49422|49422 - REMOVAL TUNNELED INTRAPERITONEAL CATHETER||549.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49421|49421 - INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN||359.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49419|49419 - INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT||632.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49418|49418 - INSJ INTRAPERITONEAL CATHETER W/IMG GUID||333.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49412|49412 - PLACEMENT INTRSTL DEV OPN W/IMG GUID 1/MLT||117.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49411|49411 - INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT||281.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49402|49402 - REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY||1220.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49400|49400 - INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX||139.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49329|49329 - UNLISTED LAPAROSCOPIC PX ABD PERTONEUM & OMENTUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49327|49327 - LAPS W/INSERTION NTRSTL DEV W/IMG GUID 1/MLT||188.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49326|49326 - LAPAROSCOPY W/OMENTOPEXY||272.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49325|49325 - LAPS W/REVISION INTRAPERITONEAL CATHETER||603.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49324|49324 - LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER||564.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49323|49323 - LAPS SURG W/DRG LYMPHOCELE PRTL CAVITY||923.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49322|49322 - LAPS SURG W/ASPIR CAVITY/CYST SINGLE/MULTIPLE||532.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49321|49321 - LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE||495.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49320|49320 - LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX||468.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49255|49255 - OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX||1128.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49250|49250 - UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX||830.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49220|49220 - STAGING LAPAROTOMY HODGKINS DISEASE/LYMPHOMA||1387.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49215|49215 - EXC PRESAC/SACROCOCCYGEAL TUMOR||3156.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49205|49205 - EXC/DESTRUCTION OPEN ABDOMINAL TUMORS >10.0 CM||2504.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49204|49204 - EXC/DESTRUCTION OPEN ABDMNL TUMORS 5.1-10.0 CM||2181.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49203|49203 - EXCISION/DESTRUCTION OPEN ABDOMINAL TUMOR 5 CM/<||1710.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49180|49180 - BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE||125.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49084|49084 - PERITONEAL LAVAGE W/WO IMAGING GUIDANCE||143.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49083|49083 - ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE||155.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49082|49082 - ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE||100.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49062|49062 - DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN||1065.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49061|49061 - DRAIN PERCUT RETROPER ABSC||267.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49060|49060 - DRAINAGE OF RETROPERITONEAL ABSCESS OPEN||1579.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49041|49041 - DRAIN PERCUT ABDOM ABSCESS||289.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49040|49040 - DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN||1433.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49021|49021 - DRAIN ABDOMINAL ABSCESS||244.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49020|49020 - DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN||2274.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49014|49014 - REEXPL PEL WND W/RMVL PREPERITONEAL PEL PACKING||552.53||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49013|49013 - PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA||669.59||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49010|49010 - EXPL RETROPERITONEUM W/WO BX SPX||1353.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49002|49002 - REOPENING RECENT LAPAROTOMY||1492.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|49000|49000 - EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX||1101.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48999|48999 - UNLISTED PROCEDURE PANCREAS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48556|48556 - RMVL TRANSPLANTED PANCREATIC ALLOGRAFT||1808.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48554|48554 - TRANSPLANTATION PANCREATIC ALLOGRAFT||3628.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48552|48552 - BKBENCH RCNSTJ CDVR PNCRS ALGRFT VEN ANAST EA||340.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48551|48551 - BKBENCH PREPJ CADAVER DONOR PANCREAS ALLOGRAFT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48550|48550 - DONOR PANCREATECTOMY DUODENAL SGM TRANSPLANT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48548|48548 - PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST||2380.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48547|48547 - DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ||2561.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48545|48545 - PANCREATORRHAPHY INJURY||1917.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48540|48540 - INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y||1871|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48520|48520 - INT ANAST PANCREATIC CYST GI TRACT DIRECT||1564.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48511|48511 - DRAIN PANCREATIC PSEUDOCYST||290.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48510|48510 - EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN||1540.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48500|48500 - MARSUPIALIZATION PANCREATIC CYST||1636.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48400|48400 - INJECTION INTRAOPERATIVE PANCREATOGRAPHY||159.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48160|48160 - PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS||4479.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48155|48155 - PANCREATECTOMY TOTAL||2586.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48154|48154 - PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY||4145.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48153|48153 - PNCRTECT W/PANCREATOJEJUNOSTOMY||4423.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48152|48152 - PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY||4129.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48150|48150 - PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY||4429.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48148|48148 - EXCISION AMPULLA VATER||1778.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48146|48146 - PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX||2677.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48145|48145 - PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY||2332.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48140|48140 - PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY||2227.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48120|48120 - EXCISION LESION PANCREAS||1574.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48105|48105 - RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS||4086.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48102|48102 - BIOPSY PANCREA PERCUTANEOUS NEEDLE||353.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48100|48100 - BIOPSY PANCREAS OPEN||1264.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48020|48020 - REMOVAL PANCREATIC CALCULUS||1679.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48001|48001 - PLACE DRAIN PERIPANCREATIC W/CHOLECYSTOSTOMY||3308.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|48000|48000 - PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS||2648.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47999|47999 - UNLISTED PROCEDURE BILIARY TRACT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47900|47900 - SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY||1944.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47802|47802 - U-TUBE HEPATICOENTEROSTOMY||2176.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47801|47801 - PLACEMENT CHOLEDOCHAL STENT||1472.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47800|47800 - RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST||2256.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47785|47785 - ANAST ROUX-EN-Y INTRAHEPATC BILIARY DUCTS & GI||4625.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47780|47780 - ANAST ROUX-EN-Y XTRHEPATC BILIARY DUCTS & GI||3520.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47765|47765 - ANAST INTRAHEPATC DUCTS & GI TRACT||4329.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47760|47760 - ANAST XTRHEPATC BILIARY DUCTS & GI TRACT||3209.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47741|47741 - CHOLECSTONTRSTM ROUX-EN-Y W/GASTRONTRSTM||2105.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47740|47740 - CHOLECYSTOENTEROSTOMY ROUX-EN-Y||1868.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47721|47721 - CHOLECYSTOENTEROSTOMY W/GASTROENTEROSTOMY||1929.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47720|47720 - CHOLECYSTOENTEROSTOMY DIRECT||1639.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47715|47715 - EXCISION CHOLEDOCHAL CYST||1894.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47712|47712 - EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC||2858.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47711|47711 - EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC||2223.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47701|47701 - PORTOENETEROSTOMY||2496.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47700|47700 - EXPL CONGENITAL ATRESIA BILE DUCTS||1498.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47630|47630 - REMOVE BILE DUCT STONE||793.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47620|47620 - CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP||1959.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47612|47612 - CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY||1811.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47610|47610 - CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT||1792.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47605|47605 - CHOLECYSTECTOMY W/CHOLANGIOGRAPHY||1401.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47600|47600 - CHOLECYSTECTOMY||1542.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47579|47579 - UNLISTED LAPAROSCOPY PROCEDURE BILIARY TRACT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47570|47570 - LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY||1105.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47564|47564 - LAPS SURG CHOLECSTC W/EXPL COMMON DUCT||1562.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47563|47563 - LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY||1023.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47562|47562 - LAPAROSCOPY SURG CHOLECYSTECTOMY||1066.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47561|47561 - LAPARO W/CHOLANGIO/BIOPSY||423.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47560|47560 - LAPAROSCOPY W/CHOLANGIO||387.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47556|47556 - BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT||619.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47555|47555 - BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT||547.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47554|47554 - BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS||712.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47553|47553 - BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE||461.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47552|47552 - BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH||460.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47550|47550 - BILIARY NDSC INTRAOPERATIVE||238.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47530|47530 - REVISE/REINSERT BILE TUBE||511.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47525|47525 - CHANGE BILE DUCT CATHETER||130.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47511|47511 - INSERT BILE DUCT DRAIN||844.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47510|47510 - INSERT CATHETER BILE DUCT||681.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47505|47505 - INJECTION FOR LIVER X-RAYS||54.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47500|47500 - INJECTION FOR LIVER X-RAYS||143.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47490|47490 - CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT||491.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47480|47480 - CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX||1238.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47460|47460 - TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS||1816.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47425|47425 - CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP||1948.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47420|47420 - CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP||1915.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47400|47400 - HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1||3080.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47382|47382 - ABLTJ 1/> LVR TUM PRQ RF||1140.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47381|47381 - ABLTJ OPN 1/> LVR TUM CRYOSURG||2122.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47380|47380 - ABLTJ OPN 1/> LVR TUM RF||2048.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47371|47371 - LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG||1800.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47370|47370 - LAPS SURG ABLTJ 1/> LVR TUM RF||1763.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47362|47362 - MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING||2060.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47361|47361 - MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR||4318.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47360|47360 - MGMT LVR HEMRRG CPLX SUTR WND/INJ||2661.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47350|47350 - MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ||1959.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47300|47300 - MARSUPIALIZATION CST/ABSC LVR||1613.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47147|47147 - BKBENCH RCNSTJ LVR GRF ARTL ANAST EA||554.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47146|47146 - BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA||475.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47142|47142 - DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI||6723.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47141|47141 - DONOR HEPATECTOMY LIVING DONOR SEG II III & IV||5613.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47140|47140 - DONOR HEPATECTOMY LIVING DONOR SEG II & III||5016.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47136|47136 - TRANSPLANTATION OF LIVER||5922.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47135|47135 - LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE||7011.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47130|47130 - HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY||4716.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47125|47125 - HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY||4386.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47122|47122 - HEPATECTOMY RESCJ TRISEGMENTECTOMY||4901.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47120|47120 - HEPATECTOMY RESCJ PARTIAL LOBECTOMY||3318.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47100|47100 - BIOPSY LIVER WEDGE||1197.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47015|47015 - LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS||1653.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47011|47011 - PERCUT DRAIN LIVER LESION||267.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47010|47010 - HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES||1709.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47001|47001 - BX LVR NDL DONE PURPOSE TM OTH MAJOR PX||148.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|47000|47000 - BIOPSY LIVER NEEDLE PERCUTANEOUS||148.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46999|46999 - UNLISTED PROCEDURE ANUS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46948|46948 - INT HRHC TRANSANAL HROID DARTLZJ 2+ W/US GDN||651.05||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46947|46947 - HEMORRHOIDOPEXY STAPLING||540.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46946|46946 - INT HRHC BY LIGATION 2+ HROID W/O IMG GDN||316.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46945|46945 - INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN||313.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46942|46942 - CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ||187.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46940|46940 - CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST||209.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46930|46930 - DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY||210.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46924|46924 - DSTRJ LESION ANUS EXTENSIVE||263.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46922|46922 - DSTRJ LESION ANUS SIMPLE SURG EXCISION||191.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46917|46917 - DSTRJ LESION ANUS SIMPLE LASER SURG||190.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46916|46916 - DSTRJ LESION ANUS SIMPLE CRYOSURGERY||206.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46910|46910 - DSTRJ LESION ANUS SMPL ELTRDSICCATION||191.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46900|46900 - DSTRJ LESION ANUS SIMPLE CHEMICAL||196.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46762|46762 - SPHNCTROP ANAL IMPLTJ ARTIF SPHNCTR||1313.75|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|46761|46761 - SPHNCTROP ANAL LEVATOR MUSC IMBRCJ||1332.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46760|46760 - SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT||1551.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46754|46754 - RMVL THIERSCH WIRE/SUTURE ANAL CANAL||324.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46753|46753 - GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE||830.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46751|46751 - SPHNCTROP ANAL INCONTINENCE/PROLAPSE CHLD||863.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46750|46750 - SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT||1089.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46748|46748 - RPR CLOACAL ANOMALY CMBN ABDL & SACROPRNL W/GRF||5493.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46746|46746 - RPR CLOACAL ANOMALY CMBN ABDL&SACROPRNL||5067.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46744|46744 - RPR CLOACAL ANOMALY SACROPERINEAL||4797.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46742|46742 - RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL||3465.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46740|46740 - RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR||3042.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46735|46735 - RPR HI IMPRF ANUS W/O FISTULA CMBN APPR||2912.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46730|46730 - RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR||2565.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46716|46716 - RPR LW IMPERFORATE ANUS W/TRPOS FISTULA||1624.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46715|46715 - RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK||697.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46712|46712 - RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR||2914.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46710|46710 - RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR||1560.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46707|46707 - REPAIR ANORECTAL FISTULA PLUG||662.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46706|46706 - REPAIR ANAL FISTULA W/FIBRIN GLUE||236.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46705|46705 - ANOPLASTY PLASTIC OPERATION STRICTURE INFANT||721.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46700|46700 - ANOPLASTY PLASTIC OPERATION STRICTURE ADULT||923.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46615|46615 - ANOSCOPY ABLATION LESION||135.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46614|46614 - ANOSCOPY CONTROL BLEEDING||92.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46612|46612 - ANOSC RMVL MULT TUMORS CAUTERY/SNARE||135.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46611|46611 - ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ||118.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46610|46610 - ANOSCOPY W/RMVL LESION CAUTERY||116.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46608|46608 - ANOSCOPY W/RMVL FOREIGN BODY||115.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46606|46606 - ANOSCOPY W/BX SINGLE/MULTIPLE||109.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46604|46604 - ANOSCOPY W/DILATION||94.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46600|46600 - ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD||57.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46505|46505 - CHEMODENERVATION INTERNAL ANAL SPHINCTER||338.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46500|46500 - INJECTION SCLEROSING SOLUTION HEMORRHOIDS||182.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46320|46320 - EXC THROMBOSED HEMORRHOID XTRNL||157.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46288|46288 - CLSR ANAL FSTL W/RCT ADVMNT FLAP||770.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46285|46285 - SURG TX ANAL FISTULA 2ND STAGE||575.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46280|46280 - TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON||658.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46275|46275 - SURG TX ANAL FISTULA INTERSPHINCTERIC||578.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46270|46270 - SURG TX ANAL FISTULA SUBQ||546.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46262|46262 - HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY||780.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46261|46261 - HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU||741.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46260|46260 - HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO||667.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46258|46258 - HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY||654.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46257|46257 - HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO||591.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46255|46255 - HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP||498.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46250|46250 - HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP||441.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46230|46230 - EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS||245.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46221|46221 - HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS||268.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46220|46220 - EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS||167.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46200|46200 - FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED||450.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46083|46083 - INCISION THROMBOSED HEMORRHOID EXTERNAL||151.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46080|46080 - SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX||227.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46070|46070 - INCISION ANAL SEPTUM INFANT||333.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46060|46060 - I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON||666.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46050|46050 - I&D PERIANAL ABSCESS SUPERFICIAL||137.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46045|46045 - I&D INTRAMURAL IM/ABSC TRANSANAL ANES||605.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46040|46040 - I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX||580.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46030|46030 - REMOVAL ANAL SETON OTHER MARKER||127.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|46020|46020 - PLACEMENT SETON||328.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45999|45999 - UNLISTED PROCEDURE RECTUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45990|45990 - ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX||153.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45915|45915 - RMVL FECAL IMPACTION/FB SPX UNDER ANES||319.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45910|45910 - DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL||278.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45905|45905 - DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL||239.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45900|45900 - RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE||286.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45825|45825 - CLOSURE RECTOURETHRAL FISTULA W/COLOSTOMY||2094.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45820|45820 - CLOSURE RECTOURETHRAL FISTULA||1681.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45805|45805 - CLSR RECTOVESICAL FISTULA W/COLOSTOMY||2078.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45800|45800 - CLOSURE RECTOVESICAL FISTULA||1721.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45563|45563 - EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY||2342.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45562|45562 - EXPL RPR & PRESACRAL DRG RECTAL INJURY||1586.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45560|45560 - REPAIR RECTOCELE SEPARATE PROCEDURE||1005.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45550|45550 - PROCTOPEXY W/SIGMOID RESCJ ABDL APPR||2099.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45541|45541 - PROCTOPEXY PERINEAL APPROACH||1322.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45540|45540 - PROCTOPEXY ABDOMINAL APPROACH||1519.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45520|45520 - PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE||56.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45505|45505 - PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE||832.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45500|45500 - PROCTOPLASTY STENOSIS||743.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45499|45499 - UNLISTED LAPAROSCOPY PROCEDURE RECTUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45402|45402 - LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ||2199|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45400|45400 - LAPAROSCOPY PROCTOPEXY PROLAPSE||1655.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45397|45397 - LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR||3081.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45395|45395 - LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY||2851.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45392|45392 - COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL||555.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45391|45391 - COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX||431.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45387|45387 - COLONOSCOPY W/STENT||504.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45386|45386 - COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT||388.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45385|45385 - COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ||450.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45384|45384 - COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS||396|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45383|45383 - LESION REMOVAL COLONOSCOPY||491.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45382|45382 - COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD||483.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45381|45381 - COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST||359.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45380|45380 - COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE||379.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45379|45379 - COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)||396.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45378|45378 - COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD||317.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45355|45355 - SURGICAL COLONOSCOPY||298.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45345|45345 - SIGMOIDOSCOPY W/STENT||253.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45342|45342 - SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX||349.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45341|45341 - SIGMOIDOSCOPY FLX NDSC US XM||228.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45340|45340 - SIGMOIDOSCOPY FLX TNDSC BALO DILAT||169.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45339|45339 - SIGMOIDOSCOPY W/ABLATE TUMR||272.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45338|45338 - SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ||206.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45337|45337 - SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE||207.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45335|45335 - SGMDSC FLX DIRED SBMCSL NJX ANY SBST||134.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45334|45334 - SIGMOIDOSCOPY FLX CONTROL BLEEDING||239.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45333|45333 - SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS||160.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45332|45332 - SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY||161.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45331|45331 - SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE||110.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45330|45330 - SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD||91.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45327|45327 - PROCTOSGMDSC RIGID TNDSC STENT PLMT||176.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45321|45321 - PROCTOSGMDSC RIGID DCMPRN VOLVULUS||155.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45320|45320 - PROCTOSGMDSC RIGID ABLATION LESION||155.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45317|45317 - PROCTOSGMDSC RIGID CONTROL BLEEDING||170.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45315|45315 - PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE||158.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45309|45309 - PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ||133.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45308|45308 - PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY||125.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45307|45307 - PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY||148.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45305|45305 - PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE||113.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45303|45303 - PROCTOSGMDSC RIGID W/DILATION||131.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45300|45300 - PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX||76.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4526F|4526F - NEUROPSYCHIATRIC INTERVENTION RECEIVED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4525F|4525F - NEUROPSYCHIATRIC INTERVENTION ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45190|45190 - DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH||980.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45172|45172 - EXC RCT TUM INCL MUSCULARIS PROPRIA||1172.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45171|45171 - EXC RCT TUM NOT INCL MUSCULARIS PROPRIA||863.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45160|45160 - EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL||1447.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45150|45150 - DIVISION STRICTURE RECTUM||559|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45136|45136 - EXC ILEOANAL RSVR W/ILEOSTOMY||2603.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45135|45135 - EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH||1947.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45130|45130 - EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH||1563.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45126|45126 - PELVIC EXENTERATION COLORECTAL MALIGNANCY||4125.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45123|45123 - PRCTECT PRTL W/O ANAST PRNL APPR||1598.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45121|45121 - PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS||2481.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45120|45120 - PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS||2261.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45119|45119 - PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM||2800.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45116|45116 - PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY||2257.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45114|45114 - PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH||2595.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45113|45113 - PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR||2842.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45112|45112 - PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX||2711.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45111|45111 - PRCTECT PRTL RESCJ RECTUM TABDL APPR||1560.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45110|45110 - PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST||2654.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4510F|4510F - PREVIOUS CARDIAC REHAB FOR QUAL CARD EVENT DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45108|45108 - ANORECTAL MYOMECTOMY||519.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45100|45100 - BX ANORECTAL WALL ANAL APPROACH||421.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45020|45020 - I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC||807.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4500F|4500F - REFERRED TO OUTPT CARD REHABILITATION PROGRAM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45005|45005 - I&D SUBMUCOSAL ABSCESS RECTUM||223.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|45000|45000 - TRANSRECTAL DRAINAGE OF PELVIC ABSCESS||600.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44979|44979 - UNLISTED LAPAROSCOPY PROCEDURE APPENDIX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44970|44970 - LAPAROSCOPIC APPENDECTOMY||853.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44960|44960 - APPENDEC RPTD APPENDIX ABSC/PRITONITIS||1249.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44955|44955 - APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX||121.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44950|44950 - APPENDECTOMY||918.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44901|44901 - DRAIN APP ABSCESS PERCUT||246.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44900|44900 - INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN||1103.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44899|44899 - UNLISTED PX MECKEL'S DIVERTICULUM & MESENTERY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44850|44850 - SUTURE MESENTERY SEPARATE PROCEDURE||1070.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44820|44820 - EXCISION LESION MESENTERY SEPARATE PROCEDURE||1200.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4481F|4481F - PT RCVNG ACE/ARB AND BETA BLOCKER < 3 MONTHS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4480F|4480F - PT RCVNG ACE/ARB BETA BLOCKER TX 3 MONS/LONGER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44800|44800 - EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT||1089.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44799|44799 - UNLISTED PROCEDURE SMALL INTESTINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44721|44721 - BKBENCH RCNSTJ INT ALGRFT ARTL ANAST EA||555.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44720|44720 - BKBENCH RCNSTJ INT ALGRFT VEN ANAST EA||358.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44715|44715 - BKBENCH PREP CADAVER/LIVING DONOR INTESTINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4470F|4470F - IMPLANT CARDIOVERT-DEFIB (ICD) COUNSELING PROV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44705|44705 - PREPARE FECAL MICROBIOTA FOR INSTILLATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44701|44701 - INTRAOPERATIVE COLONIC LAVAGE||242.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44700|44700 - EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS||1461.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44680|44680 - INTESTINAL PLICATION SEPARATE PROCEDURE||1539.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44661|44661 - CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ||2235.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44660|44660 - CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ||1929.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44650|44650 - CLSR ENTEROENTERIC/ENTEROCOLIC FSTL||2084.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44640|44640 - CLOSURE INTESTINAL CUTANEOUS FISTULA||2014.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44626|44626 - CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS||2306.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44625|44625 - CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT||1463.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44620|44620 - CLOSURE ENTEROSTOMY LG/SMALL INTESTINE||1241.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44615|44615 - INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ||1542.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44605|44605 - SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY||1877.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44604|44604 - SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY||1515.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44603|44603 - ENTERORRHAPHY MULTIPLE PERFORATIONS||2315.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44602|44602 - ENTERORRHAPHY SINGLE PERFORATION||2016.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4450F|4450F - SELF-CARE EDUCATION PROVIDED TO PATIENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44500|44500 - INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE||35.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44397|44397 - COLONOSCOPY W/STENT||402.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44394|44394 - COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE||374.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44393|44393 - COLONOSCOPY LESION REMOVAL||406.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44392|44392 - COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS||321.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44391|44391 - COLONOSCOPY STOMA CONTROL BLEEDING||366.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44390|44390 - COLONOSCOPY STOMA W/RMVL FOREIGN BODY||319.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44389|44389 - COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE||270.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44388|44388 - COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX||242.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44386|44386 - NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE||184.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44385|44385 - NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX||154.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44383|44383 - ILEOSCOPY W/STENT||240.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44382|44382 - ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE||119.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44380|44380 - ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD||99.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44379|44379 - ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT||640.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44378|44378 - ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING||602.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44377|44377 - ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE||469.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44376|44376 - ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX||444.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44373|44373 - ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE||300.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44372|44372 - ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE||374.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44370|44370 - ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT||418.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44369|44369 - ENTEROSCOPY > 2ND PRTN ABLTJ LESION||388.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44366|44366 - ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING||379.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44365|44365 - ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY||288.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44364|44364 - ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE||322.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44363|44363 - ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY||302.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44361|44361 - ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY||252.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44360|44360 - ENDOSCOPY UPPER SMALL INTESTINE||229.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44346|44346 - REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX||1692.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44345|44345 - REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX||1505.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44340|44340 - REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX||884.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44322|44322 - COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX||1411.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44320|44320 - COLOSTOMY/SKIN LEVEL CECOSTOMY||1720.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44316|44316 - CONTINENT ILEOSTOMY KOCK PROCEDURE SPX||2019.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44314|44314 - REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX||1444.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44312|44312 - REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX||846.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44310|44310 - ILEOSTOMY/JEJUNOSTOMY NON-TUBE||1496.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44300|44300 - PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN||1204.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44227|44227 - LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS||2398.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44213|44213 - LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY||273.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44212|44212 - LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY||2962.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44211|44211 - LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS||3219.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44210|44210 - LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS||2576.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44208|44208 - LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST||2857.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44207|44207 - LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST||2629.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44206|44206 - LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM||2521.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44205|44205 - LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM||1923.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44204|44204 - LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS||2211.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44203|44203 - LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS||350.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44202|44202 - LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA||1987.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44188|44188 - LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY||1750.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44187|44187 - LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE||1580.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44186|44186 - LAPAROSCOPY SURGICAL JEJUNOSTOMY||932.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44180|44180 - LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE||1317.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44160|44160 - COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS||1778.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44158|44158 - COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR||3192.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44157|44157 - COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST||3112.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44156|44156 - COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST||3298.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44155|44155 - COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY||2981.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44151|44151 - COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST||3057.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44150|44150 - COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS||2672.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44147|44147 - COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH||2773.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44146|44146 - COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY||3030.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44145|44145 - COLECTOMY PRTL W/COLOPROCTOSTOMY||2383|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44144|44144 - COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA||2532.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44143|44143 - COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT||2384.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44141|44141 - COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY||2603.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44140|44140 - COLECTOMY PARTIAL W/ANASTOMOSIS||1921.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44139|44139 - MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT||174.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44137|44137 - RMVL TRNSPLED INTESTINAL ALLOGRAFT COMPL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44136|44136 - INTESTINAL ALLOTRANSPLANTATION LIVING DONOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44135|44135 - INTESTINAL ALLOTRANSPLANTATION CADAVER DONOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44133|44133 - DONOR ENTERECTOMY OPEN LIVING DONOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44132|44132 - DONOR ENTERECTOMY OPEN CADAVER DONOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44130|44130 - ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX||1871.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44128|44128 - ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS||350.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44127|44127 - ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING||4081.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44126|44126 - ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING||3526.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44125|44125 - ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY||1691.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44121|44121 - ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA||349.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44120|44120 - ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST||1750.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44111|44111 - EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE||1407.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44110|44110 - EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM||1214.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44100|44100 - BX INTESTINE CAPSULE TUBE PRORAL 1/> SPECIMENS||165.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44055|44055 - CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS||2144.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44050|44050 - RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT||1337|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44025|44025 - COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL||1414.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44021|44021 - ENTEROTOMY SM INT OTH/THN DUO DCMPRN||1403.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44020|44020 - ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL||1392.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44015|44015 - TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD||206.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44010|44010 - DUODENOTOMY EXPLORATION/BX/FOREIGN BODY REMOVAL||1237.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4400F|4400F - REHAB THERAPY OPTIONS DISCUSSED W/PATIENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|44005|44005 - ENTEROLSS FRING INTSTINAL ADHESION SPX||1565.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43999|43999 - UNLISTED PROCEDURE STOMACH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43888|43888 - GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT||648.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43887|43887 - GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY||460.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43886|43886 - GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY||508.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43882|43882 - REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43881|43881 - IMPLTJ/RPLCMT GASTRIC NSTIM ELTRDE ANTRUM OPEN||1021.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43880|43880 - CLOSURE GASTROCOLIC FISTULA||2284.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43870|43870 - CLOSURE GASTROSTOMY SURG||1015.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43865|43865 - REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY||2445.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43860|43860 - REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY||2338.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43855|43855 - REVJ GASTRODUOL ANAST W/RCNSTJ W/VGTMY||2417.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43850|43850 - REVJ GASTRODUOL ANAST W/RCNSTJ W/O VAGOTOMY||2326.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43848|43848 - REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE||2761.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43847|43847 - GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ||2571.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43846|43846 - GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<||2329.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43845|43845 - GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM||2799.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43843|43843 - GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP||1826.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43842|43842 - GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY||1652.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43840|43840 - GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ||1938.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43832|43832 - GASTROSTOMY OPN W/CONSTJ GSTR TUBE||1506.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43831|43831 - GASTROSTOMY OPN NEONATAL FEEDING||842.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43830|43830 - GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX||994.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43825|43825 - GASTROJEJUNOSTOMY W/VAGOTOMY ANY TYPE||1863.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43820|43820 - GASTROJEJUNOSTOMY W/O VAGOTOMY||1909.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43810|43810 - GASTRODUODENOSTOMY||1451.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43800|43800 - PYLOROPLASTY||1329.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43775|43775 - LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY||1850.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43774|43774 - LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT||1374.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43773|43773 - LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE||1814.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43772|43772 - LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE||1365.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43771|43771 - LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE||1815.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43770|43770 - LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE||1595.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43763|43763 - PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC||126.7|0|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43762|43762 - PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC||58.1||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43761|43761 - REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO||150.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43760|43760 - CHANGE GASTROSTOMY TUBE PERCUTANEOUS W/O GDNCE||71.38|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|43757|43757 - DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN||113.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43756|43756 - DUODENAL INTUBAT W/IMAG GUIDED SINGLE SPECIMEN||74.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43755|43755 - GASTRIC INTUBATION DX & ASPIRATJ MULTIPLE SPEC||82.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43754|43754 - GASTRIC INTUBAT DX W/ASPIRATION SINGLE SPECIMEN||45.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43753|43753 - GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE||29.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43752|43752 - NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE||58.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43659|43659 - UNLISTED LAPAROSCOPIC PROCEDURE STOMACH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43653|43653 - LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX||811.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43652|43652 - LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV||1089.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43651|43651 - LAPS SURG TRNSXJ VAGUS NRV TRUNCAL||931.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43648|43648 - LAPS REVISION/RMVL GASTRIC NSTIM ELTRD ANTRUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43647|43647 - LAPS IMPLTJ/RPLCMT GASTRIC NSTIM ELTRD ANTRUM||1021.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43645|43645 - LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ||2656.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43644|43644 - LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM||2482.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43641|43641 - VGTMY W/PYLOROPLASTY W/WO GASTROST PARIETAL CELL||1712.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43640|43640 - VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV||1683.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43635|43635 - VAGOTOMY PFRMD W/PRTL DSTL GSTRCT||161.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43634|43634 - GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH||3038.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43633|43633 - GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ||2744.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43632|43632 - GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY||2899.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43631|43631 - GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY||2076.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43622|43622 - GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYPE||3295.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43621|43621 - GSTRCT TOT W/ROUX-EN-Y RCNSTJ||3244.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43620|43620 - GSTRCT TOT W/ESOPHAGOENTEROSTOMY||2821.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43611|43611 - EXC LOCAL MALIGNANT TUMOR STOMACH||1740.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43610|43610 - EXC LOCAL ULCER/BENIGN TUMOR STOMACH||1401.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43605|43605 - BIOPSY STOMACH LAPAROTOMY||1194.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43520|43520 - PYLOROMYOTOMY CUTTING PYLORIC MUSC||993.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43510|43510 - GSTRT W/ESOPHGL DILAT&INSJ PRM INTRAL TUBE||1371.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4350F|4350F - COUNSELING PROVIDED SYMP MNGMNT PALLIATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43502|43502 - GASTROTOMY W/SUTR RPR PRE-ESOPG/GASTRIC LAC||2179.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43501|43501 - GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER||1928.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43500|43500 - GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL||1122.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43499|43499 - UNLISTED PROCEDURE ESOPHAGUS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43496|43496 - FREE JEJUNUM TRSF W/MICROVASC ANASTOMOSIS||7131.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43460|43460 - ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE||325.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43458|43458 - DILATE ESOPHAGUS||264.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43456|43456 - DILATE ESOPHAGUS||226.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43453|43453 - DILATION ESOPHAGUS GUIDE WIRE||140.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43450|43450 - DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS||129.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43425|43425 - CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR||2117.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43420|43420 - CLSR ESOPHAGOSTOMY/FSTL CRV APPR||1484.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43415|43415 - SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR||3698.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43410|43410 - SUTR ESOPHGL WND/INJ CRV APPR||1575.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4340F|4340F - COUNSEL WOMEN CHILDBEARING POTENTIAL W/EPILEPSY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43405|43405 - LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J||2118.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43401|43401 - TRNSXJ ESOPH W/RPR ESOPHAGEAL VARICES||2219.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43400|43400 - LIGATION DIRECT ESOPHAGEAL VARICES||2156.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43361|43361 - GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT||3866.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43360|43360 - GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH||3462.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43352|43352 - ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR||1573.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43351|43351 - ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR||1937.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43350|43350 - SURGICAL OPENING ESOPHAGUS||1801.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43341|43341 - ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR||2080.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43340|43340 - ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR||1974.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43338|43338 - ESOPHAGUS LENGTHENING||190.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43337|43337 - RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH||2386.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43336|43336 - RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH||2183.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43335|43335 - RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH||1991.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43334|43334 - RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH||1848.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43333|43333 - LAPT RPR PARAESOPH HIATAL HERNIA W/MESH||1830.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43332|43332 - RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH||1686.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43331|43331 - ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH||1983.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43330|43330 - ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH||1884.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43328|43328 - ESOPG/GSTR FUNDOPLASTY W/THORACOTOMY||1733.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43327|43327 - ESOPG/GSTR FUNDOPLASTY W/LAPAROTOMY||1182.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43325|43325 - ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH||1941.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43320|43320 - EGST W/WO VAGOTOMY&PYLOROPLASTY TABDL/TTHRC AP||1996.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43314|43314 - ESPHGP CGEN DFCT THRC APPR W/RPR FSTL||4236.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43313|43313 - ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL||4168.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43312|43312 - ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL||2386.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43310|43310 - ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL||2199.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4330F|4330F - EPILEPSY SPECIFIC SAFETY COUNSELING TO PATIENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43305|43305 - ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL||1603.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43300|43300 - ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL||899.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4328F|4328F - PT/CAREGIVER QUERIED SLEEP DISTURBANCES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43289|43289 - UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43283|43283 - LAPS ESOPHAGEAL LENGTHENING ADDL||233.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43282|43282 - LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH||2521.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43281|43281 - LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH||2241.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43280|43280 - LAPS SURG ESOPG/GSTR FUNDOPLASTY||1552.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43279|43279 - LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED||1860.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43273|43273 - ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC||185.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43272|43272 - ENDO CHOLANGIOPANCREATOGRAPH||625.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43271|43271 - ENDO CHOLANGIOPANCREATOGRAPH||624.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4326F|4326F - PT/CAREGIVER QUERIED AUTONOMIC DYSFUNCJ SYMPTOMS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43269|43269 - ENDO CHOLANGIOPANCREATOGRAPH||692.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43268|43268 - ENDO CHOLANGIOPANCREATOGRAPH||633.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43267|43267 - ENDO CHOLANGIOPANCREATOGRAPH||622.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43265|43265 - ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD||841.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43264|43264 - ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT||750.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43263|43263 - ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI||617.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43262|43262 - ERCP W/SPHINCTEROTOMY/PAPILLOTOMY||625.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43261|43261 - ERCP W/BIOPSY SINGLE/MULTIPLE||531.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43260|43260 - ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING||506.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4325F|4325F - MEDICAL & SURGICAL TREATMENT OPTION REVIEW W/P||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43259|43259 - EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM||443.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43258|43258 - OPERATIVE UPPER GI ENDOSCOPY||390.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43257|43257 - EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD||469.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43256|43256 - UPPR GI ENDOSCOPY W/STENT||371.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43255|43255 - EGD TRANSORAL CONTROL BLEEDING ANY METHOD||412.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43252|43252 - EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY||319|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43251|43251 - EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH||319.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43250|43250 - EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS||276.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4324F|4324F - PT QUERIED PARKINSONS MED-RELATED COMPLICATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43249|43249 - EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM||253.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43248|43248 - EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS||275.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43247|43247 - EGD FLEXIBLE FOREIGN BODY REMOVAL||293.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43246|43246 - EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE||368.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43245|43245 - EGD DILATION GASTRIC/DUODENAL STRICTURE||275|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43244|43244 - EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES||431.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43243|43243 - EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES||390.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43242|43242 - EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY||618.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43241|43241 - EGD INTRALUMINAL TUBE/CATHETER INSERTION||227.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43240|43240 - EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST||580.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43239|43239 - EGD TRANSORAL BIOPSY SINGLE/MULTIPLE||250.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43238|43238 - EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS||428.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43237|43237 - ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS||342.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43236|43236 - ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION||256.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43235|43235 - ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC||212.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43232|43232 - ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX||381.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43231|43231 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM||278.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4322F|4322F - CRGVR PROVIDED W/ED REFERRED ADDL RESOURCES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43228|43228 - ESOPH ENDOSCOPY ABLATION||326.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43227|43227 - ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL||308.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43226|43226 - ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION||206.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43220|43220 - ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM||185.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43219|43219 - ESOPHAGUS ENDOSCOPY||250.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43217|43217 - ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE||250.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43216|43216 - ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS||211.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43215|43215 - ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY||226.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4320F|4320F - PT COUNSEL PSYCHSOC & PHARM TX ALCOHOL DEPEND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43206|43206 - ESOPHAGOSCOPY TRANSORAL W/OPTICAL ENDOMICROSCOPY||328.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43205|43205 - ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES||328.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43204|43204 - ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES||321.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43202|43202 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY||168.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43201|43201 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ||187.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43200|43200 - ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC||152.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43135|43135 - DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR||2178.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43130|43130 - DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR||1152.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43124|43124 - TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY||5615|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43123|43123 - PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ||6792.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43122|43122 - PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL||3709.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43121|43121 - PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY||4215.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43118|43118 - PRTL ESOPH DSTL W/WO PROX GASTRC W/COLON NTRPSTJ||5481.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43117|43117 - PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY||3615.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43116|43116 - PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF||7578.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43113|43113 - TOT ESOPHG W/THORCOM W/COLON NTRPSTJ/INT RCNSTJ||6593.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43112|43112 - TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY||3954.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43108|43108 - TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ||6478.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43107|43107 - TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY||3715.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43101|43101 - EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR||1485.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43100|43100 - EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR||915.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4306F|4306F - PT COUNSEL PSYCHOSOC&PHARM TX OPIOID ADDICTION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4305F|4305F - PT EDUC FOOT CARE & DAILY INSPCTN FEET RCVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43045|43045 - ESOPHAGOTOMY THORACIC APPR W/RMVL FB||1919.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43030|43030 - CRICOPHARYNGEAL MYOTOMY||759.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|43020|43020 - ESOPHAGOTOMY CERVICAL APPR W/RMVL FB||784.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4301F|4301F - PT NOT RCVNG WARFARIN THXPY NONVALV AFIB/AFLUT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4300F|4300F - PT RCVNG WARFARIN THXPY NONVALV AFIB OR AFLUT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42999|42999 - UNLISTED PROCEDURE PHARYNX ADENOIDS/TONSILS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42972|42972 - CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ||749.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42971|42971 - CTRL NASOPHARYNGEAL HEMRRG COMP REQ HOSPIZATION||669.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42970|42970 - CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS||586.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42962|42962 - CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ||758.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42961|42961 - CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ||613.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42960|42960 - CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE||246.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42955|42955 - PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING||1089.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42953|42953 - PHARYNGOESOPHAGEAL REPAIR||1390.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42950|42950 - PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX||1150.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4293F|4293F - PT SCRND HGH-RSK SEXUAL BEHAVIOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4290F|4290F - PATIENT SCREENED FOR INJECTION DRUG USE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42900|42900 - SUTURE PHARYNX WOUND/INJURY||498.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42894|42894 - RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS||3441.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42892|42892 - RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR||2727.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42890|42890 - LIMITED PHARYNGECTOMY||2053.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42870|42870 - EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX||838.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42860|42860 - EXCISION TONSIL TAGS||275.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42845|42845 - RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP||3236.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42844|42844 - RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP||1989.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42842|42842 - RADICAL RESECTION TONSIL W/O CLOSURE||1440.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42836|42836 - ADENOIDECTOMY SECONDARY AGE 12/>||352.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42835|42835 - ADENOIDECTOMY SECONDARY<AGE 12||278.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42831|42831 - ADENOIDECTOMY PRIMARY AGE 12/>||326.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42830|42830 - ADENOIDECTOMY PRIMARY <AGE 12||303.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42826|42826 - TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>||368.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42825|42825 - TONSILLECTOMY PRIMARY/SECONDARY <AGE 12||355.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42821|42821 - TONSILLECTOMY & ADENOIDECTOMY AGE 12/>||441.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42820|42820 - TONSILLECTOMY & ADENOIDECTOMY <AGE 12||424.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42815|42815 - EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX||813.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42810|42810 - EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS||420.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4280F|4280F - PNEUMOCYS JIROVECI PNEUMO PRPHYLXS PRSCRBD 3 MON||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42809|42809 - REMOVAL FOREIGN BODY PHARYNX||191.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42808|42808 - EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD||237.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42806|42806 - BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION||194.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42804|42804 - BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE||166.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42802|42802 - BIOPSY OF THROAT||196.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42800|42800 - BIOPSY OROPHARYNX||164.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4279F|4279F - PNEUMOCYSTIS JIROVECI PNEUMONIA PROPHYLAXIS RXD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4276F|4276F - POTENT ANTIRETROVIRAL THERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4274F|4274F - FLU IMMUNO ADMIND/PREVIOUSLY RCVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42725|42725 - I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR||1182.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42720|42720 - I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL||575.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4271F|4271F - PT RCVNG POT ANTI R-VIRAL THX <6 MON/NOT RCVN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4270F|4270F - PT RCVNG POTENT ANTI R-VIRAL THX 6 MON OR MORE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42700|42700 - I&D ABSCESS PERITONSILLAR||198.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4269F|4269F - APPROP METHOD OFFLOADING PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42699|42699 - UNLISTED PX SALIVARY GLANDS/DUCTS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4268F|4268F - PT ED RE NEED LONG TERM COMPRESS THXPY RCVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4267F|4267F - COMPRESSION THERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4266F|4266F - USE WET TO DRY DRESSINGS NEITHER RXD NOR RECMD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42665|42665 - LIGATION SALIVARY DUCT INTRAORAL||302.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42660|42660 - DILAT&CATHJ SALIVARY DUCT W/WO INJECTION||112.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4265F|4265F - USE OF WET TO DRY DRESSINGS PRESCRIBED RECMD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42650|42650 - DILATION SALIVARY DUCT||85.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4261F|4261F - TECH OTHER THAN SURFACE CULTURE WOUND EXUD USED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4260F|4260F - WOUND SURFACE CULTURE TECHNIQUE USED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42600|42600 - CLOSURE SALIVARY FISTULA||511.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4256F|4256F - DURATION GEN NEUR ANESTH <60 MIN DOCD RECORD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4255F|4255F - DURATION GEN NEUR ANESTH 60 MINS/> DOC RECORD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42550|42550 - INJECTION PROCEDURE SIALOGRAPHY||91.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42510|42510 - PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS||919.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4250F|4250F - ACTV WRMNG INTRAOP FOR NORMOTHERMIA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42509|42509 - PAROTID DUCT DVRJ BI W/EXC BOTH SUBMNDBLR GLANDS||1269.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42508|42508 - PAROTID DUCT DIVERSION||1043.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42507|42507 - PAROTID DUCT DIVERSION BILATERAL WILKE PX||749.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42505|42505 - PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP||659.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42500|42500 - PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM||497.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4248F|4248F - COUNSEL INIT BACK PAIN AGNST BED REST 4 DAYS/>||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4245F|4245F - PT TLK 1ST VST TO KEEP/RESUME NORMAL ACTIVITIES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42450|42450 - EXISION OF SUBLINGUAL GLAND||522.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42440|42440 - EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND||607.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4242F|4242F - TLK RE SPRVSD XRCS PROG TO PTS BACK PN >12WKS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42426|42426 - EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ||1985.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42425|42425 - EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL||1227.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42420|42420 - EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR||1750.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42415|42415 - EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR||1554.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42410|42410 - EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ||908.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4240F|4240F - INSTR THER XRCS-DR FLLWUP PT EPSD BACK PN >12 WK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42409|42409 - MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA||325.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42408|42408 - EXC SUBLINGUAL SALIVARY CYST RANULA||477.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42405|42405 - BIOPSY SALIVARY GLAND INCISIONAL||328.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42400|42400 - BIOPSY SALIVARY GLAND NEEDLE||80.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42340|42340 - SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL||492.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42335|42335 - SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL||375.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42330|42330 - SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL||240.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42320|42320 - DRAINAGE ABSCESS SUBMAXILLARY INTRAORAL||257.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42310|42310 - DRG ABSC SUBMAXILLARY/SUBLINGUAL INTRAORAL||182.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4230F|4230F - ANTICONVUL MED THERAPY 6 MOS/>||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42305|42305 - DRAINAGE ABSCESS PAROTID COMPLICATED||626.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42300|42300 - DRAINAGE ABSCESS PAROTID SIMPLE||223|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42299|42299 - UNLISTED PROCEDURE PALATE UVULA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42281|42281 - INSJ PIN-RETAINED PALATAL PROSTHESIS||221.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42280|42280 - MAXILLARY IMPRESJ PALATAL PROSTHESIS||160.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42260|42260 - REPAIR NASOLABIAL FISTULA||968.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42235|42235 - REPAIR ANTERIOR PALATE W/VOMER FLAP||1069.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42227|42227 - LENGTHENING PALATE W/ISLAND FLAP||1240.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42226|42226 - LENGTHENING PALATE & PHARYNGEAL FLAP||1311.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42225|42225 - PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP||1297.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42220|42220 - PALATOPLASTY CLEFT PALATE SEC LNGTH PX||758.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4221F|4221F - DIURETIC MEDICATION THERAPY 6 MOS/>||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42215|42215 - PALATOPLASTY CLEFT PALATE MAJOR REVJ||984.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42210|42210 - PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE||1606.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4220F|4220F - DIGOXIN MEDICATION THERAPY 6 MONTHS/>||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42205|42205 - PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE||1271.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42200|42200 - PALATOP CL PALATE SOFT&/HARD PALATE ONLY||1252.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42182|42182 - REPAIR LACERATION PALATE >2 CM/COMPLEX||377.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42180|42180 - REPAIR LACERATION PALATE </2 CM||268.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42160|42160 - DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM||215.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42145|42145 - PALATOPHARYNGOPLASTY||1028.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42140|42140 - UVULECTOMY EXCISION UVULA||226.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42120|42120 - RESCJ PALATE/EXTENSIVE RESCJ LESION||1439.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4210F|4210F - ACE/ARB MEDICATION THERAPY 6 MONTHS/>||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42107|42107 - EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE||500.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42106|42106 - EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE||256.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42104|42104 - EXC LESION PALATE UVULA W/O CLOSURE||201.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42100|42100 - BIOPSY PALATE UVULA||158.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4201F|4201F - EXTRNL BM RADIOTHXPY W/WO NODAL IRRAD AS ADJV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4200F|4200F - EXTRNL BM RADIOTHXPY TO PROST W/WO NODAL IRRAD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|42000|42000 - DRAINAGE ABSCESS PALATE UVULA||150.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4196F|4196F - PT NOT RCVNG 1ST BIOL ANTI-RHEUM DRUG THXPY RA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4195F|4195F - PT RCVNG 1ST BIOL ANTI-RHEUM DRUG THXRPY FOR RA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4194F|4194F - PATIENT RCVNG >= 10 MG DAILY PREDNISONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4193F|4193F - PATIENT RCVNG <10 MG DAILY PREDNISONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4192F|4192F - PATIENT NOT RECEIVING GLUCOCORTICOID||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4191F|4191F - APPROP ANTICONVUL THXP MONIT TST ORDRD/DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4190F|4190F - APPROP DIURETIC THXP MONIT TST ORDRD/DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4189F|4189F - APPROP DIGOXIN THXP MONIT TST ORDRD/DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41899|41899 - UNLISTED PROCEDURE DENTOALVEOLAR STRUCTURES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4188F|4188F - APPROP ACE/ARB THXP MONIT TEST ORDRD/DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4187F|4187F - DIS MODFY ANTI-RHEU DRUG THXPY RX/GVN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41874|41874 - ALVEOLOPLASTY EACH QUADRANT SPECIFY||361.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41872|41872 - GINGIVOPLASTY EACH QUADRANT SPECIFY||415.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41870|41870 - PERIODONTAL MUCOSAL GRAFTING||459.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4186F|4186F - NO CONTIN 12MON THXPY W/PPI OR H2 H2RA RCVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4185F|4185F - NONSTOP 12MON THXPY W/PPI OR H2 H2RA RCVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41850|41850 - DESTRUCTION LESION DENTOALVEOLAR STRUCTURES||183.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41830|41830 - ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY||401.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4182F|4182F - CONFORMAL RADIATION THERAPY NOT RECEIVED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41828|41828 - EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC||304.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41827|41827 - EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR||439.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41826|41826 - EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR||299.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41825|41825 - EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR||176.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41823|41823 - EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS||458.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41822|41822 - EXC FIBROUS TUBEROSITIES DENTOALVEOLAR STRUXS||258.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41821|41821 - OPRCULECTOMY EXC PRICORONAL TISSUE||82.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41820|41820 - GINGIVECTOMY EXC GINGIVA EACH QUADRANT||367.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4181F|4181F - CONFORMAL RADIATION THERAPY RECEIVED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4180F|4180F - ADJVNT CHEMO RFRRD RXD/RCVD STAGE III COLON CA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41806|41806 - RMVL EMBEDDED FB FROM DENTOALVEOLAR STRUXS BONE||375.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41805|41805 - RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS||238.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41800|41800 - DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS||204.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4179F|4179F - TAMOXIFEN OR AROMATASE INHIBITOR (AI) RXD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4178F|4178F - ANTI-D IMMUNE GLOBULIN RCVD 26-30 WKS GESTATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4177F|4177F - COUNSEL BENEF/RISK AREDS PREV AGE RELATED AMD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4176F|4176F - COUNSEL UV LITE PROTEC PREV/PROG CATARACT DEVEL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4175F|4175F - CORRECT VISUAL ACUIT 20/40/> W/IN 90 DAYS SURG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4174F|4174F - TLK VIS FXN & QUAL LIFE/TRXMNT FOR PT/CRGVR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4172F|4172F - PATIENT NOT RECEIVING (ESA) THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4171F|4171F - PATIENT RECEIVING (ESA) THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4169F|4169F - PT NOT RCVG CARE IN ICU/NOT RCVG MECHL VENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4168F|4168F - PT RCVG CARE ICU & RCVNG MECH VENT 24 HRS/<||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4167F|4167F - HEAD-BED ELEV 30-45 DEG 1ST VENT DAY ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4165F|4165F - 3D-CRT OR INTENSITY MODUL RAD THXPY RECVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4164F|4164F - ADJUVANT HORMONAL THXPY RX/ADMIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4163F|4163F - PT COUNSELING TREATMENT OPTIONS PROSTATE CANCER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4159F|4159F - CONTRACEPTION COUNSEL BEFORE ANTIVIRAL TX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41599|41599 - UNLISTED PROCEDURE TONGUE FLOOR MOUTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4158F|4158F - PATIENT COUNSELED ABOUT RISKS ALCOHOL USE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4157F|4157F - HEPATITIS B VACCINE SERIES PREVIOUSLY RECEIVED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4155F|4155F - HEPATITIS A VACCINE SERIES PREVIOUSLY RECEIVED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4153F|4153F - COMB PEGINTERF/RIBAVIRIN TX PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41530|41530 - SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION||587.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41520|41520 - FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY||363.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4151F|4151F - NO CURRENT HEPATITIS C ANTIVIRAL TREATMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41512|41512 - TONGUE BASE SUSPENSION PERMANENT SUTURE TQ||900.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41510|41510 - SUTURE TONGUE LIP MICROGNATHIA||592.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4150F|4150F - CURRENT HEPATITIS C ANTIVIRAL TREATMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41500|41500 - FIXJ TONGUE MECHANICAL OTHER/THAN SUTURE||658.29|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|4149F|4149F - HEPATITIS B VACCCINE ADMIN OR PREVIOSLY RECVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4148F|4148F - HEPATITIS A VACCINE ADMIN OR PREVIOSLY RECVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4145F|4145F - 2+ ANTI-HYPERTENSIVE AGENTS RXD OR TAKEN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4144F|4144F - ALTERNATIVE LONG-TERM CONTROL MEDICATION RXD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4142F|4142F - CORTICOSTEROID SPARING THERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4140F|4140F - INHALED CORTICOSTEROIDS PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4136F|4136F - SYSTEMIC CORTICOSTEROIDS NOT PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4135F|4135F - SYSTEMIC CORTICOSTEROIDS PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4134F|4134F - ANTIHISTAMINE/DECONGESTANT NOT PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4133F|4133F - ANTIHISTAMINE/DECONGESTANT PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4132F|4132F - SYSTEMIC ANTIMICROBIAL TX NOT PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4131F|4131F - SYSTEMIC ANTIMICROBIAL TX PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4130F|4130F - ACUTE OTITIS EXTERNA TOPICAL PREPS PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41252|41252 - RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX||308.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41251|41251 - RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE||252.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41250|41250 - RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG||217.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4124F|4124F - ANTIBIOTIC NEITHER PRESCRIBED NOR DISPENSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4120F|4120F - ANTIBIOTIC PRESCRIBED OR DISPENSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4115F|4115F - BETA BLOCKER GIVEN W/IN 24 HRS PRIOR SURG INC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41155|41155 - GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ & RAD NECK||4332.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41153|41153 - GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ||3446.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41150|41150 - GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ||3179.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41145|41145 - GLSSC COMPL/TOT W/WO TRACHS W/UNI RAD NECK DSJ||4005.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41140|41140 - GLSSC COMPL/TOT W/WOTRACHS W/O RAD NECK DSJ||3172.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41135|41135 - GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ||3117.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41130|41130 - GLOSSECTOMY HEMIGLOSSECTOMY||1886.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41120|41120 - GLOSSECTOMY <ONE-HALF TONGUE||1517.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41116|41116 - EXCISION LESION FLOOR MOUTH||317.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41115|41115 - EXCISION LINGUAL FRENUM FRENECTOMY||213.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41114|41114 - EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP||918.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41113|41113 - EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD||401.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41112|41112 - EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS||362.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41110|41110 - EXCISION LESION TONGUE W/O CLOSURE||191.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4110F|4110F - LIMA GRAFT USED IN 1ST ISOLATED CABG PXD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41108|41108 - BIOPSY FLOOR MOUTH||130.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41105|41105 - BIOPSY TONGUE POSTERIOR ONE-THIRD||161.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41100|41100 - BIOPSY TONGUE ANTERIOR TWO-THIRDS||157.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41019|41019 - PLACEMENT NEEDLE HEAD/NECK RADIOELEMENT APPLICAT||664.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41018|41018 - XTRORAL I&D FLOOR MASTICATOR SPACE||587.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41017|41017 - XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB||500.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41016|41016 - XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT||499|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41015|41015 - XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL||485.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41010|41010 - INCISION LINGUAL FRENUM FRENOTOMY||158.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4100F|4100F - BISPHOS THXPY VENOUS ORDERED OR RECEIVED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41009|41009 - INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE||417.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41008|41008 - INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE||384.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41007|41007 - INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE||358.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41006|41006 - INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD||375.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41005|41005 - INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC||181.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|41000|41000 - INTRAORAL I&D TONGUE/FLOOR LINGUAL||160.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4095F|4095F - PATIENT NOT RECEIVING ERYTHORPOIETIN THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4090F|4090F - PATIENT RECEIVING ERYTHROPOIETIN THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40899|40899 - UNLISTED PROCEDURE VESTIBULE MOUTH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4086F|4086F - ASPIRIN OR CLOPIDOGREL PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4084F|4084F - ASPIRIN RECVD W/IN 24 HRS PRIOR ED ARRIVAL/STAY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40845|40845 - VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG||1784.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40844|40844 - VESTIBULOPLASTY ENTIRE ARCH||1615.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40843|40843 - VESTIBULOPLASTY POSTERIOR BILATERAL||1241.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40842|40842 - VESTIBULOPLASTY POSTERIOR UNILATERAL||910.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40840|40840 - VESTIBULOPLASTY ANTERIOR||886.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40831|40831 - CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL||322.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40830|40830 - CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<||236.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40820|40820 - DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS||246.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40819|40819 - EXC FRENUM LABIAL/BUCCAL||334.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40818|40818 - EXC MUCOSA VESTIBULE MOUTH AS DON GRF||386.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40816|40816 - EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC||455.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40814|40814 - EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR||435.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40812|40812 - EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR||281.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40810|40810 - EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR||183.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40808|40808 - BIOPSY VESTIBULE MOUTH||153.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40806|40806 - INCISION LABIAL FRENUM FRENOTOMY||53.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40805|40805 - RMVL EMBEDDED FB VESTIBULE MOUTH COMP||322.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40804|40804 - RMVL EMBEDDED FB VESTIBULE MOUTH SMPL||190.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40801|40801 - DRG ABSC CST HMTMA VESTIBULE MOUTH COMP||315.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40800|40800 - DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL||185.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4079F|4079F - DOC REHAB SERVICES WERE CONSIDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40799|40799 - UNLISTED PROCEDURE LIPS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4077F|4077F - DOC T-PA ADMINISTRATION WAS CONSIDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40761|40761 - PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP||1500.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4075F|4075F - ANTICOAGULANT THERAPY PRESCRIBED AT DISCHARGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4073F|4073F - ORAL ANTIPLATELET THERAPY PRESCRBED AT DISCHARGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40720|40720 - PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL||1499.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4070F|4070F - DEEP VEIN THROMB PROPHYL RECVD BY HOSP DAY 2||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40702|40702 - PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS||1187.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40701|40701 - PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX||1690.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40700|40700 - PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI||1378.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4069F|4069F - VENOUS THROMBOEMBOLISM (VTE) PROPHYLAXIS RCVD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4067F|4067F - PT REFERRAL ELECTROCONVULSIVE THXPY (ECT) DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4066F|4066F - ELECTROCONVULSIVE THERAPY (ECT) PROVIDED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4065F|4065F - ANTIPSYCHOTIC PHARMACOTHERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40654|40654 - RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE||615.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40652|40652 - RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT||512.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40650|40650 - RPR LIP FULL THICKNESS VERMILION ONLY||425.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4064F|4064F - ANTIDEPRESSANT PHARMACOTHERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4063F|4063F - ANTIDEPRESSANT RXTHXY CONSIDER & NOT PRESCRIBE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4062F|4062F - PATIENT REFERRAL FOR PSYCHOTHERAPY DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4060F|4060F - PSYCHOTHERAPY SERVICES PROVIDED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4058F|4058F - PAG PROVIDED TO CAREGIVER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4056F|4056F - APPROPRIATE ORAL REHYD SOLUTION RECOMMENDED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4055F|4055F - PATIENT RECEIVING PERITONEAL DIALYSIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4054F|4054F - HEMODIALYSIS VIA CATHETER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4053F|4053F - HEMODIALYSIS VIA FUNCTIONING AVGRAFT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40530|40530 - RESCJ LIP > ONE-FOURTH W/O RCNSTJ||587.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4052F|4052F - HEMODIAL VIA FUNCTIONG AV FISTULA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40527|40527 - EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP||912.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40525|40525 - EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP||808.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40520|40520 - EXC LIP V-EXC W/PRIM DIR LINR CLSR||520.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4051F|4051F - REFERRED FOR AN ARTERIO-VENOUS (AV) FISTULA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40510|40510 - EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR||514.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4050F|4050F - HYPERTENSION PLAN OF CARE DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40500|40500 - VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT||524.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4049F|4049F - DOC ORDER GIVEN TO STOP ANTIBIO W/IN 24 HRS SURG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|40490|40490 - BIOPSY OF LIP||107.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4048F|4048F - DOC ANTIBIO GIVEN W/IN 1 HR PRIOR SURG/INCIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4047F|4047F - DOC ORDER ANTIBIO GIVEN W/IN 1 HR PRIOR SURG/INC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4046F|4046F - DOCD ANTIBIO W/IN 4 HRS PRIOR/INTRAOP SURG INCIS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4045F|4045F - APPROPRIATE EMPIRIC ANTIBIOTIC PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4044F|4044F - DOC ORDER VTE PROPHYL W/IN 24 HRS PRIOR SURG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4043F|4043F - DOC ORDER DISCONT ANTIBIO W/IN 48 HOURS OF SURG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4042F|4042F - DOC PROPHY ANTIBIO NOT GIVEN W/IN 4 HR PRIOR SUR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4041F|4041F - DOC ORDER CEFAZOLIN/CEFUROXIME ANTIMICRB PROPHYL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4040F|4040F - PNEUMOCOCCAL VACCINE ADMIN RCVD PRIOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4037F|4037F - INFLUENZA IMMUNIZATION ORDERED OR ADMINISTERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4035F|4035F - INFLUENZA IMMUNIZATION RECOMMENDED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4033F|4033F - PULMONARY REHABILITATION RECOMMENDED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4030F|4030F - LONG-TERM OXYGEN THERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4025F|4025F - INHALED BRONCHODILATOR PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4019F|4019F - DOCUMENT COUNSELING EXERCISE CALCIUM & VITAMIN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4018F|4018F - THERAPEUTIC EXERCISE INVOLVED JTS INST/PRESCRIBE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4017F|4017F - GI PROPHYLAXIS NSAID USE PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4016F|4016F - ANTI-INFLAMMATORY/ANALGESIC AGT PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4015F|4015F - PRSISTENT ASTHMA LONG TERM CTRL MED PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4014F|4014F - DSCHRG INSTRUCTIONS HRT FAILURE XCP PTS 18 YR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4013F|4013F - STATIN THERAPY RXD/CURRENTLY TAKEN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4012F|4012F - WARFARIN THERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4011F|4011F - ORAL ANTIPLATELET THERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4010F|4010F - ACE INHIBITOR/ARB THERAPY RXD/CURRENTLY TAKEN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4008F|4008F - BETA BLOCKER THERAPY RXD/CURRENTLY BEING TAKEN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4005F|4005F - PHARMACOLOGIC OSTEOPOROSIS THERAPY PRESCRIBED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4004F|4004F - PT SCRND TOBACCO USE RCVD TOBACCO CESSATION TALK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4003F|4003F - PT EDUCATION WRTTN/ORAL HRT FAILURE PTS PFRMD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4001F|4001F - TOBACCO USE CESSATION IVNTJ PHARMACOLOGIC THER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|4000F|4000F - TOBACCO USE CESSATION IVNTJ COUNSELING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39599|39599 - UNLISTED PROCEDURE DIAPHRAGM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39561|39561 - RESCJ DIAPHRAGM W/COMPLEX REPAIR||1799.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39560|39560 - RESCJ DIAPHRAGM W/SIMPLE REPAIR||1142.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39545|39545 - IMBRICATION DIAPHRAGM EVENTRATION||1317.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39541|39541 - RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC||1362.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39540|39540 - RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT||1253.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39503|39503 - RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ||8808.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39501|39501 - REPAIR LACERATION DIAPHRAGM ANY APPROACH||1226.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39499|39499 - UNLISTED PROCEDURE MEDIASTINUM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39400|39400 - MEDIASTINOSCOPY INCL BIOPSY||745.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39220|39220 - RESECTION MEDIASTINAL TUMOR||1679.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39200|39200 - RESECTION OF MEDIASTINAL CYST||1301.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39010|39010 - MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR||1172.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|39000|39000 - MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR||729.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38999|38999 - UNLISTED PROCEDURE HEMIC OR LYMPHATIC SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38900|38900 - INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION||195.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38794|38794 - CANNULATION THORACIC DUCT||421.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38792|38792 - INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE||57.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38790|38790 - INJECTION PROCEDURE LYMPHANGIOGRAPHY||120.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38780|38780 - RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL||1483.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38770|38770 - PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR||1157.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38765|38765 - INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC||1847.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38760|38760 - INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX||1205.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38747|38747 - ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC||384.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38746|38746 - THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC||325.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38745|38745 - AXILLARY LYMPHADENECTOMY COMPLETE||1244.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38740|38740 - AXILLARY LYMPHADENECTOMY SUPERFICIAL||981.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38724|38724 - CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ||2111.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38720|38720 - CERVICAL LYMPHADENECTOMY||1953.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38700|38700 - SUPRAHYOID LYMPHADENECTOMY||1167.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38589|38589 - UNLISTED LAPAROSCOPY PX LYMPHATIC SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38572|38572 - LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1||1370.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38571|38571 - LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY||1151.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38570|38570 - LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT||770.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38564|38564 - LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC||1006.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38562|38562 - LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC||1002.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38555|38555 - EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ||1433.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38550|38550 - EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ||716.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38542|38542 - DISSECTION DEEP JUGULAR NODE||748.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38531|38531 - OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES||661||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38530|38530 - BX/EXC LYMPH NODE OPEN INT MAMMARY NODE||785.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38525|38525 - BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE||616.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38520|38520 - BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD||667.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38510|38510 - BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE||606.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38505|38505 - BX/EXC LYMPH NODE NEEDLE SUPERFICIAL||102.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38500|38500 - BX/EXC LYMPH NODE OPEN SUPERFICIAL||361.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38382|38382 - SUTR&/LIG THORACIC DUCT ABDOMINAL APPROACH||1013.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38381|38381 - SUTR&/LIG THORACIC DUCT THORACIC APPROACH||1179.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38380|38380 - SUTR&/LIG THORACIC DUCT CERVICAL APPROACH||826.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38308|38308 - LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS||641.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38305|38305 - DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV||657.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38300|38300 - DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL||264.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38243|38243 - TRNSPLJ HEMATOPOIETIC CELL BOOST||168|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38242|38242 - ALLOGENEIC LYMPHOCYTE INFUSIONS||136.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38241|38241 - TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR||178.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38240|38240 - TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR||178.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38232|38232 - BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS||267.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38230|38230 - BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC||267.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38221|38221 - DIAGNOSTIC BONE MARROW BIOPSIES||107.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38220|38220 - DIAGNOSTIC BONE MARROW ASPIRATIONS||87.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38215|38215 - TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM||70.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38214|38214 - TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ||60.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38213|38213 - TRNSPL PREPJ HEMATOP PROGEN PLTLT DEPLJ||17.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38212|38212 - TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL||70.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38211|38211 - TRNSPL PREPJ HEMATOP PROGEN TUM CELL DEPLJ||107.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38210|38210 - TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL||117.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38209|38209 - TRNSP PREP HMATOP PROG THAW PREV HRV WSH PER DNR||17.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38208|38208 - TRNSPL PREP HEMATOP PROGEN THAW PREV HRV PER DNR||42.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38207|38207 - TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR||66.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38206|38206 - BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL||116.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38205|38205 - BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC||113.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38204|38204 - MGMT RCP HEMATOP PROGENITOR CELL DONOR &ACQUISJ||146.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38200|38200 - INJECTION PROCEDURE SPLENOPORTOGRAPY||211.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38129|38129 - UNLISTED LAPAROSCOPY PROCEDURE SPLEEN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38120|38120 - LAPAROSCOPIC SURGICAL SPLENECTOMY||1504.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38115|38115 - RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT||1817.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38102|38102 - SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX||378.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38101|38101 - SPLENECTOMY TOTAL EN BLOC W/OTHER PROCEDURE||1661.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|38100|38100 - SPLENECTOMY TOTAL SEPARATE PROCEDURE||1646.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37799|37799 - UNLISTED PROCEDURE VASCULAR SURGERY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37790|37790 - PENILE VENOUS OCCLUSIVE PROCEDURE||699.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37788|37788 - PENILE REVASCULARIZATION ARTERY W/WO VEIN GRAFT||2015.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37785|37785 - LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG||389.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37780|37780 - LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX||384.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37766|37766 - STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS||830.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37765|37765 - STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS||678.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37761|37761 - LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG||824.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37760|37760 - LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG||939.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37735|37735 - LIGJ & DIVJ RADICAL STRIP LONG/SHORT SAPHENOUS||944.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37722|37722 - LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW||726.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37718|37718 - LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN||653.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37700|37700 - LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ||376.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37660|37660 - LIGATION OF COMMON ILIAC VEIN||1882.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37650|37650 - LIGATION OF FEMORAL VEIN||796.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37619|37619 - INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I||2403.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37618|37618 - LIGATION MAJOR ARTERY EXTREMITY||570.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37617|37617 - LIGATION MAJOR ARTERY ABDOMEN||1959.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37616|37616 - LIGATION MAJOR ARTERY CHEST||1618.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37615|37615 - LIGATION MAJOR ARTERY NECK||742.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37609|37609 - LIGATION/BIOPSY TEMPORAL ARTERY||303.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37607|37607 - LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA||565.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37606|37606 - LIG INT/COMMON CAROTID ART W/GRADUAL OCCLUSION||827.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37605|37605 - LIGATION INTERNAL/COMMON CAROTID ARTERY||1211.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37600|37600 - LIGATION EXTERNAL CAROTID ARTERY||1055.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37565|37565 - LIGATION INTERNAL JUGULAR VEIN||1075.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3750F|3750F - PT NOT RCVNG CORTICOSTERIDS>/=10MG/DAY 60/> DAYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37501|37501 - UNLISTED VASCULAR ENDOSCOPY PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37500|37500 - VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX||1037.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3725F|3725F - SCREENING FOR DEPRESSION PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37251|37251 - IV US EACH ADD VESSEL ADD-ON||122.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37250|37250 - IV US FIRST VESSEL ADD-ON||162.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37235|37235 - REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL||588.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37234|37234 - REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL||414.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37233|37233 - REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL||497.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37232|37232 - REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL||302.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37231|37231 - REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL||1133.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37230|37230 - REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL||1043.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37229|37229 - REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL||1080.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37228|37228 - REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI||836.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37227|37227 - REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL||1115.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37226|37226 - REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL||761.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37225|37225 - REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL||923.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37224|37224 - REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI||684.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37223|37223 - REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL||320.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37222|37222 - REVASCULARIZATION ILIAC ART ANGIOP EA IPSI VSL||281.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37221|37221 - REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY||756.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37220|37220 - REVASCULARIZATION ILIAC ARTERY ANGIOP 1ST VSL||621.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37216|37216 - TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ||1474.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37215|37215 - TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ||1630.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37214|37214 - CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL||213.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37213|37213 - THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX||365.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37212|37212 - THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX||522.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37211|37211 - THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX||591.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37210|37210 - EMBOLIZATION UTERINE FIBROID||778.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3720F|3720F - COGNITIVE IMPAIRMENT/DYSFUNCTION ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37208|37208 - TRANSCATH IV STENT/OPEN ADDL||313.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37207|37207 - TRANSCATH IV STENT OPEN||646.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37206|37206 - TRANSCATH IV STENT/PERC ADDL||317.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37205|37205 - TRANSCATH IV STENT PERCUT||641.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37204|37204 - TRANSCATHETER OCCLUSION||1329.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37202|37202 - TRANSCATHETER THERAPY INFUSE||488.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37200|37200 - TRANSCATHETER BIOPSY||329.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37197|37197 - PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING||447|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37195|37195 - THROMBOLYSIS CEREBRAL IV INFUSION||1424.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37193|37193 - RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I||541.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37192|37192 - REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I||542.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37191|37191 - INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I||350.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37188|37188 - PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX||433.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37187|37187 - PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN||609.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37186|37186 - SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL||381.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37185|37185 - PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ||250.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37184|37184 - PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST||676.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37183|37183 - REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT||586.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37182|37182 - INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT||1241.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37181|37181 - VENOUS ANASTOMOSIS OPEN SPLENORENAL DISTAL||3275.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37180|37180 - VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL||2999.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37160|37160 - VENOUS ANASTOMOSIS OPEN CAVAL-MESENTERIC||3105.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37145|37145 - VENOUS ANASTOMOSIS OPEN RENOPORTAL||3057.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|37140|37140 - VENOUS ANASTOMOSIS OPEN PORTOCAVAL||3264.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3700F|3700F - PSYCHIATRIC DISORDERS/DISTURBANCES ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36870|36870 - PERCUT THROMBECT AV FISTULA||443.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36861|36861 - XTRNL CANNULA DECLTNG SPX W/BALO CATH||226.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36860|36860 - XTRNL CANNULA DECLTNG SPX W/O BALO CATH||159.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36838|36838 - DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS||1749.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36835|36835 - INSERTION THOMAS SHUNT SEPARATE PROCEDURE||730.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36833|36833 - REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF||989.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36832|36832 - REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF||874.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36831|36831 - THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF||688.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36830|36830 - CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF||992.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36825|36825 - CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF||1179.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36823|36823 - INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL||1952.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36822|36822 - INSERTION OF CANNULA(S)||566.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36821|36821 - ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT||1038.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36820|36820 - ARVEN ANAST OPN F/ARM VEIN TRPOS||1212.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36819|36819 - ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS||1116.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36818|36818 - ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS||1009.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36815|36815 - INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR||223.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36810|36810 - INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL||315.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36800|36800 - INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN||236.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36680|36680 - PLACEMENT NEEDLE INTRAOSSEOUS INFUSION||87.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36660|36660 - CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY||111.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36640|36640 - ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN||188.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36625|36625 - ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN||158.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36620|36620 - ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ||75.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36600|36600 - ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX||22.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36598|36598 - CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT||61.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36597|36597 - RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE||89.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36596|36596 - MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN||65.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36595|36595 - MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS||272.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36593|36593 - DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH||40.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36592|36592 - COLLECT BLOOD FROM CATHETER VENOUS NOS||35.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36591|36591 - COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE||31.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36590|36590 - RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ||299|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36589|36589 - RMVL TUN CVC W/O SUBQ PORT/PMP||204.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36585|36585 - RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT||410.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36584|36584 - COMPLETE REPLACEMENT PICC RS&I||96.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36583|36583 - RPLCMT COMPL TUN CTR VAD W/SUBQ PMP||471.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36582|36582 - RPLCMT COMPL TUN CTR VAD W/SUBQ PORT||449.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36581|36581 - RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP||289.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36580|36580 - RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP||97.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36578|36578 - RPLCMT CATH CTR VAD SUBQ PORT/PMP||316.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36576|36576 - RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT||284.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36575|36575 - RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP||52.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36573|36573 - INSERTION PICC W/RS&I 5 YR/>||130.04||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36572|36572 - INSERTION PICC W/RS&I < 5 YR||140.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36571|36571 - INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>||469.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36570|36570 - INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR||449.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36569|36569 - INSERTION PICC W/O IMG GDN 5 YR/>||134|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36568|36568 - INSERTION PICC W/O IMG GDN < 5 YR||140.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36566|36566 - INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT||558.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36565|36565 - INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP||518.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36563|36563 - INSJ TUNNELED CTR VAD W/SUBQ PUMP||551.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36561|36561 - INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>||519.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36560|36560 - INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR||527.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36558|36558 - INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>||409.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36557|36557 - INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR||472.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36556|36556 - INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>||178.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36555|36555 - INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y||179.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36522|36522 - PHOTOPHERESIS EXTRACORPOREAL||146.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36516|36516 - THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION||102.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36515|36515 - THER APHERESIS W/XTRCORP IMMUNODSPTJ& PLSM RENFJ||135.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36514|36514 - THERAPEUTIC APHERESIS PLASMA PHERESIS||135.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36513|36513 - THERAPEUTIC APHERESIS PLATELETS||145.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36512|36512 - THERAPEUTIC APHERESIS RED BLOOD CELLS||133.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36511|36511 - THERAPEUTIC APHERESIS WHITE BLOOD CELLS||138.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36510|36510 - CATHJ UMBILICAL VEIN DX/THER NB||89.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3650F|3650F - ELECTROENCEPHALOGRAM ORDERED RVWD OR REQ||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36500|36500 - VEN CATHJ SLCTV ORGAN BLD SAMPLING||266.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36481|36481 - PRQ PORTAL VEIN CATHETERIZATION ANY METHOD||526.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36479|36479 - ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS||259.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36478|36478 - ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN||525.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36476|36476 - ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS||259.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36475|36475 - ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN||527.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36471|36471 - INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS||148.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36470|36470 - INJECTION SCLEROSANT SINGLE INCMPTNT VEIN||118.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36469|36469 - INJECTION(S) SPIDER VEINS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36468|36468 - INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36460|36460 - TRANSFUSION INTRAUTERINE FETAL||521.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36455|36455 - EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN||171.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36450|36450 - EXCHNG TRANSFUSION BLOOD NEWBORN||158.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36440|36440 - PUSH TRANSFUSION BLOOD 2 YR/UNDER||82.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36430|36430 - TRANSFUSION BLOOD/BLOOD COMPONENTS||46.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36425|36425 - VENIPUNCTURE CUTDOWN AGE 1 YR/>||58.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36420|36420 - VENIPUNCTURE CUTDOWN UNDER AGE 1 YR||75.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36416|36416 - COLLECTION CAPILLARY BLOOD SPECIMEN||4.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36415|36415 - COLLECTION VENOUS BLOOD VENIPUNCTURE||4.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36410|36410 - VNPNXR 3 YEARS/> PHYS/QHP SKILL||13.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36406|36406 - VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN||12.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36405|36405 - VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN||24.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36400|36400 - VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN||28.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36299|36299 - UNLISTED PROCEDURE VASCULAR INJECTION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36262|36262 - REMOVAL IMPLANTED INTRA-ARTERIAL INFUSION PUMP||434.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36261|36261 - REVJ IMPLANTED INTRA-ARTERIAL INFUSION PUMP||572.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36260|36260 - INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM||919.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36254|36254 - SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I||616.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36253|36253 - SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I||571.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36252|36252 - SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL||534.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36251|36251 - SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN||409.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36248|36248 - SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH||76.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36247|36247 - SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH||482.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36246|36246 - SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH||404.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36245|36245 - SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH||365.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36228|36228 - SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT||323.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36227|36227 - SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC||158.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36226|36226 - SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY||460.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36225|36225 - SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY||476.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36224|36224 - SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART||426.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36223|36223 - SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART||440.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36222|36222 - SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART||315.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36221|36221 - NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART||325.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36218|36218 - SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH||77.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36217|36217 - SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH||488.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36216|36216 - SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH||410.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36215|36215 - SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH||361.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36200|36200 - INTRODUCTION CATHETER AORTA||230.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36160|36160 - INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR||191.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36148|36148 - ACCESS AV DIAL GRFT FOR PROC||72.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36147|36147 - ACCESS AV DIAL GRFT FOR EVAL||274.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36140|36140 - INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY||154.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36120|36120 - INTRO NEEDLE/INTRACATH RETROGRADE BRACHIAL ART||149.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36100|36100 - INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY||240.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36015|36015 - SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART||256.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36014|36014 - SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY||222.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36013|36013 - INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY||193.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36012|36012 - SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC||263.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36011|36011 - SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH||233.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36010|36010 - INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA||180.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36005|36005 - NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH||71.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36002|36002 - INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM||158.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|36000|36000 - INTRODUCTION NEEDLE/INTRACATHETER VEIN||14.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35907|35907 - EXCISION INFECTED GRAFT ABDOMEN||2940.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35905|35905 - EXCISION INFECTED GRAFT THORAX||2613.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35903|35903 - EXCISION INFECTED GRAFT EXTREMITY||861.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35901|35901 - EXCISION INFECTED NECK GRAFT||759.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35884|35884 - REVISION FEMORAL ANAST OPEN W/AUTOG GRAFT||1919.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35883|35883 - REVISION FEMORAL ANAST OPEN NONAUTOG GRAFT||1852.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35881|35881 - REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS||1575.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35879|35879 - REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP||1425.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35876|35876 - THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF||1455.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35875|35875 - THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL||911.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35870|35870 - RPR GRF-ENTERIC FSTL||1933.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35860|35860 - EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR||1244.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35840|35840 - EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD||1698.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35820|35820 - EXPL PO HEMRRG THROMBOSIS/INFCTJ CH||2991.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35800|35800 - EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK||1037.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35761|35761 - EXPL N/FLWD SURG RPR W/WO LYSIS OTHER ARTERY||577.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35741|35741 - EXPL N/FLWD SURG RPR W/WO LYSIS POPLITEAL ARTERY||774.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3573F|3573F - PT NOT POTENT RISK FRACTURE WEIGHT-BEARING SITE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3572F|3572F - PT POTENTIAL RISK FRACTURE WEIGHT-BEARING SITE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35721|35721 - EXPL N/FLWD SURG RPR W/WO LYSIS FEMORAL ARTERY||687.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3570F|3570F - REPORT BONE SCINTIGRAPHY W/X-RAY SAME REGION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35703|35703 - EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY||635.63||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35702|35702 - EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY||623.87||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35701|35701 - EXPLORATION N/FLWD SURG NECK ARTERY||843.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35700|35700 - ROPRTJ > 1 MO AFTER ORIGINAL OPRATION||235.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35697|35697 - RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART||228.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35695|35695 - TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART||1593.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35694|35694 - TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART||1532.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35693|35693 - TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART||1439.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35691|35691 - TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART||1471.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35686|35686 - CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO||254.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35685|35685 - PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT||306.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35683|35683 - BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION||635.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35682|35682 - BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS||546.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35681|35681 - BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN||122.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35671|35671 - BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART||1723.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35666|35666 - BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL||1954.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35665|35665 - BYP OTH/THN VEIN ILIOFEMORAL||1807.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35663|35663 - BYP OTH/THN VEIN ILIOILIAC||1938.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35661|35661 - BYP OTH/THN VEIN FEMORAL-FEMORAL||1671.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35656|35656 - BYP OTH/THN VEIN FEMORAL-POPLITEAL||1664.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35654|35654 - BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL||2108.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35650|35650 - BYP OTH/THN VEIN AXILLARY-AXILLARY||1641.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35647|35647 - BYP OTH/THN VEIN AORTOFEMORAL||2382.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35646|35646 - BYP OTH/THN VEIN AORTOBIFEMORAL||2643.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35645|35645 - BYP OTH/THN VEIN SUBCLAVIAN-VERTEBRAL||1481.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35642|35642 - BYP OTH/THN VEIN CAROTID-VERTEBRAL||1694.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35638|35638 - BYP OTH/THN VEIN AORTOBI-ILIAC||2706.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35637|35637 - BYP OTH/THN VEIN AORTOILIAC||2653.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35636|35636 - BYP OTH/THN VEIN SPLENORENAL||2480.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35634|35634 - BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL||2536.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35633|35633 - BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC||2786.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35632|35632 - BYPASS GRAFT W/OTHER THAN VEIN ILIO-CELIAC||2537.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35631|35631 - BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL||2839.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35626|35626 - BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE||2379.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35623|35623 - BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL||2041.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35621|35621 - BYP OTH/THN VEIN AXILLARY-FEMORAL||1695.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35616|35616 - BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY||1687.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35612|35612 - BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN||1616.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35606|35606 - BYP OTH/THN VEIN CAROTID-SUBCLAVIAN||1806.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35601|35601 - BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID||2175.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35600|35600 - HARVEST UPPER EXTREMITY ARTERY 1 SEGMENT CABG||388.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35587|35587 - IN-SITU VEIN BYP POP-TIBL PRONEAL||2115.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35585|35585 - IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART||2583.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35583|35583 - IN-SITU VEIN BYPASS FEMORAL-POPLITEAL||2216.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35572|35572 - HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX||529.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35571|35571 - BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL||2051.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35570|35570 - BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL||2131.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35566|35566 - BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL||2573.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35565|35565 - BYPASS W/VEIN ILIOFEMORAL||2031.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35563|35563 - BYPASS W/VEIN ILIOILIAC||2238.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35560|35560 - BYPASS W/VEIN AORTORENAL||2654.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3555F|3555F - PT HAD INR MEASUREMENT PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35558|35558 - BYPASS W/VEIN FEMORAL-FEMORAL||1897.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35556|35556 - BYPASS W/VEIN FEMORAL-POPLITEAL||2152.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35540|35540 - BYPASS W/VEIN AORTOBIFEMORAL||3915.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35539|35539 - BYPASS W/VEIN AORTOFEMORAL||3402.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35538|35538 - BYPASS W/VEIN AORTOBI-ILIAC||3635.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35537|35537 - BYPASS W/VEIN AORTOILIAC||3243.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35536|35536 - BYPASS W/VEIN SPLENORENAL||2624.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35535|35535 - BYPASS W/VEIN HEPATORENAL||2672.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35533|35533 - BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL||2345.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35531|35531 - BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC||3088.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3552F|3552F - HIGH RISK FOR THROMBOEMBOLISM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35526|35526 - BYPASS W/VEIN AORTOSUBCLAV/CAROTID/INNOMINATE||2610.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35525|35525 - BYPASS W/VEIN BRACHIAL-BRACHIAL||1752.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35523|35523 - BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL||1963.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35522|35522 - BYPASS W/VEIN AXILLARY-BRACHIAL||1822.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35521|35521 - BYPASS W/VEIN AXILLARY-FEMORAL||1906.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3551F|3551F - INTERMEDIATE RISK FOR THROMBOEMBOLISM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35518|35518 - BYPASS W/VEIN AXILLARY-AXILLARY||1784.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35516|35516 - BYPASS W/VEIN SUBCLAVIAN-AXILLARY||1885.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35515|35515 - BYPASS W/VEIN SUBCLAVIAN-VERTEBRAL||2051.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35512|35512 - BYPASS W/VEIN SUBCLAVIAN-BRACHIAL||1877.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35511|35511 - BYPASS W/VEIN SUBCLAVIAN-SUBCLAVIAN||1905.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35510|35510 - BYPASS W/VEIN CAROTID-BRACHIAL||1916.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3550F|3550F - LOW RISK FOR THROMBOEMBOLISM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35509|35509 - BYPASS W/VEIN CAROTID-CONTRALATERAL CAROTID||2210.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35508|35508 - BYPASS W/VEIN CAROTID-VERTEBRAL||2085.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35506|35506 - BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID||2051.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35501|35501 - BYPASS W/VEIN COMMON-IPSILATERAL CAROTID||2335.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35500|35500 - HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX||491.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35476|35476 - REPAIR VENOUS BLOCKAGE||461.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35475|35475 - REPAIR ARTERIAL BLOCKAGE||727.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35472|35472 - REPAIR ARTERIAL BLOCKAGE||548.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35471|35471 - REPAIR ARTERIAL BLOCKAGE||798.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35460|35460 - REPAIR VENOUS BLOCKAGE||477.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35458|35458 - REPAIR ARTERIAL BLOCKAGE||747.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35452|35452 - REPAIR ARTERIAL BLOCKAGE||543.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35450|35450 - REPAIR ARTERIAL BLOCKAGE||784.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35400|35400 - ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ||228.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35390|35390 - ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO||244.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35372|35372 - TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL||1505.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35371|35371 - TEAEC W/WO PATCH GRAFT COMMON FEMORAL||1258.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35363|35363 - TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL||2655.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35361|35361 - TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC||2367.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35355|35355 - TEAEC W/WO PATCH GRAFT ILIOFEMORAL||1598.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35351|35351 - TEAEC W/WO PATCH GRAFT ILIAC||1968.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35341|35341 - TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL||2109.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35331|35331 - TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA||2235.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35321|35321 - TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL||1366.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35311|35311 - TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC||2334.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35306|35306 - TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART||691.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35305|35305 - TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL||1888.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35304|35304 - TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY||1958.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35303|35303 - TEAEC W/GRAFT POPLITEAL ARTERY||1898.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35302|35302 - TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY||1724.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35301|35301 - TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC||1607.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35286|35286 - RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY||1428.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35281|35281 - RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL||2441.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35276|35276 - RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP||2172.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35271|35271 - RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP||2080.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35266|35266 - RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY||1316.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35261|35261 - REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK||1601.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35256|35256 - REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY||1554.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35251|35251 - REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL||2552.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35246|35246 - RPR BLOOD VESSEL VEIN GRF INTRATHORACIC W/O BYP||2236.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35241|35241 - RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP||2168.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35236|35236 - REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY||1491|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35231|35231 - REPAIR BLOOD VESSEL W/VEIN GRAFT NECK||1828.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35226|35226 - RPR BLOOD VESSEL DIRECT LOWER EXTREMITY||1273.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35221|35221 - RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL||2159.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35216|35216 - RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS||3029.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35211|35211 - RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS||2073.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3520F|3520F - CLOSTRIDIUM DIFFICILE TESTING PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35207|35207 - REPAIR BLOOD VESSEL DIRECT HAND FINGER||1079.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35206|35206 - REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY||1170.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35201|35201 - REPAIR BLOOD VESSEL DIRECT NECK||1419.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35190|35190 - RPR/TRAUMATIC AV FISTULA EXTREMITIES||1146.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35189|35189 - RPR/TRAUMATIC AV FISTULA THORAX & ABDOMEN||2369.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35188|35188 - RPR/TRAUMATIC AV FISTULA HEAD & NECK||1610.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35184|35184 - RPR CONGENITAL AV FISTULA EXTREMITIES||1560.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35182|35182 - RPR CONGENITAL AV FISTULA THORAX & ABDOMEN||2616.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35180|35180 - REPAIR CONGENITAL AV FISTULA HEAD & NECK||1355.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3517F|3517F - HBV STATUS ASSESSED W/ RESULTS IN 1 YR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3515F|3515F - PATIENT HAS DOCUMENTED IMMUNITY TO HEPATITIS C||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35152|35152 - DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY||2175.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35151|35151 - DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY||1917.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3514F|3514F - HEPATITIS C SCREENING DOCUMENTED AS PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35142|35142 - DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART||2037.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35141|35141 - DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY||1698.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3513F|3513F - HEPATITIS B SCREENING DOCUMENTED AS PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35132|35132 - DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY||2612.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35131|35131 - DIR RPR ANEURYSM & GRAFT ILIAC ARTERY||2136.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3512F|3512F - SYPHILIS SCREENING DOCUMENTED AS DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35122|35122 - DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN||3146.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35121|35121 - DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC||2504.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3511F|3511F - CHLAMYDIA/GONORRHEA TSTS DOCD AS DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35112|35112 - DIR RPR RUPTD ANEURYSM SPLENIC ARTERY||2723.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35111|35111 - DIR RPR ANEURYSM SPLENIC ARTERY||2037.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3510F|3510F - DOCJ TB SCREEN PERFORMED & RESULTS INTERPRET||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35103|35103 - DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS||3437.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35102|35102 - DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS||2899.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35092|35092 - DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS||3995.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35091|35091 - DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS||2760.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35082|35082 - DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA||3351.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35081|35081 - DIR RPR ANEURYSM ABDOMINAL AORTA||2685.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35045|35045 - DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY||1490.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3503F|3503F - HIV RNA VIRAL LOAD NOT <LIMITS OF QUANTIF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3502F|3502F - HIV RNA VIRAL LOAD <LIMITS OF QUANTIF||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35022|35022 - DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN||2144.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35021|35021 - DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY||1854.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35013|35013 - DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS||1891.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35011|35011 - DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION||1525.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3500F|3500F - CD4+CELL CNT/CD4+CELL % DOCD AS DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35005|35005 - DIR RPR ANEURYSM VERTEBRAL ARTERY||1624.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35002|35002 - DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY||1908.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|35001|35001 - DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY||1730.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3498F|3498F - CD4+ CELL PERCENTAGE >= 15% HIV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3497F|3497F - CD4+ CELL PERCENTAGE <15% HIV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3496F|3496F - CD4+ CELL COUNT >= 500 CELLS/MM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3495F|3495F - CD4+ CELL COUNT 200-499 CELLS/MM (HIV)||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3494F|3494F - CD4+ CELL COUNT <200 CELLS/MM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3493F|3493F - NO HIST NADIR CD4+ CELL CNT <350&AIDS CONDITION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3492F|3492F - HISTORY OF NADIR CD4+ CELL COUNT <350 CELLS/MM3||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3491F|3491F - HIV INDETERMINATE INFANTS BORN OF HIV MOTHERS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3490F|3490F - HISTORY OF AIDS-DEFINING CONDITION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34900|34900 - EVASC RPR ILIAC ART ILIO-ILIAC PROSTHESIS||1360.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34834|34834 - OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI||419.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34833|34833 - OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP||930.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34832|34832 - OPN RPR ARYSM RPR ARTL TRMA AORTO-BIFEM PROSTH||2947.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34831|34831 - OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH||2936.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34830|34830 - OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH||2740.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34826|34826 - PLMT XTN PROSTH EVASC RPR ARYSM/DSJ EA VSL||313.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34825|34825 - PLMT XTN PROSTH EVASC RPR ARYSM/DSJ 1ST VSL||1062.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34820|34820 - OPN ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI||741.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34813|34813 - PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR||362.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34812|34812 - OPN FEM ART EXPOS DLVR EVASC PROSTH UNI||514.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34808|34808 - EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE||313.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34806|34806 - TCAT PLACEMENT PHYSIOLOGIC SENSOR ANEURYSMAL SAC||156.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34805|34805 - EVASC RPR AAA AORTO-UNIILIAC/AORTO-UNIFEM PROSTH||1817.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34804|34804 - EVASC RPR AAA W/UNIBDY BFRC PROSTH||1901.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34803|34803 - EVASC RPR AAA W/MDLR BFRC PROSTH 2 LIMBS||1960.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34802|34802 - EVASC RPR AAA W/MDLR BFRC PROSTH 1 LIMB||1900.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34800|34800 - EVASC RPR AAA W/AORTO-AORTIC TUBE PROSTH||1719.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3476F|3476F - DISEASE PROGNOSIS RA ASSESSED GOOD PROG DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3475F|3475F - DISEASE PROGNOSIS RA ASSESSED POOR PROG DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3472F|3472F - RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY HIGH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3471F|3471F - RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY MOD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34718|34718 - EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI||1910.73||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34717|34717 - EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI||688.08||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3470F|3470F - RHEUMATOID ARTHRITIS (RA) DISEASE ACTIVITY LOW||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3455F|3455F - TB SCRNG DONE INTRPD </6 MOS START RA THXPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34530|34530 - SAPHENOPOPLITEAL VEIN ANASTOMOSIS||1438.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3452F|3452F - DYSPNEA NOT SCREENED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34520|34520 - CROSS-OVER VEIN GRAFT VENOUS SYSTEM||1537.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3451F|3451F - DYSPNEA SCRND MOD-SEVERE DYSPNEA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34510|34510 - VENOUS VALVE TRANSPOSITION ANY VEIN DONOR||1717.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3450F|3450F - DYSPNEA SCRND NO-MILD DYSPNEA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34502|34502 - RECONSTRUCTION VENA CAVA ANY METHOD||2300.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34501|34501 - VALVULOPLASTY FEMORAL VEIN||1389.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34490|34490 - THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN||938.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34471|34471 - THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC||1797.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34451|34451 - THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN ABDL&LEG||2236.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34421|34421 - THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC||1117.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34401|34401 - THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC||2182.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34203|34203 - EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC||1469.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34201|34201 - EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART||1574.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34151|34151 - EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART||2136.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34111|34111 - EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC||923.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34101|34101 - EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART||922.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34051|34051 - EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY||1400.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|34001|34001 - EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART||1475.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33999|33999 - UNLISTED CARDIAC SURGERY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33993|33993 - REPOSITION VAD W/IMAGING DIFFERENT SESSION||266.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33992|33992 - REMOVAL PERCUTANEOUS VAD DIFFERENT SESSION||304.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33991|33991 - INSJ PERQ VAD TRNSPTAL W/IMAGE ART&VENOUS ACCESS||929.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33990|33990 - INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY||637.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33983|33983 - RPLCMT VAD PMP IMPLTBL ICORP 1 VNTR W/BYPASS||3446.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33982|33982 - PLCMT VAD PMP IMPLTBL ICORP 1 VENTR W/O BYPASS||2934.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33981|33981 - RPLCMT XTRCORP VAD 1/BIVENTR PUMP 1/EA PUMP||1254.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33980|33980 - RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC||2875.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33979|33979 - INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC||2975.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33978|33978 - REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR||2048.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33977|33977 - REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE||1727.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33976|33976 - INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR||2396.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33975|33975 - INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE||1956.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33974|33974 - RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA||1324.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33973|33973 - INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA||776.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33971|33971 - RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF||1059.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33970|33970 - INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN||535.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33968|33968 - REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ||50.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33967|33967 - INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ||390.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33961|33961 - EXTERNAL CIRCULATION ASSIST||816.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33960|33960 - EXTERNAL CIRCULATION ASSIST||1482.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3395F|3395F - QUANT NON-HER2 IHC EVAL OF BRST CANCER PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3394F|3394F - QUANT HER2 IHC EVAL OF BRST CANCER ASCO/CAP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33945|33945 - HEART TRANSPLANT W/WO RECIPIENT CARDIECTOMY||7237.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33944|33944 - BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33940|33940 - DONOR CARDIECTOMY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33935|33935 - HEART-LUNG TRNSPL W/RECIPIENT CARDIECTOMY-PNUMEC||7368.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33933|33933 - BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33930|33930 - DONOR CARDIECTOMY-PNEUMONECTOMY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33926|33926 - RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/BYPASS||3626.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33925|33925 - RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS||2569.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33924|33924 - LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART||427.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33922|33922 - TRANSECTION PULMONARY ARTERY W/CARD BYPASS||2157.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33920|33920 - RPR PULMONARY ATRESIA W/CONSTJ/RPLCMT CONDUIT||2718.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33917|33917 - RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT||2179.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33916|33916 - PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS||6121.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33915|33915 - PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS||2044.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33910|33910 - PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS||3882.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3390F|3390F - AJCC COLON CANCER STAGE IV DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33891|33891 - BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC||1500.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3388F|3388F - AJCC COLON CANCER STAGE III DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33889|33889 - OPN SUBCLA CRTD ART TRPOS NCK INC ULAT||1217.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33886|33886 - PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA||1478.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33884|33884 - PLMT PROX XTN PROSTH EVASC RPR DTA EA PROX XTN||623.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33883|33883 - PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN||1703.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33881|33881 - EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN||2352.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33880|33880 - EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH||2734.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33877|33877 - RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS||5431.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33875|33875 - DESCENDING THORACIC AORTA GRAFT W/WO BYPASS||4099.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33871|33871 - TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA||5001.29||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33870|33870 - TRANSVERSE ARCH GRAFT W/CARDIOPULMONARY BYPASS||3779.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3386F|3386F - AJCC COLON CANCER STAGE II||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33866|33866 - AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS||1596.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33864|33864 - ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL||4834.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33863|33863 - AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT||4725.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33860|33860 - ASCENDING AORTA GRF W/CARD BYP & VALVE SSP||4803.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33859|33859 - AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ||37312.12||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33858|33858 - AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION||5201.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33853|33853 - RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/BYPASS||2766.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33852|33852 - RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/O BYPASS||2075.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33851|33851 - EXC COARCJ AORTA W/L SUBCLAV ART/PROSTC GUSSET||1971.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3384F|3384F - AJCC COLON CANCER STAGE I||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33845|33845 - EXCISION COARCTATION AORTA W/WO PDA W/GRAFT||2012.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33840|33840 - EXC COARCJ AORTA W/WO PDA W/DIRECT ANASTOMOSIS||1876.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3382F|3382F - AJCC COLON CANCER STAGE 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33824|33824 - RPR PATENT DUXUS ARTERIOSUS DIV 18 YR & OLDER||1747.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33822|33822 - RPR PATENT DUXUS ARTERIOSUS DIV UNDER 18 YR||1564.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33820|33820 - REPAIR PATENT DUCTUS ARTERIOSUS LIGATION||1453.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33814|33814 - OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/BYPASS||2368.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33813|33813 - OBLTRJ AORTOPULMONARY SEPTAL DEFECT W/O BYPASS||1862.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3380F|3380F - AJCC BREAST CANCER STAGE IV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33803|33803 - DIVISION ABERRANT VESSEL W/REANASTOMOSIS||1776.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33802|33802 - DIVISION ABERRANT VESSEL VASCULAR RING||1614.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33800|33800 - AORTIC SUSPENSION TRACHEAL DECOMPRESSION SPX||1397.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3378F|3378F - AJCC BREAST CANCER STAGE III||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33788|33788 - REIMPLANTATION ANOMALOUS PULMONARY ARTERY||2305|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33786|33786 - TOTAL REPAIR TRUNCUS ARTERIOSUS||3433.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33783|33783 - A-ROOT TLCJ VSD PULM STNS RPR W/RIMPLTJ C OSTIA||5171.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33782|33782 - A-ROOT TLCJ VSD PULM STNS RPR W/O C OST RIMPLTJ||4775.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33781|33781 - RPR TGV AORTIC P-ART RCNSTJ RPR SBPULMC OBSTRCJ||3492.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33780|33780 - RPR TGV AORTIC P-ART RCNSTJ W/CLSR V-SEPTL DFCT||3696.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33779|33779 - RPR TGV AORTIC PULM ART RCNSTJ W/RMVL PULM BAND||3621.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33778|33778 - RPR TRPOS GRT VESSEL AORTIC PULMONARY ART RCNSTJ||3544.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33777|33777 - RPR TRPOS GRT VSL ATR BAFFLE W/BYP SBPULM OBSTRC||2926.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33776|33776 - RPR TRPOS GRT VSL ATR BAFFLE W/CLSR V-SEPTL DFCT||3013.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33775|33775 - RPR TRPOS GREAT VSLS ATR BAFFLE W/RMVL PULM BAND||2854.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33774|33774 - RPR TRPOS GREAT VSLS ATRIAL BAFFLE PX W/BYPASS||2702.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33771|33771 - RPR TRPOS GREAT VSLS W/ENLGMNT V-SEPTL DFCT||3314.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33770|33770 - RPR TRPOS GREAT VSLS W/O ENLGMNT V-SEPTL DFCT||3250.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3376F|3376F - AJCC BREAST CANCER STAGE II||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33768|33768 - ANASTOMOSIS CAVOPULMARY 2ND SUPRIOR VENA CAVA||652.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33767|33767 - SHUNT SUPERIOR VENA CAVA PULM ARTERY BOTH LUNGS||2130.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33766|33766 - SHUNT SUPERIOR VENA CAVA PULMONARY ART 1 LUNG||2026.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33764|33764 - SHUNT CENTRAL W/PROSTHETIC GRAFT||1919.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33762|33762 - SHUNT DESCENDING AORTA PULMONARY ARTERY||2000.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33755|33755 - SHUNT ASCENDING AORTA PULMONARY ARTERY||1962.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33750|33750 - SHUNT SUBCLAVIAN PULMONARY ARTERY||2039.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3374F|3374F - AJCC BREAST CANCER STAGE I T1C||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33737|33737 - ATRIAL SEPTECT/SEPTOST OPN HRT W/INFL OCCLUSION||1963.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33736|33736 - ATRIAL SEPTECTOMY/SEPTOSTOMY OPEN HEART W/BYPASS||2102.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33735|33735 - ATRIAL SEPTECTOMY/SEPTOSTOMY CLOSED HEART||1908.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33732|33732 - RPR COR TRIATM/SUPVALVR RING RESCJ L ATRIAL MEMB||2473.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33730|33730 - COMPLETE RPR ANOMALOUS PULMONARY VENOUS RETURN||3103.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3372F|3372F - AJCC BREAST CANCER STAGE I T1MIC T1A/T1B||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33726|33726 - REPAIR PULMONARY VENOUS STENOSIS||3070.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33724|33724 - REPAIR ISOLATED PARTIAL PULM VENOUS RETURN||2303.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33722|33722 - CLOSURE AORTICO-LEFT VENTRICULAR TUNNEL||2494.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33720|33720 - RPR SINUS VALSALVA ANEURYSM||2303.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33710|33710 - RPR SINUS VALSALVA FISTULA W/RPR V-SEPTAL DEFECT||3086.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3370F|3370F - AJCC BREAST CANCER STAGE 0 DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33702|33702 - RPR SINUS VALSALVA FISTULA||2316.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33697|33697 - COMPL RPR T-FALLOT W/PULM ATRESIA||3080.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33694|33694 - COMPL RPR T-FALLOT W/O PULM ATRESIA TANULR PATCH||2940.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33692|33692 - COMPL RPR TETRALOGY FALLOT W/O PULM ATRESIA||2945.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33690|33690 - BANDING PULMONARY ARTERY||1771.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33688|33688 - CLSR V-SEPTAL DFCT W/RMVL P-ART BAND W/WO GUSSET||2831.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33684|33684 - CLSR V-SEPTL DFCT W/PULM VLVT/INFUND RESCJ||2844.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33681|33681 - CLSR 1 VENTRICULAR SEPTAL DEFECT W/WO PATCH||2738.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33677|33677 - CLOSURE MULTIPLE VSD W/REMOVAL ARTERY BAND||3260.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33676|33676 - CLOSURE MULTIPLE VSD W/RESECTION||3137.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33675|33675 - CLOSURE MULTIPLE VENTRICULAR SEPTAL DEFECTS||2962.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33670|33670 - RPR COMPL AV CANAL W/WO PROSTC VALVE||2975.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33665|33665 - RPR INTRM/TRANSJ AV CANAL W/WO AV VALVE RPR||2878.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33660|33660 - RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR||2637.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33647|33647 - RPR ATRIAL & VENTRIC SEPTAL DFCT DIR/PATCH CLS||2738.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33645|33645 - DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG||2591.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33641|33641 - RPR ATRIAL SEPTAL DFCT SECUNDUM W/BYP W/WO PATCH||2445|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33622|33622 - RECONSTRUCTION COMPLEX CARDIAC ANOMALY||5183.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33621|33621 - TRANSTHORACIC CATHETER INSERTION FOR STENT PLMT||1321.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33620|33620 - APPLICATION RIGHT & LEFT PULMONARY ARTERY BAND||2461.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33619|33619 - RPR 1 VNTRC W/O/F OBSTRCJ&AORTIC ARCH HYPOPLAS||4022.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33617|33617 - RPR COMPLEX CARDIAC ANOMALY MODIFIED FONTAN PX||3216.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33615|33615 - RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX||2983.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33612|33612 - RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ||2954.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33611|33611 - RPR 2 OUTLET R VNTRC W/INTRAVENTR TUNNEL RPR||3014.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33610|33610 - RPR CAR ANOMAL SURG ENLGMENT VENTR SEPTL DFCT||2640.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33608|33608 - RPR CAR ANOMAL XCP PULM ATRESIA VENTR SEPTL DFCT||2679.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33606|33606 - ANAST PULMONARY ART AORTA DAMUS-KAYE-STANSEL PX||2709.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33602|33602 - CLOSURE SEMILUNAR VALVE AORTIC/PULM SUTURE/PATCH||2439.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33600|33600 - CLOSURE ATRIOVENTRICULAR VALVE SUTURE/PATCH||2550.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33572|33572 - CORONARY ENDARTERCOMY OPEN ANY METHOD||348.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3354F|3354F - CLIN SIGN DEP SYMP BY STAND DEP ASSESS TOOL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33548|33548 - SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD||4460.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33545|33545 - RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT||4625.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33542|33542 - MYOCARDIAL RESECTION||3928.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3353F|3353F - MILD TO MOD DEP SYMP BY STAND DEP ASSESS TOOL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33536|33536 - CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS||3971.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33535|33535 - CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS||3684.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33534|33534 - CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS||3305.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33533|33533 - CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT||2815.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33530|33530 - ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ||788.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3352F|3352F - NO SIGNIF DEP SYMP CAT BY STAND DEP ASSESS TOOL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33523|33523 - CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN||1258.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33522|33522 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN||1107.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33521|33521 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN||984.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3351F|3351F - NEG DEP SYMP CAT USING STAND DEP ASSESS TOOL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33519|33519 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN||819.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33518|33518 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN||618.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33517|33517 - CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN||281.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33516|33516 - CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT||4104.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33514|33514 - CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS||3938.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33513|33513 - CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS||3725.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33512|33512 - CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS||3626.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33511|33511 - CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS||3193.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33510|33510 - CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT||2908.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3350F|3350F - MAMMO ASSESSMENT CAT BIOPSY PROVEN MALIG DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33508|33508 - NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG||24.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33507|33507 - RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ||2571.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33506|33506 - RPR ANOM CORONARY ART FROM PULM ART TO AORTA||3066.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33505|33505 - RPR ANOM CORON ART W/CONSTJ INTRAPULM ART TUNNEL||3097.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33504|33504 - RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP||2192.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33503|33503 - RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT||1944.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33502|33502 - RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION||1903.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33501|33501 - RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/O BYPASS||1681.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33500|33500 - RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS||2360.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33496|33496 - RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS||2495.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33478|33478 - OUTFLOW TRACT AGMNTJ W/WO COMMISSUR/INFUND RESCJ||2355.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33476|33476 - R VENTRIC RESCJ INFUND STEN W/WO COMMISSUROTOMY||2269.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33475|33475 - REPLACEMENT PULMONARY VALVE||3502.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33474|33474 - VALVOTOMY PULMONARY VALVE OPEN HEART W/BYPASS||3210.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33472|33472 - REVISION OF PULMONARY VALVE||2009.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33471|33471 - VALVOTOMY PULM VALVE CLSD HEART VIA PULM ARTERY||1980.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33470|33470 - VALVOTOMY PULMONARY VALVE CLSD HEART TRANSVENTR||1837.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33468|33468 - TRICUSPID VALVE RPSG&PLCTJ EBSTEIN ANOMALY||3663.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33465|33465 - REPLACEMENT TRICUSPID VALVE W/CARD BYPASS||4122.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33464|33464 - VALVULOPLASTY TRICUSPID VALVE W/RING INSERTION||3655.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33463|33463 - VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION||4614.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33460|33460 - VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP||3633.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3345F|3345F - MAMMO ASSESSMENT CAT HIGH CHANCE MALIG DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3344F|3344F - MAMMO ASSESSMENT CAT SUSPICIOUS DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33440|33440 - RPLCMT AORTIC VALVE BY TLCJ AUTOL PULM VALVE||5249.41||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3343F|3343F - MAMMO ASSESSMENT CAT PROB BENIGN DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33430|33430 - REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP||4202.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3342F|3342F - MAMMO ASSESSMENT CAT BENIGN DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33427|33427 - VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING||3678.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33426|33426 - VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING||3575.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33425|33425 - VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS||4074.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33422|33422 - VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS||2520.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33420|33420 - VALVOTOMY MITRAL VALVE CLOSED HEART||2151.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3341F|3341F - MAMMO ASSESSMENT CAT NEGATIVE DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33417|33417 - AORTOPLASTY SUPRAVALVULAR STENOSIS||2485.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33416|33416 - VENTRICULOMYOTOMY-MYECTOMY||3038.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33415|33415 - RESECTION/INCISION SUBVALVULAR TISSUE||3066.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33414|33414 - RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC||3236.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33413|33413 - REPLACEMENT AORTIC&PULMON VALVES ROSS PROCEDUR||4848.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33412|33412 - REPLACEMENT AORTIC VALVE KONNO PROCEDURE||4756.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33411|33411 - RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS||5030.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33410|33410 - RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE||3807|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3340F|3340F - MAMMO ASSESSMENT CAT INCOMP ADDTNL IMAGE DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33406|33406 - RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND||4306.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33405|33405 - RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT||3426.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33404|33404 - CONSTRUCTION APICAL-AORTIC CONDUIT||2626.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33403|33403 - VALVULOPLASTY W/CP BYPASS||2232.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33401|33401 - VALVULOPLASTY OPEN||2106.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33400|33400 - REPAIR OF AORTIC VALVE||3409.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33369|33369 - REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH||1458.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33368|33368 - REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH||1104.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33367|33367 - REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH||911.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33365|33365 - REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH||2592.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33364|33364 - REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH||2362.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33363|33363 - REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH||2221.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33362|33362 - REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH||2145.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33361|33361 - REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH||1961.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33335|33335 - INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS||2818.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33332|33332 - INSERT MAJOR VESSEL GRAFT||2091.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33330|33330 - INSJ GRAFT AORTA/GREAT VESSEL W/O SHUNT/BYPASS||2128.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33322|33322 - SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS||2072.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33321|33321 - SUTR RPR AORTA/GREAT VESSEL W/SHUNT BYPASS||1776.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33320|33320 - SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP||1584.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3331F|3331F - IMAGING STUDY NOT ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33315|33315 - CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP||2841.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33310|33310 - CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP||1732.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3330F|3330F - IMAGING STUDY ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33305|33305 - REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS||6109.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33300|33300 - REPAIR CARDIAC WOUND W/O BYPASS||3636.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3328F|3328F - PERFORMANCE STATUS DOCD RVWD 2 WKS PRIOR SURG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33289|33289 - TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR||506.97||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33286|33286 - REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR||134.92|0|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33285|33285 - INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG||137.61||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33284|33284 - RMVL IMPLANTABLE PT-ACTIVATED CAR EVENT RECORDER||336.04|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|33282|33282 - IMPLANTATION PT-ACTIVATED CARDIAC EVENT RECORDER||469.96|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|33275|33275 - TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG||799.84||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33274|33274 - TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG||750.2||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33266|33266 - NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS||2760.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33265|33265 - NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS||2019.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33264|33264 - RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD||576.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33263|33263 - RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD||555.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33262|33262 - RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD||533.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33261|33261 - OPRATIVE ABLTJ VENTR ARRHYTHMOGENIC FOC W/BYPASS||2438.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3325F|3325F - PREOP ASSES 12 MOS PRIOR CATARACT SURG W/IO LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33259|33259 - ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS||1261.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33258|33258 - ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP||975.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33257|33257 - ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE||867.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33256|33256 - ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS||2935.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33255|33255 - ABLATION & RCNSTJ ATRIA EXTNSV W/O BYPASS||2458.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33254|33254 - ABLATION & RECONSTRUCTION ATRIA LIMITED||2040.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33251|33251 - ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS||2427.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33250|33250 - ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/O BYPASS||2185.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3324F|3324F - MRI CT SCAN ORDERED REVIEWED/REQUESTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33249|33249 - INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR||1330.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33244|33244 - RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ||1252.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33243|33243 - RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM||2030.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33241|33241 - REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY||325.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33240|33240 - INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD||564.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3323F|3323F - CLIN TUMOR NODE METASTASES STAGE DOCD PRIOR SURG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33238|33238 - RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY||1393.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33237|33237 - RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY||1226.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33236|33236 - RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS||1169.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33235|33235 - RMVL TRANSVNS PM ELTRD DUAL LEAD SYS||931.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33234|33234 - RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR||713.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33233|33233 - REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY||346.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33231|33231 - INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS||575.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33230|33230 - INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS||554.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3322F|3322F - MELANOMA THAN AJCC STAGE 0||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33229|33229 - REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD||533.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33228|33228 - REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS||512.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33227|33227 - REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD||490.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33226|33226 - RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD||720.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33225|33225 - INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN||673.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33224|33224 - INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN||748.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33223|33223 - RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR||606.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33222|33222 - RELOCATION OF SKIN POCKET FOR PACEMAKER||505.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33221|33221 - INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS||514.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33220|33220 - RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB||579.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3321F|3321F - AJCC CANCER STAGE 0 OR IA MELANOMA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33218|33218 - RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB||574.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33217|33217 - INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB||547.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33216|33216 - INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB||549.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33215|33215 - RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE||446.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33214|33214 - UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS||707.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33213|33213 - INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS||512.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33212|33212 - INS PM PLS GEN W/EXIST SINGLE LEAD||486.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33211|33211 - INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX||270.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33210|33210 - INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH||265.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3320F|3320F - 0 DX IMG ORDER CHEST XRAY CT US MRI PET/NUC MED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33208|33208 - INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT||771.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33207|33207 - INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR||713.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33206|33206 - INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL||670.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33203|33203 - INSERTION EPICARDIAL ELECTRODE ENDOSCOPIC||1197.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33202|33202 - INSERTION EPICARDIAL ELECTRODE OPEN||1151.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3319F|3319F - 1 DX IMG ORDER CHEST XRAY CT US MRI PET/NUC MED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3318F|3318F - PATH REPRT MALIGNANCY DOCD & RVWD INITIA RAD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3317F|3317F - PATH REPRT MALIGNANCY DOCD & RVWD INITIATE CHE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3316F|3316F - ESTROGEN/PROGEST RECEPTOR NEGATIVE BREAST CANCER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3315F|3315F - ESTROGEN/PROGEST RECEPTOR POSITIVE BREAST CANCER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33141|33141 - TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX||201.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33140|33140 - TRANSMYOCARDIAL LASER REVASCULAR THORACOTOMY SPX||2362.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33130|33130 - RESECTION EXTERNAL CARDIAC TUMOR||2065.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33120|33120 - EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP||3100.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33050|33050 - RESECTION PERICARDIAL CYST/TUMOR||1485.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33031|33031 - PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS||3604.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33030|33030 - PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS||2927.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33025|33025 - CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX||1185.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33020|33020 - PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY||1296.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3301F|3301F - CANCER STAGE DOCD METASTATIC & REVIEWED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33019|33019 - PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT||346.35||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33018|33018 - PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY||426.77||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33017|33017 - PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY||374.33||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33016|33016 - PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED||361.08||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33015|33015 - TUBE PERICARDIOSTOMY||750.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33011|33011 - PERICARDIOCENTESIS SUBSEQUENT||178.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|33010|33010 - PERICARDIOCENTESIS INITIAL||176.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3300F|3300F - AJCC STAGE DOCUMENTED & REVIEWED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32999|32999 - UNLISTED PROCEDURE LUNGS & PLEURA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32998|32998 - ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY||422.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32997|32997 - TOTAL LUNG LAVAGE UNILATERAL||520.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32960|32960 - PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR||151.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3294F|3294F - GBS SCRNING DOCD DONE DURING WK 35-37 GESTATION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32940|32940 - PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX||1823|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3293F|3293F - ABO AND RH BLOOD TYPING DOCUMENTED AS PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3292F|3292F - HIV TSTNG ASK/DOCD/RVWD AT 1ST/2ND PRENATAL VST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3291F|3291F - PATIENT IS D (RH) POSITIVE OR SENSITIZED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3290F|3290F - PATIENT IS D (RH) NEGATIVE AND UNSENSITIZED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32906|32906 - THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL||2448.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32905|32905 - THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL||1977.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32900|32900 - RESECTION RIBS EXTRAPLEURAL ALL STAGES||2048.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3288F|3288F - FALLS RISK ASSESSMENT DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3285F|3285F - IOP REDUCED <15% PRE-INTERVENTION LEVEL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32856|32856 - BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT BI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32855|32855 - BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT UNI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32854|32854 - LUNG TRANSPLANT 2 W/CARDIOPULMONARY BYPASS||7218.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32853|32853 - LUNG TRANSPLANT 2 W/O CARDIOPULMONARY BYPASS||6777.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32852|32852 - LUNG TRANSPLANT 1 W/CARDIOPULMONARY BYPASS||5366.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32851|32851 - LUNG TRANSPLANT 1 W/O CARDIOPULMONARY BYPASS||4895.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32850|32850 - DONOR PNEUMONECTOMY FROM CADAVER DONOR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3284F|3284F - INTRAOCULAR PRESS REDUCED >/EQUAL 15%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32820|32820 - MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC||1972.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3281F|3281F - HEMOGLOBIN LEVEL <11 G/DL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32815|32815 - OPEN CLOSURE MAJOR BRONCHIAL FISTULA||4129.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32810|32810 - CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA||1329.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3280F|3280F - HEMOGLOBIN LEVEL 11 G/DL-12.9 G/DL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32800|32800 - REPAIR LUNG HERNIA THROUGH CHEST WALL||1388.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3279F|3279F - HEMOGLOBIN LEVEL>/EQUAL 13 G/DL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3278F|3278F - SERUM LEVELS CALCUM PHOSPH PARATHYR & LIPID PR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3274F|3274F - PROST CANCER RSK RECUR NOT DETER/LOW/INTERMED/HI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3273F|3273F - HIGH RISK OF RECURRENCE PROSTATE CANCER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3272F|3272F - INTERMED RISK OF RECURRENCE PROSTATE CANCER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3271F|3271F - LOW RISK OF RECURRENCE PROSTATE CANCER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3270F|3270F - BONE SCAN NOT PRIOR INITIAT TX/DX PROSTATE CA||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32701|32701 - THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE||323.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3269F|3269F - BONE SCAN PRIOR INITIAT TX/DX PROSTATE CANCER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3268F|3268F - PSA & TUMOR STAGE&GLEASON SCORE PRIOR INIT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3267F|3267F - PATH RPRT INCLUDES PT & PN CAT GLEASON||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32674|32674 - THORCOSCPY W/MEDIASTINL & REGIONL LYMPHDENECTOMY||319.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32673|32673 - THORACOSCOPY RESEXN THYMUS UNI/BILATERAL||1767.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32672|32672 - THORACOSCOPY W/RESEXN-PLICAJ EMPHYSEMA LUNG UNIL||2244.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32671|32671 - THORACOSCOPY W/PNEUMONECTOMY||2625.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32670|32670 - THORACOSCOPY W/BILOBECTOMY||2363.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3266F|3266F - HEPATITIS C GENOTYPE PRIOR ANTIVIRAL TREATMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32669|32669 - THORACOSCOPY W/SEGMENTECTOMY||1978.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32668|32668 - THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN||234.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32667|32667 - THORACOSCOPY W/THERA WEDGE RESEXN ADDL IPSILATRL||233.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32666|32666 - THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT||1280.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32665|32665 - THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE||1799.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32664|32664 - THORACOSCOPY W/THORACIC SYMPATHECTOMY||1253.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32663|32663 - THORACOSCOPY W/LOBECTOMY SINGLE LOBE||2075.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32662|32662 - THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS||1321.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32661|32661 - THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS||1181.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3265F|3265F - RNA TESTING FOR HEP C VIREMIA ORDERED/DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32659|32659 - THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC||1080.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32658|32658 - THORACOSCOPY W/RMVL CLOT/FB FROM PERICARDIAL SAC||1055.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32656|32656 - THORACOSCOPY W/PARIETAL PLEURECTOMY||1177.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32655|32655 - THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX||1408.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32654|32654 - THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE||1733.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32653|32653 - THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT||1553.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32652|32652 - THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS||2443.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32651|32651 - THORACOSCOPY W/PARTIAL PULMONARY DECORTICATION||1607.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32650|32650 - THORACOSCOPY W/PLEURODESIS||983.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3260F|3260F - TUMOR/NODES/HISTO GRADE DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32609|32609 - THORACOSCOPY WITH BIOPSYIES OF PLEURA||387.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32608|32608 - THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL||561.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32607|32607 - THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL||456.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32606|32606 - THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX||686.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32604|32604 - THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX||716.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32601|32601 - THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX||459.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32562|32562 - INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY||93.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32561|32561 - INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY||103.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32560|32560 - INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS||118.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32557|32557 - PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING||240.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32556|32556 - PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING||179.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32555|32555 - THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING||163.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32554|32554 - THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING||130.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32553|32553 - PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT||303.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32552|32552 - RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF||240.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32551|32551 - TUBE THORACOSTOMY INCLUDES WATER SEAL||249.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32550|32550 - INSERTION INDWELLING TUNNELED PLEURAL CATHETER||329.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32540|32540 - EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY||2544.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3250F|3250F - NONPRIM ANATOMIC LOCATION OF SPECIMEN SITE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32507|32507 - THORACOTOMY W/DX WEDGE RESEXN & ANTOM LUNG RESE||233.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32506|32506 - THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL||233.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32505|32505 - THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL||1369.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32504|32504 - RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ||3044.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32503|32503 - RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ||2697.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32501|32501 - RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY||366.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32491|32491 - RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG||2182.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32488|32488 - RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC||3534.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32486|32486 - RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY||3495.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32484|32484 - RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY||2131.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32482|32482 - RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC||2347.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32480|32480 - RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT||2195.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32445|32445 - REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL||5206.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32442|32442 - REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA||4527.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32440|32440 - REMOVAL OF LUNG PNEUMONECTOMY||2321.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32405|32405 - BIOPSY LUNG/MEDIASTINUM PERCUTANEOUS NEEDLE||147.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32400|32400 - BIOPSY PLEURA PERCUTANEOUS NEEDLE||127.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32320|32320 - DECORTICATION & PARIETAL PLEURECTOMY||2358.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32310|32310 - PLEURECTOMY PARIETAL SEPARATE PROCEDURE||1357.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3230F|3230F - HEARING TEST 6 MOS PRIOR TO EAR TUBE INSERTION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32225|32225 - DECORTICATION PULMONARY PARTIAL SEPARATE PROC||1470.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32220|32220 - DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE||2345.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32215|32215 - PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX||1175.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3220F|3220F - HEP C QUANT RNA TEST 12 WKS AFTER ANTIVIRAL TX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32201|32201 - DRAIN PERCUT LUNG LESION||289.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32200|32200 - PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST||1672.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3218F|3218F - HEP C RNA TEST 6 MOS BEFORE ANTIVIRAL TX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3216F|3216F - DOCUMENTED IMMUNITY HEPATITIS B||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32160|32160 - THORACOTOMY W/CARDIAC MASSAGE||1148.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3215F|3215F - DOCUMENTED IMMUNITY HEPATITIS A||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32151|32151 - THORCOM W/RMVL IPUL FB||1488.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32150|32150 - THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP||1478.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32141|32141 - THORACOTOMY W/RESECTION BULLAE||2258.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32124|32124 - THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS||1370.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32120|32120 - THORACOTOMY POSTOPERATIVE COMPLICATIONS||1287.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32110|32110 - THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR||2155.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3210F|3210F - GROUP A STREP TEST PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32100|32100 - THORACOTOMY WITH EXPLORATION||1221.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32098|32098 - THORACOTOMY W/BIOPSY OF PLEURA||1116.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32097|32097 - THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL||1188.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32096|32096 - THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL||1188.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32036|32036 - THORACOSTOMY OPEN FLAP DRAINAGE EMPYEMA||1141.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|32035|32035 - THORACOSTOMY W/RIB RESECTION EMPYEMA||1053.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3200F|3200F - BARIUM SWALLOW TEST NOT ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31899|31899 - UNLISTED PROCEDURE TRACHEA BRONCHI||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31830|31830 - REVISION TRACHEOSTOMY SCAR||494.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31825|31825 - SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR||699.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31820|31820 - SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR||477.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31805|31805 - SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC||1202.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31800|31800 - SUTURE TRACHEAL WOUND/INJURY CERVICAL||1021.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31786|31786 - EXCISION TRACHEAL TUMOR/CARCINOMA THORACIC||2146.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31785|31785 - EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL||1571.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31781|31781 - EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC||2066.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31780|31780 - EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA||1737.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31775|31775 - BRONCHOPLASTY EXCISION STENOSIS & ANASTOMOSIS||2057.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31770|31770 - BRONCHOPLASTY GRAFT REPAIR||1970|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31766|31766 - CARINAL RECONSTRUCTION||2727.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31760|31760 - TRACHEOPLASTY INTRATHORACIC||2027.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31755|31755 - TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG||2473.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31750|31750 - TRACHEOPLASTY CERVICAL||1955.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31730|31730 - TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER||214.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31725|31725 - CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX||137.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31720|31720 - CATHETER ASPIRATION NASOTRACHEAL SPX||74.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31717|31717 - CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY||159.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3170F|3170F - FLOW CYTOMETRY W/DIAG/PRIOR INITIATING TREATMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31661|31661 - BRONCHOSCOPIC THERMOPLASTY 2/> LOBES||346.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31660|31660 - BRONCHOSCOPIC THERMOPLASTY ONE LOBE||328.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31651|31651 - BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE||114.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31649|31649 - BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL||107.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31648|31648 - BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL||340.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31647|31647 - BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE||328.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31646|31646 - BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ||203.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31645|31645 - BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST||234.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31643|31643 - BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL||257.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31641|31641 - BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC||378.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31640|31640 - BRONCHOSCOPY W/EXCISION TUMOR||378.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31638|31638 - BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS||377.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31637|31637 - BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED||111.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31636|31636 - BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS||328.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31635|31635 - BRONCHOSCOPY W/REMOVAL FOREIGN BODY||276|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31634|31634 - BRONCHOSCOPY BALLOON OCCLUSION||311.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31633|31633 - BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE||92.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31632|31632 - BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE||71.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31631|31631 - BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT||336.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31630|31630 - BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX||296.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31629|31629 - BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON||297.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31628|31628 - BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE||276.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31627|31627 - BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION||139.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31626|31626 - BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT||300.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31625|31625 - BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES||249.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31624|31624 - BRNCHSC W/BRNCL ALVEOLAR LAVAGE||214.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31623|31623 - BRNCHSC BRUSHING/PROTECTED BRUSHINGS||213.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31622|31622 - BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX||213.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31620|31620 - ENDOBRONCHIAL US ADD-ON||99.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31615|31615 - TRACHEOBRNCHSC THRU EST TRACHS INC||186.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31614|31614 - TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION||1081.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31613|31613 - TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION||647.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31612|31612 - TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX||69.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31611|31611 - CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH||775.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31610|31610 - TRACHEOSTOMY FENESTRATION W/SKIN FLAPS||1028.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3160F|3160F - DOC IRON STORES PRIOR START EPO THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31605|31605 - TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE||267.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31603|31603 - TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL||326.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31601|31601 - TRACHEOSTOMY PLANNED UNDER 2 YEARS SPX||380.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31600|31600 - TRACHEOSTOMY PLANNED SEPARATE PROCEDURE||580.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31599|31599 - UNLISTED PROCEDURE LARYNX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31595|31595 - SECTION RECURRENT LARYNGEAL NERVE THER UNI SPX||1100.01|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|31590|31590 - LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE||1275.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31588|31588 - REVISION OF LARYNX||1646.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31587|31587 - LARYNGOPLASTY CRICOID SPLIT W/O GRAFT PLACEMENT||1449.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31584|31584 - LARYNGOPLASTY W/OPEN REDUCTION FRACTURE W/TRACHS||2179.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31582|31582 - REVISION OF LARYNX||2735.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31580|31580 - LARYNGOPLASTY LARYN WEB W/KEEL STENT INSERTION||1753.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31579|31579 - LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY||206.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31578|31578 - LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER||250.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31577|31577 - LARYNGOSCOPY FLX RMVL FOREIGN BODY(S)||217.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31576|31576 - LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES)||180.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31575|31575 - LARYNGOSCOPY FLEXIBLE DIAGNOSTIC||110.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31571|31571 - LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE||367.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31570|31570 - LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC||336.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31561|31561 - LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE||505.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31560|31560 - LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY||462.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3155F|3155F - CYTOGEN TEST DONE MARROW DIAG OR PRIOR TXMNT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31546|31546 - LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD GRAFT||811.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31545|31545 - LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP||534.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31541|31541 - LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP||390.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31540|31540 - LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT||356.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31536|31536 - LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE||310.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31535|31535 - LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY||278.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31531|31531 - LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE||312.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31530|31530 - LARYNGOSCOPY W/FOREIGN BODY REMOVAL||291.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31529|31529 - LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ||237.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31528|31528 - LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN||212.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31527|31527 - LARYNGOSCOPY W/WO TRACHEOSCOPY INSERT OBTURATOR||286.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31526|31526 - LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE||231.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31525|31525 - LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN||233.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31520|31520 - LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN||229.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31515|31515 - LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION||161.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31513|31513 - LARYNGOSCOPY INDIRECT W/VOCAL CORD INJECTION||193.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31512|31512 - LARYNGOSCOPY INDIRECT W/REMOVAL LESION||190.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31511|31511 - LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY||189.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31510|31510 - LARYNGOSCOPY INDIRECT W/BIOPSY||176.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3150F|3150F - FORCEPS ESOPHAGEAL BIOPSY PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31505|31505 - LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX||70.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31502|31502 - TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT||50.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31500|31500 - INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE||161.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3142F|3142F - BARIUM SWALLOW TEST ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31420|31420 - EPIGLOTTIDECTOMY||1206.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3141F|3141F - UPPER GI ENDO REPORT SHOW NO SUSPECT BARRETT'S||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3140F|3140F - UPPER GI ENDO REPORT SHOWS POSS BARRETT'S ESOPH||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31400|31400 - ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH||1436.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31395|31395 - PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/RCNSTJ||4334.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31390|31390 - PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/O RCNSTJ||4130.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31382|31382 - PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL||3056.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31380|31380 - PARTIAL LARYNGECTOMY HEMILARYNG ANTEROVERTICAL||2784.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31375|31375 - PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL||2825.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31370|31370 - PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL||2978.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31368|31368 - LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ||3521.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31367|31367 - LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ||3173.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31365|31365 - LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION||3707.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31360|31360 - LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION||2991.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3132F|3132F - DOC REFERAL FOR UPPER GI ENDOSCOPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31320|31320 - LARYNGOTOMY THYROTOMY LARYNGOFISSURE DX||935.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3130F|3130F - UPPER GI ENDOSCOPY PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31300|31300 - LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY||1814.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31299|31299 - UNLISTED PROCEDURE ACCESSORY SINUSES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31297|31297 - NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS||241.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31296|31296 - NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS||293.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31295|31295 - NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS||246.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31294|31294 - NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN||1813.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31293|31293 - NASAL/SINUS NDSC SURG MEDIAL&INF ORB WALL DCMPRN||1582.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31292|31292 - NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN||1457.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31291|31291 - NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID||1792.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31290|31290 - NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID||1687.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31288|31288 - NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS||394.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31287|31287 - NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY||340.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31276|31276 - NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS||741.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31267|31267 - NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS||465|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3125F|3125F - ESOPH BX RPRT W/DYSPL INFO||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31256|31256 - NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY||289.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31255|31255 - NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY||586.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31254|31254 - NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY||400.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31240|31240 - NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION||235.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31239|31239 - NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY||976.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31238|31238 - NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG||287.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31237|31237 - NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX||264.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31235|31235 - NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY||235.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31233|31233 - NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY||200.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31231|31231 - NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX||271.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31230|31230 - MAXILLECTOMY W/ORBITAL EXENTERATION||2993.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31225|31225 - MAXILLECTOMY W/O ORBITAL EXENTERATION||2683.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3120F|3120F - 12-LEAD ECG PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31205|31205 - ETHMOIDECTOMY EXTRANASAL TOTAL||1267.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31201|31201 - ETHMOIDECTOMY INTRANASAL TOTAL||1056.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31200|31200 - ETHMOIDECTOMY INTRANASAL ANTERIOR||786.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3119F|3119F - NO EVAL LEVEL OF ACTIVITY OR CLINICAL SYMPTOMS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3118F|3118F - NEW YORK HEART ASSOCIATION (NYHA) CLASS DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3117F|3117F - HF DISEASE SPECIFIC ASSESSMENT TOOL COMPLETED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3115F|3115F - QUANT RESULTS EVAL CURR LEVEL ACTIVITY CLIN SYMP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3112F|3112F - CT/MRI BRAIN DONE 24 HRS AFTER HOSP ARRIVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3111F|3111F - CT OR MRI BRAIN DONE W/IN 24 HRS HOSP ARRIVAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3110F|3110F - CT/MRI HMRHG/MASS LESION/ACUTE INFRC DOC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31090|31090 - SINUSOT UNI 3/> PARANSL SINUSES||1455.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31087|31087 - SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC||1559.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31086|31086 - SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC||1609.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31085|31085 - SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC||1898.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31084|31084 - SINUSOT FRNT OBLIT W/OSTPL FLAP BROW INC||1666.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31081|31081 - SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC||2058.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31080|31080 - SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC||1470.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31075|31075 - SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL||1121.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31070|31070 - SINUSOTOMY FRONTAL EXTERNAL SIMPLE||625.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31051|31051 - SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP||922.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31050|31050 - SINUSOTOMY SPHENOID W/WO BIOPSY||694.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31040|31040 - PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH||1090.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31032|31032 - SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS||817.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31030|31030 - SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS||743.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31020|31020 - SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL||507.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3100F|3100F - CAROTID IMAGNG REPORT DIR/INDIR MEAS VESSEL DIAM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31002|31002 - LAVAGE CANNULATION SPHENOID SINUS||285.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|31000|31000 - LAVAGE CANNULATION MAXILLARY SINUS||149.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30999|30999 - UNLISTED PROCEDURE NOSE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3096F|3096F - CENTRAL DUAL ENERGY ABSORPTIOMETRY ORDERED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3095F|3095F - CENTRAL DUAL ENERGY ABSORPTIOMETRY DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3093F|3093F - DOC NEW DIAG DX INIT/RECURRENT EPISODE OF MDD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30930|30930 - FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC||176.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3092F|3092F - MAJOR DEPRESSIVE DISORDER REMISSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30920|30920 - LIGATION ARTERIES INT MAXILLARY TRANSANTRAL||1200.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3091F|3091F - MAJOR DESPRESV DISORDER SEVERE W/PSYCHOT FEATURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30915|30915 - LIGATION ARTERIES ETHMOIDAL||829.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3090F|3090F - MDD SEVERE WITHOUT PSYCHOTIC FEATURES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30906|30906 - CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ||193.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30905|30905 - CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST||148.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30903|30903 - CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX||117.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30901|30901 - CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE||83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3089F|3089F - MAJOR DEPRESSIVE DISORDER MODERATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3088F|3088F - MAJOR DEPRESSIVE DISORDER MILD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3085F|3085F - SUICIDE RISK ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3084F|3084F - KT/V >/= 1.7||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3083F|3083F - KT/V EQUAL/>1.2 & <1.7||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3082F|3082F - KT/V <1.2 (CLEARANCE OF UREA (KT)/VOLUME (V))||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3080F|3080F - MOST RECENT DIASTOL BLOOD PRES >/EQUAL 90 MM HG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30802|30802 - ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL||272.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30801|30801 - ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC||193.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3079F|3079F - MOST RECENT DIASTOLIC BLOOD PRESSURE 80-89 MM HG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3078F|3078F - MOST RECENT DIASTOLIC BLOOD PRESSURE < 80 MM HG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3077F|3077F - MOST RECENT SYSTOLIC BLOOD PRES>/EQUAL 140 MM HG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3075F|3075F - MOST RECENT SYSTOLIC BLOOD PRESS 130-139MM HG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3074F|3074F - MOST RECENT SYSTOLIC BLOOD PRESSURE <130 MM HG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3073F|3073F - DOCUMENTED LENGTH CORNEAL POWER & LENS POWER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3072F|3072F - LOW RISK FOR RETINOPATHY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3066F|3066F - DOCUMENTATION OF TREATMENT FOR NEPHROPATHY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30630|30630 - REPAIR NASAL SEPTAL PERFORATIONS||895.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3062F|3062F - POSITIVE MACROALBUMINURIA TEST RESULT DOC&REV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30620|30620 - SEPTAL/OTHER INTRANASAL DERMATOPLASTY||887.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3061F|3061F - NEGATIVE MICROALBUMINURIA TEST RESULT DOC&REV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3060F|3060F - POSITIVE MICROALBUMINURIA TEST RESULT DOC&REV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30600|30600 - REPAIR FISTULA ORONASAL||621.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30580|30580 - REPAIR FISTULA OROMAXILLARY||712.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3056F|3056F - LVEF GREATER THAN 35%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30560|30560 - LYSIS INTRANASAL SYNECHIA||197.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3055F|3055F - LVEF LESS THAN OR EQUAL TO 35%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30545|30545 - REPAIR CHOANAL ATRESIA TRANSPALATINE||1321.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30540|30540 - REPAIR CHOANAL ATRESIA INTRANASAL||979.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30520|30520 - SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF||888.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3050F|3050F - MOST RECENT LDL-C >/EQUAL 130 MG/DL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3049F|3049F - MOST RECENT LDL-C 100-129 MG/DL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3048F|3048F - MOST RECENT LDL-C <100 MG/DL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3046F|3046F - MOST RECENT HEMOGLOBIN A1C LEVEL >9.0%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30465|30465 - REPAIR NASAL VESTIBULAR STENOSIS||1410.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30462|30462 - RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT||2255.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30460|30460 - RHINP DFRM W/COLUM LNGTH TIP ONLY||1091.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3045F|3045F - MOST RECENT HEMOGLOBIN A1C LEVEL GT 7.0-9.0 %||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30450|30450 - RHINOPLASTY SECONDARY MAJOR REVISION||2176.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3044F|3044F - MOST RECENT HEMOGLOBIN A1C LEVEL < 7.0%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30435|30435 - RHINOPLASTY SECONDARY INTERMEDIATE REVISION||1621.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30430|30430 - RHINOPLASTY SECONDARY MINOR REVISION||1325.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3042F|3042F - FUNCTJL EXPIR VOLUME >/EQUAL 40% PREDICTED VALUE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30420|30420 - RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR||1968.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30410|30410 - RHINP PRIM COMPLETE XTRNL PARTS||1833.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3040F|3040F - FUNCTIONAL EXPIRATORY VOLUME < 40%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30400|30400 - RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI||1452.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3038F|3038F - PULMONARY FUNC TEST WITHIN 12 MON PRIOR SURG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3037F|3037F - OXYGEN SATURATION >88%/PAO2 >55 MM HG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3035F|3035F - OXYGEN SATUR </EQUAL 88%/PAO2 </EQUAL 55 MM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30320|30320 - RMVL FOREIGN BODY INTRANASAL LATERAL RHINOTOMY||645.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30310|30310 - REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES||294.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30300|30300 - REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE||178.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3028F|3028F - OXYGEN SATURATION RESULTS DOCUMENTED & REVIEWE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3027F|3027F - SPIROMETRY TEST RESULTS FEV/FVC >/=70% W/O COPD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3025F|3025F - SPIROMETRY TEST RESULTS FEV/FVC <70% W/COPD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3023F|3023F - SPIROMETRY RESULTS DOCUMENTED AND REVIEWED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3022F|3022F - LEFT VENTRICULAR EJECTION FRACTION >/EQUAL 40%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30220|30220 - INSERTION NASAL SEPTAL PROSTHESIS BUTTON||181.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3021F|3021F - LEFT VENTRICULAR EJECTION FRACTION <40%||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30210|30210 - DISPLACEMENT THERAPY PROETZ TYPE||142.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3020F|3020F - LEFT VENTRICULAR FUNCTION ASSESSMENT DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30200|30200 - INJECTION TURBINATE THERAPEUTIC||86.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3019F|3019F - LVEF ASSESSMENT PLANNED POST DISCHARGE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3018F|3018F - PRE-PRX RISK ASSESS DEPTH&QUAL BOWEL PREP||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3017F|3017F - COLORECTAL CANCER SCREENING RESULTS DOC&REV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3016F|3016F - PT SCRND UNHLTHY OH USE BY SYSTMTC SCRNG METHD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30160|30160 - RHINECTOMY TOTAL||1117.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3015F|3015F - CERVICAL CANCER SCREENING RESULTS DOCD & RVWD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30150|30150 - RHINECTOMY PARTIAL||1110.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3014F|3014F - SCREENING MAMMOGRAPHY RESULTS DOC&REV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30140|30140 - SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL||623.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30130|30130 - EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE||540.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30125|30125 - EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG||874.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30124|30124 - EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS||404.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30120|30120 - EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA||630.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3011F|3011F - LIPID PANEL RESULTS DOCUMENTED & REVIEWED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30118|30118 - EXCISION/DESTRUCTION INTRANASAL LESION XTRNL||1102.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30117|30117 - EXCISION/DESTRUCTION INTRANASAL LESION INT APPR||480.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30115|30115 - EXCISION NASAL POLYP EXTENSIVE||614.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30110|30110 - EXCISION NASAL POLYP SIMPLE||187.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30100|30100 - BIOPSY INTRANASAL||99.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3008F|3008F - BODY MASS INDEX DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|3006F|3006F - CHEST X-RAY RESULTS DOCUMENTED & REVIEWED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30020|30020 - DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM||171.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|30000|30000 - DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH||171.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29999|29999 - UNLISTED PROCEDURE ARTHROSCOPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29916|29916 - ARTHROSCOPY HIP W/LABRAL REPAIR||1486.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29915|29915 - ARTHROSCOPY HIP W/ACETABULOPLASTY||1486.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29914|29914 - ARTHROSCOPY HIP W/FEMOROPLASTY||1459.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29907|29907 - ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS||1241.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29906|29906 - ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT||1025.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29905|29905 - ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY||973.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29904|29904 - ARTHRS SUBTALAR JOINT REMOVE LOOSE/FOREIGN BODY||900.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29902|29902 - ARTHRS MTCARPHLNGL JT W/RDCTJ UR COLTRL LIGM||847.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29901|29901 - ARTHRS METACARPOPHALANGEAL JOINT DEBRIDEMENT||757.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29900|29900 - ARTHROSCOPY METACARPOPHALANGEAL SYNOVIAL BIOPSY||663.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29899|29899 - ARTHROSCOPY ANKLE SURGICAL W/ANKLE ARTHRODESIS||1491.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29898|29898 - ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE||816.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29897|29897 - ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED||737.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29895|29895 - ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL||697.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29894|29894 - ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY||732.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29893|29893 - ENDOSCOPIC PLANTAR FASCIOTOMY||607.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29892|29892 - ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX||918.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29891|29891 - ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT||980.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29889|29889 - ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ||1729.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29888|29888 - ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ||1414.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29887|29887 - ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ||1062.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29886|29886 - ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION||900.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29885|29885 - ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG||1067.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29884|29884 - ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX||882.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29883|29883 - ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL||1199.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29882|29882 - ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL||994.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29881|29881 - ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG||779.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29880|29880 - ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING||813.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29879|29879 - ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX||942.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29877|29877 - ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG||884.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29876|29876 - ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS||932.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29875|29875 - ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX||703.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29874|29874 - ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY||764.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29873|29873 - ARTHROSCOPY KNEE LATERAL RELEASE||737.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29871|29871 - ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE||728.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29870|29870 - ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX||582.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29868|29868 - ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT||2394.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29867|29867 - ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT||1820.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29866|29866 - ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST||1493.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29863|29863 - ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY||1163.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29862|29862 - ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG||1163.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29861|29861 - ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB||1033.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29860|29860 - ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX||943.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29856|29856 - ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR||1422.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29855|29855 - ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR||1118.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29851|29851 - ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ||1328.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29850|29850 - ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ||797.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29848|29848 - NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM||721.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29847|29847 - ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY||770.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29846|29846 - ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT||741.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29845|29845 - ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE||817.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29844|29844 - ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL||708.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29843|29843 - ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE||683.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29840|29840 - ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX||643.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29838|29838 - ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE||840.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29837|29837 - ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED||752.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29836|29836 - ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE||828.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29835|29835 - ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL||717.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29834|29834 - ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB||699.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29830|29830 - ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX||644.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29828|29828 - ARTHROSCOPY SHOULDER BICEPS TENODESIS||1316.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29827|29827 - ARTHROSCOPY SHOULDER ROTATOR CUFF REPAIR||1540.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29826|29826 - ARTHROSCOPY SHOULDER W/CORACOACRM LIGMNT RELEASE||256.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29825|29825 - ARTHROSCOPY SHOULDER AHESIOLYSIS W/WO MANIPJ||832.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29824|29824 - ARTHROSCOPY SHOULDER DISTAL CLAVICULECTOMY||962.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29823|29823 - ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EXTENSIVE||893.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29822|29822 - ARTHROSCOPY SHOULDER SURG DEBRIDEMENT LIMITED||817.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29821|29821 - ARTHROSCOPY SHOULDER SURG SYNOVECTOMY COMPLETE||841.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29820|29820 - ARTHROSCOPY SHOULDER SURG SYNOVECTOMY PARTIAL||767.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29819|29819 - ARTHROSCOPY SHOULDER SURGICAL REMOVAL LOOSE/FB||832.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29807|29807 - ARTHROSCOPY SHOULDER SURGICAL REPAIR SLAP LESION||1476.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29806|29806 - ARTHROSCOPY SHOULDER SURGICAL CAPSULORRHAPHY||1516.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29805|29805 - ARTHROSCOPY SHOULDER DX W/WO SYNOVIAL BIOPSY SPX||667.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29804|29804 - ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL||923.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29800|29800 - ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX||732.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29799|29799 - UNLISTED PROCEDURE CASTING/STRAPPING||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29750|29750 - WEDGING CLUBFOOT CAST||111.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29740|29740 - WEDGING CAST EXCEPT CLUBFOOT CASTS||93.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29730|29730 - WINDOWING CAST||64.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29720|29720 - REPAIR SPICA BODY CAST/JACKET||62.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29715|29715 - REMOVAL/REVISION OF CAST||78.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29710|29710 - RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET||113.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29705|29705 - REMOVAL/BIVALVING FULL ARM/FULL LEG CAST||67.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29700|29700 - REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST||49.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29584|29584 - APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING||22.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29583|29583 - APPL MLTLAYR COMPRES SYSTEM UPPER & LOWER ARM||16.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29582|29582 - APPL MLTLAYR COMPRES THGH LEG ANKLE FT WHEN DONE||22.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29581|29581 - APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT||18.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29580|29580 - STRAPPING UNNA BOOT||51.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29550|29550 - STRAPPING TOES||27.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29540|29540 - STRAPPING ANKLE &/FOOT||37.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29530|29530 - STRAPPING KNEE||53.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29520|29520 - STRAPPING HIP||51.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29515|29515 - APPLICATION SHORT LEG SPLINT CALF FOOT||98.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29505|29505 - APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES||69.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29450|29450 - APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG||165.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29445|29445 - APPLICATION RIGID TOTAL CONTACT LEG CAST||153.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29440|29440 - ADDING WALKER PREVIOUSLY APPLIED CAST||51.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29435|29435 - APPLICATION PATELLAR TENDON BEARING CAST||122.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29425|29425 - APPLICATION SHORT LEG CAST WALKING/AMBULATORY||81.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29405|29405 - APPLICATION SHORT LEG CAST BELOW KNEE-TOE||85.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29365|29365 - APPLICATION CYLINDER CAST THIGH ANKLE||125.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29358|29358 - APPLICATION LONG LEG CAST BRACE||147.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29355|29355 - APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE||153.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29345|29345 - APPLICATION LONG LEG CAST THIGH-TOE||144.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29325|29325 - APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS||253.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29305|29305 - APPLICATION HIP SPICA CAST 1 LEG||224.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29280|29280 - STRAPPING HAND/FINGER||50.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29260|29260 - STRAPPING ELBOW/WRIST||52.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29240|29240 - STRAPPING SHOULDER||61.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29200|29200 - STRAPPING THORAX||56.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29131|29131 - APPLICATION FINGER SPLINT DYNAMIC||48.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29130|29130 - APPLICATION FINGER SPLINT STATIC||40.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29126|29126 - APPLICATION SHORT ARM SPLINT DYNAMIC||69.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29125|29125 - APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC||55.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29105|29105 - APPLICATION LONG ARM SPLINT SHOULDER HAND||84.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29086|29086 - APPLICATION CAST FINGER||71.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29085|29085 - APPLICATION CAST HAND & LOWER FOREARM GAUNTLET||94.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29075|29075 - APPLICATION CAST ELBOW FINGER SHORT ARM||88.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29065|29065 - APPLICATION CAST SHOULDER HAND LONG ARM||96.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29058|29058 - APPLICATION CAST PLASTER VELPEAU||113.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29055|29055 - APPLICATION CAST SHOULDER SPICA||195.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29049|29049 - APPLICATION CAST FIGURE-OF-8||96.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29046|29046 - APPLICATION BODY CAST SHOULDER HIPS BOTH THIGHS||256.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29044|29044 - APPLICATION BODY CAST SHOULDER HIPS W/ONE THIGH||236.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29040|29040 - APPLICATION BODY CAST SHOULDER HIPS HEAD MINERVA||213.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29035|29035 - APPLICATION BODY CAST SHOULDER HIPS||202.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29025|29025 - APPLICATION OF BODY CAST||255.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29020|29020 - APPLICATION OF BODY CAST||196.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29015|29015 - APPLICATION RISSER JACKET LOCALIZER BODY W/HEAD||249.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29010|29010 - APPLICATION RISSER JACKET LOCALIZER BODY ONLY||201.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|29000|29000 - APPLICATION HALO TYPE BODY CAST||247.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28899|28899 - UNLISTED PROCEDURE FOOT/TOES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28890|28890 - ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA||322.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28825|28825 - AMPUTATION TOE INTERPHALANGEAL JOINT||538.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28820|28820 - AMPUTATION TOE METATARSOPHALANGEAL JOINT||568.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28810|28810 - AMPUTATION METATARSAL W/TOE SINGLE||636.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28805|28805 - AMPUTATION FOOT TRANSMETARSAL||1089.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28800|28800 - AMPUTATION FOOT MIDTARSAL||797.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28760|28760 - ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK||827.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28755|28755 - ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT||470.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28750|28750 - ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT||856.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28740|28740 - ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT||899.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28737|28737 - ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR||980.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28735|28735 - ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT||1135.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28730|28730 - ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS||1060.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28725|28725 - ARTHRODESIS SUBTALAR||1099.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28715|28715 - ARTHRODESIS TRIPLE||1339.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28705|28705 - ARTHRODESIS PANTALAR||1848.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28675|28675 - OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION||584.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28666|28666 - PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ||271.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28665|28665 - CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES||188.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28660|28660 - CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES||125.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28645|28645 - OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION||687.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28636|28636 - PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ||280.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28635|28635 - CLTX METATARSOPHLNGL JT DISLC REQ ANES||193.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28630|28630 - CLTX METATARSOPHLNGL JT DISLC W/O ANES||156.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28615|28615 - OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION||1128.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28606|28606 - PRQ SKEL FIXJ TARS JT DISLC W/MANJ||557.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28605|28605 - CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES||398.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28600|28600 - CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES||262.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28585|28585 - OPEN TREATMENT TALOTARSAL JOINT DISLOCATION||1006.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28576|28576 - PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ||545.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28575|28575 - CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES||455.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28570|28570 - CLOSED TX TALOTARSAL JOINT DISLC W/O ANES||198.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28555|28555 - OPEN TREATMENT TARSAL BONE DISLOCATION||960.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28546|28546 - PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ||465.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28545|28545 - CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES||355.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28540|28540 - CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES||258.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28531|28531 - OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION||274.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28530|28530 - CLOSED TREATMENT SESAMOID FRACTURE||142.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28525|28525 - OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE||569.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28515|28515 - CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ||198.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28510|28510 - CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ||165.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28505|28505 - OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES||710.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28496|28496 - PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ||322.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28495|28495 - CLTX FX GRT TOE PHLX/PHLG W/MANJ||211.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28490|28490 - CLTX FX GRT TOE PHLX/PHLG W/O MANJ||172.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28485|28485 - OPEN TREATMENT METATARSAL FRACTURE EACH||751.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28476|28476 - PRQ SKEL FIXJ METAR FX W/MANJ||487.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28475|28475 - CLTX METAR FX W/MANJ||326.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28470|28470 - CLOSED TX METATARSAL FRACTURE W/O MANIPULATION||267.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28465|28465 - OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA||881.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28456|28456 - PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ||432.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28455|28455 - TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ||368.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28450|28450 - TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ||269.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28446|28446 - OPEN OSTEOCHONDRAL AUTOGRAFT TALUS||1737.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28445|28445 - OPEN TREATMENT TALUS FRACTURE||1531.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28436|28436 - PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ||625.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28435|28435 - CLOSED TX TALUS FRACTURE W/MANIPULATION||370.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28430|28430 - CLOSED TX TALUS FRACTURE W/O MANIPULATION||291.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28420|28420 - OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT||1771.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28415|28415 - OPEN TREATMENT CALCANEAL FRACTURE||1595.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28406|28406 - PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ||750.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28405|28405 - CLOSED TX CALCANEAL FRACTURE W/MANIPULATION||496.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28400|28400 - CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION||317.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28360|28360 - RECONSTRUCTION CLEFT FOOT||1523.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28345|28345 - RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB||533.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28344|28344 - RECONSTRUCTION TOE POLYDACTYLY||447.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28341|28341 - RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION||713.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28340|28340 - RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION||600.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28322|28322 - RPR NON/MALUNION METARSAL W/WO BONE GRAFT||826.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28320|28320 - REPAIR NONUNION/MALUNION TARSAL BONES||884|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28315|28315 - SESAMOIDECTOMY FIRST TOE SPX||464.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28313|28313 - RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY||512.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28312|28312 - OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE||456.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28310|28310 - OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE||506.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28309|28309 - OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT||1272.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28308|28308 - OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA||533.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28307|28307 - OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE||662.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28306|28306 - OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR||581.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28305|28305 - OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT||927.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28304|28304 - OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS||854.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28302|28302 - OSTEOTOMY TALUS||1003.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28300|28300 - OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION||943.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28299|28299 - CORRJ HALLUX VALGUS W/SESMDC W/2 OSTEOT||973.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28298|28298 - CORRJ HALLUX VALGUS W/SESMDC W/PROX PHLNX OSTEOT||723.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28297|28297 - CORRJ HALLUX VALGUS W/SESMDC W/1METAR MEDIAL CNF||847.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28296|28296 - CORRJ HALLUX VALGUS W/SESMDC W/DIST METAR OSTEOT||749.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28294|28294 - CORRECTION OF BUNION||765.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28293|28293 - CORRECTION OF BUNION||1016.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28292|28292 - CORRJ HALLUX VALGUS W/SESMDC W/RESCJ PROX PHAL||857.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28290|28290 - CORRECTION OF BUNION||567.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28289|28289 - HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT||787.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28288|28288 - OSTC PRTL EXOSTC/CONDYLC METAR HEAD||615.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28286|28286 - CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE||431.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28285|28285 - CORRECTION HAMMERTOE||528.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28280|28280 - SYNDACTYLIZATION TOES||512.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28272|28272 - CAPSULOTOMY IPHAL JOINT EACH JOINT SPX||363.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28270|28270 - CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX||478.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28264|28264 - CAPSULOTOMY MIDTARSAL||1019.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28262|28262 - CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH||1659.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28261|28261 - CAPSULOTOMY MIDFOOT W/TENDON LENGTHENING||1110.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28260|28260 - CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX||745.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28250|28250 - DIVISION PLANTAR FASCIA & MUSCLE SPX||571.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28240|28240 - TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC||417.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28238|28238 - RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR||708.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28234|28234 - TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON||378.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28232|28232 - TX OPEN TENDON FLEXOR TOE 1 TENDON SPX||353.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28230|28230 - TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX||405.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28226|28226 - TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON||443.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28225|28225 - TENOLYSIS EXTENSOR FOOT SINGLE TENDON||368.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28222|28222 - TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS||505.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28220|28220 - TENOLYSIS FLEXOR FOOT SINGLE TENDON||432.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28210|28210 - RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON||583.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28208|28208 - REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON||438.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28202|28202 - RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON||609.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28200|28200 - RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON||451.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28193|28193 - REMOVAL FOREIGN BODY FOOT COMPLICATED||535|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28192|28192 - REMOVAL FOREIGN BODY FOOT DEEP||452.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28190|28190 - REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS||191.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28175|28175 - RADICAL RESECTION TUMOR PHALANX OR TOE||695.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28173|28173 - RADICAL RESECTION TUMOR METATARSAL||1106.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28171|28171 - RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS||1220.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28160|28160 - HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE||387.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28153|28153 - RESECTION CONDYLE DISTAL END PHALANX EACH TOE||377.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28150|28150 - PHALANGECTOMY TOE EACH TOE||405.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28140|28140 - METATARSECTOMY||641.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28130|28130 - TALECTOMY ASTRAGALECTOMY||944.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28126|28126 - RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH||356.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28124|28124 - PARTICAL EXCISION BONE PHALANX TOE||471.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28122|28122 - PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS||640.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28120|28120 - PARTIAL EXCISION BONE TALUS/CALCANEUS||700.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28119|28119 - OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS||516.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28118|28118 - OSTECTOMY CALCANEUS||588.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28116|28116 - OSTECTOMY TARSAL COALITION||821.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28114|28114 - OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC||1194.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28113|28113 - OSTECTOMY COMPLETE 5TH METATARSAL HEAD||608.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28112|28112 - OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4||449.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28111|28111 - OSTECTOMY COMPLETE 1ST METATARSAL HEAD||477.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28110|28110 - OSTECTOMY PRTL 5TH METAR HEAD SPX||412.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28108|28108 - EXC/CURTG CST/B9 TUM PHALANGES FOOT||408.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28107|28107 - EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT||507.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28106|28106 - EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT||624.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28104|28104 - EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL||495.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28103|28103 - EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT||574.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28102|28102 - EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT||680.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28100|28100 - EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS||578.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28092|28092 - EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA||385.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28090|28090 - EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT||439.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28088|28088 - SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR||423.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28086|28086 - SYNOVECTOMY TENDON SHEATH FOOT FLEXOR||511.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28080|28080 - EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH||514.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28072|28072 - SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH||484.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28070|28070 - SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX||504.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28062|28062 - FASCIOTOMY PLANTAR FASCIA RADICAL SPX||585.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28060|28060 - FASCIECTOMY PLANTAR FASCIA PARTIAL SPX||506.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28055|28055 - NEURECTOMY INTRINSIC MUSCULATURE OF FOOT||542.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28054|28054 - ARTHRTOMY W/BX INTERPHALANGEAL JOINT||341.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28052|28052 - ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT||399.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28050|28050 - ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT||433.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28047|28047 - RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/>||1487.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28046|28046 - RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM||1068.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28045|28045 - EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM||504.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28043|28043 - EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM||378.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28041|28041 - EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>||676|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28039|28039 - EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>||513.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28035|28035 - RELEASE TARSAL TUNNEL||509.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28024|28024 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT||431.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28022|28022 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT||460.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28020|28020 - ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT||507.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28011|28011 - TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON||421.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28010|28010 - TENOTOMY PERCUTANEOUS TOE SINGLE TENDON||299.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28008|28008 - FASCIOTOMY FOOT&/TOE||421.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28005|28005 - INCISION BONE CORTEX FOOT||842.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28003|28003 - I&D BELOW FASCIA FOOT MULTIPLE AREAS||810.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28002|28002 - I&D BELOW FASCIA FOOT 1 BURSAL SPACE||473.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|28001|28001 - INCISION&DRAINAGE BURSA FOOT||243.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27899|27899 - UNLISTED PROCEDURE LEG/ANKLE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27894|27894 - DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS||1242.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27893|27893 - DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV||852.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27892|27892 - DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE||800.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27889|27889 - ANKLE DISARTICULATION||976.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27888|27888 - AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV||988.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27886|27886 - AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION||969.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27884|27884 - AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV||843.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27882|27882 - AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR||895.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27881|27881 - AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST||1274.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27880|27880 - AMPUTATION LEG THROUGH TIBIA&FIBULA||1349.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27871|27871 - ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL||988.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27870|27870 - ARTHRODESIS ANKLE OPEN||1488.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27860|27860 - MANIPULATION ANKLE UNDER GENERAL ANESTHESIA||251.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27848|27848 - OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ||1168.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27846|27846 - OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ||1048.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27842|27842 - CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ||698.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27840|27840 - CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA||516.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27832|27832 - OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB||1061.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27831|27831 - CLTX PROX TIBFIB JT DISLC REQ ANES||555.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27830|27830 - CLTX PROX TIBFIB JT DISLC W/O ANES||488.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27829|27829 - OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION||969.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27828|27828 - OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA||1853.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27827|27827 - OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY||1546.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27826|27826 - OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA||1183.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27825|27825 - CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ||703.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27824|27824 - CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ||423.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27823|27823 - OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP||1364.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27822|27822 - OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP||1201.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27818|27818 - CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION||618.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27816|27816 - CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION||397.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27814|27814 - OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE||1101.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27810|27810 - CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ||606.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27808|27808 - CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ||416.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27792|27792 - OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS||932.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27788|27788 - CLTX DSTL FIBULAR FX LAT MALLS W/MANJ||544.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27786|27786 - CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ||398.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27784|27784 - OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE||1016.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27781|27781 - CLTX PROX FIBULA/SHFT FX W/MANJ||554.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27780|27780 - CLTX PROX FIBULA/SHFT FX W/O MANJ||385.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27769|27769 - OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE||1033.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27768|27768 - CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ||608.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27767|27767 - CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ||390.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27766|27766 - OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE||864.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27762|27762 - CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ||621.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27760|27760 - CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION||424.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27759|27759 - TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA||1428.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27758|27758 - OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE||1269.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27756|27756 - PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE||816.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27752|27752 - CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ||702.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27750|27750 - CLTX TIBIAL SHAFT FX W/O MANIPULATION||441.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27745|27745 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA||1077.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27742|27742 - ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR||1077.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27740|27740 - ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA||892.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27734|27734 - ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA||859.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27732|27732 - ARREST EPIPHYSEAL OPEN DISTAL FIBULA||546.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27730|27730 - ARREST EPIPHYSEAL OPEN DISTAL TIBIA||827.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27727|27727 - REPAIR CONGENITAL PSEUDARTHROSIS TIBIA||1456.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27726|27726 - REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION||1376.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27725|27725 - RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH||1735.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27724|27724 - RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT||1823.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27722|27722 - REPAIR NONUNION/MALUNION TIBIA W/SLIDING GRAFT||1262.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27720|27720 - REPAIR NONUNION/MALUNION TIBIA W/O GRAFT||1251.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27715|27715 - OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN||1518.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27712|27712 - OSTEOT MLT W/RELIGNMT IMED ROD||1574.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27709|27709 - OSTEOTOMY TIBIA & FIBULA||1675.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27707|27707 - OSTEOTOMY FIBULA||568.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27705|27705 - OSTEOTOMY TIBIA||1088.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27704|27704 - REMOVAL ANKLE IMPLANT||819.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27703|27703 - ARTHROPLASTY ANKLE REVISION TOTAL ANKLE||1629.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27702|27702 - ARTHROPLASTY ANKLE W/IMPLANT||1395.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27700|27700 - ARTHROPLASTY ANKLE||853.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27698|27698 - REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL||921.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27696|27696 - RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS||806.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27695|27695 - RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL||689.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27692|27692 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN||155.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27691|27691 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP||1071.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27690|27690 - TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC||902.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27687|27687 - GASTROCNEMIUS RECESSION||651.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27686|27686 - LNGTH/SHRT TDN LEG/ANKLE MLT TDN SAME INC EA||794.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27685|27685 - LNGTH/SHRT TENDON LEG/ANKLE 1 TENDON SPX||662.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27681|27681 - TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN||765.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27680|27680 - TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH||614.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27676|27676 - REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT||882.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27675|27675 - RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY||701.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27665|27665 - RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH||591.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27664|27664 - RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH||515.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27659|27659 - RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH||700.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27658|27658 - REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH||533.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27656|27656 - REPAIR FASCIAL DEFECT LEG||545.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27654|27654 - REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT||1013.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27652|27652 - RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT||1000.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27650|27650 - REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON||950.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27648|27648 - INJECTION ANKLE ARTHROGRAPHY||74.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27647|27647 - RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS||1508.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27646|27646 - RADICAL RESECTION TUMOR BONE FIBULA||2144.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27645|27645 - RADICAL RESECTION OF TUMOR TIBIA||2479.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27641|27641 - PARTIAL EXCISION BONE FIBULA||961.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27640|27640 - PARTIAL EXCISION BONE TIBIA||1202.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27638|27638 - EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT||1104.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27637|27637 - EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT||1080.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27635|27635 - EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA||842.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27634|27634 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>||988.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27632|27632 - EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>||599.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27630|27630 - EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK||524.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27626|27626 - ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY||905.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27625|27625 - ARTHROTOMY W/SYNOVECTOMY ANKLE||820.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27620|27620 - ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB||648.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27619|27619 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM||695.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27618|27618 - EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM||440.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27616|27616 - RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>||1831.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27615|27615 - RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM||1468.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27614|27614 - BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP||583.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27613|27613 - BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL||235.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27612|27612 - ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH||797.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27610|27610 - ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB||929.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27607|27607 - INCISION LEG/ANKLE||875.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27606|27606 - TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES||410.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27605|27605 - TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES||268.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27604|27604 - INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA||479.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27603|27603 - INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA||559.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27602|27602 - DCMPRN FASCT LEG ANT&/LAT&PST CMPRT||733.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27601|27601 - DCMPRN FASCT LEG POST COMPARTMENT ONLY||628.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27600|27600 - DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY||603.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27599|27599 - UNLISTED PROCEDURE FEMUR/KNEE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27598|27598 - DISARTICULATION KNEE||1073.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27596|27596 - AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION||1057.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27594|27594 - AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION||743.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27592|27592 - AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR||1008.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27591|27591 - AMP THI THRU FEMUR LVL IMMT FITG TQ W/1ST CST||1266.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27590|27590 - AMPUTATION THIGH THROUGH FEMUR ANY LEVEL||1193.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27580|27580 - ARTHRODESIS KNEE ANY TECHNIQUE||2058.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27570|27570 - MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA||211.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27566|27566 - OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY||1270.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27562|27562 - CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA||674.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27560|27560 - CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA||488.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27558|27558 - OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION||1720.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27557|27557 - OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR||1511.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27556|27556 - OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR||1262.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27552|27552 - CLOSED TX KNEE DISLOCATION W/ANESTHESIA||885.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27550|27550 - CLOSED TX KNEE DISLOCATION W/O ANESTHESIA||648.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27540|27540 - OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE||1161.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27538|27538 - CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN||620.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27536|27536 - OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ||1701.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27535|27535 - OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR||1290.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27532|27532 - CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ||816.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27530|27530 - CLTX TIBIAL FX PROXIMAL W/O MANIPULATION||397.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27524|27524 - OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR||1070.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27520|27520 - CLOSED TX PATELLAR FRACTURE W/O MANIPULATION||409.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27519|27519 - OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION||1283.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27517|27517 - CLTX DSTL FEM EPIPHYSL SEP W/MANJ W/WO SKIN/SKEL||969.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27516|27516 - CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ||664.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27514|27514 - OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE||1400.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27513|27513 - OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN||1793.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27511|27511 - OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN||1437.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27510|27510 - CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ||987.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27509|27509 - PRQ SKELETAL FIXJ FEMORAL FX DISTAL END||910.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27508|27508 - CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ||695.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27507|27507 - OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE||1395.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27506|27506 - OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW||1913.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27503|27503 - CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ||1139.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27502|27502 - CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ||1110.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27501|27501 - CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ||704.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27500|27500 - CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION||675.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27499|27499 - DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE||914.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27498|27498 - DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS||906.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27497|27497 - DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE||812.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27496|27496 - DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT||754.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27495|27495 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR||1613.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27488|27488 - RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER||1718.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27487|27487 - REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE||2531.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27486|27486 - REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT||2018.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27485|27485 - ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA||950.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27479|27479 - ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB||1231.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27477|27477 - ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL||1039.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27475|27475 - ARREST EPIPHYSEAL DISTAL FEMUR||936.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27472|27472 - RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE||1813.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27470|27470 - RPR NON/MAL FEMUR DSTL H/N W/O GRF||1684.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27468|27468 - OSTPL FEMUR CMBN LNGTH&SHRT W/FEMORAL SGM TRNSFR||1915.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27466|27466 - OSTEOPLASTY FEMUR LENGTHENING||1687.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27465|27465 - OSTEOPLASTY FEMUR SHORTENING EXCLUDING 64876||1780.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27457|27457 - OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL||1373.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27455|27455 - OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL||1340.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27454|27454 - OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT||1850.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27450|27450 - OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION||1450.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27448|27448 - OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION||1167.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27447|27447 - ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS||2208.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27446|27446 - ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT||1584.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27445|27445 - ARTHROPLASTY KNEE HINGE PROSTHESIS||1792.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27443|27443 - ARTHRP FEM CONDYLES/TIBL PLATU KNE DBRDMT&PRTL||1160.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27442|27442 - ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE||1238.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27441|27441 - ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT||1160.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27440|27440 - ARTHROPLASTY KNEE TIBIAL PLATEAU||1122.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27438|27438 - ARTHROPLASTY PATELLA W/PROSTHESIS||1197.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27437|27437 - ARTHROPLASTY PATELLA W/O PROSTHESIS||936.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27435|27435 - CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE||1146.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27430|27430 - QUADRICEPSPLASTY||1051.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27429|27429 - LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR||1778.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27428|27428 - LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR||1585.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27427|27427 - LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR||1020.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27425|27425 - LATERAL RETINACULAR RELEASE OPEN||628.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27424|27424 - RCNSTJ DISLC PATELLA W/PATELLECTOMY||1060.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27422|27422 - RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL||1056.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27420|27420 - RCNSTJ DISLOCATING PATELLA||1056|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27418|27418 - ANTERIOR TIBIAL TUBERCLEPLASTY||1185.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27416|27416 - OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY||1391.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27415|27415 - OSTEOCHONDRAL ALLOGRAFT KNEE OPEN||1956.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27412|27412 - AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE||2363.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27409|27409 - RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE||1372.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27407|27407 - REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT||1116.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27405|27405 - RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL||960.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27403|27403 - ARTHROTOMY W/MENISCUS REPAIR KNEE||908.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27400|27400 - TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR||981.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27397|27397 - TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN||1297.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27396|27396 - TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON||870.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27395|27395 - LENGTHENING HAMSTRING TENDON MULTIPLE BILATERAL||1247.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27394|27394 - LENGTHENING HAMSTRING TENDON MULTIPLE 1 LEG||923.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27393|27393 - LENGTHENING HAMSTRING TENDON SINGLE||719.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27392|27392 - TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI||1005.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27391|27391 - TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG||813.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27390|27390 - TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON||629.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27386|27386 - SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ||1179.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27385|27385 - SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY||815.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27381|27381 - SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF||1134.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27380|27380 - SUTURE INFRAPATELLAR TENDON PRIMARY||839.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27372|27372 - REMOVAL FOREIGN BODY DEEP THIGH/KNEE||572.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27370|27370 - INJECTION KNEE ARTHROGRAPHY||75.79|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|27369|27369 - NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE||61.91||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27365|27365 - RADICAL RESECTION TUMOR FEMOR OR KNEE||2885.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27364|27364 - RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>||2247.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27360|27360 - PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA||1211.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27358|27358 - EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION||404.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27357|27357 - EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT||1154.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27356|27356 - EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT||1046.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27355|27355 - EXCISION/CURETTAGE CYST/TUMOR FEMUR||854.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27350|27350 - PATELLECTOMY/HEMIPATELLECTOMY||923.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27347|27347 - EXCISION LESION MENISCUS/CAPSULE KNEE||745.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27345|27345 - EXCISION SYNOVIAL CYST POPLITEAL SPACE||680.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27340|27340 - EXCISION PREPATELLAR BURSA||520.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27339|27339 - EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>||1076.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27337|27337 - EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>||602.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27335|27335 - ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA||1086.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27334|27334 - ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR||968.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27333|27333 - ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT||826.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27332|27332 - ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT||906.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27331|27331 - ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB||671.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27330|27330 - ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY||577.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27329|27329 - RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM||1488.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27328|27328 - EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM||867.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27327|27327 - EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM||446.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27326|27326 - NEURECTOMY POPLITEAL||716.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27325|27325 - NEURECTOMY HAMSTRING MUSCLE||726.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27324|27324 - BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP||553.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27323|27323 - BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL||253.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27310|27310 - ARTHRT KNE W/EXPL DRG/RMVL FB||1037.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27307|27307 - TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON||672.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27306|27306 - TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX||505.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27305|27305 - FASCIOTOMY ILIOTIBIAL OPEN||675.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27303|27303 - INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE||906.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27301|27301 - I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION||710.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27299|27299 - UNLISTED PROCEDURE PELVIS/HIP JOINT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27295|27295 - DISARTICULATION HIP||1808.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27290|27290 - INTERPELVIABDOMINAL AMPUTATION||2308.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27286|27286 - ARTHRD HIP JT W/OBTG GRF W/SUBTRCHNTRIC OSTEOT||2370.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27284|27284 - ARTHRODESIS HIP JOINT W/OBTAINING GRAFT||2296.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27282|27282 - ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT||1198.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27280|27280 - ARTHRODESIS SACROILIAC JOINT W/OBTAINING GRAFT||1472.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27275|27275 - MANIPULATION HIP JOINT GENERAL ANESTHESIA||253.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27269|27269 - OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD||1768.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27268|27268 - CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ||753.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27267|27267 - CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ||610.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27266|27266 - CLTX POST HIP ARTHRP DISLC REQ ANES||822.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27265|27265 - CLTX POST HIP ARTHRP DISLC W/O ANES||564.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27259|27259 - OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM SHRT||2218.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27258|27258 - OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM||1582.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27257|27257 - TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES||479.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27256|27256 - TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES||341.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27254|27254 - OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD||1817.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27253|27253 - OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ||1343.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27252|27252 - CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA||1081.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27250|27250 - CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA||281.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27248|27248 - OPEN TREATMENT GREATER TROCHANTERIC FRACTURE||1063.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27246|27246 - CLTX GREATER TROCHANTERIC FX W/O MANJ||544.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27245|27245 - TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW||1768.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27244|27244 - TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT||1758.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27240|27240 - CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ||1367.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27238|27238 - CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ||646.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27236|27236 - OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT||1709.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27235|27235 - PRQ SKEL FIXJ FEMORAL FX PROX END NECK||1296.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27232|27232 - CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ||1094.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27230|27230 - CLTX FEM FX PROX END NCK W/O MANJ||662.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27228|27228 - OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT||2722.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27227|27227 - OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT||2382.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27226|27226 - OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ||1506.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27222|27222 - CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ||1394.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27220|27220 - CLTX ACETABULUM HIP/SOCKT FX W/O MANJ||741.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27218|27218 - OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD||1691.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27217|27217 - OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR||1228.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27216|27216 - PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS||1305.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27215|27215 - OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD||881.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27202|27202 - OPEN TREATMENT COCCYGEAL FRACTURE||793.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27200|27200 - CLOSED TREATMENT COCCYGEAL FRACTURE||258.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27194|27194 - TREAT PELVIC RING FRACTURE||992.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27193|27193 - TREAT PELVIC RING FRACTURE||672.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27187|27187 - PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR||1414.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27185|27185 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR||942.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27181|27181 - OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ||1597.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27179|27179 - OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX||1388.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27178|27178 - OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN||1301.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27177|27177 - OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT||1586.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27176|27176 - TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU||1304.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27175|27175 - TX SLP FEMORAL EPIPHYSIS TRCJ W/O REDUCTION||946.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27170|27170 - B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA||1684.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27165|27165 - OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL||1963.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27161|27161 - OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE||1737.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27158|27158 - OSTEOTOMY PELVIS BILATERAL||1997.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27156|27156 - OSTEOT ILIAC ACTBLR/INNOMINATE BONE OSTEOT RDCTJ||2453.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27151|27151 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT||2255.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27147|27147 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ||2101.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27146|27146 - OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE||1828.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27140|27140 - OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX||1276.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27138|27138 - REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT||2206.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27137|27137 - REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT||2119.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27134|27134 - REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT||2766.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27132|27132 - CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT||2409.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27130|27130 - ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT||2067.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27125|27125 - HEMIARTHROPLASTY HIP PARTIAL||1617.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27122|27122 - ACETABULOPLASTY RESECTION FEMORAL HEAD||1574.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27120|27120 - ACETABULOPLASTY||1846.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27111|27111 - TRANSFER ILIOPSOAS FEMORAL NECK||1181.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27110|27110 - TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR||1374.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27105|27105 - TR PARASPI MUSC HIP FASC/TDN XTN GRF||1229.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27100|27100 - TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF||1169.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27098|27098 - TRANSFER ADDUCTOR ISCHIUM||964.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27097|27097 - RELEASE/RECESSION HAMSTRING PROXIMAL||960.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27096|27096 - INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA||118.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27095|27095 - INJECTION HIP ARTHROGRAPHY W/ANESTHESIA||118.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27093|27093 - INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA||101.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27091|27091 - RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA||2291.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27090|27090 - REMOVAL HIP PROSTHESIS SEPARATE PROCEDURE||1181.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27087|27087 - REMOVAL FOREIGN BODY PELVIS/HIP DEEP||898.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27086|27086 - RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS||210.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27080|27080 - COCCYGECTOMY PRIMARY||718.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27078|27078 - RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR||2864.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27077|27077 - RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL||4053.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27076|27076 - RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC||3557.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27075|27075 - RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL||3019.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27071|27071 - PARTIAL EXCISION DEEP PELVIS||1300.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27070|27070 - PARTIAL EXCISION SUPERFICIAL PELVIS||1210.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27067|27067 - EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC||1471.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27066|27066 - EXCISION BONE CYST/BENIGN TUMOR DEEP||1152.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27065|27065 - EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL||720.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27062|27062 - EXCISION TROCHANTERIC BURSA/CALCIFICATION||642.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27060|27060 - EXCISION ISCHIAL BURSA||646.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27059|27059 - RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5 CM/>||2597.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27057|27057 - DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI||1346.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27054|27054 - ARTHROTOMY W/SYNOVECTOMY HIP JOINT||970|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27052|27052 - ARTHROTOMY W/BIOPSY HIP JOINT||812.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27050|27050 - ARTHROTOMY W/BIOPSY SACROILIAC JOINT||549.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27049|27049 - RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM||1928.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27048|27048 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM||859.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27047|27047 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM||531.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27045|27045 - EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>||1076.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27043|27043 - EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>||675.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27041|27041 - BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM||968.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27040|27040 - BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL||285.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27036|27036 - CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC||1436.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27035|27035 - DNRVTJ HIP JT INTRAPEL/XTRPEL INTRA-ARTCLR BRNCH||1481.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27033|27033 - ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY||1389.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27030|27030 - ARTHROTOMY HIP W/DRAINAGE||1333.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27027|27027 - DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI||1197.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27025|27025 - FASCIOTOMY HIP/THIGH ANY TYPE||1308.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27006|27006 - TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX||1046.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27005|27005 - TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE||1033.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27003|27003 - TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY||838.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27001|27001 - TENOTOMY ADDUCTOR HIP OPEN||766.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|27000|27000 - TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX||618.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26992|26992 - INCISION BONE CORTEX PELVIS&/HIP JOINT||1362.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26991|26991 - I&D PELVIS/HIP JOINT AREA INFECTED BURSA||744.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26990|26990 - I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA||881.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26989|26989 - UNLISTED PROCEDURE HANDS/FINGERS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26952|26952 - AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP||902.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26951|26951 - AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR||899.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26910|26910 - AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER||1004.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26863|26863 - ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT||332.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26862|26862 - ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT||1012.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26861|26861 - ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT||149.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26860|26860 - ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ||779.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26852|26852 - ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT||1108.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26850|26850 - ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ||964.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26844|26844 - ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT||1155.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26843|26843 - ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH||1024.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26842|26842 - ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT||1101.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26841|26841 - ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ||1012.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26820|26820 - FUSION OPPOSITION THUMB W/AUTOGENOUS GRAFT||1095.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26785|26785 - OPEN TX INTERPHALANGEAL JOINT DISLOCATION||760.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26776|26776 - PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ||620.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26775|26775 - CLTX IPHAL JT DISLC W/MANJ REQ ANES||483.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26770|26770 - CLTX IPHAL JT DISLC W/MANJ W/O ANES||352.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26765|26765 - OPEN TX DISTAL PHALANGEAL FRACTURE EACH||698.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26756|26756 - PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA||586.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26755|26755 - CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA||383.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26750|26750 - CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA||253.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26746|26746 - OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA||1043.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26742|26742 - CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ||469.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26740|26740 - CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ||296.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26735|26735 - OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA||838.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26727|26727 - PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T||659.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26725|26725 - CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA||426.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26720|26720 - CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA||253.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26715|26715 - OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION||805.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26706|26706 - PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ||619.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26705|26705 - CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES||525.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26700|26700 - CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES||419.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26686|26686 - OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ||879.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26685|26685 - OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB||811.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26676|26676 - PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT||704.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26675|26675 - CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES||578.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26670|26670 - CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES||421.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26665|26665 - OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB||883.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26650|26650 - PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB||670.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26645|26645 - CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ||542.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26641|26641 - CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ||465.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26615|26615 - OPEN TX METACARPAL FRACTURE SINGLE EA BONE||805.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26608|26608 - PRQ SKELETAL FIXJ METACARPAL FX EACH BONE||670.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26607|26607 - CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE||639.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26605|26605 - CLTX METACARPAL FX W/MANIPULATION EACH BONE||407.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26600|26600 - CLTX METACARPAL FX W/O MANIPULATION EACH BONE||378.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26596|26596 - EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES||1056.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26593|26593 - RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE||831.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26591|26591 - REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE||606.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26590|26590 - REPAIR MACRODACTYLIA EACH DIGIT||1806.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26587|26587 - RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE||1325.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26580|26580 - REPAIR CLEFT HAND||2138.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26568|26568 - OSTEOPLASTY LENGTHENING METACARPAL/PHALANX||1249.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26567|26567 - OSTEOTOMY PHALANX FINGER EACH||947.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26565|26565 - OSTEOTOMY METACARPAL EACH||950.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26562|26562 - REPAIR SYNDACTYLY EACH SPACE COMPLEX||1813.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26561|26561 - REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT||1331.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26560|26560 - REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS||810.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26556|26556 - TRANSFER FREE TOE JOINT W/MVASC ANASTOMOSIS||4126.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26555|26555 - TR FNGR AXH POS W/O MVASC ANAST||1924.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26554|26554 - TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 2||4595.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26553|26553 - TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 1||3863.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26551|26551 - TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND||4259.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26550|26550 - POLLICIZATION DIGIT||2266.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26548|26548 - RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL||1066.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26546|26546 - RPR NON-UNION MTCRPL/PHALANX||1384.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26545|26545 - RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT||968.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26542|26542 - RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS||947.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26541|26541 - RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF||1118.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26540|26540 - RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT||916.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26536|26536 - ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA||974.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26535|26535 - ARTHROPLASTY INTERPHALANGEAL JOINT EACH||581|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26531|26531 - ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT||881.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26530|26530 - ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH||757.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26525|26525 - CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH||904.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26520|26520 - CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH||903.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26518|26518 - CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS||1164.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26517|26517 - CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS||1164.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26516|26516 - CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT||979.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26510|26510 - CROSS INTRINSIC TRANSFER EACH TENDON||828.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26508|26508 - RELEASE THENAR MUSCLE||865.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26502|26502 - RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX||985.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26500|26500 - RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX||874.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26499|26499 - CORRECTION CLAW FINGER OTHER METHODS||1155.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26498|26498 - TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS||1602.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26497|26497 - TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR||1205.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26496|26496 - OPPONENSPLASTY OTHER METHODS||1199.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26494|26494 - OPPONENSPLASTY HYPOTHENAR MUSC TR||1110.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26492|26492 - OPPONENSPLASTY TDN TR W/GRF EA TDN||1227.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26490|26490 - OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN||1105.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26489|26489 - TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH||1283.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26485|26485 - TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH||1127.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26483|26483 - TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT||1181.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26480|26480 - TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN||1047.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26479|26479 - SHORTENING TENDON FLEXOR HAND/FINGER EACH||865.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26478|26478 - LENGTHENING TENDON FLEXOR HAND/FINGER EACH||867.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26477|26477 - SHORTENING TENDON EXTENSOR HAND/FINGER EACH||811.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26476|26476 - LENGTHENING TENDON EXTENSOR HAND/FINGER EACH||813.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26474|26474 - TENODESIS DISTAL JOINT EACH||669.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26471|26471 - TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH||853.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26460|26460 - TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON||544.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26455|26455 - TENOTOMY FLEXOR FINGER OPEN EACH TENDON||560.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26450|26450 - TENOTOMY FLEXOR PALM OPEN EACH TENDON||560.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26449|26449 - TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA||1008.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26445|26445 - TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH||799.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26442|26442 - TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO||1344.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26440|26440 - TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON||861.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26437|26437 - REALIGNMENT EXTENSOR TENDON HAND EACH TENDON||863.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26434|26434 - REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT||894.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26433|26433 - REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF||738.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26432|26432 - CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING||689.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26428|26428 - RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER||1048.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26426|26426 - RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR||732.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26420|26420 - REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH||996.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26418|26418 - REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH||798.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26416|26416 - RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD||1200.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26415|26415 - EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA||959.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26412|26412 - REPAIR EXTENSOR TENDON HAND W/GRAFT EACH||951.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26410|26410 - REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH||783.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26392|26392 - RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD||1371.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26390|26390 - EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F||1164.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26373|26373 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA||1178.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26372|26372 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA||1231.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26370|26370 - RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN||1061.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26358|26358 - RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON||1276.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26357|26357 - RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON||1207.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26356|26356 - RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON||1522.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26352|26352 - RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON||1130.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26350|26350 - RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON||988.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26341|26341 - MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD||105.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26340|26340 - MANIPULATION FINGER JOINT UNDER ANES EACH JOINT||459.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26320|26320 - REMOVAL IMPLANT FROM FINGER/HAND||487.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26262|26262 - RADICAL RESECTION TUMOR DISTAL PHALANX FINGER||891.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26260|26260 - RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER||1111.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26250|26250 - RADICAL RESECTION TUMOR METACARPAL||1467.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26236|26236 - PARTIAL EXCISION DISTAL PHALANX FINGER||621.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26235|26235 - PARTIAL EXCISION PROXIMAL/MIDDLE PHALANX FINGER||697.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26230|26230 - PARTIAL EXCISION BONE METACARPAL||705.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26215|26215 - EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT||792.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26210|26210 - EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER||621.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26205|26205 - EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT||850.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26200|26200 - EXCISION/CURETTAGE CYST/TUMOR METACARPAL||636.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26185|26185 - SESAMOIDECTOMY THUMB/FINGER SEPARATE PROCEDURE||780.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26180|26180 - EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH||624.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26170|26170 - EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH||572.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26160|26160 - EXC LESION TDN SHTH/JT CAPSL HAND/FNGR||465.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26145|26145 - SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN||723.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26140|26140 - SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT||712.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26135|26135 - SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD||779.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26130|26130 - SYNOVECTOMY CARPOMETACARPAL JOINT||648.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26125|26125 - FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR||397.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26123|26123 - FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR||1177.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26121|26121 - FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT||845.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26118|26118 - RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>||1526.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26117|26117 - RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM||1052.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26116|26116 - EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM||743.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26115|26115 - EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM||476.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26113|26113 - EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5CM/>||784.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26111|26111 - EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>||598.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26110|26110 - ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH||450.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26105|26105 - ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH||470.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26100|26100 - ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH||464.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26080|26080 - ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA||545.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26075|26075 - ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA||456.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26070|26070 - ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT||438.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26060|26060 - TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT||373.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26055|26055 - TENDON SHEATH INCISION||430.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26045|26045 - FASCIOTOMY PALMAR OPEN PARTIAL||657.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26040|26040 - FASCIOTOMY PALMAR PERCUTANEOUS||435.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26037|26037 - DECOMPRESSIVE FASCIOTOMY HAND||810.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26035|26035 - DECOMPRESSION FINGERS&/HAND INJECTION INJURY||1204.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26034|26034 - INCISION BONE CORTEX HAND/FINGER||758.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26030|26030 - DRAINAGE OF PALMAR BURSA MULTIPLE BURSA||698.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26025|26025 - DRAINAGE OF PALMAR BURSA SINGLE BURSA||593.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26020|26020 - DRAINAGE TENDON SHEATH DIGIT&/PALM EACH||609.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26011|26011 - DRAINAGE FINGER ABSCESS COMPLICATED||260.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|26010|26010 - DRAINAGE FINGER ABSCESS SIMPLE||192.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25999|25999 - UNLISTED PROCEDURE FOREARM/WRIST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25931|25931 - TRANSMETACARPAL AMPUTATION RE-AMPUTATION||969.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25929|25929 - TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ||849.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25927|25927 - TRANSMETACARPAL AMPUTATION||1132.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25924|25924 - DISARTICULATION THRU WRIST RE-AMPUTATION||893.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25922|25922 - DISARTICULATION THRU WRIST SEC CLOSURE/SCAR REVJ||806.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25920|25920 - DISARTICULATION THROUGH WRIST||981.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25915|25915 - KRUKENBERG PROCEDURE||1522.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25909|25909 - AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION||985.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25907|25907 - AMP F/ARM THRU RADIUS&ULNA SEC CLOSURE/SCAR RE||823.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25905|25905 - AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR||1008.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25900|25900 - AMPUTATION FOREARM THROUGH RADIUS & ULNA||1024.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25830|25830 - ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE||1342.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25825|25825 - ARTHRODESIS WRIST LIMITED W/AUTOGRAFT||1072.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25820|25820 - ARTHRODESIS WRIST LIMITED W/O BONE GRAFT||869.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25810|25810 - ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT||1235.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25805|25805 - ARTHRODESIS WRIST W/SLIDING GRAFT||1203.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25800|25800 - ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT||1042.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25695|25695 - OPEN TREATMENT LUNATE DISLOCATION||895.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25690|25690 - CLOSED TX LUNATE DISLOCATION W/MANIPULATION||670.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25685|25685 - OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC||1040.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25680|25680 - CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ||666.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25676|25676 - OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC||890.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25675|25675 - CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ||561.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25671|25671 - PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION||743.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25670|25670 - OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES||855.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25660|25660 - CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ||572.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25652|25652 - OPEN TREATMENT ULNAR STYLOID FRACTURE||879.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25651|25651 - PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE||682.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25650|25650 - CLOSED TREATMENT ULNAR STYLOID FRACTURE||416.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25645|25645 - OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA||802.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25635|25635 - CLTX CARPAL BONE FX W/MANJ EACH BONE||570.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25630|25630 - CLTX CARPAL BONE FX W/O MANJ EACH BONE||389.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25628|25628 - OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE||1020.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25624|25624 - CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ||599.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25622|25622 - CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ||382.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25609|25609 - OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 3 FRAG||1482.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25608|25608 - OPTX DSTL RADL I-ARTIC FX/EPIPHYSL SEP 2 FRAG||1163.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25607|25607 - OPTX DSTL RADL X-ARTIC FX/EPIPHYSL SEP||1036.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25606|25606 - PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP||936.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25605|25605 - CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF||734.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25600|25600 - CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ||414.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25575|25575 - OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA||1275.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25574|25574 - OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA||948.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25565|25565 - CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ||665.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25560|25560 - CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN||342.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25545|25545 - OPEN TREATMENT OF ULNAR SHAFT FRACTURE||881.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25535|25535 - CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION||636.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25530|25530 - CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION||325.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25526|25526 - OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE||1365.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25525|25525 - OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE||1116.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25520|25520 - CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT||748.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25515|25515 - OPEN TREATMENT RADIAL SHAFT FRACTURE||946.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25505|25505 - CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION||646.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25500|25500 - CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION||343.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25492|25492 - PROPH TX N/P/PLTWR W/WO METHYLMECRYLATE RAD&UL||1302.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25491|25491 - PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE ULNA||1070.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25490|25490 - PROPH TX N/P/PLTWR W/WO METHYLACRYLATE RADIUS||965.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25455|25455 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA||962.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25450|25450 - EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U||866.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25449|25449 - REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT||1486.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25447|25447 - ARTHRP INTERPOS INTERCARPAL/METACARPAL JOINTS||1171.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25446|25446 - ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS||1671.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25445|25445 - ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM||1023.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25444|25444 - ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE||1131.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25443|25443 - ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL||1107.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25442|25442 - ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA||1119.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25441|25441 - ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS||1287.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25440|25440 - RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC||1096.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25431|25431 - REPAIR NONUNION CARPAL BONE EACH BONE||1116.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25430|25430 - INSERTION VASCULAR PEDICLE CARPAL BONE||997.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25426|25426 - REPAIR DEFECT W/AUTOGRAFT RADIUS&ULNA||1599.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25425|25425 - REPAIR DEFECT W/AUTOGRAFT RADIUS/ULNA||1407.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25420|25420 - RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT||1688.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25415|25415 - RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF||1401.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25405|25405 - RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT||1499.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25400|25400 - RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT||1167.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25394|25394 - OSTEOPLASTY CARPAL BONE SHORTENING||1110.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25393|25393 - OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAF||1634.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25392|25392 - OSTEOPLASTY RADIUS & ULNA SHORTENING||1465|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25391|25391 - OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT||1438.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25390|25390 - OSTEOPLASTY RADIUS/ULNA SHORTENING||1114.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25375|25375 - MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA||1141.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25370|25370 - MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA||1320.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25365|25365 - OSTEOTOMY RADIUS & ULNA||1318.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25360|25360 - OSTEOTOMY ULNA||949.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25355|25355 - OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD||1107.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25350|25350 - OSTEOTOMY RADIUS DISTAL THIRD||977.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25337|25337 - RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ||1262.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25335|25335 - CENTRALIZATION WRST ULNA||1266.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25332|25332 - ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ||1204.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25320|25320 - CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS||1399.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25316|25316 - FLEXOR ORIGIN SLIDE F/ARM&/WRST TENDON TRANSFE||1272.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25315|25315 - FLEXOR ORIGIN SLIDE FOREARM &/WRIST||1115.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25312|25312 - TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR||1042.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25310|25310 - TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN||896.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25301|25301 - TENODESIS WRIST EXTENSORS FINGERS||915.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25300|25300 - TENODESIS WRIST FLEXORS FINGERS||990.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25295|25295 - TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA||760.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25290|25290 - TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA||649.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25280|25280 - LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN||819.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25275|25275 - RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT||962.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25274|25274 - RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN||974.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25272|25272 - RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU||807.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25270|25270 - RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN||718.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25265|25265 - RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA||1079.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25263|25263 - RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS||904.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25260|25260 - RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU||912.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25259|25259 - MANIPULATION WRIST UNDER ANESTHESIA||573.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25251|25251 - REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST||1018.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25250|25250 - REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE||746.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25248|25248 - EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST||600.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25246|25246 - INJECTION WRIST ARTHROGRAPHY||107.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25240|25240 - EXCISION DISTAL ULNA PARTIAL/COMPLETE||609.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25230|25230 - RADICAL STYLOIDECTOMY SEPARATE PROCEDURE||610.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25215|25215 - CARPECTOMY ALL BONES PROXIMAL ROW||878.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25210|25210 - CARPECTOMY 1 BONE||693.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25170|25170 - RADICAL RESECTION TUMOR RADIUS OR ULNA||2067.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25151|25151 - PARTIAL EXCISION BONE RADIUS||850.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25150|25150 - PARTIAL EXCISION BONE ULNA||805.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25145|25145 - SEQUESTRECTOMY FOREARM &/WRIST||748.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25136|25136 - EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT||695.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25135|25135 - EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT||804.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25130|25130 - EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES||633.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25126|25126 - EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT||862.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25125|25125 - EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT||874.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25120|25120 - EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA||724.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25119|25119 - SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA||710.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25118|25118 - SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT||539.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25116|25116 - RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS||868.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25115|25115 - RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS||1096.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25112|25112 - EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT||546.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25111|25111 - EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY||449.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25110|25110 - EXCISION LESION TENDON SHEATH FOREARM&/WRIST||487.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25109|25109 - EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA||756.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25107|25107 - ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE||872.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25105|25105 - ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY||684.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25101|25101 - ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB||569.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25100|25100 - ARTHROTOMY WRIST JOINT WITH BIOPSY||486.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25085|25085 - CAPSULOTOMY WRIST||641.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25078|25078 - RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>||1688.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25077|25077 - RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM||1260.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25076|25076 - EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM||734.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25075|25075 - EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM||455.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25073|25073 - EXC TUMOR SFT TISS FOREARM&/WRIST SUBFASC 3CM/>||761.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25071|25071 - EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>||610.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25066|25066 - BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP||512.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25065|25065 - BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL||234.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25040|25040 - ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB||801.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25035|25035 - INCISION DEEP BONE CORTEX FOREARM&/WRIST||849.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25031|25031 - INCISION & DRAINAGE FOREARM&/WRIST BURSA||517.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25028|25028 - I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA||732.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25025|25025 - DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT||1737.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25024|25024 - DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB||1113.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25023|25023 - DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT||1568.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25020|25020 - DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT||813.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25001|25001 - INCISION FLEXOR TENDON SHEATH WRIST||479.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|25000|25000 - INCISION EXTENSOR TENDON SHEATH WRIST||477.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24999|24999 - UNLISTED PROCEDURE HUMERUS/ELBOW||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24940|24940 - CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE||1523.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24935|24935 - STUMP ELONGATION UPPER EXTREMITY||1452.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24931|24931 - AMPUTATION ARM THRU HUMERUS W/IMPLANT||1102.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24930|24930 - AMPUTATION ARM THRU HUMERUS RE-AMPUTATION||1093.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24925|24925 - AMP ARM THRU HUMERUS SECONDARY CLSR/SCAR REVJ||796.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24920|24920 - AMPUTATION ARM THRU HUMERUS OPEN CIRCULAR||965.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24900|24900 - AMPUTATION ARM THRU HUMERUS W/PRIMARY CLOSURE||1033.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24802|24802 - ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT||1424.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24800|24800 - ARTHRODESIS ELBOW JOINT LOCAL||1166.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24685|24685 - OPEN TREATMENT ULNAR FRACTURE PROXIMAL END||924.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24675|24675 - CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ||585.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24670|24670 - CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ||363.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24666|24666 - OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC||1039.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24665|24665 - OPEN TX RADIAL HEAD/NECK FRACTURE||920.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24655|24655 - CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION||560.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24650|24650 - CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION||330.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24640|24640 - CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ||130.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24635|24635 - OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW||974.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24620|24620 - CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ||778.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24615|24615 - OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION||1009.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24605|24605 - TREATMENT CLOSED ELBOW DISLOCATION REQ ANES||657.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24600|24600 - TREATMENT CLOSED ELBOW DISLOCATION W/O ANES||467.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24587|24587 - OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR||1544.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24586|24586 - OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO||1551.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24582|24582 - PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ||1134.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24579|24579 - OPEN TREATMENT HUMERAL CONDYLAR FRACTURE||1186.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24577|24577 - CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ||699.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24576|24576 - CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ||421.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24575|24575 - OPEN TX HUMERAL EPICONDYLAR FRACTURE||1040.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24566|24566 - PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ||1010.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24565|24565 - CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ||678.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24560|24560 - CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ||397.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24546|24546 - OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN||1485.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24545|24545 - OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN||1321.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24538|24538 - PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX||1052.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24535|24535 - CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ||800.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24530|24530 - CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ||477.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24516|24516 - TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE||1225.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24515|24515 - OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE||1245.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24505|24505 - CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ||635.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24500|24500 - CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION||449.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24498|24498 - PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT||1234.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24495|24495 - DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL||932.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24470|24470 - HEMIEPIPHYSEAL ARREST||936.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24435|24435 - REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT||1533.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24430|24430 - REPAIR NON/MALUNION HUMERUS W/O GRAFT||1508.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24420|24420 - OSTEOPLASTY HUMERUS||1407.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24410|24410 - MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT||1367.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24400|24400 - OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION||1167.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24371|24371 - REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT||2559.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24370|24370 - REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT||2220.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24366|24366 - ARTHROPLASTY RADIAL HEAD W/IMPLANT||967.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24365|24365 - ARTHROPLASTY RADIAL HEAD||904.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24363|24363 - ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM||2142.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24362|24362 - ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ||1510.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24361|24361 - ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT||1433.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24360|24360 - ARTHROPLASTY ELBOW W/MEMBRANE||1277.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24359|24359 - TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR||934.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24358|24358 - TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN||739.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24357|24357 - TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS||625.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24346|24346 - RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF||1559.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24345|24345 - REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW||991.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24344|24344 - RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT||1565.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24343|24343 - REPAIR LATERAL COLLATERAL LIGAMENT ELBOW||997.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24342|24342 - RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF||1107.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24341|24341 - REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA||1054.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24340|24340 - TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE||870.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24332|24332 - TENOLYSIS TRICEPS||862.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24331|24331 - FLEXOR-PLASTY ELBOW W/EXTENSOR ADVANCEMENT||1051.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24330|24330 - FLEXOR-PLASTY ELBOW||1016.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24320|24320 - TENOPLASTY ELBOW TO SHOULDER SINGLE||1106.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24310|24310 - TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON||674.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24305|24305 - TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON||820.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24301|24301 - MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE||1069.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24300|24300 - MANIPULATION ELBOW UNDER ANESTHESIA||570.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24220|24220 - INJECTION ELBOW ARTHROGRAPHY||97.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24201|24201 - REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP||516.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24200|24200 - RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS||196.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24164|24164 - PROSTHESIS REMOVAL RADIAL HEAD||702.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24160|24160 - PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS||856.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24155|24155 - RESECTION ELBOW JOINT ARTHRECTOMY||1211.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24152|24152 - RADICAL RESECTION TUMOR RADIAL HEAD/NECK||1861.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24150|24150 - RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS||2165.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24149|24149 - RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT||1665.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24147|24147 - PARTIAL EXCISION BONE OLECRANON PROCESS||882.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24145|24145 - PARTIAL EXCISION BONE RADIAL HEAD/NECK||841.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24140|24140 - PARTIAL EXCISION BONE HUMERUS||1002.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24138|24138 - SEQUESTRECTOMY OLECRANON PROCESS||948.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24136|24136 - SEQUESTRECTOMY RADIAL HEAD OR NECK||880.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24134|24134 - SEQUESTRECTOMY SHAFT/DISTAL HUMERUS||1060.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24130|24130 - EXCISION RADIAL HEAD||717.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24126|24126 - EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT||916.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24125|24125 - EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/AGRFT||872.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24120|24120 - EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN||745.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24116|24116 - EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT||1225.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24115|24115 - EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT||1042.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24110|24110 - EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS||828.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24105|24105 - EXCISION OLECRANON BURSA||487.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24102|24102 - ARTHROTOMY ELBOW W/SYNOVECTOMY||872.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24101|24101 - ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB||704.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24100|24100 - ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY||584.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24079|24079 - RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5CM/>||1916.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24077|24077 - RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM||1471.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24076|24076 - EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM||766.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24075|24075 - EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM||465.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24073|24073 - EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>||994.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24071|24071 - EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>||582.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24066|24066 - BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP||579.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24065|24065 - BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL||239.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24006|24006 - ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX||1011.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|24000|24000 - ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB||673.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23935|23935 - INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW||712.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23931|23931 - INCISION&DRAINAGE UPPER ARM/ELBOW BURSA||224.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23930|23930 - I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA||307.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23929|23929 - UNLISTED PROCEDURE SHOULDER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23921|23921 - DISRTCJ SHOULDER SECONDARY CLSR/SCAR REVISION||604.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23920|23920 - DISARTICULATION SHOULDER||1590.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23900|23900 - INTERTHORACOSCAPULAR AMPUTATION||1960.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23802|23802 - ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT||1818.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23800|23800 - ARTHRODESIS GLENOHUMERAL JOINT||1461.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23700|23700 - MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS||275.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23680|23680 - OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE||1319.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23675|23675 - CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ||702.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23670|23670 - OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX||1237.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23665|23665 - CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ||552.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23660|23660 - OPEN TX ACUTE SHOULDER DISLOCATION||825.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23655|23655 - CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES||554.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23650|23650 - CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES||395.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23630|23630 - OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE||1105.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23625|23625 - CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION||492.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23620|23620 - CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ||354.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23616|23616 - OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT||1784.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23615|23615 - OPEN TREATMENT PROXIMAL HUMERAL FRACTURE||1258.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23605|23605 - CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ||598.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23600|23600 - CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION||420.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23585|23585 - OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD||1398.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23575|23575 - CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION||520.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23570|23570 - CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION||329.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23552|23552 - OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF||932.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23550|23550 - OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC||807.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23545|23545 - CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION||426.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23540|23540 - CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION||313.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23532|23532 - OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF||880.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23530|23530 - OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC||798.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23525|23525 - CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION||483.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23520|23520 - CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION||321.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23515|23515 - OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION||1020.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23505|23505 - CLSD TX CLAVICULAR FRACTURE W/MANIPULATION||459.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23500|23500 - CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION||306.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23491|23491 - PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS||1444.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23490|23490 - PROPH TX W/WO METHYLMETHACRYLATE CLAVICLE||1261.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23485|23485 - OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL||1370|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23480|23480 - OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION||1165.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23474|23474 - REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT||2539.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23473|23473 - REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT||2467.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23472|23472 - ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER||2143.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23470|23470 - ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY||1728.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23466|23466 - CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS||1599.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23465|23465 - CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK||1598.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23462|23462 - CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR||1530.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23460|23460 - CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK||1555.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23455|23455 - CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR||1433.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23450|23450 - CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON||1351.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23440|23440 - RESECTION/TRANSPLANTATION LONG TENDON BICEPS||1077.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23430|23430 - TENODESIS LONG TENDON BICEPS||1060.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23420|23420 - RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC||1381.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23415|23415 - CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY||985.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23412|23412 - OPEN REPAIR OF ROTATOR CUFF CHRONIC||1216.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23410|23410 - OPEN REPAIR OF ROTATOR CUFF ACUTE||1170.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23406|23406 - TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION||1107.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23405|23405 - TENOTOMY SHOULDER AREA 1 TENDON||892.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23400|23400 - SCAPULOPEXY||1382.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23397|23397 - MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE||1628.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23395|23395 - MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE||1836.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23350|23350 - INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG||73.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23332|23332 - REMOVE SHOULDER FOREIGN BODY||1256.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23331|23331 - REMOVE SHOULDER FOREIGN BODY||837.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23330|23330 - REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS||214.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23220|23220 - RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS||2699.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23210|23210 - RADICAL RESECTION TUMOR SCAPULA||2459.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23200|23200 - RADICAL RESECTION TUMOR CLAVICLE||2095.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23195|23195 - RESECTION HUMERAL HEAD||1069.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23190|23190 - OSTECTOMY SCAPULA PARTIAL||801.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23184|23184 - PARTIAL EXCISION BONE PROXIMAL HUMERUS||1045.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23182|23182 - PARTIAL EXCISION BONE SCAPULA||932.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23180|23180 - PARTIAL EXCISION BONE CLAVICLE||956.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23174|23174 - SEQUESTRECTOMY HUMERAL HEAD SURGERY NECK||1071.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23172|23172 - SEQUESTRECTOMY SCAPULA||794.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23170|23170 - SEQUESTRECTOMY CLAVICLE||782.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23156|23156 - EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT||958.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23155|23155 - EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT||1123.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23150|23150 - EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS||933.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23146|23146 - EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT||871.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23145|23145 - EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/AGRFT||983.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23140|23140 - EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA||749.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23130|23130 - PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE||859.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23125|23125 - CLAVICULECTOMY TOTAL||1001.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23120|23120 - CLAVICULECTOMY PARTIAL||826.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23107|23107 - ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB||935.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23106|23106 - ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX||693.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23105|23105 - ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY||903.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23101|23101 - ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG||640.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23100|23100 - ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY||701.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23078|23078 - RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5 CM/>||2049.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23077|23077 - RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM||1652.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23076|23076 - EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM||770.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23075|23075 - EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM||440.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23073|23073 - EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>||993.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23071|23071 - EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>||598.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23066|23066 - BIOPSY SOFT TISSUE SHOULDER DEEP||492.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23065|23065 - BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL||242.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23044|23044 - ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB||813.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23040|23040 - ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB||1021.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23035|23035 - INCISION BONE CORTEX SHOULDER AREA||967.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23031|23031 - I&D SHOULDER INFECTED BURSA||306.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23030|23030 - I&D SHOULDER DEEP ABSCESS/HEMATOMA||362.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23020|23020 - CAPSULAR CONTRACTURE RELEASE||979.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|23000|23000 - REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN||517.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22999|22999 - UNLISTED PX ABDOMEN MUSCULOSKELETAL SYSTEM||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22905|22905 - RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>||1927.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22904|22904 - RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM||1517.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22903|22903 - EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>||624.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22902|22902 - EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM||464.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22901|22901 - EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>||957.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22900|22900 - EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM||784.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22899|22899 - UNLISTED PROCEDURE SPINE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22865|22865 - RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR||2956.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22864|22864 - RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL||2765.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22862|22862 - REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR||3017.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22861|22861 - REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC CRV||2894.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22857|22857 - TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC LMBR||2392.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22856|22856 - TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV||2392.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22855|22855 - REMOVAL ANTERIOR INSTRUMENTATION||1607.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22852|22852 - REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION||985.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22851|22851 - APPLY SPINE PROSTH DEVICE||595.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22850|22850 - REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION||1031.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22849|22849 - REINSERTION SPINAL FIXATION DEVICE||1871.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22848|22848 - PELVIC FIXATION OTHER THAN SACRUM||521.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22847|22847 - ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS||1282.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22846|22846 - ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS||1113.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22845|22845 - ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS||1073.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22844|22844 - POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE||1424.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22843|22843 - POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG||1182.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22842|22842 - POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG||1112.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22841|22841 - INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS||549.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22840|22840 - POSTERIOR NON-SEGMENTAL INSTRUMENTATION||1111.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22830|22830 - EXPLORATION SPINAL FUSION||1159.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22819|22819 - KYPHECTOMY 3 OR MORE SEGMENTS||3940.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22818|22818 - KYPHECTOMY SINGLE OR TWO SEGMENTS||3122.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22812|22812 - ARTHRODESIS ANTERIOR SPINAL DFRM 8/> VRT SEG||3169.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22810|22810 - ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SEG||2928.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22808|22808 - ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SEG||2622.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22804|22804 - ARTHRODESIS POSTERIOR SPINAL DFRM 13/> VRT SEG||3481.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22802|22802 - ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SEG||3024.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22800|22800 - ARTHRODESIS POSTERIOR SPINAL DFRM UP 6 VRT SEG||1941.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22634|22634 - ARTHDSIS POST/POSTERLATRL/POSTINTRBDYADL SPC/SEG||723.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22633|22633 - ARTHDSIS POST/POSTEROLATRL/POSTINTERBODY LUMBAR||2667.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22632|22632 - ARTHRODESIS POSTERIOR INTERBODY EA ADDL||465.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22630|22630 - ARTHRODESIS POSTERIOR INTERBODY LUMBAR||2216.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22614|22614 - ARTHRODESIS POSTERIOR/POSTEROLATERAL EA ADDL||570.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22612|22612 - ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR||2293.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22610|22610 - ARTHRODESIS POSTERIOR/POSTEROLATERAL THORACIC||1799.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22600|22600 - ARTHRODESIS PST/PSTLAT CERVICAL BELW C2 SGM||1841.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22595|22595 - ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2||2152.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22590|22590 - ARTHRODESIS POSTERIOR CRANIOCERVICAL||2261.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22586|22586 - ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5-S1||2230.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22585|22585 - ARTHRODESIS ANTERIOR INTERBODY EA ADDL NTRSPC||490.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22558|22558 - ARTHRODESIS ANTERIOR INTERBODY LUMBAR||2216.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22556|22556 - ARTHRD ANT MIN DISCECTOMY INTERBODY THORACIC||2392.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22554|22554 - ARTHRD ANT MIN DISCECT INTERBODY CERV BELOW C2||1830.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22552|22552 - ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC||572.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22551|22551 - ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2||2481.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22548|22548 - ARTHRD ANT TRANSORL/XTRORAL C1-C2 W/WO EXC ODNTD||2805.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22534|22534 - ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR||527.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22533|22533 - ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR||2411.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22532|22532 - ARTHRODESIS LATERAL EXTRACAVITARY THORACIC||2559.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22527|22527 - PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL||216.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22526|22526 - PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LEVEL||479.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22525|22525 - PERCUT KYPHOPLASTY ADD-ON||375.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22524|22524 - PERCUT KYPHOPLASTY LUMBAR||778.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22523|22523 - PERCUT KYPHOPLASTY THOR||819.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22522|22522 - PERCUT VERTEBROPLASTY ADDL||328.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22521|22521 - PERCUT VERTEBROPLASTY LUMB||703.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22520|22520 - PERCUT VERTEBROPLASTY THOR||740.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22505|22505 - MANIPULATION SPINE REQUIRING ANESTHESIA||170.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22328|22328 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA||412.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22327|22327 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH||2116.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22326|22326 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR||2127.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22325|22325 - OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM||2054.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22319|22319 - OPTX&/RDCTJ ODNTD FX&/DISLC ANT W/INT FIXJ||2614.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22318|22318 - OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT||2340.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22315|22315 - CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ||1096.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22310|22310 - CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING||397.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22305|22305 - CLOSED TX SPINE PROCESS FX||243.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22226|22226 - OSTEOT SPI W/DSKC ANT APPR 1 VRT SGM EA VRT SGM||530.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22224|22224 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM LMBR||2261.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22222|22222 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM THRC||2184.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22220|22220 - OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM CRV||2315.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22216|22216 - OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM||529.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22214|22214 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR||2115.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22212|22212 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC||2100.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22210|22210 - OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV||2533.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22208|22208 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM||852.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22207|22207 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR||3434.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22206|22206 - OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC||3383.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22116|22116 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA||203.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22114|22114 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR||1420.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22112|22112 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC||1515.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22110|22110 - PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV||1541.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22103|22103 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA||206.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22102|22102 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR||1164.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22101|22101 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC||1305.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22100|22100 - PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV||1299.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22015|22015 - I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC||1320.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|22010|22010 - I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR||1343.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21936|21936 - RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>||2028.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21935|21935 - RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM||1478.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21933|21933 - EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>||1063.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21932|21932 - EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM||949.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21931|21931 - EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>||674.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21930|21930 - EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM||520.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21925|21925 - BIOPSY SOFT TISSUE BACK/FLANK DEEP||497.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21920|21920 - BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL||231.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21899|21899 - UNLISTED PROCEDURE NECK/THORAX||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21825|21825 - OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION||797.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21820|21820 - CLOSED TREATMENT STERNUM FRACTURE||199.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21810|21810 - TREATMENT OF RIB FRACTURE(S)||736.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21805|21805 - TREATMENT OF RIB FRACTURE||377.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21800|21800 - TREATMENT OF RIB FRACTURE||155.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21750|21750 - CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX||1016.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21743|21743 - REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC||2834.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21742|21742 - REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC||2153.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21740|21740 - REPAIR PECTUS EXCAVATUM/CARINATUM OPEN||1719.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21725|21725 - DIVISION STERNOCLEIDOMASTOID OPEN W/CAST||686.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21720|21720 - DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST||716.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21705|21705 - DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB||903.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21700|21700 - DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB||565.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21685|21685 - HYOID MYOTOMY & SUSPENSION||1445.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21632|21632 - RADICAL RESECTION STERNUM W/MEDSTNL LMPHADEC||1788.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21630|21630 - RADICAL RESECTION STERNUM||1810.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21627|21627 - STERNAL DEBRIDEMENT||790.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21620|21620 - OSTECTOMY STERNUM PARTIAL||744.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21616|21616 - EXCISION 1ST &/CERVICAL RIB W/SYMPATHECTOMY||1219.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21615|21615 - EXCISION 1ST &/CERVICAL RIB||943.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21610|21610 - COSTOTRANSVERSECTOMY SEPARATE PROCEDURE||1695.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21603|21603 - EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC||2623.79||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21602|21602 - EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC||2366.21||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21601|21601 - EXCISION CHEST WALL TUMOR INCLUDING RIBS||1773.75||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21600|21600 - EXCISION RIB PARTIAL||814.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21558|21558 - RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>||1948.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21557|21557 - RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM||1337.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21556|21556 - EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM||754.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21555|21555 - EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM||439.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21554|21554 - EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>||1050.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21552|21552 - EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>||640.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21550|21550 - BIOPSY SOFT TISSUE NECK/THORAX||225.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21510|21510 - INCISION DEEP OPENING BONE CORTEX THORAX||734.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21502|21502 - I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI||761.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21501|21501 - I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX||457.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21499|21499 - UNLISTED MUSCULOSKELETAL PROCEDURE HEAD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21497|21497 - INTERDENTAL WIRING OTHER THAN FRACTURE||850.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21495|21495 - TREAT HYOID BONE FRACTURE||1011.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21490|21490 - OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION||1329.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21485|21485 - CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ||805.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21480|21480 - CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ||46.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21470|21470 - OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION||1733.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21465|21465 - OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE||1362.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21462|21462 - OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION||1459.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21461|21461 - OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION||1333.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21454|21454 - OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION||835.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21453|21453 - CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION||1092.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21452|21452 - PERCUTANEOUS TX MANDIBULAR FX W/EXTERNAL FIXJ||493.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21451|21451 - CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION||884.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21450|21450 - CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION||681.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21445|21445 - OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX||871.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21440|21440 - CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX||650.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21436|21436 - OPTX CRNFCL SEP LFT III TYP COMP INT FIXJ W/BONE||2978.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21435|21435 - OPEN TX CRANIOFACIAL SEP COMP W/INT&/XTRNL FIX||1975.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21433|21433 - OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR||2401.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21432|21432 - OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ||1023.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21431|21431 - CLOSED TX CRANIOFACIAL SEPARATION||967.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21423|21423 - OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR||1150.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21422|21422 - OPEN TREATMENT PALATAL/MAXILLARY FRACTURE||953.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21421|21421 - CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT||927.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21408|21408 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT||1308.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21407|21407 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT||934.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21406|21406 - OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT||800.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21401|21401 - CLOSED TX FX ORBIT EXCEPT BLOWOUT W/MANIPULATION||435.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21400|21400 - CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION||218.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21395|21395 - OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF||1416.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21390|21390 - OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC||1147.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21387|21387 - OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR||1070.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21386|21386 - OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL||947.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21385|21385 - OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL||995.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21366|21366 - OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT||1741.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21365|21365 - OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG||1610.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21360|21360 - OPEN TX DEPRESSED MALAR FRACTURE||762.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21356|21356 - OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE||540.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21355|21355 - PERCUTANEOUS TX MALAR AREA FRACTURE||466.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21348|21348 - OPTX NASOMAX CPLX FX LEFT II TYPE W/BONE GRAFT||1592.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21347|21347 - OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN||1593.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21346|21346 - OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ||1322.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21345|21345 - CLOSED TX NASOMAXILLARY COMPLEX FRACTURE||918.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21344|21344 - OPEN TX COMPLICATED FRONTAL SINUS FRACTURE||2281.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21343|21343 - OPEN TX DEPRESSED FRONTAL SINUS FRACTURE||1745.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21340|21340 - PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE||1174.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21339|21339 - OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION||1132.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21338|21338 - OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION||1074.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21337|21337 - CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION||422.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21336|21336 - OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION||926.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21335|21335 - OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM||1049.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21330|21330 - OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI||813.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21325|21325 - OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED||669.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21320|21320 - CLOSED TREATMENT NASAL FRACTURE W/STABILIZATION||196.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21315|21315 - CLOSED TX NASAL FRACTURE W/O STABILIZATION||219.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21310|21310 - CLOSED TREATMENT NASAL FRACTURE W/O MANIPULATION||40.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21299|21299 - UNLISTED CRANIOFACIAL & MAXILLOFACIAL PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21296|21296 - REDUCTION MASSETER MUSCLE & BONE INTRAORAL||607.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21295|21295 - REDUCTION MASSETER MUSCLE & BONE EXTRAORAL||260.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21282|21282 - LATERAL CANTHOPEXY||537.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21280|21280 - MEDIAL CANTHOPEXY SEPARATE PROCEDURE||818.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21275|21275 - SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ||1214.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21270|21270 - MALAR AUGMENTATION PROSTHETIC MATERIAL||1052.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21268|21268 - ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC||2594.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21267|21267 - ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL||2227.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21263|21263 - PERIORBITAL OSTEOTOMIES W/BONE GRAFTS W/FOREHEAD||2697.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21261|21261 - PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA & XTR||3139|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21260|21260 - PERIORBITAL OSTEOTOMIES BONE GRAFTS EXTRACRANIAL||1760.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21256|21256 - RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS||1714.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21255|21255 - RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG||1992.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21249|21249 - RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE||1759.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21248|21248 - RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL||1267.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21247|21247 - RCNSTJ MNDBLR CONDYLE W/BONE CARTLG AUTOGRAFTS||2411.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21246|21246 - RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE||1199.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21245|21245 - RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL||1295.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21244|21244 - RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE||1520.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21243|21243 - ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT||2387.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21242|21242 - ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT||1437.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21240|21240 - ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT||1567.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21235|21235 - GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR||820.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21230|21230 - GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR||1116.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21215|21215 - GRAFT BONE MANDIBLE||1292.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21210|21210 - GRAFT BONE NASAL/MAXILLARY/MALAR AREAS||1207.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21209|21209 - OSTEOPLASTY FACIAL BONES REDUCTION||936.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21208|21208 - OSTEOPLASTY FACIAL BONES AUGMENTATION||1215.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21206|21206 - OSTEOTOMY MAXILLA SEGMENTAL||1709.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21199|21199 - OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT||1470.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21198|21198 - OSTEOTOMY MANDIBLE SEGMENTAL||1661.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21196|21196 - RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI||2115.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21195|21195 - RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD||1933.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21194|21194 - RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT||1998.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21193|21193 - RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF||1885.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21188|21188 - RCNSTJ MDFC OTH/THN LEFORT OSTEOT & BONE GRAFTS||2297.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21184|21184 - RCNSTJ ORBIT/FHD/NASETHMD EXC BONE TUM GRF>80SQ||3438.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21183|21183 - RCNSTJ ORBIT/FHD/NASETHMD EXC BONE GRF>40 <80||3356.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21182|21182 - RCNSTJ ORBIT/FHD/NASETHMD EXCBONE TUM GRF<40SQCM||2827.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21181|21181 - RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC||1016.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21180|21180 - RCNSTJ FOREHEAD &/ SUPRAORBITAL RIMS W/AUTOGRAFT||2264.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21179|21179 - RCNSTJ FOREHEAD &/ SUPRAORB RIMS W/ALGRF/PROSTC||2087.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21175|21175 - RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD||3295.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21172|21172 - RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD||2603.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21160|21160 - RCNSTJ MIDFACE LEFORT III W/FHD W/LEFORT I||3793.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21159|21159 - RCNSTJ MIDFACE LEFORT III W/FHD W/O LEFORT I||3623.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21155|21155 - RCNSTJ MIDFACE LEFORT III W/LEFORT I||3121.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21154|21154 - RCNSTJ MIDFACE LEFORT III W/O LEFORT I||3104.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21151|21151 - RCNSTJ MIDFACE LEFORT II W/BONE GRAFTS||2756.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21150|21150 - RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION||2370.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21147|21147 - RCNSTJ MIDFACE LEFORT I 3/> PIECE W/BONE GRAFTS||2368.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21146|21146 - RCNSTJ MIDFACE LEFORT I 2 PIECES W/BONE GRAFTS||2505.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21145|21145 - RCNSTJ MIDFACE LEFORT I 1 PIECE W/BONE GRAFTS||2198.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21143|21143 - RCNSTJ MIDFACE LEFORT I 3/> PIECE W/O BONE GRAFT||2107.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21142|21142 - RCNSTJ MIDFACE LEFORT I 2 PIECES W/O BONE GRAFT||2031.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21141|21141 - RCNSTJ MIDFACE LEFORT I 1 PIECE W/O BONE GRAFT||1991.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21139|21139 - RDCTJ FHD CNTRG & SETBACK ANT FRONTAL SINUS WALL||1519.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21138|21138 - RDCTJ FHD CNTRG & PROSTHETIC MATRL/BONE GRAFT||1276.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21137|21137 - REDUCTION FOREHEAD CONTOURING ONLY||1086.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21127|21127 - AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL||1222.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21125|21125 - AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL||1130.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21123|21123 - GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS||1197.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21122|21122 - GENIOPLASTY 2/> SLIDING OSTEOTOMIES||918.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21121|21121 - GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE||894.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21120|21120 - GENIOPLASTY AUGMENTATION||766.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21116|21116 - INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY||60.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21110|21110 - APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC||925.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21100|21100 - APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX||550.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21089|21089 - UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21088|21088 - IMPRESSION & PREPARATION FACIAL PROSTHESIS||2374.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21087|21087 - IMPRESSION & PREPARATION NASAL PROSTHESIS||2178.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21086|21086 - IMPRESSION & PREPARATION AURICULAR PROSTHESIS||2194.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21085|21085 - IMPRESSION & PREPARATION ORAL SURGICAL SPLINT||907.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21084|21084 - IMPRESSION & PREPARATION SPEECH AID PROSTHESIS||2038.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21083|21083 - IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS||1703.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21082|21082 - IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES||1892.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21081|21081 - IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES||2023.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21080|21080 - IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES||2211.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21079|21079 - IMPRESSION & PREPARATION INTERIM OBTURATOR PROST||1984.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21077|21077 - IMPRESSION & PREPARATION ORBITAL PROSTHESIS||2984.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21076|21076 - IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES||1182.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21073|21073 - MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA||363.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21070|21070 - CORONOIDECTOMY SEPARATE PROCEDURE||892.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21060|21060 - MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX||1184.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21050|21050 - CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX||1254.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21049|21049 - EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC||1781.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21048|21048 - EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT||1598.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21047|21047 - EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB||1868.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21046|21046 - EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT||1559.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21045|21045 - EXCISION MALIGNANT TUMOR MANDIBLE RADICAL||1774.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21044|21044 - EXCISION MALIGNANT TUMOR MANDIBLE||1270.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21040|21040 - EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT||586.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21034|21034 - EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA||1683.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21032|21032 - EXCISION MAXILLARY TORUS PALATINUS||405|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21031|21031 - EXCISION TORUS MANDIBULARIS||408.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21030|21030 - EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG||586.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21029|21029 - REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE||925.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21026|21026 - EXCISION FACIAL BONE||702.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21025|21025 - EXCISION BONE MANDIBLE||1064.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21016|21016 - RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>||1501.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21015|21015 - RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM||986|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21014|21014 - EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>||750.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21013|21013 - EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM||581.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21012|21012 - EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>||483.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21011|21011 - EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM||370.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|21010|21010 - ARTHROTOMY TEMPOROMANDIBULAR JOINT||1054.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20999|20999 - UNLISTED PROCEDURE MUSCSKELETAL SYSTEM GENERAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20985|20985 - CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS||213.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20982|20982 - ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE||552.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20979|20979 - LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE||48.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20975|20975 - ELECTRICAL STIMULATION BONE HEALING INVASIVE||253.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20974|20974 - ELECTRICAL STIMULATION BONE HEALING NONINVASIVE||69.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20973|20973 - FR OSTQ FLAP W/MVASC ANAST GRT TOE W/WEB SPACE||3958.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20972|20972 - FREE OSTQ FLAP W/MVASC ANASTOMOSIS METATARSAL||3247.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20970|20970 - FREE OSTQ FLAP W/MVASC ANASTOMOSIS ILIAC CREST||4025.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20969|20969 - FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE||4058.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20962|20962 - BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR||3280.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20957|20957 - BONE GRAFT MICROVASCULAR ANAST METATARSAL||3867.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20956|20956 - BONE GRAFT MICROVASCULAR ANAST ILIAC CREST||3795.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20955|20955 - BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA||3660.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20950|20950 - MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME||129.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20938|20938 - AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC||267.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20937|20937 - AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION||243.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20936|20936 - AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION||179.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20934|20934 - INTERCALARY ALLOGRAFT COMPLETE||1087.99||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20933|20933 - HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL||998.38||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20932|20932 - OSTEOARTICULAR ALLOGRAFT W/ARTICULAR SURF & BONE||1088.53||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20931|20931 - ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL||162.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20930|20930 - ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED||171.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20926|20926 - TISSUE GRAFTS OTHER||622.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20924|20924 - TENDON GRAFT FROM A DISTANCE||719.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20922|20922 - FASCIA LATA GRAFT INCISION & AREA EXPOSURE||706.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20920|20920 - FASCIA LATA GRAFT BY STRIPPER||572.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20912|20912 - CARTILAGE GRAFT NASAL SEPTUM||695.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20910|20910 - CARTILAGE GRAFT COSTOCHONDRAL||638.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20902|20902 - BONE GRAFT ANY DONOR AREA MAJOR/LARGE||452.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20900|20900 - BONE GRAFT ANY DONOR AREA MINOR/SMALL||314.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20838|20838 - REPLANTATION FOOT COMPLETE AMPUTATION||3680.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20827|20827 - RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION||2673.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20824|20824 - RPLJ THMB CARP/MTCRPL JT MP JT COMPL AMPUTATION||3144.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20822|20822 - RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP||2588.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20816|20816 - RPLJ DGT EXCEPT THMB MTCARPHLNGL JT COMPL AMP||3035.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20808|20808 - REPLANTATION HAND COMPLETE AMPUTATION||5754.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20805|20805 - REPLANTATION FOREARM COMPLETE AMPUTATION||4169.65|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20802|20802 - REPLANTATION ARM COMPLETE AMPUTATION||3319.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20705|20705 - REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE||182.46||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20704|20704 - MANUAL PREP&INSJ I-ARTIC DRUG DELIVERY DEVICE||221.79||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20703|20703 - REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE||152.54||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20702|20702 - MANUAL PREP&INSJ INTRAMEDULLARY DRUG DLVR DEVICE||212.9||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20701|20701 - REMOVAL DEEP DRUG DELIVERY DEVICE||95.4||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20700|20700 - MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV||127.91||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20697|20697 - XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT||2623.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20696|20696 - XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ||1577.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20694|20694 - REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES||477.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20693|20693 - ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES||645.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20692|20692 - APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM||1569.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20690|20690 - APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM||830.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20680|20680 - REMOVAL IMPLANT DEEP||605.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20670|20670 - REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE||209.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20665|20665 - REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL||127.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20664|20664 - APPL HALO 6/> PINS THIN SKULL OSTEOLOGY||1221.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20663|20663 - APPLICATION HALO FEMORAL INCLUDING REMOVAL||580.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20662|20662 - APPLICATION HALO PELVIC INCLUDING REMOVAL||620.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20661|20661 - APPLICATION HALO CRANIAL INCLUDING REMOVAL||707.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20660|20660 - APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX||350.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20650|20650 - INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX||217.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20615|20615 - ASPIRATION & INJECTION TREATMENT BONE CYST||227.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20612|20612 - ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ||83.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20610|20610 - ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US||98.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2060F|2060F - PT INTRVWD BY EVAL CLINICIAN </DATE DIAG MDD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20605|20605 - ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US||58.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20600|20600 - ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US||55.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20561|20561 - NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES||38.43||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20560|20560 - NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES||25.44||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20555|20555 - PLACEMENT NEEDLES MUSCLE SUBSEQUENT RADIOELEMENT||476.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20553|20553 - INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES||60.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20552|20552 - INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES||53.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20551|20551 - INJECTION SINGLE TENDON ORIGIN/INSERTION||60.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20550|20550 - INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS||59.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20527|20527 - INJECTION ENZYME PALMAR FASCIAL CORD||85.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20526|20526 - INJECTION THERAPEUTIC CARPAL TUNNEL||81.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20525|20525 - RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP||356.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20520|20520 - REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE||207.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2050F|2050F - WOUND CHARACTERISTICS DOCD PRIOR DEBRIDEMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20501|20501 - INJECTION SINUS TRACT DIAGNOSTIC||55.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20500|20500 - INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC||124.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2044F|2044F - DOC MNTL HLTH ASSES PRIOR INTVN BACK PAIN 6WKS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2040F|2040F - PHYS EXAM ON DATE OF INIT VST FOR LBP DONE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2035F|2035F - TYMPANIC MEMBRANE MOBILITY ASSESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2031F|2031F - HYDRATION STATUS DOCUMENTED DEHYDRATED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2030F|2030F - HYDRATION STATUS DOCD NORMALLY HYDRATED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2029F|2029F - COMPLETE PHYSICAL SKIN EXAM PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2028F|2028F - FOOT EXAMINATION PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2027F|2027F - OPTIC NERVE HEAD EVALUATION PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2026F|2026F - EYE IMG VALID MATCH DX 7 STND FLD W/EVC RTNOPTHY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20251|20251 - BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL||591.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20250|20250 - BIOPSY VERTEBRAL BODY OPEN THORACIC||544.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2024F|2024F - 7 STANDARD FLD RETINAL PHOTO W/EVC RTNOPTHY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20245|20245 - BIOPSY BONE OPEN DEEP||895.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20240|20240 - BIOPSY BONE OPEN SUPERFICIAL||316.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2022F|2022F - DILATED RETINAL EXAM W/EVIDENCE OF RETINOPATHY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20225|20225 - BIOPSY BONE TROCAR/NEEDLE DEEP||160.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20220|20220 - BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL||104.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2021F|2021F - DILATED MACULAR OR FUNDUS EXAM PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2020F|2020F - DILATED FUNDUS EVALUATION PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20206|20206 - BIOPSY MUSCLE PERCUTANEOUS NEEDLE||85.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20205|20205 - BIOPSY MUSCLE DEEP||218.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20200|20200 - BIOPSY MUSCLE SUPERFICIAL||136.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2019F|2019F - DILATED MACULAR EXAM PERFORMED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2018F|2018F - HYDRATION STATUS ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2016F|2016F - ASTHMA RISK ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2015F|2015F - ASTHMA IMPAIRMENT ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20150|20150 - EXCISION EPIPHYSEAL BAR||1424.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2014F|2014F - MENTAL STATUS ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2010F|2010F - VITAL SIGNS RECORDED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20103|20103 - EXPLORATION PENETRATING WOUND SPX EXTREMITY||504.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20102|20102 - EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK||360.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20101|20101 - EXPLORATION PENETRATING WOUND SPX CHEST||296.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20100|20100 - EXPLORATION PENETRATING WOUND SPX NECK||865.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2004F|2004F - INITIAL EXAMINATION INVOLVED JOINTS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2002F|2002F - CLINICAL SIGNS VOLUME OVERLOAD ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2001F|2001F - WEIGHT RECORDED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|2000F|2000F - BLOOD PRESSURE MEASURED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|20005|20005 - I&D SOFT TISSUE ABSCESS SUBFASC||330.86|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|19499|19499 - UNLISTED PROCEDURE BREAST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19396|19396 - PREPARATION MOULAGE CUSTOM BREAST IMPLANT||210.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19380|19380 - REVISION RECONSTRUCTED BREAST||1117.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19371|19371 - PERIPROSTHETIC CAPSULECTOMY BREAST||1134.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19370|19370 - OPEN PERIPROSTHETIC CAPSULOTOMY BREAST||990.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19369|19369 - BREAST RECONSTRUCTION TRAM FLAP DOUBLE PEDICLE||2991.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19368|19368 - BREAST RECONSTRUCTION TRAM 1 PEDCL MVASC ANAST||3231.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19367|19367 - BREAST RECONSTRUCTION TRAM FLAP 1 PEDICLE||2616.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19366|19366 - BREAST RECONSTRUCTION OTHER TECHNIQUE||1993.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19364|19364 - BREAST RECONSTRUCTION FREE FLAP||4036.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19361|19361 - BRST RCNSTJ W/LATSMS D/SI FLAP WO PRSTHC IMPL||2326.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19357|19357 - BRST RCNSTJ IMMT/DLYD W/TISS EXPANDER SBSQ XPNSJ||2155.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19355|19355 - CORRECTION INVERTED NIPPLES||812.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19350|19350 - NIPPLE/AREOLA RECONSTRUCTION||974.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19342|19342 - DLYD INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ||1336.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19340|19340 - IMMT INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNSTJ||1365.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19330|19330 - REMOVAL MAMMARY IMPLANT MATERIAL||912.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19328|19328 - REMOVAL INTACT MAMMARY IMPLANT||713.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19325|19325 - MAMMAPLASTY AUGMENTATION W/PROSTHETIC IMPLANT||932.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19324|19324 - MAMMAPLASTY AUGMENTATION W/O PROSTHETIC IMPLANT||693.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19318|19318 - REDUCTION MAMMAPLASTY||1611.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19316|19316 - MASTOPEXY||1115.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19307|19307 - MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN||1688.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19306|19306 - MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES||1693.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19305|19305 - MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES||1601.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19304|19304 - MASTECTOMY SUBCUTANEOUS||806.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19303|19303 - MASTECTOMY SIMPLE COMPLETE||1423.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19302|19302 - MASTECTOMY PARTIAL W/AXILLARY LYMPHADENECTOMY||1269.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19301|19301 - MASTECTOMY PARTIAL||918.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19300|19300 - MASTECTOMY GYNECOMASTIA||573.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19298|19298 - PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST||462.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19297|19297 - PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST||135.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19296|19296 - PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST||300.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19295|19295 - PLACE BREAST CLIP PERCUT||122.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19291|19291 - PLACE NEEDLE WIRE BREAST||45.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19290|19290 - PLACE NEEDLE WIRE BREAST||92.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19272|19272 - EXC CHEST TUMOR W/RCNSTJ W/MEDSTNL LMPHADEC||2584.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19271|19271 - EXC CHEST TUMOR W/RCNSTJ W/O MEDSTNL LMPHADEC||2340.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19260|19260 - EXCISION CHEST WALL TUMOR INCLUDING RIBS||1724.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19126|19126 - EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL||231.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19125|19125 - EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES||644.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19120|19120 - EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION||580.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19112|19112 - EXCISION LACTIFEROUS DUCT FISTULA||435.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19110|19110 - NIPPLE EXPLORATION||477.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19105|19105 - ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA||285.74|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19103|19103 - BX BREAST PERCUT W/DEVICE||275.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19102|19102 - BX BREAST PERCUT W/IMAGE||147.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19101|19101 - BIOPSY BREAST OPEN INCISIONAL||313.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19100|19100 - BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX||100.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19030|19030 - INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM||111.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19020|19020 - MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP||426.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19001|19001 - PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST||31.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|19000|19000 - PUNCTURE ASPIRATION CYST BREAST||63.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17999|17999 - UNLISTED PX SKIN MUC MEMBRANE & SUBQ TISSUE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17380|17380 - ELECTROLYSIS EPILATION EACH 30 MINUTES||108.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17360|17360 - CHEMICAL EXFOLIATION ACNE||141.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17340|17340 - CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE||68.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17315|17315 - MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE||76.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17314|17314 - MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE||270.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17313|17313 - MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS||492.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17312|17312 - MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE||291.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17311|17311 - MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS||548.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17286|17286 - DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM||414.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17284|17284 - DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM||302.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17283|17283 - DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM||259.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17282|17282 - DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM||207.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17281|17281 - DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM||179.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17280|17280 - DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<||129.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17276|17276 - DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM||306.51|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17274|17274 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM||254.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17273|17273 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM||208.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17272|17272 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM||184.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17271|17271 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM||159.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17270|17270 - DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>||143.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17266|17266 - DESTRUCTION MAL LESION TRUNK/ARM/LEG > 4.0 CM||231.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17264|17264 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM||198.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17263|17263 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM||185.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17262|17262 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM||167.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17261|17261 - DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM||131.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17260|17260 - DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<||98.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17250|17250 - CHEMICAL CAUTERIZATION OF GRANULATION TISSUE||51.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17111|17111 - DESTRUCTION BENIGN LESIONS 15/>||182.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17110|17110 - DESTRUCTION BENIGN LESIONS UP TO 14||97.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17108|17108 - DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM||753.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17107|17107 - DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM||503.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17106|17106 - DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM||392.32|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17004|17004 - DESTRUCTION PREMALIGNANT LESION 15/>||188.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17003|17003 - DESTRUCTION PREMALIGNANT LESION 2-14 EA||6.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|17000|17000 - DESTRUCTION PREMALIGNANT LESION 1ST||79.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|16036|16036 - ESCHAROTOMY EACH ADDITIONAL INCISION||121.01|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|16035|16035 - ESCHAROTOMY FIRST INCISION||290.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|16030|16030 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE||190.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|16025|16025 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM||160.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|16020|16020 - DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL||76.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|16000|16000 - INITIAL TX 1ST DEGREE BURN LOCAL TX||66.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15999|15999 - UNLISTED PROCEDURE EXCISION PRESSURE ULCER||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15958|15958 - EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC||1695.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15956|15956 - EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN||1663.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15953|15953 - EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY||1428.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15952|15952 - EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE||1304.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15951|15951 - EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY||1250.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15950|15950 - EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR||830.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15946|15946 - EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN||2367.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15945|15945 - EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY||1425.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15944|15944 - EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE||1287.73|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15941|15941 - EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT||1286.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15940|15940 - EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE||994.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15937|15937 - EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC||1497.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15936|15936 - EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR||1286.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15935|15935 - EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY||1588.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15934|15934 - EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR||1323.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15933|15933 - EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY||1200.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15931|15931 - EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE||970.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15922|15922 - EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR||1119.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15920|15920 - EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR||871.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15879|15879 - SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15878|15878 - SUCTION ASSISTED LIPECTOMY UPPER EXTREMITY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15877|15877 - SUCTION ASSISTED LIPECTOMY TRUNK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15876|15876 - SUCTION ASSISTED LIPECTOMY HEAD & NECK||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15860|15860 - IV INJECTION TEST VASCULAR FLOW FLAP/GRAFT||160.66|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15852|15852 - DRESSING CHANGE UNDER ANESTHESIA||67.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15851|15851 - REMOVAL SUTURES UNDER ANESTHESIA OTHER SURGEON||67.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15850|15850 - REMOVAL SUTURES UNDER ANESTHESIA SAME SURGEON||56.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15847|15847 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE ABDOMEN||716.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15845|15845 - GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR||1413.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15842|15842 - GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG||3601.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15841|15841 - GRAFT FACIAL NERVE PARALYSIS FREE MUSCLE GRAFT||2344.9|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15840|15840 - GRAFT FACIAL NERVE PARALYSIS FREE FASCIAL GRAFT||1471.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15839|15839 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA||1052.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15838|15838 - EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD||826.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15837|15837 - EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND||1013.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15836|15836 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM||1078.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15835|15835 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK||1226.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15834|15834 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP||1274.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15833|15833 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG||1256.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15832|15832 - EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH||1300.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15830|15830 - EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY||1682.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15829|15829 - RHYTIDECTOMY SMAS FLAP||3888.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15828|15828 - RHYTIDECTOMY CHEEK CHIN & NECK||3479.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15826|15826 - RHYTIDECTOMY GLABELLAR FROWN LINES||1330.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15825|15825 - RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING||1841.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15824|15824 - RHYTIDECTOMY FOREHEAD||1636.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15823|15823 - BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN||788.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15822|15822 - BLEPHAROPLASTY UPPER EYELID||553.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15821|15821 - BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD||778.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15820|15820 - BLEPHAROPLASTY LOWER EYELID||730.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15819|15819 - CERVICOPLASTY||1084.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15793|15793 - CHEMICAL PEEL NONFACIAL DERMAL||516.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15792|15792 - CHEMICAL PEEL NONFACIAL EPIDERMAL||368.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15789|15789 - CHEMICAL PEEL FACIAL DERMAL||600.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15788|15788 - CHEMICAL PEEL FACIAL EPIDERMAL||349.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15787|15787 - ABRASION EACH ADDITIONAL 4 LESIONS OR LESS||25.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15786|15786 - ABRASION 1 LESION||198.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15783|15783 - DERMABRASION SUPERFICIAL ANY SITE||532.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15782|15782 - DERMABRASION REGIONAL OTHER THAN FACE||604.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15781|15781 - DERMABRASION SEGMENTAL FACE||613.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15780|15780 - DERMABRASION TOTAL FACE||902.84|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15777|15777 - IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT||308.58|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15776|15776 - PUNCH GRAFT HAIR TRANSPLANT >15 PUNCH GRAFTS||426.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15775|15775 - PUNCH GRAFT HAIR TRANSPLANT 1-15 PUNCH GRAFTS||308.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15774|15774 - GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 25 CC||204.83||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15773|15773 - GRAFTING OF AUTOLOGOUS FAT BY LIPO 25 CC OR LESS||716.69||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15772|15772 - GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 50 CC||213.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15771|15771 - GRAFTING OF AUTOLOGOUS FAT BY LIPO 50 CC OR LESS||708.87||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15770|15770 - GRAFT DERMA-FAT-FASCIA||964.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15769|15769 - GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC||713.33||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15760|15760 - GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA||1024.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15758|15758 - FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS||3371.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15757|15757 - FREE SKIN FLAP W/MICROVASCULAR ANASTOMOSIS||3366.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15756|15756 - FREE MUSCLE/MYOCUTANEOUS FLAP W/MVASC ANAST||3423.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15750|15750 - FLAP NEUROVASCULAR PEDICLE||1316.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15740|15740 - FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY||1235.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15738|15738 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR||1811.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15736|15736 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR||1671.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15734|15734 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK||1931.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15732|15732 - MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP HEAD&NC||1648.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15731|15731 - FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE||1472.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15650|15650 - TRANSFER ANY PEDICLE FLAP ANY LOCATION||553.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15630|15630 - DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS||497.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15620|15620 - DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F||463.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15610|15610 - DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS||343.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15600|15600 - DELAY FLAP/SECTIONING FLAP TRUNK||295.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15576|15576 - FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL||969.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15574|15574 - FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F||1102.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15572|15572 - FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS||1064.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15570|15570 - FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK||1053.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15278|15278 - SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM ADL 100SQ CM||79.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15277|15277 - SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM 1ST 100SQ CM||312.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15276|15276 - SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM||36.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15275|15275 - SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM||147.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15274|15274 - APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM||63.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15273|15273 - APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM||301.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15272|15272 - APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC||25.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15271|15271 - APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25||126.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15261|15261 - FTH/GFT FREE W/DIR CLSR N/E/E/L EA 20 SQ CM/<||206.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15260|15260 - FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<||1238.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15241|15241 - FTH/GT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA20CM/<||163.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15240|15240 - FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<||1150.77|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15221|15221 - FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<||105.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15220|15220 - FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<||886.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15201|15201 - FTH/GFT FR W/DIR CLSR TRNK EA ADDL 20 CM/<||116.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15200|15200 - FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<||959.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15157|15157 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT EA 100 EA||242.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15156|15156 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM||244.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15155|15155 - CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<||901.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15152|15152 - CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA||224.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15151|15151 - CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM||160.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15150|15150 - CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<||905.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15136|15136 - DERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA||116.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15135|15135 - DERMAL AUTOGRAFT F/S/N/H/F/G/M/D GT 1ST 100||1100.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15131|15131 - DERMAL AUTOGRAFT TRUNK/ARM/LEG EA 100 CM/EA||133.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15130|15130 - DERMAL AUTOGRAFT TRUNK/ARM/LEG 1ST 100 CM||810.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15121|15121 - SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %||194.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15120|15120 - SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %||1022.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15116|15116 - EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT EA 100 CM||223.3|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15115|15115 - EPIDERMAL AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/<||1091.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15111|15111 - EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD||148.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15110|15110 - EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD||1076.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15101|15101 - SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD||159.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15100|15100 - SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD||1032.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15050|15050 - PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM||637.88|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15040|15040 - HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<||182.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15005|15005 - PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT||132.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15004|15004 - PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT||391.21|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15003|15003 - PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT||66.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|15002|15002 - PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT||327.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1494F|1494F - COGNITION ASSESSED AND REVIEWED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1493F|1493F - DEMENTIA SEVERITY CLASSIFIED SEVERE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1491F|1491F - DEMENTIA SEVERITY CLASSIFIED MODERATE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1490F|1490F - DEMENTIA SEVERITY CLASSIFIED MILD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1461F|1461F - NO QUAL CARD EVENT/DIAG IN PREVIOUS 12 MONTHS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1460F|1460F - QUALIFYING CARD EVENT/DIAGNOSIS PRIOR 12 MONTHS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1451F|1451F - SYMPTOMS SHOW CLIN IMPRTNT DROP SINCE ASSESSMENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1450F|1450F - SYMPTOMS IMPROVED/CONSIST W/TXMNT GOAL ASSESSMNT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14350|14350 - FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE||1033.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14302|14302 - ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM||325.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14301|14301 - ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM||1290.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14061|14061 - ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM||1204.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14060|14060 - ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<||974.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14041|14041 - ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM||1128.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14040|14040 - ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<||918.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14021|14021 - ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM||1041.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14020|14020 - ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<||819.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1400F|1400F - PARKINSON DISEASE DIAGNOSIS REVIEWED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14001|14001 - ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM||944.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|14000|14000 - ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<||722.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13160|13160 - SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC||1158.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13153|13153 - REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<||206.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13152|13152 - REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM||608.2|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13151|13151 - REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM||453.55|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13150|13150 - CMPLX RPR E/N/E/L 1.0 CM/<||393.28|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13133|13133 - REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<||191.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13132|13132 - REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM||817.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13131|13131 - REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM||393.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13122|13122 - REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<||124.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13121|13121 - REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM||467.4|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13120|13120 - REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM||350.19|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13102|13102 - REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<||108.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13101|13101 - REPAIR COMPLEX TRUNK 2.6-7.5 CM||406.23|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|13100|13100 - REPAIR COMPLEX TRUNK 1.1-2.5 CM||334.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1220F|1220F - PATIENT SCREENED DEPRESSION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1205F|1205F - ETIOLOGY OF EPILEPSY SYNDROME RVWD & DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12057|12057 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM||574.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12056|12056 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM||527.92|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12055|12055 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM||424.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12054|12054 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM||328.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12053|12053 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM||311.16|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12052|12052 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM||295.27|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12051|12051 - REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<||362.05|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12047|12047 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM||484.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12046|12046 - RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM||430.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12045|12045 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM||376.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12044|12044 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM||306.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12042|12042 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM||404.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12041|12041 - REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<||222.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12037|12037 - REPAIR INTERMEDIATE S/A/T/E >30.0 CM||469.49|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12036|12036 - REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM||401.98|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12035|12035 - REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM||342.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12034|12034 - REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM||294.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12032|12032 - REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM||278.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12031|12031 - REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<||217.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12021|12021 - TX SUPERFICIAL WOUND DEHISCENCE W/PACKING||199.67|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12020|12020 - TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE||266.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12018|12018 - SIMPLE REPAIR F/E/E/N/L/M >30.0 CM||274.7|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12017|12017 - SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM||237.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12016|12016 - SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM||206.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12015|12015 - SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM||153.41|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12014|12014 - SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM||124.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12013|12013 - SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM||98.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12011|12011 - SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<||87.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1200F|1200F - SEIZURE TYPE FREQUENCY DOCUMENTED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12007|12007 - SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM||229.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12006|12006 - SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM||187.76|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12005|12005 - SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM||153.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12004|12004 - SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM||115.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12002|12002 - SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM||93.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|12001|12001 - SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<||71.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11983|11983 - RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT||248.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11982|11982 - REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT||141.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11981|11981 - INSJ NON-BIODEGRADABLE DRUG DELIVERY IMPLANT||118.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11980|11980 - SUBCUTANEOUS HORMONE PELLET IMPLANTATION||117.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11976|11976 - REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES||139.94|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11975|11975 - INSERT CONTRACEPTIVE CAP||204.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11971|11971 - REMOVAL TISS EXPANDER W/O INSERTION PROSTHESIS||450.63|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11970|11970 - REPLACEMENT TISS EXPANDER PERMANENT PROSTHESIS||878.56|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11960|11960 - INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ||1283.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11954|11954 - SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC||168.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11952|11952 - SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC||149.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11951|11951 - SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC||108.81|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11950|11950 - SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<||70.09|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11922|11922 - TATTOOING INCL MICROPIGMENTATION EA 20.0 CM||43.02|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11921|11921 - TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM||195.85|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11920|11920 - TATTOOING INCL MICROPIGMENTATION 6.0 CM/<||167.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11901|11901 - INJECTION INTRALESIONAL >7 LESIONS||70.36|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11900|11900 - INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS||45.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1183F|1183F - NEUROPSYCHIATRIC SYMPTOMS ABSENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1182F|1182F - NEUROPSYCHIATRIC SYMPTOMS ONE OR MORE PRESENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1181F|1181F - NEUROPSYCHIATRIC SYMPTS ASSESSED RESULTS REVIEWD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1180F|1180F - THROMBOEMBOLIC RISK ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11772|11772 - EXCISION PILONIDAL CYST/SINUS COMPLICATED||804.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11771|11771 - EXCISION PILONIDAL CYST/SINUS EXTENSIVE||610.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11770|11770 - EXCISION PILONIDAL CYST/SINUS SIMPLE||259.48|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11765|11765 - WEDGE EXCISION SKIN NAIL FOLD||127.97|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11762|11762 - RECONSTRUCTION NAIL BED W/GRAFT||267.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11760|11760 - REPAIR NAIL BED||189.53|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1175F|1175F - FUNCTIONAL STATUS DEMENTIA ASSESS RESULTS RVWD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11755|11755 - BIOPSY NAIL UNIT SEPARATE PROCEDURE||113.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11752|11752 - REMOVE NAIL BED/TIP||369.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11750|11750 - EXCISION NAIL MATRIX PERMANENT REMOVAL||306.79|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11740|11740 - EVACUATION SUBUNGUAL HEMATOMA||45.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11732|11732 - AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL||30.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11730|11730 - AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1||74.62|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11721|11721 - DEBRIDEMENT NAIL ANY METHOD 6/>||36.8|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11720|11720 - DEBRIDEMENT NAIL ANY METHOD 1-5||21.89|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11719|11719 - TRIMMING NONDYSTROPHIC NAILS ANY NUMBER||11.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1170F|1170F - FUNCTIONAL STATUS ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11646|11646 - EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM||572.93|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11644|11644 - EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM||412.03|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11643|11643 - EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM||331.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11642|11642 - EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM||264.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11641|11641 - EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM||224.54|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11640|11640 - EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<||177.82|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11626|11626 - EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM||424.12|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11624|11624 - EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM||344.38|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11623|11623 - EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM||303.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11622|11622 - EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM||245.57|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11621|11621 - EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM||213.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11620|11620 - EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<||170.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1160F|1160F - RVW ALL MEDS BY RXNG PRCTIONR OR CLIN RPH DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11606|11606 - EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM||455.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11604|11604 - EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM||306.61|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11603|11603 - EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM||278.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11602|11602 - EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM||233.33|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11601|11601 - EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM||212.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11600|11600 - EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<||168.44|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1159F|1159F - MEDICATION LIST DOCUMENTED IN MEDICAL RECORD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1158F|1158F - ADVNC CARE PLANNING TLK DOCD IN MED RCRD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1157F|1157F - ADVNC CARE PLAN OR EQV LGL DOC IN MED RCRD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1153F|1153F - DOC ADVANCED DISEASE DX CARE GOALS W/O COMFORT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1152F|1152F - DOC ADVANCED DISEASE DX CARE GOALS COMFORT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1151F|1151F - DOC PT W/O SUBSTANTIAL RISK DEATH WITHIN 1 YEAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1150F|1150F - DOC PT W/SUBSTANTIAL RISK DEATH WITHIN 1 YEAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11471|11471 - EXCISION H/P/P/U COMPLEX REPAIR||492.22|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11470|11470 - EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR||394.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11463|11463 - EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR||459.06|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11462|11462 - EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR||338.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11451|11451 - EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR||455.43|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11450|11450 - EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR||351.08|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11446|11446 - EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM||461.78|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11444|11444 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM||323.68|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11443|11443 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM||253.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11442|11442 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM||262.29|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11441|11441 - EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM||185.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11440|11440 - EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<||143.72|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11426|11426 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM||389.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11424|11424 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM||254.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11423|11423 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM||222.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11422|11422 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM||190.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11421|11421 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM||157|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11420|11420 - EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<||115.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11406|11406 - EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM||346.26|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11404|11404 - EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM||227.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11403|11403 - EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM||264.52|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11402|11402 - EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM||228.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11401|11401 - EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM||205.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11400|11400 - EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<||111.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1137F|1137F - EPISODE BACK PAIN LASTING >12 WKS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1136F|1136F - EPISODE BACK PAIN LASTING 12 WEEKS/<||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1135F|1135F - EPISODE BACK PAIN LASTING >SIX WEEKS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1134F|1134F - EPISODE BACK PAIN LASTING SIX WEEKS/<||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11313|11313 - SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM||140.39|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11312|11312 - SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM||105.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11311|11311 - SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM||90.96|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11310|11310 - SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<||62.18|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1130F|1130F - BK PAIN & FXN ASSESSED CERTAIN ASPECTS OF CARE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11308|11308 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM||106.59|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11307|11307 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM||92.35|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11306|11306 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM||77.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11305|11305 - SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<||48.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11303|11303 - SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM||107.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11302|11302 - SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM||90.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11301|11301 - SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM||72.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11300|11300 - SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<||43.11|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1128F|1128F - SUBS EPISODE FOR CONDITION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1127F|1127F - NEW EPISODE FOR CONDITION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1126F|1126F - PAIN SEVERITY QUANTIFIED NO PAIN PRESENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1125F|1125F - PAIN SEVERITY QUANTIFIED PAIN PRESENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1124F|1124F - ADV CARE PLN/ NO ALT DCSN MKR DOCD OR REFUSAL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1123F|1123F - ADV CARE PLN TLKD & ALT DCSN MAKER DOCD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1121F|1121F - SUBSEQUENT EVALUATION CONDITION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11201|11201 - REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10||24.04|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11200|11200 - REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15||101.64|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1119F|1119F - INITIAL EVALUATION FOR CONDITION||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1118F|1118F - GERD SYMPTOMS ASSESSED AFTER 12 MONTHS THERAPY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1116F|1116F - AURICULAR/PERIAURICULAR PAIN ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1111F|1111F - DISCHRG MEDS RECONCILED W/CURRENT MED LIST||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1110F|1110F - PT DISCHARGE INPT FACILITY WITHIN LAST 60 DAYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11107|11107 - INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION||48.8||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11106|11106 - INCISIONAL BIOPSY SKIN SINGLE LESION||91.39||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11105|11105 - PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION||40.93||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11104|11104 - PUNCH BIOPSY SKIN SINGLE LESION||75.06||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11102|11102 - TANGENTIAL BIOPSY SKIN SINGLE LESION||59.85||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11101|11101 - BIOPSY SKIN SUBQ&/MUCOUS MEMBRANE EA ADDL LESN||35.68|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|11100|11100 - BX SKIN SUBCUTANEOUS&/MUCOUS MEMBRANE 1 LESION||70.87|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|11057|11057 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4||53.25|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11056|11056 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4||33.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11055|11055 - PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1||29.34|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11047|11047 - DEBRIDEMENT BONE EACH ADDITIONAL 20 SQ CM||141.47|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11046|11046 - DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM||79.91|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11045|11045 - DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM||38.99|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11044|11044 - DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<||341.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11043|11043 - DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<||227.95|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11042|11042 - DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<||85.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1101F|1101F - PT FALLS ASSESS DOCD W/O FALL/INJURY PAST YEAR||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11012|11012 - DBRDMT FX&/DISLC SUBQ T/M/F BONE||614.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11011|11011 - DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC||433.45|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11010|11010 - DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS||403.07|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11008|11008 - REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION||398.1|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11006|11006 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL||1026.37|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11005|11005 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL||1134.14|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11004|11004 - DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR||842.69|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11001|11001 - DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF||20.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|11000|11000 - DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF||42.17|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1018F|1018F - DYSPNEA ASSESSED NOT PRESENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10180|10180 - INCISION & DRAINAGE COMPLEX PO WOUND INFECTION||253.42|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10160|10160 - PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST||135.13|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1015F|1015F - COPD SYMPTOMS ASSESSED/TOOL COMPLETED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10140|10140 - I&D HEMATOMA SEROMA/FLUID COLLECTION||166.71|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1012F|1012F - ANGINA ABSENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10121|10121 - INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL||264.31|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10120|10120 - INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE||131.46|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1011F|1011F - ANGINA PRESENT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1010F|1010F - SEVERITY OF ANGINA ASSESSED BY LEVEL OF ACTIVITY||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1008F|1008F - GI&RENAL PRESCRIBED/OTC NSAID RISK FACTORS ASSES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10081|10081 - INCISION & DRAINAGE PILONIDAL CYST COMPLICATED||243.87|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10080|10080 - INCISION & DRAINAGE PILONIDAL CYST SIMPLE||142.83|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1007F|1007F - ANTI-INFLAMMATORY/ANALGESIC SYMPTOM RELIEF ASSES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1006F|1006F - OSTEOARTHRITIS SYMPTOMS&FUNCJAL STATUS ASSES||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10061|10061 - INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE||279.6|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10060|10060 - INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE||158.75|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1005F|1005F - ASTHMA SYMPTOMS EVALUATED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1004F|1004F - CLINICAL SYMPTOMS VOL OVERLOAD ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10040|10040 - ACNE SURGERY||126.24|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|1003F|1003F - LEVEL ACTIVITY ASSESSED||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10022|10022 - FINE NEEDLE ASPIRATION WITH IMAGING GUIDANCE||93.94|0||0|10/01/2018
58-2102532|106|SH SH311|106-SH SH311|10021|10021 - FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION||101.86|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10010|10010 - FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL||126.66||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10009|10009 - FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION||173.33||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10008|10008 - FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL||93.11||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10007|10007 - FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION||142.89||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10006|10006 - FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL||75.9|0|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10005|10005 - FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION||111.44|0|||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|10004|10004 - FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL||66.15||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0318T|0318T - REPLACE AORTIC VALVE TTHORAC||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0317T|0317T - ELEC ALYS NSTIM PLS GEN VAGUS NRV W/REPRGRMG||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0316T|0316T - REPLACEMENT PULSE GENERATOR VAGUS NERVE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0315T|0315T - REMOVAL PULSE GENERATOR VAGUS NERVE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0314T|0314T - LAPS RMVL NSTIM ELTRD ARRAY & PLS GEN VAGUS NRV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0313T|0313T - LAPS REVJ/REPLCMT NSTIM ELTRD ARRAY VAGUS NRV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0312T|0312T - LAPS IMPLTJ NSTIM ELTRD ARRAY&PLS GEN VAGUS NRV||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0311T|0311T - CAL & ALYS CNTRL ARTL PRESS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0310T|0310T - MOTOR FUNCTION MAPPING NAVIGATED TMS TX PLAN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0309T|0309T - ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L4/L5||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0308T|0308T - INSJ OC TLSCP PROSTH RMVL CRYSTALLINE/IO LENS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0307T|0307T - RMVL INTRACARDIAC ISCHEMIA MONITORING DEVICE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0306T|0306T - INTERROGATION EVAL ICAR ISCHM MNTRNG SYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0305T|0305T - PROGRAM EVAL ICAR ISCHM MNTRNG SYS||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0304T|0304T - INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS DEVICE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0303T|0303T - INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS ELTRD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0302T|0302T - INSJ/RMVL RPLCMT ICAR ISCHM MNTRNG SYS COMPL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0301T|0301T - DEST/REDUC MALIG BRST TUMR W/US THRMORX GUIDANCE||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0300T|0300T - ESW HI ENERGY W/TOPCAL APP &DRESNG CARE ADL WND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0299T|0299T - ESW HI ENERGY W/TOPCAL APP &DRESNG CARE 1ST WND||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0298T|0298T - EXT ECG > 48HR TO 21 DAY REVIEW AND INTERPRETATN||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0297T|0297T - EXT ECG > 48HR TO 21 DAY SCAN ANALYSIS W/REPORT||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0296T|0296T - EXT ECG > 48HR TO 21 DAY RCRD W/CONECT INTL RCRD||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0295T|0295T - EXT ECG > 48HR TO 21 DAY RCRD SCAN ANLYS REP R&I||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0294T|0294T - INS LT ATRL HEMDYN MTR PRSR SENSR LEAD W/S&I||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0293T|0293T - INS LT ATRL HEMODYN MOTR CMPLETE SYST W/S&I||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0292T|0292T - IV OCT FOR PROC ADDL VESSEL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0291T|0291T - IV OCT FOR PROC INIT VESSEL||0|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|01996|01996 - DAILY HOSP MGMT EDRL/SARACH CONT DRUG ADMN||202.5|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0130U|||965.09||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0129U|||1844.67||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0128U|||91.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0127U|||91.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0126U|||114.71||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0125U|||114.71||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0124U|||91.64||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0120U|||4141.85||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0116U|||407.42||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0113U|||1254||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0111U|||1125.78||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0110U|||44.73||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0109U|||235.34||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0107U|||26.4||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0105U|||1567.5||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0103U|0103U - HERED OVA CA PNL 24 GENES||1844.67||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0102U|0102U - HERED BRST CA RLTD DO 17 GEN||1930.17||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0101U|0101U - HERED COLON CA DO 15 GENES||1930.17||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0096U|0096U - HPV HI RISK TYPES MALE URINE||57.9||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0093U|0093U - RX MNTR 65 COM DRUGS URINE||102.53||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0090U|0090U - ONC CUTAN MLNMA MRNA 23 GENE||3217.5||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0089U|0089U - ONC MLNMA PRAME & LINC00518||1254||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0084U|0084U - RBC DNA GNOTYP 10 BLD GROUPS||1188||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0082U|0082U - RX TEST DEF 90+ RX/SBSTS UR||407.42||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0080U|0080U - ONC LNG 5 CLIN RSK FACTR ALG||5808||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0078U|0078U - PAIN MGT OPI USE GNOTYP PNL||744||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0076U|0076U - CYP2D6 3' GENE DUP/MLT||744||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0075U|0075U - CYP2D6 5' GENE DUP/MLT||744||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0074U|0074U - CYP2D6 NONDUPLICATED GENE||744||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0073U|0073U - CYP2D6 GEN CYP2D7-2D6 HYBRID||744||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0073T|0073T - DELIVERY COMP IMRT||534.15|0||0|01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0072U|0072U - CYP2D6 GEN CYP2D6-2D7 HYBRID||744||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0071U|0071U - CYP2D6 FULL GENE SEQUENCE||497.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0070U|0070U - CYP2D6 GEN COM&SLCT RAR VRNT||1116.01||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0069U|0069U - ONC CLRCT MICRORNA MIR-31-3P||627||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0068U|0068U - CANDIDA SPECIES PNL AMP PRB||235.34||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0066U|0066U - PAMG-1 IA CERVICO-VAG FLUID||25.23||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0065U|0065U - SYFLS TST NONTREPONEMAL ANTB||29.85||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|0064U|0064U - ANTB TP TOTAL&RPR IA QUAL||51.69||||01/01/2020
58-2102532|106|SH SH311|106-SH SH311|00000|||0|0|0|0|10/01/2017