hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|AR,"To the best of its knowledge and belief, the hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date indicated.",,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Johnson Regional Medical Center,11/25/2025,2.0.0,Johnson Regional Medical Center,"110 East Poplar Street, Clarksville, AR 72830",3028,TRUE,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,setting,drug_unit_of_measurement,drug_type_of_measurement,modifiers,standard_charge|gross,standard_charge|discounted_cash,standard_charge|Aetna|PPO|negotiated_dollar,estimated_amount|Aetna|PPO,standard_charge|Aetna|PPO|negotiated_percentage,standard_charge|Aetna|PPO|methodology,standard_charge|Aetna|PPO|negotiated_algorithm,additional_payer_notes|Aetna|PPO,standard_charge|Aetna|Full Risk and Plan for Plan Sponsors|negotiated_dollar,estimated_amount|Aetna|Full Risk and Plan for Plan Sponsors,standard_charge|Aetna|Full Risk and Plan for Plan Sponsors|negotiated_percentage,standard_charge|Aetna|Full Risk and Plan for Plan Sponsors|methodology,standard_charge|Aetna|Full Risk and Plan for Plan Sponsors|negotiated_algorithm,additional_payer_notes|Aetna|Full Risk and Plan for Plan Sponsors,standard_charge|Arkansas Blue Cross Blue Shield|PPO Network|negotiated_dollar,estimated_amount|Arkansas Blue Cross Blue Shield|PPO Network,standard_charge|Arkansas Blue Cross Blue Shield|PPO Network|negotiated_percentage,standard_charge|Arkansas Blue Cross Blue Shield|PPO Network|methodology,standard_charge|Arkansas Blue Cross Blue Shield|PPO Network|negotiated_algorithm,additional_payer_notes|Arkansas Blue Cross Blue Shield|PPO Network,standard_charge|Arkansas First Source|PPO Network|negotiated_dollar,estimated_amount|Arkansas First Source|PPO Network,standard_charge|Arkansas First Source|PPO Network|negotiated_percentage,standard_charge|Arkansas First Source|PPO Network|methodology,standard_charge|Arkansas First Source|PPO Network|negotiated_algorithm,additional_payer_notes|Arkansas First Source|PPO Network,standard_charge|Arkansas Blue Cross Blue Shield Health Advantage|HMO Network|negotiated_dollar,estimated_amount|Arkansas Blue Cross Blue Shield Health Advantage|HMO Network,standard_charge|Arkansas Blue Cross Blue Shield Health Advantage|HMO Network|negotiated_percentage,standard_charge|Arkansas Blue Cross Blue Shield Health Advantage|HMO Network|methodology,standard_charge|Arkansas Blue Cross Blue Shield Health Advantage|HMO Network|negotiated_algorithm,additional_payer_notes|Arkansas Blue Cross Blue Shield Health Advantage|HMO Network,standard_charge|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|HMO Network|negotiated_dollar,estimated_amount|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|HMO Network,standard_charge|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|HMO Network|negotiated_percentage,standard_charge|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|HMO Network|methodology,standard_charge|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|HMO Network|negotiated_algorithm,additional_payer_notes|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|HMO Network,standard_charge|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|PFFS|negotiated_dollar,estimated_amount|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|PFFS,standard_charge|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|PFFS|negotiated_percentage,standard_charge|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|PFFS|methodology,standard_charge|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|PFFS|negotiated_algorithm,additional_payer_notes|Arkansas Blue Cross Blue Shield Medi-Pak Advantage|PFFS,standard_charge|Cigna|Benefit Plans|negotiated_dollar,estimated_amount|Cigna|Benefit Plans,standard_charge|Cigna|Benefit Plans|negotiated_percentage,standard_charge|Cigna|Benefit Plans|methodology,standard_charge|Cigna|Benefit Plans|negotiated_algorithm,additional_payer_notes|Cigna|Benefit Plans,"standard_charge|Humana D/B/A ChoiceCare Network|Medicare HMO,POS,PPO,PFFS|negotiated_dollar","estimated_amount|Humana D/B/A ChoiceCare Network|Medicare HMO,POS,PPO,PFFS","standard_charge|Humana D/B/A ChoiceCare Network|Medicare HMO,POS,PPO,PFFS|negotiated_percentage","standard_charge|Humana D/B/A ChoiceCare Network|Medicare HMO,POS,PPO,PFFS|methodology","standard_charge|Humana D/B/A ChoiceCare Network|Medicare HMO,POS,PPO,PFFS|negotiated_algorithm","additional_payer_notes|Humana D/B/A ChoiceCare Network|Medicare HMO,POS,PPO,PFFS",standard_charge|NovaSys Health|Commercial Exchange Product|negotiated_dollar,estimated_amount|NovaSys Health|Commercial Exchange Product,standard_charge|NovaSys Health|Commercial Exchange Product|negotiated_percentage,standard_charge|NovaSys Health|Commercial Exchange Product|methodology,standard_charge|NovaSys Health|Commercial Exchange Product|negotiated_algorithm,additional_payer_notes|NovaSys Health|Commercial Exchange Product,standard_charge|NovaSys Health|Hospital Provider Agreement - Preferred and Choice Rates|negotiated_dollar,estimated_amount|NovaSys Health|Hospital Provider Agreement - Preferred and Choice Rates,standard_charge|NovaSys Health|Hospital Provider Agreement - Preferred and Choice Rates|negotiated_percentage,standard_charge|NovaSys Health|Hospital Provider Agreement - Preferred and Choice Rates|methodology,standard_charge|NovaSys Health|Hospital Provider Agreement - Preferred and Choice Rates|negotiated_algorithm,additional_payer_notes|NovaSys Health|Hospital Provider Agreement - Preferred and Choice Rates,standard_charge|NovaSys Health|Hospital Provider Agreement - Select Rates|negotiated_dollar,estimated_amount|NovaSys Health|Hospital Provider Agreement - Select Rates,standard_charge|NovaSys Health|Hospital Provider Agreement - Select Rates|negotiated_percentage,standard_charge|NovaSys Health|Hospital Provider Agreement - Select Rates|methodology,standard_charge|NovaSys Health|Hospital Provider Agreement - Select Rates|negotiated_algorithm,additional_payer_notes|NovaSys Health|Hospital Provider Agreement - Select Rates,standard_charge|NovaSys Health|Medicare Products|negotiated_dollar,estimated_amount|NovaSys Health|Medicare Products,standard_charge|NovaSys Health|Medicare Products|negotiated_percentage,standard_charge|NovaSys Health|Medicare Products|methodology,standard_charge|NovaSys Health|Medicare Products|negotiated_algorithm,additional_payer_notes|NovaSys Health|Medicare Products,standard_charge|NovaSys Health|Medicaid Pass Program Products|negotiated_dollar,estimated_amount|NovaSys Health|Medicaid Pass Program Products,standard_charge|NovaSys Health|Medicaid Pass Program Products|negotiated_percentage,standard_charge|NovaSys Health|Medicaid Pass Program Products|methodology,standard_charge|NovaSys Health|Medicaid Pass Program Products|negotiated_algorithm,additional_payer_notes|NovaSys Health|Medicaid Pass Program Products,standard_charge|APC PASSE D/B/A Summit Community Care|Medicaid HMO|negotiated_dollar,estimated_amount|APC PASSE D/B/A Summit Community Care|Medicaid HMO,standard_charge|APC PASSE D/B/A Summit Community Care|Medicaid HMO|negotiated_percentage,standard_charge|APC PASSE D/B/A Summit Community Care|Medicaid HMO|methodology,standard_charge|APC PASSE D/B/A Summit Community Care|Medicaid HMO|negotiated_algorithm,additional_payer_notes|APC PASSE D/B/A Summit Community Care|Medicaid HMO,standard_charge|United Healthcare|All Payer Appendix|negotiated_dollar,estimated_amount|United Healthcare|All Payer Appendix,standard_charge|United Healthcare|All Payer Appendix|negotiated_percentage,standard_charge|United Healthcare|All Payer Appendix|methodology,standard_charge|United Healthcare|All Payer Appendix|negotiated_algorithm,additional_payer_notes|United Healthcare|All Payer Appendix,standard_charge|United Healthcare|Medicare Advantage Benefit Plan|negotiated_dollar,estimated_amount|United Healthcare|Medicare Advantage Benefit Plan,standard_charge|United Healthcare|Medicare Advantage Benefit Plan|negotiated_percentage,standard_charge|United Healthcare|Medicare Advantage Benefit Plan|methodology,standard_charge|United Healthcare|Medicare Advantage Benefit Plan|negotiated_algorithm,additional_payer_notes|United Healthcare|Medicare Advantage Benefit Plan,standard_charge|min,standard_charge|max,additional_generic_notes
PR MED/SURG OUTPATIENT - NORTH,1101200,CDM,,,111,RC,inpatient,,,,1032.06,567.633,1000,,,per diem,,,,1032.06,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"$6,150 conversion price multiplied by the raltive weights for each MS-DRG",,,,,,,,,,,,"$7,399 conversion factor multiplied MS DRG 30 Weights",1140,,,per diem,,,,980.457,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,980.457,1140,
PRIVATE ROOM MED/SURG - NORTH,1111200,CDM,,,111,RC,inpatient,,,,1031.648,567.4064,1000,,,per diem,,,,1031.648,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"$6,150 conversion price multiplied by the raltive weights for each MS-DRG",,,,,,,,,,,,"$7,399 conversion factor multiplied MS DRG 30 Weights",1140,,,per diem,,,,980.0656,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,980.0656,1140,
PRIVATE ROOM OB - CENTRAL,1121100,CDM,,,112,RC,inpatient,,,,1032.06,567.633,,928.854,90,percent of total billed charges,,,,1032.06,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,928.854,90,percent of total billed charges,,,,980.457,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,928.854,1032.06,
PRIVATE ROOM PSYCH,1140000,CDM,,,114,RC,inpatient,,,,1461.57,803.8635,790,,,per diem,,,,1461.57,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,885,,,per diem,,,,1315.413,90,percent of total billed charges,,,,1388.4915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,790,1461.57,
REHAB - PRIVATE ROOM,1180000,CDM,,,118,RC,inpatient,,,,1013.52,557.436,,912.168,90,percent of total billed charges,,,,1013.52,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,912.168,90,percent of total billed charges,,,,962.844,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,912.168,1013.52,
SEMI-PRIVATE ROOM PSYCH,1240000,CDM,,,124,RC,inpatient,,,,1013.52,557.436,790,,,per diem,,,,1013.52,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,885,,,per diem,,,,912.168,90,percent of total billed charges,,,,962.844,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,790,1013.52,
NEWBORN NURSERY,1700000,CDM,,,170,RC,inpatient,,,,860.05,473.0275,,774.045,90,percent of total billed charges,,,,860.05,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,774.045,90,percent of total billed charges,,,,817.0475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,774.045,860.05,
INTENSIVE CARE UNIT,2000000,CDM,,,200,RC,inpatient,,,,1833.4,1008.37,1200,,,per diem,,,,1833.4,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,"$6,150 conversion price multiplied by the raltive weights for each MS-DRG",,,,,,,785,,,per diem,,,1330,,,per diem,,,,1741.73,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,785,1833.4,
POTASSIUM PHOSPATES 3mmol/ml,2500007,CDM,,,250,RC,inpatient,3,ML,,10.609,5.83495,,9.5481,90,percent of total billed charges,,,,10.609,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.5481,90,percent of total billed charges,,,,10.07855,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.5481,10.609,
LIDOCAINE 1%/EPI 1:100000 20ml,2500008,CDM,,,250,RC,inpatient,20,ML,,9.7644,5.37042,,8.78796,90,percent of total billed charges,,,,9.7644,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.78796,90,percent of total billed charges,,,,9.27618,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.78796,9.7644,
LIDOCAINE 1% EPI/1:100000 10ml,2500009,CDM,,,250,RC,inpatient,10,ML,,9.1052,5.00786,,8.19468,90,percent of total billed charges,,,,9.1052,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.19468,90,percent of total billed charges,,,,8.64994,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.19468,9.1052,
ACTIVATED CHARCOAL 25GM,2500080,CDM,,,250,RC,inpatient,25,GR,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,21.836,
NEPHRAMINE 5.4% INJ,2500155,CDM,,,250,RC,inpatient,1,EA,,209.811,115.39605,,188.8299,90,percent of total billed charges,,,,209.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.8299,90,percent of total billed charges,,,,199.32045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.8299,209.811,
NEURONTIN 300MG CAPSULE PO,2500205,CDM,,,250,RC,inpatient,300,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
AFRIN 0.05% SPRAY 15ML,2500210,CDM,,,250,RC,inpatient,15,ML,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
NEUT 4% 5ML INJ,2500215,CDM,,,250,RC,inpatient,5,ML,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,16.171,
ALBUMINAR 25% 10 ML INJ,2500230,CDM,,,250,RC,inpatient,10,ML,,516.957,284.32635,,465.2613,90,percent of total billed charges,,,,516.957,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,465.2613,90,percent of total billed charges,,,,491.10915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,465.2613,516.957,
AMARYL  2MG TAB,2500420,CDM,,,250,RC,inpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
AMBIEN 10mg TABLET,2500430,CDM,,,250,RC,inpatient,10,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
KETOCONAZOLE 2% 60gr CREAM,2500445,CDM,,,250,RC,inpatient,60,GR,,96.511,53.08105,,86.8599,90,percent of total billed charges,,,,96.511,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,86.8599,90,percent of total billed charges,,,,91.68545,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,86.8599,96.511,
AMINOCAPROIC ACID 250ML 5GRAM,2500450,CDM,,,250,RC,inpatient,250,ml,,21.321,11.72655,,19.1889,90,percent of total billed charges,,,,21.321,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.1889,90,percent of total billed charges,,,,20.25495,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.1889,21.321,
NORCURON 10MG VIAL POWDER,2500495,CDM,,,250,RC,inpatient,10,ME,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,90,percent of total billed charges,,,,64.28745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,67.671,
AMMONIA INHALANT 15%,2500500,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
AMOXIL 125MG/5MLSUSP.(5ML),2500510,CDM,,,250,RC,inpatient,125,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
NORMAL SALINE 250ML SOLUTION,2500535,CDM,,,250,RC,inpatient,250,ML,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.6721,90,percent of total billed charges,,,,21.82055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.6721,22.969,
NORMAL SALINE  50ml SOLUTION,2500545,CDM,,,250,RC,inpatient,50,ML,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,31.003,
AMOXIL PER 1ml (50mg),2500550,CDM,,,250,RC,inpatient,1,ME,,6.489,3.56895,,5.8401,90,percent of total billed charges,,,,6.489,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.8401,90,percent of total billed charges,,,,6.16455,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.8401,6.489,
NORMAL SALINE 100ml SOLUTION,2500555,CDM,,,250,RC,inpatient,100,ML,,37.904,20.8472,,34.1136,90,percent of total billed charges,,,,37.904,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.1136,90,percent of total billed charges,,,,36.0088,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.1136,37.904,
NORMAL SALINE 500ML SOLUTION,2500565,CDM,,,250,RC,inpatient,500,ML,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,33.372,
NORMAL SALINE 0.9% 3ML INJ,2500575,CDM,,,250,RC,inpatient,3,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
NORMAL SALINE 1000ML SOLUTION,2500585,CDM,,,250,RC,inpatient,1000,ML,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,90,percent of total billed charges,,,,25.14745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,26.471,
AMPHOGEL/ALTERNAGEL SUSP.,2500590,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SODIUM CHLORIDE 0.9% 10ml SYR,2500595,CDM,A4216,HCPCS,250,RC,inpatient,10,ML,,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.3094,90,percent of total billed charges,,,,11.9377,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.3094,12.566,
RIFAXIMIN 550mg TABLET,2500616,CDM,,,250,RC,inpatient,550,ME,,83.224,45.7732,,74.9016,90,percent of total billed charges,,,,83.224,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,74.9016,90,percent of total billed charges,,,,79.0628,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,74.9016,83.224,
NORMAL SALINE IRRIG 1000ML,2500645,CDM,,,250,RC,inpatient,1000,ML,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,33.372,
AMPICILLIN 250MG INJ,2500660,CDM,,,250,RC,inpatient,250,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
NORVASC 5MG TAB,2500715,CDM,,,250,RC,inpatient,5,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
OCUFEN 0.03% DROPS OPHT,2500745,CDM,,,250,RC,inpatient,1,EA,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,90,percent of total billed charges,,,,43.6411,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,45.938,
ANUSOL HC 30gr TUBE,2500910,CDM,,,250,RC,inpatient,30,GR,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.6375,167.375,
ANUSOL HC SUPP.,2500920,CDM,,,250,RC,inpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
AQUAMEPHYTON 1MG/0.5ML INJ.,2500990,CDM,,,250,RC,inpatient,1,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
ASPIRIN 325mg TAB,2501070,CDM,,,250,RC,inpatient,325,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
PENICILLIN 5MIL UNITS INJ,2501115,CDM,,,250,RC,inpatient,5,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
ATARAX 10MG/5ML SYRUP,2501130,CDM,,,250,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ATIVAN 0.5mg TABLET,2501150,CDM,,,250,RC,inpatient,0.5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ATIVAN 1mg TAB,2501160,CDM,,,250,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PEPCID 20MG TAB,2501165,CDM,,,250,RC,inpatient,20,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
PEPCID 20MG/2ML INJ,2501175,CDM,,,250,RC,inpatient,20,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
ATROPINE 0.8mg/2ml INJ,2501200,CDM,,,250,RC,inpatient,0.8,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
PEPTO BISMOL 262MG/15ML LIQ,2501205,CDM,,,250,RC,inpatient,262,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
ATROVENT 0.02% LIQUID,2501230,CDM,,,250,RC,inpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
AUGMENTIN 875MG/125MG TAB,2501290,CDM,,,250,RC,inpatient,875,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
AVITENE SHEET,2501320,CDM,,,250,RC,inpatient,1,EA,,353.084,194.1962,,317.7756,90,percent of total billed charges,,,,353.084,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.7756,90,percent of total billed charges,,,,335.4298,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.7756,353.084,
PHENERGAN 12.5MG SUPPOS,2501325,CDM,,,250,RC,inpatient,12.5,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
AZACTAM 1GM 15ML INJ,2501340,CDM,,,250,RC,inpatient,15,ML,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,90,percent of total billed charges,,,,43.6411,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,45.938,
PHENERGAN 25MG SUPPOS,2501345,CDM,,,250,RC,inpatient,25,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
PHENERGAN 50mg,2501375,CDM,,,250,RC,inpatient,50,ME,,11.845,6.51475,,10.6605,90,percent of total billed charges,,,,11.845,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.6605,90,percent of total billed charges,,,,11.25275,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.6605,11.845,
BENADRYL 12.5MG/5ML  ELIXIR,2501500,CDM,,,250,RC,inpatient,12.5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
BENADRYL 2% TOPICAL,2501510,CDM,,,250,RC,inpatient,1,EA,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,14.935,
PILOCAR 1% DROPS,2501515,CDM,,,250,RC,inpatient,1,EA,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,40.17,
VASOPRESSIN 20u/1ml 1ml VIAL,2501595,CDM,,,250,RC,inpatient,1,ML,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.6721,90,percent of total billed charges,,,,21.82055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.6721,22.969,
BETADINE 30 GR  OINTMENT,2501600,CDM,,,250,RC,inpatient,30,GR,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
POVIDINE-IODINE OPHTHALMIC,2501610,CDM,,,250,RC,inpatient,1,EA,,16.995,9.34725,,15.2955,90,percent of total billed charges,,,,16.995,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.2955,90,percent of total billed charges,,,,16.14525,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.2955,16.995,
LEVOBUNOLOL 0.5% OPTHALMIC,2501640,CDM,,,250,RC,inpatient,1,EA,,15.45,8.4975,,13.905,90,percent of total billed charges,,,,15.45,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.905,90,percent of total billed charges,,,,14.6775,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.905,15.45,
BETOPTIC 0.5%  DROPS,2501670,CDM,,,250,RC,inpatient,1,EA,,60.873,33.48015,,54.7857,90,percent of total billed charges,,,,60.873,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.7857,90,percent of total billed charges,,,,57.82935,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.7857,60.873,
BIAXIN 125MG/5ML SUSP,2501690,CDM,,,250,RC,inpatient,125,ME,,80.237,44.13035,,72.2133,90,percent of total billed charges,,,,80.237,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.2133,90,percent of total billed charges,,,,76.22515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.2133,80.237,
BIC/SHOHL SOL 550MG/334MG/5ML,2501730,CDM,,,250,RC,inpatient,550,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
BLEPH-10/BLEPHAMIDE 15CC DROPS,2501740,CDM,,,250,RC,inpatient,1,EA,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.5157,90,percent of total billed charges,,,,48.04435,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.5157,50.573,
PPD SKIN TEST INJECTION,2501745,CDM,,,250,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
PRED FORTE OPTH 1% 5ML DROPS,2501785,CDM,,,250,RC,inpatient,5,ML,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.5157,90,percent of total billed charges,,,,48.04435,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.5157,50.573,
BREVIBLOC 10MG/ML INJ,2501830,CDM,,,250,RC,inpatient,10,ME,,86.005,47.30275,,77.4045,90,percent of total billed charges,,,,86.005,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.4045,90,percent of total billed charges,,,,81.70475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.4045,86.005,
PRELONE 15MG/5ML ELIXIR,2501835,CDM,,,250,RC,inpatient,15,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
BSS 15 ML INJ,2501880,CDM,,,250,RC,inpatient,15,ML,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,90,percent of total billed charges,,,,22.8969,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,24.102,
PREMARIN 25MG/5ML INJ,2501885,CDM,,,250,RC,inpatient,25,ME,,99.807,54.89385,,89.8263,90,percent of total billed charges,,,,99.807,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.8263,90,percent of total billed charges,,,,94.81665,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.8263,99.807,
PREMARIN VAG 42.5 GR CREAM,2501895,CDM,,,250,RC,inpatient,42.5,GR,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.9051,90,percent of total billed charges,,,,99.12205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.9051,104.339,
CLEOCIN SUSPENSION,2501913,CDM,,,250,RC,inpatient,1,EA,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,90,percent of total billed charges,,,,34.93245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,36.771,
STERILE WATER FOR INJ 500ml,2501923,CDM,,,250,RC,inpatient,500,ML,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,90,percent of total billed charges,,,,34.93245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,36.771,
BUSPAR 5MG TAB,2501930,CDM,,,250,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
AMIDATE INJECTION 20MG AMPULE,2501934,CDM,,,250,RC,inpatient,20,ME,,64.272,35.3496,,57.8448,90,percent of total billed charges,,,,64.272,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.8448,90,percent of total billed charges,,,,61.0584,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.8448,64.272,
LAMISIL 1% CREAM 30gr TUBE,2501942,CDM,,,250,RC,inpatient,30,GR,,27.089,14.89895,,24.3801,90,percent of total billed charges,,,,27.089,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.3801,90,percent of total billed charges,,,,25.73455,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.3801,27.089,
SEROQUEL 100MG,2501948,CDM,,,250,RC,inpatient,100,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
IPRATROPIUM ALBUTERAL SULF 4gr,2501962,CDM,,,250,RC,inpatient,4,GR,,822.764,452.5202,,740.4876,90,percent of total billed charges,,,,822.764,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,740.4876,90,percent of total billed charges,,,,781.6258,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,740.4876,822.764,
TYPHOID INJECTION,2501971,CDM,,,250,RC,inpatient,1,EA,,100.94,55.517,,90.846,90,percent of total billed charges,,,,100.94,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,90.846,90,percent of total billed charges,,,,95.893,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,90.846,100.94,
PRISCOLINE 100MG/4ML INJ,2501975,CDM,,,250,RC,inpatient,100,ME,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,90,percent of total billed charges,,,,34.93245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,36.771,
CORDARONE/AMIODARONE 50mg/1ml,2501977,CDM,,,250,RC,inpatient,50,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
PROCTFOAM,2501984,CDM,,,250,RC,inpatient,1,EA,,56.238,30.9309,,50.6142,90,percent of total billed charges,,,,56.238,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.6142,90,percent of total billed charges,,,,53.4261,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.6142,56.238,
PIOGLITAZONE Hcl 15MG TABLET,2501993,CDM,,,250,RC,inpatient,15,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
CALAMINE LOTION,2502000,CDM,,,250,RC,inpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
FLOMAX 0.4MG CAPSULE,2502001,CDM,,,250,RC,inpatient,0.4,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
AUGMENTIN 400MG/5ML SUSPENSION,2502003,CDM,,,250,RC,inpatient,400,ME,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,119.274,
FLOVENT 44 MCG INHALER,2502007,CDM,,,250,RC,inpatient,1,EA,,88.374,48.6057,,79.5366,90,percent of total billed charges,,,,88.374,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.5366,90,percent of total billed charges,,,,83.9553,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.5366,88.374,
FLOVENT 110 MCG INHALER,2502008,CDM,,,250,RC,inpatient,1,EA,,512.94,282.117,,461.646,90,percent of total billed charges,,,,512.94,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,461.646,90,percent of total billed charges,,,,487.293,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,461.646,512.94,
FLOVENT 220 MCG INHALER,2502009,CDM,,,250,RC,inpatient,1,EA,,478.435,263.13925,,430.5915,90,percent of total billed charges,,,,478.435,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.5915,90,percent of total billed charges,,,,454.51325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.5915,478.435,
DUONEB INHALATIONAL SOLUTION,2502012,CDM,,,250,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
VALPROATE SODIUM 500MG/5ML INJ,2502013,CDM,,,250,RC,inpatient,500,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
LANTUS INSULIN,2502014,CDM,,,250,RC,inpatient,1,EA,,103.206,56.7633,,92.8854,90,percent of total billed charges,,,,103.206,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,92.8854,90,percent of total billed charges,,,,98.0457,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,92.8854,103.206,
ZYVOX 600mg TABLET,2502017,CDM,,,250,RC,inpatient,600,ME,,120.51,66.2805,,108.459,90,percent of total billed charges,,,,120.51,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.459,90,percent of total billed charges,,,,114.4845,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.459,120.51,
"ADVAIR 15,000mcg INHALER",2502018,CDM,,,250,RC,inpatient,1,EA,,506.657,278.66135,,455.9913,90,percent of total billed charges,,,,506.657,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,455.9913,90,percent of total billed charges,,,,481.32415,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,455.9913,506.657,
"ADVAIR 7,500mcg INHALER",2502019,CDM,,,250,RC,inpatient,1,EA,,362.251,199.23805,,326.0259,90,percent of total billed charges,,,,362.251,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,326.0259,90,percent of total billed charges,,,,344.13845,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,326.0259,362.251,
VERAPAMIL 2.5mg/ml 4ml INJ,2502020,CDM,,,250,RC,inpatient,2.5,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
"ADVAIR 3,000mcg MD INHALER",2502021,CDM,,,250,RC,inpatient,1,EA,,311.781,171.47955,,280.6029,90,percent of total billed charges,,,,311.781,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.6029,90,percent of total billed charges,,,,296.19195,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.6029,311.781,
MEGALE 40mg,2502026,CDM,,,250,RC,inpatient,40,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
CILOXAN 0.3% EYE DROPS,2502029,CDM,,,250,RC,inpatient,1,EA,,56.238,30.9309,,50.6142,90,percent of total billed charges,,,,56.238,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.6142,90,percent of total billed charges,,,,53.4261,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.6142,56.238,
REMINYL 4MG TABLET,2502033,CDM,,,250,RC,inpatient,4,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
LEXAPRO 10MG TABLET,2502034,CDM,,,250,RC,inpatient,10,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
BRIMONIDINE TARTRATE 5ml BOTTL,2502066,CDM,,,250,RC,inpatient,5,ML,,41.612,22.8866,,37.4508,90,percent of total billed charges,,,,41.612,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.4508,90,percent of total billed charges,,,,39.5314,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.4508,41.612,
CALCIMAR 200 I.U./ML INJ,2502070,CDM,,,250,RC,inpatient,200,ML,,129.574,71.2657,,116.6166,90,percent of total billed charges,,,,129.574,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,116.6166,90,percent of total billed charges,,,,123.0953,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,116.6166,129.574,
PROTONIX 40mg INJ,2502072,CDM,,,250,RC,inpatient,40,ME,,65.405,35.97275,,58.8645,90,percent of total billed charges,,,,65.405,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.8645,90,percent of total billed charges,,,,62.13475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.8645,65.405,
GEODON 20 mg INJ,2502073,CDM,,,250,RC,inpatient,20,ME,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.9051,90,percent of total billed charges,,,,99.12205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.9051,104.339,
XOPENEX 0.5mg,2502083,CDM,,,250,RC,inpatient,0.5,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
LEVAQUIN 500mg TABLET,2502088,CDM,,,250,RC,inpatient,500,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,90,percent of total billed charges,,,,23.97325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,25.235,
NAMENDA 5mg TABLET,2502091,CDM,,,250,RC,inpatient,5,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
FLONASE NASAL SPRAY,2502096,CDM,,,250,RC,inpatient,1,EA,,161.71,88.9405,,145.539,90,percent of total billed charges,,,,161.71,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,145.539,90,percent of total billed charges,,,,153.6245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,145.539,161.71,
PULMICORT RESPULES 0.5mg/2ml,2502097,CDM,,,250,RC,inpatient,0.5,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
POLYETHYLENE GLYCOL 3350 PKT,2502099,CDM,,,250,RC,inpatient,1,EA,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
CALCIUM CHLORIDE 10ML INJ,2502100,CDM,,,250,RC,inpatient,10,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
CAL CHLOR ABBJ 10% 100MG.ML IN,2502110,CDM,,,250,RC,inpatient,100,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
TOPROL XL 5mg TABLET,2502117,CDM,,,250,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LOPRESSOR/METOPROLOL 25mg TAB,2502118,CDM,,,250,RC,inpatient,25,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
LIPITOR 40mg TABLET,2502119,CDM,,,250,RC,inpatient,40,ME,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.4218,90,percent of total billed charges,,,,13.1119,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.4218,13.802,
SPIRIVA INHALER,2502121,CDM,,,250,RC,inpatient,1,EA,,284.383,156.41065,,255.9447,90,percent of total billed charges,,,,284.383,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,255.9447,90,percent of total billed charges,,,,270.16385,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,255.9447,284.383,
ROXICODONE 5mg TABLET,2502132,CDM,,,250,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
COREG 25mg TABLET,2502137,CDM,,,250,RC,inpatient,25,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
CYMBALTA 30mg CAPSULE,2502139,CDM,,,250,RC,inpatient,30,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
ABILIFY 5mg TABLET,2502151,CDM,,,250,RC,inpatient,5,ME,,35.638,19.6009,,32.0742,90,percent of total billed charges,,,,35.638,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.0742,90,percent of total billed charges,,,,33.8561,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.0742,35.638,
NORCO 7.5/325 TABLET,2502162,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PROTONIX 40mg DELAYED REL TAB,2502168,CDM,,,250,RC,inpatient,40,ME,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,14.935,
BOUDREAUX BUTT PASTE 60gr,2502169,CDM,,,250,RC,inpatient,60,GR,,18.849,10.36695,,16.9641,90,percent of total billed charges,,,,18.849,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.9641,90,percent of total billed charges,,,,17.90655,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.9641,18.849,
TRANS DERM SCOPOLAMINE PATCH,2502177,CDM,,,250,RC,inpatient,1,EA,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.6721,90,percent of total billed charges,,,,21.82055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.6721,22.969,
CARAFATE 1GR TAB,2502190,CDM,,,250,RC,inpatient,1,GR,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
ZYDIS 5mg TABLET,2502199,CDM,,,250,RC,inpatient,5,ME,,27.604,15.1822,,24.8436,90,percent of total billed charges,,,,27.604,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.8436,90,percent of total billed charges,,,,26.2238,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.8436,27.604,
ZOFRAN 4mg ORAL DISINTEGRATING,2502201,CDM,,,250,RC,inpatient,4,ME,,59.637,32.80035,,53.6733,90,percent of total billed charges,,,,59.637,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53.6733,90,percent of total billed charges,,,,56.65515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53.6733,59.637,
RISPERDAL 0.5mg TABLET,2502207,CDM,,,250,RC,inpatient,0.5,ME,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,14.935,
VICODIN/LORECT 5/325 TAB,2502208,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
CARAFATE SUSPENSION 1gr,2502214,CDM,,,250,RC,inpatient,1,GR,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
MANNITOL 20% PREMIX IN 500ml,2502217,CDM,,,250,RC,inpatient,500,ML,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,90,percent of total billed charges,,,,45.7938,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,48.204,
FEMARA 2.5mg TABLET,2502222,CDM,,,250,RC,inpatient,2.5,ME,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,29.87,
KWELL CREAM 5% 60gr,2502223,CDM,,,250,RC,inpatient,60,GR,,69.937,38.46535,,62.9433,90,percent of total billed charges,,,,69.937,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.9433,90,percent of total billed charges,,,,66.44015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.9433,69.937,
ESTRACE CREAM 0.01%,2502224,CDM,,,250,RC,inpatient,1,EA,,212.077,116.64235,,190.8693,90,percent of total billed charges,,,,212.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,190.8693,90,percent of total billed charges,,,,201.47315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,190.8693,212.077,
ZYRTEC (CETIRIZINE) 10mg,2502232,CDM,,,250,RC,inpatient,10,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
VITAMIN D 400 I.U.,2502247,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PREDNISOLONE 5ml UNIT DOSE,2502278,CDM,,,250,RC,inpatient,5,ML,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
NEUIONTIN 400mg CAPSULE,2502282,CDM,,,250,RC,inpatient,400,ME,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,90,percent of total billed charges,,,,7.14305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,7.519,
VRAYLAR 1.5 MG CAPSULE,2502293,CDM,,,250,RC,inpatient,1.5,ME,,90.949,50.02195,,81.8541,90,percent of total billed charges,,,,90.949,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.8541,90,percent of total billed charges,,,,86.40155,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.8541,90.949,
TRINTELLIX 5MG TABLET,2502297,CDM,,,250,RC,inpatient,5,ME,,28.84,15.862,,25.956,90,percent of total billed charges,,,,28.84,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.956,90,percent of total billed charges,,,,27.398,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.956,28.84,
VALACYCLOVIR 1000mg TABLET,2502303,CDM,,,250,RC,inpatient,1000,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
METHADONE 10mg TABLETS,2502321,CDM,,,250,RC,inpatient,10,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
KAYEXALATE 15gr/60ml SUSPEN,2502324,CDM,,,250,RC,inpatient,15,GR,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
VENTOLIN HFA 8gr,2502329,CDM,,,250,RC,inpatient,8,GR,,41.406,22.7733,,37.2654,90,percent of total billed charges,,,,41.406,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.2654,90,percent of total billed charges,,,,39.3357,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.2654,41.406,
FERROUS SULFATE 325mg,2502334,CDM,,,250,RC,inpatient,325,ME,,5.253,2.88915,,4.7277,90,percent of total billed charges,,,,5.253,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.7277,90,percent of total billed charges,,,,4.99035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.7277,5.253,
TRIPLE ANTIBIOTIC OINT PACKET,2502337,CDM,,,250,RC,inpatient,1,EA,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
ATROVENT HFA INHALER 12.9gr,2502342,CDM,,,250,RC,inpatient,12.9,GR,,933.798,513.5889,,840.4182,90,percent of total billed charges,,,,933.798,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,840.4182,90,percent of total billed charges,,,,887.1081,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,840.4182,933.798,
SENOKOT 8.6mg TABLET,2502343,CDM,,,250,RC,inpatient,8.6,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
MELATONIN 3mg TABLET,2502348,CDM,,,250,RC,inpatient,3,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
EXELON 935 PATCH,2502349,CDM,,,250,RC,inpatient,1,EA,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.2086,90,percent of total billed charges,,,,21.3313,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.2086,22.454,
POTASSIUM CHLORIDE 20meg/15ml,2502356,CDM,,,250,RC,inpatient,15,ML,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
NYSTATIN ORAL SUSPENSION 5ml,2502357,CDM,,,250,RC,inpatient,5,ML,,5.562,3.0591,,5.0058,90,percent of total billed charges,,,,5.562,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.0058,90,percent of total billed charges,,,,5.2839,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.0058,5.562,
LACTULOSE 10gr/15ml UNIT DOSE,2502358,CDM,,,250,RC,inpatient,10,GR,,8.652,4.7586,,7.7868,90,percent of total billed charges,,,,8.652,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.7868,90,percent of total billed charges,,,,8.2194,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.7868,8.652,
ROBITUSSIN DM 5ml UD CUPS,2502361,CDM,,,250,RC,inpatient,5,ML,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
BENADRYL 12.5mg/5ml,2502362,CDM,,,250,RC,inpatient,12.5,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
SILVADENE CREAM 20gr TUBE,2502363,CDM,,,250,RC,inpatient,20,GR,,13.699,7.53445,,12.3291,90,percent of total billed charges,,,,13.699,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.3291,90,percent of total billed charges,,,,13.01405,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.3291,13.699,
BACTRIM SUSPENSION,2502366,CDM,,,250,RC,inpatient,1,EA,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
MEGACE 400mg/10ml UNIT DOSE,2502369,CDM,,,250,RC,inpatient,400,ME,,27.913,15.35215,,25.1217,90,percent of total billed charges,,,,27.913,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.1217,90,percent of total billed charges,,,,26.51735,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.1217,27.913,
LIDOCAINE HCl VISCOUS 20ml,2502371,CDM,,,250,RC,inpatient,20,ML,,5.871,3.22905,,5.2839,90,percent of total billed charges,,,,5.871,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.2839,90,percent of total billed charges,,,,5.57745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.2839,5.871,
ERYTHROMYCIN BASE 1gr OINT,2502373,CDM,,,250,RC,inpatient,1,GR,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,90,percent of total billed charges,,,,25.14745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,26.471,
PROVENTIL/ALBUTEROL UNIT DOSE,2502375,CDM,,,250,RC,inpatient,1,EA,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
MIRAPEX 0.5mg TABLET,2502376,CDM,,,250,RC,inpatient,0.5,ME,,12.36,6.798,,11.124,90,percent of total billed charges,,,,12.36,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.124,90,percent of total billed charges,,,,11.742,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.124,12.36,
HUMALOG INSULIN 3ml VIAL,2502383,CDM,,,250,RC,inpatient,3,ML,,82.297,45.26335,,74.0673,90,percent of total billed charges,,,,82.297,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,74.0673,90,percent of total billed charges,,,,78.18215,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,74.0673,82.297,
HUMULIN R INSULIN 3ml VIAL,2502384,CDM,,,250,RC,inpatient,3,ML,,36.668,20.1674,,33.0012,90,percent of total billed charges,,,,36.668,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0012,90,percent of total billed charges,,,,34.8346,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0012,36.668,
LICE SHAMPOO,2502386,CDM,,,250,RC,inpatient,1,EA,,22.042,12.1231,,19.8378,90,percent of total billed charges,,,,22.042,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.8378,90,percent of total billed charges,,,,20.9399,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.8378,22.042,
DURAGESIC 12mcg/hr PATCT,2502387,CDM,,,250,RC,inpatient,1,EA,,31.724,17.4482,,28.5516,90,percent of total billed charges,,,,31.724,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.5516,90,percent of total billed charges,,,,30.1378,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.5516,31.724,
DEPAKOTE SPRINKLE 125mg CAP,2502393,CDM,,,250,RC,inpatient,125,ME,,5.047,2.77585,,4.5423,90,percent of total billed charges,,,,5.047,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.5423,90,percent of total billed charges,,,,4.79465,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.5423,5.047,
BACTROBAN 22gr OINTMENT TUBE,2502396,CDM,,,250,RC,inpatient,22,GR,,102.382,56.3101,,92.1438,90,percent of total billed charges,,,,102.382,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,92.1438,90,percent of total billed charges,,,,97.2629,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,92.1438,102.382,
CEFEPIME 1gr VIAL,2502397,CDM,,,250,RC,inpatient,1,GR,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,90,percent of total billed charges,,,,27.30015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,28.737,
BUMETANIDE 2.5mg/10ml VIAL,2502398,CDM,,,250,RC,inpatient,2.5,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
CYTOTEC 200mcg TABLET,2502399,CDM,,,250,RC,inpatient,1,EA,,7.828,4.3054,,7.0452,90,percent of total billed charges,,,,7.828,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.0452,90,percent of total billed charges,,,,7.4366,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.0452,7.828,
CATAPRES TTS1  TTS1 TOPICAL,2502400,CDM,,,250,RC,inpatient,1,EA,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,90,percent of total billed charges,,,,27.30015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,28.737,
OMNICEF 300mg CAPSULE,2502402,CDM,,,250,RC,inpatient,300,ME,,14.729,8.10095,,13.2561,90,percent of total billed charges,,,,14.729,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.2561,90,percent of total billed charges,,,,13.99255,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.2561,14.729,
ZONISAMIDE 100mg CAPSULE,2502409,CDM,,,250,RC,inpatient,100,ME,,4.944,2.7192,,4.4496,90,percent of total billed charges,,,,4.944,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.4496,90,percent of total billed charges,,,,4.6968,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.4496,4.944,
CATAPRES TTS 2  TTS2 TOPICAL,2502410,CDM,,,250,RC,inpatient,1,EA,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.1333,90,percent of total billed charges,,,,37.08515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.1333,39.037,
ENTERIC COATED ASPIRIN 81mg,2502413,CDM,,,250,RC,inpatient,81,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
LITHIUM CARBONATE 300mg IR TAB,2502414,CDM,,,250,RC,inpatient,300,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
MARCAINE 0.5% EPINEPHRINE 10ml,2502417,CDM,,,250,RC,inpatient,10,ML,,11.33,6.2315,,10.197,90,percent of total billed charges,,,,11.33,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.197,90,percent of total billed charges,,,,10.7635,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.197,11.33,
LIDOCAINE 2% JELLY 30ml TUBE,2502419,CDM,,,250,RC,inpatient,30,ML,,48.719,26.79545,,43.8471,90,percent of total billed charges,,,,48.719,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.8471,90,percent of total billed charges,,,,46.28305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.8471,48.719,
POLYTRIM OPTHALMIC DROPS 10ml,2502429,CDM,,,250,RC,inpatient,10,ML,,39.964,21.9802,,35.9676,90,percent of total billed charges,,,,39.964,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.9676,90,percent of total billed charges,,,,37.9658,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.9676,39.964,
LIDOCAINE 5% CREAM 30gr TUBE,2502443,CDM,,,250,RC,inpatient,30,GR,,125.042,68.7731,,112.5378,90,percent of total billed charges,,,,125.042,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,112.5378,90,percent of total billed charges,,,,118.7899,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,112.5378,125.042,
OMNICEF 250mg/5ml SUSPENSION,2502451,CDM,,,250,RC,inpatient,250,ME,,18.128,9.9704,,16.3152,90,percent of total billed charges,,,,18.128,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.3152,90,percent of total billed charges,,,,17.2216,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.3152,18.128,
AMOXIL 100/5 5ml BOTTLE,2502453,CDM,,,250,RC,inpatient,5,ML,,21.115,11.61325,,19.0035,90,percent of total billed charges,,,,21.115,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.0035,90,percent of total billed charges,,,,20.05925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.0035,21.115,
PROZAC 20MG CAP,2502455,CDM,,,250,RC,inpatient,20,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
PYRIDOSTIGMINE 60mg TABLET,2502473,CDM,,,250,RC,inpatient,60,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
ZINC SULFATE 220 mg TABS,2502481,CDM,,,250,RC,inpatient,220,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
ZOSYN 2.25gr,2502494,CDM,,,250,RC,inpatient,2.25,GR,,35.02,19.261,,31.518,90,percent of total billed charges,,,,35.02,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.518,90,percent of total billed charges,,,,33.269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.518,35.02,
ZOSYN 3.375gr VIAL,2502496,CDM,J2543,HCPCS,250,RC,inpatient,3.375,GR,,72.203,39.71165,,64.9827,90,percent of total billed charges,,,,72.203,100,percent of total billed charges,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,1.872,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.9827,90,percent of total billed charges,,,,68.59285,95,percent of total billed charges,,,,,,,,,4.36,,,fee schedule,,,4.36,,,fee schedule,,,,,,,,,,,,,,,1.872,72.203,
MIDODRINE 5mg TABLET,2502497,CDM,,,250,RC,inpatient,5,ME,,7.107,3.90885,,6.3963,90,percent of total billed charges,,,,7.107,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3963,90,percent of total billed charges,,,,6.75165,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3963,7.107,
NAFCILLIN 2gr VIAL,2502499,CDM,,,250,RC,inpatient,2,GR,,89.301,49.11555,,80.3709,90,percent of total billed charges,,,,89.301,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,80.3709,90,percent of total billed charges,,,,84.83595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,80.3709,89.301,
HALDOL DECANOATE 100mg/ml VIAL,2502501,CDM,,,250,RC,inpatient,100,ME,,113.609,62.48495,,102.2481,90,percent of total billed charges,,,,113.609,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102.2481,90,percent of total billed charges,,,,107.92855,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102.2481,113.609,
DOPAMINE 400mg/250ml DSW,2502519,CDM,,,250,RC,inpatient,400,ME,,68.701,37.78555,,61.8309,90,percent of total billed charges,,,,68.701,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.8309,90,percent of total billed charges,,,,65.26595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.8309,68.701,
MOBIC 15mg TABLET,2502524,CDM,,,250,RC,inpatient,15,ME,,16.686,9.1773,,15.0174,90,percent of total billed charges,,,,16.686,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.0174,90,percent of total billed charges,,,,15.8517,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.0174,16.686,
QUESTRAN LIGHT 1 PKT POWDER,2502525,CDM,,,250,RC,inpatient,1,EA,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
BUPIVACCINE 0.51 PF 10ml VIAL,2502531,CDM,,,250,RC,inpatient,10,ML,,10.094,5.5517,,9.0846,90,percent of total billed charges,,,,10.094,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.0846,90,percent of total billed charges,,,,9.5893,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.0846,10.094,
MAGNESIUM SULFATE 20gr/500ml,2502534,CDM,,,250,RC,inpatient,20,GR,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
ZEMURIN 10mg/ml 5 ml VIAL,2502541,CDM,,,250,RC,inpatient,10,ME,,30.385,16.71175,,27.3465,90,percent of total billed charges,,,,30.385,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.3465,90,percent of total billed charges,,,,28.86575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.3465,30.385,
TAMIFLU 6mg/ml,2502542,CDM,,,250,RC,inpatient,6,ME,,8.549,4.70195,,7.6941,90,percent of total billed charges,,,,8.549,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6941,90,percent of total billed charges,,,,8.12155,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6941,8.549,
ETHAMBUTOL HCL 400 MG TABLET,2502563,CDM,,,250,RC,inpatient,400,ME,,8.24,4.532,,7.416,90,percent of total billed charges,,,,8.24,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.416,90,percent of total billed charges,,,,7.828,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.416,8.24,
NEBIVOLOL HCL 5mg TABLET,2502564,CDM,,,250,RC,inpatient,5,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
ACETYLCYSTEINE 20% INJECTION,2502567,CDM,,,250,RC,inpatient,1,EA,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
RIVASTIGMINE 4.6mg PATCH TD24,2502579,CDM,,,250,RC,inpatient,4.6,ME,,26.265,14.44575,,23.6385,90,percent of total billed charges,,,,26.265,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.6385,90,percent of total billed charges,,,,24.95175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.6385,26.265,
RACEPINEPHRINE 2.25% AEROSOL,2502605,CDM,,,250,RC,inpatient,1,EA,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.9618,90,percent of total billed charges,,,,32.6819,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.9618,34.402,
METHYL SALICYLATE/MENTHOL 35.4,2502623,CDM,,,250,RC,inpatient,1,EA,,8.446,4.6453,,7.6014,90,percent of total billed charges,,,,8.446,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6014,90,percent of total billed charges,,,,8.0237,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6014,8.446,
CHIBROXIN 0.3% DROPS,2502640,CDM,,,250,RC,inpatient,1,EA,,55.105,30.30775,,49.5945,90,percent of total billed charges,,,,55.105,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.5945,90,percent of total billed charges,,,,52.34975,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.5945,55.105,
TRANEXAMIC ACID 1000mg/10ml IN,2502648,CDM,,,250,RC,inpatient,1000,ME,,19.467,10.70685,,17.5203,90,percent of total billed charges,,,,19.467,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.5203,90,percent of total billed charges,,,,18.49365,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.5203,19.467,
CHLORASEPTIC SPRAY  AEROSOL,2502650,CDM,,,250,RC,inpatient,1,EA,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
NICARDIPINE 25mg/10ml INJ,2502652,CDM,,,250,RC,inpatient,25,ME,,36.359,19.99745,,32.7231,90,percent of total billed charges,,,,36.359,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.7231,90,percent of total billed charges,,,,34.54105,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.7231,36.359,
ENTRESTO 24/26 mg TAB,2502653,CDM,,,250,RC,inpatient,24,ME,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,21.836,
BUPROPION XL 150mg TAB,2502654,CDM,,,250,RC,inpatient,150,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
RISPERIDONE MICRO 37.5mg,2502658,CDM,J2794,HCPCS,250,RC,inpatient,37.5,ME,,1408.113,774.46215,,1267.3017,90,percent of total billed charges,,,,1408.113,100,percent of total billed charges,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,10.224,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1267.3017,90,percent of total billed charges,,,,1337.70735,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.224,1408.113,
DABIGATRAN ETEXLIATE MESYLATE,2502671,CDM,,,250,RC,inpatient,1,EA,,15.244,8.3842,,13.7196,90,percent of total billed charges,,,,15.244,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.7196,90,percent of total billed charges,,,,14.4818,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.7196,15.244,
TOLTERODINE TARTRATE 2mg TAB,2502677,CDM,,,250,RC,inpatient,2,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
FOSPHENYTOIN 50mg/ml VIAL,2502683,CDM,,,250,RC,inpatient,50,ME,,37.595,20.67725,,33.8355,90,percent of total billed charges,,,,37.595,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.8355,90,percent of total billed charges,,,,35.71525,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.8355,37.595,
HEP B VACCINE 5mcg/0.5ml,2502684,CDM,,,250,RC,inpatient,0.5,ML,,51.5,28.325,,46.35,90,percent of total billed charges,,,,51.5,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.35,90,percent of total billed charges,,,,48.925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.35,51.5,
RISPERIDONE MICRO 12.5mg,2502687,CDM,,,250,RC,inpatient,12.5,ME,,413.442,227.3931,,372.0978,90,percent of total billed charges,,,,413.442,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,372.0978,90,percent of total billed charges,,,,392.7699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,372.0978,413.442,
CEFAZOLIN/ DEXTROSE 2gr,2502689,CDM,,,250,RC,inpatient,2,GR,,10.094,5.5517,,9.0846,90,percent of total billed charges,,,,10.094,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.0846,90,percent of total billed charges,,,,9.5893,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.0846,10.094,
DILTIAZEM HCL 5mg/ml VIAL,2502701,CDM,,,250,RC,inpatient,5,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,90,percent of total billed charges,,,,23.97325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,25.235,
DILTIAZEM 5mg/ml 10ml VIAL,2502702,CDM,,,250,RC,inpatient,5,ME,,18.025,9.91375,,16.2225,90,percent of total billed charges,,,,18.025,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.2225,90,percent of total billed charges,,,,17.12375,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.2225,18.025,
GENTAMICIN SULFATE CR 15GM TUB,2502709,CDM,,,250,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
LEVOTHYROXINE 100mcg  VIAL,2502714,CDM,J0650,HCPCS,250,RC,inpatient,1,EA,,105.266,57.8963,,94.7394,90,percent of total billed charges,,,,105.266,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.7394,90,percent of total billed charges,,,,100.0027,95,percent of total billed charges,,,,,,,,,12.04,,,fee schedule,,,12.04,,,fee schedule,,,,,,,,,,,,,,,12.04,105.266,
OLANZAPINE 10mg TAB,2502722,CDM,,,250,RC,inpatient,10,ME,,44.599,24.52945,,40.1391,90,percent of total billed charges,,,,44.599,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.1391,90,percent of total billed charges,,,,42.36905,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.1391,44.599,
GLUTOSE 15 ORAL GEL,2502739,CDM,,,250,RC,inpatient,1,EA,,13.699,7.53445,,12.3291,90,percent of total billed charges,,,,13.699,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.3291,90,percent of total billed charges,,,,13.01405,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.3291,13.699,
CLEOCIN 300MG/2ML INJ.,2502860,CDM,,,250,RC,inpatient,300,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
ROBINUL 0.2mg/ml INJ,2502905,CDM,,,250,RC,inpatient,0.2,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
ROBINUL 0.2MG/ML 20ML INJ,2502915,CDM,,,250,RC,inpatient,0.2,ME,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,21.836,
COCCIODIN 1:100 INJ.,2502930,CDM,,,250,RC,inpatient,1,EA,,102.073,56.14015,,91.8657,90,percent of total billed charges,,,,102.073,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.8657,90,percent of total billed charges,,,,96.96935,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.8657,102.073,
COGENTIN 1MG TAB.,2502950,CDM,,,250,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
COGENTIN PER MG/ML (2ML),2502960,CDM,,,250,RC,inpatient,1,ME,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,90,percent of total billed charges,,,,27.30015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,28.737,
COLACE 100mg CAP,2502980,CDM,,,250,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
COLYTE POWDER,2503040,CDM,,,250,RC,inpatient,1,EA,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,90,percent of total billed charges,,,,43.6411,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,45.938,
ROMAZICON 0.5MG/ML,2503045,CDM,,,250,RC,inpatient,0.5,ME,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.1751,114.639,
COMPAZINE 5MG TAB,2503070,CDM,,,250,RC,inpatient,5,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
SANDOSTATIN 50MCG/ML 1ML INJ,2503105,CDM,,,250,RC,inpatient,50,ML,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,21.836,
CORTISPORIN OPTH SUSP.,2503200,CDM,,,250,RC,inpatient,1,EA,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.9224,90,percent of total billed charges,,,,30.5292,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.9224,32.136,
CORTISPORIN OTIC SUSP.,2503220,CDM,,,250,RC,inpatient,1,EA,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.9224,90,percent of total billed charges,,,,30.5292,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.9224,32.136,
SILVADENE 85GR CREAM,2503265,CDM,,,250,RC,inpatient,85,GR,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,90,percent of total billed charges,,,,34.93245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,36.771,
SILVER NITRATE STICK 10EA TOP,2503275,CDM,,,250,RC,inpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
CYCLOGYL OPTH 1% GTTS.,2503320,CDM,,,250,RC,inpatient,1,EA,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,90,percent of total billed charges,,,,27.30015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,28.737,
D10W 1000ML,2503420,CDM,,,250,RC,inpatient,1000,ML,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,31.003,
SODIUM BICARBONATE 8.4% 50ML,2503425,CDM,,,250,RC,inpatient,50,ML,,55.105,30.30775,,49.5945,90,percent of total billed charges,,,,55.105,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.5945,90,percent of total billed charges,,,,52.34975,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.5945,55.105,
SODIUM BICARB 4.2% 5ML INJ,2503435,CDM,,,250,RC,inpatient,5,ML,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
SODIUM BICARB 8.4%/10MEQ/10ML,2503445,CDM,,,250,RC,inpatient,10,ML,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,33.372,
SODIUM CHLORIDE 0.45% 1000ML,2503455,CDM,,,250,RC,inpatient,1000,ML,,31.518,17.3349,,28.3662,90,percent of total billed charges,,,,31.518,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.3662,90,percent of total billed charges,,,,29.9421,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.3662,31.518,
D5 NORMAL SALINE 1000ML,2503470,CDM,,,250,RC,inpatient,1000,ML,,35.638,19.6009,,32.0742,90,percent of total billed charges,,,,35.638,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.0742,90,percent of total billed charges,,,,33.8561,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.0742,35.638,
SODIUM CHLORIDE 500ML 3% SOL,2503475,CDM,,,250,RC,inpatient,500,ML,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
D51/2 NORMAL SALINE 1000ML,2503490,CDM,,,250,RC,inpatient,1000,ML,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,90,percent of total billed charges,,,,39.23785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,41.303,
SODIUM CHLOR CONC 23.4% INJ,2503495,CDM,,,250,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
D5RL 1000ML,2503510,CDM,,,250,RC,inpatient,1000,ML,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,90,percent of total billed charges,,,,45.7938,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,48.204,
D5W 50ML,2503520,CDM,,,250,RC,inpatient,50,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
SODIUM PHOSP 60mEq na/15ml INJ,2503525,CDM,,,250,RC,inpatient,15,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
D5W 100ML,2503530,CDM,,,250,RC,inpatient,100,ML,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.1333,90,percent of total billed charges,,,,37.08515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.1333,39.037,
D5W 250ML,2503540,CDM,,,250,RC,inpatient,250,ML,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.6721,90,percent of total billed charges,,,,21.82055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.6721,22.969,
D5W 500ML,2503550,CDM,,,250,RC,inpatient,500,ML,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,90,percent of total billed charges,,,,39.23785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,41.303,
D5W 1000ML,2503560,CDM,,,250,RC,inpatient,1000,ML,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,90,percent of total billed charges,,,,43.6411,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,45.938,
D5W ADD-VAN 50ML,2503570,CDM,,,250,RC,inpatient,50,ML,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
D5W ADD-VAN 100ML,2503580,CDM,,,250,RC,inpatient,100,ML,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
D5W ADD-VAN 250ML,2503590,CDM,,,250,RC,inpatient,250,ML,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
DAKIN'S SOLUTION 0.25%,2503620,CDM,,,250,RC,inpatient,1,EA,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
STERILE WATER 20ml INJ,2503695,CDM,,,250,RC,inpatient,20,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
DEBROX 14ML GTTS.,2503770,CDM,,,250,RC,inpatient,14,ML,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
SUFENTA INJ,2503805,CDM,,,250,RC,inpatient,1,EA,,72.306,39.7683,,65.0754,90,percent of total billed charges,,,,72.306,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.0754,90,percent of total billed charges,,,,68.6907,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.0754,72.306,
SUPRANE CHG PER MIN LIQUID,2503835,CDM,,,250,RC,inpatient,1,EA,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.1321,90,percent of total billed charges,,,,2.25055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.1321,2.369,
DEXAMETH SOD PHOS 4mg/ml,2503840,CDM,,,250,RC,inpatient,4,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
SUSPHRINE 1:200/0.3ML INJ,2503885,CDM,,,250,RC,inpatient,0.3,ML,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,21.836,
DEMEROL 25mg/ml,2503920,CDM,,,250,RC,inpatient,25,ME,,17.819,9.80045,,16.0371,90,percent of total billed charges,,,,17.819,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.0371,90,percent of total billed charges,,,,16.92805,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.0371,17.819,
DEMEROL 50mg/ml INJ,2503930,CDM,,,250,RC,inpatient,50,ME,,4.944,2.7192,,4.4496,90,percent of total billed charges,,,,4.944,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.4496,90,percent of total billed charges,,,,4.6968,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.4496,4.944,
SYNTHROID 0.088MG TAB,2503975,CDM,,,250,RC,inpatient,0.088,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DEXTROSE ABBOJECT 50%/50ML INJ,2504180,CDM,,,250,RC,inpatient,50,ML,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.4427,51.603,
DIFLUCAN 100MG TAB,2504290,CDM,,,250,RC,inpatient,100,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,90,percent of total billed charges,,,,23.97325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,25.235,
DIPRIVAN 10MG/ML (100ML) INJ,2504410,CDM,,,250,RC,inpatient,10,ME,,200.644,110.3542,,180.5796,90,percent of total billed charges,,,,200.644,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,180.5796,90,percent of total billed charges,,,,190.6118,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,180.5796,200.644,
DIPRIVAN 20ML INJ,2504430,CDM,,,250,RC,inpatient,20,ML,,37.904,20.8472,,34.1136,90,percent of total billed charges,,,,37.904,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.1136,90,percent of total billed charges,,,,36.0088,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.1136,37.904,
"THROMBIN 20,000 UNITS TOPICAL",2504485,CDM,,,250,RC,inpatient,1,EA,,172.01,94.6055,,154.809,90,percent of total billed charges,,,,172.01,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,154.809,90,percent of total billed charges,,,,163.4095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,154.809,172.01,
TIMOPTIC 0.5% DROPS,2504605,CDM,,,250,RC,inpatient,1,EA,,53.972,29.6846,,48.5748,90,percent of total billed charges,,,,53.972,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.5748,90,percent of total billed charges,,,,51.2734,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.5748,53.972,
DULCOLAX/BISACODYL 5MG TAB,2504660,CDM,,,250,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DULCOLAX 10MG SUPPOS,2504670,CDM,,,250,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DURAGESIC 100MCG/HR TOPICAL,2504680,CDM,,,250,RC,inpatient,1,EA,,86.005,47.30275,,77.4045,90,percent of total billed charges,,,,86.005,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.4045,90,percent of total billed charges,,,,81.70475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.4045,86.005,
DURAGESIC 25MCG/HR TOPICAL,2504690,CDM,,,250,RC,inpatient,1,EA,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.9224,90,percent of total billed charges,,,,30.5292,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.9224,32.136,
DURAGESIC 50MCG/HR TOPICAL,2504700,CDM,,,250,RC,inpatient,1,EA,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,90,percent of total billed charges,,,,43.6411,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,45.938,
DURAGESIC 75MCG/HR TOPICAL,2504710,CDM,,,250,RC,inpatient,1,EA,,69.937,38.46535,,62.9433,90,percent of total billed charges,,,,69.937,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.9433,90,percent of total billed charges,,,,66.44015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.9433,69.937,
LABETALOL HCL 100MG/20ML,2504865,CDM,,,250,RC,inpatient,100,ME,,98.674,54.2707,,88.8066,90,percent of total billed charges,,,,98.674,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.8066,90,percent of total billed charges,,,,93.7403,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.8066,98.674,
TRIDIL/NITRO 25MG/5ML INJ,2504965,CDM,,,250,RC,inpatient,25,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
TRUSOPT 2% 10ml OPTHALMIC DROP,2505035,CDM,,,250,RC,inpatient,10,ML,,153.161,84.23855,,137.8449,90,percent of total billed charges,,,,153.161,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,137.8449,90,percent of total billed charges,,,,145.50295,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,137.8449,153.161,
EPHEDRINE 50MG/ML INJ,2505120,CDM,,,250,RC,inpatient,50,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
"EPINEPHRINE 1:1,000 INJ",2505130,CDM,,,250,RC,inpatient,1,EA,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,31.003,
TYLENOL 10GR (650MG) SUPPOS,2505135,CDM,,,250,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
"EPINEPHRINE 1:10,000 AB3.5 INJ",2505150,CDM,,,250,RC,inpatient,1,EA,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,90,percent of total billed charges,,,,39.23785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,41.303,
EPSOM SALT POWDER,2505190,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TYLENOL 5GR (325MG) SUPPOS,2505205,CDM,,,250,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TYLENOL W/COD ELIX 5CC,2505235,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ERYTHROCIN 500MG VIAL POWDER,2505250,CDM,,,250,RC,inpatient,500,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,16.171,
UNIPEN 2GM ADD-VAN INJ,2505345,CDM,,,250,RC,inpatient,1,EA,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,90,percent of total billed charges,,,,34.93245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,36.771,
VALISONE 0.05% CREAM,2505415,CDM,,,250,RC,inpatient,1,EA,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
FLAGYL 500MG PRE-MIX INJ,2505560,CDM,,,250,RC,inpatient,500,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,31.003,
FLEETS ENEMA,2505580,CDM,,,250,RC,inpatient,1,EA,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,90,percent of total billed charges,,,,6.6538,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,7.004,
FLEETS OIL RETENTION  ENEMA,2505600,CDM,,,250,RC,inpatient,1,EA,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
VASOTEC 1.25MG/ML INJ,2505635,CDM,,,250,RC,inpatient,1.25,ME,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,90,percent of total billed charges,,,,39.23785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,41.303,
VIBRAMYCIN 100mg VIAL,2505765,CDM,,,250,RC,inpatient,100,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
FOLVITE INJ 5MG/ML INJ,2505770,CDM,,,250,RC,inpatient,5,ME,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,90,percent of total billed charges,,,,34.93245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,36.771,
VIOFORM MILD CREAM,2505805,CDM,,,250,RC,inpatient,1,EA,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,90,percent of total billed charges,,,,34.93245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0939,36.771,
VISINE/COLLYRIUM FRESH 0.05%,2505825,CDM,,,250,RC,inpatient,1,EA,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,14.935,
GARAMYCIN 5ML DROPS,2505970,CDM,,,250,RC,inpatient,5,ML,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,40.17,
GLUCOPHAGE 500MG TAB,2506060,CDM,,,250,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
GLUCOPHAGE 850MG TAB,2506070,CDM,,,250,RC,inpatient,850,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
XANAX 0.5MG TAB,2506115,CDM,,,250,RC,inpatient,0.5,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
GLYCERIN SUPP ADULT  SUPPOSIT,2506140,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
GLYCER SUPP PED INFANT SUPPOS,2506150,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
HABITROL PATCH 14MG TOPICAL,2506210,CDM,,,250,RC,inpatient,14,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
HABITROL PATCH 21MG TOPICAL,2506220,CDM,,,250,RC,inpatient,21,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.613,90,percent of total billed charges,,,,18.5915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.613,19.57,
ZEMURON 50mg,2506245,CDM,,,250,RC,inpatient,50,ME,,101.558,55.8569,,91.4022,90,percent of total billed charges,,,,101.558,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.4022,90,percent of total billed charges,,,,96.4801,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.4022,101.558,
HALDOL 1MG TAB,2506260,CDM,,,250,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LISINOPRIL 20mg TAB,2506285,CDM,,,250,RC,inpatient,20,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
LISINOPRIL  5mg TAB,2506295,CDM,,,250,RC,inpatient,5,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
HCTZ/ESIDRIX 25MG TAB,2506320,CDM,,,250,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
HEMABATE (PROSTIN 15M) 250MCG,2506360,CDM,,,250,RC,inpatient,1,EA,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,90,percent of total billed charges,,,,64.28745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,67.671,
ZITHROMAX 200MG/5ML SUSP,2506365,CDM,,,250,RC,inpatient,200,ME,,74.572,41.0146,,67.1148,90,percent of total billed charges,,,,74.572,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.1148,90,percent of total billed charges,,,,70.8434,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.1148,74.572,
ZOCOR 10MG TAB,2506385,CDM,,,250,RC,inpatient,10,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
HEPARIN 5000 UNITS/CC INJECT,2506410,CDM,,,250,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
"HEPARIN PREMIX 25,000 UNTS INJ",2506440,CDM,,,250,RC,inpatient,1,EA,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,33.372,
HESPAN 6% INJ,2506450,CDM,,,250,RC,inpatient,1,EA,,153.676,84.5218,,138.3084,90,percent of total billed charges,,,,153.676,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,138.3084,90,percent of total billed charges,,,,145.9922,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,138.3084,153.676,
HUMIST DROPS SALINE,2506510,CDM,,,250,RC,inpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
HYDROCORTISONE 2.5% CREAM,2506570,CDM,,,250,RC,inpatient,1,EA,,7.622,4.1921,,6.8598,90,percent of total billed charges,,,,7.622,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.8598,90,percent of total billed charges,,,,7.2409,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.8598,7.622,
AMPICILLIN 2 GR VIAL INJECTION,2506595,CDM,,,250,RC,inpatient,2,GR,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
ARICEPT 5MG TABLET,2506605,CDM,,,250,RC,inpatient,5,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
HYGROTON 25MG TAB,2506620,CDM,,,250,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
HYTRIN 1MG CAP,2506670,CDM,,,250,RC,inpatient,1,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
HYTRIN 5MG CAP,2506690,CDM,,,250,RC,inpatient,5,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
MIACALCIN NASAL SPRAY,2506695,CDM,,,250,RC,inpatient,1,EA,,76.838,42.2609,,69.1542,90,percent of total billed charges,,,,76.838,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.1542,90,percent of total billed charges,,,,72.9961,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.1542,76.838,
CLEOCIN 900mg PREMIX IV,2506715,CDM,,,250,RC,inpatient,900,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,90,percent of total billed charges,,,,23.97325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,25.235,
CLEOCIN 600mg PREMIX IV,2506725,CDM,,,250,RC,inpatient,600,ME,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,90,percent of total billed charges,,,,22.8969,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,24.102,
IMDUR 30MG SLOW RELEASE,2506730,CDM,,,250,RC,inpatient,30,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
MAGNESIUM 40mg in D5W IV,2506765,CDM,,,250,RC,inpatient,40,ME,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,90,percent of total billed charges,,,,25.14745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,26.471,
IMODIUM 2MG CAP,2506770,CDM,,,250,RC,inpatient,2,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
IMURAN 50MG TAB,2506780,CDM,,,250,RC,inpatient,50,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
AMBIEN 5 MG,2506795,CDM,,,250,RC,inpatient,5,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
REMERON 15MG,2506805,CDM,,,250,RC,inpatient,15,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
RISPERDAL 1 MG,2506815,CDM,,,250,RC,inpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
INDERAL 20MG TAB,2506820,CDM,,,250,RC,inpatient,20,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ZYPREXA 2.5 MG,2506825,CDM,,,250,RC,inpatient,2.5,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
SEROQUEL 25 MG TABLET,2506855,CDM,,,250,RC,inpatient,25,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
EFFEXOR 25 MG TABLET,2506865,CDM,,,250,RC,inpatient,25,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
LUVOX 50 MG TABLET,2506885,CDM,,,250,RC,inpatient,50,ME,,8.6005,4.730275,,7.74045,90,percent of total billed charges,,,,8.6005,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.74045,90,percent of total billed charges,,,,8.170475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.74045,8.6005,
DDAVP 4 MCG/1ML,2506905,CDM,,,250,RC,inpatient,1,ML,,77.971,42.88405,,70.1739,90,percent of total billed charges,,,,77.971,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.1739,90,percent of total billed charges,,,,74.07245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.1739,77.971,
LIPITOR 10 MG TABLET,2506915,CDM,,,250,RC,inpatient,10,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
INDOCIN 25MG CAP,2506920,CDM,,,250,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
KLONOPIN 1MG TABLET,2506955,CDM,,,250,RC,inpatient,1,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
IMITREX 25 MG TABLET,2506985,CDM,,,250,RC,inpatient,25,ME,,37.904,20.8472,,34.1136,90,percent of total billed charges,,,,37.904,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.1136,90,percent of total billed charges,,,,36.0088,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.1136,37.904,
ZITHROMAX 250 MG TABLET,2507005,CDM,,,250,RC,inpatient,250,ME,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,90,percent of total billed charges,,,,22.8969,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,24.102,
XALATAN .005% 2.5ML BOTTLE,2507035,CDM,,,250,RC,inpatient,2.5,ML,,160.474,88.2607,,144.4266,90,percent of total billed charges,,,,160.474,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,144.4266,90,percent of total billed charges,,,,152.4503,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,144.4266,160.474,
SANTYL 30 GM OINTMENT,2507055,CDM,,,250,RC,inpatient,1,EA,,498.623,274.24265,,448.7607,90,percent of total billed charges,,,,498.623,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,448.7607,90,percent of total billed charges,,,,473.69185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,448.7607,498.623,
INSULIN NPH INJ,2507060,CDM,,,250,RC,inpatient,1,EA,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,90,percent of total billed charges,,,,45.7938,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,48.204,
EFFEXOR XR 75 MG TABLET,2507065,CDM,,,250,RC,inpatient,75,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
INSUL REG U-100 INJ,2507070,CDM,,,250,RC,inpatient,1,EA,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,90,percent of total billed charges,,,,45.7938,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,48.204,
RISPERDAL 1 MG/ML LIQUID,2507115,CDM,,,250,RC,inpatient,1,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
ISMO 20MG TAB,2507120,CDM,,,250,RC,inpatient,20,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
OCUFLOX SOLUTION,2507125,CDM,,,250,RC,inpatient,1,EA,,74.572,41.0146,,67.1148,90,percent of total billed charges,,,,74.572,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.1148,90,percent of total billed charges,,,,70.8434,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.1148,74.572,
ISOPTO ATROPINE % DROPS,2507150,CDM,,,250,RC,inpatient,1,EA,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,90,percent of total billed charges,,,,43.6411,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.3442,45.938,
MARCAINE SPINAL 7.5MG/ML INJ,2507155,CDM,,,250,RC,inpatient,7.5,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
EFFEXOR 37.5 MG CAPSULE,2507185,CDM,,,250,RC,inpatient,37.5,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
SINGULAIR 10 MG TABLET,2507215,CDM,,,250,RC,inpatient,10,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
ISORDIL 10MG TAB,2507220,CDM,,,250,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
WELLBUTRIN SR 100MG TABLET,2507225,CDM,,,250,RC,inpatient,100,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
DETROL 1MG TABLET,2507235,CDM,,,250,RC,inpatient,1,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
K-DUR 20MEQ SLOW RELEASE,2507270,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
CELEXA 20 MG TABLET,2507305,CDM,,,250,RC,inpatient,20,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
KCL 20MEQ/1000ML INJ,2507330,CDM,,,250,RC,inpatient,1000,ML,,47.071,25.88905,,42.3639,90,percent of total billed charges,,,,47.071,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.3639,90,percent of total billed charges,,,,44.71745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.3639,47.071,
ULTANE 250 ML CHG PER MIN LIQ,2507335,CDM,,,250,RC,inpatient,250,ML,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.1321,90,percent of total billed charges,,,,2.25055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.1321,2.369,
KCL 20MEQ D5NS 20MEQ/1000ML IN,2507350,CDM,,,250,RC,inpatient,1000,ML,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.7324,90,percent of total billed charges,,,,59.8842,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.7324,63.036,
KCL 20MEQ D5W 20MEQ/1000ML INJ,2507360,CDM,,,250,RC,inpatient,1000,ML,,47.071,25.88905,,42.3639,90,percent of total billed charges,,,,47.071,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.3639,90,percent of total billed charges,,,,44.71745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.3639,47.071,
KCL 20MEQ NS 20MEQ/1000ML INJ,2507370,CDM,,,250,RC,inpatient,1000,ML,,65.405,35.97275,,58.8645,90,percent of total billed charges,,,,65.405,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.8645,90,percent of total billed charges,,,,62.13475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.8645,65.405,
KCL 40MEQ D51/2NS 40MEQ/1000ML,2507380,CDM,,,250,RC,inpatient,1000,ML,,47.071,25.88905,,42.3639,90,percent of total billed charges,,,,47.071,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.3639,90,percent of total billed charges,,,,44.71745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.3639,47.071,
KCL 40MEQ D5NS 40MEQ/1000ML,2507400,CDM,,,250,RC,inpatient,1000,ML,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.7324,90,percent of total billed charges,,,,59.8842,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.7324,63.036,
KCL 40MEQ NS 40MEQ/1000ML INJ,2507420,CDM,,,250,RC,inpatient,1000,ML,,65.405,35.97275,,58.8645,90,percent of total billed charges,,,,65.405,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.8645,90,percent of total billed charges,,,,62.13475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.8645,65.405,
KCL CONCENTRATE 20MEQ INJ,2507430,CDM,,,250,RC,inpatient,1,EA,,16.892,9.2906,,15.2028,90,percent of total billed charges,,,,16.892,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.2028,90,percent of total billed charges,,,,16.0474,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.2028,16.892,
KCL CONCENTRATE 40MEQ INJ,2507440,CDM,,,250,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
KELFEX 250MG CAP,2507460,CDM,,,250,RC,inpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
KEFLEX PER 1ml (50mg),2507470,CDM,,,250,RC,inpatient,50,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
KEFLEX 500MG CAP,2507490,CDM,,,250,RC,inpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
KENALOG CREAM 0.1% 15 GR CREAM,2507540,CDM,,,250,RC,inpatient,15,GR,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
KETALAR 50MG/ML INJ,2507580,CDM,,,250,RC,inpatient,50,ME,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.6339,57.371,
KLONOPIN 0.5MG TAB,2507600,CDM,,,250,RC,inpatient,0.5,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
LACTATED RINGERS 500ML SOL,2507680,CDM,,,250,RC,inpatient,500,ML,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.1333,90,percent of total billed charges,,,,37.08515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.1333,39.037,
LACTATED RINGERS 1000ML SOL,2507690,CDM,,,250,RC,inpatient,1000,ML,,43.672,24.0196,,39.3048,90,percent of total billed charges,,,,43.672,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.3048,90,percent of total billed charges,,,,41.4884,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.3048,43.672,
LACTINEX GRANULES POWDER,2507700,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LANOLIN 30GM OINTMENT,2507730,CDM,,,250,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
LANOXIN 0.125MG TAB,2507770,CDM,,,250,RC,inpatient,0.125,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LASIX 20MG TABLET,2507830,CDM,,,250,RC,inpatient,20,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LESCOL 20MG CAP,2507890,CDM,,,250,RC,inpatient,20,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
LEVOPHED 1MG/4ML INJ,2507940,CDM,,,250,RC,inpatient,1,ME,,35.638,19.6009,,32.0742,90,percent of total billed charges,,,,35.638,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.0742,90,percent of total billed charges,,,,33.8561,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.0742,35.638,
LEVSIN 0.125MG TAB,2507950,CDM,,,250,RC,inpatient,0.125,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LIBRIUM 25MG CAP,2508000,CDM,,,250,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
INJ LIDOCAINE 10 MG,2508050,CDM,J2001,HCPCS,250,RC,inpatient,10,ME,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.036,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,,,,,,,,0.036,33.372,
LIDOCAINE 1% INJ 2ml,2508060,CDM,,,250,RC,inpatient,2,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
LIDOCAINE 1% PER 10CC,2508070,CDM,,,250,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
LIDOCAINE 2%,2508080,CDM,,,250,RC,inpatient,1,EA,,43.672,24.0196,,39.3048,90,percent of total billed charges,,,,43.672,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.3048,90,percent of total billed charges,,,,41.4884,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.3048,43.672,
LIDOCAINE 4% 50ML TOPICAL,2508120,CDM,,,250,RC,inpatient,50,ML,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,90,percent of total billed charges,,,,23.97325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,25.235,
LIDOCAINE 100<mg/5ml INJ,2508150,CDM,,,250,RC,inpatient,100,ME,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.9224,90,percent of total billed charges,,,,30.5292,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.9224,32.136,
LIDOCAINE VISCOUS 20ml GEL,2508180,CDM,,,250,RC,inpatient,20,ML,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
LIDOCAINE W/EPI PER 10CC,2508200,CDM,,,250,RC,inpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
LIORESAL 10MG TAB,2508250,CDM,,,250,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LIPOSYN II 20% 200ML INJ,2508270,CDM,,,250,RC,inpatient,200,ML,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.4427,51.603,
LIQUIFILM TEARS 1.4% OPHTH,2508290,CDM,,,250,RC,inpatient,1,EA,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,31.003,
LITHIUM CARBONATE 300MG TAB,2508300,CDM,,,250,RC,inpatient,300,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LOMOTIL 2.5MG/0.025MG TAB,2508330,CDM,,,250,RC,inpatient,2.5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LOPID 600MG TAB,2508360,CDM,,,250,RC,inpatient,600,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
LOPRESSOR 50MG TAB,2508370,CDM,,,250,RC,inpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
METOPOLOL TARTRATE 5 MG/5ML,2508390,CDM,,,250,RC,inpatient,5,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,90,percent of total billed charges,,,,23.97325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,25.235,
LOTRIMIN 1% 30 GR CREAM,2508460,CDM,,,250,RC,inpatient,30,GR,,62.006,34.1033,,55.8054,90,percent of total billed charges,,,,62.006,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.8054,90,percent of total billed charges,,,,58.9057,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.8054,62.006,
LOTRIMIN SOLUTION 1% 10ML TOP,2508480,CDM,,,250,RC,inpatient,10,ML,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,33.372,
LOTRISONE COMB CREAM,2508490,CDM,,,250,RC,inpatient,1,EA,,56.238,30.9309,,50.6142,90,percent of total billed charges,,,,56.238,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.6142,90,percent of total billed charges,,,,53.4261,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.6142,56.238,
LOXITANE 10MG TAB,2508510,CDM,,,250,RC,inpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
MACROBID 100MG SLOW REL,2508600,CDM,,,250,RC,inpatient,100,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
MAG-OX 400 400MG TAB,2508640,CDM,,,250,RC,inpatient,400,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MAGNESIUM CITRATE 10OZ ELIXIR,2508670,CDM,,,250,RC,inpatient,1,EA,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
MARCNE/SENSOR 0.25% INJ INTRAV,2508730,CDM,,,250,RC,inpatient,1,EA,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,21.836,
MARCANE/SENSOR 0.25% MPF W/EPI,2508740,CDM,,,250,RC,inpatient,1,EA,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,90,percent of total billed charges,,,,25.14745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,26.471,
MARCAINE/SENSOR 0.5% MPF W EPI,2508750,CDM,,,250,RC,inpatient,1,EA,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,90,percent of total billed charges,,,,27.30015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,28.737,
MARCAINE/SENSOR PER 30ML INJ,2508770,CDM,,,250,RC,inpatient,30,ML,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
MARCAINE SENSOR 1/2% 30ML MPF,2508780,CDM,,,250,RC,inpatient,30,ML,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,21.836,
MAXITROL 3.5MG/10000U .1 DROPS,2508820,CDM,,,250,RC,inpatient,3.5,ME,,65.405,35.97275,,58.8645,90,percent of total billed charges,,,,65.405,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.8645,90,percent of total billed charges,,,,62.13475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.8645,65.405,
MECLOMEN 50MG CAP,2508850,CDM,,,250,RC,inpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MEDROL 4MG TAB,2508870,CDM,,,250,RC,inpatient,4,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MEPHYTON 5MG TAB,2508990,CDM,,,250,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
METAMUCIL/HYDROCIL PKG PWDR,2509010,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
METHERGINE 0.2 MG/ML INJ,2509040,CDM,,,250,RC,inpatient,0.2,ME,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,14.935,
MEVACOR 20MG TAB,2509120,CDM,,,250,RC,inpatient,20,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
MEXITIL 200MG CAP,2509140,CDM,,,250,RC,inpatient,200,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
MEXITIL 250MG CAP,2509150,CDM,,,250,RC,inpatient,250,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
MICRO-K 10MEQ (750 MG) SLOW RE,2509180,CDM,,,250,RC,inpatient,750,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MIDAMOR 5MG TAB,2509200,CDM,,,250,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MILK OF MAGNESIA 30ML SUSP,2509230,CDM,,,250,RC,inpatient,30,ML,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
OLANZAPINE 1MG,2509235,CDM,J2359,HCPCS,250,RC,inpatient,1,ME,,2.06,1.133,,1.854,90,percent of total billed charges,,,,2.06,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1.854,90,percent of total billed charges,,,,1.957,95,percent of total billed charges,,,,,,,,,0.89,,,fee schedule,,,0.89,,,fee schedule,,,,,,,,,,,,,,,0.89,2.06,
MINERAL OIL 10ML ELIXIR,2509240,CDM,,,250,RC,inpatient,10,ML,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
MINIPRES 1MG CAP,2509260,CDM,,,250,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MONISTAT 7 45 GR CREAM,2509380,CDM,,,250,RC,inpatient,45,GR,,47.071,25.88905,,42.3639,90,percent of total billed charges,,,,47.071,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.3639,90,percent of total billed charges,,,,44.71745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.3639,47.071,
MORPHINE 15MG TAB,2509430,CDM,,,250,RC,inpatient,15,ME,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,90,percent of total billed charges,,,,7.14305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,7.519,
MORPHINE PCA 1MG/ML PCA INJ,2509450,CDM,,,250,RC,inpatient,1,ME,,26.265,14.44575,,23.6385,90,percent of total billed charges,,,,26.265,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.6385,90,percent of total billed charges,,,,24.95175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.6385,26.265,
MUCOSIL-20 20% 30ML LIQUID,2509510,CDM,,,250,RC,inpatient,30,ML,,128.441,70.64255,,115.5969,90,percent of total billed charges,,,,128.441,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,115.5969,90,percent of total billed charges,,,,122.01895,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,115.5969,128.441,
MULTI VIT W/MINERAL TAB,2509540,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MVI 10ML INJ INTRAVENOUS,2509570,CDM,,,250,RC,inpatient,10,ML,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,14.935,
MYCELEX TROCHE 10MG LOZENGE,2509580,CDM,,,250,RC,inpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
"MYCOSTATIN 100,000  U/GM CREAM",2509630,CDM,,,250,RC,inpatient,1,EA,,68.804,37.8422,,61.9236,90,percent of total billed charges,,,,68.804,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.9236,90,percent of total billed charges,,,,65.3638,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.9236,68.804,
MYLANTA CHEW TABLET,2509700,CDM,,,250,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MYLICON DROPS 40mg/0.6ml DROPS,2509730,CDM,,,250,RC,inpatient,40,ME,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,90,percent of total billed charges,,,,22.8969,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,24.102,
MYLICON-80 MYLAN GAS 80MG TAB,2509740,CDM,,,250,RC,inpatient,80,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
NAPROSYN 500MG TAB,2509890,CDM,,,250,RC,inpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
RANEXA 500mg TAB,2510030,CDM,,,250,RC,inpatient,500,ME,,15.965,8.78075,,14.3685,90,percent of total billed charges,,,,15.965,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.3685,90,percent of total billed charges,,,,15.16675,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.3685,15.965,
XARELTO 70mg,2510070,CDM,,,250,RC,inpatient,70,ME,,14.523,7.98765,,13.0707,90,percent of total billed charges,,,,14.523,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.0707,90,percent of total billed charges,,,,13.79685,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.0707,14.523,
BRILINTA 90 TABLET,2510160,CDM,,,250,RC,inpatient,1,EA,,10.609,5.83495,,9.5481,90,percent of total billed charges,,,,10.609,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.5481,90,percent of total billed charges,,,,10.07855,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.5481,10.609,
LIDOCAINE HCL JEL 2% Mml,2510260,CDM,,,250,RC,inpatient,2,ML,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
VANCOMYCIN 750mg,2510380,CDM,,,250,RC,inpatient,750,ME,,26.677,14.67235,,24.0093,90,percent of total billed charges,,,,26.677,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.0093,90,percent of total billed charges,,,,25.34315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.0093,26.677,
LIDOCAINE HCl/PF 200mg,2510430,CDM,,,250,RC,inpatient,200,ME,,14.626,8.0443,,13.1634,90,percent of total billed charges,,,,14.626,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.1634,90,percent of total billed charges,,,,13.8947,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.1634,14.626,
BETHANOCHOL 10mg TABLET,2510480,CDM,,,250,RC,inpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
SUGAMMADEX SODIUM 200MG/2ML VI,2510490,CDM,,,250,RC,inpatient,200,ME,,130.707,71.88885,,117.6363,90,percent of total billed charges,,,,130.707,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,117.6363,90,percent of total billed charges,,,,124.17165,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,117.6363,130.707,
FISH OIL 1000mg SOFTGEL CAP,2510560,CDM,,,250,RC,inpatient,1000,ME,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,90,percent of total billed charges,,,,4.20755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,4.429,
LEVEMIR 100u/1mgl,2510570,CDM,,,250,RC,inpatient,100,ME,,699.473,384.71015,,629.5257,90,percent of total billed charges,,,,699.473,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,629.5257,90,percent of total billed charges,,,,664.49935,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,629.5257,699.473,
ELIQUIS 5mg TABLET,2510580,CDM,,,250,RC,inpatient,5,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
NYSTATIN POWDER 15gr BOTTLE,2510590,CDM,,,250,RC,inpatient,15,GR,,31.518,17.3349,,28.3662,90,percent of total billed charges,,,,31.518,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.3662,90,percent of total billed charges,,,,29.9421,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.3662,31.518,
AMIODARONE 50mg/ml,2510610,CDM,,,250,RC,inpatient,50,ME,,34.196,18.8078,,30.7764,90,percent of total billed charges,,,,34.196,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.7764,90,percent of total billed charges,,,,32.4862,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.7764,34.196,
METHYLENE BLUE 0.5% INJ,2510611,CDM,,,250,RC,inpatient,1,EA,,256.47,141.0585,,230.823,90,percent of total billed charges,,,,256.47,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,230.823,90,percent of total billed charges,,,,243.6465,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,230.823,256.47,
CLINIMIX E 5%/20% 2L IV BAG,2510621,CDM,,,250,RC,inpatient,1,EA,,84.151,46.28305,,75.7359,90,percent of total billed charges,,,,84.151,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.7359,90,percent of total billed charges,,,,79.94345,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.7359,84.151,
NALOXEGOL 25MG TABLET,2510622,CDM,,,250,RC,inpatient,25,ME,,26.162,14.3891,,23.5458,90,percent of total billed charges,,,,26.162,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.5458,90,percent of total billed charges,,,,24.8539,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.5458,26.162,
VANCOMYCIN ORAL SOLUTION,2510624,CDM,,,250,RC,inpatient,1,EA,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
ROPIVACAINE .2%/EPIDURAL,2510625,CDM,,,250,RC,inpatient,1,EA,,93.833,51.60815,,84.4497,90,percent of total billed charges,,,,93.833,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.4497,90,percent of total billed charges,,,,89.14135,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.4497,93.833,
KETOTIFEN .025% OPTHALMIC DROP,2510629,CDM,,,250,RC,inpatient,1,EA,,15.759,8.66745,,14.1831,90,percent of total billed charges,,,,15.759,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.1831,90,percent of total billed charges,,,,14.97105,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.1831,15.759,
HYDROCODONE/ACETAMIN 7.5mg,2510630,CDM,,,250,RC,inpatient,7.5,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
HUMULIN 70/30 3ML VIAL,2510633,CDM,,,250,RC,inpatient,3,ML,,16.48,9.064,,14.832,90,percent of total billed charges,,,,16.48,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.832,90,percent of total billed charges,,,,15.656,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.832,16.48,
PALIPERIDONE ER 6MG TABLET,2510635,CDM,,,250,RC,inpatient,6,ME,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.0151,90,percent of total billed charges,,,,30.62705,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.0151,32.239,
LACOSAMIDE 100MG TABLET,2510636,CDM,,,250,RC,inpatient,100,ME,,32.754,18.0147,,29.4786,90,percent of total billed charges,,,,32.754,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.4786,90,percent of total billed charges,,,,31.1163,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.4786,32.754,
PALIPERIDONE ER 3MG TABLET,2510637,CDM,,,250,RC,inpatient,3,ME,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.0151,90,percent of total billed charges,,,,30.62705,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.0151,32.239,
CLINIMIX 5% / 20%,2510638,CDM,,,250,RC,inpatient,1,EA,,161.813,88.99715,,145.6317,90,percent of total billed charges,,,,161.813,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,145.6317,90,percent of total billed charges,,,,153.72235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,145.6317,161.813,
DICLOFENAC SODIUM 1% GEL,2510639,CDM,,,250,RC,inpatient,1,EA,,61.388,33.7634,,55.2492,90,percent of total billed charges,,,,61.388,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.2492,90,percent of total billed charges,,,,58.3186,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.2492,61.388,
LETS GEL,2510642,CDM,,,250,RC,inpatient,1,EA,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,90,percent of total billed charges,,,,24.56035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,25.853,
KEDRAB 300UNIT/2ML (150UNI/ML),2510644,CDM,,,250,RC,inpatient,2,ML,,558.878,307.3829,,502.9902,90,percent of total billed charges,,,,558.878,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,502.9902,90,percent of total billed charges,,,,530.9341,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,502.9902,558.878,
LACOSAMIDE 50MG TABLET,2510646,CDM,,,250,RC,inpatient,50,ME,,26.265,14.44575,,23.6385,90,percent of total billed charges,,,,26.265,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.6385,90,percent of total billed charges,,,,24.95175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.6385,26.265,
OLMESARTAN 40MG TABLET,2510647,CDM,,,250,RC,inpatient,40,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
SORBITOL SOLUTION 30 ML,2510649,CDM,,,250,RC,inpatient,30,ML,,7.21,3.9655,,6.489,90,percent of total billed charges,,,,7.21,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.489,90,percent of total billed charges,,,,6.8495,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.489,7.21,
PRAVASTATIN 20 MG,2510651,CDM,,,250,RC,inpatient,20,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
JARDIANCE 10 MG TABLET,2510653,CDM,,,250,RC,inpatient,10,ME,,45.011,24.75605,,40.5099,90,percent of total billed charges,,,,45.011,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.5099,90,percent of total billed charges,,,,42.76045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.5099,45.011,
FINASTERIDE 1 MG TABLET,2510657,CDM,,,250,RC,inpatient,1,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
ARIPIPRAZOLE 2MG TABLET,2510658,CDM,,,250,RC,inpatient,2,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
MYRBETRIQ ER 25 MG TABLET,2510659,CDM,,,250,RC,inpatient,25,ME,,30.694,16.8817,,27.6246,90,percent of total billed charges,,,,30.694,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.6246,90,percent of total billed charges,,,,29.1593,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.6246,30.694,
RELISTOR 12 MG SYRINGE,2510669,CDM,,,250,RC,inpatient,12,ME,,283.25,155.7875,,254.925,90,percent of total billed charges,,,,283.25,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,254.925,90,percent of total billed charges,,,,269.0875,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,254.925,283.25,
Tobramycin 0.3% EYE DROPS 5ML,2510671,CDM,,,250,RC,inpatient,5,ML,,23.278,12.8029,,20.9502,90,percent of total billed charges,,,,23.278,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.9502,90,percent of total billed charges,,,,22.1141,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.9502,23.278,
Nitroglycerin 25 mg,2510675,CDM,,,250,RC,inpatient,25,ME,,38.934,21.4137,,35.0406,90,percent of total billed charges,,,,38.934,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.0406,90,percent of total billed charges,,,,36.9873,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.0406,38.934,
CHLORHEXIDINE ORAL RINSE 473ML,2510676,CDM,,,250,RC,inpatient,473,ML,,74.572,41.0146,,67.1148,90,percent of total billed charges,,,,74.572,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.1148,90,percent of total billed charges,,,,70.8434,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.1148,74.572,
"CREON 12,0000 UNIT CAPSULE",2510678,CDM,,,250,RC,inpatient,1,EA,,11.639,6.40145,,10.4751,90,percent of total billed charges,,,,11.639,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.4751,90,percent of total billed charges,,,,11.05705,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.4751,11.639,
CORTEF 5 MG TABLET,2510679,CDM,,,250,RC,inpatient,5,ME,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,90,percent of total billed charges,,,,4.3054,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,4.532,
Latuda 20 mg tablet,2510680,CDM,,,250,RC,inpatient,20,ME,,95.584,52.5712,,86.0256,90,percent of total billed charges,,,,95.584,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,86.0256,90,percent of total billed charges,,,,90.8048,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,86.0256,95.584,
Polysporin ointment 30 Gram TU,2510681,CDM,,,250,RC,inpatient,30,GR,,15.656,8.6108,,14.0904,90,percent of total billed charges,,,,15.656,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.0904,90,percent of total billed charges,,,,14.8732,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.0904,15.656,
OFLOXACIN 0.3% OTIC DROPS 5ML,2510685,CDM,,,250,RC,inpatient,5,ML,,147.599,81.17945,,132.8391,90,percent of total billed charges,,,,147.599,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,132.8391,90,percent of total billed charges,,,,140.21905,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,132.8391,147.599,
GLYDE 6ML SYRINGE,2510686,CDM,,,250,RC,inpatient,6,ML,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
REMDESIVIR 100MG/20ML VIAL,2510688,CDM,,,250,RC,inpatient,20,ME,,1192.122,655.6671,,1072.9098,90,percent of total billed charges,,,,1192.122,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1072.9098,90,percent of total billed charges,,,,1132.5159,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1072.9098,1192.122,
MIRALAX 238 GRAM BOTTLE,2510689,CDM,,,250,RC,inpatient,238,GR,,16.377,9.00735,,14.7393,90,percent of total billed charges,,,,16.377,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.7393,90,percent of total billed charges,,,,15.55815,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.7393,16.377,
D51/3NS 500mL,2510700,CDM,,,250,RC,inpatient,3500,ML,,31.518,17.3349,,28.3662,90,percent of total billed charges,,,,31.518,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.3662,90,percent of total billed charges,,,,29.9421,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.3662,31.518,
RESTASIS 0.05% OPTHALMIC DROPS,2510702,CDM,,,250,RC,inpatient,1,EA,,626.034,344.3187,,563.4306,90,percent of total billed charges,,,,626.034,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,563.4306,90,percent of total billed charges,,,,594.7323,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,563.4306,626.034,
SENSORCAINE-MPF0.25% 10ML VIAL,2510704,CDM,,,250,RC,inpatient,10,ML,,36.668,20.1674,,33.0012,90,percent of total billed charges,,,,36.668,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0012,90,percent of total billed charges,,,,34.8346,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.0012,36.668,
FENOFIBRATE 160 MG TABLET,2510718,CDM,,,250,RC,inpatient,160,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
ACYCLOVIR 5% OINTMENT (15GRAM),2510719,CDM,,,250,RC,inpatient,15,GR,,64.375,35.40625,,57.9375,90,percent of total billed charges,,,,64.375,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.9375,90,percent of total billed charges,,,,61.15625,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.9375,64.375,
AZTREONAM 2 GRAM VIAL,2510720,CDM,,,250,RC,inpatient,2,GR,,121.746,66.9603,,109.5714,90,percent of total billed charges,,,,121.746,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.5714,90,percent of total billed charges,,,,115.6587,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.5714,121.746,
LINZESS 290 MCG CAPSULE,2510723,CDM,,,250,RC,inpatient,1,EA,,33.475,18.41125,,30.1275,90,percent of total billed charges,,,,33.475,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.1275,90,percent of total billed charges,,,,31.80125,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.1275,33.475,
METHENAMINE 1 GRAM TABLET,2510724,CDM,,,250,RC,inpatient,1,GR,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
HYDROMORPHONE 0.2MG/ML 6MC PCA,2510727,CDM,,,250,RC,inpatient,0.2,ME,,44.187,24.30285,,39.7683,90,percent of total billed charges,,,,44.187,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.7683,90,percent of total billed charges,,,,41.97765,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.7683,44.187,
NUPLAZID 34 MG CAPSULE,2510732,CDM,,,250,RC,inpatient,34,ME,,310.442,170.7431,,279.3978,90,percent of total billed charges,,,,310.442,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,279.3978,90,percent of total billed charges,,,,294.9199,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,279.3978,310.442,
TETRACYCLINE 500MG CAPSULE,2510735,CDM,,,250,RC,inpatient,500,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
CLINDAMYCIN 600MG/4mL VIAL,2510740,CDM,,,250,RC,inpatient,600,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
HYDROCORT SODIUM SUCC 500MG V,2510741,CDM,J1720,HCPCS,250,RC,inpatient,500,ME,,122.261,67.24355,,110.0349,90,percent of total billed charges,,,,122.261,100,percent of total billed charges,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,13.392,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,110.0349,90,percent of total billed charges,,,,116.14795,95,percent of total billed charges,,,,,,,,,4.94,,,fee schedule,,,4.94,,,fee schedule,,,,,,,,,,,,,,,4.94,122.261,
TRIAMCINOLONE 0.05% OINTMENT,2510743,CDM,,,250,RC,inpatient,1,EA,,332.484,182.8662,,299.2356,90,percent of total billed charges,,,,332.484,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,299.2356,90,percent of total billed charges,,,,315.8598,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,299.2356,332.484,
JARDIANCE 25MG TABLET,2510745,CDM,,,250,RC,inpatient,25,ME,,32.96,18.128,,29.664,90,percent of total billed charges,,,,32.96,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.664,90,percent of total billed charges,,,,31.312,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.664,32.96,
TRELEGY E 100MCG/62.5MCG/25MCG,2510746,CDM,,,250,RC,inpatient,1,EA,,336.501,185.07555,,302.8509,90,percent of total billed charges,,,,336.501,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.8509,90,percent of total billed charges,,,,319.67595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.8509,336.501,
SILDENAFIL 20MG TABLET,2510747,CDM,,,250,RC,inpatient,20,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
ARMODAFINIL 50MG TABLET,2510749,CDM,,,250,RC,inpatient,50,ME,,24.411,13.42605,,21.9699,90,percent of total billed charges,,,,24.411,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.9699,90,percent of total billed charges,,,,23.19045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.9699,24.411,
DESVENLAFAXINE ER 50MG TAB,2510750,CDM,,,250,RC,inpatient,50,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
TADALAFIL 5MG TAB,2510751,CDM,,,250,RC,inpatient,5,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
ATOMOXETINE 60 MG CAP,2510752,CDM,,,250,RC,inpatient,60,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
TOBRADEX OPTHALMIC OINT 3.5G,2510753,CDM,,,250,RC,inpatient,1,EA,,536.63,295.1465,,482.967,90,percent of total billed charges,,,,536.63,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,482.967,90,percent of total billed charges,,,,509.7985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,482.967,536.63,
Mineral Oil 30ML Unit Dose Cup,2510755,CDM,,,250,RC,inpatient,30,ML,,5.047,2.77585,,4.5423,90,percent of total billed charges,,,,5.047,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.5423,90,percent of total billed charges,,,,4.79465,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.5423,5.047,
Dofetilide 125 mcg Capsule,2510756,CDM,,,250,RC,inpatient,1,EA,,8.652,4.7586,,7.7868,90,percent of total billed charges,,,,8.652,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.7868,90,percent of total billed charges,,,,8.2194,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.7868,8.652,
Omnipaque 300 ML Vial,2510757,CDM,,,250,RC,inpatient,300,ML,,86.314,47.4727,,77.6826,90,percent of total billed charges,,,,86.314,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.6826,90,percent of total billed charges,,,,81.9983,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.6826,86.314,
Normal Saline 10 ML Vial,2510758,CDM,,,250,RC,inpatient,10,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
PRECEDEX 80 MCG/ML 20 ML VIAL,2510759,CDM,,,250,RC,inpatient,80,ML,,54.693,30.08115,,49.2237,90,percent of total billed charges,,,,54.693,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.2237,90,percent of total billed charges,,,,51.95835,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.2237,54.693,
LIDOCAINE 1% 5 ML INJECTION,2510760,CDM,J2001,HCPCS,250,RC,inpatient,5,ML,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.036,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,,,,,,,,0.036,4.12,
DEXTROSE 5% 25 ML BAG,2510761,CDM,,,250,RC,inpatient,25,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
Actidose-Aqua 25g /120 ML Tube,2510762,CDM,,,250,RC,inpatient,120,ML,,32.754,18.0147,,29.4786,90,percent of total billed charges,,,,32.754,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.4786,90,percent of total billed charges,,,,31.1163,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.4786,32.754,
Ketamine 50mg/ml 1ml Syringe,2510763,CDM,,,250,RC,inpatient,1,ME,,15.553,8.55415,,13.9977,90,percent of total billed charges,,,,15.553,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.9977,90,percent of total billed charges,,,,14.77535,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.9977,15.553,
Clindamycin 900mg/6ml vial,2510765,CDM,J0736,HCPCS,250,RC,inpatient,6,ME,,80.958,44.5269,,72.8622,90,percent of total billed charges,,,,80.958,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.8622,90,percent of total billed charges,,,,76.9101,95,percent of total billed charges,,,,,,,,,1.61,,,fee schedule,,,1.61,,,fee schedule,,,,,,,,,,,,,,,1.61,80.958,
ITRACONAZOLE 100 MG CAPSULE,2510767,CDM,,,250,RC,inpatient,100,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
FENTANYL 50MCG/1ML VIAL,2510803,CDM,,,250,RC,inpatient,50,ML,,2.163,1.18965,,1.9467,90,percent of total billed charges,,,,2.163,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1.9467,90,percent of total billed charges,,,,2.05485,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1.9467,2.163,
KETOCONAZOLE SHAMPOO 120ML,2510804,CDM,,,250,RC,inpatient,120,ML,,44.702,24.5861,,40.2318,90,percent of total billed charges,,,,44.702,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.2318,90,percent of total billed charges,,,,42.4669,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.2318,44.702,
VANCOMYCIN 1.5G VIAL,2510805,CDM,J3371,HCPCS,250,RC,inpatient,1,EA,,38.419,21.13045,,34.5771,90,percent of total billed charges,,,,38.419,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.5771,90,percent of total billed charges,,,,36.49805,95,percent of total billed charges,,,,,,,,,6.4,,,fee schedule,,,6.4,,,fee schedule,,,,,,,,,,,,,,,6.4,38.419,
CLOBETASOL PROPIONATE OINT 60G,2510806,CDM,,,250,RC,inpatient,1,EA,,26.368,14.5024,,23.7312,90,percent of total billed charges,,,,26.368,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.7312,90,percent of total billed charges,,,,25.0496,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.7312,26.368,
Exemestane 25mg,2510807,CDM,J8999,HCPCS,250,RC,inpatient,25,ME,,22.351,12.29305,,20.1159,90,percent of total billed charges,,,,22.351,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.1159,90,percent of total billed charges,,,,21.23345,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.1159,22.351,
duloxetine 20mg capsule,2510808,CDM,,,250,RC,inpatient,20,ME,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
Olanzapine 10mg inj,2510811,CDM,J2359,HCPCS,250,RC,inpatient,10,ME,,32.857,18.07135,,29.5713,90,percent of total billed charges,,,,32.857,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.5713,90,percent of total billed charges,,,,31.21415,95,percent of total billed charges,,,,,,,,,0.89,,,fee schedule,,,0.89,,,fee schedule,,,,,,,,,,,,,,,0.89,32.857,
METFORMIN ER 750,2510812,CDM,,,250,RC,inpatient,1,EA,,1.339,0.73645,,1.2051,90,percent of total billed charges,,,,1.339,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1.2051,90,percent of total billed charges,,,,1.27205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1.2051,1.339,
DEXMEDTOMIDINE 4CG/ML 100ML,2518013,CDM,,,250,RC,inpatient,100,ML,,92.494,50.8717,,83.2446,90,percent of total billed charges,,,,92.494,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.2446,90,percent of total billed charges,,,,87.8693,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.2446,92.494,
NACL 5000 CC,2705250,CDM,,,250,RC,inpatient,1,EA,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,31.003,
NITROGLYCERIN 1gr OINT,25002500,CDM,,,250,RC,inpatient,1,GR,,8.652,4.7586,,7.7868,90,percent of total billed charges,,,,8.652,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.7868,90,percent of total billed charges,,,,8.2194,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.7868,8.652,
anastrozole 1mg,25810809,CDM,J8999,HCPCS,250,RC,inpatient,1,ME,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.1321,90,percent of total billed charges,,,,2.25055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.1321,2.369,
TETRABENAZINE 12.5MG TABLET,2510801,CDM,,,251,RC,inpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,90,percent of total billed charges,,,,3.42475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,3.605,
TOLVAPTAN 30MG TAB,2510802,CDM,,,251,RC,inpatient,,,,161.916,89.0538,,145.7244,90,percent of total billed charges,,,,161.916,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,145.7244,90,percent of total billed charges,,,,153.8202,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,145.7244,161.916,
IV SOLUTION D20W,2704430,CDM,,,258,RC,inpatient,,,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,90,percent of total billed charges,,,,7.14305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,7.519,
IV SOLUTION 1000ML,2709690,CDM,,,258,RC,inpatient,,,,5.356,2.9458,,4.8204,90,percent of total billed charges,,,,5.356,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.8204,90,percent of total billed charges,,,,5.0882,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.8204,5.356,
IV SOLUTION 500ML,2709700,CDM,,,258,RC,inpatient,,,,5.665,3.11575,,5.0985,90,percent of total billed charges,,,,5.665,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.0985,90,percent of total billed charges,,,,5.38175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.0985,5.665,
IV SOLUTION 250ML,2709710,CDM,,,258,RC,inpatient,,,,24.72,13.596,,22.248,90,percent of total billed charges,,,,24.72,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.248,90,percent of total billed charges,,,,23.484,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.248,24.72,
IV SOLUTION 150ML,2709720,CDM,,,258,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
HYDRATION IV INFUS INIT HR LDR,2600002,CDM,96360,CPT,260,RC,inpatient,,,,181.177,99.64735,,163.0593,90,percent of total billed charges,,,,181.177,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,163.0593,90,percent of total billed charges,,,,172.11815,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,32.288875,,,fee schedule,,,32.288875,196.077,
HYDRATION IV INF ADD'L HR LDRP,2600003,CDM,96361,CPT,260,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,,,,,,12.316375,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12.316375,,,fee schedule,,,12.316375,51.603,
ADMIN SUBQ/IM INJECTION LDRP,2600004,CDM,96372,CPT,260,RC,inpatient,,,,59.122,32.5171,,53.2098,90,percent of total billed charges,,,,59.122,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,,,,,,14.313625,,,fee schedule,,,,,,,,,,53.2098,90,percent of total billed charges,,,,56.1659,95,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.313625,,,fee schedule,,,14.313625,64.0395,
IV PUSH INITIAL LDRP,2600005,CDM,96374,CPT,260,RC,inpatient,,,,128.853,70.86915,,115.9677,90,percent of total billed charges,,,,128.853,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,115.9677,90,percent of total billed charges,,,,122.41035,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.61625,,,fee schedule,,,36.61625,196.077,
IV PUSH EA ADD'L NEW MED LDRP,2600006,CDM,96375,CPT,260,RC,inpatient,,,,90.022,49.5121,,81.0198,90,percent of total billed charges,,,,90.022,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,15.31225,,,fee schedule,,,15.31225,,,fee schedule,,,,,,,,,15.31225,,,fee schedule,,,,,,,,,,81.0198,90,percent of total billed charges,,,,85.5209,95,percent of total billed charges,,,15.7716175,,,fee schedule,,,,,,,,,,,,,,,,,,,,,15.31225,,,fee schedule,,,15.31225,90.022,
IV PUSH SEQUENT SAME MED LDRP,2600007,CDM,96376,CPT,260,RC,inpatient,,,,21.527,11.83985,,19.3743,90,percent of total billed charges,,,,21.527,100,percent of total billed charges,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,29.295,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.3743,90,percent of total billed charges,,,,20.45065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.3743,32.55,
IV INFUSION INITIAL HR - OP,2600020,CDM,96365,CPT,260,RC,inpatient,,,,190.344,104.6892,,171.3096,90,percent of total billed charges,,,,190.344,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,,,,,,,,171.3096,90,percent of total billed charges,,,,180.8268,95,percent of total billed charges,,,64.457915,,,fee schedule,,,90.58,,,fee schedule,,,90.58,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,62.5805,196.077,
IV INFUSION EACH ADD'L HR - OP,2600021,CDM,96366,CPT,260,RC,inpatient,,,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,,,,,,20.305375,,,fee schedule,,,,,,,,,,56.7324,90,percent of total billed charges,,,,59.8842,95,percent of total billed charges,,,20.91453625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,20.305375,,,fee schedule,,,20.305375,63.036,
HYDRATION IV INFUS INIT HR -OP,2600022,CDM,96360,CPT,260,RC,inpatient,,,,181.177,99.64735,,163.0593,90,percent of total billed charges,,,,181.177,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,163.0593,90,percent of total billed charges,,,,172.11815,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,32.288875,,,fee schedule,,,32.288875,196.077,
HYDRATION IV INFUS EA + HR- OP,2600023,CDM,96361,CPT,260,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,,,,,,12.316375,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12.316375,,,fee schedule,,,12.316375,51.603,
IV INFUSION INITIAL HOUR - OBS,2600030,CDM,96365,CPT,260,RC,inpatient,,,,190.344,104.6892,,171.3096,90,percent of total billed charges,,,,190.344,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,,,,,,,,171.3096,90,percent of total billed charges,,,,180.8268,95,percent of total billed charges,,,64.457915,,,fee schedule,,,90.58,,,fee schedule,,,90.58,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,62.5805,196.077,
IV INFUSION EA ADD'L HR - OBS,2600040,CDM,96366,CPT,260,RC,inpatient,,,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,,,,,,20.305375,,,fee schedule,,,,,,,,,,56.7324,90,percent of total billed charges,,,,59.8842,95,percent of total billed charges,,,20.91453625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,20.305375,,,fee schedule,,,20.305375,63.036,
HYDRATION IV INFUS INIT HR-OBS,2600050,CDM,96360,CPT,260,RC,inpatient,,,,218.978,120.4379,,197.0802,90,percent of total billed charges,,,,218.978,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,197.0802,90,percent of total billed charges,,,,208.0291,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,32.288875,,,fee schedule,,,32.288875,218.978,
IV INFUS SEQUENTIAL 1 HR - OP,2600070,CDM,96367,CPT,260,RC,inpatient,,,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,28.294375,,,fee schedule,,,28.294375,,,fee schedule,,,,,,,,,28.294375,,,fee schedule,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,29.14320625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.294375,,,fee schedule,,,28.294375,64.0395,
IV INFUS SEQUENTIAL 1 HR - OBS,2600767,CDM,96367,CPT,260,RC,inpatient,,,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,28.294375,,,fee schedule,,,28.294375,,,fee schedule,,,,,,,,,28.294375,,,fee schedule,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,29.14320625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.294375,,,fee schedule,,,28.294375,64.0395,
IV INFUSION INITIAL HR - LDRP,2603100,CDM,96365,CPT,260,RC,inpatient,,,,190.344,104.6892,,171.3096,90,percent of total billed charges,,,,190.344,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,,,,,,,,171.3096,90,percent of total billed charges,,,,180.8268,95,percent of total billed charges,,,64.457915,,,fee schedule,,,90.58,,,fee schedule,,,90.58,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,62.5805,196.077,
IV INFUSION EA ADD'L HR - LDRP,2603101,CDM,96366,CPT,260,RC,inpatient,,,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,,,,,,20.305375,,,fee schedule,,,,,,,,,,56.7324,90,percent of total billed charges,,,,59.8842,95,percent of total billed charges,,,20.91453625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,20.305375,,,fee schedule,,,20.305375,63.036,
IV INFUSION 1ST HOUR ER,4500081,CDM,96365,CPT,260,RC,inpatient,,,,190.344,104.6892,,171.3096,90,percent of total billed charges,,,,190.344,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,,,,,,,,171.3096,90,percent of total billed charges,,,,180.8268,95,percent of total billed charges,,,64.457915,,,fee schedule,,,90.58,,,fee schedule,,,90.58,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,62.5805,196.077,
IV INFUSION THERAPY EA ADDL HR,4500082,CDM,96366,CPT,260,RC,inpatient,,,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,,,,,,20.305375,,,fee schedule,,,,,,,,,,56.7324,90,percent of total billed charges,,,,59.8842,95,percent of total billed charges,,,20.91453625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,20.305375,,,fee schedule,,,20.305375,63.036,
IV PUSH EACH NEW MED -  ER,4500225,CDM,96375,CPT,260,RC,inpatient,,,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,15.31225,,,fee schedule,,,15.31225,,,fee schedule,,,,,,,,,15.31225,,,fee schedule,,,,,,,,,,45.5157,90,percent of total billed charges,,,,48.04435,95,percent of total billed charges,,,15.7716175,,,fee schedule,,,,,,,,,,,,,,,,,,,,,15.31225,,,fee schedule,,,15.31225,50.573,
INJECTION ADMIN SUBQ/IM - OP,9490000,CDM,96372,CPT,260,RC,inpatient,,,,61.388,33.7634,,55.2492,90,percent of total billed charges,,,,61.388,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,,,,,,14.313625,,,fee schedule,,,,,,,,,,55.2492,90,percent of total billed charges,,,,58.3186,95,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.313625,,,fee schedule,,,14.313625,64.0395,
THER PROPH DIAG INJ INV PUSH,9490010,CDM,96374,CPT,260,RC,inpatient,,,,134.106,73.7583,,120.6954,90,percent of total billed charges,,,,134.106,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,120.6954,90,percent of total billed charges,,,,127.4007,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.61625,,,fee schedule,,,36.61625,196.077,
TXT PRO DX INJ NEW DRUG ADD ON,9490020,CDM,96375,CPT,260,RC,inpatient,,,,93.627,51.49485,,84.2643,90,percent of total billed charges,,,,93.627,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,15.31225,,,fee schedule,,,15.31225,,,fee schedule,,,,,,,,,15.31225,,,fee schedule,,,,,,,,,,84.2643,90,percent of total billed charges,,,,88.94565,95,percent of total billed charges,,,15.7716175,,,fee schedule,,,,,,,,,,,,,,,,,,,,,15.31225,,,fee schedule,,,15.31225,93.627,
INJECTION SUB Q/IM - OBS,9490030,CDM,96372,CPT,260,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,,,,,,14.313625,,,fee schedule,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.313625,,,fee schedule,,,14.313625,75.19,
IV PUSH INITIAL - OP,9490040,CDM,96374,CPT,260,RC,inpatient,,,,134.106,73.7583,,120.6954,90,percent of total billed charges,,,,134.106,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,120.6954,90,percent of total billed charges,,,,127.4007,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.61625,,,fee schedule,,,36.61625,196.077,
IV PUSH EA ADD'L NEW MED - OP,9490050,CDM,96375,CPT,260,RC,inpatient,,,,93.627,51.49485,,84.2643,90,percent of total billed charges,,,,93.627,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,15.31225,,,fee schedule,,,15.31225,,,fee schedule,,,,,,,,,15.31225,,,fee schedule,,,,,,,,,,84.2643,90,percent of total billed charges,,,,88.94565,95,percent of total billed charges,,,15.7716175,,,fee schedule,,,,,,,,,,,,,,,,,,,,,15.31225,,,fee schedule,,,15.31225,93.627,
IV PUSH SEQUENT SAME MED - OBS,9499077,CDM,96376,CPT,260,RC,inpatient,,,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,29.295,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.2086,90,percent of total billed charges,,,,21.3313,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.2086,32.55,
ARM COMPRESSION SLEEVE,013272,CDM,,,270,RC,inpatient,,,,46.35,25.4925,,41.715,90,percent of total billed charges,,,,46.35,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.715,90,percent of total billed charges,,,,44.0325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.715,46.35,
MASIMO PULSE OX ADHES SENSOR,2700002,CDM,,,270,RC,inpatient,,,,24.823,13.65265,,22.3407,90,percent of total billed charges,,,,24.823,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.3407,90,percent of total billed charges,,,,23.58185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.3407,24.823,
ALLEVYN DRESSING,2700004,CDM,,,270,RC,inpatient,,,,10.197,5.60835,,9.1773,90,percent of total billed charges,,,,10.197,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.1773,90,percent of total billed charges,,,,9.68715,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.1773,10.197,
DISP PEAK FLOW - RT,2700010,CDM,,,270,RC,inpatient,,,,2.987,1.64285,,2.6883,90,percent of total billed charges,,,,2.987,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.6883,90,percent of total billed charges,,,,2.83765,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.6883,2.987,
C-ARM DRAPE #DYNJE4400,2700044,CDM,,,270,RC,inpatient,,,,18.952,10.4236,,17.0568,90,percent of total billed charges,,,,18.952,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.0568,90,percent of total billed charges,,,,18.0044,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.0568,18.952,
DENTAL UNIT,2700055,CDM,,,270,RC,inpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,90,percent of total billed charges,,,,34.0518,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,35.844,
OXYGEN PER HOUR,2700080,CDM,,,270,RC,inpatient,,,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
CEEA 25MM,2700085,CDM,,,270,RC,inpatient,,,,1695.071,932.28905,,1525.5639,90,percent of total billed charges,,,,1695.071,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1525.5639,90,percent of total billed charges,,,,1610.31745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1525.5639,1695.071,
SUPER SPONGES,2700095,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
MEDIPORE,2700104,CDM,,,270,RC,inpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
PNEUMOTHORAX TRAY,2700106,CDM,,,270,RC,inpatient,,,,220.729,121.40095,,198.6561,90,percent of total billed charges,,,,220.729,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.6561,90,percent of total billed charges,,,,209.69255,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.6561,220.729,
O2 TUBING CONNECTOR - RT,2700110,CDM,,,270,RC,inpatient,,,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,90,percent of total billed charges,,,,6.6538,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,7.004,
TRACH TRAY,2700115,CDM,,,270,RC,inpatient,,,,49.955,27.47525,,44.9595,90,percent of total billed charges,,,,49.955,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.9595,90,percent of total billed charges,,,,47.45725,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.9595,49.955,
HORIZ0N IV BLOOD TUBING,2700116,CDM,,,270,RC,inpatient,,,,12.051,6.62805,,10.8459,90,percent of total billed charges,,,,12.051,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.8459,90,percent of total billed charges,,,,11.44845,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.8459,12.051,
RESUS BAG/DISPOSABLE ADULT,2700140,CDM,,,270,RC,inpatient,,,,69.525,38.23875,,62.5725,90,percent of total billed charges,,,,69.525,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.5725,90,percent of total billed charges,,,,66.04875,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.5725,69.525,
CATH SUPRAPUBIC,2700145,CDM,,,270,RC,inpatient,,,,38.728,21.3004,,34.8552,90,percent of total billed charges,,,,38.728,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.8552,90,percent of total billed charges,,,,36.7916,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.8552,38.728,
INSUFFLATION TUBING,2700155,CDM,,,270,RC,inpatient,,,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,90,percent of total billed charges,,,,25.14745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.8239,26.471,
LIGACLIP 10MM #ER320,2700164,CDM,,,270,RC,inpatient,,,,134.209,73.81495,,120.7881,90,percent of total billed charges,,,,134.209,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,120.7881,90,percent of total billed charges,,,,127.49855,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,120.7881,134.209,
CHUX EACH,2700185,CDM,,,270,RC,inpatient,,,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.1321,90,percent of total billed charges,,,,2.25055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.1321,2.369,
ALCOHOL 4 OZ,2700195,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
BLUNT TROCAR 10MM,2700267,CDM,,,270,RC,inpatient,,,,407.777,224.27735,,366.9993,90,percent of total billed charges,,,,407.777,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,366.9993,90,percent of total billed charges,,,,387.38815,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,366.9993,407.777,
ENDOSTITCH 10MM,2700275,CDM,,,270,RC,inpatient,,,,661.981,364.08955,,595.7829,90,percent of total billed charges,,,,661.981,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,595.7829,90,percent of total billed charges,,,,628.88195,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,595.7829,661.981,
BETADINE 4 OZ.,2700280,CDM,,,270,RC,inpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,90,percent of total billed charges,,,,4.20755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,4.429,
CATHETER STRAIGHT,2700365,CDM,,,270,RC,inpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,90,percent of total billed charges,,,,25.93025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,27.295,
AUTO SUTURE PROTACK 5MM,2700372,CDM,,,270,RC,inpatient,,,,1078.513,593.18215,,970.6617,90,percent of total billed charges,,,,1078.513,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,970.6617,90,percent of total billed charges,,,,1024.58735,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,970.6617,1078.513,
DYNAGRAFT BONE PUTTY 5CC,2700387,CDM,,,270,RC,inpatient,,,,1050.394,577.7167,,945.3546,90,percent of total billed charges,,,,1050.394,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,945.3546,90,percent of total billed charges,,,,997.8743,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,945.3546,1050.394,
SALEM SUMP TUBE,2700405,CDM,,,270,RC,inpatient,,,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
NACL IRRIGATION 1000cc,2700420,CDM,,,270,RC,inpatient,,,,21.527,11.83985,,19.3743,90,percent of total billed charges,,,,21.527,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.3743,90,percent of total billed charges,,,,20.45065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.3743,21.527,
ARROW TWIN CATH,2700425,CDM,,,270,RC,inpatient,,,,32.96,18.128,,29.664,90,percent of total billed charges,,,,32.96,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.664,90,percent of total billed charges,,,,31.312,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.664,32.96,
ABDOMINAL PAD,2700460,CDM,,,270,RC,inpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,90,percent of total billed charges,,,,3.42475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,3.605,
PULSE OX PROBE,2700469,CDM,,,270,RC,inpatient,,,,44.187,24.30285,,39.7683,90,percent of total billed charges,,,,44.187,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.7683,90,percent of total billed charges,,,,41.97765,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.7683,44.187,
ABDOMINAL BINDER-UN,2700470,CDM,,,270,RC,inpatient,,,,22.351,12.29305,,20.1159,90,percent of total billed charges,,,,22.351,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.1159,90,percent of total billed charges,,,,21.23345,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.1159,22.351,
ABDUCTION PILLOW (LG),2700490,CDM,,,270,RC,inpatient,,,,42.436,23.3398,,38.1924,90,percent of total billed charges,,,,42.436,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.1924,90,percent of total billed charges,,,,40.3142,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.1924,42.436,
Wound Vac Canister Large,2700502,CDM,,,270,RC,inpatient,,,,75.087,41.29785,,67.5783,90,percent of total billed charges,,,,75.087,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.5783,90,percent of total billed charges,,,,71.33265,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.5783,75.087,
DISPOSABLE MYRINGOTOMY KNIFE,2700513,CDM,,,270,RC,inpatient,,,,49.646,27.3053,,44.6814,90,percent of total billed charges,,,,49.646,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.6814,90,percent of total billed charges,,,,47.1637,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.6814,49.646,
C-SECTION TRAY,2700525,CDM,,,270,RC,inpatient,,,,104.648,57.5564,,94.1832,90,percent of total billed charges,,,,104.648,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.1832,90,percent of total billed charges,,,,99.4156,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.1832,104.648,
ACE BANDAGE 2-6 INC,2700530,CDM,,,270,RC,inpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,90,percent of total billed charges,,,,4.3054,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,4.532,
ACE BANDAGE,2700531,CDM,,,270,RC,inpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,90,percent of total billed charges,,,,3.7183,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,3.914,
TUBING; BLOOD/FLUID WARMER,2700535,CDM,,,270,RC,inpatient,,,,17.613,9.68715,,15.8517,90,percent of total billed charges,,,,17.613,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.8517,90,percent of total billed charges,,,,16.73235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.8517,17.613,
HEEL LIFT BOOT,2700555,CDM,,,270,RC,inpatient,,,,70.555,38.80525,,63.4995,90,percent of total billed charges,,,,70.555,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.4995,90,percent of total billed charges,,,,67.02725,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.4995,70.555,
UMBILICAL VESSEL TRAY,2700565,CDM,,,270,RC,inpatient,,,,141.11,77.6105,,126.999,90,percent of total billed charges,,,,141.11,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.999,90,percent of total billed charges,,,,134.0545,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.999,141.11,
DIAPER AND PULLUPS ADULT,2700570,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
ARROW JUGULAR IV KIT,2700575,CDM,,,270,RC,inpatient,,,,64.272,35.3496,,57.8448,90,percent of total billed charges,,,,64.272,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.8448,90,percent of total billed charges,,,,61.0584,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.8448,64.272,
AMNIHOOK,2700590,CDM,,,270,RC,inpatient,,,,8.343,4.58865,,7.5087,90,percent of total billed charges,,,,8.343,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.5087,90,percent of total billed charges,,,,7.92585,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.5087,8.343,
ANGLE NEEDLE - 90 DEGREE,2700600,CDM,,,270,RC,inpatient,,,,34.814,19.1477,,31.3326,90,percent of total billed charges,,,,34.814,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.3326,90,percent of total billed charges,,,,33.0733,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.3326,34.814,
Aggressive Plus Cutter,2700603,CDM,,,270,RC,inpatient,,,,85.49,47.0195,,76.941,90,percent of total billed charges,,,,85.49,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,76.941,90,percent of total billed charges,,,,81.2155,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,76.941,85.49,
Vac Drape,2700615,CDM,,,270,RC,inpatient,,,,13.184,7.2512,,11.8656,90,percent of total billed charges,,,,13.184,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.8656,90,percent of total billed charges,,,,12.5248,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.8656,13.184,
ANTI REFLUX VALVE,2700620,CDM,,,270,RC,inpatient,,,,18.231,10.02705,,16.4079,90,percent of total billed charges,,,,18.231,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.4079,90,percent of total billed charges,,,,17.31945,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.4079,18.231,
GAIT BELT,2700625,CDM,,,270,RC,inpatient,,,,13.39,7.3645,,12.051,90,percent of total billed charges,,,,13.39,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.051,90,percent of total billed charges,,,,12.7205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.051,13.39,
AQUACEL DRESSING,2700635,CDM,,,270,RC,inpatient,,,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,90,percent of total billed charges,,,,6.6538,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,7.004,
AQUACEL DRESSING AG 4x5,2700636,CDM,,,270,RC,inpatient,,,,20.085,11.04675,,18.0765,90,percent of total billed charges,,,,20.085,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.0765,90,percent of total billed charges,,,,19.08075,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.0765,20.085,
ARM SLING S-M-LG-XLG,2700650,CDM,A4565,HCPCS,270,RC,inpatient,,,,8.549,4.70195,,7.6941,90,percent of total billed charges,,,,8.549,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6941,90,percent of total billed charges,,,,8.12155,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6941,8.549,
ARROW ART. CATH SET,2700670,CDM,,,270,RC,inpatient,,,,31.827,17.50485,,28.6443,90,percent of total billed charges,,,,31.827,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.6443,90,percent of total billed charges,,,,30.23565,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.6443,31.827,
ARROW DRAINAGE TRAY,2700680,CDM,,,270,RC,inpatient,,,,281.705,154.93775,,253.5345,90,percent of total billed charges,,,,281.705,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,253.5345,90,percent of total billed charges,,,,267.61975,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,253.5345,281.705,
ARROW PERC INTRO KT,2700690,CDM,,,270,RC,inpatient,,,,129.883,71.43565,,116.8947,90,percent of total billed charges,,,,129.883,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,116.8947,90,percent of total billed charges,,,,123.38885,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,116.8947,129.883,
ARROW TWIN CATH,2700700,CDM,,,270,RC,inpatient,,,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.9618,90,percent of total billed charges,,,,32.6819,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.9618,34.402,
ART PRESSURE MONITO,2700710,CDM,,,270,RC,inpatient,,,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,16.171,
ARTERIAL LINE SETUP,2700720,CDM,,,270,RC,inpatient,,,,204.97,112.7335,,184.473,90,percent of total billed charges,,,,204.97,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,184.473,90,percent of total billed charges,,,,194.7215,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,184.473,204.97,
ASEPTO-DISP,2700740,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
BABY LOTION,2700770,CDM,,,270,RC,inpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
Granufoam Lg Wound Vac,2700811,CDM,,,270,RC,inpatient,,,,109.9731,60.485205,,98.97579,90,percent of total billed charges,,,,109.9731,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,98.97579,90,percent of total billed charges,,,,104.474445,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,98.97579,109.9731,
Granufoam Small Wound Vac,2700817,CDM,,,270,RC,inpatient,,,,77.2191,42.470505,,69.49719,90,percent of total billed charges,,,,77.2191,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.49719,90,percent of total billed charges,,,,73.358145,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.49719,77.2191,
BEAVER BLADE,2700860,CDM,,,270,RC,inpatient,,,,51.809,28.49495,,46.6281,90,percent of total billed charges,,,,51.809,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.6281,90,percent of total billed charges,,,,49.21855,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.6281,51.809,
DEPUY OSCILLATING SAW BLADE,2700902,CDM,,,270,RC,inpatient,,,,378.834,208.3587,,340.9506,90,percent of total billed charges,,,,378.834,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,340.9506,90,percent of total billed charges,,,,359.8923,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,340.9506,378.834,
Granuforam Med- Wound Vac,2700903,CDM,,,270,RC,inpatient,,,,97.2732,53.50026,,87.54588,90,percent of total billed charges,,,,97.2732,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.54588,90,percent of total billed charges,,,,92.40954,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.54588,97.2732,
ACCUFORM NASAL SPLINT KIT,2700912,CDM,,,270,RC,inpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.4056,90,percent of total billed charges,,,,32.0948,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.4056,33.784,
SURGITIE 2-0 POLYSORB,2700914,CDM,,,270,RC,inpatient,,,,161.195,88.65725,,145.0755,90,percent of total billed charges,,,,161.195,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,145.0755,90,percent of total billed charges,,,,153.13525,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,145.0755,161.195,
BEDPAN,2700920,CDM,,,270,RC,inpatient,,,,3.193,1.75615,,2.8737,90,percent of total billed charges,,,,3.193,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.8737,90,percent of total billed charges,,,,3.03335,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.8737,3.193,
BAIR HUGGER THERAPY BLANKET,2700930,CDM,,,270,RC,inpatient,,,,68.495,37.67225,,61.6455,90,percent of total billed charges,,,,68.495,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.6455,90,percent of total billed charges,,,,65.07025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.6455,68.495,
BIB PACK,2700960,CDM,,,270,RC,inpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,90,percent of total billed charges,,,,34.0518,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,35.844,
BILI MASKS,2700970,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
COTTON UMBILICAL TAPE,2700996,CDM,,,270,RC,inpatient,,,,12.772,7.0246,,11.4948,90,percent of total billed charges,,,,12.772,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4948,90,percent of total billed charges,,,,12.1334,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4948,12.772,
BLOOD ADMIN SET,2701020,CDM,,,270,RC,inpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,90,percent of total billed charges,,,,34.0518,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,35.844,
TONSIL SPONGE,2701041,CDM,,,270,RC,inpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,90,percent of total billed charges,,,,3.7183,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,3.914,
BLOOD WARMER - USE CH,2701050,CDM,,,270,RC,inpatient,,,,57.062,31.3841,,51.3558,90,percent of total billed charges,,,,57.062,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.3558,90,percent of total billed charges,,,,54.2089,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.3558,57.062,
BLOOD ADMIN SET,2701060,CDM,,,270,RC,inpatient,,,,8.858,4.8719,,7.9722,90,percent of total billed charges,,,,8.858,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.9722,90,percent of total billed charges,,,,8.4151,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.9722,8.858,
BONE MARROW TRAY,2701080,CDM,,,270,RC,inpatient,,,,76.323,41.97765,,68.6907,90,percent of total billed charges,,,,76.323,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,68.6907,90,percent of total billed charges,,,,72.50685,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,68.6907,76.323,
BONE WAX,2701090,CDM,,,270,RC,inpatient,,,,10.609,5.83495,,9.5481,90,percent of total billed charges,,,,10.609,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.5481,90,percent of total billed charges,,,,10.07855,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.5481,10.609,
POST-OP SHOE,2701100,CDM,,,270,RC,inpatient,,,,11.021,6.06155,,9.9189,90,percent of total billed charges,,,,11.021,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.9189,90,percent of total billed charges,,,,10.46995,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.9189,11.021,
FLEX-IT STYLET,2701102,CDM,,,270,RC,inpatient,,,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
FOAM HEAD REST,2701103,CDM,,,270,RC,inpatient,,,,8.343,4.58865,,7.5087,90,percent of total billed charges,,,,8.343,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.5087,90,percent of total billed charges,,,,7.92585,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.5087,8.343,
BREATHING CIR PED,2701150,CDM,,,270,RC,inpatient,,,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.4218,90,percent of total billed charges,,,,13.1119,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.4218,13.802,
BREATHING CIRCUIT,2701160,CDM,,,270,RC,inpatient,,,,69.937,38.46535,,62.9433,90,percent of total billed charges,,,,69.937,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.9433,90,percent of total billed charges,,,,66.44015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.9433,69.937,
BRIEFS-MESH PANTIES,2701170,CDM,,,270,RC,inpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,90,percent of total billed charges,,,,4.01185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,4.223,
HH - DIAL-A-FLOW,2701185,CDM,,,270,RC,inpatient,,,,13.287,7.30785,,11.9583,90,percent of total billed charges,,,,13.287,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.9583,90,percent of total billed charges,,,,12.62265,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.9583,13.287,
BURR,2701230,CDM,,,270,RC,inpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
UNNA BOOT DRESSING (SUPPLY),2701241,CDM,,,270,RC,inpatient,,,,6.798,3.7389,,6.1182,90,percent of total billed charges,,,,6.798,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.1182,90,percent of total billed charges,,,,6.4581,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.1182,6.798,
CAST PADDING 2-6 IN,2701320,CDM,,,270,RC,inpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,90,percent of total billed charges,,,,4.01185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,4.223,
DBM BONE PUTTY 2.5cc #APUT02,2701333,CDM,,,270,RC,inpatient,,,,779.401,428.67055,,701.4609,90,percent of total billed charges,,,,779.401,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,701.4609,90,percent of total billed charges,,,,740.43095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,701.4609,779.401,
BREAST PUMP KIT - DOUBLE,2701335,CDM,,,270,RC,inpatient,,,,84.048,46.2264,,75.6432,90,percent of total billed charges,,,,84.048,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.6432,90,percent of total billed charges,,,,79.8456,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.6432,84.048,
NITRO TUBING,2701345,CDM,,,270,RC,inpatient,,,,32.754,18.0147,,29.4786,90,percent of total billed charges,,,,32.754,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.4786,90,percent of total billed charges,,,,31.1163,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.4786,32.754,
PREMIUM SURGICLIP,2701355,CDM,,,270,RC,inpatient,,,,125.351,68.94305,,112.8159,90,percent of total billed charges,,,,125.351,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,112.8159,90,percent of total billed charges,,,,119.08345,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,112.8159,125.351,
ACCLARENT INFLATION DEVICE,2701362,CDM,,,270,RC,inpatient,,,,149.556,82.2558,,134.6004,90,percent of total billed charges,,,,149.556,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,134.6004,90,percent of total billed charges,,,,142.0782,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,134.6004,149.556,
EYEGUARD S2020,2701367,CDM,,,270,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,119.274,
CAST-LEG LONG,2701390,CDM,,,270,RC,inpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.5285,90,percent of total billed charges,,,,93.44675,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.5285,98.365,
CASTING TAPE 3M SCOTCH CAST +,2701430,CDM,,,270,RC,inpatient,,,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
CATH DRAIN BAG,2701460,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
ISLAND DRESSING,2701461,CDM,,,270,RC,inpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
CATH PLUG & DRAIN TUB,2701470,CDM,,,270,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
CATH SECURE TUBE HOLDER,2701480,CDM,,,270,RC,inpatient,,,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,90,percent of total billed charges,,,,6.6538,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,7.004,
MYOSURE CANISTER KIT,2701481,CDM,,,270,RC,inpatient,,,,22.351,12.29305,,20.1159,90,percent of total billed charges,,,,22.351,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.1159,90,percent of total billed charges,,,,21.23345,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.1159,22.351,
EPIDURAL TUBING SET,2701512,CDM,,,270,RC,inpatient,,,,18.54,10.197,,16.686,90,percent of total billed charges,,,,18.54,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.686,90,percent of total billed charges,,,,17.613,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.686,18.54,
BODY MESH,2701521,CDM,,,270,RC,inpatient,,,,54.487,29.96785,,49.0383,90,percent of total billed charges,,,,54.487,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.0383,90,percent of total billed charges,,,,51.76265,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.0383,54.487,
CEMENT MIXING BOWL,2701540,CDM,,,270,RC,inpatient,,,,20.394,11.2167,,18.3546,90,percent of total billed charges,,,,20.394,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.3546,90,percent of total billed charges,,,,19.3743,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.3546,20.394,
MATERNIMATES HYDROGEL PACKS,2701563,CDM,,,270,RC,inpatient,,,,24.72,13.596,,22.248,90,percent of total billed charges,,,,24.72,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.248,90,percent of total billed charges,,,,23.484,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.248,24.72,
MASTISOL 3CC,2701571,CDM,,,270,RC,inpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
"CEMENT, HOWMEDICA",2701580,CDM,,,270,RC,inpatient,,,,209.605,115.28275,,188.6445,90,percent of total billed charges,,,,209.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.6445,90,percent of total billed charges,,,,199.12475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.6445,209.605,
CENTRAL VENOUS SET,2701590,CDM,,,270,RC,inpatient,,,,73.13,40.2215,,65.817,90,percent of total billed charges,,,,73.13,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.817,90,percent of total billed charges,,,,69.4735,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.817,73.13,
TX 60 RELOAD,2701591,CDM,,,270,RC,inpatient,,,,235.87,129.7285,,212.283,90,percent of total billed charges,,,,235.87,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,212.283,90,percent of total billed charges,,,,224.0765,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,212.283,235.87,
TX 60 LINEAR STAPLER,2701593,CDM,,,270,RC,inpatient,,,,220.935,121.51425,,198.8415,90,percent of total billed charges,,,,220.935,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.8415,90,percent of total billed charges,,,,209.88825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.8415,220.935,
TCR 55 RELOAD,2701594,CDM,,,270,RC,inpatient,,,,129.986,71.4923,,116.9874,90,percent of total billed charges,,,,129.986,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,116.9874,90,percent of total billed charges,,,,123.4867,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,116.9874,129.986,
CERCLAGE WIRES/W/EYES,2701595,CDM,,,270,RC,inpatient,,,,23.278,12.8029,,20.9502,90,percent of total billed charges,,,,23.278,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.9502,90,percent of total billed charges,,,,22.1141,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.9502,23.278,
ECHELON 60 RELOAD GST60B,2701596,CDM,,,270,RC,inpatient,,,,236.797,130.23835,,213.1173,90,percent of total billed charges,,,,236.797,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,213.1173,90,percent of total billed charges,,,,224.95715,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,213.1173,236.797,
55 MM LINEAR CUTTER,2701599,CDM,,,270,RC,inpatient,,,,242.462,133.3541,,218.2158,90,percent of total billed charges,,,,242.462,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,218.2158,90,percent of total billed charges,,,,230.3389,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,218.2158,242.462,
SUTURE BOLSTER,2701602,CDM,,,270,RC,inpatient,,,,33.269,18.29795,,29.9421,90,percent of total billed charges,,,,33.269,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.9421,90,percent of total billed charges,,,,31.60555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.9421,33.269,
CERVICAL COLLAR,2701610,CDM,,,270,RC,inpatient,,,,9.888,5.4384,,8.8992,90,percent of total billed charges,,,,9.888,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8992,90,percent of total billed charges,,,,9.3936,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8992,9.888,
CHEST DRAINAGE DEVICE UNIT,2701620,CDM,A7041,HCPCS,270,RC,inpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,90,percent of total billed charges,,,,64.28745,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,67.671,
BLAKE SILICONE DRAIN 15fr/19fr,2701624,CDM,,,270,RC,inpatient,,,,38.522,21.1871,,34.6698,90,percent of total billed charges,,,,38.522,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.6698,90,percent of total billed charges,,,,36.5959,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.6698,38.522,
CHEST TUBE,2701630,CDM,,,270,RC,inpatient,,,,14.214,7.8177,,12.7926,90,percent of total billed charges,,,,14.214,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.7926,90,percent of total billed charges,,,,13.5033,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.7926,14.214,
GYNEX MONSELS,2701632,CDM,,,270,RC,inpatient,,,,35.638,19.6009,,32.0742,90,percent of total billed charges,,,,35.638,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.0742,90,percent of total billed charges,,,,33.8561,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.0742,35.638,
GYNEX LOOP ELECTRODES,2701634,CDM,,,270,RC,inpatient,,,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.9618,90,percent of total billed charges,,,,32.6819,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.9618,34.402,
CHUX,2701650,CDM,,,270,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
HH - EAKIN SEAL,2701657,CDM,A4404,HCPCS,270,RC,inpatient,,,,10.918,6.0049,,9.8262,90,percent of total billed charges,,,,10.918,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.8262,90,percent of total billed charges,,,,10.3721,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.8262,10.918,
EXTENDED SHOE HORNES,2701659,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
CIRCUMCISION TRAY,2701660,CDM,,,270,RC,inpatient,,,,42.539,23.39645,,38.2851,90,percent of total billed charges,,,,42.539,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.2851,90,percent of total billed charges,,,,40.41205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.2851,42.539,
CUSTOM CUT POUCH,2701667,CDM,,,270,RC,inpatient,,,,13.596,7.4778,,12.2364,90,percent of total billed charges,,,,13.596,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.2364,90,percent of total billed charges,,,,12.9162,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.2364,13.596,
CLAVE PIGGYBACK,2701670,CDM,,,270,RC,inpatient,,,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,16.171,
CLAVICAL SPLINT,2701680,CDM,,,270,RC,inpatient,,,,13.184,7.2512,,11.8656,90,percent of total billed charges,,,,13.184,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.8656,90,percent of total billed charges,,,,12.5248,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.8656,13.184,
HY-N-DRY STOCKINETTE,2701689,CDM,,,270,RC,inpatient,,,,10.094,5.5517,,9.0846,90,percent of total billed charges,,,,10.094,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.0846,90,percent of total billed charges,,,,9.5893,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.0846,10.094,
CLOSED DRAINAGE BAG,2701700,CDM,,,270,RC,inpatient,,,,15.862,8.7241,,14.2758,90,percent of total billed charges,,,,15.862,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.2758,90,percent of total billed charges,,,,15.0689,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.2758,15.862,
JP DRAIN FLAT ROUND SILICONE.,2701717,CDM,,,270,RC,inpatient,,,,12.772,7.0246,,11.4948,90,percent of total billed charges,,,,12.772,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4948,90,percent of total billed charges,,,,12.1334,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4948,12.772,
COBAN WRAP,2701720,CDM,,,270,RC,inpatient,,,,5.459,3.00245,,4.9131,90,percent of total billed charges,,,,5.459,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.9131,90,percent of total billed charges,,,,5.18605,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.9131,5.459,
"COBAN WRAP 4""",2701730,CDM,,,270,RC,inpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,90,percent of total billed charges,,,,3.81615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,4.017,
COOPER UTERINE MANIPULATOR,2701745,CDM,,,270,RC,inpatient,,,,88.58,48.719,,79.722,90,percent of total billed charges,,,,88.58,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.722,90,percent of total billed charges,,,,84.151,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.722,88.58,
COLD PACK,2701760,CDM,,,270,RC,inpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,90,percent of total billed charges,,,,3.81615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,4.017,
COLLECTION SOCK,2701790,CDM,,,270,RC,inpatient,,,,41.612,22.8866,,37.4508,90,percent of total billed charges,,,,41.612,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.4508,90,percent of total billed charges,,,,39.5314,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.4508,41.612,
CEMENT CUP CURRETTE (YELLOW),2701829,CDM,,,270,RC,inpatient,,,,112.373,61.80515,,101.1357,90,percent of total billed charges,,,,112.373,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,101.1357,90,percent of total billed charges,,,,106.75435,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,101.1357,112.373,
STRYKER 5.5 BUR #375-950-000,2701842,CDM,,,270,RC,inpatient,,,,182.001,100.10055,,163.8009,90,percent of total billed charges,,,,182.001,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,163.8009,90,percent of total billed charges,,,,172.90095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,163.8009,182.001,
SAFE SHEATH INTRODUCER,2701845,CDM,,,270,RC,inpatient,,,,139.668,76.8174,,125.7012,90,percent of total billed charges,,,,139.668,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.7012,90,percent of total billed charges,,,,132.6846,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.7012,139.668,
SECTION CONNECT TUBING,2701890,CDM,,,270,RC,inpatient,,,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
CONNECT TUBE SUCTION,2701910,CDM,,,270,RC,inpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MEPILEX DRESSING 4x12,2701918,CDM,,,270,RC,inpatient,,,,63.448,34.8964,,57.1032,90,percent of total billed charges,,,,63.448,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.1032,90,percent of total billed charges,,,,60.2756,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.1032,63.448,
RAYTECS,2701940,CDM,,,270,RC,inpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,90,percent of total billed charges,,,,4.20755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,4.429,
ROBINSIN RED RUBBER CATH - ALL,2701971,CDM,,,270,RC,inpatient,,,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
BARD FOLEY CATH 30cc; ALL,2701972,CDM,,,270,RC,inpatient,,,,11.227,6.17485,,10.1043,90,percent of total billed charges,,,,11.227,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.1043,90,percent of total billed charges,,,,10.66565,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.1043,11.227,
BARD FOLEY CATH 5cc; ALL,2701974,CDM,,,270,RC,inpatient,,,,8.24,4.532,,7.416,90,percent of total billed charges,,,,8.24,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.416,90,percent of total billed charges,,,,7.828,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.416,8.24,
CVP MAN SETUP,2702050,CDM,,,270,RC,inpatient,,,,121.025,66.56375,,108.9225,90,percent of total billed charges,,,,121.025,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.9225,90,percent of total billed charges,,,,114.97375,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.9225,121.025,
CYSTO PACK,2702090,CDM,,,270,RC,inpatient,,,,12.36,6.798,,11.124,90,percent of total billed charges,,,,12.36,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.124,90,percent of total billed charges,,,,11.742,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.124,12.36,
CYSTO STRAIGHT TUBI,2702100,CDM,,,270,RC,inpatient,,,,16.789,9.23395,,15.1101,90,percent of total billed charges,,,,16.789,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.1101,90,percent of total billed charges,,,,15.94955,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.1101,16.789,
CYSTO Y TUBING,2702110,CDM,,,270,RC,inpatient,,,,33.681,18.52455,,30.3129,90,percent of total billed charges,,,,33.681,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.3129,90,percent of total billed charges,,,,31.99695,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.3129,33.681,
90S CRUISE SUC PROBE 4.0X135MM,2702124,CDM,,,270,RC,inpatient,,,,362.56,199.408,,326.304,90,percent of total billed charges,,,,362.56,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,326.304,90,percent of total billed charges,,,,344.432,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,326.304,362.56,
LITHOTOMY PACK,2702140,CDM,,,270,RC,inpatient,,,,88.58,48.719,,79.722,90,percent of total billed charges,,,,88.58,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.722,90,percent of total billed charges,,,,84.151,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.722,88.58,
DEBRIEDMENT KIT,2702170,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
JACKSON PRATT RESERVOIR,2702184,CDM,,,270,RC,inpatient,,,,10.609,5.83495,,9.5481,90,percent of total billed charges,,,,10.609,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.5481,90,percent of total billed charges,,,,10.07855,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.5481,10.609,
DELEE MUCOUS TRAP,2702190,CDM,,,270,RC,inpatient,,,,14.111,7.76105,,12.6999,90,percent of total billed charges,,,,14.111,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.6999,90,percent of total billed charges,,,,13.40545,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.6999,14.111,
ACU PUNCH 3+5mm,2702233,CDM,,,270,RC,inpatient,,,,7.313,4.02215,,6.5817,90,percent of total billed charges,,,,7.313,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.5817,90,percent of total billed charges,,,,6.94735,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.5817,7.313,
DERMABOND ADHESIVE,2702243,CDM,,,270,RC,inpatient,,,,45.629,25.09595,,41.0661,90,percent of total billed charges,,,,45.629,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.0661,90,percent of total billed charges,,,,43.34755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.0661,45.629,
JONES COTTON,2702251,CDM,,,270,RC,inpatient,,,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.4218,90,percent of total billed charges,,,,13.1119,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.4218,13.802,
WHITE RIGID SOCK AID,2702266,CDM,,,270,RC,inpatient,,,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
DIAPERS BABY,2702310,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
DIAPERS-DISP PER 60,2702320,CDM,,,270,RC,inpatient,,,,18.952,10.4236,,17.0568,90,percent of total billed charges,,,,18.952,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.0568,90,percent of total billed charges,,,,18.0044,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.0568,18.952,
DISP EMESIS BASIS,2702360,CDM,,,270,RC,inpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,90,percent of total billed charges,,,,3.42475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,3.605,
DISP GRADUATE 1000,2702470,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
DRESSING-ADAPTIC PK,2702570,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
DUO DERM,2702610,CDM,,,270,RC,inpatient,,,,5.253,2.88915,,4.7277,90,percent of total billed charges,,,,5.253,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.7277,90,percent of total billed charges,,,,4.99035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.7277,5.253,
DUO-TUBE/KEOFEED,2702630,CDM,,,270,RC,inpatient,,,,45.423,24.98265,,40.8807,90,percent of total billed charges,,,,45.423,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.8807,90,percent of total billed charges,,,,43.15185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.8807,45.423,
DURA PREP 3M 8630,2702640,CDM,,,270,RC,inpatient,,,,10.506,5.7783,,9.4554,90,percent of total billed charges,,,,10.506,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.4554,90,percent of total billed charges,,,,9.9807,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.4554,10.506,
TRIGGER SWITCH BOVEY E0520,2702642,CDM,,,270,RC,inpatient,,,,63.139,34.72645,,56.8251,90,percent of total billed charges,,,,63.139,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.8251,90,percent of total billed charges,,,,59.98205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.8251,63.139,
E-Z TEMP,2702650,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
FOGARTY CHOLANGIOCATHETER,2702670,CDM,,,270,RC,inpatient,,,,78.589,43.22395,,70.7301,90,percent of total billed charges,,,,78.589,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.7301,90,percent of total billed charges,,,,74.65955,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.7301,78.589,
ELASTO-GEL DRESSING,2702710,CDM,,,270,RC,inpatient,,,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
ENDO BAG,2702730,CDM,,,270,RC,inpatient,,,,67.362,37.0491,,60.6258,90,percent of total billed charges,,,,67.362,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.6258,90,percent of total billed charges,,,,63.9939,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.6258,67.362,
ENDOTRACH TUBE,2702770,CDM,,,270,RC,inpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,90,percent of total billed charges,,,,3.7183,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,3.914,
ENEMA ADMIN SET,2702780,CDM,,,270,RC,inpatient,,,,5.047,2.77585,,4.5423,90,percent of total billed charges,,,,5.047,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.5423,90,percent of total billed charges,,,,4.79465,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.5423,5.047,
ENEMA BUCKET,2702790,CDM,,,270,RC,inpatient,,,,4.738,2.6059,,4.2642,90,percent of total billed charges,,,,4.738,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.2642,90,percent of total billed charges,,,,4.5011,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.2642,4.738,
EPIDURAL TRAY,2702840,CDM,,,270,RC,inpatient,,,,64.89,35.6895,,58.401,90,percent of total billed charges,,,,64.89,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.401,90,percent of total billed charges,,,,61.6455,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.401,64.89,
ERU TIEMANN CATH,2702850,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
ESMARK BANDAGE,2702860,CDM,,,270,RC,inpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ESOPH STETH TEMP,2702870,CDM,,,270,RC,inpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,90,percent of total billed charges,,,,3.81615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,4.017,
EXTREMITY SHEET,2702960,CDM,,,270,RC,inpatient,,,,16.48,9.064,,14.832,90,percent of total billed charges,,,,16.48,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.832,90,percent of total billed charges,,,,15.656,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.832,16.48,
MEGADYNE ELECTRODE #0113M,2702977,CDM,,,270,RC,inpatient,,,,14.729,8.10095,,13.2561,90,percent of total billed charges,,,,14.729,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.2561,90,percent of total billed charges,,,,13.99255,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.2561,14.729,
EYE PADS,2702980,CDM,,,270,RC,inpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,90,percent of total billed charges,,,,3.42475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,3.605,
LARYN AIRWAY #KLTSD404,2702983,CDM,,,270,RC,inpatient,,,,92.391,50.81505,,83.1519,90,percent of total billed charges,,,,92.391,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.1519,90,percent of total billed charges,,,,87.77145,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.1519,92.391,
LARYN AIRWAY #KLTSD405,2702984,CDM,,,270,RC,inpatient,,,,92.391,50.81505,,83.1519,90,percent of total billed charges,,,,92.391,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.1519,90,percent of total billed charges,,,,87.77145,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.1519,92.391,
FEEDING TUBE - 5 FR,2703020,CDM,,,270,RC,inpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,90,percent of total billed charges,,,,4.3054,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,4.532,
"FEEDING TUBE, VIVONE",2703030,CDM,,,270,RC,inpatient,,,,57.062,31.3841,,51.3558,90,percent of total billed charges,,,,57.062,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.3558,90,percent of total billed charges,,,,54.2089,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.3558,57.062,
FEMALE CATH KIT,2703050,CDM,,,270,RC,inpatient,,,,8.446,4.6453,,7.6014,90,percent of total billed charges,,,,8.446,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6014,90,percent of total billed charges,,,,8.0237,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6014,8.446,
FEMORAL SUCTION TAM,2703090,CDM,,,270,RC,inpatient,,,,43.054,23.6797,,38.7486,90,percent of total billed charges,,,,43.054,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.7486,90,percent of total billed charges,,,,40.9013,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.7486,43.054,
MEDLINE ABDOMEN DRAPE/W/POUCH,2703103,CDM,,,270,RC,inpatient,,,,23.072,12.6896,,20.7648,90,percent of total billed charges,,,,23.072,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.7648,90,percent of total billed charges,,,,21.9184,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.7648,23.072,
FIBEROPTIC CHARGE,2703120,CDM,,,270,RC,inpatient,,,,90.022,49.5121,,81.0198,90,percent of total billed charges,,,,90.022,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.0198,90,percent of total billed charges,,,,85.5209,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.0198,90.022,
PENTAX SCISSORS #3142,2703142,CDM,,,270,RC,inpatient,,,,86.005,47.30275,,77.4045,90,percent of total billed charges,,,,86.005,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.4045,90,percent of total billed charges,,,,81.70475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.4045,86.005,
VISCERAL RETAINER FISH,2703150,CDM,,,270,RC,inpatient,,,,120.716,66.3938,,108.6444,90,percent of total billed charges,,,,120.716,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.6444,90,percent of total billed charges,,,,114.6802,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.6444,120.716,
PERIWASH,2703175,CDM,,,270,RC,inpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,90,percent of total billed charges,,,,4.01185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,4.223,
FOAM BEDPAD EGGCRATE,2703210,CDM,,,270,RC,inpatient,,,,49.646,27.3053,,44.6814,90,percent of total billed charges,,,,49.646,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.6814,90,percent of total billed charges,,,,47.1637,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.6814,49.646,
FOLEY LATEX FREE CATH,2703290,CDM,,,270,RC,inpatient,,,,17.613,9.68715,,15.8517,90,percent of total billed charges,,,,17.613,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.8517,90,percent of total billed charges,,,,16.73235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.8517,17.613,
CATH PUREWICK,2703291,CDM,,,270,RC,inpatient,,,,8.961,4.92855,,8.0649,90,percent of total billed charges,,,,8.961,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.0649,90,percent of total billed charges,,,,8.51295,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.0649,8.961,
FOLEY PRECONNECT - ADULT,2703300,CDM,,,270,RC,inpatient,,,,38.316,21.0738,,34.4844,90,percent of total billed charges,,,,38.316,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.4844,90,percent of total billed charges,,,,36.4002,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.4844,38.316,
GASTRIC EASI-LAVAGE,2703360,CDM,,,270,RC,inpatient,,,,156.56,86.108,,140.904,90,percent of total billed charges,,,,156.56,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,140.904,90,percent of total billed charges,,,,148.732,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,140.904,156.56,
GASTROSTOMY KIT-FLX,2703380,CDM,,,270,RC,inpatient,,,,385.22,211.871,,346.698,90,percent of total billed charges,,,,385.22,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,346.698,90,percent of total billed charges,,,,365.959,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,346.698,385.22,
GAUZE-ADAPTIC ROLL,2703390,CDM,,,270,RC,inpatient,,,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,90,percent of total billed charges,,,,7.14305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,7.519,
GAUZE - IDOFORM,2703400,CDM,,,270,RC,inpatient,,,,6.798,3.7389,,6.1182,90,percent of total billed charges,,,,6.798,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.1182,90,percent of total billed charges,,,,6.4581,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.1182,6.798,
GAUZE-TUBE,2703410,CDM,,,270,RC,inpatient,,,,35.02,19.261,,31.518,90,percent of total billed charges,,,,35.02,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.518,90,percent of total billed charges,,,,33.269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.518,35.02,
SURGIFOAM SZ 12-7 1972,2703470,CDM,,,270,RC,inpatient,,,,10.3,5.665,,9.27,90,percent of total billed charges,,,,10.3,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.27,90,percent of total billed charges,,,,9.785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.27,10.3,
GELFOAM SIZE 50,2703480,CDM,,,270,RC,inpatient,,,,49.955,27.47525,,44.9595,90,percent of total billed charges,,,,49.955,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.9595,90,percent of total billed charges,,,,47.45725,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.9595,49.955,
LEG LIFTER,2703514,CDM,,,270,RC,inpatient,,,,12.36,6.798,,11.124,90,percent of total billed charges,,,,12.36,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.124,90,percent of total billed charges,,,,11.742,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.124,12.36,
GIA LOAD UNIT,2703530,CDM,,,270,RC,inpatient,,,,197.76,108.768,,177.984,90,percent of total billed charges,,,,197.76,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,177.984,90,percent of total billed charges,,,,187.872,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,177.984,197.76,
GIGLI SAW,2703540,CDM,,,270,RC,inpatient,,,,20.085,11.04675,,18.0765,90,percent of total billed charges,,,,20.085,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.0765,90,percent of total billed charges,,,,19.08075,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.0765,20.085,
GLOVE HYPOALERGENIC,2703550,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
"GLOVES, STERILE SURGEON",2703570,CDM,,,270,RC,inpatient,,,,9.579,5.26845,,8.6211,90,percent of total billed charges,,,,9.579,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.6211,90,percent of total billed charges,,,,9.10005,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.6211,9.579,
GLYCINE - 3000ML BAG,2703600,CDM,,,270,RC,inpatient,,,,55.62,30.591,,50.058,90,percent of total billed charges,,,,55.62,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.058,90,percent of total billed charges,,,,52.839,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.058,55.62,
CATH NAT LATEX - ALL,2703623,CDM,,,270,RC,inpatient,,,,91.155,50.13525,,82.0395,90,percent of total billed charges,,,,91.155,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,82.0395,90,percent of total billed charges,,,,86.59725,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,82.0395,91.155,
"GOWN-ISOLATION, DISP - SINGLE",2703650,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
RC NEEDLE BIOMET 35 & 24MM,2703674,CDM,,,270,RC,inpatient,,,,288.915,158.90325,,260.0235,90,percent of total billed charges,,,,288.915,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.0235,90,percent of total billed charges,,,,274.46925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.0235,288.915,
DRESSING STICK,2703689,CDM,,,270,RC,inpatient,,,,4.944,2.7192,,4.4496,90,percent of total billed charges,,,,4.944,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.4496,90,percent of total billed charges,,,,4.6968,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.4496,4.944,
DIABETIC SHOE NWB,2703691,CDM,,,270,RC,inpatient,,,,35.535,19.54425,,31.9815,90,percent of total billed charges,,,,35.535,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.9815,90,percent of total billed charges,,,,33.75825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.9815,35.535,
HEEL PROTECTOR - FOAM,2703770,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
HEEL PROTECTOR - SHEEPSKIN,2703775,CDM,,,270,RC,inpatient,,,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,90,percent of total billed charges,,,,7.14305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,7.519,
PROBE COVER #PC 3787,2703787,CDM,,,270,RC,inpatient,,,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.4218,90,percent of total billed charges,,,,13.1119,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.4218,13.802,
HEMOVAC-MEDIUM,2703840,CDM,,,270,RC,inpatient,,,,104.133,57.27315,,93.7197,90,percent of total billed charges,,,,104.133,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.7197,90,percent of total billed charges,,,,98.92635,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.7197,104.133,
HIBICLENS 4OZ,2703860,CDM,,,270,RC,inpatient,,,,7.828,4.3054,,7.0452,90,percent of total billed charges,,,,7.828,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.0452,90,percent of total billed charges,,,,7.4366,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.0452,7.828,
IOBAN ISOLATION DRAPE,2703870,CDM,,,270,RC,inpatient,,,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,90,percent of total billed charges,,,,45.7938,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.3836,48.204,
HOT-LINE FLUID WARMER SET,2703893,CDM,,,270,RC,inpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,90,percent of total billed charges,,,,25.93025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,27.295,
HYDROGEN PEROXIDE 4 0,2703930,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
SUCTION/IRRIGATOR ASC1201,2703961,CDM,,,270,RC,inpatient,,,,86.314,47.4727,,77.6826,90,percent of total billed charges,,,,86.314,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.6826,90,percent of total billed charges,,,,81.9983,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.6826,86.314,
ILEOSTOMY APPLIANCE,2704010,CDM,,,270,RC,inpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
SHOULDER IMMOBILIZER,2704030,CDM,,,270,RC,inpatient,,,,12.463,6.85465,,11.2167,90,percent of total billed charges,,,,12.463,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.2167,90,percent of total billed charges,,,,11.83985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.2167,12.463,
IRRIGATOR,2704096,CDM,,,270,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,75.19,
INPERSOL 1.5%,2704100,CDM,,,270,RC,inpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,90,percent of total billed charges,,,,44.91315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,47.277,
INTRODUCER SET - 7 FR,2704160,CDM,,,270,RC,inpatient,,,,99.807,54.89385,,89.8263,90,percent of total billed charges,,,,99.807,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.8263,90,percent of total billed charges,,,,94.81665,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.8263,99.807,
INTUBATING STYLET,2704170,CDM,,,270,RC,inpatient,,,,18.952,10.4236,,17.0568,90,percent of total billed charges,,,,18.952,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.0568,90,percent of total billed charges,,,,18.0044,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.0568,18.952,
IOBAN LARGE,2704180,CDM,,,270,RC,inpatient,,,,71.379,39.25845,,64.2411,90,percent of total billed charges,,,,71.379,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.2411,90,percent of total billed charges,,,,67.81005,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.2411,71.379,
IOBAN MEDIUM,2704190,CDM,,,270,RC,inpatient,,,,19.158,10.5369,,17.2422,90,percent of total billed charges,,,,19.158,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.2422,90,percent of total billed charges,,,,18.2001,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.2422,19.158,
IRRIGATION TRAY,2704220,CDM,,,270,RC,inpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,90,percent of total billed charges,,,,4.20755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,4.429,
ISOMIL 32 OZ CAN,2704250,CDM,,,270,RC,inpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
LONG HANDLED BATH SPONGE,2704251,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
IV BURETTE/ VOLUTROL,2704280,CDM,,,270,RC,inpatient,,,,35.329,19.43095,,31.7961,90,percent of total billed charges,,,,35.329,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.7961,90,percent of total billed charges,,,,33.56255,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.7961,35.329,
IV CATH JELCO,2704290,CDM,,,270,RC,inpatient,,,,7.931,4.36205,,7.1379,90,percent of total billed charges,,,,7.931,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.1379,90,percent of total billed charges,,,,7.53445,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.1379,7.931,
IV EXTENSION SET,2704300,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
IV FLOW CONTROL,2704310,CDM,,,270,RC,inpatient,,,,10.815,5.94825,,9.7335,90,percent of total billed charges,,,,10.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.7335,90,percent of total billed charges,,,,10.27425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.7335,10.815,
"DERMATOME CUTTINGHEAD, BARD",2704367,CDM,,,270,RC,inpatient,,,,66.744,36.7092,,60.0696,90,percent of total billed charges,,,,66.744,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.0696,90,percent of total billed charges,,,,63.4068,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.0696,66.744,
IV SET V1464 PRIMARY,2704370,CDM,,,270,RC,inpatient,,,,6.592,3.6256,,5.9328,90,percent of total billed charges,,,,6.592,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.9328,90,percent of total billed charges,,,,6.2624,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.9328,6.592,
IV SET V1912 SECONDARY,2704380,CDM,,,270,RC,inpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,90,percent of total billed charges,,,,4.3054,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,4.532,
IV SET 805-25 DONOR,2704390,CDM,,,270,RC,inpatient,,,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,90,percent of total billed charges,,,,6.6538,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3036,7.004,
IV SET 8955 BACKCHK,2704410,CDM,,,270,RC,inpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,90,percent of total billed charges,,,,4.01185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,4.223,
VIASYS STACKHOUSE VACCUM TUBE,2704422,CDM,,,270,RC,inpatient,,,,13.39,7.3645,,12.051,90,percent of total billed charges,,,,13.39,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.051,90,percent of total billed charges,,,,12.7205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.051,13.39,
VIASYS STACKHOUSE TUBE REDUCER,2704423,CDM,,,270,RC,inpatient,,,,29.252,16.0886,,26.3268,90,percent of total billed charges,,,,29.252,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.3268,90,percent of total billed charges,,,,27.7894,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.3268,29.252,
IV START/CARE KIT,2704450,CDM,,,270,RC,inpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,90,percent of total billed charges,,,,4.3054,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,4.532,
IVAC BURETTE IV SET,2704460,CDM,,,270,RC,inpatient,,,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,90,percent of total billed charges,,,,24.56035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,25.853,
IVAC PUMP CASSETTE,2704470,CDM,,,270,RC,inpatient,,,,23.175,12.74625,,20.8575,90,percent of total billed charges,,,,23.175,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.8575,90,percent of total billed charges,,,,22.01625,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.8575,23.175,
MAX CORE BIOPSY NEEDLE #MC1410,2704502,CDM,,,270,RC,inpatient,,,,105.163,57.83965,,94.6467,90,percent of total billed charges,,,,105.163,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.6467,90,percent of total billed charges,,,,99.90485,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.6467,105.163,
DISPOSABLE TOURNIQUET,2704515,CDM,,,270,RC,inpatient,,,,272.2805,149.754275,,245.05245,90,percent of total billed charges,,,,272.2805,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,245.05245,90,percent of total billed charges,,,,258.666475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,245.05245,272.2805,
SALINE HEPLOCK,2704520,CDM,,,270,RC,inpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,90,percent of total billed charges,,,,4.3054,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,4.532,
ARTHREX TWIST-IN-CANNULA,2704521,CDM,,,270,RC,inpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.6339,57.371,
PE TUBE #240072,2704539,CDM,,,270,RC,inpatient,,,,97.335,53.53425,,87.6015,90,percent of total billed charges,,,,97.335,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.6015,90,percent of total billed charges,,,,92.46825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.6015,97.335,
K-THERMIA UNIT (LARGE),2704540,CDM,,,270,RC,inpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,90,percent of total billed charges,,,,34.0518,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,35.844,
K WIRES,2704550,CDM,,,270,RC,inpatient,,,,64.272,35.3496,,57.8448,90,percent of total billed charges,,,,64.272,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.8448,90,percent of total billed charges,,,,61.0584,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.8448,64.272,
K WIRES THREADED,2704560,CDM,,,270,RC,inpatient,,,,194.052,106.7286,,174.6468,90,percent of total billed charges,,,,194.052,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,174.6468,90,percent of total billed charges,,,,184.3494,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,174.6468,194.052,
K-THERMIA PAD 24X69,2704580,CDM,,,270,RC,inpatient,,,,43.878,24.1329,,39.4902,90,percent of total billed charges,,,,43.878,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.4902,90,percent of total billed charges,,,,41.6841,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.4902,43.878,
K-THERMIA DISP PAD 18X24,2704590,CDM,,,270,RC,inpatient,,,,21.939,12.06645,,19.7451,90,percent of total billed charges,,,,21.939,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.7451,90,percent of total billed charges,,,,20.84205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.7451,21.939,
K-THERMIA LEG PAD 12X12,2704600,CDM,,,270,RC,inpatient,,,,21.939,12.06645,,19.7451,90,percent of total billed charges,,,,21.939,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.7451,90,percent of total billed charges,,,,20.84205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.7451,21.939,
MAX CORE BIOPSY #MC1410,2704601,CDM,,,270,RC,inpatient,,,,53.354,29.3447,,48.0186,90,percent of total billed charges,,,,53.354,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.0186,90,percent of total billed charges,,,,50.6863,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.0186,53.354,
K-WIRE COVERS,2704610,CDM,,,270,RC,inpatient,,,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
LIGHTWEIGHT REACHER,2704613,CDM,,,270,RC,inpatient,,,,12.978,7.1379,,11.6802,90,percent of total billed charges,,,,12.978,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.6802,90,percent of total billed charges,,,,12.3291,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.6802,12.978,
KARAYA PASTE & POWDER,2704620,CDM,A4406,HCPCS,270,RC,inpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
"STOMAHESIVE WAFER, ALL",2704631,CDM,,,270,RC,inpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,90,percent of total billed charges,,,,4.01185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,4.223,
KERLIX,2704650,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
KIDNEY STONE FILTER,2704660,CDM,,,270,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
PEANUTS,2704670,CDM,,,270,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
MEDTRONIC DOYLE II INTRANAS AS,2704671,CDM,,,270,RC,inpatient,,,,69.422,38.1821,,62.4798,90,percent of total billed charges,,,,69.422,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.4798,90,percent of total billed charges,,,,65.9509,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.4798,69.422,
KLING - ALL SIZES,2704690,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
KNEE SPLINT,2704710,CDM,,,270,RC,inpatient,,,,38.625,21.24375,,34.7625,90,percent of total billed charges,,,,38.625,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.7625,90,percent of total billed charges,,,,36.69375,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.7625,38.625,
LACERATION TRAY,2704715,CDM,,,270,RC,inpatient,,,,12.772,7.0246,,11.4948,90,percent of total billed charges,,,,12.772,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4948,90,percent of total billed charges,,,,12.1334,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4948,12.772,
KOPAN LOCALIZER NEEDLE,2704730,CDM,,,270,RC,inpatient,,,,73.13,40.2215,,65.817,90,percent of total billed charges,,,,73.13,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.817,90,percent of total billed charges,,,,69.4735,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.817,73.13,
KUGEL HERNIA PATCH; LGE OVAL,2704741,CDM,,,270,RC,inpatient,,,,658.582,362.2201,,592.7238,90,percent of total billed charges,,,,658.582,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,592.7238,90,percent of total billed charges,,,,625.6529,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,592.7238,658.582,
LACRIMAL SET/JACKSON,2704750,CDM,,,270,RC,inpatient,,,,136.99,75.3445,,123.291,90,percent of total billed charges,,,,136.99,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,123.291,90,percent of total billed charges,,,,130.1405,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,123.291,136.99,
LAP CHOLECYSTECTOMY PACK,2704752,CDM,,,270,RC,inpatient,,,,136.784,75.2312,,123.1056,90,percent of total billed charges,,,,136.784,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,123.1056,90,percent of total billed charges,,,,129.9448,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,123.1056,136.784,
LAPARTOMY PACKS VI,2704770,CDM,,,270,RC,inpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.4056,90,percent of total billed charges,,,,32.0948,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.4056,33.784,
LAP SPONGES,2704780,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
GRANEE NEEDLE,2704841,CDM,,,270,RC,inpatient,,,,108.356,59.5958,,97.5204,90,percent of total billed charges,,,,108.356,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,97.5204,90,percent of total billed charges,,,,102.9382,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,97.5204,108.356,
LIGAMENT PROSTHESIS,2704890,CDM,,,270,RC,inpatient,,,,58.813,32.34715,,52.9317,90,percent of total billed charges,,,,58.813,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.9317,90,percent of total billed charges,,,,55.87235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.9317,58.813,
LIMB HOLDER,2704900,CDM,,,270,RC,inpatient,,,,3.09,1.6995,,2.781,90,percent of total billed charges,,,,3.09,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.781,90,percent of total billed charges,,,,2.9355,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.781,3.09,
LUKI TUBE,2704990,CDM,,,270,RC,inpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,90,percent of total billed charges,,,,4.01185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,4.223,
LUMBAR PUNCTURE TRAY,2705000,CDM,,,270,RC,inpatient,,,,41.715,22.94325,,37.5435,90,percent of total billed charges,,,,41.715,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.5435,90,percent of total billed charges,,,,39.62925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.5435,41.715,
MAJOR BASIN,2705030,CDM,,,270,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,119.274,
MALICOT CATHETER,2705040,CDM,,,270,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.4427,51.603,
LARGE TOWEL DRAPE (DYNJSD1010),2705095,CDM,,,270,RC,inpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,90,percent of total billed charges,,,,4.20755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,4.429,
TABLE COVER 24X53 & 44X76,2705100,CDM,,,270,RC,inpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,90,percent of total billed charges,,,,4.3054,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.0788,4.532,
MEDICAL ADHESIVE,2705120,CDM,,,270,RC,inpatient,,,,81.473,44.81015,,73.3257,90,percent of total billed charges,,,,81.473,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,73.3257,90,percent of total billed charges,,,,77.39935,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,73.3257,81.473,
CHLORA PREP 26ml,2705123,CDM,,,270,RC,inpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,90,percent of total billed charges,,,,25.93025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,27.295,
MINOR BASIN,2705170,CDM,,,270,RC,inpatient,,,,52.633,28.94815,,47.3697,90,percent of total billed charges,,,,52.633,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.3697,90,percent of total billed charges,,,,50.00135,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.3697,52.633,
BASIC PACK,2705180,CDM,,,270,RC,inpatient,,,,22.557,12.40635,,20.3013,90,percent of total billed charges,,,,22.557,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.3013,90,percent of total billed charges,,,,21.42915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.3013,22.557,
"CATHETER,FOLEY 16F/10CC",2705185,CDM,,,270,RC,inpatient,,,,5.562,3.0591,,5.0058,90,percent of total billed charges,,,,5.562,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.0058,90,percent of total billed charges,,,,5.2839,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.0058,5.562,
MONITOR ELECTRODES,2705190,CDM,,,270,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
MULTI LIMEN CATH KIT 30,2705200,CDM,,,270,RC,inpatient,,,,189.108,104.0094,,170.1972,90,percent of total billed charges,,,,189.108,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.1972,90,percent of total billed charges,,,,179.6526,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.1972,189.108,
NASO-PHARYN AIRWAY,2705270,CDM,,,270,RC,inpatient,,,,55.62,30.591,,50.058,90,percent of total billed charges,,,,55.62,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.058,90,percent of total billed charges,,,,52.839,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.058,55.62,
PERINEAL COLD PACK,2705275,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
SPOT INK #GIS-44,2705286,CDM,,,270,RC,inpatient,,,,57.989,31.89395,,52.1901,90,percent of total billed charges,,,,57.989,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.1901,90,percent of total billed charges,,,,55.08955,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.1901,57.989,
SPINAL NEEDLE,2705290,CDM,,,270,RC,inpatient,,,,34.608,19.0344,,31.1472,90,percent of total billed charges,,,,34.608,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.1472,90,percent of total billed charges,,,,32.8776,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.1472,34.608,
NEEDLE COUNTERS,2705300,CDM,,,270,RC,inpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,90,percent of total billed charges,,,,4.01185,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8007,4.223,
NEEDLES,2705320,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
FOLEY CATHETER TRAY,2705321,CDM,,,270,RC,inpatient,,,,32.96,18.128,,29.664,90,percent of total billed charges,,,,32.96,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.664,90,percent of total billed charges,,,,31.312,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.664,32.96,
UNIVERSAL BREATHING CIRCUIT,2705325,CDM,,,270,RC,inpatient,,,,13.905,7.64775,,12.5145,90,percent of total billed charges,,,,13.905,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.5145,90,percent of total billed charges,,,,13.20975,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.5145,13.905,
NEPHROSTOMY SET,2705340,CDM,,,270,RC,inpatient,,,,263.371,144.85405,,237.0339,90,percent of total billed charges,,,,263.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,237.0339,90,percent of total billed charges,,,,250.20245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,237.0339,263.371,
ENDO GIA UNIVERSAL STAPLER,2705345,CDM,,,270,RC,inpatient,,,,240.711,132.39105,,216.6399,90,percent of total billed charges,,,,240.711,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,216.6399,90,percent of total billed charges,,,,228.67545,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,216.6399,240.711,
NG TUBE HOLDER,2705360,CDM,,,270,RC,inpatient,,,,6.489,3.56895,,5.8401,90,percent of total billed charges,,,,6.489,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.8401,90,percent of total billed charges,,,,6.16455,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.8401,6.489,
NIPPLE SHIELD,2705370,CDM,,,270,RC,inpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,90,percent of total billed charges,,,,25.93025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,27.295,
MASIMO SENSOR PEDI #1767,2705373,CDM,,,270,RC,inpatient,,,,49.955,27.47525,,44.9595,90,percent of total billed charges,,,,49.955,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.9595,90,percent of total billed charges,,,,47.45725,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.9595,49.955,
MEROCEL NASAL PACKING,2705390,CDM,,,270,RC,inpatient,,,,32.342,17.7881,,29.1078,90,percent of total billed charges,,,,32.342,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.1078,90,percent of total billed charges,,,,30.7249,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.1078,32.342,
NUGAUZE,2705400,CDM,,,270,RC,inpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
OB/GYN PACK III,2705420,CDM,,,270,RC,inpatient,,,,46.865,25.77575,,42.1785,90,percent of total billed charges,,,,46.865,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.1785,90,percent of total billed charges,,,,44.52175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.1785,46.865,
HORIZON PRIMARY TUBING,2705430,CDM,,,270,RC,inpatient,,,,12.875,7.08125,,11.5875,90,percent of total billed charges,,,,12.875,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.5875,90,percent of total billed charges,,,,12.23125,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.5875,12.875,
HORIZON TNG TUBING,2705440,CDM,,,270,RC,inpatient,,,,22.042,12.1231,,19.8378,90,percent of total billed charges,,,,22.042,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.8378,90,percent of total billed charges,,,,20.9399,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.8378,22.042,
OP-SITE,2705460,CDM,,,270,RC,inpatient,,,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,90,percent of total billed charges,,,,22.8969,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6918,24.102,
ORAL/NASAL AIRWAY,2705480,CDM,,,270,RC,inpatient,,,,5.253,2.88915,,4.7277,90,percent of total billed charges,,,,5.253,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.7277,90,percent of total billed charges,,,,4.99035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.7277,5.253,
ORTHO BLUE CURETTE,2705490,CDM,,,270,RC,inpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,40.17,
MIC KEY FEEDING TUBE 2.7,2705497,CDM,,,270,RC,inpatient,,,,176.645,97.15475,,158.9805,90,percent of total billed charges,,,,176.645,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,158.9805,90,percent of total billed charges,,,,167.81275,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,158.9805,176.645,
ORTHO SORB K WIRES,2705510,CDM,,,270,RC,inpatient,,,,264.813,145.64715,,238.3317,90,percent of total billed charges,,,,264.813,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,238.3317,90,percent of total billed charges,,,,251.57235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,238.3317,264.813,
UNDERBUTTOCKS DRAPE DYNJP6002,2705552,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
O2 MASK,2705560,CDM,,,270,RC,inpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,90,percent of total billed charges,,,,3.81615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,4.017,
VAC CANNISTER SET,2705562,CDM,,,270,RC,inpatient,,,,92.391,50.81505,,83.1519,90,percent of total billed charges,,,,92.391,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.1519,90,percent of total billed charges,,,,87.77145,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.1519,92.391,
SUTURE PER PACK,2705599,CDM,,,270,RC,inpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,55.517,
PARACENTESIS TRAY,2705620,CDM,,,270,RC,inpatient,,,,120.716,66.3938,,108.6444,90,percent of total billed charges,,,,120.716,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.6444,90,percent of total billed charges,,,,114.6802,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.6444,120.716,
PARR IRRIGATION SYS,2705630,CDM,,,270,RC,inpatient,,,,87.138,47.9259,,78.4242,90,percent of total billed charges,,,,87.138,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,78.4242,90,percent of total billed charges,,,,82.7811,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,78.4242,87.138,
PAS AIR PUMP SYSTEM,2705650,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
PAS STOCKING,2705670,CDM,,,270,RC,inpatient,,,,36.977,20.33735,,33.2793,90,percent of total billed charges,,,,36.977,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.2793,90,percent of total billed charges,,,,35.12815,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.2793,36.977,
CRE 18-20mm #M00558380,2705697,CDM,,,270,RC,inpatient,,,,346.183,190.40065,,311.5647,90,percent of total billed charges,,,,346.183,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.5647,90,percent of total billed charges,,,,328.87385,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.5647,346.183,
GOLD PROBE #M00560070,2705698,CDM,,,270,RC,inpatient,,,,346.183,190.40065,,311.5647,90,percent of total billed charges,,,,346.183,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.5647,90,percent of total billed charges,,,,328.87385,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.5647,346.183,
PEDI BAG,2705700,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
TEVDEK - ALL,2705701,CDM,,,270,RC,inpatient,,,,21.733,11.95315,,19.5597,90,percent of total billed charges,,,,21.733,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.5597,90,percent of total billed charges,,,,20.64635,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.5597,21.733,
U-DRAPE,2705734,CDM,,,270,RC,inpatient,,,,54.487,29.96785,,49.0383,90,percent of total billed charges,,,,54.487,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.0383,90,percent of total billed charges,,,,51.76265,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.0383,54.487,
PNEUPAC VENT CIRCUIT,2705735,CDM,,,270,RC,inpatient,,,,54.487,29.96785,,49.0383,90,percent of total billed charges,,,,54.487,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.0383,90,percent of total billed charges,,,,51.76265,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.0383,54.487,
ENSEAL 35cm #ETSDC-01,2705743,CDM,,,270,RC,inpatient,,,,753.342,414.3381,,678.0078,90,percent of total billed charges,,,,753.342,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,678.0078,90,percent of total billed charges,,,,715.6749,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,678.0078,753.342,
PENROSE DRAIN,2705770,CDM,,,270,RC,inpatient,,,,7.931,4.36205,,7.1379,90,percent of total billed charges,,,,7.931,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.1379,90,percent of total billed charges,,,,7.53445,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.1379,7.931,
NOVASURE DEVICE KIT #NS2000,2705795,CDM,,,270,RC,inpatient,,,,2063.811,1135.09605,,1857.4299,90,percent of total billed charges,,,,2063.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1857.4299,90,percent of total billed charges,,,,1960.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1857.4299,2063.811,
PERINEAL SOLUTION,2705800,CDM,,,270,RC,inpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
HYDRO-SURG #0026870,2705805,CDM,,,270,RC,inpatient,,,,186.636,102.6498,,167.9724,90,percent of total billed charges,,,,186.636,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,167.9724,90,percent of total billed charges,,,,177.3042,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,167.9724,186.636,
ENDO PEANUT #173019,2705808,CDM,,,270,RC,inpatient,,,,67.362,37.0491,,60.6258,90,percent of total billed charges,,,,67.362,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.6258,90,percent of total billed charges,,,,63.9939,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.6258,67.362,
PERITONEAL CATH CON,2705820,CDM,,,270,RC,inpatient,,,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
XEROFORM PADS,2705850,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
INSPACE LARGE,2705857,CDM,,,270,RC,inpatient,,,,14832,8157.6,,13348.8,90,percent of total billed charges,,,,14832,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13348.8,90,percent of total billed charges,,,,14090.4,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13348.8,14832,
PEZZAR STYLET,2705870,CDM,,,270,RC,inpatient,,,,108.665,59.76575,,97.7985,90,percent of total billed charges,,,,108.665,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,97.7985,90,percent of total billed charges,,,,103.23175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,97.7985,108.665,
APPLIED 15MM #COR37,2705896,CDM,,,270,RC,inpatient,,,,107.841,59.31255,,97.0569,90,percent of total billed charges,,,,107.841,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,97.0569,90,percent of total billed charges,,,,102.44895,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,97.0569,107.841,
"FIBERWIRE C-13 38""",2705898,CDM,,,270,RC,inpatient,,,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.5157,90,percent of total billed charges,,,,48.04435,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.5157,50.573,
ARTHROSCOPY DRAIN/W/FLUID COLL,2705932,CDM,,,270,RC,inpatient,,,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.9051,90,percent of total billed charges,,,,99.12205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.9051,104.339,
APPLIED HUSSAN TROCAR,2705939,CDM,,,270,RC,inpatient,,,,65.096,35.8028,,58.5864,90,percent of total billed charges,,,,65.096,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.5864,90,percent of total billed charges,,,,61.8412,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.5864,65.096,
BOVIE PAD,2705940,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
APPLIED BAG #CD001,2705942,CDM,,,270,RC,inpatient,,,,42.539,23.39645,,38.2851,90,percent of total billed charges,,,,42.539,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.2851,90,percent of total billed charges,,,,40.41205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.2851,42.539,
APPLIED 13GA #C2201,2705943,CDM,,,270,RC,inpatient,,,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.1333,90,percent of total billed charges,,,,37.08515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.1333,39.037,
POST-OP SHOE ALL,2705950,CDM,,,270,RC,inpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,90,percent of total billed charges,,,,44.91315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,47.277,
QUICKTRACH 4MM,2705953,CDM,,,270,RC,inpatient,,,,271.714,149.4427,,244.5426,90,percent of total billed charges,,,,271.714,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,244.5426,90,percent of total billed charges,,,,258.1283,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,244.5426,271.714,
POSTOP STER ELECTRO,2705960,CDM,,,270,RC,inpatient,,,,38.728,21.3004,,34.8552,90,percent of total billed charges,,,,38.728,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.8552,90,percent of total billed charges,,,,36.7916,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.8552,38.728,
UNI STAPLER ROTIC 60 LOAD,2705998,CDM,,,270,RC,inpatient,,,,402.112,221.1616,,361.9008,90,percent of total billed charges,,,,402.112,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,361.9008,90,percent of total billed charges,,,,382.0064,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,361.9008,402.112,
APPLIED GELPORT #C8XX2,2706006,CDM,,,270,RC,inpatient,,,,988.594,543.7267,,889.7346,90,percent of total billed charges,,,,988.594,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,889.7346,90,percent of total billed charges,,,,939.1643,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,889.7346,988.594,
COUDE CATH W/5CC BALLOON 16FR,2706009,CDM,,,270,RC,inpatient,,,,23.999,13.19945,,21.5991,90,percent of total billed charges,,,,23.999,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.5991,90,percent of total billed charges,,,,22.79905,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.5991,23.999,
PREP TRAY,2706020,CDM,,,270,RC,inpatient,,,,11.845,6.51475,,10.6605,90,percent of total billed charges,,,,11.845,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.6605,90,percent of total billed charges,,,,11.25275,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.6605,11.845,
PREPERITONEAL DISTENT BALLOON,2706025,CDM,,,270,RC,inpatient,,,,666.616,366.6388,,599.9544,90,percent of total billed charges,,,,666.616,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,599.9544,90,percent of total billed charges,,,,633.2852,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,599.9544,666.616,
PROVIDONE SWABSTICK,2706060,CDM,,,270,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
FEEDING PUMP BAG,2706070,CDM,,,270,RC,inpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,40.17,
NEURO PATTY #DMA1003,2706073,CDM,,,270,RC,inpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,90,percent of total billed charges,,,,3.81615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.6153,4.017,
BAG FLOW #650,2706075,CDM,,,270,RC,inpatient,,,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
PUMP SET,2706080,CDM,,,270,RC,inpatient,,,,13.39,7.3645,,12.051,90,percent of total billed charges,,,,13.39,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.051,90,percent of total billed charges,,,,12.7205,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.051,13.39,
PUMP TUBING,2706090,CDM,,,270,RC,inpatient,,,,144.2,79.31,,129.78,90,percent of total billed charges,,,,144.2,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,129.78,90,percent of total billed charges,,,,136.99,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,129.78,144.2,
CONTOUR STAPLER #CS40G,2706094,CDM,,,270,RC,inpatient,,,,442.694,243.4817,,398.4246,90,percent of total billed charges,,,,442.694,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,398.4246,90,percent of total billed charges,,,,420.5593,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,398.4246,442.694,
CONTOUR LOAD #CR40G,2706095,CDM,,,270,RC,inpatient,,,,296.331,162.98205,,266.6979,90,percent of total billed charges,,,,296.331,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,266.6979,90,percent of total billed charges,,,,281.51445,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,266.6979,296.331,
PURSE STRING,2706100,CDM,,,270,RC,inpatient,,,,318.682,175.2751,,286.8138,90,percent of total billed charges,,,,318.682,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,286.8138,90,percent of total billed charges,,,,302.7479,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,286.8138,318.682,
ABLATOR 90o 4m,2706146,CDM,,,270,RC,inpatient,,,,355.35,195.4425,,319.815,90,percent of total billed charges,,,,355.35,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,319.815,90,percent of total billed charges,,,,337.5825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,319.815,355.35,
LAVH DRAPE - MEDLINE,2706152,CDM,,,270,RC,inpatient,,,,39.243,21.58365,,35.3187,90,percent of total billed charges,,,,39.243,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.3187,90,percent of total billed charges,,,,37.28085,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.3187,39.243,
LINVATEC 9mm SAWBLADE,2706158,CDM,,,270,RC,inpatient,,,,238.754,131.3147,,214.8786,90,percent of total billed charges,,,,238.754,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,214.8786,90,percent of total billed charges,,,,226.8163,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,214.8786,238.754,
REINF STRIPS 4X30,2706160,CDM,,,270,RC,inpatient,,,,31.93,17.5615,,28.737,90,percent of total billed charges,,,,31.93,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.737,90,percent of total billed charges,,,,30.3335,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.737,31.93,
4-PORT MANIFOLD (FILTER),2706162,CDM,,,270,RC,inpatient,,,,63.86,35.123,,57.474,90,percent of total billed charges,,,,63.86,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.474,90,percent of total billed charges,,,,60.667,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.474,63.86,
RIB BELT ELASTIC-AL,2706180,CDM,,,270,RC,inpatient,,,,10.3,5.665,,9.27,90,percent of total billed charges,,,,10.3,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.27,90,percent of total billed charges,,,,9.785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.27,10.3,
TRICUT 4mm #1884004HR,2706193,CDM,,,270,RC,inpatient,,,,365.238,200.8809,,328.7142,90,percent of total billed charges,,,,365.238,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.7142,90,percent of total billed charges,,,,346.9761,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.7142,365.238,
SINUS BLADE,2706196,CDM,,,270,RC,inpatient,,,,566.294,311.4617,,509.6646,90,percent of total billed charges,,,,566.294,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,509.6646,90,percent of total billed charges,,,,537.9793,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,509.6646,566.294,
SINUS SHEATH,2706197,CDM,,,270,RC,inpatient,,,,126.484,69.5662,,113.8356,90,percent of total billed charges,,,,126.484,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,113.8356,90,percent of total billed charges,,,,120.1598,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,113.8356,126.484,
ROLLER BALL ELEC,2706210,CDM,,,270,RC,inpatient,,,,77.147,42.43085,,69.4323,90,percent of total billed charges,,,,77.147,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.4323,90,percent of total billed charges,,,,73.28965,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.4323,77.147,
ROTH RETRIEVAL,2706220,CDM,,,270,RC,inpatient,,,,111.24,61.182,,100.116,90,percent of total billed charges,,,,111.24,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,100.116,90,percent of total billed charges,,,,105.678,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,100.116,111.24,
ROUTINE DRESSING TR,2706240,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
SANITARY PAD,2706280,CDM,,,270,RC,inpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,90,percent of total billed charges,,,,3.42475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,3.605,
SCALPEL BLADE - DISPOSABLE,2706310,CDM,,,270,RC,inpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
MAGNETIC DRAPE #DYNJMDS1,2706318,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
SCROTAL SUPPORT,2706350,CDM,,,270,RC,inpatient,,,,29.046,15.9753,,26.1414,90,percent of total billed charges,,,,29.046,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.1414,90,percent of total billed charges,,,,27.5937,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.1414,29.046,
SENSOR GUARD,2706400,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
"GEL PACK LG 9X12"" ACCURATE MFG",2706405,CDM,,,270,RC,inpatient,,,,6.695,3.68225,,6.0255,90,percent of total billed charges,,,,6.695,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.0255,90,percent of total billed charges,,,,6.36025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.0255,6.695,
"GEL PACK SM 5x9""",2706406,CDM,,,270,RC,inpatient,,,,4.944,2.7192,,4.4496,90,percent of total billed charges,,,,4.944,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.4496,90,percent of total billed charges,,,,4.6968,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.4496,4.944,
APPLIED RETRACTOR LG #G6313,2706412,CDM,,,270,RC,inpatient,,,,172.628,94.9454,,155.3652,90,percent of total billed charges,,,,172.628,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,155.3652,90,percent of total billed charges,,,,163.9966,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,155.3652,172.628,
SHEET 3/4 TABLE COVER,2706460,CDM,,,270,RC,inpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
ENDOCLIP APPLIER ALL,2706566,CDM,,,270,RC,inpatient,,,,389.752,214.3636,,350.7768,90,percent of total billed charges,,,,389.752,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,350.7768,90,percent of total billed charges,,,,370.2644,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,350.7768,389.752,
SILICON SUMP TUBE,2706590,CDM,,,270,RC,inpatient,,,,48.307,26.56885,,43.4763,90,percent of total billed charges,,,,48.307,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.4763,90,percent of total billed charges,,,,45.89165,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.4763,48.307,
SILVERLON 4X12,2706603,CDM,,,270,RC,inpatient,,,,76.941,42.31755,,69.2469,90,percent of total billed charges,,,,76.941,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.2469,90,percent of total billed charges,,,,73.09395,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.2469,76.941,
SLINGSHOT 2 A&A SLING,2706624,CDM,,,270,RC,inpatient,,,,139.874,76.9307,,125.8866,90,percent of total billed charges,,,,139.874,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.8866,90,percent of total billed charges,,,,132.8803,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.8866,139.874,
SINGLE SLOT HD SCRE,2706660,CDM,,,270,RC,inpatient,,,,38.728,21.3004,,34.8552,90,percent of total billed charges,,,,38.728,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.8552,90,percent of total billed charges,,,,36.7916,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.8552,38.728,
SITZ BATH,2706670,CDM,,,270,RC,inpatient,,,,6.489,3.56895,,5.8401,90,percent of total billed charges,,,,6.489,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.8401,90,percent of total billed charges,,,,6.16455,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.8401,6.489,
SKIN BARRIER BIK 8X,2706690,CDM,,,270,RC,inpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,40.17,
SKIN STAPLE REMOVER,2706750,CDM,,,270,RC,inpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
SLING & SWATHE,2706810,CDM,,,270,RC,inpatient,,,,68.495,37.67225,,61.6455,90,percent of total billed charges,,,,68.495,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.6455,90,percent of total billed charges,,,,65.07025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.6455,68.495,
SNAP COVER C-ARM DRAPE,2706840,CDM,,,270,RC,inpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SORBAVIEW DRESSING,2706910,CDM,,,270,RC,inpatient,,,,7.622,4.1921,,6.8598,90,percent of total billed charges,,,,7.622,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.8598,90,percent of total billed charges,,,,7.2409,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.8598,7.622,
TRANSPEC CONTAINER,2706940,CDM,,,270,RC,inpatient,,,,51.397,28.26835,,46.2573,90,percent of total billed charges,,,,51.397,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.2573,90,percent of total billed charges,,,,48.82715,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.2573,51.397,
SPINAL ANES. SET,2706950,CDM,,,270,RC,inpatient,,,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,90,percent of total billed charges,,,,24.56035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,25.853,
APPLIED ACCESS SHEATH B7016,2707016,CDM,,,270,RC,inpatient,,,,190.55,104.8025,,171.495,90,percent of total billed charges,,,,190.55,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.495,90,percent of total billed charges,,,,181.0225,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.495,190.55,
SPLINT POST FEMUR S,2707020,CDM,,,270,RC,inpatient,,,,131.325,72.22875,,118.1925,90,percent of total billed charges,,,,131.325,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.1925,90,percent of total billed charges,,,,124.75875,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.1925,131.325,
CHOLANG KIT# CS-01700,2707021,CDM,,,270,RC,inpatient,,,,209.811,115.39605,,188.8299,90,percent of total billed charges,,,,209.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.8299,90,percent of total billed charges,,,,199.32045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.8299,209.811,
ENDO CLIP LG# 176625,2707022,CDM,,,270,RC,inpatient,,,,239.063,131.48465,,215.1567,90,percent of total billed charges,,,,239.063,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,215.1567,90,percent of total billed charges,,,,227.10985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,215.1567,239.063,
SURETRANS $8592000,2707031,CDM,,,270,RC,inpatient,,,,697.207,383.46385,,627.4863,90,percent of total billed charges,,,,697.207,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,627.4863,90,percent of total billed charges,,,,662.34665,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,627.4863,697.207,
SPLINT FOREARM,2707075,CDM,,,270,RC,inpatient,,,,15.656,8.6108,,14.0904,90,percent of total billed charges,,,,15.656,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.0904,90,percent of total billed charges,,,,14.8732,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.0904,15.656,
GELFOAM SPONGE SZ 100,2707087,CDM,,,270,RC,inpatient,,,,36.153,19.88415,,32.5377,90,percent of total billed charges,,,,36.153,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.5377,90,percent of total billed charges,,,,34.34535,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.5377,36.153,
TALON GRASPING DEVICE,2707111,CDM,,,270,RC,inpatient,,,,149.041,81.97255,,134.1369,90,percent of total billed charges,,,,149.041,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,134.1369,90,percent of total billed charges,,,,141.58895,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,134.1369,149.041,
PLASTER BANDAGE J&J,2707120,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
SPLIT SHEET ENT,2707125,CDM,,,270,RC,inpatient,,,,12.978,7.1379,,11.6802,90,percent of total billed charges,,,,12.978,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.6802,90,percent of total billed charges,,,,12.3291,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.6802,12.978,
SPRING CLIP (BULLDOG),2707130,CDM,,,270,RC,inpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,90,percent of total billed charges,,,,25.93025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,27.295,
ARTHREX FIBERWIRE #AR7201,2707201,CDM,,,270,RC,inpatient,,,,80.237,44.13035,,72.2133,90,percent of total billed charges,,,,80.237,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.2133,90,percent of total billed charges,,,,76.22515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.2133,80.237,
STERI-STRIP,2707220,CDM,,,270,RC,inpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,90,percent of total billed charges,,,,4.20755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,4.429,
STERILE CONNECTOR S,2707240,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
STERILE IRRIG SOLUTION,2707250,CDM,,,270,RC,inpatient,,,,14.626,8.0443,,13.1634,90,percent of total billed charges,,,,14.626,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.1634,90,percent of total billed charges,,,,13.8947,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.1634,14.626,
STERILE TUBN POST-O,2707290,CDM,,,270,RC,inpatient,,,,95.79,52.6845,,86.211,90,percent of total billed charges,,,,95.79,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,86.211,90,percent of total billed charges,,,,91.0005,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,86.211,95.79,
STERILE WATER 1000 CC,2707300,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
STERILE WATER 500cc,2707301,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
BIOPATCH PROTECTIVE DISK W/CHG,2707304,CDM,,,270,RC,inpatient,,,,16.377,9.00735,,14.7393,90,percent of total billed charges,,,,16.377,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.7393,90,percent of total billed charges,,,,15.55815,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.7393,16.377,
STERILE WATER 3000cc,2707310,CDM,,,270,RC,inpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,90,percent of total billed charges,,,,44.91315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,47.277,
STERILE 2X2,2707320,CDM,,,270,RC,inpatient,,,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
STERILE 4X4 SINGLE,2707330,CDM,,,270,RC,inpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,90,percent of total billed charges,,,,3.42475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,3.605,
STERILE 4X4 10 PACK,2707340,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
MCGRATH MAC3 350-005-000,2707356,CDM,,,270,RC,inpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,90,percent of total billed charges,,,,44.91315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,47.277,
HARMONIC CURVED SHEARS ACE36E,2707358,CDM,,,270,RC,inpatient,,,,646.325,355.47875,,581.6925,90,percent of total billed charges,,,,646.325,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,581.6925,90,percent of total billed charges,,,,614.00875,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,581.6925,646.325,
ENSEAL TISSUE SEALER G2,2707359,CDM,,,270,RC,inpatient,,,,1203.555,661.95525,,1083.1995,90,percent of total billed charges,,,,1203.555,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1083.1995,90,percent of total billed charges,,,,1143.37725,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1083.1995,1203.555,
STOCKINETTE,2707360,CDM,,,270,RC,inpatient,,,,20.497,11.27335,,18.4473,90,percent of total billed charges,,,,20.497,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.4473,90,percent of total billed charges,,,,19.47215,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.4473,20.497,
STOMA BAG,2707370,CDM,,,270,RC,inpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
STOMA BAG CLAMP,2707380,CDM,,,270,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
STOMAHESIVE PASTE,2707410,CDM,,,270,RC,inpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,90,percent of total billed charges,,,,25.93025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.5655,27.295,
STOMAHESIVE 4X4,2707420,CDM,,,270,RC,inpatient,,,,11.845,6.51475,,10.6605,90,percent of total billed charges,,,,11.845,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.6605,90,percent of total billed charges,,,,11.25275,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.6605,11.845,
STONE BASKET-JOHNSON,2707430,CDM,,,270,RC,inpatient,,,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,90,percent of total billed charges,,,,27.30015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,28.737,
STOPCOCK 3WAY,2707440,CDM,,,270,RC,inpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,90,percent of total billed charges,,,,3.7183,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,3.914,
SUBCLAB/JUGULAR CAT,2707450,CDM,,,270,RC,inpatient,,,,31.93,17.5615,,28.737,90,percent of total billed charges,,,,31.93,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.737,90,percent of total billed charges,,,,30.3335,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.737,31.93,
SUCTION CANNISTER 1000/150,2707460,CDM,,,270,RC,inpatient,,,,4.738,2.6059,,4.2642,90,percent of total billed charges,,,,4.738,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.2642,90,percent of total billed charges,,,,4.5011,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.2642,4.738,
SUCTION CATH,2707470,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
SUCTION POLYP TRAP,2707480,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
SUPPLEMENTAL FEEDING,2707490,CDM,,,270,RC,inpatient,,,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
SURGICAL CLIPPER,2707550,CDM,,,270,RC,inpatient,,,,30.488,16.7684,,27.4392,90,percent of total billed charges,,,,30.488,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.4392,90,percent of total billed charges,,,,28.9636,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.4392,30.488,
SURGICEL 1/2 X2 #1955,2707580,CDM,,,270,RC,inpatient,,,,59.122,32.5171,,53.2098,90,percent of total billed charges,,,,59.122,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53.2098,90,percent of total billed charges,,,,56.1659,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53.2098,59.122,
SURGICEL,2707590,CDM,,,270,RC,inpatient,,,,215.888,118.7384,,194.2992,90,percent of total billed charges,,,,215.888,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,194.2992,90,percent of total billed charges,,,,205.0936,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,194.2992,215.888,
SUTURE REMOVAL TRAY,2707670,CDM,,,270,RC,inpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
"SUTURE CHROMIC 36""",2707690,CDM,,,270,RC,inpatient,,,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
SYRINGE-EARBULB,2707820,CDM,,,270,RC,inpatient,,,,24.72,13.596,,22.248,90,percent of total billed charges,,,,24.72,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.248,90,percent of total billed charges,,,,23.484,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.248,24.72,
SYRINGE (ALL),2707830,CDM,,,270,RC,inpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
TRANSPORE TAPE,2707870,CDM,,,270,RC,inpatient,,,,27.398,15.0689,,24.6582,90,percent of total billed charges,,,,27.398,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.6582,90,percent of total billed charges,,,,26.0281,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.6582,27.398,
TED HOSE-ALL,2707890,CDM,,,270,RC,inpatient,,,,6.592,3.6256,,5.9328,90,percent of total billed charges,,,,6.592,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.9328,90,percent of total billed charges,,,,6.2624,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.9328,6.592,
PTFE PLEDGETS #007975,2707900,CDM,,,270,RC,inpatient,,,,73.439,40.39145,,66.0951,90,percent of total billed charges,,,,73.439,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.0951,90,percent of total billed charges,,,,69.76705,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.0951,73.439,
TEGADERM,2707920,CDM,A6258,HCPCS,270,RC,inpatient,,,,5.356,2.9458,,4.8204,90,percent of total billed charges,,,,5.356,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.8204,90,percent of total billed charges,,,,5.0882,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.8204,5.356,
CAESAREAN DRAPE #7965,2707965,CDM,,,270,RC,inpatient,,,,51.191,28.15505,,46.0719,90,percent of total billed charges,,,,51.191,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.0719,90,percent of total billed charges,,,,48.63145,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.0719,51.191,
TELFA PADS,2707980,CDM,,,270,RC,inpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,90,percent of total billed charges,,,,3.7183,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,3.914,
DSE TUBING,2708009,CDM,,,270,RC,inpatient,,,,5.15,2.8325,,4.635,90,percent of total billed charges,,,,5.15,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.635,90,percent of total billed charges,,,,4.8925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.635,5.15,
TENS ELECTRODES,2708020,CDM,,,270,RC,inpatient,,,,69.937,38.46535,,62.9433,90,percent of total billed charges,,,,69.937,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.9433,90,percent of total billed charges,,,,66.44015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62.9433,69.937,
TEXAS CATHETER,2708070,CDM,,,270,RC,inpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,90,percent of total billed charges,,,,4.1097,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.8934,4.326,
THERMO HEAD COVER,2708090,CDM,,,270,RC,inpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
THERMODRAPE BLANKET,2708120,CDM,,,270,RC,inpatient,,,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,90,percent of total billed charges,,,,24.56035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,25.853,
THOMAS SPLINT PAD,2708150,CDM,,,270,RC,inpatient,,,,18.952,10.4236,,17.0568,90,percent of total billed charges,,,,18.952,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.0568,90,percent of total billed charges,,,,18.0044,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.0568,18.952,
THORACENTESIS TRAY,2708170,CDM,,,270,RC,inpatient,,,,141.11,77.6105,,126.999,90,percent of total billed charges,,,,141.11,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.999,90,percent of total billed charges,,,,134.0545,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.999,141.11,
TOE CAP,2708180,CDM,,,270,RC,inpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
TONSIL SNARES,2708190,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
COLOSTOMY/ILEOSTOMY KIT,2708199,CDM,,,270,RC,inpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,90,percent of total billed charges,,,,4.20755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,4.429,
TOOTHBRUSH,2708200,CDM,,,270,RC,inpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,90,percent of total billed charges,,,,3.42475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.2445,3.605,
TRACHEAL TUBES,2708250,CDM,,,270,RC,inpatient,,,,195.7,107.635,,176.13,90,percent of total billed charges,,,,195.7,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,176.13,90,percent of total billed charges,,,,185.915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,176.13,195.7,
TRACHEOST CLEAN TRA,2708260,CDM,,,270,RC,inpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,90,percent of total billed charges,,,,4.20755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.9861,4.429,
SPILLPROOF URINAL,2708312,CDM,,,270,RC,inpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,90,percent of total billed charges,,,,44.91315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,47.277,
TUBING CONNECTOR Y,2708320,CDM,,,270,RC,inpatient,,,,11.845,6.51475,,10.6605,90,percent of total billed charges,,,,11.845,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.6605,90,percent of total billed charges,,,,11.25275,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.6605,11.845,
TUBING CONNECTORS,2708330,CDM,,,270,RC,inpatient,,,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
X-SPAN NET DRESSING SZ 8,2708340,CDM,,,270,RC,inpatient,,,,29.458,16.2019,,26.5122,90,percent of total billed charges,,,,29.458,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.5122,90,percent of total billed charges,,,,27.9851,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.5122,29.458,
UMBILICAL CATHETER,2708380,CDM,,,270,RC,inpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,90,percent of total billed charges,,,,44.91315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.5493,47.277,
URETERAL STINT,2708440,CDM,,,270,RC,inpatient,,,,294.683,162.07565,,265.2147,90,percent of total billed charges,,,,294.683,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.2147,90,percent of total billed charges,,,,279.94885,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.2147,294.683,
URETHAL CATH TRAY,2708450,CDM,,,270,RC,inpatient,,,,15.862,8.7241,,14.2758,90,percent of total billed charges,,,,15.862,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.2758,90,percent of total billed charges,,,,15.0689,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.2758,15.862,
URETHRAL CATHETER,2708470,CDM,,,270,RC,inpatient,,,,32.033,17.61815,,28.8297,90,percent of total billed charges,,,,32.033,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.8297,90,percent of total billed charges,,,,30.43135,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.8297,32.033,
URI PAN (HAT) 800cc,2708480,CDM,,,270,RC,inpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,90,percent of total billed charges,,,,3.7183,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,3.914,
URINAL-MALE,2708510,CDM,,,270,RC,inpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,90,percent of total billed charges,,,,3.7183,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.5226,3.914,
URINE LEG BAG,2708540,CDM,,,270,RC,inpatient,,,,5.356,2.9458,,4.8204,90,percent of total billed charges,,,,5.356,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.8204,90,percent of total billed charges,,,,5.0882,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.8204,5.356,
VACCUUM CURETTE,2708610,CDM,,,270,RC,inpatient,,,,6.18,3.399,,5.562,90,percent of total billed charges,,,,6.18,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.562,90,percent of total billed charges,,,,5.871,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.562,6.18,
BOVIE PENCIL,2708630,CDM,,,270,RC,inpatient,,,,11.227,6.17485,,10.1043,90,percent of total billed charges,,,,11.227,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.1043,90,percent of total billed charges,,,,10.66565,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.1043,11.227,
BOVIE SUCTION E2610-6,2708640,CDM,,,270,RC,inpatient,,,,36.153,19.88415,,32.5377,90,percent of total billed charges,,,,36.153,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.5377,90,percent of total billed charges,,,,34.34535,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.5377,36.153,
VARICES INJ NEEDLE,2708650,CDM,,,270,RC,inpatient,,,,125.557,69.05635,,113.0013,90,percent of total billed charges,,,,125.557,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,113.0013,90,percent of total billed charges,,,,119.27915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,113.0013,125.557,
DRAPE IMPERVIOUS,2708675,CDM,,,270,RC,inpatient,,,,6.0461,3.325355,,5.44149,90,percent of total billed charges,,,,6.0461,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.44149,90,percent of total billed charges,,,,5.743795,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.44149,6.0461,
VASCULAR GRAFT BIFURCATED,2708690,CDM,,,270,RC,inpatient,,,,859.638,472.8009,,773.6742,90,percent of total billed charges,,,,859.638,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,773.6742,90,percent of total billed charges,,,,816.6561,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,773.6742,859.638,
VASELINE 0.6OZ,2708700,CDM,,,270,RC,inpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.708,4.12,
VASELINE GAUZE,2708710,CDM,,,270,RC,inpatient,,,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,90,percent of total billed charges,,,,7.14305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.7671,7.519,
HELMET CUSHIONED INSERT,2708725,CDM,,,270,RC,inpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.6339,57.371,
VESSEL LOOPS,2708750,CDM,,,270,RC,inpatient,,,,6.18,3.399,,5.562,90,percent of total billed charges,,,,6.18,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.562,90,percent of total billed charges,,,,5.871,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.562,6.18,
VIAL ADAPTER,2708760,CDM,,,270,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
VITAL SIGNS MASK,2708790,CDM,,,270,RC,inpatient,,,,7.107,3.90885,,6.3963,90,percent of total billed charges,,,,7.107,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3963,90,percent of total billed charges,,,,6.75165,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.3963,7.107,
DRI-LOCK CANNULA,2708925,CDM,,,270,RC,inpatient,,,,39.3975,21.668625,,35.45775,90,percent of total billed charges,,,,39.3975,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.45775,90,percent of total billed charges,,,,37.427625,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.45775,39.3975,
WIRE 28 GAUGE,2708940,CDM,,,270,RC,inpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
YANKAUER SUCTION,2708950,CDM,,,270,RC,inpatient,,,,4.738,2.6059,,4.2642,90,percent of total billed charges,,,,4.738,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.2642,90,percent of total billed charges,,,,4.5011,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.2642,4.738,
"TACH, CIFFED, D.I.C. SZ 9",2708985,CDM,,,270,RC,inpatient,,,,6.695,3.68225,,6.0255,90,percent of total billed charges,,,,6.695,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.0255,90,percent of total billed charges,,,,6.36025,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.0255,6.695,
Synthes 2.5 Reaming Rod Ball,2708986,CDM,,,270,RC,inpatient,,,,227.63,125.1965,,204.867,90,percent of total billed charges,,,,227.63,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,204.867,90,percent of total billed charges,,,,216.2485,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,204.867,227.63,
Slingshot 70 DEG Suture Passr,2708987,CDM,,,270,RC,inpatient,,,,680.83,374.4565,,612.747,90,percent of total billed charges,,,,680.83,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,612.747,90,percent of total billed charges,,,,646.7885,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,612.747,680.83,
Slingshot 45 Deg Sut Passr,2708988,CDM,,,270,RC,inpatient,,,,680.83,374.4565,,612.747,90,percent of total billed charges,,,,680.83,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,612.747,90,percent of total billed charges,,,,646.7885,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,612.747,680.83,
Oxygen Reservoir,2708989,CDM,,,270,RC,inpatient,,,,100.94,55.517,,90.846,90,percent of total billed charges,,,,100.94,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,90.846,90,percent of total billed charges,,,,95.893,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,90.846,100.94,
PUREWICK EXT FEMALE CATHETER,2709001,CDM,,,270,RC,inpatient,,,,33.063,18.18465,,29.7567,90,percent of total billed charges,,,,33.063,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.7567,90,percent of total billed charges,,,,31.40985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.7567,33.063,
STERILE EVAC. CONTAINER,2709080,CDM,,,270,RC,inpatient,,,,42.024,23.1132,,37.8216,90,percent of total billed charges,,,,42.024,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.8216,90,percent of total billed charges,,,,39.9228,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.8216,42.024,
"5"" ONE CONNECTOR",2709090,CDM,,,270,RC,inpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,90,percent of total billed charges,,,,3.5226,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.3372,3.708,
TROCAR 5mm,2709110,CDM,,,270,RC,inpatient,,,,202.395,111.31725,,182.1555,90,percent of total billed charges,,,,202.395,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,182.1555,90,percent of total billed charges,,,,192.27525,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,182.1555,202.395,
"ORTHO GLASS SPLINT 2""",2709120,CDM,,,270,RC,inpatient,,,,74.469,40.95795,,67.0221,90,percent of total billed charges,,,,74.469,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.0221,90,percent of total billed charges,,,,70.74555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.0221,74.469,
SILCONE CANNULA,2709225,CDM,,,270,RC,inpatient,,,,64.89,35.6895,,58.401,90,percent of total billed charges,,,,64.89,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.401,90,percent of total billed charges,,,,61.6455,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.401,64.89,
STAY FIX EPIDURAL DRESSING,2709228,CDM,,,270,RC,inpatient,,,,18.54,10.197,,16.686,90,percent of total billed charges,,,,18.54,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.686,90,percent of total billed charges,,,,17.613,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.686,18.54,
BARRIER HOODS - DEPUY,2709286,CDM,,,270,RC,inpatient,,,,84.048,46.2264,,75.6432,90,percent of total billed charges,,,,84.048,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.6432,90,percent of total billed charges,,,,79.8456,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.6432,84.048,
EMPTY EVACUATED CONT 2000ML,2709406,CDM,,,270,RC,inpatient,,,,43.157,23.73635,,38.8413,90,percent of total billed charges,,,,43.157,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.8413,90,percent of total billed charges,,,,40.99915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.8413,43.157,
PALL BLOOD FILTER,2709510,CDM,,,270,RC,inpatient,,,,121.025,66.56375,,108.9225,90,percent of total billed charges,,,,121.025,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.9225,90,percent of total billed charges,,,,114.97375,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.9225,121.025,
PLATELET ADMINISTRATION KIT,2709530,CDM,,,270,RC,inpatient,,,,13.287,7.30785,,11.9583,90,percent of total billed charges,,,,13.287,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.9583,90,percent of total billed charges,,,,12.62265,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.9583,13.287,
SUTURE GUN/DISPOSABLE - OR,2709560,CDM,,,270,RC,inpatient,,,,111.24,61.182,,100.116,90,percent of total billed charges,,,,111.24,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,100.116,90,percent of total billed charges,,,,105.678,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,100.116,111.24,
ENEMA/PER USAGE - OR,2709590,CDM,,,270,RC,inpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
EYE TRAY - OR,2709600,CDM,,,270,RC,inpatient,,,,21.527,11.83985,,19.3743,90,percent of total billed charges,,,,21.527,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.3743,90,percent of total billed charges,,,,20.45065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.3743,21.527,
UTERINE ASPIRATING TUBING,2709616,CDM,,,270,RC,inpatient,,,,17.613,9.68715,,15.8517,90,percent of total billed charges,,,,17.613,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.8517,90,percent of total billed charges,,,,16.73235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.8517,17.613,
VACCUM EXTRACTOR,2709620,CDM,,,270,RC,inpatient,,,,74.263,40.84465,,66.8367,90,percent of total billed charges,,,,74.263,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.8367,90,percent of total billed charges,,,,70.54985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.8367,74.263,
SUTURE SUPRAMID LOOPED 3-0,2709630,CDM,,,270,RC,inpatient,,,,71.07,39.0885,,63.963,90,percent of total billed charges,,,,71.07,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.963,90,percent of total billed charges,,,,67.5165,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.963,71.07,
SURTURE GUN - OR,2709660,CDM,,,270,RC,inpatient,,,,57.062,31.3841,,51.3558,90,percent of total billed charges,,,,57.062,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.3558,90,percent of total billed charges,,,,54.2089,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.3558,57.062,
TROCAR 5MM,2709860,CDM,,,270,RC,inpatient,,,,202.395,111.31725,,182.1555,90,percent of total billed charges,,,,202.395,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,182.1555,90,percent of total billed charges,,,,192.27525,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,182.1555,202.395,
TROCAR 12MM,2709880,CDM,,,270,RC,inpatient,,,,273.465,150.40575,,246.1185,90,percent of total billed charges,,,,273.465,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,246.1185,90,percent of total billed charges,,,,259.79175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,246.1185,273.465,
ARTHREX PUMP TUBING AR-6410,2709904,CDM,,,270,RC,inpatient,,,,110.416,60.7288,,99.3744,90,percent of total billed charges,,,,110.416,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.3744,90,percent of total billed charges,,,,104.8952,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.3744,110.416,
FETAL SCALP LEAD,2709915,CDM,,,270,RC,inpatient,,,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.9618,90,percent of total billed charges,,,,32.6819,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.9618,34.402,
JADA,2709916,CDM,,,270,RC,inpatient,,,,3459.255,1902.59025,,3113.3295,90,percent of total billed charges,,,,3459.255,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3113.3295,90,percent of total billed charges,,,,3286.29225,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3113.3295,3459.255,
IUPC,2709925,CDM,,,270,RC,inpatient,,,,132.767,73.02185,,119.4903,90,percent of total billed charges,,,,132.767,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.4903,90,percent of total billed charges,,,,126.12865,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.4903,132.767,
FRED ANTI FOG,2709930,CDM,,,270,RC,inpatient,,,,8.446,4.6453,,7.6014,90,percent of total billed charges,,,,8.446,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6014,90,percent of total billed charges,,,,8.0237,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.6014,8.446,
LINEAR CUTTER,2709931,CDM,,,270,RC,inpatient,,,,744.999,409.74945,,670.4991,90,percent of total billed charges,,,,744.999,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,670.4991,90,percent of total billed charges,,,,707.74905,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,670.4991,744.999,
MULTIDEX POWDER,2709935,CDM,,,270,RC,inpatient,,,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,90,percent of total billed charges,,,,24.56035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,25.853,
ENDO STITCH LOADS,2709980,CDM,,,270,RC,inpatient,,,,123.703,68.03665,,111.3327,90,percent of total billed charges,,,,123.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.3327,90,percent of total billed charges,,,,117.51785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.3327,123.703,
INSPACE MEDIUM,2709998,CDM,,,270,RC,inpatient,,,,14832,8157.6,,13348.8,90,percent of total billed charges,,,,14832,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13348.8,90,percent of total billed charges,,,,14090.4,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13348.8,14832,
CRASH CART - LDRP,2790020,CDM,,,270,RC,inpatient,,,,106.914,58.8027,,96.2226,90,percent of total billed charges,,,,106.914,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.2226,90,percent of total billed charges,,,,101.5683,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.2226,106.914,
ART PRESS MONITOR/DAILY - ICU,7390000,CDM,,,270,RC,inpatient,,,,22.66,12.463,,20.394,90,percent of total billed charges,,,,22.66,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.394,90,percent of total billed charges,,,,21.527,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.394,22.66,
ARTERIAL LINE SETUP - ICU,7390010,CDM,,,270,RC,inpatient,,,,263.371,144.85405,,237.0339,90,percent of total billed charges,,,,263.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,237.0339,90,percent of total billed charges,,,,250.20245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,237.0339,263.371,
LAPAROSCOPIC ELECTRODE J-HOOK,2700021,CDM,,,272,RC,inpatient,,,,85.49,47.0195,,76.941,90,percent of total billed charges,,,,85.49,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,76.941,90,percent of total billed charges,,,,81.2155,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,76.941,85.49,
V-LOC SUTURE O GS-21,2700311,CDM,,,272,RC,inpatient,,,,66.744,36.7092,,60.0696,90,percent of total billed charges,,,,66.744,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.0696,90,percent of total billed charges,,,,63.4068,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.0696,66.744,
6.5mm X 75 Dri Lock Cannula,2701425,CDM,,,272,RC,inpatient,,,,16.2122,8.91671,,14.59098,90,percent of total billed charges,,,,16.2122,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.59098,90,percent of total billed charges,,,,15.40159,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.59098,16.2122,
STAPLER NTLC75,2701546,CDM,,,272,RC,inpatient,,,,141.522,77.8371,,127.3698,90,percent of total billed charges,,,,141.522,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,127.3698,90,percent of total billed charges,,,,134.4459,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,127.3698,141.522,
STAPLER SR75 RELOADS,2701547,CDM,,,272,RC,inpatient,,,,217.742,119.7581,,195.9678,90,percent of total billed charges,,,,217.742,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,195.9678,90,percent of total billed charges,,,,206.8549,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,195.9678,217.742,
STAPLER PSEE60A POWERED PLUS,2701551,CDM,,,272,RC,inpatient,,,,797.426,438.5843,,717.6834,90,percent of total billed charges,,,,797.426,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,717.6834,90,percent of total billed charges,,,,757.5547,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,717.6834,797.426,
STAPLER; HEMORRHOID,2701552,CDM,,,272,RC,inpatient,,,,911.344,501.2392,,820.2096,90,percent of total billed charges,,,,911.344,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,820.2096,90,percent of total billed charges,,,,865.7768,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,820.2096,911.344,
PICC LINE KIT,2701836,CDM,,,272,RC,inpatient,,,,378.319,208.07545,,340.4871,90,percent of total billed charges,,,,378.319,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,340.4871,90,percent of total billed charges,,,,359.40305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,340.4871,378.319,
CAPIO SUTURE (REF #833-114),2702539,CDM,,,272,RC,inpatient,,,,74.057,40.73135,,66.6513,90,percent of total billed charges,,,,74.057,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.6513,90,percent of total billed charges,,,,70.35415,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.6513,74.057,
FOGARTY EMBOL CATH,2703250,CDM,,,272,RC,inpatient,,,,155.427,85.48485,,139.8843,90,percent of total billed charges,,,,155.427,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,139.8843,90,percent of total billed charges,,,,147.65565,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,139.8843,155.427,
CHEST TUBE INSERTION KIT,2703425,CDM,,,272,RC,inpatient,,,,106.193,58.40615,,95.5737,90,percent of total billed charges,,,,106.193,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,95.5737,90,percent of total billed charges,,,,100.88335,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,95.5737,106.193,
BEDSIDE STERILE KIT,2703618,CDM,,,272,RC,inpatient,,,,199.511,109.73105,,179.5599,90,percent of total billed charges,,,,199.511,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,179.5599,90,percent of total billed charges,,,,189.53545,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,179.5599,199.511,
APPLIED SINGLE SITE TROCAR,2703671,CDM,,,272,RC,inpatient,,,,1593.204,876.2622,,1433.8836,90,percent of total billed charges,,,,1593.204,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.8836,90,percent of total billed charges,,,,1513.5438,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.8836,1593.204,
ALEXIS WOUND PROTECTOR/RETRAC,2703672,CDM,,,272,RC,inpatient,,,,124.424,68.4332,,111.9816,90,percent of total billed charges,,,,124.424,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.9816,90,percent of total billed charges,,,,118.2028,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.9816,124.424,
BOSTON SCIENCE GLIDEWIRE,2704551,CDM,,,272,RC,inpatient,,,,94.966,52.2313,,85.4694,90,percent of total billed charges,,,,94.966,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.4694,90,percent of total billed charges,,,,90.2177,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.4694,94.966,
UNIVERSAL STAPLER LOAD 30-2.5,2705346,CDM,,,272,RC,inpatient,,,,213.828,117.6054,,192.4452,90,percent of total billed charges,,,,213.828,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,192.4452,90,percent of total billed charges,,,,203.1366,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,192.4452,213.828,
LIGASURE OPEN LF4418,2705746,CDM,,,272,RC,inpatient,,,,713.172,392.2446,,641.8548,90,percent of total billed charges,,,,713.172,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,641.8548,90,percent of total billed charges,,,,677.5134,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,641.8548,713.172,
Z-THREAD TROCAR 5X100mm,2705934,CDM,,,272,RC,inpatient,,,,48.719,26.79545,,43.8471,90,percent of total billed charges,,,,48.719,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.8471,90,percent of total billed charges,,,,46.28305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.8471,48.719,
Z-THREAD TROCARS 11X100mm,2705937,CDM,,,272,RC,inpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.6339,57.371,
SILASTIC STINT,2706570,CDM,,,272,RC,inpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
SIMPLEX CEMENT,2706620,CDM,,,272,RC,inpatient,,,,110.416,60.7288,,99.3744,90,percent of total billed charges,,,,110.416,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.3744,90,percent of total billed charges,,,,104.8952,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.3744,110.416,
ULTRASOUND PROBE COVER,2706944,CDM,,,272,RC,inpatient,,,,31.724,17.4482,,28.5516,90,percent of total billed charges,,,,31.724,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.5516,90,percent of total billed charges,,,,30.1378,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.5516,31.724,
"SUTURE MO-6 18"" ETHIBOND",2707730,CDM,,,272,RC,inpatient,,,,53.148,29.2314,,47.8332,90,percent of total billed charges,,,,53.148,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.8332,90,percent of total billed charges,,,,50.4906,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.8332,53.148,
Crossflow inflow cass tubing,2707777,CDM,,,272,RC,inpatient,,,,10.506,5.7783,,9.4554,90,percent of total billed charges,,,,10.506,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.4554,90,percent of total billed charges,,,,9.9807,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.4554,10.506,
Arm positioning kit,2707778,CDM,,,272,RC,inpatient,,,,127.308,70.0194,,114.5772,90,percent of total billed charges,,,,127.308,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,114.5772,90,percent of total billed charges,,,,120.9426,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,114.5772,127.308,
OPTIMA STENT - ALL,2708066,CDM,,,272,RC,inpatient,,,,212.592,116.9256,,191.3328,90,percent of total billed charges,,,,212.592,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,191.3328,90,percent of total billed charges,,,,201.9624,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,191.3328,212.592,
PREVENA PEEL & PLACE DRESSING,2709622,CDM,,,272,RC,inpatient,,,,670.221,368.62155,,603.1989,90,percent of total billed charges,,,,670.221,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,603.1989,90,percent of total billed charges,,,,636.70995,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,603.1989,670.221,
X PASS Suture Braid 2,2722324,CDM,,,272,RC,inpatient,,,,105.0291,57.766005,,94.52619,90,percent of total billed charges,,,,105.0291,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.52619,90,percent of total billed charges,,,,99.777645,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.52619,105.0291,
ECHOGENIC NEEDLES,2723253,CDM,,,272,RC,inpatient,,,,38.213,21.01715,,34.3917,90,percent of total billed charges,,,,38.213,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.3917,90,percent of total billed charges,,,,36.30235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.3917,38.213,
STERILE DISP TOURNIQUET,2723362,CDM,,,272,RC,inpatient,,,,126.587,69.62285,,113.9283,90,percent of total billed charges,,,,126.587,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,113.9283,90,percent of total billed charges,,,,120.25765,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,113.9283,126.587,
PREVENA DRESSING,2723533,CDM,,,272,RC,inpatient,,,,395.726,217.6493,,356.1534,90,percent of total billed charges,,,,395.726,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,356.1534,90,percent of total billed charges,,,,375.9397,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,356.1534,395.726,
CERVICAL RIPENING BALLOON,2723706,CDM,,,272,RC,inpatient,,,,112.064,61.6352,,100.8576,90,percent of total billed charges,,,,112.064,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,100.8576,90,percent of total billed charges,,,,106.4608,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,100.8576,112.064,
PRINEO SKIN CLOSURE SYSTEM,2724159,CDM,,,272,RC,inpatient,,,,189.932,104.4626,,170.9388,90,percent of total billed charges,,,,189.932,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.9388,90,percent of total billed charges,,,,180.4354,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.9388,189.932,
SWEEP SUCTION PROBE,2724455,CDM,,,272,RC,inpatient,,,,412.412,226.8266,,371.1708,90,percent of total billed charges,,,,412.412,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,371.1708,90,percent of total billed charges,,,,391.7914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,371.1708,412.412,
UTERINE MANIP ADVINCULA 3CM,2724530,CDM,,,272,RC,inpatient,,,,141.522,77.8371,,127.3698,90,percent of total billed charges,,,,141.522,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,127.3698,90,percent of total billed charges,,,,134.4459,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,127.3698,141.522,
VIZADISC KNEE PROTRACKING KIT,2724560,CDM,,,272,RC,inpatient,,,,443.518,243.9349,,399.1662,90,percent of total billed charges,,,,443.518,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,399.1662,90,percent of total billed charges,,,,421.3421,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,399.1662,443.518,
MYOSURE LITE TISSUE DEVICE,2724596,CDM,,,272,RC,inpatient,,,,859.638,472.8009,,773.6742,90,percent of total billed charges,,,,859.638,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,773.6742,90,percent of total billed charges,,,,816.6561,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,773.6742,859.638,
SINGLE USE SEAL SET,2724597,CDM,,,272,RC,inpatient,,,,23.793,13.08615,,21.4137,90,percent of total billed charges,,,,23.793,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.4137,90,percent of total billed charges,,,,22.60335,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.4137,23.793,
AQUILEX INFLOW TUBESET,2724598,CDM,,,272,RC,inpatient,,,,189.52,104.236,,170.568,90,percent of total billed charges,,,,189.52,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.568,90,percent of total billed charges,,,,180.044,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.568,189.52,
AQUILEX OUTFLOW TUBESET,2724599,CDM,,,272,RC,inpatient,,,,43.569,23.96295,,39.2121,90,percent of total billed charges,,,,43.569,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.2121,90,percent of total billed charges,,,,41.39055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.2121,43.569,
MYOSURE REACH TIS REMOVAL DEV,2724671,CDM,,,272,RC,inpatient,,,,1596.088,877.8484,,1436.4792,90,percent of total billed charges,,,,1596.088,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1436.4792,90,percent of total billed charges,,,,1516.2836,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1436.4792,1596.088,
SONICISION 7 DISSECTOR,2724701,CDM,,,272,RC,inpatient,,,,631.081,347.09455,,567.9729,90,percent of total billed charges,,,,631.081,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,567.9729,90,percent of total billed charges,,,,599.52695,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,567.9729,631.081,
MYOSURE TUBING,2724809,CDM,,,272,RC,inpatient,,,,190.241,104.63255,,171.2169,90,percent of total billed charges,,,,190.241,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.2169,90,percent of total billed charges,,,,180.72895,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.2169,190.241,
SILICONE RETRACTOR CORD,2725120,CDM,,,272,RC,inpatient,,,,12.9986,7.14923,,11.69874,90,percent of total billed charges,,,,12.9986,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.69874,90,percent of total billed charges,,,,12.34867,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.69874,12.9986,
3.2 BONE PIN 110 MM,2725220,CDM,,,272,RC,inpatient,,,,262.7324,144.50282,,236.45916,90,percent of total billed charges,,,,262.7324,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.45916,90,percent of total billed charges,,,,249.59578,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.45916,262.7324,
3.2MM BONE PIN 140MM,2725255,CDM,,,272,RC,inpatient,,,,262.7324,144.50282,,236.45916,90,percent of total billed charges,,,,262.7324,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.45916,90,percent of total billed charges,,,,249.59578,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.45916,262.7324,
TIBIA CHECKPOINT STERILE,2725380,CDM,,,272,RC,inpatient,,,,104.0506,57.22783,,93.64554,90,percent of total billed charges,,,,104.0506,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.64554,90,percent of total billed charges,,,,98.84807,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.64554,104.0506,
MAKO BLADE STANDARD,2725605,CDM,,,272,RC,inpatient,,,,400.8966,220.49313,,360.80694,90,percent of total billed charges,,,,400.8966,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,360.80694,90,percent of total billed charges,,,,380.85177,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,360.80694,400.8966,
EEA STAPLER 28MM & 31MM,2725640,CDM,,,272,RC,inpatient,,,,1688.067,928.43685,,1519.2603,90,percent of total billed charges,,,,1688.067,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1519.2603,90,percent of total billed charges,,,,1603.66365,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1519.2603,1688.067,
"3DMAX LIGHT  0117321, 0117311",2726660,CDM,,,272,RC,inpatient,,,,364.414,200.4277,,327.9726,90,percent of total billed charges,,,,364.414,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.9726,90,percent of total billed charges,,,,346.1933,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.9726,364.414,
BARD SOFT MESH 6X6,2727102,CDM,,,272,RC,inpatient,,,,120.819,66.45045,,108.7371,90,percent of total billed charges,,,,120.819,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.7371,90,percent of total billed charges,,,,114.77805,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.7371,120.819,
INSORB STAPLER,2727123,CDM,,,272,RC,inpatient,,,,99.395,54.66725,,89.4555,90,percent of total billed charges,,,,99.395,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.4555,90,percent of total billed charges,,,,94.42525,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.4555,99.395,
PROXIMATE CUTTER RELOAD,2727150,CDM,,,272,RC,inpatient,,,,1589.084,873.9962,,1430.1756,90,percent of total billed charges,,,,1589.084,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1430.1756,90,percent of total billed charges,,,,1509.6298,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1430.1756,1589.084,
SHORT HARMONIC HANDPIECE HAR23,2727434,CDM,,,272,RC,inpatient,,,,567.839,312.31145,,511.0551,90,percent of total billed charges,,,,567.839,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,511.0551,90,percent of total billed charges,,,,539.44705,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,511.0551,567.839,
SURGICAL APPLICATOR,2727808,CDM,,,272,RC,inpatient,,,,52.942,29.1181,,47.6478,90,percent of total billed charges,,,,52.942,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.6478,90,percent of total billed charges,,,,50.2949,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.6478,52.942,
SURGICAL POWDER,2727810,CDM,,,272,RC,inpatient,,,,431.57,237.3635,,388.413,90,percent of total billed charges,,,,431.57,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,388.413,90,percent of total billed charges,,,,409.9915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,388.413,431.57,
BALLOON SINUPLASTY SYSTEM,2727949,CDM,,,272,RC,inpatient,,,,3352.65,1843.9575,,3017.385,90,percent of total billed charges,,,,3352.65,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3017.385,90,percent of total billed charges,,,,3185.0175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3017.385,3352.65,
KII OPT ACCESS 8X100,2728245,CDM,,,272,RC,inpatient,,,,48.719,26.79545,,43.8471,90,percent of total billed charges,,,,48.719,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.8471,90,percent of total billed charges,,,,46.28305,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.8471,48.719,
BARTHOLIN CATHETER,2728386,CDM,,,272,RC,inpatient,,,,60.564,33.3102,,54.5076,90,percent of total billed charges,,,,60.564,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.5076,90,percent of total billed charges,,,,57.5358,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.5076,60.564,
STAPLER TLH90,2728393,CDM,,,272,RC,inpatient,,,,169.538,93.2459,,152.5842,90,percent of total billed charges,,,,169.538,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,152.5842,90,percent of total billed charges,,,,161.0611,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,152.5842,169.538,
STAPLER TRH90,2728394,CDM,,,272,RC,inpatient,,,,64.478,35.4629,,58.0302,90,percent of total billed charges,,,,64.478,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.0302,90,percent of total billed charges,,,,61.2541,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.0302,64.478,
PROXIMATE RELOAD THICK TISSUE,2728422,CDM,,,272,RC,inpatient,,,,1620.293,891.16115,,1458.2637,90,percent of total billed charges,,,,1620.293,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1458.2637,90,percent of total billed charges,,,,1539.27835,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1458.2637,1620.293,
J HOOK,2728442,CDM,,,272,RC,inpatient,,,,70.04,38.522,,63.036,90,percent of total billed charges,,,,70.04,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.036,90,percent of total billed charges,,,,66.538,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.036,70.04,
PERFIX PLUG XLG,2728522,CDM,,,272,RC,inpatient,,,,294.065,161.73575,,264.6585,90,percent of total billed charges,,,,294.065,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,264.6585,90,percent of total billed charges,,,,279.36175,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,264.6585,294.065,
VENTRALIGHT MESH,2728523,CDM,,,272,RC,inpatient,,,,729.755,401.36525,,656.7795,90,percent of total billed charges,,,,729.755,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,656.7795,90,percent of total billed charges,,,,693.26725,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,656.7795,729.755,
ETS FLEX 45 ARTIC LINEAR,2728524,CDM,,,272,RC,inpatient,,,,328.467,180.65685,,295.6203,90,percent of total billed charges,,,,328.467,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.6203,90,percent of total billed charges,,,,312.04365,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.6203,328.467,
ETS 45 RELOAD VASCULAR,2728525,CDM,,,272,RC,inpatient,,,,193.022,106.1621,,173.7198,90,percent of total billed charges,,,,193.022,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,173.7198,90,percent of total billed charges,,,,183.3709,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,173.7198,193.022,
ETS 45MM BLUE RELOAD,2728526,CDM,,,272,RC,inpatient,,,,192.301,105.76555,,173.0709,90,percent of total billed charges,,,,192.301,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,173.0709,90,percent of total billed charges,,,,182.68595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,173.0709,192.301,
POWERPORT CLEAR VUL,2728529,CDM,,,272,RC,inpatient,,,,550.226,302.6243,,495.2034,90,percent of total billed charges,,,,550.226,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,495.2034,90,percent of total billed charges,,,,522.7147,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,495.2034,550.226,
PERFIX PLUG LG 1.6 X 1.9,2728560,CDM,,,272,RC,inpatient,,,,244.419,134.43045,,219.9771,90,percent of total billed charges,,,,244.419,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,219.9771,90,percent of total billed charges,,,,232.19805,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,219.9771,244.419,
SYNTHES CABLE WITH CRIMP,2728972,CDM,,,272,RC,inpatient,,,,787.126,432.9193,,708.4134,90,percent of total billed charges,,,,787.126,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,708.4134,90,percent of total billed charges,,,,747.7697,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,708.4134,787.126,
C-SECTION CLEAR DRAPE,2729025,CDM,,,272,RC,inpatient,,,,49.337,27.13535,,44.4033,90,percent of total billed charges,,,,49.337,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.4033,90,percent of total billed charges,,,,46.87015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.4033,49.337,
3DMAX LIGHT MESH XL,2729726,CDM,,,272,RC,inpatient,,,,401.906,221.0483,,361.7154,90,percent of total billed charges,,,,401.906,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,361.7154,90,percent of total billed charges,,,,381.8107,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,361.7154,401.906,
"PORT, INDWELLING (IMPLANTABLE)",2701015,CDM,C1788,HCPCS,278,RC,inpatient,,,,917.009,504.35495,,825.3081,90,percent of total billed charges,,,,917.009,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,825.3081,90,percent of total billed charges,,,,871.15855,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,825.3081,917.009,
BARD MESH 3 X 6,2701544,CDM,C1781,HCPCS,278,RC,inpatient,,,,84.46,46.453,,76.014,90,percent of total billed charges,,,,84.46,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,76.014,90,percent of total billed charges,,,,80.237,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,76.014,84.46,
SECURESTRAP 25 FIXATION DEVICE,2703681,CDM,C1781,HCPCS,278,RC,inpatient,,,,855.312,470.4216,,769.7808,90,percent of total billed charges,,,,855.312,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,769.7808,90,percent of total billed charges,,,,812.5464,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,769.7808,855.312,
PERFIX PLUG #0112760,2705828,CDM,C1781,HCPCS,278,RC,inpatient,,,,232.677,127.97235,,209.4093,90,percent of total billed charges,,,,232.677,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,209.4093,90,percent of total billed charges,,,,221.04315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,209.4093,232.677,
VASCULAR ACCESS SYTEM DUEL,2705946,CDM,,,278,RC,inpatient,,,,368.637,202.75035,,331.7733,90,percent of total billed charges,,,,368.637,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,331.7733,90,percent of total billed charges,,,,350.20515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,331.7733,368.637,
OBTRYX HALO TM-URETHERAL SLING,2707436,CDM,C1771,HCPCS,278,RC,inpatient,,,,2088.943,1148.91865,,1880.0487,90,percent of total billed charges,,,,2088.943,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1880.0487,90,percent of total billed charges,,,,1984.49585,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,1880.0487,2088.943,
VENTRALIGHT ST MESH 4x6,2707496,CDM,C1781,HCPCS,278,RC,inpatient,,,,640.66,352.363,,576.594,90,percent of total billed charges,,,,640.66,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,576.594,90,percent of total billed charges,,,,608.627,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,576.594,640.66,
ECHO 2 VENTRALIGHT MESH 9943,2709943,CDM,C1781,HCPCS,278,RC,inpatient,,,,1874.085,1030.74675,,1686.6765,90,percent of total billed charges,,,,1874.085,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1686.6765,90,percent of total billed charges,,,,1780.38075,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,1686.6765,1874.085,
"ECHO 2 8"" CIRCLE MESH 9944",2709944,CDM,C1781,HCPCS,278,RC,inpatient,,,,2557.696,1406.7328,,2301.9264,90,percent of total billed charges,,,,2557.696,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2301.9264,90,percent of total billed charges,,,,2429.8112,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,2301.9264,2557.696,
VENTRALEX MESH PATCH 5950007,2780007,CDM,C1781,HCPCS,278,RC,inpatient,,,,644.78,354.629,,580.302,90,percent of total billed charges,,,,644.78,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,580.302,90,percent of total billed charges,,,,612.541,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,580.302,644.78,
VENTRALEX MESH PATCH 5950008,2780008,CDM,C1781,HCPCS,278,RC,inpatient,,,,812.979,447.13845,,731.6811,90,percent of total billed charges,,,,812.979,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,731.6811,90,percent of total billed charges,,,,772.33005,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,731.6811,812.979,
VENTRALEX MESH PATCH 5950009,2780009,CDM,C1781,HCPCS,278,RC,inpatient,,,,1031.648,567.4064,,928.4832,90,percent of total billed charges,,,,1031.648,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,928.4832,90,percent of total billed charges,,,,980.0656,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,928.4832,1031.648,
BARD MESH 6x6,2780117,CDM,C1781,HCPCS,278,RC,inpatient,,,,101.146,55.6303,,91.0314,90,percent of total billed charges,,,,101.146,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.0314,90,percent of total billed charges,,,,96.0887,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,91.0314,101.146,
SYNTHES 4.0 30MM,2781619,CDM,,,278,RC,inpatient,,,,288.915,158.90325,,260.0235,90,percent of total billed charges,,,,288.915,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.0235,90,percent of total billed charges,,,,274.46925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,260.0235,288.915,
CAPIO SLIM SUTURE CAPT DEVICE,2782631,CDM,C2631,HCPCS,278,RC,inpatient,,,,1191.813,655.49715,,1072.6317,90,percent of total billed charges,,,,1191.813,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1072.6317,90,percent of total billed charges,,,,1132.22235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,1072.6317,1191.813,
BARD SOFT MESH 3X6,2784062,CDM,C1781,HCPCS,278,RC,inpatient,,,,97.747,53.76085,,87.9723,90,percent of total billed charges,,,,97.747,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.9723,90,percent of total billed charges,,,,92.85965,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,87.9723,97.747,
SYNTHES CABLE W/CRIMP,2788971,CDM,,,278,RC,inpatient,,,,996.834,548.2587,,897.1506,90,percent of total billed charges,,,,996.834,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,897.1506,90,percent of total billed charges,,,,946.9923,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,897.1506,996.834,
"VENTRALIGHT ECHO CIRCLE 6""",2789960,CDM,,,278,RC,inpatient,,,,1496.487,823.06785,,1346.8383,90,percent of total billed charges,,,,1496.487,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1346.8383,90,percent of total billed charges,,,,1421.66265,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"Charges greather than $5,000 are paid at 75% of eligible charges, $8,000 max",,,,,,,1346.8383,1496.487,
BILIRUBIN LIGHT - NURSERY,2700980,CDM,,,279,RC,inpatient,,,,34.608,19.0344,,31.1472,90,percent of total billed charges,,,,34.608,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.1472,90,percent of total billed charges,,,,32.8776,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.1472,34.608,
BLOOD DRAW/FINGER STICK,3000000,CDM,36416,CPT,300,RC,inpatient,,,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
BLOOD DRAWING - LABORATORY,3000002,CDM,36415,CPT,300,RC,inpatient,,,,27.81,15.2955,,25.029,90,percent of total billed charges,,,,27.81,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.029,90,percent of total billed charges,,,,26.4195,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.029,27.81,
DRUG SCREEN COLLECT (DOT),3000010,CDM,99001,CPT,300,RC,inpatient,,,,47.792,26.2856,,43.0128,90,percent of total billed charges,,,,47.792,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.0128,90,percent of total billed charges,,,,45.4024,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.0128,47.792,
DRUG SCREEN MULTI PER ENCOUNT,3000012,CDM,80307,CPT,300,RC,inpatient,,,,131.222,72.1721,,118.0998,90,percent of total billed charges,,,,131.222,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.0998,90,percent of total billed charges,,,,124.6609,95,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,79.81,,,fee schedule,,,,,,,,,,,,,,,79.81,131.222,
KEPPRA,3000015,CDM,80177,CPT,300,RC,inpatient,,,,180.662,99.3641,,162.5958,90,percent of total billed charges,,,,180.662,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,13.5945,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,162.5958,90,percent of total billed charges,,,,171.6289,95,percent of total billed charges,,,,,,,,,18.09,,,fee schedule,,,18.09,,,fee schedule,,,,,,,,,,,,,,,13.5945,180.662,
NON DOT DRUG SCREEN SPECIMEN,3000020,CDM,99001,CPT,300,RC,inpatient,,,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,90,percent of total billed charges,,,,27.30015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.8633,28.737,
CYCLOSPORINE,3000027,CDM,80158,CPT,300,RC,inpatient,,,,216.403,119.02165,,194.7627,90,percent of total billed charges,,,,216.403,100,percent of total billed charges,,,20.577,,,fee schedule,,,20.577,,,fee schedule,,,18.5193,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,194.7627,90,percent of total billed charges,,,,205.58285,95,percent of total billed charges,,,,,,,,,25.78,,,fee schedule,,,25.78,,,fee schedule,,,,,,,,,,,,,,,18.5193,216.403,
CELL COUNT FLUID,3000050,CDM,89050,CPT,300,RC,inpatient,,,,28.325,15.57875,,25.4925,90,percent of total billed charges,,,,28.325,100,percent of total billed charges,,,5.3808,,,fee schedule,,,5.3808,,,fee schedule,,,4.84272,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.4925,90,percent of total billed charges,,,,26.90875,95,percent of total billed charges,,,,,,,,,6.75,,,fee schedule,,,6.75,,,fee schedule,,,,,,,,,,,,,,,4.84272,28.325,
COUMADIN (WARFRIN) LEVEL,3000060,CDM,80299,CPT,300,RC,inpatient,,,,180.662,99.3641,,162.5958,90,percent of total billed charges,,,,180.662,100,percent of total billed charges,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,19.12464,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,162.5958,90,percent of total billed charges,,,,171.6289,95,percent of total billed charges,,,,,,,,,19.55,,,fee schedule,,,19.55,,,fee schedule,,,,,,,,,,,,,,,19.12464,180.662,
LAMOTRIGINE (LAMICTAL),3000070,CDM,80175,CPT,300,RC,inpatient,,,,130.295,71.66225,,117.2655,90,percent of total billed charges,,,,130.295,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,13.5945,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,117.2655,90,percent of total billed charges,,,,123.78025,95,percent of total billed charges,,,,,,,,,18.09,,,fee schedule,,,18.09,,,fee schedule,,,,,,,,,,,,,,,13.5945,130.295,
TRILEPTAL (OXCARBAZEPINE),3000172,CDM,80183,CPT,300,RC,inpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,13.5945,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,90,percent of total billed charges,,,,64.28745,95,percent of total billed charges,,,,,,,,,18.06,,,fee schedule,,,18.06,,,fee schedule,,,,,,,,,,,,,,,13.5945,67.671,
COVID-19 ANTIGEN TEST,3000426,CDM,87426,CPT,300,RC,inpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,35.33,,,fee schedule,,,35.33,,,fee schedule,,,31.797,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.4787,90,percent of total billed charges,,,,115.56085,95,percent of total billed charges,,,,,,,,,45.23,,,fee schedule,,,45.23,,,fee schedule,,,,,,,,,,,,,,,31.797,121.643,
Advanced Lipid Panel w/Inflam,3002172,CDM,80061 83704,CPT,300,RC,inpatient,,,,667.028,366.8654,,600.3252,90,percent of total billed charges,,,,667.028,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.3252,90,percent of total billed charges,,,,633.6766,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.3252,667.028,
Collagen Type 1-C Telopeptide,3002523,CDM,82523,CPT,300,RC,inpatient,,,,399.331,219.63205,,359.3979,90,percent of total billed charges,,,,399.331,100,percent of total billed charges,,,21.2952,,,fee schedule,,,21.2952,,,fee schedule,,,19.16568,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,359.3979,90,percent of total billed charges,,,,379.36445,95,percent of total billed charges,,,,,,,,,26.69,,,fee schedule,,,26.69,,,fee schedule,,,,,,,,,,,,,,,19.16568,399.331,
Bile Acid Pregnancy Quest,3002542,CDM,82542,CPT,300,RC,inpatient,,,,30.179,16.59845,,27.1611,90,percent of total billed charges,,,,30.179,100,percent of total billed charges,,,27.4626,,,fee schedule,,,27.4626,,,fee schedule,,,24.71634,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.1611,90,percent of total billed charges,,,,28.67005,95,percent of total billed charges,,,,,,,,,25.79,,,fee schedule,,,25.79,,,fee schedule,,,,,,,,,,,,,,,24.71634,30.179,
PARANEOPLASTIC AB PROFILE,3003519,CDM,86255 83519,CPT,300,RC,inpatient,,,,1389.882,764.4351,,1250.8938,90,percent of total billed charges,,,,1389.882,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1250.8938,90,percent of total billed charges,,,,1320.3879,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1250.8938,1389.882,
Bullous Pemphigoid BP 180 ASB,3003520,CDM,83520,CPT,300,RC,inpatient,,,,101.455,55.80025,,91.3095,90,percent of total billed charges,,,,101.455,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.3095,90,percent of total billed charges,,,,96.38225,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,17.71902,101.455,
Mutated Citrullinated Vimentin,3003550,CDM,83520,CPT,300,RC,inpatient,,,,60.976,33.5368,,54.8784,90,percent of total billed charges,,,,60.976,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.8784,90,percent of total billed charges,,,,57.9272,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,17.71902,60.976,
AMNISURE ROM,3003628,CDM,84112,CPT,300,RC,inpatient,,,,115.36,63.448,,103.824,90,percent of total billed charges,,,,115.36,100,percent of total billed charges,,,111.8454,,,fee schedule,,,111.8454,,,fee schedule,,,100.66086,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.824,90,percent of total billed charges,,,,109.592,95,percent of total billed charges,,,,,,,,,90.64,,,fee schedule,,,90.64,,,fee schedule,,,,,,,,,,,,,,,90.64,115.36,
Organic Acids,3003918,CDM,8391882570,CPT,300,RC,inpatient,,,,315.283,173.40565,,283.7547,90,percent of total billed charges,,,,315.283,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.7547,90,percent of total billed charges,,,,299.51885,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.7547,315.283,
Phospholipase A2 Receptor,3006255,CDM,86255,CPT,300,RC,inpatient,,,,17.304,9.5172,,15.5736,90,percent of total billed charges,,,,17.304,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,12.3633,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.5736,90,percent of total billed charges,,,,16.4388,95,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,17.22,,,fee schedule,,,,,,,,,,,,,,,12.3633,17.304,
Islet Cell AB,3006341,CDM,86341,CPT,300,RC,inpatient,,,,64.581,35.51955,,58.1229,90,percent of total billed charges,,,,64.581,100,percent of total billed charges,,,26.8698,,,fee schedule,,,26.8698,,,fee schedule,,,24.18282,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.1229,90,percent of total billed charges,,,,61.35195,95,percent of total billed charges,,,,,,,,,28.25,,,fee schedule,,,28.25,,,fee schedule,,,,,,,,,,,,,,,24.18282,64.581,
Strongyloides ABI66,3006682,CDM,86682,CPT,300,RC,inpatient,,,,36.565,20.11075,,32.9085,90,percent of total billed charges,,,,36.565,100,percent of total billed charges,,,14.8314,,,fee schedule,,,14.8314,,,fee schedule,,,13.34826,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.9085,90,percent of total billed charges,,,,34.73675,95,percent of total billed charges,,,,,,,,,18.57,,,fee schedule,,,18.57,,,fee schedule,,,,,,,,,,,,,,,13.34826,36.565,
CULTURE BACTERIAL BLOOD AEROB,3007040,CDM,87040,CPT,300,RC,inpatient,,,,111.24,61.182,,100.116,90,percent of total billed charges,,,,111.24,100,percent of total billed charges,,,11.7648,,,fee schedule,,,11.7648,,,fee schedule,,,10.58832,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,100.116,90,percent of total billed charges,,,,105.678,95,percent of total billed charges,,,,,,,,,14.75,,,fee schedule,,,14.75,,,fee schedule,,,,,,,,,,,,,,,10.58832,111.24,
GIARDIA AG IA,3007329,CDM,87329,CPT,300,RC,inpatient,,,,67.259,36.99245,,60.5331,90,percent of total billed charges,,,,67.259,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,12.29148,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.5331,90,percent of total billed charges,,,,63.89605,95,percent of total billed charges,,,,,,,,,12.92,,,fee schedule,,,12.92,,,fee schedule,,,,,,,,,,,,,,,12.29148,67.259,
FUNGITELL 1-3 B-D-GLUCAN ASSAY,3007449,CDM,87449,CPT,300,RC,inpatient,,,,275.525,151.53875,,247.9725,90,percent of total billed charges,,,,275.525,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,12.29148,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,247.9725,90,percent of total billed charges,,,,261.74875,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.29148,275.525,
RESP VIRUS 12-25 TARGETS,3007633,CDM,87633,CPT,300,RC,inpatient,,,,1167.814,642.2977,,1051.0326,90,percent of total billed charges,,,,1167.814,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1051.0326,90,percent of total billed charges,,,,1109.4233,95,percent of total billed charges,,,,,,,,,242.38,,,fee schedule,,,242.38,,,fee schedule,,,,,,,,,,,,,,,242.38,1167.814,
COVID PCR,3007635,CDM,87635,CPT,300,RC,inpatient,,,,176.645,97.15475,,158.9805,90,percent of total billed charges,,,,176.645,100,percent of total billed charges,,,51.31,,,fee schedule,,,51.31,,,fee schedule,,,46.179,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,158.9805,90,percent of total billed charges,,,,167.81275,95,percent of total billed charges,,,,,,,,,51.31,,,fee schedule,,,51.31,,,fee schedule,,,,,,,,,,,,,,,46.179,176.645,
HEPATITIS PANEL,3008007,CDM,80074,CPT,300,RC,inpatient,,,,451.552,248.3536,,406.3968,90,percent of total billed charges,,,,451.552,100,percent of total billed charges,,,54.2982,,,fee schedule,,,54.2982,,,fee schedule,,,48.86838,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,406.3968,90,percent of total billed charges,,,,428.9744,95,percent of total billed charges,,,,,,,,,68.01,,,fee schedule,,,68.01,,,fee schedule,,,,,,,,,,,,,,,48.86838,451.552,
CLOZAPINE (CLOZARIL),3008015,CDM,80159,CPT,300,RC,inpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,22.971,,,fee schedule,,,22.971,,,fee schedule,,,20.6739,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,143.7777,90,percent of total billed charges,,,,151.76535,95,percent of total billed charges,,,,,,,,,25.23,,,fee schedule,,,25.23,,,fee schedule,,,,,,,,,,,,,,,20.6739,159.753,
EVEROLIMUS,3008016,CDM,80169,CPT,300,RC,inpatient,,,,233.707,128.53885,,210.3363,90,percent of total billed charges,,,,233.707,100,percent of total billed charges,,,15.6522,,,fee schedule,,,15.6522,,,fee schedule,,,14.08698,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,210.3363,90,percent of total billed charges,,,,222.02165,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.08698,233.707,
ZONEGRAN (CONISAMIDE),3008029,CDM,80203,CPT,300,RC,inpatient,,,,184.267,101.34685,,165.8403,90,percent of total billed charges,,,,184.267,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,13.5945,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,165.8403,90,percent of total billed charges,,,,175.05365,95,percent of total billed charges,,,,,,,,,18.09,,,fee schedule,,,18.09,,,fee schedule,,,,,,,,,,,,,,,13.5945,184.267,
DRUG SCREEN SEND-OUT,3008030,CDM,80307,CPT,300,RC,inpatient,,,,131.222,72.1721,,118.0998,90,percent of total billed charges,,,,131.222,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.0998,90,percent of total billed charges,,,,124.6609,95,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,79.81,,,fee schedule,,,,,,,,,,,,,,,79.81,131.222,
SARS-COV-2RNA-QUAL-RT-PCR39448,3008076,CDM,87635,CPT,300,RC,inpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,51.31,,,fee schedule,,,51.31,,,fee schedule,,,46.179,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.4787,90,percent of total billed charges,,,,115.56085,95,percent of total billed charges,,,,,,,,,51.31,,,fee schedule,,,51.31,,,fee schedule,,,,,,,,,,,,,,,46.179,121.643,
CYCTIC FIBROSIS SCREEN,3008122,CDM,81220,CPT,300,RC,inpatient,,,,653.947,359.67085,,588.5523,90,percent of total billed charges,,,,653.947,100,percent of total billed charges,,,634.524,,,fee schedule,,,634.524,,,fee schedule,,,571.0716,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,588.5523,90,percent of total billed charges,,,,621.24965,95,percent of total billed charges,,,,,,,,,372,,,fee schedule,,,372,,,fee schedule,,,,,,,,,,,,,,,372,653.947,
MTHFR,3008129,CDM,81291,CPT,300,RC,inpatient,,,,567.427,312.08485,,510.6843,90,percent of total billed charges,,,,567.427,100,percent of total billed charges,,,74.4876,,,fee schedule,,,74.4876,,,fee schedule,,,67.03884,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,510.6843,90,percent of total billed charges,,,,539.05565,95,percent of total billed charges,,,,,,,,,83.52,,,fee schedule,,,83.52,,,fee schedule,,,,,,,,,,,,,,,67.03884,567.427,
HIV 1 AG W HIV 1&2 AG IA,3008738,CDM,87389,CPT,300,RC,inpatient,,,,124.012,68.2066,,111.6108,90,percent of total billed charges,,,,124.012,100,percent of total billed charges,,,27.4512,,,fee schedule,,,27.4512,,,fee schedule,,,24.70608,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.6108,90,percent of total billed charges,,,,117.8114,95,percent of total billed charges,,,,,,,,,34.12,,,fee schedule,,,34.12,,,fee schedule,,,,,,,,,,,,,,,24.70608,124.012,
BCR/ABL1 MAJOR BREAKPOINT,3009106,CDM,81206,CPT,300,RC,inpatient,,,,254.822,140.1521,,229.3398,90,percent of total billed charges,,,,254.822,100,percent of total billed charges,,,186.9144,,,fee schedule,,,186.9144,,,fee schedule,,,168.22296,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,229.3398,90,percent of total billed charges,,,,242.0809,95,percent of total billed charges,,,,,,,,,80.62,,,fee schedule,,,80.62,,,fee schedule,,,,,,,,,,,,,,,80.62,254.822,
BCR/ABL1 MINOR BREAKPOINT,3009107,CDM,81207,CPT,300,RC,inpatient,,,,254.822,140.1521,,229.3398,90,percent of total billed charges,,,,254.822,100,percent of total billed charges,,,165.1176,,,fee schedule,,,165.1176,,,fee schedule,,,148.60584,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,229.3398,90,percent of total billed charges,,,,242.0809,95,percent of total billed charges,,,,,,,,,67.19,,,fee schedule,,,67.19,,,fee schedule,,,,,,,,,,,,,,,67.19,254.822,
DEXAMETHASONE,3009391,CDM,80299,CPT,300,RC,inpatient,,,,46.659,25.66245,,41.9931,90,percent of total billed charges,,,,46.659,100,percent of total billed charges,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,19.12464,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.9931,90,percent of total billed charges,,,,44.32605,95,percent of total billed charges,,,,,,,,,19.55,,,fee schedule,,,19.55,,,fee schedule,,,,,,,,,,,,,,,19.12464,46.659,
SARS-COV-2 ANTI IgG,3009504,CDM,86769,CPT,300,RC,inpatient,,,,72.203,39.71165,,64.9827,90,percent of total billed charges,,,,72.203,100,percent of total billed charges,,,42.13,,,fee schedule,,,42.13,,,fee schedule,,,37.917,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.9827,90,percent of total billed charges,,,,68.59285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.917,72.203,
CARBAMAZEPINE,3010340,CDM,80156,CPT,300,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,16.6098,,,fee schedule,,,16.6098,,,fee schedule,,,14.94882,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,20.79,,,fee schedule,,,20.79,,,fee schedule,,,,,,,,,,,,,,,14.94882,119.274,
CARDIAC RISK PROFILE,3010400,CDM,80061,CPT,300,RC,inpatient,,,,224.746,123.6103,,202.2714,90,percent of total billed charges,,,,224.746,100,percent of total billed charges,,,15.2646,,,fee schedule,,,15.2646,,,fee schedule,,,13.73814,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,202.2714,90,percent of total billed charges,,,,213.5087,95,percent of total billed charges,,,,,,,,,18.16,,,fee schedule,,,18.16,,,fee schedule,,,,,,,,,,,,,,,13.73814,224.746,
DEPAKANE-VALPROIC ACID,3010620,CDM,80164,CPT,300,RC,inpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,15.4356,,,fee schedule,,,15.4356,,,fee schedule,,,13.89204,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,104.1021,90,percent of total billed charges,,,,109.88555,95,percent of total billed charges,,,,,,,,,19.34,,,fee schedule,,,19.34,,,fee schedule,,,,,,,,,,,,,,,13.89204,115.669,
DIGITOXIN,3010650,CDM,80299,CPT,300,RC,inpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,19.12464,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.2041,90,percent of total billed charges,,,,135.32655,95,percent of total billed charges,,,,,,,,,19.55,,,fee schedule,,,19.55,,,fee schedule,,,,,,,,,,,,,,,19.12464,142.449,
DIGOXIN,3010660,CDM,80162,CPT,300,RC,inpatient,,,,97.232,53.4776,,87.5088,90,percent of total billed charges,,,,97.232,100,percent of total billed charges,,,15.1392,,,fee schedule,,,15.1392,,,fee schedule,,,13.62528,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.5088,90,percent of total billed charges,,,,92.3704,95,percent of total billed charges,,,,,,,,,18.96,,,fee schedule,,,18.96,,,fee schedule,,,,,,,,,,,,,,,13.62528,97.232,
DILANTIN PHENYTOIN,3010670,CDM,80185,CPT,300,RC,inpatient,,,,104.648,57.5564,,94.1832,90,percent of total billed charges,,,,104.648,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,13.5945,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.1832,90,percent of total billed charges,,,,99.4156,95,percent of total billed charges,,,,,,,,,18.93,,,fee schedule,,,18.93,,,fee schedule,,,,,,,,,,,,,,,13.5945,104.648,
DRUG SCREEN TEST (NON DOT),3010710,CDM,80307,CPT,300,RC,inpatient,,,,81.576,44.8668,,73.4184,90,percent of total billed charges,,,,81.576,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,73.4184,90,percent of total billed charges,,,,77.4972,95,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,79.81,,,fee schedule,,,,,,,,,,,,,,,73.4184,81.576,
DRUG SCREEN TEST (DOT),3010720,CDM,80307,CPT,300,RC,inpatient,,,,81.576,44.8668,,73.4184,90,percent of total billed charges,,,,81.576,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,73.4184,90,percent of total billed charges,,,,77.4972,95,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,79.81,,,fee schedule,,,,,,,,,,,,,,,73.4184,81.576,
DRUG SCREEN-SERUM,3010740,CDM,80307,CPT,300,RC,inpatient,,,,201.468,110.8074,,181.3212,90,percent of total billed charges,,,,201.468,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,181.3212,90,percent of total billed charges,,,,191.3946,95,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,79.81,,,fee schedule,,,,,,,,,,,,,,,79.81,201.468,
FK506 (TACROLIMUS),3010885,CDM,80197,CPT,300,RC,inpatient,,,,193.743,106.55865,,174.3687,90,percent of total billed charges,,,,193.743,100,percent of total billed charges,,,15.6522,,,fee schedule,,,15.6522,,,fee schedule,,,14.08698,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,174.3687,90,percent of total billed charges,,,,184.05585,95,percent of total billed charges,,,,,,,,,19.6,,,fee schedule,,,19.6,,,fee schedule,,,,,,,,,,,,,,,14.08698,193.743,
GENTAMICIN LEVEL,3010950,CDM,80170,CPT,300,RC,inpatient,,,,124.321,68.37655,,111.8889,90,percent of total billed charges,,,,124.321,100,percent of total billed charges,,,18.6732,,,fee schedule,,,18.6732,,,fee schedule,,,16.80588,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.8889,90,percent of total billed charges,,,,118.10495,95,percent of total billed charges,,,,,,,,,23.41,,,fee schedule,,,23.41,,,fee schedule,,,,,,,,,,,,,,,16.80588,124.321,
LITHIUM,3011280,CDM,80178,CPT,300,RC,inpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,7.5354,,,fee schedule,,,7.5354,,,fee schedule,,,6.78186,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,90,percent of total billed charges,,,,64.28745,95,percent of total billed charges,,,,,,,,,9.43,,,fee schedule,,,9.43,,,fee schedule,,,,,,,,,,,,,,,6.78186,67.671,
ELECTROLYTE PANEL,3011330,CDM,80051,CPT,300,RC,inpatient,,,,138.947,76.42085,,125.0523,90,percent of total billed charges,,,,138.947,100,percent of total billed charges,,,7.9914,,,fee schedule,,,7.9914,,,fee schedule,,,7.19226,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.0523,90,percent of total billed charges,,,,131.99965,95,percent of total billed charges,,,,,,,,,10.01,,,fee schedule,,,10.01,,,fee schedule,,,,,,,,,,,,,,,7.19226,138.947,
PHENOBARBITAL,3011610,CDM,80184,CPT,300,RC,inpatient,,,,101.97,56.0835,,91.773,90,percent of total billed charges,,,,101.97,100,percent of total billed charges,,,17.442,,,fee schedule,,,17.442,,,fee schedule,,,15.6978,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.773,90,percent of total billed charges,,,,96.8715,95,percent of total billed charges,,,,,,,,,16.36,,,fee schedule,,,16.36,,,fee schedule,,,,,,,,,,,,,,,15.6978,101.97,
SALICYLATE,3011830,CDM,80307,CPT,300,RC,inpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.5285,90,percent of total billed charges,,,,93.44675,95,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,79.81,,,fee schedule,,,,,,,,,,,,,,,79.81,98.365,
VANCOMYCIN PEAK OR TROUGH,3012380,CDM,80202,CPT,300,RC,inpatient,,,,120.407,66.22385,,108.3663,90,percent of total billed charges,,,,120.407,100,percent of total billed charges,,,15.4356,,,fee schedule,,,15.4356,,,fee schedule,,,13.89204,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,108.3663,90,percent of total billed charges,,,,114.38665,95,percent of total billed charges,,,,,,,,,19.34,,,fee schedule,,,19.34,,,fee schedule,,,,,,,,,,,,,,,13.89204,120.407,
CHROMOGRANIN A,3018631,CDM,86316,CPT,300,RC,inpatient,,,,166.963,91.82965,,150.2667,90,percent of total billed charges,,,,166.963,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,21.35106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.2667,90,percent of total billed charges,,,,158.61485,95,percent of total billed charges,,,,,,,,,29.72,,,fee schedule,,,29.72,,,fee schedule,,,,,,,,,,,,,,,21.35106,166.963,
"BK VIRUS DNA, QUANT URINE",3018779,CDM,87799,CPT,300,RC,inpatient,,,,393.46,216.403,,354.114,90,percent of total billed charges,,,,393.46,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,43.95384,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.114,90,percent of total billed charges,,,,373.787,95,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,61.17,,,fee schedule,,,,,,,,,,,,,,,43.95384,393.46,
CD-4 CELLS,3020230,CDM,86361,CPT,300,RC,inpatient,,,,498.623,274.24265,,448.7607,90,percent of total billed charges,,,,498.623,100,percent of total billed charges,,,30.5292,,,fee schedule,,,30.5292,,,fee schedule,,,27.47628,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,448.7607,90,percent of total billed charges,,,,473.69185,95,percent of total billed charges,,,,,,,,,28.75,,,fee schedule,,,28.75,,,fee schedule,,,,,,,,,,,,,,,27.47628,498.623,
CLO TEST  - ENDO,3020430,CDM,87077,CPT,300,RC,inpatient,,,QW,81.576,44.8668,,73.4184,90,percent of total billed charges,,,,81.576,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,8.29008,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,73.4184,90,percent of total billed charges,,,,77.4972,95,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,11.53,,,fee schedule,,,,,,,,,,,,,,,8.29008,81.576,
"HEPATITIS C RNA, QUANTITATIVE",3020515,CDM,87522,CPT,300,RC,inpatient,,,,1398.637,769.25035,,1258.7733,90,percent of total billed charges,,,,1398.637,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,43.95384,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1258.7733,90,percent of total billed charges,,,,1328.70515,95,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,61.17,,,fee schedule,,,,,,,,,,,,,,,43.95384,1398.637,
RPR,3020770,CDM,86592,CPT,300,RC,inpatient,,,,21.218,11.6699,,19.0962,90,percent of total billed charges,,,,21.218,100,percent of total billed charges,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,4.38102,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.0962,90,percent of total billed charges,,,,20.1571,95,percent of total billed charges,,,,,,,,,5.9,,,fee schedule,,,5.9,,,fee schedule,,,,,,,,,,,,,,,4.38102,21.218,
MYCOPHANOLATE,3028018,CDM,80180,CPT,300,RC,inpatient,,,,942.347,518.29085,,848.1123,90,percent of total billed charges,,,,942.347,100,percent of total billed charges,,,20.577,,,fee schedule,,,20.577,,,fee schedule,,,18.5193,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,848.1123,90,percent of total billed charges,,,,895.22965,95,percent of total billed charges,,,,,,,,,20.06,,,fee schedule,,,20.06,,,fee schedule,,,,,,,,,,,,,,,18.5193,942.347,
"ANTISMOOTH MUSCLE AB, QUANT",3029185,CDM,83516,CPT,300,RC,inpatient,,,,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,11.82978,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.8161,90,percent of total billed charges,,,,287.97255,95,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,16.48,,,fee schedule,,,,,,,,,,,,,,,11.82978,303.129,
CBC W/DIFF,3050040,CDM,89051,CPT,300,RC,inpatient,,,,30.694,16.8817,,27.6246,90,percent of total billed charges,,,,30.694,100,percent of total billed charges,,,6.384,,,fee schedule,,,6.384,,,fee schedule,,,5.7456,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.6246,90,percent of total billed charges,,,,29.1593,95,percent of total billed charges,,,,,,,,,7.86,,,fee schedule,,,7.86,,,fee schedule,,,,,,,,,,,,,,,5.7456,30.694,
SED RATE ESR,3050220,CDM,85652,CPT,300,RC,inpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,3.078,,,fee schedule,,,3.078,,,fee schedule,,,2.7702,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,,,,,,,3.85,,,fee schedule,,,3.85,,,fee schedule,,,,,,,,,,,,,,,2.7702,49.234,
BACTERIAL AG - NEIS MEN W,3060480,CDM,86403,CPT,300,RC,inpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,11.84004,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.1982,90,percent of total billed charges,,,,45.5981,95,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,14.55,,,fee schedule,,,,,,,,,,,,,,,11.84004,47.998,
URINALYSIS WITH MICRO,3070100,CDM,81001,CPT,300,RC,inpatient,,,,40.582,22.3201,,36.5238,90,percent of total billed charges,,,,40.582,100,percent of total billed charges,,,3.6138,,,fee schedule,,,3.6138,,,fee schedule,,,3.25242,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.5238,90,percent of total billed charges,,,,38.5529,95,percent of total billed charges,,,,,,,,,4.52,,,fee schedule,,,4.52,,,fee schedule,,,,,,,,,,,,,,,3.25242,40.582,
FERN TEST,3090010,CDM,89060,CPT,300,RC,inpatient,,,,39.346,21.6403,,35.4114,90,percent of total billed charges,,,,39.346,100,percent of total billed charges,,,8.3562,,,fee schedule,,,8.3562,,,fee schedule,,,7.52058,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.4114,90,percent of total billed charges,,,,37.3787,95,percent of total billed charges,,,,,,,,,10.21,,,fee schedule,,,10.21,,,fee schedule,,,,,,,,,,,,,,,7.52058,39.346,
ARTERIAL BLOOD GASES,4100040,CDM,82803,CPT,300,RC,inpatient,,,,197.451,108.59805,,177.7059,90,percent of total billed charges,,,,197.451,100,percent of total billed charges,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,26.74782,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,177.7059,90,percent of total billed charges,,,,187.57845,95,percent of total billed charges,,,,,,,,,27.63,,,fee schedule,,,27.63,,,fee schedule,,,,,,,,,,,,,,,26.74782,197.451,
SPUTUM COLLECTION,4100235,CDM,89220,CPT,300,RC,inpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,145.85616,,,fee schedule,,,19.30675,,,fee schedule,,,19.30675,,,fee schedule,,,,,,,,,19.30675,,,fee schedule,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,19.8859525,,,fee schedule,,,9.66,,,fee schedule,,,9.66,,,fee schedule,,,,,,,,,19.30675,,,fee schedule,,,9.66,162.0624,
GASTROCCULT BLOOD,4502271,CDM,82271,CPT,300,RC,inpatient,,,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,6.0648,,,fee schedule,,,6.0648,,,fee schedule,,,5.45832,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,4.69,,,fee schedule,,,4.69,,,fee schedule,,,,,,,,,,,,,,,4.69,6.901,
HEMOCCULT STOOL,4502272,CDM,82272,CPT,300,RC,inpatient,,,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,4.8222,,,fee schedule,,,4.8222,,,fee schedule,,,4.33998,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,4.69,,,fee schedule,,,4.69,,,fee schedule,,,,,,,,,,,,,,,4.33998,6.901,
BLOOD GLUCOSE W/DEVICE,4502962,CDM,82962,CPT,300,RC,inpatient,,,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,3.7392,,,fee schedule,,,3.7392,,,fee schedule,,,3.36528,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,4.37,,,fee schedule,,,4.37,,,fee schedule,,,,,,,,,,,,,,,3.36528,6.901,
A-1 ANTITIRYPSIN R/L,3010000,CDM,82103,CPT,301,RC,inpatient,,,,99.601,54.78055,,89.6409,90,percent of total billed charges,,,,99.601,100,percent of total billed charges,,,15.3216,,,fee schedule,,,15.3216,,,fee schedule,,,13.78944,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.6409,90,percent of total billed charges,,,,94.62095,95,percent of total billed charges,,,,,,,,,19.18,,,fee schedule,,,19.18,,,fee schedule,,,,,,,,,,,,,,,13.78944,99.601,
ACETOMINOPHEN R/L,3010010,CDM,80307,CPT,301,RC,inpatient,,,,164.903,90.69665,,148.4127,90,percent of total billed charges,,,,164.903,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,148.4127,90,percent of total billed charges,,,,156.65785,95,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,79.81,,,fee schedule,,,,,,,,,,,,,,,79.81,164.903,
ACID PHOSPHATASE-PR,3010020,CDM,84066,CPT,301,RC,inpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,11.0124,,,fee schedule,,,11.0124,,,fee schedule,,,9.91116,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,,,,,,,13.8,,,fee schedule,,,13.8,,,fee schedule,,,,,,,,,,,,,,,9.91116,49.234,
ALBUMIN CSF/PART OF MULSCLER,3010040,CDM,82042,CPT,301,RC,inpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,8.8692,,,fee schedule,,,8.8692,,,fee schedule,,,7.98228,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.3303,90,percent of total billed charges,,,,47.84865,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,7.39,50.367,
ALBUMIN - SERUM,3010045,CDM,82040,CPT,301,RC,inpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,5.643,,,fee schedule,,,5.643,,,fee schedule,,,5.0787,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.3303,90,percent of total billed charges,,,,47.84865,95,percent of total billed charges,,,,,,,,,7.08,,,fee schedule,,,7.08,,,fee schedule,,,,,,,,,,,,,,,5.0787,50.367,
ALCOHOL-ETHYL-ETOH,3010050,CDM,80307,CPT,301,RC,inpatient,,,,103.515,56.93325,,93.1635,90,percent of total billed charges,,,,103.515,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.1635,90,percent of total billed charges,,,,98.33925,95,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,79.81,,,fee schedule,,,,,,,,,,,,,,,79.81,103.515,
ALDOLASE R/L,3010070,CDM,82085,CPT,301,RC,inpatient,,,,95.996,52.7978,,86.3964,90,percent of total billed charges,,,,95.996,100,percent of total billed charges,,,11.0694,,,fee schedule,,,11.0694,,,fee schedule,,,9.96246,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,86.3964,90,percent of total billed charges,,,,91.1962,95,percent of total billed charges,,,,,,,,,13.87,,,fee schedule,,,13.87,,,fee schedule,,,,,,,,,,,,,,,9.96246,95.996,
ALK PHOSPHATASE,3010090,CDM,84075,CPT,301,RC,inpatient,,,,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.0974,90,percent of total billed charges,,,,54.9917,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,57.886,
ALPHA FETOPROTEIN R,3010100,CDM,82105,CPT,301,RC,inpatient,,,,149.968,82.4824,,134.9712,90,percent of total billed charges,,,,149.968,100,percent of total billed charges,,,19.1178,,,fee schedule,,,19.1178,,,fee schedule,,,17.20602,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,134.9712,90,percent of total billed charges,,,,142.4696,95,percent of total billed charges,,,,,,,,,23.95,,,fee schedule,,,23.95,,,fee schedule,,,,,,,,,,,,,,,17.20602,149.968,
AMMONIA,3010150,CDM,82140,CPT,301,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,16.6098,,,fee schedule,,,16.6098,,,fee schedule,,,14.94882,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,12.49,,,fee schedule,,,12.49,,,fee schedule,,,,,,,,,,,,,,,12.49,114.536,
AMYLASE,3010160,CDM,82150,CPT,301,RC,inpatient,,,,73.954,40.6747,,66.5586,90,percent of total billed charges,,,,73.954,100,percent of total billed charges,,,7.3872,,,fee schedule,,,7.3872,,,fee schedule,,,6.64848,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.5586,90,percent of total billed charges,,,,70.2563,95,percent of total billed charges,,,,,,,,,9.26,,,fee schedule,,,9.26,,,fee schedule,,,,,,,,,,,,,,,6.64848,73.954,
LIPOPROTEIN (A),3010165,CDM,83695,CPT,301,RC,inpatient,,,,138.947,76.42085,,125.0523,90,percent of total billed charges,,,,138.947,100,percent of total billed charges,,,16.3248,,,fee schedule,,,16.3248,,,fee schedule,,,14.69232,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.0523,90,percent of total billed charges,,,,131.99965,95,percent of total billed charges,,,,,,,,,18.69,,,fee schedule,,,18.69,,,fee schedule,,,,,,,,,,,,,,,14.69232,138.947,
APOLIPOPROTEIN B,3010175,CDM,82172,CPT,301,RC,inpatient,,,,110.622,60.8421,,99.5598,90,percent of total billed charges,,,,110.622,100,percent of total billed charges,,,24.0426,,,fee schedule,,,24.0426,,,fee schedule,,,21.63834,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.5598,90,percent of total billed charges,,,,105.0909,95,percent of total billed charges,,,,,,,,,22.12,,,fee schedule,,,22.12,,,fee schedule,,,,,,,,,,,,,,,21.63834,110.622,
ANGIOTENSIN CONN EN,3010180,CDM,82164,CPT,301,RC,inpatient,,,,89.713,49.34215,,80.7417,90,percent of total billed charges,,,,89.713,100,percent of total billed charges,,,16.644,,,fee schedule,,,16.644,,,fee schedule,,,14.9796,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,80.7417,90,percent of total billed charges,,,,85.22735,95,percent of total billed charges,,,,,,,,,20.84,,,fee schedule,,,20.84,,,fee schedule,,,,,,,,,,,,,,,14.9796,89.713,
B-12 R/L,3010190,CDM,82607,CPT,301,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,17.1912,,,fee schedule,,,17.1912,,,fee schedule,,,15.47208,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,21.52,,,fee schedule,,,21.52,,,fee schedule,,,,,,,,,,,,,,,15.47208,114.536,
B-6 LABORATORY,3010200,CDM,84207,CPT,301,RC,inpatient,,,,420.24,231.132,,378.216,90,percent of total billed charges,,,,420.24,100,percent of total billed charges,,,32.034,,,fee schedule,,,32.034,,,fee schedule,,,28.8306,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.216,90,percent of total billed charges,,,,399.228,95,percent of total billed charges,,,,,,,,,40.11,,,fee schedule,,,40.11,,,fee schedule,,,,,,,,,,,,,,,28.8306,420.24,
BETA SUBUNIT HCG R/L,3010210,CDM,84702,CPT,301,RC,inpatient,,,,177.057,97.38135,,159.3513,90,percent of total billed charges,,,,177.057,100,percent of total billed charges,,,17.157,,,fee schedule,,,17.157,,,fee schedule,,,15.4413,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,159.3513,90,percent of total billed charges,,,,168.20415,95,percent of total billed charges,,,,,,,,,11.54,,,fee schedule,,,11.54,,,fee schedule,,,,,,,,,,,,,,,11.54,177.057,
B-TYPE NATRIURETIC PEPTIDE/BNP,3010214,CDM,83880,CPT,301,RC,inpatient,,,,207.751,114.26305,,186.9759,90,percent of total billed charges,,,,207.751,100,percent of total billed charges,,,44.7564,,,fee schedule,,,44.7564,,,fee schedule,,,40.28076,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,186.9759,90,percent of total billed charges,,,,197.36345,95,percent of total billed charges,,,,,,,,,47.43,,,fee schedule,,,47.43,,,fee schedule,,,,,,,,,,,,,,,40.28076,207.751,
BETA 2 MICROGLOBULIN,3010220,CDM,82232,CPT,301,RC,inpatient,,,,185.709,102.13995,,167.1381,90,percent of total billed charges,,,,185.709,100,percent of total billed charges,,,18.4452,,,fee schedule,,,18.4452,,,fee schedule,,,16.60068,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,167.1381,90,percent of total billed charges,,,,176.42355,95,percent of total billed charges,,,,,,,,,23.11,,,fee schedule,,,23.11,,,fee schedule,,,,,,,,,,,,,,,16.60068,185.709,
BILIRUBIN DIRECT,3010230,CDM,82248,CPT,301,RC,inpatient,,,,73.954,40.6747,,66.5586,90,percent of total billed charges,,,,73.954,100,percent of total billed charges,,,5.7228,,,fee schedule,,,5.7228,,,fee schedule,,,5.15052,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.5586,90,percent of total billed charges,,,,70.2563,95,percent of total billed charges,,,,,,,,,7.17,,,fee schedule,,,7.17,,,fee schedule,,,,,,,,,,,,,,,5.15052,73.954,
BILIRUBIN TOTAL,3010240,CDM,82247,CPT,301,RC,inpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,5.7228,,,fee schedule,,,5.7228,,,fee schedule,,,5.15052,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,161.0199,90,percent of total billed charges,,,,169.96545,95,percent of total billed charges,,,,,,,,,7.17,,,fee schedule,,,7.17,,,fee schedule,,,,,,,,,,,,,,,5.15052,178.911,
OCCULT BLOOD - FECAL,3010260,CDM,82272,CPT,301,RC,inpatient,,,,34.608,19.0344,,31.1472,90,percent of total billed charges,,,,34.608,100,percent of total billed charges,,,4.8222,,,fee schedule,,,4.8222,,,fee schedule,,,4.33998,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.1472,90,percent of total billed charges,,,,32.8776,95,percent of total billed charges,,,,,,,,,4.69,,,fee schedule,,,4.69,,,fee schedule,,,,,,,,,,,,,,,4.33998,34.608,
BUN,3010270,CDM,84520,CPT,301,RC,inpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,4.503,,,fee schedule,,,4.503,,,fee schedule,,,4.0527,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.3303,90,percent of total billed charges,,,,47.84865,95,percent of total billed charges,,,,,,,,,5.63,,,fee schedule,,,5.63,,,fee schedule,,,,,,,,,,,,,,,4.0527,50.367,
C-PEPTIDE,3010290,CDM,84681,CPT,301,RC,inpatient,,,,216.403,119.02165,,194.7627,90,percent of total billed charges,,,,216.403,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,21.35106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,194.7627,90,percent of total billed charges,,,,205.58285,95,percent of total billed charges,,,,,,,,,29.71,,,fee schedule,,,29.71,,,fee schedule,,,,,,,,,,,,,,,21.35106,216.403,
CALCIUM,3010310,CDM,82310,CPT,301,RC,inpatient,,,,39.346,21.6403,,35.4114,90,percent of total billed charges,,,,39.346,100,percent of total billed charges,,,5.8824,,,fee schedule,,,5.8824,,,fee schedule,,,5.29416,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.4114,90,percent of total billed charges,,,,37.3787,95,percent of total billed charges,,,,,,,,,7.36,,,fee schedule,,,7.36,,,fee schedule,,,,,,,,,,,,,,,5.29416,39.346,
CALCIUM URINE,3010320,CDM,82340,CPT,301,RC,inpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,6.8742,,,fee schedule,,,6.8742,,,fee schedule,,,6.18678,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.3303,90,percent of total billed charges,,,,47.84865,95,percent of total billed charges,,,,,,,,,8.62,,,fee schedule,,,8.62,,,fee schedule,,,,,,,,,,,,,,,6.18678,50.367,
TROPONIN I,3010325,CDM,84484,CPT,301,RC,inpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,12.79422,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,143.7777,90,percent of total billed charges,,,,151.76535,95,percent of total billed charges,,,,,,,,,14.05,,,fee schedule,,,14.05,,,fee schedule,,,,,,,,,,,,,,,12.79422,159.753,
TROPONIN 5TH GEN 1 HOUR,3010326,CDM,84484,CPT,301,RC,inpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,12.79422,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,143.7777,90,percent of total billed charges,,,,151.76535,95,percent of total billed charges,,,,,,,,,14.05,,,fee schedule,,,14.05,,,fee schedule,,,,,,,,,,,,,,,12.79422,159.753,
TROPONIN 5TH GEN 3 HOUR,3010327,CDM,84484,CPT,301,RC,inpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,12.79422,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,143.7777,90,percent of total billed charges,,,,151.76535,95,percent of total billed charges,,,,,,,,,14.05,,,fee schedule,,,14.05,,,fee schedule,,,,,,,,,,,,,,,12.79422,159.753,
ALBUMIN - BODY FLUID,3010335,CDM,82042,CPT,301,RC,inpatient,,,,56.65,31.1575,,50.985,90,percent of total billed charges,,,,56.65,100,percent of total billed charges,,,8.8692,,,fee schedule,,,8.8692,,,fee schedule,,,7.98228,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.985,90,percent of total billed charges,,,,53.8175,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,7.39,56.65,
CARBON MONO-CARBOXY,3010350,CDM,82375,CPT,301,RC,inpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,14.0448,,,fee schedule,,,14.0448,,,fee schedule,,,12.64032,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.2852,90,percent of total billed charges,,,,124.8566,95,percent of total billed charges,,,,,,,,,17.6,,,fee schedule,,,17.6,,,fee schedule,,,,,,,,,,,,,,,12.64032,131.428,
"CATECHOLAMINES, PLASMA",3010407,CDM,82384,CPT,301,RC,inpatient,,,,391.915,215.55325,,352.7235,90,percent of total billed charges,,,,391.915,100,percent of total billed charges,,,28.785,,,fee schedule,,,28.785,,,fee schedule,,,25.9065,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,352.7235,90,percent of total billed charges,,,,372.31925,95,percent of total billed charges,,,,,,,,,36.06,,,fee schedule,,,36.06,,,fee schedule,,,,,,,,,,,,,,,25.9065,391.915,
CATECHOLAMINE TOTAL,3010410,CDM,82384,CPT,301,RC,inpatient,,,,174.688,96.0784,,157.2192,90,percent of total billed charges,,,,174.688,100,percent of total billed charges,,,28.785,,,fee schedule,,,28.785,,,fee schedule,,,25.9065,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,157.2192,90,percent of total billed charges,,,,165.9536,95,percent of total billed charges,,,,,,,,,36.06,,,fee schedule,,,36.06,,,fee schedule,,,,,,,,,,,,,,,25.9065,174.688,
CBG TEST - FINGER STICK,3010420,CDM,82947,CPT,301,RC,inpatient,,,QW,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,4.03218,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,5.6,,,fee schedule,,,,,,,,,,,,,,,4.03218,17.201,
CEA R/L,3010430,CDM,82378,CPT,301,RC,inpatient,,,,158.62,87.241,,142.758,90,percent of total billed charges,,,,158.62,100,percent of total billed charges,,,21.6144,,,fee schedule,,,21.6144,,,fee schedule,,,19.45296,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,142.758,90,percent of total billed charges,,,,150.689,95,percent of total billed charges,,,,,,,,,27.09,,,fee schedule,,,27.09,,,fee schedule,,,,,,,,,,,,,,,19.45296,158.62,
CHLORIDE,3010440,CDM,82435,CPT,301,RC,inpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,5.244,,,fee schedule,,,5.244,,,fee schedule,,,4.7196,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.2295,90,percent of total billed charges,,,,57.24225,95,percent of total billed charges,,,,,,,,,6.56,,,fee schedule,,,6.56,,,fee schedule,,,,,,,,,,,,,,,4.7196,60.255,
CERULOPLASMIN,3010445,CDM,82390,CPT,301,RC,inpatient,,,,81.061,44.58355,,72.9549,90,percent of total billed charges,,,,81.061,100,percent of total billed charges,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,11.01924,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.9549,90,percent of total billed charges,,,,77.00795,95,percent of total billed charges,,,,,,,,,15.33,,,fee schedule,,,15.33,,,fee schedule,,,,,,,,,,,,,,,11.01924,81.061,
CHOLESTEROL,3010460,CDM,82465,CPT,301,RC,inpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,4.959,,,fee schedule,,,4.959,,,fee schedule,,,4.4631,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,,,,,,,6.22,,,fee schedule,,,6.22,,,fee schedule,,,,,,,,,,,,,,,4.4631,49.234,
CORTISOL R/L,3010500,CDM,82533,CPT,301,RC,inpatient,,,,135.342,74.4381,,121.8078,90,percent of total billed charges,,,,135.342,100,percent of total billed charges,,,18.582,,,fee schedule,,,18.582,,,fee schedule,,,16.7238,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,121.8078,90,percent of total billed charges,,,,128.5749,95,percent of total billed charges,,,,,,,,,22.53,,,fee schedule,,,22.53,,,fee schedule,,,,,,,,,,,,,,,16.7238,135.342,
CORTISOL URINE R/L,3010510,CDM,82533,CPT,301,RC,inpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,18.582,,,fee schedule,,,18.582,,,fee schedule,,,16.7238,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.3826,90,percent of total billed charges,,,,179.8483,95,percent of total billed charges,,,,,,,,,22.53,,,fee schedule,,,22.53,,,fee schedule,,,,,,,,,,,,,,,16.7238,189.314,
CO2,3010520,CDM,82374,CPT,301,RC,inpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,5.5632,,,fee schedule,,,5.5632,,,fee schedule,,,5.00688,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.3303,90,percent of total billed charges,,,,47.84865,95,percent of total billed charges,,,,,,,,,6.99,,,fee schedule,,,6.99,,,fee schedule,,,,,,,,,,,,,,,5.00688,50.367,
THYROTROPIN RECEPTOR ANTIBODY,3010521,CDM,83519,CPT,301,RC,inpatient,,,,184.267,101.34685,,165.8403,90,percent of total billed charges,,,,184.267,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,18.8784,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,165.8403,90,percent of total billed charges,,,,175.05365,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.87,184.267,
CPK,3010530,CDM,82550,CPT,301,RC,inpatient,,,,64.169,35.29295,,57.7521,90,percent of total billed charges,,,,64.169,100,percent of total billed charges,,,7.4214,,,fee schedule,,,7.4214,,,fee schedule,,,6.67926,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.7521,90,percent of total billed charges,,,,60.96055,95,percent of total billed charges,,,,,,,,,9.31,,,fee schedule,,,9.31,,,fee schedule,,,,,,,,,,,,,,,6.67926,64.169,
CPK-MB,3010540,CDM,82553,CPT,301,RC,inpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,13.167,,,fee schedule,,,13.167,,,fee schedule,,,11.8503,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.072,90,percent of total billed charges,,,,133.076,95,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,16.48,,,fee schedule,,,,,,,,,,,,,,,11.8503,140.08,
CREATININE,3010550,CDM,82565,CPT,301,RC,inpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,5.8368,,,fee schedule,,,5.8368,,,fee schedule,,,5.25312,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.3303,90,percent of total billed charges,,,,47.84865,95,percent of total billed charges,,,,,,,,,7.31,,,fee schedule,,,7.31,,,fee schedule,,,,,,,,,,,,,,,5.25312,50.367,
CREATININE CLEARANCE,3010560,CDM,82575,CPT,301,RC,inpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,10.7844,,,fee schedule,,,10.7844,,,fee schedule,,,9.70596,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.4787,90,percent of total billed charges,,,,115.56085,95,percent of total billed charges,,,,,,,,,13.5,,,fee schedule,,,13.5,,,fee schedule,,,,,,,,,,,,,,,9.70596,121.643,
CREATININE-URINE,3010570,CDM,82570,CPT,301,RC,inpatient,,,,65.302,35.9161,,58.7718,90,percent of total billed charges,,,,65.302,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.7718,90,percent of total billed charges,,,,62.0369,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,65.302,
DEHYDROEPIANDROSTERONE SULFATE,3010603,CDM,82627,CPT,301,RC,inpatient,,,,290.975,160.03625,,261.8775,90,percent of total billed charges,,,,290.975,100,percent of total billed charges,,,25.3422,,,fee schedule,,,25.3422,,,fee schedule,,,22.80798,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.8775,90,percent of total billed charges,,,,276.42625,95,percent of total billed charges,,,,,,,,,31.74,,,fee schedule,,,31.74,,,fee schedule,,,,,,,,,,,,,,,22.80798,290.975,
DHEA,3010630,CDM,82626,CPT,301,RC,inpatient,,,,321.875,177.03125,,289.6875,90,percent of total billed charges,,,,321.875,100,percent of total billed charges,,,28.8078,,,fee schedule,,,28.8078,,,fee schedule,,,25.92702,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,289.6875,90,percent of total billed charges,,,,305.78125,95,percent of total billed charges,,,,,,,,,36.09,,,fee schedule,,,36.09,,,fee schedule,,,,,,,,,,,,,,,25.92702,321.875,
ELECTROPHOR PROTEIN,3010770,CDM,84165,CPT,301,RC,inpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,11.01924,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,,,,,,,15.33,,,fee schedule,,,15.33,,,fee schedule,,,,,,,,,,,,,,,11.01924,49.234,
ERYTHROPOIETIN,3010800,CDM,82668,CPT,301,RC,inpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,21.4206,,,fee schedule,,,21.4206,,,fee schedule,,,19.27854,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.2041,90,percent of total billed charges,,,,135.32655,95,percent of total billed charges,,,,,,,,,26.84,,,fee schedule,,,26.84,,,fee schedule,,,,,,,,,,,,,,,19.27854,142.449,
ESTRADIOL,3010810,CDM,82670,CPT,301,RC,inpatient,,,,229.793,126.38615,,206.8137,90,percent of total billed charges,,,,229.793,100,percent of total billed charges,,,31.8516,,,fee schedule,,,31.8516,,,fee schedule,,,28.66644,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,206.8137,90,percent of total billed charges,,,,218.30335,95,percent of total billed charges,,,,,,,,,39.91,,,fee schedule,,,39.91,,,fee schedule,,,,,,,,,,,,,,,28.66644,229.793,
"ESTROGEN, TOTAL",3010830,CDM,82672,CPT,301,RC,inpatient,,,,256.985,141.34175,,231.2865,90,percent of total billed charges,,,,256.985,100,percent of total billed charges,,,24.738,,,fee schedule,,,24.738,,,fee schedule,,,22.2642,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,231.2865,90,percent of total billed charges,,,,244.13575,95,percent of total billed charges,,,,,,,,,30.97,,,fee schedule,,,30.97,,,fee schedule,,,,,,,,,,,,,,,22.2642,256.985,
FAT STOOL QUAN R/L,3010870,CDM,82710,CPT,301,RC,inpatient,,,,141.316,77.7238,,127.1844,90,percent of total billed charges,,,,141.316,100,percent of total billed charges,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,17.2368,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,127.1844,90,percent of total billed charges,,,,134.2502,95,percent of total billed charges,,,,,,,,,16.62,,,fee schedule,,,16.62,,,fee schedule,,,,,,,,,,,,,,,16.62,141.316,
FERRITIN R/L,3010880,CDM,82728,CPT,301,RC,inpatient,,,,134.209,73.81495,,120.7881,90,percent of total billed charges,,,,134.209,100,percent of total billed charges,,,15.5382,,,fee schedule,,,15.5382,,,fee schedule,,,13.98438,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,120.7881,90,percent of total billed charges,,,,127.49855,95,percent of total billed charges,,,,,,,,,19.46,,,fee schedule,,,19.46,,,fee schedule,,,,,,,,,,,,,,,13.98438,134.209,
FOLIC ACID R/L,3010890,CDM,82746,CPT,301,RC,inpatient,,,,190.653,104.85915,,171.5877,90,percent of total billed charges,,,,190.653,100,percent of total billed charges,,,16.758,,,fee schedule,,,16.758,,,fee schedule,,,15.0822,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.5877,90,percent of total billed charges,,,,181.12035,95,percent of total billed charges,,,,,,,,,21,,,fee schedule,,,21,,,fee schedule,,,,,,,,,,,,,,,15.0822,190.653,
FREE T3,3010900,CDM,84481,CPT,301,RC,inpatient,,,,385.632,212.0976,,347.0688,90,percent of total billed charges,,,,385.632,100,percent of total billed charges,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,17.38044,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,347.0688,90,percent of total billed charges,,,,366.3504,95,percent of total billed charges,,,,,,,,,24.19,,,fee schedule,,,24.19,,,fee schedule,,,,,,,,,,,,,,,17.38044,385.632,
FREE T4,3010910,CDM,84439,CPT,301,RC,inpatient,,,,152.337,83.78535,,137.1033,90,percent of total billed charges,,,,152.337,100,percent of total billed charges,,,10.2828,,,fee schedule,,,10.2828,,,fee schedule,,,9.25452,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,137.1033,90,percent of total billed charges,,,,144.72015,95,percent of total billed charges,,,,,,,,,12.88,,,fee schedule,,,12.88,,,fee schedule,,,,,,,,,,,,,,,9.25452,152.337,
FSH (FOLIC STIM. HORMONE),3010920,CDM,83001,CPT,301,RC,inpatient,,,,234.531,128.99205,,211.0779,90,percent of total billed charges,,,,234.531,100,percent of total billed charges,,,21.1812,,,fee schedule,,,21.1812,,,fee schedule,,,19.06308,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,211.0779,90,percent of total billed charges,,,,222.80445,95,percent of total billed charges,,,,,,,,,26.55,,,fee schedule,,,26.55,,,fee schedule,,,,,,,,,,,,,,,19.06308,234.531,
GAMMA GLUTAMYL GTT,3010930,CDM,82977,CPT,301,RC,inpatient,,,,78.692,43.2806,,70.8228,90,percent of total billed charges,,,,78.692,100,percent of total billed charges,,,8.208,,,fee schedule,,,8.208,,,fee schedule,,,7.3872,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.8228,90,percent of total billed charges,,,,74.7574,95,percent of total billed charges,,,,,,,,,10.28,,,fee schedule,,,10.28,,,fee schedule,,,,,,,,,,,,,,,7.3872,78.692,
GASTRIN R/L,3010940,CDM,82941,CPT,301,RC,inpatient,,,,167.272,91.9996,,150.5448,90,percent of total billed charges,,,,167.272,100,percent of total billed charges,,,20.0982,,,fee schedule,,,20.0982,,,fee schedule,,,18.08838,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.5448,90,percent of total billed charges,,,,158.9084,95,percent of total billed charges,,,,,,,,,25.19,,,fee schedule,,,25.19,,,fee schedule,,,,,,,,,,,,,,,18.08838,167.272,
GLUCOSE  - FLUID,3010970,CDM,82945,CPT,301,RC,inpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,4.03218,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,5.6,,,fee schedule,,,,,,,,,,,,,,,4.03218,55.517,
GLUCOSE POSTPRANDIAL,3010971,CDM,82947,CPT,301,RC,inpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,4.03218,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,5.6,,,fee schedule,,,,,,,,,,,,,,,4.03218,55.517,
G6PD GLUCOSE-6-PHOS,3011030,CDM,82955,CPT,301,RC,inpatient,,,,82.606,45.4333,,74.3454,90,percent of total billed charges,,,,82.606,100,percent of total billed charges,,,11.058,,,fee schedule,,,11.058,,,fee schedule,,,9.9522,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,74.3454,90,percent of total billed charges,,,,78.4757,95,percent of total billed charges,,,,,,,,,13.85,,,fee schedule,,,13.85,,,fee schedule,,,,,,,,,,,,,,,9.9522,82.606,
HAPTOGLOBIN,3011040,CDM,83010,CPT,301,RC,inpatient,,,,125.557,69.05635,,113.0013,90,percent of total billed charges,,,,125.557,100,percent of total billed charges,,,14.3412,,,fee schedule,,,14.3412,,,fee schedule,,,12.90708,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,113.0013,90,percent of total billed charges,,,,119.27915,95,percent of total billed charges,,,,,,,,,17.96,,,fee schedule,,,17.96,,,fee schedule,,,,,,,,,,,,,,,12.90708,125.557,
CYSTATIN C,3011057,CDM,82610,CPT,301,RC,inpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,21.1128,,,fee schedule,,,21.1128,,,fee schedule,,,19.00152,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,161.0199,90,percent of total billed charges,,,,169.96545,95,percent of total billed charges,,,,,,,,,19.63,,,fee schedule,,,19.63,,,fee schedule,,,,,,,,,,,,,,,19.00152,178.911,
CHROMIUM,3011083,CDM,82495,CPT,301,RC,inpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,23.1192,,,fee schedule,,,23.1192,,,fee schedule,,,20.80728,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.2852,90,percent of total billed charges,,,,124.8566,95,percent of total billed charges,,,,,,,,,9.98,,,fee schedule,,,9.98,,,fee schedule,,,,,,,,,,,,,,,9.98,131.428,
HEAVY METAL SCREEN - ARSENIC,3011084,CDM,82175,CPT,301,RC,inpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,21.6258,,,fee schedule,,,21.6258,,,fee schedule,,,19.46322,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.2852,90,percent of total billed charges,,,,124.8566,95,percent of total billed charges,,,,,,,,,27.09,,,fee schedule,,,27.09,,,fee schedule,,,,,,,,,,,,,,,19.46322,131.428,
HEAVY METAL SCREEN - LEAD,3011087,CDM,83655,CPT,301,RC,inpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,13.8054,,,fee schedule,,,13.8054,,,fee schedule,,,12.42486,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,143.7777,90,percent of total billed charges,,,,151.76535,95,percent of total billed charges,,,,,,,,,17.28,,,fee schedule,,,17.28,,,fee schedule,,,,,,,,,,,,,,,12.42486,159.753,
HEAVY METAL SCREEN - MERCURY,3011088,CDM,83825,CPT,301,RC,inpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,18.5364,,,fee schedule,,,18.5364,,,fee schedule,,,16.68276,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.2852,90,percent of total billed charges,,,,124.8566,95,percent of total billed charges,,,,,,,,,23.22,,,fee schedule,,,23.22,,,fee schedule,,,,,,,,,,,,,,,16.68276,131.428,
STRONTIUM,3011089,CDM,83018,CPT,301,RC,inpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,25.0344,,,fee schedule,,,25.0344,,,fee schedule,,,22.53096,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.2852,90,percent of total billed charges,,,,124.8566,95,percent of total billed charges,,,,,,,,,31.28,,,fee schedule,,,31.28,,,fee schedule,,,,,,,,,,,,,,,22.53096,131.428,
HGB A1C,3011130,CDM,83036,CPT,301,RC,inpatient,,,,72.821,40.05155,,65.5389,90,percent of total billed charges,,,,72.821,100,percent of total billed charges,,,11.0694,,,fee schedule,,,11.0694,,,fee schedule,,,9.96246,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.5389,90,percent of total billed charges,,,,69.17995,95,percent of total billed charges,,,,,,,,,13.87,,,fee schedule,,,13.87,,,fee schedule,,,,,,,,,,,,,,,9.96246,72.821,
HGB ELECTROPHOR R/L,3011140,CDM,83020,CPT,301,RC,inpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,13.20462,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.5899,90,percent of total billed charges,,,,81.90045,95,percent of total billed charges,,,,,,,,,18.39,,,fee schedule,,,18.39,,,fee schedule,,,,,,,,,,,,,,,13.20462,86.211,
"IMMUNOGLOBIN A,QUANTITATIVE",3011151,CDM,82784,CPT,301,RC,inpatient,,,,122.776,67.5268,,110.4984,90,percent of total billed charges,,,,122.776,100,percent of total billed charges,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,9.5418,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,110.4984,90,percent of total billed charges,,,,116.6372,95,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,8.24,,,fee schedule,,,,,,,,,,,,,,,8.24,122.776,
"IMMUNOGLOBIN G, QUANTATIVE",3011156,CDM,82784,CPT,301,RC,inpatient,,,,122.776,67.5268,,110.4984,90,percent of total billed charges,,,,122.776,100,percent of total billed charges,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,9.5418,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,110.4984,90,percent of total billed charges,,,,116.6372,95,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,8.24,,,fee schedule,,,,,,,,,,,,,,,8.24,122.776,
INOR PHOS PO4,3011170,CDM,84100,CPT,301,RC,inpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,5.4036,,,fee schedule,,,5.4036,,,fee schedule,,,4.86324,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.2295,90,percent of total billed charges,,,,57.24225,95,percent of total billed charges,,,,,,,,,6.78,,,fee schedule,,,6.78,,,fee schedule,,,,,,,,,,,,,,,4.86324,60.255,
INSULIN-LIKE GROWTH FACTOR 1,3011175,CDM,84305,CPT,301,RC,inpatient,,,,226.291,124.46005,,203.6619,90,percent of total billed charges,,,,226.291,100,percent of total billed charges,,,24.2364,,,fee schedule,,,24.2364,,,fee schedule,,,21.81276,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,203.6619,90,percent of total billed charges,,,,214.97645,95,percent of total billed charges,,,,,,,,,30.36,,,fee schedule,,,30.36,,,fee schedule,,,,,,,,,,,,,,,21.81276,226.291,
INSULIN R/L,3011180,CDM,83525,CPT,301,RC,inpatient,,,,82.606,45.4333,,74.3454,90,percent of total billed charges,,,,82.606,100,percent of total billed charges,,,13.0302,,,fee schedule,,,13.0302,,,fee schedule,,,11.72718,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,74.3454,90,percent of total billed charges,,,,78.4757,95,percent of total billed charges,,,,,,,,,16.34,,,fee schedule,,,16.34,,,fee schedule,,,,,,,,,,,,,,,11.72718,82.606,
IRON BINDING CAPACITY,3011190,CDM,83550,CPT,301,RC,inpatient,,,,77.559,42.65745,,69.8031,90,percent of total billed charges,,,,77.559,100,percent of total billed charges,,,9.9636,,,fee schedule,,,9.9636,,,fee schedule,,,8.96724,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.8031,90,percent of total billed charges,,,,73.68105,95,percent of total billed charges,,,,,,,,,12.48,,,fee schedule,,,12.48,,,fee schedule,,,,,,,,,,,,,,,8.96724,77.559,
IRON TOTAL,3011200,CDM,83540,CPT,301,RC,inpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,6.63822,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.2295,90,percent of total billed charges,,,,57.24225,95,percent of total billed charges,,,,,,,,,9.25,,,fee schedule,,,9.25,,,fee schedule,,,,,,,,,,,,,,,6.63822,60.255,
ISOENZYME CPK R/L,3011210,CDM,82552,CPT,301,RC,inpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,15.2646,,,fee schedule,,,15.2646,,,fee schedule,,,13.73814,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.1484,90,percent of total billed charges,,,,67.7122,95,percent of total billed charges,,,,,,,,,19.13,,,fee schedule,,,19.13,,,fee schedule,,,,,,,,,,,,,,,13.73814,71.276,
LACTIC ACID,3011230,CDM,83605,CPT,301,RC,inpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,13.1898,,,fee schedule,,,13.1898,,,fee schedule,,,11.87082,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.072,90,percent of total billed charges,,,,133.076,95,percent of total billed charges,,,,,,,,,15.25,,,fee schedule,,,15.25,,,fee schedule,,,,,,,,,,,,,,,11.87082,140.08,
LDH,3011240,CDM,83615,CPT,301,RC,inpatient,,,,40.582,22.3201,,36.5238,90,percent of total billed charges,,,,40.582,100,percent of total billed charges,,,6.8856,,,fee schedule,,,6.8856,,,fee schedule,,,6.19704,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.5238,90,percent of total billed charges,,,,38.5529,95,percent of total billed charges,,,,,,,,,8.63,,,fee schedule,,,8.63,,,fee schedule,,,,,,,,,,,,,,,6.19704,40.582,
LDL CHOLESTEROL - DIRECT,3011255,CDM,83721,CPT,301,RC,inpatient,,,,83.842,46.1131,,75.4578,90,percent of total billed charges,,,,83.842,100,percent of total billed charges,,,11.97,,,fee schedule,,,11.97,,,fee schedule,,,10.773,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.4578,90,percent of total billed charges,,,,79.6499,95,percent of total billed charges,,,,,,,,,13.62,,,fee schedule,,,13.62,,,fee schedule,,,,,,,,,,,,,,,10.773,83.842,
LIPASE,3011270,CDM,83690,CPT,301,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,7.8546,,,fee schedule,,,7.8546,,,fee schedule,,,7.06914,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,,,,,,,9.84,,,fee schedule,,,9.84,,,fee schedule,,,,,,,,,,,,,,,7.06914,75.19,
LUTEINIZING HORMONE,3011320,CDM,83002,CPT,301,RC,inpatient,,,,155.015,85.25825,,139.5135,90,percent of total billed charges,,,,155.015,100,percent of total billed charges,,,21.1128,,,fee schedule,,,21.1128,,,fee schedule,,,19.00152,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,139.5135,90,percent of total billed charges,,,,147.26425,95,percent of total billed charges,,,,,,,,,26.45,,,fee schedule,,,26.45,,,fee schedule,,,,,,,,,,,,,,,19.00152,155.015,
MAGNESIUM-MG,3011440,CDM,83735,CPT,301,RC,inpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,7.638,,,fee schedule,,,7.638,,,fee schedule,,,6.8742,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,,,,,,,9.57,,,fee schedule,,,9.57,,,fee schedule,,,,,,,,,,,,,,,6.8742,55.517,
METANEPHRINES TOTAL,3011460,CDM,83835,CPT,301,RC,inpatient,,,,244.419,134.43045,,219.9771,90,percent of total billed charges,,,,244.419,100,percent of total billed charges,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,17.38044,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,219.9771,90,percent of total billed charges,,,,232.19805,95,percent of total billed charges,,,,,,,,,21.51,,,fee schedule,,,21.51,,,fee schedule,,,,,,,,,,,,,,,17.38044,244.419,
METHYLMALONIC ACID,3011475,CDM,83921,CPT,301,RC,inpatient,,,,330.527,181.78985,,297.4743,90,percent of total billed charges,,,,330.527,100,percent of total billed charges,,,24.1794,,,fee schedule,,,24.1794,,,fee schedule,,,21.76146,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.4743,90,percent of total billed charges,,,,314.00065,95,percent of total billed charges,,,,,,,,,23.51,,,fee schedule,,,23.51,,,fee schedule,,,,,,,,,,,,,,,21.76146,330.527,
OSMOLALITY SERUM,3011550,CDM,83930,CPT,301,RC,inpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,7.5354,,,fee schedule,,,7.5354,,,fee schedule,,,6.78186,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,90,percent of total billed charges,,,,64.28745,95,percent of total billed charges,,,,,,,,,9.43,,,fee schedule,,,9.43,,,fee schedule,,,,,,,,,,,,,,,6.78186,67.671,
OSMOLALITY; URINE,3011551,CDM,83935,CPT,301,RC,inpatient,,,,70.04,38.522,,63.036,90,percent of total billed charges,,,,70.04,100,percent of total billed charges,,,7.7748,,,fee schedule,,,7.7748,,,fee schedule,,,6.99732,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.036,90,percent of total billed charges,,,,66.538,95,percent of total billed charges,,,,,,,,,9.73,,,fee schedule,,,9.73,,,fee schedule,,,,,,,,,,,,,,,6.99732,70.04,
PARATHYROID PTH R/L,3011590,CDM,83970,CPT,301,RC,inpatient,,,,287.679,158.22345,,258.9111,90,percent of total billed charges,,,,287.679,100,percent of total billed charges,,,47.0592,,,fee schedule,,,47.0592,,,fee schedule,,,42.35328,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,258.9111,90,percent of total billed charges,,,,273.29505,95,percent of total billed charges,,,,,,,,,58.94,,,fee schedule,,,58.94,,,fee schedule,,,,,,,,,,,,,,,42.35328,287.679,
PH BLOOD,3011600,CDM,82800,CPT,301,RC,inpatient,,,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,12.54,,,fee schedule,,,12.54,,,fee schedule,,,11.286,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.7208,90,percent of total billed charges,,,,49.3164,95,percent of total billed charges,,,,,,,,,12.1,,,fee schedule,,,12.1,,,fee schedule,,,,,,,,,,,,,,,11.286,51.912,
PORPHYRINS QUANT.,3011640,CDM,84120,CPT,301,RC,inpatient,,,,122.776,67.5268,,110.4984,90,percent of total billed charges,,,,122.776,100,percent of total billed charges,,,16.7694,,,fee schedule,,,16.7694,,,fee schedule,,,15.09246,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,110.4984,90,percent of total billed charges,,,,116.6372,95,percent of total billed charges,,,,,,,,,19.11,,,fee schedule,,,19.11,,,fee schedule,,,,,,,,,,,,,,,15.09246,122.776,
POTASSIUM,3011650,CDM,84132,CPT,301,RC,inpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,5.4264,,,fee schedule,,,5.4264,,,fee schedule,,,4.88376,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,90,percent of total billed charges,,,,64.28745,95,percent of total billed charges,,,,,,,,,6.56,,,fee schedule,,,6.56,,,fee schedule,,,,,,,,,,,,,,,4.88376,67.671,
POTASSIUM URINE,3011660,CDM,84133,CPT,301,RC,inpatient,,,,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,5.3922,,,fee schedule,,,5.3922,,,fee schedule,,,4.85298,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.8529,90,percent of total billed charges,,,,51.56695,95,percent of total billed charges,,,,,,,,,6.14,,,fee schedule,,,6.14,,,fee schedule,,,,,,,,,,,,,,,4.85298,54.281,
PREALBUMIN,3011665,CDM,84134,CPT,301,RC,inpatient,,,,134.209,73.81495,,120.7881,90,percent of total billed charges,,,,134.209,100,percent of total billed charges,,,16.6326,,,fee schedule,,,16.6326,,,fee schedule,,,14.96934,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,120.7881,90,percent of total billed charges,,,,127.49855,95,percent of total billed charges,,,,,,,,,20.83,,,fee schedule,,,20.83,,,fee schedule,,,,,,,,,,,,,,,14.96934,134.209,
PREGNANCY TEST SERUM,3011670,CDM,84703,CPT,301,RC,inpatient,,,,103.515,56.93325,,93.1635,90,percent of total billed charges,,,,103.515,100,percent of total billed charges,,,8.5728,,,fee schedule,,,8.5728,,,fee schedule,,,7.71552,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.1635,90,percent of total billed charges,,,,98.33925,95,percent of total billed charges,,,,,,,,,10.73,,,fee schedule,,,10.73,,,fee schedule,,,,,,,,,,,,,,,7.71552,103.515,
PROGESTERONE,3011700,CDM,84144,CPT,301,RC,inpatient,,,,197.966,108.8813,,178.1694,90,percent of total billed charges,,,,197.966,100,percent of total billed charges,,,23.7804,,,fee schedule,,,23.7804,,,fee schedule,,,21.40236,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,178.1694,90,percent of total billed charges,,,,188.0677,95,percent of total billed charges,,,,,,,,,29.79,,,fee schedule,,,29.79,,,fee schedule,,,,,,,,,,,,,,,21.40236,197.966,
PROLACTIN,3011720,CDM,84146,CPT,301,RC,inpatient,,,,167.272,91.9996,,150.5448,90,percent of total billed charges,,,,167.272,100,percent of total billed charges,,,22.0932,,,fee schedule,,,22.0932,,,fee schedule,,,19.88388,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.5448,90,percent of total billed charges,,,,158.9084,95,percent of total billed charges,,,,,,,,,27.67,,,fee schedule,,,27.67,,,fee schedule,,,,,,,,,,,,,,,19.88388,167.272,
PSA -,3011730,CDM,84153,CPT,301,RC,inpatient,,,,135.342,74.4381,,121.8078,90,percent of total billed charges,,,,135.342,100,percent of total billed charges,,,20.9646,,,fee schedule,,,20.9646,,,fee schedule,,,18.86814,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,121.8078,90,percent of total billed charges,,,,128.5749,95,percent of total billed charges,,,,,,,,,26.27,,,fee schedule,,,26.27,,,fee schedule,,,,,,,,,,,,,,,18.86814,135.342,
PTH - RELATED PEPTIDE,3011738,CDM,83519,CPT,301,RC,inpatient,,,,218.772,120.3246,,196.8948,90,percent of total billed charges,,,,218.772,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,18.8784,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,196.8948,90,percent of total billed charges,,,,207.8334,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.87,218.772,
PROTEIN TOTAL,3011750,CDM,84155,CPT,301,RC,inpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,4.1838,,,fee schedule,,,4.1838,,,fee schedule,,,3.76542,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,,,,,,,5.23,,,fee schedule,,,5.23,,,fee schedule,,,,,,,,,,,,,,,3.76542,49.234,
PROTEIN TOTAL FLUID,3011760,CDM,84157,CPT,301,RC,inpatient,,,,169.95,93.4725,,152.955,90,percent of total billed charges,,,,169.95,100,percent of total billed charges,,,4.56,,,fee schedule,,,4.56,,,fee schedule,,,4.104,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,152.955,90,percent of total billed charges,,,,161.4525,95,percent of total billed charges,,,,,,,,,5.25,,,fee schedule,,,5.25,,,fee schedule,,,,,,,,,,,,,,,4.104,169.95,
RENIN,3011790,CDM,84244,CPT,301,RC,inpatient,,,,163.358,89.8469,,147.0222,90,percent of total billed charges,,,,163.358,100,percent of total billed charges,,,25.0686,,,fee schedule,,,25.0686,,,fee schedule,,,22.56174,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.0222,90,percent of total billed charges,,,,155.1901,95,percent of total billed charges,,,,,,,,,31.41,,,fee schedule,,,31.41,,,fee schedule,,,,,,,,,,,,,,,22.56174,163.358,
REVERSE T3,3011800,CDM,84482,CPT,301,RC,inpatient,,,,345.153,189.83415,,310.6377,90,percent of total billed charges,,,,345.153,100,percent of total billed charges,,,17.9664,,,fee schedule,,,17.9664,,,fee schedule,,,16.16976,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,310.6377,90,percent of total billed charges,,,,327.89535,95,percent of total billed charges,,,,,,,,,22.51,,,fee schedule,,,22.51,,,fee schedule,,,,,,,,,,,,,,,16.16976,345.153,
RED CELL FOLATE,3011815,CDM,82747,CPT,301,RC,inpatient,,,,153.573,84.46515,,138.2157,90,percent of total billed charges,,,,153.573,100,percent of total billed charges,,,20.121,,,fee schedule,,,20.121,,,fee schedule,,,18.1089,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,138.2157,90,percent of total billed charges,,,,145.89435,95,percent of total billed charges,,,,,,,,,24.73,,,fee schedule,,,24.73,,,fee schedule,,,,,,,,,,,,,,,18.1089,153.573,
SERUM ACETONE,3011840,CDM,82009,CPT,301,RC,inpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,5.1528,,,fee schedule,,,5.1528,,,fee schedule,,,4.63752,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,,,,,,,6.46,,,fee schedule,,,6.46,,,fee schedule,,,,,,,,,,,,,,,4.63752,49.234,
SGOT,3011850,CDM,84450,CPT,301,RC,inpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,,,,,,,7.38,,,fee schedule,,,7.38,,,fee schedule,,,,,,,,,,,,,,,5.31468,55.517,
SGPT,3011860,CDM,84460,CPT,301,RC,inpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,6.042,,,fee schedule,,,6.042,,,fee schedule,,,5.4378,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,,,,,,,7.56,,,fee schedule,,,7.56,,,fee schedule,,,,,,,,,,,,,,,5.4378,49.234,
ACETYLCHOLINE RECEPTOR BLOC AB,3011983,CDM,83519,CPT,301,RC,inpatient,,,,364.826,200.6543,,328.3434,90,percent of total billed charges,,,,364.826,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,18.8784,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.3434,90,percent of total billed charges,,,,346.5847,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.87,364.826,
SODIUM,3012080,CDM,84295,CPT,301,RC,inpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,5.4834,,,fee schedule,,,5.4834,,,fee schedule,,,4.93506,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,,,,,,,6.87,,,fee schedule,,,6.87,,,fee schedule,,,,,,,,,,,,,,,4.93506,55.517,
SODIUM URINE,3012090,CDM,84300,CPT,301,RC,inpatient,,,,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,5.7684,,,fee schedule,,,5.7684,,,fee schedule,,,5.19156,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.6397,90,percent of total billed charges,,,,59.78635,95,percent of total billed charges,,,,,,,,,6.94,,,fee schedule,,,6.94,,,fee schedule,,,,,,,,,,,,,,,5.19156,62.933,
AFP & AFP - L3,3012107,CDM,82107,CPT,301,RC,inpatient,,,,238.754,131.3147,,214.8786,90,percent of total billed charges,,,,238.754,100,percent of total billed charges,,,73.4274,,,fee schedule,,,73.4274,,,fee schedule,,,66.08466,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,214.8786,90,percent of total billed charges,,,,226.8163,95,percent of total billed charges,,,,,,,,,92.99,,,fee schedule,,,92.99,,,fee schedule,,,,,,,,,,,,,,,66.08466,238.754,
STONE ASSAY R/L,3012110,CDM,82365,CPT,301,RC,inpatient,,,,111.755,61.46525,,100.5795,90,percent of total billed charges,,,,111.755,100,percent of total billed charges,,,14.706,,,fee schedule,,,14.706,,,fee schedule,,,13.2354,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,100.5795,90,percent of total billed charges,,,,106.16725,95,percent of total billed charges,,,,,,,,,18.41,,,fee schedule,,,18.41,,,fee schedule,,,,,,,,,,,,,,,13.2354,111.755,
T PROTEIN URINE,3012130,CDM,84156,CPT,301,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,4.1838,,,fee schedule,,,4.1838,,,fee schedule,,,3.76542,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,,,,,,,5.25,,,fee schedule,,,5.25,,,fee schedule,,,,,,,,,,,,,,,3.76542,75.19,
TESTOSTERONE R/L,3012140,CDM,84403,CPT,301,RC,inpatient,,,,181.795,99.98725,,163.6155,90,percent of total billed charges,,,,181.795,100,percent of total billed charges,,,29.4234,,,fee schedule,,,29.4234,,,fee schedule,,,26.48106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,163.6155,90,percent of total billed charges,,,,172.70525,95,percent of total billed charges,,,,,,,,,36.87,,,fee schedule,,,36.87,,,fee schedule,,,,,,,,,,,,,,,26.48106,181.795,
THIAMINE,3012160,CDM,84425,CPT,301,RC,inpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,24.2022,,,fee schedule,,,24.2022,,,fee schedule,,,21.78198,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,192.3525,90,percent of total billed charges,,,,203.03875,95,percent of total billed charges,,,,,,,,,30.33,,,fee schedule,,,30.33,,,fee schedule,,,,,,,,,,,,,,,21.78198,213.725,
THYROXINE BINDING GLOBULIN,3012183,CDM,84442,CPT,301,RC,inpatient,,,,177.057,97.38135,,159.3513,90,percent of total billed charges,,,,177.057,100,percent of total billed charges,,,16.8492,,,fee schedule,,,16.8492,,,fee schedule,,,15.16428,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,159.3513,90,percent of total billed charges,,,,168.20415,95,percent of total billed charges,,,,,,,,,21.12,,,fee schedule,,,21.12,,,fee schedule,,,,,,,,,,,,,,,15.16428,177.057,
THYROGLOBULIN LEVEL,3012185,CDM,84432,CPT,301,RC,inpatient,,,,99.601,54.78055,,89.6409,90,percent of total billed charges,,,,99.601,100,percent of total billed charges,,,18.3084,,,fee schedule,,,18.3084,,,fee schedule,,,16.47756,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.6409,90,percent of total billed charges,,,,94.62095,95,percent of total billed charges,,,,,,,,,22.94,,,fee schedule,,,22.94,,,fee schedule,,,,,,,,,,,,,,,16.47756,99.601,
THYROID STIMLATING (TSH),3012220,CDM,84443,CPT,301,RC,inpatient,,,,107.017,58.85935,,96.3153,90,percent of total billed charges,,,,107.017,100,percent of total billed charges,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,17.2368,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.3153,90,percent of total billed charges,,,,101.66615,95,percent of total billed charges,,,,,,,,,23.98,,,fee schedule,,,23.98,,,fee schedule,,,,,,,,,,,,,,,17.2368,107.017,
TISSUE TRANSGLUTAMINASE IGA A,3012223,CDM,83516,CPT,301,RC,inpatient,,,,191.683,105.42565,,172.5147,90,percent of total billed charges,,,,191.683,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,11.82978,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,172.5147,90,percent of total billed charges,,,,182.09885,95,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,16.48,,,fee schedule,,,,,,,,,,,,,,,11.82978,191.683,
TOPAMAX,3012245,CDM,80201,CPT,301,RC,inpatient,,,,138.947,76.42085,,125.0523,90,percent of total billed charges,,,,138.947,100,percent of total billed charges,,,13.5888,,,fee schedule,,,13.5888,,,fee schedule,,,12.22992,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.0523,90,percent of total billed charges,,,,131.99965,95,percent of total billed charges,,,,,,,,,17.03,,,fee schedule,,,17.03,,,fee schedule,,,,,,,,,,,,,,,12.22992,138.947,
TRANSFERRIN,3012250,CDM,84466,CPT,301,RC,inpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,14.5464,,,fee schedule,,,14.5464,,,fee schedule,,,13.09176,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.5285,90,percent of total billed charges,,,,93.44675,95,percent of total billed charges,,,,,,,,,18.24,,,fee schedule,,,18.24,,,fee schedule,,,,,,,,,,,,,,,13.09176,98.365,
TRIGLYCERIDES,3012270,CDM,84478,CPT,301,RC,inpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,6.5436,,,fee schedule,,,6.5436,,,fee schedule,,,5.88924,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.8842,90,percent of total billed charges,,,,63.2111,95,percent of total billed charges,,,,,,,,,8.22,,,fee schedule,,,8.22,,,fee schedule,,,,,,,,,,,,,,,5.88924,66.538,
T3 RIA,3012310,CDM,84480,CPT,301,RC,inpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,16.1652,,,fee schedule,,,16.1652,,,fee schedule,,,14.54868,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.4787,90,percent of total billed charges,,,,115.56085,95,percent of total billed charges,,,,,,,,,20.25,,,fee schedule,,,20.25,,,fee schedule,,,,,,,,,,,,,,,14.54868,121.643,
T4,3012320,CDM,84436,CPT,301,RC,inpatient,,,,70.04,38.522,,63.036,90,percent of total billed charges,,,,70.04,100,percent of total billed charges,,,7.8318,,,fee schedule,,,7.8318,,,fee schedule,,,7.04862,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.036,90,percent of total billed charges,,,,66.538,95,percent of total billed charges,,,,,,,,,8.9,,,fee schedule,,,8.9,,,fee schedule,,,,,,,,,,,,,,,7.04862,70.04,
UREA NITROGEN URINE,3012340,CDM,84540,CPT,301,RC,inpatient,,,,64.169,35.29295,,57.7521,90,percent of total billed charges,,,,64.169,100,percent of total billed charges,,,6.3384,,,fee schedule,,,6.3384,,,fee schedule,,,5.70456,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.7521,90,percent of total billed charges,,,,60.96055,95,percent of total billed charges,,,,,,,,,6.78,,,fee schedule,,,6.78,,,fee schedule,,,,,,,,,,,,,,,5.70456,64.169,
URIC ACID,3012350,CDM,84550,CPT,301,RC,inpatient,,,,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,5.1528,,,fee schedule,,,5.1528,,,fee schedule,,,4.63752,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.0974,90,percent of total billed charges,,,,54.9917,95,percent of total billed charges,,,,,,,,,6.46,,,fee schedule,,,6.46,,,fee schedule,,,,,,,,,,,,,,,4.63752,57.886,
VITAMIN D 25-HYDROXY,3012385,CDM,82306,CPT,301,RC,inpatient,,,,220.008,121.0044,,198.0072,90,percent of total billed charges,,,,220.008,100,percent of total billed charges,,,33.744,,,fee schedule,,,33.744,,,fee schedule,,,30.3696,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.0072,90,percent of total billed charges,,,,209.0076,95,percent of total billed charges,,,,,,,,,42.27,,,fee schedule,,,42.27,,,fee schedule,,,,,,,,,,,,,,,30.3696,220.008,
"VITAMIN D 1,25 DIHYDROXY",3012389,CDM,82652,CPT,301,RC,inpatient,,,,405.305,222.91775,,364.7745,90,percent of total billed charges,,,,405.305,100,percent of total billed charges,,,43.89,,,fee schedule,,,43.89,,,fee schedule,,,39.501,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,364.7745,90,percent of total billed charges,,,,385.03975,95,percent of total billed charges,,,,,,,,,54.96,,,fee schedule,,,54.96,,,fee schedule,,,,,,,,,,,,,,,39.501,405.305,
CHLORIDE RANDOM URINE,3012436,CDM,82436,CPT,301,RC,inpatient,,,,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,6.555,,,fee schedule,,,6.555,,,fee schedule,,,5.8995,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.6397,90,percent of total billed charges,,,,59.78635,95,percent of total billed charges,,,,,,,,,7.18,,,fee schedule,,,7.18,,,fee schedule,,,,,,,,,,,,,,,5.8995,62.933,
THIOPURINE METHYL TRANSFERASE,3012542,CDM,83789,CPT,301,RC,inpatient,,,,402.936,221.6148,,362.6424,90,percent of total billed charges,,,,402.936,100,percent of total billed charges,,,27.4854,,,fee schedule,,,27.4854,,,fee schedule,,,24.73686,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,362.6424,90,percent of total billed charges,,,,382.7892,95,percent of total billed charges,,,,,,,,,25.79,,,fee schedule,,,25.79,,,fee schedule,,,,,,,,,,,,,,,24.73686,402.936,
ESTROGENS FRACTION,3012650,CDM,82671,CPT,301,RC,inpatient,,,,515.927,283.75985,,464.3343,90,percent of total billed charges,,,,515.927,100,percent of total billed charges,,,36.822,,,fee schedule,,,36.822,,,fee schedule,,,33.1398,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,464.3343,90,percent of total billed charges,,,,490.13065,95,percent of total billed charges,,,,,,,,,34.28,,,fee schedule,,,34.28,,,fee schedule,,,,,,,,,,,,,,,33.1398,515.927,
PH BODY FLUID,3012670,CDM,83986,CPT,301,RC,inpatient,,,,37.904,20.8472,,34.1136,90,percent of total billed charges,,,,37.904,100,percent of total billed charges,,,4.0812,,,fee schedule,,,4.0812,,,fee schedule,,,3.67308,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.1136,90,percent of total billed charges,,,,36.0088,95,percent of total billed charges,,,,,,,,,5.12,,,fee schedule,,,5.12,,,fee schedule,,,,,,,,,,,,,,,3.67308,37.904,
BASIC METABOLIC PANEL,3012700,CDM,80048,CPT,301,RC,inpatient,,,,391.709,215.43995,,352.5381,90,percent of total billed charges,,,,391.709,100,percent of total billed charges,,,9.6444,,,fee schedule,,,9.6444,,,fee schedule,,,8.67996,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,352.5381,90,percent of total billed charges,,,,372.12355,95,percent of total billed charges,,,,,,,,,12.09,,,fee schedule,,,12.09,,,fee schedule,,,,,,,,,,,,,,,8.67996,391.709,
COMPREHENSIVE METABOLIC PANEL,3012710,CDM,80053,CPT,301,RC,inpatient,,,,745.926,410.2593,,671.3334,90,percent of total billed charges,,,,745.926,100,percent of total billed charges,,,12.0384,,,fee schedule,,,12.0384,,,fee schedule,,,10.83456,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,671.3334,90,percent of total billed charges,,,,708.6297,95,percent of total billed charges,,,,,,,,,15.1,,,fee schedule,,,15.1,,,fee schedule,,,,,,,,,,,,,,,10.83456,745.926,
ACTH,3012720,CDM,82024,CPT,301,RC,inpatient,,,,323.111,177.71105,,290.7999,90,percent of total billed charges,,,,323.111,100,percent of total billed charges,,,44.0268,,,fee schedule,,,44.0268,,,fee schedule,,,39.62412,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,290.7999,90,percent of total billed charges,,,,306.95545,95,percent of total billed charges,,,,,,,,,23.66,,,fee schedule,,,23.66,,,fee schedule,,,,,,,,,,,,,,,23.66,323.111,
ALDOSTERONE,3012790,CDM,82088,CPT,301,RC,inpatient,,,,372.242,204.7331,,335.0178,90,percent of total billed charges,,,,372.242,100,percent of total billed charges,,,46.455,,,fee schedule,,,46.455,,,fee schedule,,,41.8095,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,335.0178,90,percent of total billed charges,,,,353.6299,95,percent of total billed charges,,,,,,,,,58.2,,,fee schedule,,,58.2,,,fee schedule,,,,,,,,,,,,,,,41.8095,372.242,
NICOTINE ALKALOIDS NOS URINE,3012800,CDM,80323,CPT,301,RC,inpatient,,,,155.015,85.25825,,139.5135,90,percent of total billed charges,,,,155.015,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,139.5135,90,percent of total billed charges,,,,147.26425,95,percent of total billed charges,,,,,,,,,45.59,,,fee schedule,,,45.59,,,fee schedule,,,,,,,,,,,,,,,45.59,155.015,
TESTOSTERONE-FREE,3012870,CDM,84402,CPT,301,RC,inpatient,,,,273.877,150.63235,,246.4893,90,percent of total billed charges,,,,273.877,100,percent of total billed charges,,,29.0358,,,fee schedule,,,29.0358,,,fee schedule,,,26.13222,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,246.4893,90,percent of total billed charges,,,,260.18315,95,percent of total billed charges,,,,,,,,,36.36,,,fee schedule,,,36.36,,,fee schedule,,,,,,,,,,,,,,,26.13222,273.877,
ZINC LEVEL,3012880,CDM,84630,CPT,301,RC,inpatient,,,,87.344,48.0392,,78.6096,90,percent of total billed charges,,,,87.344,100,percent of total billed charges,,,12.9846,,,fee schedule,,,12.9846,,,fee schedule,,,11.68614,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,78.6096,90,percent of total billed charges,,,,82.9768,95,percent of total billed charges,,,,,,,,,16.26,,,fee schedule,,,16.26,,,fee schedule,,,,,,,,,,,,,,,11.68614,87.344,
ELECTROPHORESIS/URINE PROTEIN,3012900,CDM,84166,CPT,301,RC,inpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,20.3262,,,fee schedule,,,20.3262,,,fee schedule,,,18.29358,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.1484,90,percent of total billed charges,,,,67.7122,95,percent of total billed charges,,,,,,,,,27.75,,,fee schedule,,,27.75,,,fee schedule,,,,,,,,,,,,,,,18.29358,71.276,
"OCCULT BLOOD, GASTRIC",3012915,CDM,82271,CPT,301,RC,inpatient,,,,73.336,40.3348,,66.0024,90,percent of total billed charges,,,,73.336,100,percent of total billed charges,,,6.0648,,,fee schedule,,,6.0648,,,fee schedule,,,5.45832,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.0024,90,percent of total billed charges,,,,69.6692,95,percent of total billed charges,,,,,,,,,4.69,,,fee schedule,,,4.69,,,fee schedule,,,,,,,,,,,,,,,4.69,73.336,
MICROALBUMIN,3012920,CDM,82043,CPT,301,RC,inpatient,,,,76.323,41.97765,,68.6907,90,percent of total billed charges,,,,76.323,100,percent of total billed charges,,,6.5892,,,fee schedule,,,6.5892,,,fee schedule,,,5.93028,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,68.6907,90,percent of total billed charges,,,,72.50685,95,percent of total billed charges,,,,,,,,,8.27,,,fee schedule,,,8.27,,,fee schedule,,,,,,,,,,,,,,,5.93028,76.323,
LEAD BLOOD LEVEL,3012940,CDM,83655,CPT,301,RC,inpatient,,,,68.598,37.7289,,61.7382,90,percent of total billed charges,,,,68.598,100,percent of total billed charges,,,13.8054,,,fee schedule,,,13.8054,,,fee schedule,,,12.42486,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.7382,90,percent of total billed charges,,,,65.1681,95,percent of total billed charges,,,,,,,,,17.28,,,fee schedule,,,17.28,,,fee schedule,,,,,,,,,,,,,,,12.42486,68.598,
"CRYOGLOBULINS, QUALITATIVE",3012950,CDM,82595,CPT,301,RC,inpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,6.63822,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.2295,90,percent of total billed charges,,,,57.24225,95,percent of total billed charges,,,,,,,,,9.25,,,fee schedule,,,9.25,,,fee schedule,,,,,,,,,,,,,,,6.63822,60.255,
PSA - FREE,3012970,CDM,84154,CPT,301,RC,inpatient,,,,190.447,104.74585,,171.4023,90,percent of total billed charges,,,,190.447,100,percent of total billed charges,,,20.9646,,,fee schedule,,,20.9646,,,fee schedule,,,18.86814,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.4023,90,percent of total billed charges,,,,180.92465,95,percent of total billed charges,,,,,,,,,26.27,,,fee schedule,,,26.27,,,fee schedule,,,,,,,,,,,,,,,18.86814,190.447,
TRYPTASE,3012995,CDM,83520,CPT,301,RC,inpatient,,,,178.293,98.06115,,160.4637,90,percent of total billed charges,,,,178.293,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,160.4637,90,percent of total billed charges,,,,169.37835,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,17.71902,178.293,
HOMOCYSTEINE,3013010,CDM,83090,CPT,301,RC,inpatient,,,,331.763,182.46965,,298.5867,90,percent of total billed charges,,,,331.763,100,percent of total billed charges,,,20.4288,,,fee schedule,,,20.4288,,,fee schedule,,,18.38592,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.5867,90,percent of total billed charges,,,,315.17485,95,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,24.09,,,fee schedule,,,,,,,,,,,,,,,18.38592,331.763,
HEMOGLOBIN FRACTIONATION,3013021,CDM,83021,CPT,301,RC,inpatient,,,,25.338,13.9359,,22.8042,90,percent of total billed charges,,,,25.338,100,percent of total billed charges,,,20.5884,,,fee schedule,,,20.5884,,,fee schedule,,,18.52956,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.8042,90,percent of total billed charges,,,,24.0711,95,percent of total billed charges,,,,,,,,,25.79,,,fee schedule,,,25.79,,,fee schedule,,,,,,,,,,,,,,,18.52956,25.79,
IRT FOR CF,3013022,CDM,83520,CPT,301,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,13.4415,19.6878,
AMINO ACIDS (6 OR MORE) QUANT,3013023,CDM,82139,CPT,301,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,17.30862,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,24.09,,,fee schedule,,,,,,,,,,,,,,,13.4415,24.09,
CARNITINE (TOTAL & FREE) QUANT,3013024,CDM,82379,CPT,301,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,17.30862,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,24.09,,,fee schedule,,,,,,,,,,,,,,,13.4415,24.09,
"ACYLCARNITINES, QUANTATIVE",3013025,CDM,82017,CPT,301,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,17.30862,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,24.09,,,fee schedule,,,,,,,,,,,,,,,13.4415,24.09,
TSH - NEONATAL SCREEN,3013026,CDM,84443,CPT,301,RC,inpatient,,,,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,17.2368,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.3094,90,percent of total billed charges,,,,11.9377,95,percent of total billed charges,,,,,,,,,23.98,,,fee schedule,,,23.98,,,fee schedule,,,,,,,,,,,,,,,11.3094,23.98,
TOTAL THYROXINE (ELUTION),3013027,CDM,84437,CPT,301,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,6.63822,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,9.25,,,fee schedule,,,9.25,,,fee schedule,,,,,,,,,,,,,,,6.63822,14.935,
GALACTOSE 1 PHOSPHATE URIDYL,3013028,CDM,82775,CPT,301,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,24.0198,,,fee schedule,,,24.0198,,,fee schedule,,,21.61782,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,30.08,,,fee schedule,,,30.08,,,fee schedule,,,,,,,,,,,,,,,13.4415,30.08,
17 ALPHA HYDROXYPROGESTERONE,3013029,CDM,83498,CPT,301,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,30.9738,,,fee schedule,,,30.9738,,,fee schedule,,,27.87642,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,38.79,,,fee schedule,,,38.79,,,fee schedule,,,,,,,,,,,,,,,13.4415,38.79,
BIOTINIDASE,3013030,CDM,82261,CPT,301,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,17.30862,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,24.09,,,fee schedule,,,,,,,,,,,,,,,13.4415,24.09,
GLUTAMIC ACID DECARBOXYLASE,3013519,CDM,83519,CPT,301,RC,inpatient,,,,264.092,145.2506,,237.6828,90,percent of total billed charges,,,,264.092,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,18.8784,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,237.6828,90,percent of total billed charges,,,,250.8874,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.87,264.092,
RA - IGA,3013523,CDM,83520,CPT,301,RC,inpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,90,percent of total billed charges,,,,34.0518,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,17.71902,35.844,
RA - IGG,3013524,CDM,83520,CPT,301,RC,inpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,90,percent of total billed charges,,,,34.0518,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,17.71902,35.844,
RA - IGM,3013525,CDM,83520,CPT,301,RC,inpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,90,percent of total billed charges,,,,34.0518,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,17.71902,35.844,
"METANEPHRINES, PLASMA FREE",3013835,CDM,83835,CPT,301,RC,inpatient,,,,427.347,235.04085,,384.6123,90,percent of total billed charges,,,,427.347,100,percent of total billed charges,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,17.38044,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,384.6123,90,percent of total billed charges,,,,405.97965,95,percent of total billed charges,,,,,,,,,21.51,,,fee schedule,,,21.51,,,fee schedule,,,,,,,,,,,,,,,17.38044,427.347,
AMH - FEMALE,3013856,CDM,83520,CPT,301,RC,inpatient,,,,181.074,99.5907,,162.9666,90,percent of total billed charges,,,,181.074,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,162.9666,90,percent of total billed charges,,,,172.0203,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,17.71902,181.074,
ALPHA 1 ANTITRYPSIN PHENOTYPE,3013952,CDM,82104,CPT,301,RC,inpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,16.4844,,,fee schedule,,,16.4844,,,fee schedule,,,14.83596,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,161.0199,90,percent of total billed charges,,,,169.96545,95,percent of total billed charges,,,,,,,,,20.65,,,fee schedule,,,20.65,,,fee schedule,,,,,,,,,,,,,,,14.83596,178.911,
"MYELIN BASIC PROTEIN, CSF",3014030,CDM,83873,CPT,301,RC,inpatient,,,,205.382,112.9601,,184.8438,90,percent of total billed charges,,,,205.382,100,percent of total billed charges,,,19.608,,,fee schedule,,,19.608,,,fee schedule,,,17.6472,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,184.8438,90,percent of total billed charges,,,,195.1129,95,percent of total billed charges,,,,,,,,,24.57,,,fee schedule,,,24.57,,,fee schedule,,,,,,,,,,,,,,,17.6472,205.382,
OLIGOCLONAL IMMUNOGLOBIN,3014040,CDM,83916,CPT,301,RC,inpatient,,,,200.335,110.18425,,180.3015,90,percent of total billed charges,,,,200.335,100,percent of total billed charges,,,31.2246,,,fee schedule,,,31.2246,,,fee schedule,,,28.10214,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,180.3015,90,percent of total billed charges,,,,190.31825,95,percent of total billed charges,,,,,,,,,28.72,,,fee schedule,,,28.72,,,fee schedule,,,,,,,,,,,,,,,28.10214,200.335,
IGG SYNTHESIS RATE,3014050,CDM,82784,CPT,301,RC,inpatient,,,,229.793,126.38615,,206.8137,90,percent of total billed charges,,,,229.793,100,percent of total billed charges,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,9.5418,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,206.8137,90,percent of total billed charges,,,,218.30335,95,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,8.24,,,fee schedule,,,,,,,,,,,,,,,8.24,229.793,
"IMMUNOGLOBIN E, TOTAL",3014060,CDM,82785,CPT,301,RC,inpatient,,,,178.293,98.06115,,160.4637,90,percent of total billed charges,,,,178.293,100,percent of total billed charges,,,18.7644,,,fee schedule,,,18.7644,,,fee schedule,,,16.88796,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,160.4637,90,percent of total billed charges,,,,169.37835,95,percent of total billed charges,,,,,,,,,23.13,,,fee schedule,,,23.13,,,fee schedule,,,,,,,,,,,,,,,16.88796,178.293,
MYOGLOBIN-SERUM,3014070,CDM,83874,CPT,301,RC,inpatient,,,,79.928,43.9604,,71.9352,90,percent of total billed charges,,,,79.928,100,percent of total billed charges,,,14.7288,,,fee schedule,,,14.7288,,,fee schedule,,,13.25592,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,71.9352,90,percent of total billed charges,,,,75.9316,95,percent of total billed charges,,,,,,,,,18.43,,,fee schedule,,,18.43,,,fee schedule,,,,,,,,,,,,,,,13.25592,79.928,
GTT - EACH ADDL SPECIMEN,3014100,CDM,82952,CPT,301,RC,inpatient,,,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,4.4688,,,fee schedule,,,4.4688,,,fee schedule,,,4.02192,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.0151,90,percent of total billed charges,,,,30.62705,95,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,5.6,,,fee schedule,,,,,,,,,,,,,,,4.02192,32.239,
GTT - 1ST 3 SPECIMENS,3014110,CDM,82951,CPT,301,RC,inpatient,,,,137.711,75.74105,,123.9399,90,percent of total billed charges,,,,137.711,100,percent of total billed charges,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,13.20462,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,123.9399,90,percent of total billed charges,,,,130.82545,95,percent of total billed charges,,,,,,,,,18.39,,,fee schedule,,,18.39,,,fee schedule,,,,,,,,,,,,,,,13.20462,137.711,
GTT - 5TH SPECIMEN,3014130,CDM,82952,CPT,301,RC,inpatient,,,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,4.4688,,,fee schedule,,,4.4688,,,fee schedule,,,4.02192,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.0151,90,percent of total billed charges,,,,30.62705,95,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,5.6,,,fee schedule,,,,,,,,,,,,,,,4.02192,32.239,
PROCALCITONIN (PCT),3014310,CDM,84145,CPT,301,RC,inpatient,,,,409.013,224.95715,,368.1117,90,percent of total billed charges,,,,409.013,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,368.1117,90,percent of total billed charges,,,,388.56235,95,percent of total billed charges,,,,,,,,,28.69,,,fee schedule,,,28.69,,,fee schedule,,,,,,,,,,,,,,,28.69,409.013,
VITAMIN E (TOCOPHEROL),3014446,CDM,84446,CPT,301,RC,inpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,16.1652,,,fee schedule,,,16.1652,,,fee schedule,,,14.54868,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.8842,90,percent of total billed charges,,,,63.2111,95,percent of total billed charges,,,,,,,,,20.25,,,fee schedule,,,20.25,,,fee schedule,,,,,,,,,,,,,,,14.54868,66.538,
ACETYLCHOLINE RECEPTOR MOD AB,3015198,CDM,83519,CPT,301,RC,inpatient,,,,364.826,200.6543,,328.3434,90,percent of total billed charges,,,,364.826,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,18.8784,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.3434,90,percent of total billed charges,,,,346.5847,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.87,364.826,
"PANCREATIC ELASTASE, FECAL",3015208,CDM,83789,CPT,301,RC,inpatient,,,,361.221,198.67155,,325.0989,90,percent of total billed charges,,,,361.221,100,percent of total billed charges,,,27.4854,,,fee schedule,,,27.4854,,,fee schedule,,,24.73686,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.0989,90,percent of total billed charges,,,,343.15995,95,percent of total billed charges,,,,,,,,,25.79,,,fee schedule,,,25.79,,,fee schedule,,,,,,,,,,,,,,,24.73686,361.221,
HEPATIC PANEL,3015500,CDM,80076,CPT,301,RC,inpatient,,,,211.665,116.41575,,190.4985,90,percent of total billed charges,,,,211.665,100,percent of total billed charges,,,9.3138,,,fee schedule,,,9.3138,,,fee schedule,,,8.38242,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,190.4985,90,percent of total billed charges,,,,201.08175,95,percent of total billed charges,,,,,,,,,11.67,,,fee schedule,,,11.67,,,fee schedule,,,,,,,,,,,,,,,8.38242,211.665,
CENTROMERE B ANTIBODY,3016153,CDM,83516,CPT,301,RC,inpatient,,,,41.818,22.9999,,37.6362,90,percent of total billed charges,,,,41.818,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,11.82978,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.6362,90,percent of total billed charges,,,,39.7271,95,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,16.48,,,fee schedule,,,,,,,,,,,,,,,11.82978,41.818,
RIBOSOMAL P ANTIBODY,3016154,CDM,83516,CPT,301,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,11.82978,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,16.48,,,fee schedule,,,,,,,,,,,,,,,11.82978,119.274,
RENAL FUNCTION PANEL,3016550,CDM,80069,CPT,301,RC,inpatient,,,,164.285,90.35675,,147.8565,90,percent of total billed charges,,,,164.285,100,percent of total billed charges,,,9.8952,,,fee schedule,,,9.8952,,,fee schedule,,,8.90568,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.8565,90,percent of total billed charges,,,,156.07075,95,percent of total billed charges,,,,,,,,,12.4,,,fee schedule,,,12.4,,,fee schedule,,,,,,,,,,,,,,,8.90568,164.285,
ACYLCARNITINE,3018201,CDM,82017,CPT,301,RC,inpatient,,,,238.445,131.14475,,214.6005,90,percent of total billed charges,,,,238.445,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,17.30862,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,214.6005,90,percent of total billed charges,,,,226.52275,95,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,24.09,,,fee schedule,,,,,,,,,,,,,,,17.30862,238.445,
"ARSENIC, BLOOD",3018217,CDM,82175,CPT,301,RC,inpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,21.6258,,,fee schedule,,,21.6258,,,fee schedule,,,19.46322,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,192.3525,90,percent of total billed charges,,,,203.03875,95,percent of total billed charges,,,,,,,,,27.09,,,fee schedule,,,27.09,,,fee schedule,,,,,,,,,,,,,,,19.46322,213.725,
VITAMIN C (ASCORBIC ACID),3018218,CDM,82180,CPT,301,RC,inpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,11.2746,,,fee schedule,,,11.2746,,,fee schedule,,,10.14714,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.3767,90,percent of total billed charges,,,,90.11985,95,percent of total billed charges,,,,,,,,,14.12,,,fee schedule,,,14.12,,,fee schedule,,,,,,,,,,,,,,,10.14714,94.863,
ADH NEWBORN SCREENING,3018226,CDM,,,301,RC,inpatient,,,,144.303,79.36665,,129.8727,90,percent of total billed charges,,,,144.303,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,129.8727,90,percent of total billed charges,,,,137.08785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,129.8727,144.303,
CHLORIDE - 24 Hr URINE,3018243,CDM,82436,CPT,301,RC,inpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,6.555,,,fee schedule,,,6.555,,,fee schedule,,,5.8995,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.1484,90,percent of total billed charges,,,,67.7122,95,percent of total billed charges,,,,,,,,,7.18,,,fee schedule,,,7.18,,,fee schedule,,,,,,,,,,,,,,,5.8995,71.276,
COPPER - SERUM,3018252,CDM,82525,CPT,301,RC,inpatient,,,,130.295,71.66225,,117.2655,90,percent of total billed charges,,,,130.295,100,percent of total billed charges,,,14.1474,,,fee schedule,,,14.1474,,,fee schedule,,,12.73266,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,117.2655,90,percent of total billed charges,,,,123.78025,95,percent of total billed charges,,,,,,,,,17.72,,,fee schedule,,,17.72,,,fee schedule,,,,,,,,,,,,,,,12.73266,130.295,
COPPER - URINE 24 HR,3018253,CDM,82525,CPT,301,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,14.1474,,,fee schedule,,,14.1474,,,fee schedule,,,12.73266,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,17.72,,,fee schedule,,,17.72,,,fee schedule,,,,,,,,,,,,,,,12.73266,119.274,
FETAL FIBRONECTIN,3018273,CDM,82731,CPT,301,RC,inpatient,,,,335.265,184.39575,,301.7385,90,percent of total billed charges,,,,335.265,100,percent of total billed charges,,,73.4274,,,fee schedule,,,73.4274,,,fee schedule,,,66.08466,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,301.7385,90,percent of total billed charges,,,,318.50175,95,percent of total billed charges,,,,,,,,,91.98,,,fee schedule,,,91.98,,,fee schedule,,,,,,,,,,,,,,,66.08466,335.265,
VITAMIN K MEPHYTON,3018275,CDM,84597,CPT,301,RC,inpatient,,,,424.978,233.7379,,382.4802,90,percent of total billed charges,,,,424.978,100,percent of total billed charges,,,15.6408,,,fee schedule,,,15.6408,,,fee schedule,,,14.07672,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,382.4802,90,percent of total billed charges,,,,403.7291,95,percent of total billed charges,,,,,,,,,19.57,,,fee schedule,,,19.57,,,fee schedule,,,,,,,,,,,,,,,14.07672,424.978,
"IMMUNOGLOBULIN M,QUANTITATIVE",3018278,CDM,82784,CPT,301,RC,inpatient,,,,116.905,64.29775,,105.2145,90,percent of total billed charges,,,,116.905,100,percent of total billed charges,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,9.5418,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,105.2145,90,percent of total billed charges,,,,111.05975,95,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,8.24,,,fee schedule,,,,,,,,,,,,,,,8.24,116.905,
GESTATIONAL GLUCOSE 1 HR 50G,3018295,CDM,82950,CPT,301,RC,inpatient,,,,71.585,39.37175,,64.4265,90,percent of total billed charges,,,,71.585,100,percent of total billed charges,,,5.415,,,fee schedule,,,5.415,,,fee schedule,,,4.8735,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.4265,90,percent of total billed charges,,,,68.00575,95,percent of total billed charges,,,,,,,,,6.78,,,fee schedule,,,6.78,,,fee schedule,,,,,,,,,,,,,,,4.8735,71.585,
"HISTAMINE, PLASMA",3018308,CDM,83088,CPT,301,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,33.6642,,,fee schedule,,,33.6642,,,fee schedule,,,30.29778,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,39.86,,,fee schedule,,,39.86,,,fee schedule,,,,,,,,,,,,,,,30.29778,119.274,
TISSUE TRANSGLUTAMINASE AB IGG,3018351,CDM,83516,CPT,301,RC,inpatient,,,,191.683,105.42565,,172.5147,90,percent of total billed charges,,,,191.683,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,11.82978,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,172.5147,90,percent of total billed charges,,,,182.09885,95,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,16.48,,,fee schedule,,,,,,,,,,,,,,,11.82978,191.683,
INHIBIN B,3018352,CDM,83520,CPT,301,RC,inpatient,,,,313.223,172.27265,,281.9007,90,percent of total billed charges,,,,313.223,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,17.71902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,281.9007,90,percent of total billed charges,,,,297.56185,95,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,18.49,,,fee schedule,,,,,,,,,,,,,,,17.71902,313.223,
MAGNESIUM 24 HR URINE,3018373,CDM,83735,CPT,301,RC,inpatient,,,,62.624,34.4432,,56.3616,90,percent of total billed charges,,,,62.624,100,percent of total billed charges,,,7.638,,,fee schedule,,,7.638,,,fee schedule,,,6.8742,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.3616,90,percent of total billed charges,,,,59.4928,95,percent of total billed charges,,,,,,,,,9.57,,,fee schedule,,,9.57,,,fee schedule,,,,,,,,,,,,,,,6.8742,62.624,
"MERCURY, BLOOD",3018382,CDM,83825,CPT,301,RC,inpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,18.5364,,,fee schedule,,,18.5364,,,fee schedule,,,16.68276,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,192.3525,90,percent of total billed charges,,,,203.03875,95,percent of total billed charges,,,,,,,,,23.22,,,fee schedule,,,23.22,,,fee schedule,,,,,,,,,,,,,,,16.68276,213.725,
FREE LAMBDA LIGHT CHAIN,3018387,CDM,83883,CPT,301,RC,inpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,13.9536,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,161.0199,90,percent of total billed charges,,,,169.96545,95,percent of total billed charges,,,,,,,,,19.42,,,fee schedule,,,19.42,,,fee schedule,,,,,,,,,,,,,,,13.9536,178.911,
FREE KAPPA LIGHT CHAIN,3018388,CDM,83883,CPT,301,RC,inpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,13.9536,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,161.0199,90,percent of total billed charges,,,,169.96545,95,percent of total billed charges,,,,,,,,,19.42,,,fee schedule,,,19.42,,,fee schedule,,,,,,,,,,,,,,,13.9536,178.911,
"CALPROTECTIN, STOOL",3018399,CDM,83993,CPT,301,RC,inpatient,,,,214.652,118.0586,,193.1868,90,percent of total billed charges,,,,214.652,100,percent of total billed charges,,,22.3782,,,fee schedule,,,22.3782,,,fee schedule,,,20.14038,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,193.1868,90,percent of total billed charges,,,,203.9194,95,percent of total billed charges,,,,,,,,,28.33,,,fee schedule,,,28.33,,,fee schedule,,,,,,,,,,,,,,,20.14038,214.652,
PREGNENOLONE,3018414,CDM,84140,CPT,301,RC,inpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,23.5638,,,fee schedule,,,23.5638,,,fee schedule,,,21.20742,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,161.0199,90,percent of total billed charges,,,,169.96545,95,percent of total billed charges,,,,,,,,,29.53,,,fee schedule,,,29.53,,,fee schedule,,,,,,,,,,,,,,,21.20742,178.911,
PROTEIN / CSF ELECTROPHORESIS,3018415,CDM,84157,CPT,301,RC,inpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,4.56,,,fee schedule,,,4.56,,,fee schedule,,,4.104,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.1484,90,percent of total billed charges,,,,67.7122,95,percent of total billed charges,,,,,,,,,5.25,,,fee schedule,,,5.25,,,fee schedule,,,,,,,,,,,,,,,4.104,71.276,
ELECTROPHORESIS - PROTEIN CSF,3018416,CDM,84166,CPT,301,RC,inpatient,,,,282.529,155.39095,,254.2761,90,percent of total billed charges,,,,282.529,100,percent of total billed charges,,,20.3262,,,fee schedule,,,20.3262,,,fee schedule,,,18.29358,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,254.2761,90,percent of total billed charges,,,,268.40255,95,percent of total billed charges,,,,,,,,,27.75,,,fee schedule,,,27.75,,,fee schedule,,,,,,,,,,,,,,,18.29358,282.529,
SEROTONIN,3018426,CDM,84260,CPT,301,RC,inpatient,,,,238.445,131.14475,,214.6005,90,percent of total billed charges,,,,238.445,100,percent of total billed charges,,,35.3172,,,fee schedule,,,35.3172,,,fee schedule,,,31.78548,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,214.6005,90,percent of total billed charges,,,,226.52275,95,percent of total billed charges,,,,,,,,,44.24,,,fee schedule,,,44.24,,,fee schedule,,,,,,,,,,,,,,,31.78548,238.445,
SEX HORMONE BINDING GLOBULIN,3018427,CDM,84270,CPT,301,RC,inpatient,,,,145.23,79.8765,,130.707,90,percent of total billed charges,,,,145.23,100,percent of total billed charges,,,24.7722,,,fee schedule,,,24.7722,,,fee schedule,,,22.29498,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,130.707,90,percent of total billed charges,,,,137.9685,95,percent of total billed charges,,,,,,,,,31.03,,,fee schedule,,,31.03,,,fee schedule,,,,,,,,,,,,,,,22.29498,145.23,
TSI THYROID STIMULATING IMMUNO,3018444,CDM,84445,CPT,301,RC,inpatient,,,,364.826,200.6543,,328.3434,90,percent of total billed charges,,,,364.826,100,percent of total billed charges,,,57.9804,,,fee schedule,,,57.9804,,,fee schedule,,,52.18236,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.3434,90,percent of total billed charges,,,,346.5847,95,percent of total billed charges,,,,,,,,,72.62,,,fee schedule,,,72.62,,,fee schedule,,,,,,,,,,,,,,,52.18236,364.826,
ARGININE VASOPRESSIN ADH/AVP,3018458,CDM,84588,CPT,301,RC,inpatient,,,,143.067,78.68685,,128.7603,90,percent of total billed charges,,,,143.067,100,percent of total billed charges,,,38.6916,,,fee schedule,,,38.6916,,,fee schedule,,,34.82244,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.7603,90,percent of total billed charges,,,,135.91365,95,percent of total billed charges,,,,,,,,,48.47,,,fee schedule,,,48.47,,,fee schedule,,,,,,,,,,,,,,,34.82244,143.067,
VITAMIN A (RETINOL),3018459,CDM,84590,CPT,301,RC,inpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,13.2354,,,fee schedule,,,13.2354,,,fee schedule,,,11.91186,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.5899,90,percent of total billed charges,,,,81.90045,95,percent of total billed charges,,,,,,,,,15.26,,,fee schedule,,,15.26,,,fee schedule,,,,,,,,,,,,,,,11.91186,86.211,
ACETYLCHOLINE RECEPTOR BIND AB,3019835,CDM,83519,CPT,301,RC,inpatient,,,,364.826,200.6543,,328.3434,90,percent of total billed charges,,,,364.826,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,18.8784,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.3434,90,percent of total billed charges,,,,346.5847,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.87,364.826,
ALPHA-2-MACROGLOBULIN,3020020,CDM,83883,CPT,301,RC,inpatient,,,,221.141,121.62755,,199.0269,90,percent of total billed charges,,,,221.141,100,percent of total billed charges,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,13.9536,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,199.0269,90,percent of total billed charges,,,,210.08395,95,percent of total billed charges,,,,,,,,,19.42,,,fee schedule,,,19.42,,,fee schedule,,,,,,,,,,,,,,,13.9536,221.141,
CALCIUM IONIZED,3020200,CDM,82330,CPT,301,RC,inpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,15.5952,,,fee schedule,,,15.5952,,,fee schedule,,,14.03568,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.5285,90,percent of total billed charges,,,,93.44675,95,percent of total billed charges,,,,,,,,,18.87,,,fee schedule,,,18.87,,,fee schedule,,,,,,,,,,,,,,,14.03568,98.365,
CITRIC ACID-URINE,3070040,CDM,82507,CPT,301,RC,inpatient,,,,530.553,291.80415,,477.4977,90,percent of total billed charges,,,,530.553,100,percent of total billed charges,,,31.692,,,fee schedule,,,31.692,,,fee schedule,,,28.5228,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,477.4977,90,percent of total billed charges,,,,504.02535,95,percent of total billed charges,,,,,,,,,39.71,,,fee schedule,,,39.71,,,fee schedule,,,,,,,,,,,,,,,28.5228,530.553,
THYROID PEROXIDASE,3012210,CDM,86376,CPT,302,RC,inpatient,,,,99.601,54.78055,,89.6409,90,percent of total billed charges,,,,99.601,100,percent of total billed charges,,,16.587,,,fee schedule,,,16.587,,,fee schedule,,,14.9283,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.6409,90,percent of total billed charges,,,,94.62095,95,percent of total billed charges,,,,,,,,,20.78,,,fee schedule,,,20.78,,,fee schedule,,,,,,,,,,,,,,,14.9283,99.601,
RAST - PORK (f26) IgE,3012318,CDM,86003,CPT,302,RC,inpatient,,,,38.934,21.4137,,35.0406,90,percent of total billed charges,,,,38.934,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.0406,90,percent of total billed charges,,,,36.9873,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,38.934,
BLOOD TYPING SEROLOGIC ABO,3020000,CDM,86900,CPT,302,RC,inpatient,,,,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,119.6658,,,fee schedule,,,119.6658,,,fee schedule,,,107.69922,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.8529,90,percent of total billed charges,,,,51.56695,95,percent of total billed charges,,,,,,,,,4.26,,,fee schedule,,,4.26,,,fee schedule,,,,,,,,,,,,,,,4.26,119.6658,
RAST - ALMOND,3020012,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
ANTI SS-A/Ro ANTIBODY,3020015,CDM,86235,CPT,302,RC,inpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,18.39618,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.3767,90,percent of total billed charges,,,,90.11985,95,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,25.61,,,fee schedule,,,,,,,,,,,,,,,18.39618,94.863,
HAZELNUT ALLERGEN,3020027,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
SALMON ALLERGEN,3020028,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
TUNA ALLERGEN,3020029,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
MOUSE URINE PROTEIN ALLERGEN,3020031,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
ANTI-SS-B/La ANTIBODY,3020035,CDM,86235,CPT,302,RC,inpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,18.39618,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.3767,90,percent of total billed charges,,,,90.11985,95,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,25.61,,,fee schedule,,,,,,,,,,,,,,,18.39618,94.863,
ANA R/L,3020040,CDM,86038,CPT,302,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,13.7826,,,fee schedule,,,13.7826,,,fee schedule,,,12.40434,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,17.26,,,fee schedule,,,17.26,,,fee schedule,,,,,,,,,,,,,,,12.40434,119.274,
ANTI DNA ANTIBODY,3020050,CDM,86225,CPT,302,RC,inpatient,,,,97.232,53.4776,,87.5088,90,percent of total billed charges,,,,97.232,100,percent of total billed charges,,,15.6636,,,fee schedule,,,15.6636,,,fee schedule,,,14.09724,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.5088,90,percent of total billed charges,,,,92.3704,95,percent of total billed charges,,,,,,,,,19.62,,,fee schedule,,,19.62,,,fee schedule,,,,,,,,,,,,,,,14.09724,97.232,
ANTI SC1-70,3020055,CDM,86235,CPT,302,RC,inpatient,,,,195.597,107.57835,,176.0373,90,percent of total billed charges,,,,195.597,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,18.39618,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,176.0373,90,percent of total billed charges,,,,185.81715,95,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,25.61,,,fee schedule,,,,,,,,,,,,,,,18.39618,195.597,
ANTI-CARDIOLIP IGA,3020060,CDM,86147,CPT,302,RC,inpatient,,,,203.837,112.11035,,183.4533,90,percent of total billed charges,,,,203.837,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,26.1117,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,183.4533,90,percent of total billed charges,,,,193.64515,95,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,36.33,,,fee schedule,,,,,,,,,,,,,,,26.1117,203.837,
ANTI JO-1,3020065,CDM,86235,CPT,302,RC,inpatient,,,,232.162,127.6891,,208.9458,90,percent of total billed charges,,,,232.162,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,18.39618,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208.9458,90,percent of total billed charges,,,,220.5539,95,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,25.61,,,fee schedule,,,,,,,,,,,,,,,18.39618,232.162,
ANTI-CARDIOLIP IGG,3020070,CDM,86147,CPT,302,RC,inpatient,,,,239.681,131.82455,,215.7129,90,percent of total billed charges,,,,239.681,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,26.1117,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,215.7129,90,percent of total billed charges,,,,227.69695,95,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,36.33,,,fee schedule,,,,,,,,,,,,,,,26.1117,239.681,
ANTI-CARDIOLIP IGM,3020080,CDM,86147,CPT,302,RC,inpatient,,,,239.681,131.82455,,215.7129,90,percent of total billed charges,,,,239.681,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,26.1117,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,215.7129,90,percent of total billed charges,,,,227.69695,95,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,36.33,,,fee schedule,,,,,,,,,,,,,,,26.1117,239.681,
ANTI-NEUTROPHIL CYTOPLAS/ANTI,3020100,CDM,86256,CPT,302,RC,inpatient,,,,234.531,128.99205,,211.0779,90,percent of total billed charges,,,,234.531,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,12.3633,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,211.0779,90,percent of total billed charges,,,,222.80445,95,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,17.22,,,fee schedule,,,,,,,,,,,,,,,12.3633,234.531,
ANTIBODY PANEL EACH,3020120,CDM,86870,CPT,302,RC,inpatient,,,,295.198,162.3589,,265.6782,90,percent of total billed charges,,,,295.198,100,percent of total billed charges,,,334.0314,,,fee schedule,,,334.0314,,,fee schedule,,,300.62826,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.6782,90,percent of total billed charges,,,,280.4381,95,percent of total billed charges,,,,,,,,,11,,,fee schedule,,,11,,,fee schedule,,,,,,,,,,,,,,,11,334.0314,
ANTIBODY TITER,3020130,CDM,86886,CPT,302,RC,inpatient,,,,87.344,48.0392,,78.6096,90,percent of total billed charges,,,,87.344,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,145.85616,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,78.6096,90,percent of total billed charges,,,,82.9768,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,7.39,162.0624,
ANTISTREPTOLYSIN O,3020140,CDM,86060,CPT,302,RC,inpatient,,,,92.082,50.6451,,82.8738,90,percent of total billed charges,,,,92.082,100,percent of total billed charges,,,8.322,,,fee schedule,,,8.322,,,fee schedule,,,7.4898,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,82.8738,90,percent of total billed charges,,,,87.4779,95,percent of total billed charges,,,,,,,,,10.43,,,fee schedule,,,10.43,,,fee schedule,,,,,,,,,,,,,,,7.4898,92.082,
BRUCELLA IgG,3020165,CDM,86622,CPT,302,RC,inpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,10.1802,,,fee schedule,,,10.1802,,,fee schedule,,,9.16218,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.4787,90,percent of total billed charges,,,,115.56085,95,percent of total billed charges,,,,,,,,,12.76,,,fee schedule,,,12.76,,,fee schedule,,,,,,,,,,,,,,,9.16218,121.643,
BRUCELLA IgM,3020166,CDM,86622,CPT,302,RC,inpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,10.1802,,,fee schedule,,,10.1802,,,fee schedule,,,9.16218,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,104.1021,90,percent of total billed charges,,,,109.88555,95,percent of total billed charges,,,,,,,,,12.76,,,fee schedule,,,12.76,,,fee schedule,,,,,,,,,,,,,,,9.16218,115.669,
C REACTIVE PROTEIN,3020170,CDM,86140,CPT,302,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,75.19,
CRP CARDIAC ULTRASENS,3020175,CDM,86141,CPT,302,RC,inpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,14.763,,,fee schedule,,,14.763,,,fee schedule,,,13.2867,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.3767,90,percent of total billed charges,,,,90.11985,95,percent of total billed charges,,,,,,,,,17.89,,,fee schedule,,,17.89,,,fee schedule,,,,,,,,,,,,,,,13.2867,94.863,
CA 19-9,3020190,CDM,86301,CPT,302,RC,inpatient,,,,266.77,146.7235,,240.093,90,percent of total billed charges,,,,266.77,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,21.35106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,240.093,90,percent of total billed charges,,,,253.4315,95,percent of total billed charges,,,,,,,,,29.72,,,fee schedule,,,29.72,,,fee schedule,,,,,,,,,,,,,,,21.35106,266.77,
CANCER ANTIGEN 125,3020210,CDM,86304,CPT,302,RC,inpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,21.35106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.3826,90,percent of total billed charges,,,,179.8483,95,percent of total billed charges,,,,,,,,,29.72,,,fee schedule,,,29.72,,,fee schedule,,,,,,,,,,,,,,,21.35106,189.314,
CANCER ANTIGEN 15-3,3020215,CDM,86300,CPT,302,RC,inpatient,,,,194.052,106.7286,,174.6468,90,percent of total billed charges,,,,194.052,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,21.35106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,174.6468,90,percent of total billed charges,,,,184.3494,95,percent of total billed charges,,,,,,,,,29.72,,,fee schedule,,,29.72,,,fee schedule,,,,,,,,,,,,,,,21.35106,194.052,
COLD AGGLUTININS,3020260,CDM,86157,CPT,302,RC,inpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,9.1884,,,fee schedule,,,9.1884,,,fee schedule,,,8.26956,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.5899,90,percent of total billed charges,,,,81.90045,95,percent of total billed charges,,,,,,,,,11.51,,,fee schedule,,,11.51,,,fee schedule,,,,,,,,,,,,,,,8.26956,86.211,
COMPLEMENT TOTAL,3020270,CDM,86162,CPT,302,RC,inpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,23.1648,,,fee schedule,,,23.1648,,,fee schedule,,,20.84832,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,192.3525,90,percent of total billed charges,,,,203.03875,95,percent of total billed charges,,,,,,,,,29.02,,,fee schedule,,,29.02,,,fee schedule,,,,,,,,,,,,,,,20.84832,213.725,
COOMBS DIRECT,3020280,CDM,86880,CPT,302,RC,inpatient,,,,59.019,32.46045,,53.1171,90,percent of total billed charges,,,,59.019,100,percent of total billed charges,,,59.2344,,,fee schedule,,,59.2344,,,fee schedule,,,53.31096,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53.1171,90,percent of total billed charges,,,,56.06805,95,percent of total billed charges,,,,,,,,,7.67,,,fee schedule,,,7.67,,,fee schedule,,,,,,,,,,,,,,,7.67,59.2344,
COOMBS INDIRECT,3020290,CDM,86885,CPT,302,RC,inpatient,,,,72.821,40.05155,,65.5389,90,percent of total billed charges,,,,72.821,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,145.85616,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.5389,90,percent of total billed charges,,,,69.17995,95,percent of total billed charges,,,,,,,,,8.16,,,fee schedule,,,8.16,,,fee schedule,,,,,,,,,,,,,,,8.16,162.0624,
ECHOVIRUS #11,3020296,CDM,86658,CPT,302,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,13.36878,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,18.61,,,fee schedule,,,,,,,,,,,,,,,13.36878,95.481,
COXSACKIE B VIRUS ANTIBODY,3020297,CDM,86658,CPT,302,RC,inpatient,,,,65.302,35.9161,,58.7718,90,percent of total billed charges,,,,65.302,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,13.36878,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.7718,90,percent of total billed charges,,,,62.0369,95,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,18.61,,,fee schedule,,,,,,,,,,,,,,,13.36878,65.302,
ECHOVIRUS #4,3020298,CDM,86658,CPT,302,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,13.36878,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,18.61,,,fee schedule,,,,,,,,,,,,,,,13.36878,95.481,
ECHOVIRUS #7,3020299,CDM,86658,CPT,302,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,13.36878,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,18.61,,,fee schedule,,,,,,,,,,,,,,,13.36878,95.481,
CROSSMATCH EACH UNIT,3020300,CDM,86920,CPT,302,RC,inpatient,,,,39.346,21.6403,,35.4114,90,percent of total billed charges,,,,39.346,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,145.85616,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.4114,90,percent of total billed charges,,,,37.3787,95,percent of total billed charges,,,,,,,,,34,,,fee schedule,,,34,,,fee schedule,,,,,,,,,,,,,,,34,162.0624,
ECHOVIRUS #9,3020301,CDM,86658,CPT,302,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,13.36878,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,18.61,,,fee schedule,,,,,,,,,,,,,,,13.36878,95.481,
ECHOVIRUS #30,3020302,CDM,86658,CPT,302,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,13.36878,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,18.61,,,fee schedule,,,,,,,,,,,,,,,13.36878,95.481,
CRYPTOCOCCAL ANTIGEN,3020320,CDM,86403,CPT,302,RC,inpatient,,,,113.3,62.315,,101.97,90,percent of total billed charges,,,,113.3,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,11.84004,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,101.97,90,percent of total billed charges,,,,107.635,95,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,14.55,,,fee schedule,,,,,,,,,,,,,,,11.84004,113.3,
CYTOMEGALOVIRUS AB IGM,3020330,CDM,86645,CPT,302,RC,inpatient,,,,146.363,80.49965,,131.7267,90,percent of total billed charges,,,,146.363,100,percent of total billed charges,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,17.2881,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,131.7267,90,percent of total billed charges,,,,139.04485,95,percent of total billed charges,,,,,,,,,24.06,,,fee schedule,,,24.06,,,fee schedule,,,,,,,,,,,,,,,17.2881,146.363,
CYTOMEGALOVIRUS AB IGG,3020333,CDM,86644,CPT,302,RC,inpatient,,,,218.772,120.3246,,196.8948,90,percent of total billed charges,,,,218.772,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,14.76414,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,196.8948,90,percent of total billed charges,,,,207.8334,95,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,20.55,,,fee schedule,,,,,,,,,,,,,,,14.76414,218.772,
EHRLICHIA CHAFFENSIS AB IGG,3020340,CDM,86666,CPT,302,RC,inpatient,,,,167.272,91.9996,,150.5448,90,percent of total billed charges,,,,167.272,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,10.44468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.5448,90,percent of total billed charges,,,,158.9084,95,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,14.53,,,fee schedule,,,,,,,,,,,,,,,10.44468,167.272,
EHRLICHIA CHAFFENIS AB IGM,3020341,CDM,86666,CPT,302,RC,inpatient,,,,167.272,91.9996,,150.5448,90,percent of total billed charges,,,,167.272,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,10.44468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.5448,90,percent of total billed charges,,,,158.9084,95,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,14.53,,,fee schedule,,,,,,,,,,,,,,,10.44468,167.272,
EPSTEIN BARR AB IGM (VIRAL CAP,3020360,CDM,86665,CPT,302,RC,inpatient,,,,163.358,89.8469,,147.0222,90,percent of total billed charges,,,,163.358,100,percent of total billed charges,,,20.6796,,,fee schedule,,,20.6796,,,fee schedule,,,18.61164,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.0222,90,percent of total billed charges,,,,155.1901,95,percent of total billed charges,,,,,,,,,25.91,,,fee schedule,,,25.91,,,fee schedule,,,,,,,,,,,,,,,18.61164,163.358,
TULAREMIA ANTIBODY IGG,3020371,CDM,86000,CPT,302,RC,inpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,7.9572,,,fee schedule,,,7.9572,,,fee schedule,,,7.16148,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.072,90,percent of total billed charges,,,,133.076,95,percent of total billed charges,,,,,,,,,2.26,,,fee schedule,,,2.26,,,fee schedule,,,,,,,,,,,,,,,2.26,140.08,
FETAL BLEED SCREEN,3020390,CDM,86850,CPT,302,RC,inpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,46.49832,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.2295,90,percent of total billed charges,,,,57.24225,95,percent of total billed charges,,,,,,,,,5,,,fee schedule,,,5,,,fee schedule,,,,,,,,,,,,,,,5,60.255,
FTA,3020400,CDM,86780,CPT,302,RC,inpatient,,,,124.321,68.37655,,111.8889,90,percent of total billed charges,,,,124.321,100,percent of total billed charges,,,15.0936,,,fee schedule,,,15.0936,,,fee schedule,,,13.58424,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.8889,90,percent of total billed charges,,,,118.10495,95,percent of total billed charges,,,,,,,,,19.55,,,fee schedule,,,19.55,,,fee schedule,,,,,,,,,,,,,,,13.58424,124.321,
GIARDIASIS ANTIBODY,3020420,CDM,86674,CPT,302,RC,inpatient,,,,224.746,123.6103,,202.2714,90,percent of total billed charges,,,,224.746,100,percent of total billed charges,,,16.7808,,,fee schedule,,,16.7808,,,fee schedule,,,15.10272,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,202.2714,90,percent of total billed charges,,,,213.5087,95,percent of total billed charges,,,,,,,,,21.02,,,fee schedule,,,21.02,,,fee schedule,,,,,,,,,,,,,,,15.10272,224.746,
HEPATITIS B SURFACE ANTIBODY,3020470,CDM,86706,CPT,302,RC,inpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,11.01924,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,104.1021,90,percent of total billed charges,,,,109.88555,95,percent of total billed charges,,,,,,,,,15.33,,,fee schedule,,,15.33,,,fee schedule,,,,,,,,,,,,,,,11.01924,115.669,
HEPATITIS C ANTIBODY,3020490,CDM,86803,CPT,302,RC,inpatient,,,,195.597,107.57835,,176.0373,90,percent of total billed charges,,,,195.597,100,percent of total billed charges,,,16.2678,,,fee schedule,,,16.2678,,,fee schedule,,,14.64102,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,176.0373,90,percent of total billed charges,,,,185.81715,95,percent of total billed charges,,,,,,,,,20.39,,,fee schedule,,,20.39,,,fee schedule,,,,,,,,,,,,,,,14.64102,195.597,
IMMUNOFIXATION - SERUM,3020512,CDM,86334,CPT,302,RC,inpatient,,,,87.344,48.0392,,78.6096,90,percent of total billed charges,,,,87.344,100,percent of total billed charges,,,25.4676,,,fee schedule,,,25.4676,,,fee schedule,,,22.92084,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,78.6096,90,percent of total billed charges,,,,82.9768,95,percent of total billed charges,,,,,,,,,31.9,,,fee schedule,,,31.9,,,fee schedule,,,,,,,,,,,,,,,22.92084,87.344,
"VARICELLA ZOSTER AB, IGG",3020520,CDM,86787,CPT,302,RC,inpatient,,,,157.384,86.5612,,141.6456,90,percent of total billed charges,,,,157.384,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,13.21488,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,141.6456,90,percent of total billed charges,,,,149.5148,95,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,18.4,,,fee schedule,,,,,,,,,,,,,,,13.21488,157.384,
"VARICELLA ZOSTER AB, IGM",3020530,CDM,86787,CPT,302,RC,inpatient,,,,138.947,76.42085,,125.0523,90,percent of total billed charges,,,,138.947,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,13.21488,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.0523,90,percent of total billed charges,,,,131.99965,95,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,18.4,,,fee schedule,,,,,,,,,,,,,,,13.21488,138.947,
HLA-B27,3020550,CDM,86812,CPT,302,RC,inpatient,,,,180.662,99.3641,,162.5958,90,percent of total billed charges,,,,180.662,100,percent of total billed charges,,,29.4234,,,fee schedule,,,29.4234,,,fee schedule,,,26.48106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,162.5958,90,percent of total billed charges,,,,171.6289,95,percent of total billed charges,,,,,,,,,36.85,,,fee schedule,,,36.85,,,fee schedule,,,,,,,,,,,,,,,26.48106,180.662,
LEGIONELLA SCREEN,3020600,CDM,86713,CPT,302,RC,inpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,17.442,,,fee schedule,,,17.442,,,fee schedule,,,15.6978,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.2041,90,percent of total billed charges,,,,135.32655,95,percent of total billed charges,,,,,,,,,21.86,,,fee schedule,,,21.86,,,fee schedule,,,,,,,,,,,,,,,15.6978,142.449,
LYME DISEASE ANTIBODY TOTAL,3020610,CDM,86618,CPT,302,RC,inpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,19.4142,,,fee schedule,,,19.4142,,,fee schedule,,,17.47278,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.1484,90,percent of total billed charges,,,,67.7122,95,percent of total billed charges,,,,,,,,,24.32,,,fee schedule,,,24.32,,,fee schedule,,,,,,,,,,,,,,,17.47278,71.276,
MONO SLIDE TEST,3020620,CDM,86308,CPT,302,RC,inpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.8842,90,percent of total billed charges,,,,63.2111,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,66.538,
MUMPS ANTIBODIES IGG,3020634,CDM,86735,CPT,302,RC,inpatient,,,,205.382,112.9601,,184.8438,90,percent of total billed charges,,,,205.382,100,percent of total billed charges,,,14.877,,,fee schedule,,,14.877,,,fee schedule,,,13.3893,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,184.8438,90,percent of total billed charges,,,,195.1129,95,percent of total billed charges,,,,,,,,,18.63,,,fee schedule,,,18.63,,,fee schedule,,,,,,,,,,,,,,,13.3893,205.382,
"MUMPS ANTIBODIES,IgM",3020635,CDM,86735,CPT,302,RC,inpatient,,,,104.648,57.5564,,94.1832,90,percent of total billed charges,,,,104.648,100,percent of total billed charges,,,14.877,,,fee schedule,,,14.877,,,fee schedule,,,13.3893,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.1832,90,percent of total billed charges,,,,99.4156,95,percent of total billed charges,,,,,,,,,18.63,,,fee schedule,,,18.63,,,fee schedule,,,,,,,,,,,,,,,13.3893,104.648,
PARVOVIRUS B19 IgG,3020655,CDM,86747,CPT,302,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,17.1342,,,fee schedule,,,17.1342,,,fee schedule,,,15.42078,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,21.46,,,fee schedule,,,21.46,,,fee schedule,,,,,,,,,,,,,,,15.42078,148.732,
PARVOVIRUS B19 AB 1gM,3020666,CDM,86747,CPT,302,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,17.1342,,,fee schedule,,,17.1342,,,fee schedule,,,15.42078,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,21.46,,,fee schedule,,,21.46,,,fee schedule,,,,,,,,,,,,,,,15.42078,148.732,
PLATELET ANTIBODIES IGA,3020667,CDM,86022,CPT,302,RC,inpatient,,,,341.651,187.90805,,307.4859,90,percent of total billed charges,,,,341.651,100,percent of total billed charges,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,18.84762,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.4859,90,percent of total billed charges,,,,324.56845,95,percent of total billed charges,,,,,,,,,26.23,,,fee schedule,,,26.23,,,fee schedule,,,,,,,,,,,,,,,18.84762,341.651,
PLATELET ANTIBODY IGG,3020668,CDM,86022,CPT,302,RC,inpatient,,,,341.651,187.90805,,307.4859,90,percent of total billed charges,,,,341.651,100,percent of total billed charges,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,18.84762,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.4859,90,percent of total billed charges,,,,324.56845,95,percent of total billed charges,,,,,,,,,26.23,,,fee schedule,,,26.23,,,fee schedule,,,,,,,,,,,,,,,18.84762,341.651,
PLATELET ANTIBODIES IGM,3020669,CDM,86022,CPT,302,RC,inpatient,,,,341.651,187.90805,,307.4859,90,percent of total billed charges,,,,341.651,100,percent of total billed charges,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,18.84762,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.4859,90,percent of total billed charges,,,,324.56845,95,percent of total billed charges,,,,,,,,,26.23,,,fee schedule,,,26.23,,,fee schedule,,,,,,,,,,,,,,,18.84762,341.651,
RA QUANTITATIVE,3020690,CDM,86430,CPT,302,RC,inpatient,,,,72.821,40.05155,,65.5389,90,percent of total billed charges,,,,72.821,100,percent of total billed charges,,,6.9996,,,fee schedule,,,6.9996,,,fee schedule,,,6.29964,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.5389,90,percent of total billed charges,,,,69.17995,95,percent of total billed charges,,,,,,,,,8.11,,,fee schedule,,,8.11,,,fee schedule,,,,,,,,,,,,,,,6.29964,72.821,
BLOD TYPING SEROLOGIC RH,3020720,CDM,86901,CPT,302,RC,inpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,31.4982,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,,,,,,,35,,,fee schedule,,,35,,,fee schedule,,,,,,,,,,,,,,,31.4982,49.234,
TYPHUS FEVER GROUP IGG,3020730,CDM,86757,CPT,302,RC,inpatient,,,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,19.8531,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.7208,90,percent of total billed charges,,,,49.3164,95,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,27.64,,,fee schedule,,,,,,,,,,,,,,,19.8531,51.912,
TYPHUS FEVER GROUP IGM,3020740,CDM,86757,CPT,302,RC,inpatient,,,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,19.8531,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.7208,90,percent of total billed charges,,,,49.3164,95,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,27.64,,,fee schedule,,,,,,,,,,,,,,,19.8531,51.912,
RAST CORN,3020741,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
ALTERNARIA ALTERNATA (m6),3020742,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST WHEAT lgG,3020743,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST-SOYBEAN,3020744,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST-TOMATO,3020745,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RMSF GROUP IGG,3020750,CDM,86757,CPT,302,RC,inpatient,,,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,19.8531,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.7208,90,percent of total billed charges,,,,49.3164,95,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,27.64,,,fee schedule,,,,,,,,,,,,,,,19.8531,51.912,
RMSF GROUP IGM,3020760,CDM,86757,CPT,302,RC,inpatient,,,,78.692,43.2806,,70.8228,90,percent of total billed charges,,,,78.692,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,19.8531,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.8228,90,percent of total billed charges,,,,74.7574,95,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,27.64,,,fee schedule,,,,,,,,,,,,,,,19.8531,78.692,
RUBELLA IGM,3020783,CDM,86762,CPT,302,RC,inpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,14.76414,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.3767,90,percent of total billed charges,,,,90.11985,95,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,20.55,,,fee schedule,,,,,,,,,,,,,,,14.76414,94.863,
RUBELLA TITER IGG,3020790,CDM,86762,CPT,302,RC,inpatient,,,,64.169,35.29295,,57.7521,90,percent of total billed charges,,,,64.169,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,14.76414,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.7521,90,percent of total billed charges,,,,60.96055,95,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,20.55,,,fee schedule,,,,,,,,,,,,,,,14.76414,64.169,
HEPATITIS B CORE IGM,3020815,CDM,86705,CPT,302,RC,inpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,13.4178,,,fee schedule,,,13.4178,,,fee schedule,,,12.07602,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.5285,90,percent of total billed charges,,,,93.44675,95,percent of total billed charges,,,,,,,,,16.81,,,fee schedule,,,16.81,,,fee schedule,,,,,,,,,,,,,,,12.07602,98.365,
THYROGLOBULIN ANTIBODY,3020830,CDM,86800,CPT,302,RC,inpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,18.1374,,,fee schedule,,,18.1374,,,fee schedule,,,16.32366,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.5285,90,percent of total billed charges,,,,93.44675,95,percent of total billed charges,,,,,,,,,22.71,,,fee schedule,,,22.71,,,fee schedule,,,,,,,,,,,,,,,16.32366,98.365,
TOXOPLASMOSIS ANTIBODY IGM,3020840,CDM,86778,CPT,302,RC,inpatient,,,,152.337,83.78535,,137.1033,90,percent of total billed charges,,,,152.337,100,percent of total billed charges,,,16.4274,,,fee schedule,,,16.4274,,,fee schedule,,,14.78466,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,137.1033,90,percent of total billed charges,,,,144.72015,95,percent of total billed charges,,,,,,,,,20.56,,,fee schedule,,,20.56,,,fee schedule,,,,,,,,,,,,,,,14.78466,152.337,
TOXOPLASMOSIS AB IGG,3020841,CDM,86777,CPT,302,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,14.76414,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,20.55,,,fee schedule,,,,,,,,,,,,,,,14.76414,148.732,
TB SKIN TEST,3020890,CDM,86580,CPT,302,RC,inpatient,,,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,23.14656,,,fee schedule,,,10.319125,,,fee schedule,,,10.319125,,,fee schedule,,,,,,,,,10.319125,,,fee schedule,,,,,,,,,,20.2086,90,percent of total billed charges,,,,21.3313,95,percent of total billed charges,,,10.62869875,,,fee schedule,,,8,,,fee schedule,,,8,,,fee schedule,,,,,,,,,10.319125,,,fee schedule,,,8,25.7184,
C-1 ESTERASE INHIBITORS,3020910,CDM,86160,CPT,302,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,12.312,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,17.14,,,fee schedule,,,17.14,,,fee schedule,,,,,,,,,,,,,,,12.312,114.536,
ANTI MITOCHONDRIAL ANTIBODY,3021035,CDM,86255,CPT,302,RC,inpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,12.3633,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.072,90,percent of total billed charges,,,,133.076,95,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,17.22,,,fee schedule,,,,,,,,,,,,,,,12.3633,140.08,
BETA - 2 GLYCOPROTEIN IgM,3021090,CDM,86146,CPT,302,RC,inpatient,,,,107.017,58.85935,,96.3153,90,percent of total billed charges,,,,107.017,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,26.1117,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.3153,90,percent of total billed charges,,,,101.66615,95,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,36.33,,,fee schedule,,,,,,,,,,,,,,,26.1117,107.017,
BETA - 2 GLYCOPROTEIN IgG,3021091,CDM,86146,CPT,302,RC,inpatient,,,,107.017,58.85935,,96.3153,90,percent of total billed charges,,,,107.017,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,26.1117,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.3153,90,percent of total billed charges,,,,101.66615,95,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,36.33,,,fee schedule,,,,,,,,,,,,,,,26.1117,107.017,
BETA - 2 GLYCOPROTEIN IgA,3021092,CDM,86146,CPT,302,RC,inpatient,,,,107.017,58.85935,,96.3153,90,percent of total billed charges,,,,107.017,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,26.1117,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.3153,90,percent of total billed charges,,,,101.66615,95,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,36.33,,,fee schedule,,,,,,,,,,,,,,,26.1117,107.017,
INSULIN AUTOANTIBODIES,3021162,CDM,86337,CPT,302,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,24.4074,,,fee schedule,,,24.4074,,,fee schedule,,,21.96666,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,30.58,,,fee schedule,,,30.58,,,fee schedule,,,,,,,,,,,,,,,21.96666,148.732,
WESTNILE VIRUS CSF IgG,3021516,CDM,86789,CPT,302,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,14.76414,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,20.78,,,fee schedule,,,20.78,,,fee schedule,,,,,,,,,,,,,,,14.76414,148.732,
WESTNILE VIRUS CSF IgM,3021517,CDM,86788,CPT,302,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,17.2881,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,24.32,,,fee schedule,,,24.32,,,fee schedule,,,,,,,,,,,,,,,17.2881,148.732,
WEST NILE VIRUS IgG,3021518,CDM,86789,CPT,302,RC,inpatient,,,,195.597,107.57835,,176.0373,90,percent of total billed charges,,,,195.597,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,14.76414,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,176.0373,90,percent of total billed charges,,,,185.81715,95,percent of total billed charges,,,,,,,,,20.78,,,fee schedule,,,20.78,,,fee schedule,,,,,,,,,,,,,,,14.76414,195.597,
WEST NILE VIRUS IgM,3021519,CDM,86788,CPT,302,RC,inpatient,,,,195.597,107.57835,,176.0373,90,percent of total billed charges,,,,195.597,100,percent of total billed charges,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,17.2881,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,176.0373,90,percent of total billed charges,,,,185.81715,95,percent of total billed charges,,,,,,,,,24.32,,,fee schedule,,,24.32,,,fee schedule,,,,,,,,,,,,,,,17.2881,195.597,
"ALPHA GAL - GALACTOSE 1,3 IgE",3022930,CDM,86003,CPT,302,RC,inpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.4056,90,percent of total billed charges,,,,32.0948,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,33.784,
ALPHA GAL - BEEF IgE,3022931,CDM,86003,CPT,302,RC,inpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.4056,90,percent of total billed charges,,,,32.0948,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,33.784,
ALPHA GAL - PORK IgE,3022932,CDM,86003,CPT,302,RC,inpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.4056,90,percent of total billed charges,,,,32.0948,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,33.784,
ALPHA GAL - LAMB/MUTTON IgE,3022933,CDM,86003,CPT,302,RC,inpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.4056,90,percent of total billed charges,,,,32.0948,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,33.784,
BARTONELLA QUINTANA Ab IGM,3023425,CDM,86611,CPT,302,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,10.44468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,14.53,,,fee schedule,,,,,,,,,,,,,,,10.44468,75.19,
BARTONELLA QUINTANA Ab IGG,3023426,CDM,86611,CPT,302,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,10.44468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,14.53,,,fee schedule,,,,,,,,,,,,,,,10.44468,75.19,
BARTONELLA HENSELAE Ab IGG,3023427,CDM,86611,CPT,302,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,10.44468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,14.53,,,fee schedule,,,,,,,,,,,,,,,10.44468,75.19,
BARTONELLA HENSELAE Ab IGM,3023428,CDM,86611,CPT,302,RC,inpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,10.44468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.671,90,percent of total billed charges,,,,71.4305,95,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,14.53,,,fee schedule,,,,,,,,,,,,,,,10.44468,75.19,
1A-2 ANTIBODY,3023617,CDM,86341,CPT,302,RC,inpatient,,,,257.294,141.5117,,231.5646,90,percent of total billed charges,,,,257.294,100,percent of total billed charges,,,26.8698,,,fee schedule,,,26.8698,,,fee schedule,,,24.18282,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,231.5646,90,percent of total billed charges,,,,244.4293,95,percent of total billed charges,,,,,,,,,28.25,,,fee schedule,,,28.25,,,fee schedule,,,,,,,,,,,,,,,24.18282,257.294,
S PNEUMONIAE ANTIGEN,3024460,CDM,86403,CPT,302,RC,inpatient,,,,183.34,100.837,,165.006,90,percent of total billed charges,,,,183.34,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,11.84004,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,165.006,90,percent of total billed charges,,,,174.173,95,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,14.55,,,fee schedule,,,,,,,,,,,,,,,11.84004,183.34,
RAST - CASHEW,3026001,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST - WALNUT,3026003,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST - PEANUT,3026004,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST - COCONUT,3026016,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST - EGG WHITE,3026017,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
"RAST - FISH, COD",3026018,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST - GREEN PEA,3026020,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST - MILK,3026021,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST - OAT,3026022,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
T-SPOT TB TEST,3026481,CDM,86481,CPT,302,RC,inpatient,,,,133.591,73.47505,,120.2319,90,percent of total billed charges,,,,133.591,100,percent of total billed charges,,,114,,,fee schedule,,,114,,,fee schedule,,,102.6,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,120.2319,90,percent of total billed charges,,,,126.91145,95,percent of total billed charges,,,,,,,,,87.22,,,fee schedule,,,87.22,,,fee schedule,,,,,,,,,,,,,,,87.22,133.591,
RPR TITER,3026593,CDM,86593,CPT,302,RC,inpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,5.016,,,fee schedule,,,5.016,,,fee schedule,,,4.5144,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.2596,90,percent of total billed charges,,,,34.0518,95,percent of total billed charges,,,,,,,,,6.29,,,fee schedule,,,6.29,,,fee schedule,,,,,,,,,,,,,,,4.5144,35.844,
"HSV 2 - IGM, IFA (CSF)",3026696,CDM,86696,CPT,302,RC,inpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,19.8531,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.2041,90,percent of total billed charges,,,,135.32655,95,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,27.64,,,fee schedule,,,,,,,,,,,,,,,19.8531,142.449,
LISTERIA ANTIBODY CF,3026723,CDM,86723,CPT,302,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,13.53294,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,18.84,,,fee schedule,,,18.84,,,fee schedule,,,,,,,,,,,,,,,13.53294,119.274,
ASPERGILLUS FUMIGATUS (m3),3027010,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
BERMUDA GRASS (g2),3027011,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
BIRCH (BETUAL VERRUCOSA (t3),3027012,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
CAT DANDER (e1),3027013,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
CLADOSPORIUM HERBARUM (m2),3027014,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
COCKROACH (i6),3027015,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
COMMON RAGWEED (short w1),3027016,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
DERMATOPHAGOIDES FARINAE (d2),3027017,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
DERMATOPHAGOIDES PTERONYSSINUS,3027018,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
DOG DANDER (e5),3027019,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
ELM (ULMUS AMERICANA)(t8),3027020,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
"MAPLE (BOX ELDER,ACER NEGINDO)",3027021,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
MOUNTAIN CEDAR (JUNIPERUS SAB),3027022,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
MULBERRY (t70),3027023,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
OAK (QUERCUS ALBA)(t70),3027024,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
PECAN/HICKORY (t22),3027025,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
PENICILLUM NOTATUM (m1),3027026,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
ROUGH MARSH ELDER (Iva)(w16),3027027,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
ROUGH PIGWEED (w14),3027028,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
TIMOTHY GRASS (g6),3027029,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
WALNUT (t10),3027030,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
FFP THAWING EACH UNIT,3027296,CDM,86927,CPT,302,RC,inpatient,,,,321.257,176.69135,,289.1313,90,percent of total billed charges,,,,321.257,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,145.85616,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,289.1313,90,percent of total billed charges,,,,305.19415,95,percent of total billed charges,,,,,,,,,5,,,fee schedule,,,5,,,fee schedule,,,,,,,,,,,,,,,5,321.257,
RAST - CLAM,3028601,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST - SCALLOP,3028602,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST SHRIMP,3028603,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
RAST = SESAME SEED,3028604,CDM,86003,CPT,302,RC,inpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.883,90,percent of total billed charges,,,,28.3765,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,29.87,
MYELOPEROXIDASE ANTIBODY,3028606,CDM,86021,CPT,302,RC,inpatient,,,,157.384,86.5612,,141.6456,90,percent of total billed charges,,,,157.384,100,percent of total billed charges,,,17.157,,,fee schedule,,,17.157,,,fee schedule,,,15.4413,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,141.6456,90,percent of total billed charges,,,,149.5148,95,percent of total billed charges,,,,,,,,,21.49,,,fee schedule,,,21.49,,,fee schedule,,,,,,,,,,,,,,,15.4413,157.384,
CYCLIC CITRULLINATED PEPTIDE,3028620,CDM,86200,CPT,302,RC,inpatient,,,,166.963,91.82965,,150.2667,90,percent of total billed charges,,,,166.963,100,percent of total billed charges,,,14.763,,,fee schedule,,,14.763,,,fee schedule,,,13.2867,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.2667,90,percent of total billed charges,,,,158.61485,95,percent of total billed charges,,,,,,,,,18.69,,,fee schedule,,,18.69,,,fee schedule,,,,,,,,,,,,,,,13.2867,166.963,
ENDOMYSIAL ANTIBODY IGA,3028625,CDM,86255,CPT,302,RC,inpatient,,,,191.683,105.42565,,172.5147,90,percent of total billed charges,,,,191.683,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,12.3633,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,172.5147,90,percent of total billed charges,,,,182.09885,95,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,17.22,,,fee schedule,,,,,,,,,,,,,,,12.3633,191.683,
LCM VIRUS - IGG,3028627,CDM,86727,CPT,302,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,13.20462,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,18.38,,,fee schedule,,,18.38,,,fee schedule,,,,,,,,,,,,,,,13.20462,114.536,
"HEPATITIS B SURFACE Ab, QUANT",3028631,CDM,86317,CPT,302,RC,inpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,17.0886,,,fee schedule,,,17.0886,,,fee schedule,,,15.37974,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,104.1021,90,percent of total billed charges,,,,109.88555,95,percent of total billed charges,,,,,,,,,21.41,,,fee schedule,,,21.41,,,fee schedule,,,,,,,,,,,,,,,15.37974,115.669,
"INHIBIN A, ULTRASENSITIVE",3028633,CDM,86336,CPT,302,RC,inpatient,,,,313.223,172.27265,,281.9007,90,percent of total billed charges,,,,313.223,100,percent of total billed charges,,,17.7726,,,fee schedule,,,17.7726,,,fee schedule,,,15.99534,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,281.9007,90,percent of total billed charges,,,,297.56185,95,percent of total billed charges,,,,,,,,,21.77,,,fee schedule,,,21.77,,,fee schedule,,,,,,,,,,,,,,,15.99534,313.223,
INTRINSIC FACTOR BLOCKING ANTI,3028634,CDM,86340,CPT,302,RC,inpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,17.1912,,,fee schedule,,,17.1912,,,fee schedule,,,15.47208,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.3466,90,percent of total billed charges,,,,113.3103,95,percent of total billed charges,,,,,,,,,21.52,,,fee schedule,,,21.52,,,fee schedule,,,,,,,,,,,,,,,15.47208,119.274,
LIVER KIDNEY MICROSOMAL LKM1AB,3028637,CDM,86376,CPT,302,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,16.587,,,fee schedule,,,16.587,,,fee schedule,,,14.9283,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,20.78,,,fee schedule,,,20.78,,,fee schedule,,,,,,,,,,,,,,,14.9283,95.481,
QUANIFERON TB GOLD,3028648,CDM,86480,CPT,302,RC,inpatient,,,,228.969,125.93295,,206.0721,90,percent of total billed charges,,,,228.969,100,percent of total billed charges,,,70.6572,,,fee schedule,,,70.6572,,,fee schedule,,,63.59148,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,206.0721,90,percent of total billed charges,,,,217.52055,95,percent of total billed charges,,,,,,,,,89.48,,,fee schedule,,,89.48,,,fee schedule,,,,,,,,,,,,,,,63.59148,228.969,
CALIFORNIA ENCEPHALITIS-SERUM,3028651,CDM,86651,CPT,302,RC,inpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,13.53294,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.5899,90,percent of total billed charges,,,,81.90045,95,percent of total billed charges,,,,,,,,,18.84,,,fee schedule,,,18.84,,,fee schedule,,,,,,,,,,,,,,,13.53294,86.211,
EAST EQUINE ENCEPHALITIS,3028652,CDM,86652,CPT,302,RC,inpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,13.53294,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.5899,90,percent of total billed charges,,,,81.90045,95,percent of total billed charges,,,,,,,,,18.84,,,fee schedule,,,18.84,,,fee schedule,,,,,,,,,,,,,,,13.53294,86.211,
WESTERN EQUINE ENCEPHALITIS,3028654,CDM,86654,CPT,302,RC,inpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,13.53294,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.5899,90,percent of total billed charges,,,,81.90045,95,percent of total billed charges,,,,,,,,,18.84,,,fee schedule,,,18.84,,,fee schedule,,,,,,,,,,,,,,,13.53294,86.211,
"VDRL, SERUM",3028659,CDM,86592,CPT,302,RC,inpatient,,,,53.766,29.5713,,48.3894,90,percent of total billed charges,,,,53.766,100,percent of total billed charges,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,4.38102,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.3894,90,percent of total billed charges,,,,51.0777,95,percent of total billed charges,,,,,,,,,5.9,,,fee schedule,,,5.9,,,fee schedule,,,,,,,,,,,,,,,4.38102,53.766,
"HSV 1 - IGM, IFA (CSF)",3028669,CDM,86695,CPT,302,RC,inpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,13.53294,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.2041,90,percent of total billed charges,,,,135.32655,95,percent of total billed charges,,,,,,,,,13.55,,,fee schedule,,,13.55,,,fee schedule,,,,,,,,,,,,,,,13.53294,142.449,
LCM VIRUS - IGM,3028672,CDM,86727,CPT,302,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,13.20462,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,18.38,,,fee schedule,,,18.38,,,fee schedule,,,,,,,,,,,,,,,13.20462,114.536,
VARICELL-ZOSTER - IGG,3028687,CDM,86787,CPT,302,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,13.21488,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,18.4,,,fee schedule,,,,,,,,,,,,,,,13.21488,114.536,
HERPES SIMPLES 1/2 - IGM,3028694,CDM,86694,CPT,302,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,14.76414,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,20.55,,,fee schedule,,,,,,,,,,,,,,,14.76414,114.536,
HERPES SIMPLEX I - IGG,3028695,CDM,86695,CPT,302,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,13.53294,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,13.55,,,fee schedule,,,13.55,,,fee schedule,,,,,,,,,,,,,,,13.53294,114.536,
HEPATITIS A VIRUS ANTIBODY IGM,3029030,CDM,86709,CPT,302,RC,inpatient,,,,64.169,35.29295,,57.7521,90,percent of total billed charges,,,,64.169,100,percent of total billed charges,,,12.8364,,,fee schedule,,,12.8364,,,fee schedule,,,11.55276,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.7521,90,percent of total billed charges,,,,60.96055,95,percent of total billed charges,,,,,,,,,16.07,,,fee schedule,,,16.07,,,fee schedule,,,,,,,,,,,,,,,11.55276,64.169,
C3 COMPLEMENT,3029040,CDM,86160,CPT,302,RC,inpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,12.312,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,,,,,,,17.14,,,fee schedule,,,17.14,,,fee schedule,,,,,,,,,,,,,,,12.312,55.517,
C4 COMPLEMENT,3029050,CDM,86160,CPT,302,RC,inpatient,,,,44.496,24.4728,,40.0464,90,percent of total billed charges,,,,44.496,100,percent of total billed charges,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,12.312,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.0464,90,percent of total billed charges,,,,42.2712,95,percent of total billed charges,,,,,,,,,17.14,,,fee schedule,,,17.14,,,fee schedule,,,,,,,,,,,,,,,12.312,44.496,
MEASLES (RUBEOLA) IGM,3029070,CDM,86765,CPT,302,RC,inpatient,,,,149.968,82.4824,,134.9712,90,percent of total billed charges,,,,149.968,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,13.21488,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,134.9712,90,percent of total billed charges,,,,142.4696,95,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,18.4,,,fee schedule,,,,,,,,,,,,,,,13.21488,149.968,
MEASLES (RUBEOLA) IGG,3029080,CDM,86765,CPT,302,RC,inpatient,,,,173.143,95.22865,,155.8287,90,percent of total billed charges,,,,173.143,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,13.21488,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,155.8287,90,percent of total billed charges,,,,164.48585,95,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,18.4,,,fee schedule,,,,,,,,,,,,,,,13.21488,173.143,
"HERPES SIMPLEX VIRUS II, IgG",3029112,CDM,86696,CPT,302,RC,inpatient,,,,185.709,102.13995,,167.1381,90,percent of total billed charges,,,,185.709,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,19.8531,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,167.1381,90,percent of total billed charges,,,,176.42355,95,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,27.64,,,fee schedule,,,,,,,,,,,,,,,19.8531,185.709,
EPSTEIN BARR NUCLEAR ANTIGEN,3029120,CDM,86664,CPT,302,RC,inpatient,,,,163.358,89.8469,,147.0222,90,percent of total billed charges,,,,163.358,100,percent of total billed charges,,,17.4306,,,fee schedule,,,17.4306,,,fee schedule,,,15.68754,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.0222,90,percent of total billed charges,,,,155.1901,95,percent of total billed charges,,,,,,,,,21.84,,,fee schedule,,,21.84,,,fee schedule,,,,,,,,,,,,,,,15.68754,163.358,
EPSTEIN BARR IGG VIRAL CAP,3029140,CDM,86665,CPT,302,RC,inpatient,,,,155.015,85.25825,,139.5135,90,percent of total billed charges,,,,155.015,100,percent of total billed charges,,,20.6796,,,fee schedule,,,20.6796,,,fee schedule,,,18.61164,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,139.5135,90,percent of total billed charges,,,,147.26425,95,percent of total billed charges,,,,,,,,,25.91,,,fee schedule,,,25.91,,,fee schedule,,,,,,,,,,,,,,,18.61164,155.015,
"HEPATITIS A ANTIBODY,TOTAL",3029150,CDM,86708,CPT,302,RC,inpatient,,,,113.3,62.315,,101.97,90,percent of total billed charges,,,,113.3,100,percent of total billed charges,,,14.1246,,,fee schedule,,,14.1246,,,fee schedule,,,12.71214,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,101.97,90,percent of total billed charges,,,,107.635,95,percent of total billed charges,,,,,,,,,17.69,,,fee schedule,,,17.69,,,fee schedule,,,,,,,,,,,,,,,12.71214,113.3,
HEPATITIS B CORE ANTI IGG/IGM,3029160,CDM,86704,CPT,302,RC,inpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,12.3633,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,104.1021,90,percent of total billed charges,,,,109.88555,95,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,17.22,,,fee schedule,,,,,,,,,,,,,,,12.3633,115.669,
"GALACTOSE-ALPHA 1,3IGE 092524",3029524,CDM,86003,CPT,302,RC,inpatient,,,,92.7,50.985,,83.43,90,percent of total billed charges,,,,92.7,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.35572,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.43,90,percent of total billed charges,,,,88.065,95,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,7.46,,,fee schedule,,,,,,,,,,,,,,,5.35572,92.7,
BACTERIAL AG - NEIS MEN A,3060460,CDM,86403,CPT,302,RC,inpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,11.84004,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.1982,90,percent of total billed charges,,,,45.5981,95,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,14.55,,,fee schedule,,,,,,,,,,,,,,,11.84004,47.998,
BACTERIAL AG - H INFLUE B,3060470,CDM,86403,CPT,302,RC,inpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,11.84004,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.1484,90,percent of total billed charges,,,,67.7122,95,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,14.55,,,fee schedule,,,,,,,,,,,,,,,11.84004,71.276,
BACTERIAL AG - STREP PNEUMONIA,3060490,CDM,86403,CPT,302,RC,inpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,11.84004,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.1484,90,percent of total billed charges,,,,67.7122,95,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,14.55,,,fee schedule,,,,,,,,,,,,,,,11.84004,71.276,
BACTERIAL AG - STREP B,3060500,CDM,86403,CPT,302,RC,inpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,11.84004,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.1484,90,percent of total billed charges,,,,67.7122,95,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,14.55,,,fee schedule,,,,,,,,,,,,,,,11.84004,71.276,
BACTERIAL AG - NEIS MEN B,3060520,CDM,86403,CPT,302,RC,inpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,11.84004,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.1982,90,percent of total billed charges,,,,45.5981,95,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,14.55,,,fee schedule,,,,,,,,,,,,,,,11.84004,47.998,
SM/RNP ANTIBODY,3066235,CDM,86235,CPT,302,RC,inpatient,,,,304.262,167.3441,,273.8358,90,percent of total billed charges,,,,304.262,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,18.39618,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,273.8358,90,percent of total billed charges,,,,289.0489,95,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,25.61,,,fee schedule,,,,,,,,,,,,,,,18.39618,304.262,
RNP ANTIBODY,3068623,CDM,86235,CPT,302,RC,inpatient,,,,266.77,146.7235,,240.093,90,percent of total billed charges,,,,266.77,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,18.39618,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,240.093,90,percent of total billed charges,,,,253.4315,95,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,25.61,,,fee schedule,,,,,,,,,,,,,,,18.39618,266.77,
SMITH ANTIBODY,3068626,CDM,86235,CPT,302,RC,inpatient,,,,297.567,163.66185,,267.8103,90,percent of total billed charges,,,,297.567,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,18.39618,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,267.8103,90,percent of total billed charges,,,,282.68865,95,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,25.61,,,fee schedule,,,,,,,,,,,,,,,18.39618,297.567,
CHROMATIN (NUCLEOSONSAL) ANTI,3068627,CDM,86235,CPT,302,RC,inpatient,,,,297.567,163.66185,,267.8103,90,percent of total billed charges,,,,297.567,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,18.39618,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,267.8103,90,percent of total billed charges,,,,282.68865,95,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,25.61,,,fee schedule,,,,,,,,,,,,,,,18.39618,297.567,
ANTITHROMBIN III,3050000,CDM,85300,CPT,305,RC,inpatient,,,,205.382,112.9601,,184.8438,90,percent of total billed charges,,,,205.382,100,percent of total billed charges,,,13.509,,,fee schedule,,,13.509,,,fee schedule,,,12.1581,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,184.8438,90,percent of total billed charges,,,,195.1129,95,percent of total billed charges,,,,,,,,,16.93,,,fee schedule,,,16.93,,,fee schedule,,,,,,,,,,,,,,,12.1581,205.382,
CBC/PLT/DIFF/AUTO,3050020,CDM,85025,CPT,305,RC,inpatient,,,,88.992,48.9456,,80.0928,90,percent of total billed charges,,,,88.992,100,percent of total billed charges,,,8.8578,,,fee schedule,,,8.8578,,,fee schedule,,,7.97202,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,80.0928,90,percent of total billed charges,,,,84.5424,95,percent of total billed charges,,,,,,,,,11.1,,,fee schedule,,,11.1,,,fee schedule,,,,,,,,,,,,,,,7.97202,88.992,
CBC W/O DIFF,3050030,CDM,85027,CPT,305,RC,inpatient,,,,59.019,32.46045,,53.1171,90,percent of total billed charges,,,,59.019,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,6.63822,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53.1171,90,percent of total billed charges,,,,56.06805,95,percent of total billed charges,,,,,,,,,9.25,,,fee schedule,,,9.25,,,fee schedule,,,,,,,,,,,,,,,6.63822,59.019,
D-DIMER,3050050,CDM,85378,CPT,305,RC,inpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,11.0808,,,fee schedule,,,11.0808,,,fee schedule,,,9.97272,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.5285,90,percent of total billed charges,,,,93.44675,95,percent of total billed charges,,,,,,,,,10.19,,,fee schedule,,,10.19,,,fee schedule,,,,,,,,,,,,,,,9.97272,98.365,
DIFFERENTIAL - AUTO,3050060,CDM,85004,CPT,305,RC,inpatient,,,,17.304,9.5172,,15.5736,90,percent of total billed charges,,,,17.304,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,6.63822,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.5736,90,percent of total billed charges,,,,16.4388,95,percent of total billed charges,,,,,,,,,9.04,,,fee schedule,,,9.04,,,fee schedule,,,,,,,,,,,,,,,6.63822,17.304,
DIFFERENTIAL - MANUAL,3050065,CDM,85007,CPT,305,RC,inpatient,,,,36.977,20.33735,,33.2793,90,percent of total billed charges,,,,36.977,100,percent of total billed charges,,,4.332,,,fee schedule,,,4.332,,,fee schedule,,,3.8988,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.2793,90,percent of total billed charges,,,,35.12815,95,percent of total billed charges,,,,,,,,,4.92,,,fee schedule,,,4.92,,,fee schedule,,,,,,,,,,,,,,,3.8988,36.977,
FACTOR VIII ASSAY,3050070,CDM,85240,CPT,305,RC,inpatient,,,,290.048,159.5264,,261.0432,90,percent of total billed charges,,,,290.048,100,percent of total billed charges,,,20.406,,,fee schedule,,,20.406,,,fee schedule,,,18.3654,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.0432,90,percent of total billed charges,,,,275.5456,95,percent of total billed charges,,,,,,,,,25.58,,,fee schedule,,,25.58,,,fee schedule,,,,,,,,,,,,,,,18.3654,290.048,
von WILLEBRAND FACTOR,3050078,CDM,85246,CPT,305,RC,inpatient,,,,158.62,87.241,,142.758,90,percent of total billed charges,,,,158.62,100,percent of total billed charges,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,23.53644,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,142.758,90,percent of total billed charges,,,,150.689,95,percent of total billed charges,,,,,,,,,32.78,,,fee schedule,,,32.78,,,fee schedule,,,,,,,,,,,,,,,23.53644,158.62,
von WILLEBRAND MULTIMERIC,3050081,CDM,85247,CPT,305,RC,inpatient,,,,265.328,145.9304,,238.7952,90,percent of total billed charges,,,,265.328,100,percent of total billed charges,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,23.53644,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,238.7952,90,percent of total billed charges,,,,252.0616,95,percent of total billed charges,,,,,,,,,32.78,,,fee schedule,,,32.78,,,fee schedule,,,,,,,,,,,,,,,23.53644,265.328,
FIBRINOGEN,3050090,CDM,85384,CPT,305,RC,inpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,11.0808,,,fee schedule,,,11.0808,,,fee schedule,,,9.97272,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.9039,90,percent of total billed charges,,,,64.28745,95,percent of total billed charges,,,,,,,,,12.13,,,fee schedule,,,12.13,,,fee schedule,,,,,,,,,,,,,,,9.97272,67.671,
HEMATOCRIT (HCT),3050100,CDM,85014,CPT,305,RC,inpatient,,,,33.475,18.41125,,30.1275,90,percent of total billed charges,,,,33.475,100,percent of total billed charges,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,2.43162,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.1275,90,percent of total billed charges,,,,31.80125,95,percent of total billed charges,,,,,,,,,3.38,,,fee schedule,,,3.38,,,fee schedule,,,,,,,,,,,,,,,2.43162,33.475,
HEMOGLOBIN (HGB),3050110,CDM,85018,CPT,305,RC,inpatient,,,,33.475,18.41125,,30.1275,90,percent of total billed charges,,,,33.475,100,percent of total billed charges,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,2.43162,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.1275,90,percent of total billed charges,,,,31.80125,95,percent of total billed charges,,,,,,,,,3.38,,,fee schedule,,,3.38,,,fee schedule,,,,,,,,,,,,,,,2.43162,33.475,
KLEINHAUER BETKE STAIN,3050130,CDM,85460,CPT,305,RC,inpatient,,,,134.209,73.81495,,120.7881,90,percent of total billed charges,,,,134.209,100,percent of total billed charges,,,8.8122,,,fee schedule,,,8.8122,,,fee schedule,,,7.93098,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,120.7881,90,percent of total billed charges,,,,127.49855,95,percent of total billed charges,,,,,,,,,11.05,,,fee schedule,,,11.05,,,fee schedule,,,,,,,,,,,,,,,7.93098,134.209,
LUPUS ANTICOAGULANT,3050140,CDM,85730,CPT,305,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,6.8514,,,fee schedule,,,6.8514,,,fee schedule,,,6.16626,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,8.58,,,fee schedule,,,8.58,,,fee schedule,,,,,,,,,,,,,,,6.16626,148.732,
LYSOZYME (SERUM),3050145,CDM,85549,CPT,305,RC,inpatient,,,,164.903,90.69665,,148.4127,90,percent of total billed charges,,,,164.903,100,percent of total billed charges,,,21.375,,,fee schedule,,,21.375,,,fee schedule,,,19.2375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,148.4127,90,percent of total billed charges,,,,156.65785,95,percent of total billed charges,,,,,,,,,26.78,,,fee schedule,,,26.78,,,fee schedule,,,,,,,,,,,,,,,19.2375,164.903,
PART THROMB TIME PTT,3050150,CDM,85730,CPT,305,RC,inpatient,,,,76.323,41.97765,,68.6907,90,percent of total billed charges,,,,76.323,100,percent of total billed charges,,,6.8514,,,fee schedule,,,6.8514,,,fee schedule,,,6.16626,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,68.6907,90,percent of total billed charges,,,,72.50685,95,percent of total billed charges,,,,,,,,,8.58,,,fee schedule,,,8.58,,,fee schedule,,,,,,,,,,,,,,,6.16626,76.323,
PLATELET COUNT - AUTO,3050160,CDM,85049,CPT,305,RC,inpatient,,,,39.346,21.6403,,35.4114,90,percent of total billed charges,,,,39.346,100,percent of total billed charges,,,5.1072,,,fee schedule,,,5.1072,,,fee schedule,,,4.59648,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.4114,90,percent of total billed charges,,,,37.3787,95,percent of total billed charges,,,,,,,,,6.25,,,fee schedule,,,6.25,,,fee schedule,,,,,,,,,,,,,,,4.59648,39.346,
PROTEIN C,3050170,CDM,85302,CPT,305,RC,inpatient,,,,463.191,254.75505,,416.8719,90,percent of total billed charges,,,,463.191,100,percent of total billed charges,,,13.6914,,,fee schedule,,,13.6914,,,fee schedule,,,12.32226,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,416.8719,90,percent of total billed charges,,,,440.03145,95,percent of total billed charges,,,,,,,,,17.16,,,fee schedule,,,17.16,,,fee schedule,,,,,,,,,,,,,,,12.32226,463.191,
PROTEIN - S TOTAL,3050180,CDM,85305,CPT,305,RC,inpatient,,,,203.837,112.11035,,183.4533,90,percent of total billed charges,,,,203.837,100,percent of total billed charges,,,13.2354,,,fee schedule,,,13.2354,,,fee schedule,,,11.91186,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,183.4533,90,percent of total billed charges,,,,193.64515,95,percent of total billed charges,,,,,,,,,16.55,,,fee schedule,,,16.55,,,fee schedule,,,,,,,,,,,,,,,11.91186,203.837,
PROTHROMBIN TIME PT,3050190,CDM,85610,CPT,305,RC,inpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,4.8906,,,fee schedule,,,4.8906,,,fee schedule,,,4.40154,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.1982,90,percent of total billed charges,,,,45.5981,95,percent of total billed charges,,,,,,,,,5.61,,,fee schedule,,,5.61,,,fee schedule,,,,,,,,,,,,,,,4.40154,47.998,
RED BLOOD CELL COUNT - AUTO,3050200,CDM,85041,CPT,305,RC,inpatient,,,,25.956,14.2758,,23.3604,90,percent of total billed charges,,,,25.956,100,percent of total billed charges,,,3.4428,,,fee schedule,,,3.4428,,,fee schedule,,,3.09852,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.3604,90,percent of total billed charges,,,,24.6582,95,percent of total billed charges,,,,,,,,,4.3,,,fee schedule,,,4.3,,,fee schedule,,,,,,,,,,,,,,,3.09852,25.956,
RETIC COUNT - AUTO,3050210,CDM,85045,CPT,305,RC,inpatient,,,,36.977,20.33735,,33.2793,90,percent of total billed charges,,,,36.977,100,percent of total billed charges,,,4.5486,,,fee schedule,,,4.5486,,,fee schedule,,,4.09374,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.2793,90,percent of total billed charges,,,,35.12815,95,percent of total billed charges,,,,,,,,,5.72,,,fee schedule,,,5.72,,,fee schedule,,,,,,,,,,,,,,,4.09374,36.977,
WHITE CELL COUNT WBC - AUTO,3050250,CDM,85048,CPT,305,RC,inpatient,,,,28.325,15.57875,,25.4925,90,percent of total billed charges,,,,28.325,100,percent of total billed charges,,,2.8956,,,fee schedule,,,2.8956,,,fee schedule,,,2.60604,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.4925,90,percent of total billed charges,,,,26.90875,95,percent of total billed charges,,,,,,,,,3.64,,,fee schedule,,,3.64,,,fee schedule,,,,,,,,,,,,,,,2.60604,28.325,
HEMOGLOBINOPATHY SCREEN,3050260,CDM,85660,CPT,305,RC,inpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,6.2814,,,fee schedule,,,6.2814,,,fee schedule,,,5.65326,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,,,,,,,7.88,,,fee schedule,,,7.88,,,fee schedule,,,,,,,,,,,,,,,5.65326,55.517,
HEMACUE HEMOGLOBIN,3050270,CDM,85018,CPT,305,RC,inpatient,,,QW,33.475,18.41125,,30.1275,90,percent of total billed charges,,,,33.475,100,percent of total billed charges,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,2.43162,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.1275,90,percent of total billed charges,,,,31.80125,95,percent of total billed charges,,,,,,,,,3.38,,,fee schedule,,,3.38,,,fee schedule,,,,,,,,,,,,,,,2.43162,33.475,
FACTOR IX ASSAY,3050290,CDM,85250,CPT,305,RC,inpatient,,,,223.51,122.9305,,201.159,90,percent of total billed charges,,,,223.51,100,percent of total billed charges,,,21.7056,,,fee schedule,,,21.7056,,,fee schedule,,,19.53504,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,201.159,90,percent of total billed charges,,,,212.3345,95,percent of total billed charges,,,,,,,,,27.19,,,fee schedule,,,27.19,,,fee schedule,,,,,,,,,,,,,,,19.53504,223.51,
FACTOR 5 ASSAY,3050310,CDM,85220,CPT,305,RC,inpatient,,,,312.09,171.6495,,280.881,90,percent of total billed charges,,,,312.09,100,percent of total billed charges,,,20.121,,,fee schedule,,,20.121,,,fee schedule,,,18.1089,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.881,90,percent of total billed charges,,,,296.4855,95,percent of total billed charges,,,,,,,,,25.2,,,fee schedule,,,25.2,,,fee schedule,,,,,,,,,,,,,,,18.1089,312.09,
FACTOR 7 ASSAY,3050320,CDM,85230,CPT,305,RC,inpatient,,,,259.354,142.6447,,233.4186,90,percent of total billed charges,,,,259.354,100,percent of total billed charges,,,20.406,,,fee schedule,,,20.406,,,fee schedule,,,18.3654,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,233.4186,90,percent of total billed charges,,,,246.3863,95,percent of total billed charges,,,,,,,,,25.58,,,fee schedule,,,25.58,,,fee schedule,,,,,,,,,,,,,,,18.3654,259.354,
"PORTEIN - S, FREE",3050340,CDM,85306,CPT,305,RC,inpatient,,,,203.837,112.11035,,183.4533,90,percent of total billed charges,,,,203.837,100,percent of total billed charges,,,17.4648,,,fee schedule,,,17.4648,,,fee schedule,,,15.71832,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,183.4533,90,percent of total billed charges,,,,193.64515,95,percent of total billed charges,,,,,,,,,21.89,,,fee schedule,,,21.89,,,fee schedule,,,,,,,,,,,,,,,15.71832,203.837,
d RUSSELL VIPER VENOM TIME,3050400,CDM,85613,CPT,305,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,10.9212,,,fee schedule,,,10.9212,,,fee schedule,,,9.82908,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,8.24,,,fee schedule,,,,,,,,,,,,,,,8.24,148.732,
HEXAGONAL PHASE PHOSPHOLIPID,3050410,CDM,85598,CPT,305,RC,inpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,18.44748,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,192.3525,90,percent of total billed charges,,,,203.03875,95,percent of total billed charges,,,,,,,,,25.3,,,fee schedule,,,25.3,,,fee schedule,,,,,,,,,,,,,,,18.44748,213.725,
ANTI THROMBIN III ANTIGEN,3055158,CDM,85301,CPT,305,RC,inpatient,,,,214.652,118.0586,,193.1868,90,percent of total billed charges,,,,214.652,100,percent of total billed charges,,,12.3234,,,fee schedule,,,12.3234,,,fee schedule,,,11.09106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,193.1868,90,percent of total billed charges,,,,203.9194,95,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,15.45,,,fee schedule,,,,,,,,,,,,,,,11.09106,214.652,
PROTEIN S ACTIVITY,3055306,CDM,85306,CPT,305,RC,inpatient,,,,202.704,111.4872,,182.4336,90,percent of total billed charges,,,,202.704,100,percent of total billed charges,,,17.4648,,,fee schedule,,,17.4648,,,fee schedule,,,15.71832,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,182.4336,90,percent of total billed charges,,,,192.5688,95,percent of total billed charges,,,,,,,,,21.89,,,fee schedule,,,21.89,,,fee schedule,,,,,,,,,,,,,,,15.71832,202.704,
MORPHOLOGY,3057200,CDM,85008,CPT,305,RC,inpatient,,,,46.762,25.7191,,42.0858,90,percent of total billed charges,,,,46.762,100,percent of total billed charges,,,3.9102,,,fee schedule,,,3.9102,,,fee schedule,,,3.51918,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.0858,90,percent of total billed charges,,,,44.4239,95,percent of total billed charges,,,,,,,,,4.92,,,fee schedule,,,4.92,,,fee schedule,,,,,,,,,,,,,,,3.51918,46.762,
VON WILLEBRAND RISTOCETIN COF,3058524,CDM,85245,CPT,305,RC,inpatient,,,,245.655,135.11025,,221.0895,90,percent of total billed charges,,,,245.655,100,percent of total billed charges,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,23.53644,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,221.0895,90,percent of total billed charges,,,,233.37225,95,percent of total billed charges,,,,,,,,,32.78,,,fee schedule,,,32.78,,,fee schedule,,,,,,,,,,,,,,,23.53644,245.655,
PROTEIN C ACTIVITY,3058530,CDM,85303,CPT,305,RC,inpatient,,,,202.704,111.4872,,182.4336,90,percent of total billed charges,,,,202.704,100,percent of total billed charges,,,15.7776,,,fee schedule,,,15.7776,,,fee schedule,,,14.19984,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,182.4336,90,percent of total billed charges,,,,192.5688,95,percent of total billed charges,,,,,,,,,19.75,,,fee schedule,,,19.75,,,fee schedule,,,,,,,,,,,,,,,14.19984,202.704,
DRVVT CONFIRMATION,3058559,CDM,85597,CPT,305,RC,inpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,18.44748,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.8588,90,percent of total billed charges,,,,141.2954,95,percent of total billed charges,,,,,,,,,25.67,,,fee schedule,,,25.67,,,fee schedule,,,,,,,,,,,,,,,18.44748,148.732,
GIARDIA ANTIGEN IMMUNO ASSAY,3010960,CDM,87329,CPT,306,RC,inpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,12.29148,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,118.2852,90,percent of total billed charges,,,,124.8566,95,percent of total billed charges,,,,,,,,,12.92,,,fee schedule,,,12.92,,,fee schedule,,,,,,,,,,,,,,,12.29148,131.428,
ROTAVIRUS ANTIGEN,3011820,CDM,87425,CPT,306,RC,inpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,12.29148,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,126.072,90,percent of total billed charges,,,,133.076,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.29148,140.08,
HEPATITIS B SURFACE ANTIGEN,3020480,CDM,87340,CPT,306,RC,inpatient,,,,93.627,51.49485,,84.2643,90,percent of total billed charges,,,,93.627,100,percent of total billed charges,,,11.7762,,,fee schedule,,,11.7762,,,fee schedule,,,10.59858,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.2643,90,percent of total billed charges,,,,88.94565,95,percent of total billed charges,,,,,,,,,14.75,,,fee schedule,,,14.75,,,fee schedule,,,,,,,,,,,,,,,10.59858,93.627,
RSV ANTIGEN PREP,3020780,CDM,87634,CPT,306,RC,inpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,72.0252,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.0824,90,percent of total billed charges,,,,108.8092,95,percent of total billed charges,,,,,,,,,86.66,,,fee schedule,,,86.66,,,fee schedule,,,,,,,,,,,,,,,72.0252,114.536,
STOOL FOR WBC,3020800,CDM,89055,CPT,306,RC,inpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,4.38102,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.1982,90,percent of total billed charges,,,,45.5981,95,percent of total billed charges,,,,,,,,,5.96,,,fee schedule,,,5.96,,,fee schedule,,,,,,,,,,,,,,,4.38102,47.998,
"STREP SCREEN, GROUP A",3020810,CDM,87651,CPT,306,RC,inpatient,,,,250.805,137.94275,,225.7245,90,percent of total billed charges,,,,250.805,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,225.7245,90,percent of total billed charges,,,,238.26475,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,250.805,
BACITRACIN TEST,3060020,CDM,87163,CPT,306,RC,inpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,90,percent of total billed charges,,,,47.06585,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,49.543,
BACTERIA IDENTIFICATION #1,3060030,CDM,87077,CPT,306,RC,inpatient,,,,145.539,80.04645,,130.9851,90,percent of total billed charges,,,,145.539,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,8.29008,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,130.9851,90,percent of total billed charges,,,,138.26205,95,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,11.53,,,fee schedule,,,,,,,,,,,,,,,8.29008,145.539,
BACTERIAL IDENTIFICATION 2,3060031,CDM,87077,CPT,306,RC,inpatient,,,,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,8.29008,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.6397,90,percent of total billed charges,,,,59.78635,95,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,11.53,,,fee schedule,,,,,,,,,,,,,,,8.29008,62.933,
BACTERIAL IDENTIFICATION 3,3060032,CDM,87077,CPT,306,RC,inpatient,,,,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,8.29008,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.6397,90,percent of total billed charges,,,,59.78635,95,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,11.53,,,fee schedule,,,,,,,,,,,,,,,8.29008,62.933,
CATALASE,3060070,CDM,87163,CPT,306,RC,inpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,90,percent of total billed charges,,,,47.06585,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,49.543,
CLOSTRIDIUM DIFFICILE,3060080,CDM,87324,CPT,306,RC,inpatient,,,,124.321,68.37655,,111.8889,90,percent of total billed charges,,,,124.321,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,12.29148,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.8889,90,percent of total billed charges,,,,118.10495,95,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,12.87,,,fee schedule,,,,,,,,,,,,,,,12.29148,124.321,
CRYTOSPORIDIUM,3060100,CDM,87206,CPT,306,RC,inpatient,,,,25.956,14.2758,,23.3604,90,percent of total billed charges,,,,25.956,100,percent of total billed charges,,,6.1446,,,fee schedule,,,6.1446,,,fee schedule,,,5.53014,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.3604,90,percent of total billed charges,,,,24.6582,95,percent of total billed charges,,,,,,,,,7.67,,,fee schedule,,,7.67,,,fee schedule,,,,,,,,,,,,,,,5.53014,25.956,
CULTURE BACTERIA-ANY SOURCE,3060110,CDM,87070,CPT,306,RC,inpatient,,,,193.228,106.2754,,173.9052,90,percent of total billed charges,,,,193.228,100,percent of total billed charges,,,9.8268,,,fee schedule,,,9.8268,,,fee schedule,,,8.84412,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,173.9052,90,percent of total billed charges,,,,183.5666,95,percent of total billed charges,,,,,,,,,12.3,,,fee schedule,,,12.3,,,fee schedule,,,,,,,,,,,,,,,8.84412,193.228,
CULTURE - FUNGUS - TO LABCORP,3060122,CDM,87102,CPT,306,RC,inpatient,,,,81.061,44.58355,,72.9549,90,percent of total billed charges,,,,81.061,100,percent of total billed charges,,,9.5874,,,fee schedule,,,9.5874,,,fee schedule,,,8.62866,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.9549,90,percent of total billed charges,,,,77.00795,95,percent of total billed charges,,,,,,,,,12,,,fee schedule,,,12,,,fee schedule,,,,,,,,,,,,,,,8.62866,81.061,
CULTURE - AFB - TO LABCORP,3060132,CDM,87116,CPT,306,RC,inpatient,,,,81.061,44.58355,,72.9549,90,percent of total billed charges,,,,81.061,100,percent of total billed charges,,,12.312,,,fee schedule,,,12.312,,,fee schedule,,,11.0808,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.9549,90,percent of total billed charges,,,,77.00795,95,percent of total billed charges,,,,,,,,,15.43,,,fee schedule,,,15.43,,,fee schedule,,,,,,,,,,,,,,,11.0808,81.061,
CULTURE ANAEROBIC R,3060140,CDM,87075,CPT,306,RC,inpatient,,,,149.968,82.4824,,134.9712,90,percent of total billed charges,,,,149.968,100,percent of total billed charges,,,10.7958,,,fee schedule,,,10.7958,,,fee schedule,,,9.71622,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,134.9712,90,percent of total billed charges,,,,142.4696,95,percent of total billed charges,,,,,,,,,12.49,,,fee schedule,,,12.49,,,fee schedule,,,,,,,,,,,,,,,9.71622,149.968,
CULTURE BLOOD,3060150,CDM,87040,CPT,306,RC,inpatient,,,,88.58,48.719,,79.722,90,percent of total billed charges,,,,88.58,100,percent of total billed charges,,,11.7648,,,fee schedule,,,11.7648,,,fee schedule,,,10.58832,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.722,90,percent of total billed charges,,,,84.151,95,percent of total billed charges,,,,,,,,,14.75,,,fee schedule,,,14.75,,,fee schedule,,,,,,,,,,,,,,,10.58832,88.58,
CULTURE; STOOL,3060170,CDM,87045,CPT,306,RC,inpatient,,,,147.599,81.17945,,132.8391,90,percent of total billed charges,,,,147.599,100,percent of total billed charges,,,10.7616,,,fee schedule,,,10.7616,,,fee schedule,,,9.68544,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,132.8391,90,percent of total billed charges,,,,140.21905,95,percent of total billed charges,,,,,,,,,13.47,,,fee schedule,,,13.47,,,fee schedule,,,,,,,,,,,,,,,9.68544,147.599,
CULTURE; STOOL - E COLI O157,3060173,CDM,87046,CPT,306,RC,inpatient,,,,36.977,20.33735,,33.2793,90,percent of total billed charges,,,,36.977,100,percent of total billed charges,,,10.7616,,,fee schedule,,,10.7616,,,fee schedule,,,9.68544,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.2793,90,percent of total billed charges,,,,35.12815,95,percent of total billed charges,,,,,,,,,3.37,,,fee schedule,,,3.37,,,fee schedule,,,,,,,,,,,,,,,3.37,36.977,
CULTURE-URINE,3060200,CDM,87086,CPT,306,RC,inpatient,,,,81.061,44.58355,,72.9549,90,percent of total billed charges,,,,81.061,100,percent of total billed charges,,,9.1998,,,fee schedule,,,9.1998,,,fee schedule,,,8.27982,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.9549,90,percent of total billed charges,,,,77.00795,95,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,11.53,,,fee schedule,,,,,,,,,,,,,,,8.27982,81.061,
EHLICHIA CHAFFEENSIS DNA PCR,3060205,CDM,87798,CPT,306,RC,inpatient,,,,504.906,277.6983,,454.4154,90,percent of total billed charges,,,,504.906,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,454.4154,90,percent of total billed charges,,,,479.6607,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,504.906,
HSV DNA AMP PROBE,3060230,CDM,87529,CPT,306,RC,inpatient,,,,177.057,97.38135,,159.3513,90,percent of total billed charges,,,,177.057,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,159.3513,90,percent of total billed charges,,,,168.20415,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,177.057,
HELICOBACTER PYLORI ANTIGEN,3060236,CDM,87338,CPT,306,RC,inpatient,,,,222.377,122.30735,,200.1393,90,percent of total billed charges,,,,222.377,100,percent of total billed charges,,,16.3932,,,fee schedule,,,16.3932,,,fee schedule,,,14.75388,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,200.1393,90,percent of total billed charges,,,,211.25815,95,percent of total billed charges,,,,,,,,,6.12,,,fee schedule,,,6.12,,,fee schedule,,,,,,,,,,,,,,,6.12,222.377,
HERPES CULTURE - TYPE 1,3060240,CDM,87255,CPT,306,RC,inpatient,,,,99.601,54.78055,,89.6409,90,percent of total billed charges,,,,99.601,100,percent of total billed charges,,,38.6004,,,fee schedule,,,38.6004,,,fee schedule,,,34.74036,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.6409,90,percent of total billed charges,,,,94.62095,95,percent of total billed charges,,,,,,,,,47.31,,,fee schedule,,,47.31,,,fee schedule,,,,,,,,,,,,,,,34.74036,99.601,
INFLUENZA A&B,3060257,CDM,87502,CPT,306,RC,inpatient,,,,158.62,87.241,,142.758,90,percent of total billed charges,,,,158.62,100,percent of total billed charges,,,109.212,,,fee schedule,,,109.212,,,fee schedule,,,98.2908,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,142.758,90,percent of total billed charges,,,,150.689,95,percent of total billed charges,,,,,,,,,119.75,,,fee schedule,,,119.75,,,fee schedule,,,,,,,,,,,,,,,98.2908,158.62,
MALARIA SMEAR,3060260,CDM,87207,CPT,306,RC,inpatient,,,,55.4346,30.48903,,49.89114,90,percent of total billed charges,,,,55.4346,100,percent of total billed charges,,,6.8286,,,fee schedule,,,6.8286,,,fee schedule,,,6.14574,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.89114,90,percent of total billed charges,,,,52.66287,95,percent of total billed charges,,,,,,,,,8.56,,,fee schedule,,,8.56,,,fee schedule,,,,,,,,,,,,,,,6.14574,55.4346,
OPTHOCHIN TEST,3060270,CDM,87163,CPT,306,RC,inpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,90,percent of total billed charges,,,,47.06585,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,49.543,
ENTEROVIRUS GROUP PCR,3060273,CDM,87798,CPT,306,RC,inpatient,,,,415.193,228.35615,,373.6737,90,percent of total billed charges,,,,415.193,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,373.6737,90,percent of total billed charges,,,,394.43335,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,415.193,
OVA CYSTS PARA FECES,3060280,CDM,87177,CPT,306,RC,inpatient,,,,72.821,40.05155,,65.5389,90,percent of total billed charges,,,,72.821,100,percent of total billed charges,,,10.146,,,fee schedule,,,10.146,,,fee schedule,,,9.1314,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,65.5389,90,percent of total billed charges,,,,69.17995,95,percent of total billed charges,,,,,,,,,12.71,,,fee schedule,,,12.71,,,fee schedule,,,,,,,,,,,,,,,9.1314,72.821,
POTASSIUM OH,3060320,CDM,87210,CPT,306,RC,inpatient,,,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,6.6348,,,fee schedule,,,6.6348,,,fee schedule,,,5.97132,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.0151,90,percent of total billed charges,,,,30.62705,95,percent of total billed charges,,,,,,,,,6.1,,,fee schedule,,,6.1,,,fee schedule,,,,,,,,,,,,,,,5.97132,32.239,
GRAM STAIN,3060350,CDM,87205,CPT,306,RC,inpatient,,,,40.582,22.3201,,36.5238,90,percent of total billed charges,,,,40.582,100,percent of total billed charges,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,4.38102,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.5238,90,percent of total billed charges,,,,38.5529,95,percent of total billed charges,,,,,,,,,6.1,,,fee schedule,,,6.1,,,fee schedule,,,,,,,,,,,,,,,4.38102,40.582,
STAPH LATEX,3060360,CDM,87163,CPT,306,RC,inpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,90,percent of total billed charges,,,,47.06585,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,49.543,
VIRAL CULTURE R/L,3060370,CDM,87252,CPT,306,RC,inpatient,,,,323.111,177.71105,,290.7999,90,percent of total billed charges,,,,323.111,100,percent of total billed charges,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,26.74782,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,290.7999,90,percent of total billed charges,,,,306.95545,95,percent of total billed charges,,,,,,,,,37.22,,,fee schedule,,,37.22,,,fee schedule,,,,,,,,,,,,,,,26.74782,323.111,
WET PREP,3060390,CDM,87210,CPT,306,RC,inpatient,,,,40.582,22.3201,,36.5238,90,percent of total billed charges,,,,40.582,100,percent of total billed charges,,,6.6348,,,fee schedule,,,6.6348,,,fee schedule,,,5.97132,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.5238,90,percent of total billed charges,,,,38.5529,95,percent of total billed charges,,,,,,,,,6.1,,,fee schedule,,,6.1,,,fee schedule,,,,,,,,,,,,,,,5.97132,40.582,
SPECIAL MICROBIOLOGY CULTURE,3060410,CDM,87076,CPT,306,RC,inpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,8.29008,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,11.53,,,fee schedule,,,,,,,,,,,,,,,8.29008,14.935,
STREP ID - GROUP A,3060420,CDM,87147,CPT,306,RC,inpatient,,,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.2086,90,percent of total billed charges,,,,21.3313,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,22.454,
STREP ID - GROUP B,3060421,CDM,87147,CPT,306,RC,inpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,90,percent of total billed charges,,,,47.06585,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,49.543,
STREP ID - GROUP C,3060422,CDM,87147,CPT,306,RC,inpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,90,percent of total billed charges,,,,47.06585,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,49.543,
STREP ID - GROUP F,3060423,CDM,87147,CPT,306,RC,inpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,90,percent of total billed charges,,,,47.06585,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,49.543,
STREP ID - GROUP G,3060424,CDM,87147,CPT,306,RC,inpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.31468,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.5887,90,percent of total billed charges,,,,47.06585,95,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,7.39,,,fee schedule,,,,,,,,,,,,,,,5.31468,49.543,
HERPES CULTURE - TYPE 2,3060430,CDM,87252,CPT,306,RC,inpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,26.74782,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.8842,90,percent of total billed charges,,,,63.2111,95,percent of total billed charges,,,,,,,,,37.22,,,fee schedule,,,37.22,,,fee schedule,,,,,,,,,,,,,,,26.74782,66.538,
HIV RNA/PCR QUANT (VIRAL LOAD),3060530,CDM,87536,CPT,306,RC,inpatient,,,,487.602,268.1811,,438.8418,90,percent of total billed charges,,,,487.602,100,percent of total billed charges,,,97.014,,,fee schedule,,,97.014,,,fee schedule,,,87.3126,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,438.8418,90,percent of total billed charges,,,,463.2219,95,percent of total billed charges,,,,,,,,,121.51,,,fee schedule,,,121.51,,,fee schedule,,,,,,,,,,,,,,,87.3126,487.602,
"VARICELLA (VZV) DNA, QL RT PCR",3060973,CDM,87798,CPT,306,RC,inpatient,,,,376.877,207.28235,,339.1893,90,percent of total billed charges,,,,376.877,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,339.1893,90,percent of total billed charges,,,,358.03315,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,376.877,
EPSTEIN-BARR VIRUS PCR QUANT,3061018,CDM,87799,CPT,306,RC,inpatient,,,,273.465,150.40575,,246.1185,90,percent of total billed charges,,,,273.465,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,43.95384,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,246.1185,90,percent of total billed charges,,,,259.79175,95,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,61.17,,,fee schedule,,,,,,,,,,,,,,,43.95384,273.465,
LACTOBACILLUS SPECIES,3061550,CDM,87799,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,43.95384,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,61.17,,,fee schedule,,,,,,,,,,,,,,,43.95384,95.481,
C DIFF AMPLIFIED PROBE,3061637,CDM,87493,CPT,306,RC,inpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,42.4878,,,fee schedule,,,42.4878,,,fee schedule,,,38.23902,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,161.0199,90,percent of total billed charges,,,,169.96545,95,percent of total billed charges,,,,,,,,,51.95,,,fee schedule,,,51.95,,,fee schedule,,,,,,,,,,,,,,,38.23902,178.911,
CANDIDA ALBICAUS,3064818,CDM,87481,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,95.481,
MEGASPHAERA SPECIES,3065091,CDM,87799,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,43.95384,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,61.17,,,fee schedule,,,,,,,,,,,,,,,43.95384,95.481,
ATOPOBIUM VAGINAL,3065509,CDM,87799,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,43.95384,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,61.17,,,fee schedule,,,,,,,,,,,,,,,43.95384,95.481,
OVA & PARASITE COLON WASHING,3067209,CDM,87209,CPT,306,RC,inpatient,,,,73.954,40.6747,,66.5586,90,percent of total billed charges,,,,73.954,100,percent of total billed charges,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,18.44748,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.5586,90,percent of total billed charges,,,,70.2563,95,percent of total billed charges,,,,,,,,,25.95,,,fee schedule,,,25.95,,,fee schedule,,,,,,,,,,,,,,,18.44748,73.954,
LYME TEST BY PCR,3067476,CDM,87801,CPT,306,RC,inpatient,,,,357.719,196.74545,,321.9471,90,percent of total billed charges,,,,357.719,100,percent of total billed charges,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,72.0252,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,321.9471,90,percent of total billed charges,,,,339.83305,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,50.12,357.719,
CANDIDA TROPICALIS,3067481,CDM,87481,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,95.481,
CHLYMD TRACH DNA AMP PROBE,3067491,CDM,87491,CPT,306,RC,inpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.2041,90,percent of total billed charges,,,,135.32655,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,142.449,
CYTOMEGALOVIRUS - PCR - QUANT,3067497,CDM,87497,CPT,306,RC,inpatient,,,,491.207,270.16385,,442.0863,90,percent of total billed charges,,,,491.207,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,43.95384,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,442.0863,90,percent of total billed charges,,,,466.64665,95,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,61.17,,,fee schedule,,,,,,,,,,,,,,,43.95384,491.207,
GC NUCLEIC ACID AMPLIFICATION,3067591,CDM,87591,CPT,306,RC,inpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.2041,90,percent of total billed charges,,,,135.32655,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,142.449,
CANDIDA GLABRATA,3068187,CDM,87481,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,95.481,
SUSCEPTIBILITY STUDY - MIC,3068718,CDM,87186,CPT,306,RC,inpatient,,,,116.39,64.0145,,104.751,90,percent of total billed charges,,,,116.39,100,percent of total billed charges,,,9.861,,,fee schedule,,,9.861,,,fee schedule,,,8.8749,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,104.751,90,percent of total billed charges,,,,110.5705,95,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,8.24,,,fee schedule,,,,,,,,,,,,,,,8.24,116.39,
AFB SMEAR,3068720,CDM,87206,CPT,306,RC,inpatient,,,,30.694,16.8817,,27.6246,90,percent of total billed charges,,,,30.694,100,percent of total billed charges,,,6.1446,,,fee schedule,,,6.1446,,,fee schedule,,,5.53014,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.6246,90,percent of total billed charges,,,,29.1593,95,percent of total billed charges,,,,,,,,,7.67,,,fee schedule,,,7.67,,,fee schedule,,,,,,,,,,,,,,,5.53014,30.694,
CANDIDA PARAPSILOSIS,3068748,CDM,87481,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,95.481,
GARDNERELLA VAGINALIS,3068751,CDM,87512,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,47.6064,,,fee schedule,,,47.6064,,,fee schedule,,,42.84576,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,23.52,,,fee schedule,,,23.52,,,fee schedule,,,,,,,,,,,,,,,23.52,95.481,
HIV-1 PROBE & REVERSE TRNSCRP,3068753,CDM,87535,CPT,306,RC,inpatient,,,,368.431,202.63705,,331.5879,90,percent of total billed charges,,,,368.431,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,331.5879,90,percent of total billed charges,,,,350.00945,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,368.431,
TRICHOMONAS VAGINALIS,3068766,CDM,87661,CPT,306,RC,inpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9329,90,percent of total billed charges,,,,90.70695,95,percent of total billed charges,,,,,,,,,47.87,,,fee schedule,,,47.87,,,fee schedule,,,,,,,,,,,,,,,36.00234,95.481,
HERPES SIM VIRUS I PCR CSF,3068780,CDM,87801,CPT,306,RC,inpatient,,,,177.057,97.38135,,159.3513,90,percent of total billed charges,,,,177.057,100,percent of total billed charges,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,72.0252,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,159.3513,90,percent of total billed charges,,,,168.20415,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,50.12,177.057,
HEPATITIS C VIRUS GENOTYPING,3068790,CDM,87902,CPT,306,RC,inpatient,,,,739.437,406.69035,,665.4933,90,percent of total billed charges,,,,739.437,100,percent of total billed charges,,,293.493,,,fee schedule,,,293.493,,,fee schedule,,,264.1437,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,665.4933,90,percent of total billed charges,,,,702.46515,95,percent of total billed charges,,,,,,,,,364.64,,,fee schedule,,,364.64,,,fee schedule,,,,,,,,,,,,,,,264.1437,739.437,
SURESWAB CAND NUCLEIC ACID PRO,3068791,CDM,87481,CPT,306,RC,inpatient,,,,290.666,159.8663,,261.5994,90,percent of total billed charges,,,,290.666,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.5994,90,percent of total billed charges,,,,276.1327,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,290.666,
SURESWAB - GLABRATA,3068792,CDM,87481,CPT,306,RC,inpatient,,,,290.666,159.8663,,261.5994,90,percent of total billed charges,,,,290.666,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.5994,90,percent of total billed charges,,,,276.1327,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,290.666,
SURESWAB - TRICHOMONAS,3068793,CDM,87661,CPT,306,RC,inpatient,,,,290.666,159.8663,,261.5994,90,percent of total billed charges,,,,290.666,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.5994,90,percent of total billed charges,,,,276.1327,95,percent of total billed charges,,,,,,,,,47.87,,,fee schedule,,,47.87,,,fee schedule,,,,,,,,,,,,,,,36.00234,290.666,
SURESWAB - LACTOBACILLUS,3068794,CDM,87798,CPT,306,RC,inpatient,,,,290.666,159.8663,,261.5994,90,percent of total billed charges,,,,290.666,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,36.00234,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.5994,90,percent of total billed charges,,,,276.1327,95,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,50.12,,,fee schedule,,,,,,,,,,,,,,,36.00234,290.666,
HEPATITIS BE AG IA,3090025,CDM,87350,CPT,306,RC,inpatient,,,,132.664,72.9652,,119.3976,90,percent of total billed charges,,,,132.664,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,11.82978,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.3976,90,percent of total billed charges,,,,126.0308,95,percent of total billed charges,,,,,,,,,16.45,,,fee schedule,,,16.45,,,fee schedule,,,,,,,,,,,,,,,11.82978,132.664,
"HEPATITIS B VIRUS DNA, QUANT",3090027,CDM,87517,CPT,306,RC,inpatient,,,,305.807,168.19385,,275.2263,90,percent of total billed charges,,,,305.807,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,43.95384,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,275.2263,90,percent of total billed charges,,,,290.51665,95,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,61.17,,,fee schedule,,,,,,,,,,,,,,,43.95384,305.807,
URINE COLLECT - 24 HOUR,3012460,CDM,81050,CPT,307,RC,inpatient,,,,19.673,10.82015,,17.7057,90,percent of total billed charges,,,,19.673,100,percent of total billed charges,,,4.1496,,,fee schedule,,,4.1496,,,fee schedule,,,3.73464,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.7057,90,percent of total billed charges,,,,18.68935,95,percent of total billed charges,,,,,,,,,4.28,,,fee schedule,,,4.28,,,fee schedule,,,,,,,,,,,,,,,3.73464,19.673,
PREG TEST- URINE,3070050,CDM,81025,CPT,307,RC,inpatient,,,,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,9.8154,,,fee schedule,,,9.8154,,,fee schedule,,,8.83386,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.0974,90,percent of total billed charges,,,,54.9917,95,percent of total billed charges,,,,,,,,,8.74,,,fee schedule,,,8.74,,,fee schedule,,,,,,,,,,,,,,,8.74,57.886,
REDUCING SUB URINE,3070060,CDM,81002,CPT,307,RC,inpatient,,,,25.956,14.2758,,23.3604,90,percent of total billed charges,,,,25.956,100,percent of total billed charges,,,3.9672,,,fee schedule,,,3.9672,,,fee schedule,,,3.57048,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.3604,90,percent of total billed charges,,,,24.6582,95,percent of total billed charges,,,,,,,,,3.66,,,fee schedule,,,3.66,,,fee schedule,,,,,,,,,,,,,,,3.57048,25.956,
URINALYSIS DIPSTICK,3070080,CDM,81002,CPT,307,RC,inpatient,,,,21.218,11.6699,,19.0962,90,percent of total billed charges,,,,21.218,100,percent of total billed charges,,,3.9672,,,fee schedule,,,3.9672,,,fee schedule,,,3.57048,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.0962,90,percent of total billed charges,,,,20.1571,95,percent of total billed charges,,,,,,,,,3.66,,,fee schedule,,,3.66,,,fee schedule,,,,,,,,,,,,,,,3.57048,21.218,
URINALYSIS MICRO ONLY,3070090,CDM,81015,CPT,307,RC,inpatient,,,,28.325,15.57875,,25.4925,90,percent of total billed charges,,,,28.325,100,percent of total billed charges,,,3.477,,,fee schedule,,,3.477,,,fee schedule,,,3.1293,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.4925,90,percent of total billed charges,,,,26.90875,95,percent of total billed charges,,,,,,,,,4.34,,,fee schedule,,,4.34,,,fee schedule,,,,,,,,,,,,,,,3.1293,28.325,
CRYSTAL ID,3090000,CDM,89060,CPT,309,RC,inpatient,,,,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,8.3562,,,fee schedule,,,8.3562,,,fee schedule,,,7.52058,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.8529,90,percent of total billed charges,,,,51.56695,95,percent of total billed charges,,,,,,,,,10.21,,,fee schedule,,,10.21,,,fee schedule,,,,,,,,,,,,,,,7.52058,54.281,
FACTOR 5 LEIDEN,3001241,CDM,81241,CPT,310,RC,inpatient,,,,458.968,252.4324,,413.0712,90,percent of total billed charges,,,,458.968,100,percent of total billed charges,,,83.6418,,,fee schedule,,,83.6418,,,fee schedule,,,75.27762,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.0712,90,percent of total billed charges,,,,436.0196,95,percent of total billed charges,,,,,,,,,58.32,,,fee schedule,,,58.32,,,fee schedule,,,,,,,,,,,,,,,58.32,458.968,
FACTOR 2 DNA ANALYSIS,3008124,CDM,81240,CPT,310,RC,inpatient,,,,454.539,249.99645,,409.0851,90,percent of total billed charges,,,,454.539,100,percent of total billed charges,,,74.8866,,,fee schedule,,,74.8866,,,fee schedule,,,67.39794,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,409.0851,90,percent of total billed charges,,,,431.81205,95,percent of total billed charges,,,,,,,,,30.81,,,fee schedule,,,30.81,,,fee schedule,,,,,,,,,,,,,,,30.81,454.539,
QNATAL,3008142,CDM,81420,CPT,310,RC,inpatient,,,,3337.715,1835.74325,,3003.9435,90,percent of total billed charges,,,,3337.715,100,percent of total billed charges,,,865.317,,,fee schedule,,,865.317,,,fee schedule,,,778.7853,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3003.9435,90,percent of total billed charges,,,,3170.82925,95,percent of total billed charges,,,,,,,,,985.8,,,fee schedule,,,985.8,,,fee schedule,,,,,,,,,,,,,,,778.7853,3337.715,
FRAGILE X PCR,3018124,CDM,81243,CPT,310,RC,inpatient,,,,357.719,196.74545,,321.9471,90,percent of total billed charges,,,,357.719,100,percent of total billed charges,,,65.0256,,,fee schedule,,,65.0256,,,fee schedule,,,58.52304,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,321.9471,90,percent of total billed charges,,,,339.83305,95,percent of total billed charges,,,,,,,,,64.66,,,fee schedule,,,64.66,,,fee schedule,,,,,,,,,,,,,,,58.52304,357.719,
TISSUE CULTURE,3098823,CDM,88230,CPT,310,RC,inpatient,,,,357.719,196.74545,,321.9471,90,percent of total billed charges,,,,357.719,100,percent of total billed charges,,,132.7986,,,fee schedule,,,132.7986,,,fee schedule,,,119.51874,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,321.9471,90,percent of total billed charges,,,,339.83305,95,percent of total billed charges,,,,,,,,,91.26,,,fee schedule,,,91.26,,,fee schedule,,,,,,,,,,,,,,,91.26,357.719,
CHROMOSOME ANALYSIS,3098826,CDM,88262,CPT,310,RC,inpatient,,,,476.89,262.2895,,429.201,90,percent of total billed charges,,,,476.89,100,percent of total billed charges,,,143.0586,,,fee schedule,,,143.0586,,,fee schedule,,,128.75274,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,429.201,90,percent of total billed charges,,,,453.0455,95,percent of total billed charges,,,,,,,,,177.99,,,fee schedule,,,177.99,,,fee schedule,,,,,,,,,,,,,,,128.75274,476.89,
"Cytopathology,selective cellul",3108112,CDM,88112,CPT,310,RC,inpatient,,,,54.899,30.19445,,49.4091,90,percent of total billed charges,,,,54.899,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,46.49832,,,fee schedule,,,67.9065,,,fee schedule,,,67.9065,,,fee schedule,,,,,,,,,67.9065,,,fee schedule,,,,,,,,,,49.4091,90,percent of total billed charges,,,,52.15405,95,percent of total billed charges,,,69.943695,,,fee schedule,,,55.88,,,fee schedule,,,55.88,,,fee schedule,,,,,,,,,67.9065,,,fee schedule,,,46.49832,69.943695,
HEREDITARY HEMACHROMATOSIS,3108125,CDM,81256,CPT,310,RC,inpatient,,,,243.08,133.694,,218.772,90,percent of total billed charges,,,,243.08,100,percent of total billed charges,,,74.5104,,,fee schedule,,,74.5104,,,fee schedule,,,67.05936,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,218.772,90,percent of total billed charges,,,,230.926,95,percent of total billed charges,,,,,,,,,77.28,,,fee schedule,,,77.28,,,fee schedule,,,,,,,,,,,,,,,67.05936,243.08,
HLA CLASS - B51,3108138,CDM,81381,CPT,310,RC,inpatient,,,,1040.712,572.3916,,936.6408,90,percent of total billed charges,,,,1040.712,100,percent of total billed charges,,,193.686,,,fee schedule,,,193.686,,,fee schedule,,,174.3174,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,936.6408,90,percent of total billed charges,,,,988.6764,95,percent of total billed charges,,,,,,,,,96.72,,,fee schedule,,,96.72,,,fee schedule,,,,,,,,,,,,,,,96.72,1040.712,
CYTP FNA INTERPRET & REPORT,3108173,CDM,88173,CPT,310,RC,inpatient,,,,116.184,63.9012,,104.5656,90,percent of total billed charges,,,,116.184,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,46.49832,,,fee schedule,,,167.10325,,,fee schedule,,,167.10325,,,fee schedule,,,,,,,,,167.10325,,,fee schedule,,,,,,,,,,104.5656,90,percent of total billed charges,,,,110.3748,95,percent of total billed charges,,,172.1163475,,,fee schedule,,,,,,,,,,,,,,,,,,,,,167.10325,,,fee schedule,,,46.49832,172.1163475,
Level I - Surgical pathology,3108300,CDM,88300,CPT,310,RC,inpatient,,,,18.54,10.197,,16.686,90,percent of total billed charges,,,,18.54,100,percent of total billed charges,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,23.14656,,,fee schedule,,,16.310875,,,fee schedule,,,16.310875,,,fee schedule,,,,,,,,,16.310875,,,fee schedule,,,,,,,,,,16.686,90,percent of total billed charges,,,,17.613,95,percent of total billed charges,,,16.80020125,,,fee schedule,,,9,,,fee schedule,,,9,,,fee schedule,,,,,,,,,16.310875,,,fee schedule,,,9,25.7184,
Level II - Surgical pathology,3108302,CDM,88302,CPT,310,RC,inpatient,,,,34.608,19.0344,,31.1472,90,percent of total billed charges,,,,34.608,100,percent of total billed charges,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,23.14656,,,fee schedule,,,33.2875,,,fee schedule,,,33.2875,,,fee schedule,,,,,,,,,33.2875,,,fee schedule,,,,,,,,,,31.1472,90,percent of total billed charges,,,,32.8776,95,percent of total billed charges,,,34.286125,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,33.2875,,,fee schedule,,,18,34.608,
Level III - Surgical pathology,3108304,CDM,88304,CPT,310,RC,inpatient,,,,54.899,30.19445,,49.4091,90,percent of total billed charges,,,,54.899,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,46.49832,,,fee schedule,,,42.940875,,,fee schedule,,,42.940875,,,fee schedule,,,,,,,,,42.940875,,,fee schedule,,,,,,,,,,49.4091,90,percent of total billed charges,,,,52.15405,95,percent of total billed charges,,,44.22910125,,,fee schedule,,,22,,,fee schedule,,,22,,,fee schedule,,,,,,,,,42.940875,,,fee schedule,,,22,54.899,
Level IV - Surgical pathology,3108305,CDM,88305,CPT,310,RC,inpatient,,,,51.191,28.15505,,46.0719,90,percent of total billed charges,,,,51.191,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,46.49832,,,fee schedule,,,71.568125,,,fee schedule,,,71.568125,,,fee schedule,,,,,,,,,71.568125,,,fee schedule,,,,,,,,,,46.0719,90,percent of total billed charges,,,,48.63145,95,percent of total billed charges,,,73.71516875,,,fee schedule,,,28,,,fee schedule,,,28,,,fee schedule,,,,,,,,,71.568125,,,fee schedule,,,28,73.71516875,
Level V - Surgical pathology,3108307,CDM,88307,CPT,310,RC,inpatient,,,,295.198,162.3589,,265.6782,90,percent of total billed charges,,,,295.198,100,percent of total billed charges,,,334.0314,,,fee schedule,,,334.0314,,,fee schedule,,,300.62826,,,fee schedule,,,287.604,,,fee schedule,,,287.604,,,fee schedule,,,,,,,,,287.604,,,fee schedule,,,,,,,,,,265.6782,90,percent of total billed charges,,,,280.4381,95,percent of total billed charges,,,296.23212,,,fee schedule,,,53,,,fee schedule,,,53,,,fee schedule,,,,,,,,,287.604,,,fee schedule,,,53,334.0314,
Level VI - Surgical pathology,3108309,CDM,88309,CPT,310,RC,inpatient,,,,600.696,330.3828,,540.6264,90,percent of total billed charges,,,,600.696,100,percent of total billed charges,,,800.2686,,,fee schedule,,,800.2686,,,fee schedule,,,720.24174,,,fee schedule,,,432.07175,,,fee schedule,,,432.07175,,,fee schedule,,,,,,,,,432.07175,,,fee schedule,,,,,,,,,,540.6264,90,percent of total billed charges,,,,570.6612,95,percent of total billed charges,,,445.0339025,,,fee schedule,,,46,,,fee schedule,,,46,,,fee schedule,,,,,,,,,432.07175,,,fee schedule,,,46,800.2686,
Decalcification procedure,3108311,CDM,88311,CPT,310,RC,inpatient,,,,14.523,7.98765,,13.0707,90,percent of total billed charges,,,,14.523,100,percent of total billed charges,,,7.82,,,fee schedule,,,7.82,,,fee schedule,,,7.038,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,,,,,,20.305375,,,fee schedule,,,,,,,,,,13.0707,90,percent of total billed charges,,,,13.79685,95,percent of total billed charges,,,20.91453625,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,20.305375,,,fee schedule,,,7.038,20.91453625,
SPECIAL STAIN GROUP I,3108312,CDM,88312,CPT,310,RC,inpatient,,,,94.245,51.83475,,84.8205,90,percent of total billed charges,,,,94.245,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,46.49832,,,fee schedule,,,112.51175,,,fee schedule,,,112.51175,,,fee schedule,,,,,,,,,112.51175,,,fee schedule,,,,,,,,,,84.8205,90,percent of total billed charges,,,,89.53275,95,percent of total billed charges,,,115.8871025,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,112.51175,,,fee schedule,,,13,115.8871025,
SPECIAL STAIN GROUP II,3108313,CDM,88313,CPT,310,RC,inpatient,,,,76.735,42.20425,,69.0615,90,percent of total billed charges,,,,76.735,100,percent of total billed charges,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,31.4982,,,fee schedule,,,82.885875,,,fee schedule,,,82.885875,,,fee schedule,,,,,,,,,82.885875,,,fee schedule,,,,,,,,,,69.0615,90,percent of total billed charges,,,,72.89825,95,percent of total billed charges,,,85.37245125,,,fee schedule,,,7,,,fee schedule,,,7,,,fee schedule,,,,,,,,,82.885875,,,fee schedule,,,7,85.37245125,
Immunohistochemistry ea add'l,3108341,CDM,88341,CPT,310,RC,inpatient,,,,82.606,45.4333,,74.3454,90,percent of total billed charges,,,,82.606,100,percent of total billed charges,,,56.88,,,fee schedule,,,56.88,,,fee schedule,,,51.192,,,fee schedule,,,90.542,,,fee schedule,,,90.542,,,fee schedule,,,,,,,,,90.542,,,fee schedule,,,,,,,,,,74.3454,90,percent of total billed charges,,,,78.4757,95,percent of total billed charges,,,93.25826,,,fee schedule,,,40.26,,,fee schedule,,,40.26,,,fee schedule,,,,,,,,,90.542,,,fee schedule,,,40.26,93.25826,
Immunohistochemistry per spec,3108342,CDM,88342,CPT,310,RC,inpatient,,,,93.73,51.5515,,84.357,90,percent of total billed charges,,,,93.73,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,145.85616,,,fee schedule,,,105.85425,,,fee schedule,,,105.85425,,,fee schedule,,,,,,,,,105.85425,,,fee schedule,,,,,,,,,,84.357,90,percent of total billed charges,,,,89.0435,95,percent of total billed charges,,,109.0298775,,,fee schedule,,,39.6,,,fee schedule,,,39.6,,,fee schedule,,,,,,,,,105.85425,,,fee schedule,,,39.6,162.0624,
FLOW CYTOTOGY,3110000,CDM,88182,CPT,311,RC,inpatient,,,,362.972,199.6346,,326.6748,90,percent of total billed charges,,,,362.972,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,46.49832,,,fee schedule,,,166.770375,,,fee schedule,,,166.770375,,,fee schedule,,,,,,,,,166.770375,,,fee schedule,,,,,,,,,,326.6748,90,percent of total billed charges,,,,344.8234,95,percent of total billed charges,,,171.7734863,,,fee schedule,,,34,,,fee schedule,,,34,,,fee schedule,,,,,,,,,166.770375,,,fee schedule,,,34,362.972,
CYTOPATHOLOGY EVAL FNA,3118172,CDM,88172,CPT,311,RC,inpatient,,,,336.707,185.18885,,303.0363,90,percent of total billed charges,,,,336.707,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,145.85616,,,fee schedule,,,55.590125,,,fee schedule,,,55.590125,,,fee schedule,,,,,,,,,55.590125,,,fee schedule,,,,,,,,,,303.0363,90,percent of total billed charges,,,,319.87165,95,percent of total billed charges,,,57.25782875,,,fee schedule,,,52.89,,,fee schedule,,,52.89,,,fee schedule,,,,,,,,,55.590125,,,fee schedule,,,52.89,336.707,
FNA BX W/FLURO 1ST LESION,3200007,CDM,10007,CPT,320,RC,inpatient,,,,826.266,454.4463,,743.6394,90,percent of total billed charges,,,,826.266,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,594.023625,,,fee schedule,,,88.211875,,,fee schedule,,,88.211875,,,fee schedule,,,,,,,,,88.211875,,,fee schedule,,,,,,,,,,743.6394,90,percent of total billed charges,,,,784.9527,95,percent of total billed charges,,,90.85823125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,88.211875,,,fee schedule,,,88.211875,826.266,
ABDOMEN ACUTE SERIES,3200010,CDM,74022,CPT,320,RC,inpatient,,,,375.229,206.37595,,337.7061,90,percent of total billed charges,,,,375.229,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,49.93125,,,fee schedule,,,49.93125,,,fee schedule,,,,,,,,,49.93125,,,fee schedule,,,,,,,,,,337.7061,90,percent of total billed charges,,,,356.46755,95,percent of total billed charges,,,51.4291875,,,fee schedule,,,32,,,fee schedule,,,32,,,fee schedule,,,,,,,,,49.93125,,,fee schedule,,,32,375.229,
X-RAY ABDOMEN 1 VIEW,3200020,CDM,74018,CPT,320,RC,inpatient,,,,206.618,113.6399,,185.9562,90,percent of total billed charges,,,,206.618,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,30.291625,,,fee schedule,,,30.291625,,,fee schedule,,,,,,,,,30.291625,,,fee schedule,,,,,,,,,,185.9562,90,percent of total billed charges,,,,196.2871,95,percent of total billed charges,,,31.20037375,,,fee schedule,,,20.26,,,fee schedule,,,20.26,,,fee schedule,,,,,,,,,30.291625,,,fee schedule,,,20.26,206.618,
X-RAY ANKLE 3 VIEWS BILATERAL,3200045,CDM,73610,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,18,87.55,
X-RAY BONE SURVEY COMPLETE,3200150,CDM,77075,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,99.529625,,,fee schedule,,,99.529625,,,fee schedule,,,,,,,,,99.529625,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,102.5155138,,,fee schedule,,,72.09,,,fee schedule,,,72.09,,,fee schedule,,,,,,,,,99.529625,,,fee schedule,,,72.09,167.375,
"X-RAY,SPINE CERVICAL 3 OR LESS",3200210,CDM,72040,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,39.612125,,,fee schedule,,,39.612125,,,fee schedule,,,,,,,,,39.612125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,40.80048875,,,fee schedule,,,28,,,fee schedule,,,28,,,fee schedule,,,,,,,,,39.612125,,,fee schedule,,,28,87.55,
SWALLOW STUDY/W/VIDEO,3200220,CDM,74230,CPT,320,RC,inpatient,,,,194.979,107.23845,,175.4811,90,percent of total billed charges,,,,194.979,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,124.49525,,,fee schedule,,,124.49525,,,fee schedule,,,,,,,,,124.49525,,,fee schedule,,,,,,,,,,175.4811,90,percent of total billed charges,,,,185.23005,95,percent of total billed charges,,,128.2301075,,,fee schedule,,,29,,,fee schedule,,,29,,,fee schedule,,,,,,,,,124.49525,,,fee schedule,,,29,194.979,
"X-RAY,SPINE CERVICAL;4 OR 5 V",3200230,CDM,72050,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,53.592875,,,fee schedule,,,53.592875,,,fee schedule,,,,,,,,,53.592875,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,55.20066125,,,fee schedule,,,32,,,fee schedule,,,32,,,fee schedule,,,,,,,,,53.592875,,,fee schedule,,,32,167.375,
"X-RAY,SPINE CERVICAL 6 OR MORE",3200240,CDM,72052,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,64.457915,,,fee schedule,,,55,,,fee schedule,,,55,,,fee schedule,,,,,,,,,62.5805,,,fee schedule,,,55,167.375,
X-RAY CHEST 2 VIEWS,3200250,CDM,71046,CPT,320,RC,inpatient,,,,217.227,119.47485,,195.5043,90,percent of total billed charges,,,,217.227,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,33.620375,,,fee schedule,,,33.620375,,,fee schedule,,,,,,,,,33.620375,,,fee schedule,,,,,,,,,,195.5043,90,percent of total billed charges,,,,206.36565,95,percent of total billed charges,,,34.62898625,,,fee schedule,,,21.87,,,fee schedule,,,21.87,,,fee schedule,,,,,,,,,33.620375,,,fee schedule,,,21.87,217.227,
CHOLANGIOGRAPHY INTRAOPERATIVE,3200280,CDM,74300,CPT,320,RC,inpatient,,,FY,369.77,203.3735,,332.793,90,percent of total billed charges,,,,369.77,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,332.793,90,percent of total billed charges,,,,351.2815,95,percent of total billed charges,,,,,,,,,24,,,fee schedule,,,24,,,fee schedule,,,,,,,,,,,,,,,24,369.77,
X-RAY SACRUM & COCCYX > 2,3200310,CDM,72220,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.6004025,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,17,87.55,
X-RAY COLON W/AIR W/HD BARIUM,3200320,CDM,74280,CPT,320,RC,inpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,219.364625,,,fee schedule,,,219.364625,,,fee schedule,,,,,,,,,219.364625,,,fee schedule,,,,,,,,,,320.4639,90,percent of total billed charges,,,,338.26745,95,percent of total billed charges,,,225.9455638,,,fee schedule,,,45,,,fee schedule,,,45,,,fee schedule,,,,,,,,,219.364625,,,fee schedule,,,45,356.071,
X-RAY COLON BARIUM ENEMA,3200330,CDM,74270,CPT,320,RC,inpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,153.1225,,,fee schedule,,,153.1225,,,fee schedule,,,,,,,,,153.1225,,,fee schedule,,,,,,,,,,320.4639,90,percent of total billed charges,,,,338.26745,95,percent of total billed charges,,,157.716175,,,fee schedule,,,49,,,fee schedule,,,49,,,fee schedule,,,,,,,,,153.1225,,,fee schedule,,,49,356.071,
CYSTOGRAPHY MINIMUM 3 VIEWS,3200340,CDM,74430,CPT,320,RC,inpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,,,,,,,,320.4639,90,percent of total billed charges,,,,338.26745,95,percent of total billed charges,,,42.514795,,,fee schedule,,,,,,,,,,,,,,,,,,,,,41.2765,,,fee schedule,,,41.2765,366.59,
VOIDING URETHROCYSTOGRAPHY,3200345,CDM,74455,CPT,320,RC,inpatient,,,,345.462,190.0041,,310.9158,90,percent of total billed charges,,,,345.462,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,103.857,,,fee schedule,,,103.857,,,fee schedule,,,,,,,,,103.857,,,fee schedule,,,,,,,,,,310.9158,90,percent of total billed charges,,,,328.1889,95,percent of total billed charges,,,106.97271,,,fee schedule,,,,,,,,,,,,,,,,,,,,,103.857,,,fee schedule,,,103.857,345.462,
X-RAY ELBOW (BILAT) AP & LAT,3200415,CDM,73070,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,18,87.55,
ESOPHAGRAM,3200430,CDM,74220,CPT,320,RC,inpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,97.1995,,,fee schedule,,,97.1995,,,fee schedule,,,,,,,,,97.1995,,,fee schedule,,,,,,,,,,320.4639,90,percent of total billed charges,,,,338.26745,95,percent of total billed charges,,,100.115485,,,fee schedule,,,36,,,fee schedule,,,36,,,fee schedule,,,,,,,,,97.1995,,,fee schedule,,,36,356.071,
X-RAY FACIAL BONES MIN 3 VWS,3200450,CDM,70150,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,48.6862975,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,18,167.375,
X-RAY CHEST 1 VIEW,3200500,CDM,71045,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,25.631375,,,fee schedule,,,25.631375,,,fee schedule,,,,,,,,,25.631375,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,26.40031625,,,fee schedule,,,11.86,,,fee schedule,,,11.86,,,fee schedule,,,,,,,,,25.631375,,,fee schedule,,,11.86,87.55,
FLUOROSCOPY UP TO 1 HR,3200510,CDM,76000,CPT,320,RC,inpatient,,,,450.316,247.6738,,405.2844,90,percent of total billed charges,,,,450.316,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,42.608,,,fee schedule,,,42.608,,,fee schedule,,,,,,,,,42.608,,,fee schedule,,,,,,,,,,405.2844,90,percent of total billed charges,,,,427.8002,95,percent of total billed charges,,,43.88624,,,fee schedule,,,,,,,,,,,,,,,,,,,,,42.608,,,fee schedule,,,42.608,450.316,
X-RAY FOOT COMPLETE BILATERAL,3200535,CDM,73630,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,35.31470875,,,fee schedule,,,28,,,fee schedule,,,28,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,28,87.55,
FOREIGN BODY SINGLE FILM CHILD,3200570,CDM,76010,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,7.2,,,fee schedule,,,7.2,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,7.2,87.55,
FLUORO NEEDLE PLACEMENT,3200600,CDM,77002,CPT,320,RC,inpatient,,,,89.61,49.2855,,80.649,90,percent of total billed charges,,,,89.61,100,percent of total billed charges,,,75.65,,,fee schedule,,,75.65,,,fee schedule,,,68.085,,,fee schedule,,,115.8405,,,fee schedule,,,115.8405,,,fee schedule,,,,,,,,,115.8405,,,fee schedule,,,,,,,,,,80.649,90,percent of total billed charges,,,,85.1295,95,percent of total billed charges,,,119.315715,,,fee schedule,,,65.45,,,fee schedule,,,65.45,,,fee schedule,,,,,,,,,115.8405,,,fee schedule,,,65.45,119.315715,
X-RAY HAND 3 VW MINIMUM/BIL,3200611,CDM,73130,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,37.282,,,fee schedule,,,37.282,,,fee schedule,,,,,,,,,37.282,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,38.40046,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,37.282,,,fee schedule,,,25,87.55,
HYSTEROSALPINGOGRAPHY S&I,3200710,CDM,74740,CPT,320,RC,inpatient,,,,345.462,190.0041,,310.9158,90,percent of total billed charges,,,,345.462,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,93.537875,,,fee schedule,,,93.537875,,,fee schedule,,,,,,,,,93.537875,,,fee schedule,,,,,,,,,,310.9158,90,percent of total billed charges,,,,328.1889,95,percent of total billed charges,,,96.34401125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,93.537875,,,fee schedule,,,93.537875,345.462,
UROGRAPHY IV/W/WO KUB (IVP),3200720,CDM,74400,CPT,320,RC,inpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,134.814375,,,fee schedule,,,134.814375,,,fee schedule,,,,,,,,,134.814375,,,fee schedule,,,,,,,,,,320.4639,90,percent of total billed charges,,,,338.26745,95,percent of total billed charges,,,138.8588063,,,fee schedule,,,55,,,fee schedule,,,55,,,fee schedule,,,,,,,,,134.814375,,,fee schedule,,,55,356.071,
X-RAY SPINE/LUMBOSACRAL AP/LAT,3200800,CDM,72100,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,39.945,,,fee schedule,,,39.945,,,fee schedule,,,,,,,,,39.945,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,41.14335,,,fee schedule,,,28,,,fee schedule,,,28,,,fee schedule,,,,,,,,,39.945,,,fee schedule,,,28,167.375,
X-RAY SPINE LUMBAR COMPL/W/OBL,3200820,CDM,72110,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,51.9285,,,fee schedule,,,51.9285,,,fee schedule,,,,,,,,,51.9285,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,53.486355,,,fee schedule,,,40,,,fee schedule,,,40,,,fee schedule,,,,,,,,,51.9285,,,fee schedule,,,40,167.375,
X-RAY LUMBOSCRAL COMPLETE W/BE,3200825,CDM,72114,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,61.249,,,fee schedule,,,61.249,,,fee schedule,,,,,,,,,61.249,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,63.08647,,,fee schedule,,,45,,,fee schedule,,,45,,,fee schedule,,,,,,,,,61.249,,,fee schedule,,,45,167.375,
X-RAY BOTH KNEES STANDING A&P,3200840,CDM,73565,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,39.945,,,fee schedule,,,39.945,,,fee schedule,,,,,,,,,39.945,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,41.14335,,,fee schedule,,,22,,,fee schedule,,,22,,,fee schedule,,,,,,,,,39.945,,,fee schedule,,,22,87.55,
X-RAY MANDIBLE;COMPL MIN 4 VIE,3200850,CDM,70110,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,43.606625,,,fee schedule,,,43.606625,,,fee schedule,,,,,,,,,43.606625,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,44.91482375,,,fee schedule,,,26,,,fee schedule,,,26,,,fee schedule,,,,,,,,,43.606625,,,fee schedule,,,26,167.375,
"MYELOGRAPHY,CERVICAL, S&I",3200870,CDM,72240,CPT,320,RC,inpatient,,,,960.578,528.3179,,864.5202,90,percent of total billed charges,,,,960.578,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,588.249,,,fee schedule,,,111.846,,,fee schedule,,,111.846,,,fee schedule,,,,,,,,,111.846,,,fee schedule,,,,,,,,,,864.5202,90,percent of total billed charges,,,,912.5491,95,percent of total billed charges,,,115.20138,,,fee schedule,,,,,,,,,,,,,,,,,,,,,111.846,,,fee schedule,,,111.846,960.578,
"MYELOGRAPHY,LUMBOSACRAL, S&I",3200880,CDM,62304,CPT,320,RC,inpatient,,,,978.809,538.34495,,880.9281,90,percent of total billed charges,,,,978.809,100,percent of total billed charges,,,753.3675,,,fee schedule,,,753.3675,,,fee schedule,,,678.03075,,,fee schedule,,,115.507625,,,fee schedule,,,115.507625,,,fee schedule,,,,,,,,,115.507625,,,fee schedule,,,,,,,,,,880.9281,90,percent of total billed charges,,,,929.86855,95,percent of total billed charges,,,118.9728538,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,115.507625,,,fee schedule,,,115.507625,978.809,
X-RAY NASASL BONES COMPL MIN 3,3200900,CDM,70160,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,37.614875,,,fee schedule,,,37.614875,,,fee schedule,,,,,,,,,37.614875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,38.74332125,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,37.614875,,,fee schedule,,,23,87.55,
X-RAY NECK SOFT TISSUE,3200910,CDM,70360,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,31.29025,,,fee schedule,,,31.29025,,,fee schedule,,,,,,,,,31.29025,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,32.2289575,,,fee schedule,,,10,,,fee schedule,,,10,,,fee schedule,,,,,,,,,31.29025,,,fee schedule,,,10,87.55,
FLUORO GUIDE SPINAL INJECTIONS,3200920,CDM,77003,CPT,320,RC,inpatient,,,,88.683,48.77565,,79.8147,90,percent of total billed charges,,,,88.683,100,percent of total billed charges,,,66.93,,,fee schedule,,,66.93,,,fee schedule,,,60.237,,,fee schedule,,,105.1885,,,fee schedule,,,105.1885,,,fee schedule,,,,,,,,,105.1885,,,fee schedule,,,,,,,,,,79.8147,90,percent of total billed charges,,,,84.24885,95,percent of total billed charges,,,108.344155,,,fee schedule,,,65.45,,,fee schedule,,,65.45,,,fee schedule,,,,,,,,,105.1885,,,fee schedule,,,60.237,108.344155,
MAMMO GUIDE NEEDLE PLCMNT RT,3200930,CDM,19281,CPT,320,RC,inpatient,,,RT,721.824,397.0032,,649.6416,90,percent of total billed charges,,,,721.824,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1372.5855,,,fee schedule,,,96.200875,,,fee schedule,,,96.200875,,,fee schedule,,,,,,,,,96.200875,,,fee schedule,,,,,,,,,,649.6416,90,percent of total billed charges,,,,685.7328,95,percent of total billed charges,,,99.08690125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,96.200875,,,fee schedule,,,96.200875,1525.095,
MAMMO GUIDE NEEDLE PLCMT LT,3200935,CDM,19281,CPT,320,RC,inpatient,,,LT,721.824,397.0032,,649.6416,90,percent of total billed charges,,,,721.824,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1372.5855,,,fee schedule,,,96.200875,,,fee schedule,,,96.200875,,,fee schedule,,,,,,,,,96.200875,,,fee schedule,,,,,,,,,,649.6416,90,percent of total billed charges,,,,685.7328,95,percent of total billed charges,,,99.08690125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,96.200875,,,fee schedule,,,96.200875,1525.095,
BREAST TISSUE SPEC SURG RT,3200950,CDM,76098,CPT,320,RC,inpatient,,,,685.671,377.11905,,617.1039,90,percent of total billed charges,,,,685.671,100,percent of total billed charges,,,462.34,,,fee schedule,,,462.34,,,fee schedule,,,416.106,,,fee schedule,,,42.608,,,fee schedule,,,42.608,,,fee schedule,,,,,,,,,42.608,,,fee schedule,,,,,,,,,,617.1039,90,percent of total billed charges,,,,651.38745,95,percent of total billed charges,,,43.88624,,,fee schedule,,,14,,,fee schedule,,,14,,,fee schedule,,,,,,,,,42.608,,,fee schedule,,,14,685.671,
BREAST TISSUE SPEC SURG LT,3200951,CDM,76098,CPT,320,RC,inpatient,,,,685.671,377.11905,,617.1039,90,percent of total billed charges,,,,685.671,100,percent of total billed charges,,,462.34,,,fee schedule,,,462.34,,,fee schedule,,,416.106,,,fee schedule,,,42.608,,,fee schedule,,,42.608,,,fee schedule,,,,,,,,,42.608,,,fee schedule,,,,,,,,,,617.1039,90,percent of total billed charges,,,,651.38745,95,percent of total billed charges,,,43.88624,,,fee schedule,,,14,,,fee schedule,,,14,,,fee schedule,,,,,,,,,42.608,,,fee schedule,,,14,685.671,
X-RAY ORBITS COMPL MIN 4 VIEWS,3200960,CDM,70200,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,47.934,,,fee schedule,,,47.934,,,fee schedule,,,,,,,,,47.934,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,49.37202,,,fee schedule,,,14,,,fee schedule,,,14,,,fee schedule,,,,,,,,,47.934,,,fee schedule,,,14,167.375,
X-RAY PELVIS 1 OR 2 VIEWS,3201020,CDM,72170,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,27.9615,,,fee schedule,,,27.9615,,,fee schedule,,,,,,,,,27.9615,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,28.800345,,,fee schedule,,,21,,,fee schedule,,,21,,,fee schedule,,,,,,,,,27.9615,,,fee schedule,,,21,167.375,
"X-RAY,RIBS BILAT/W/CHEST MIN 4",3201050,CDM,71111,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,52.59425,,,fee schedule,,,52.59425,,,fee schedule,,,,,,,,,52.59425,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,54.1720775,,,fee schedule,,,32,,,fee schedule,,,32,,,fee schedule,,,,,,,,,52.59425,,,fee schedule,,,32,167.375,
X-RAY RIBS BILATERAL 3 VIEWS,3201051,CDM,71110,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,43.9395,,,fee schedule,,,43.9395,,,fee schedule,,,,,,,,,43.9395,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,45.257685,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,43.9395,,,fee schedule,,,25,167.375,
X-RAY SACROILIAC JNT > 3 VIEW,3201070,CDM,72202,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,39.27925,,,fee schedule,,,39.27925,,,fee schedule,,,,,,,,,39.27925,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,40.4576275,,,fee schedule,,,21,,,fee schedule,,,21,,,fee schedule,,,,,,,,,39.27925,,,fee schedule,,,21,167.375,
X-RAY SINUSES LESS THAN 3 VWS,3201180,CDM,70210,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,14,,,fee schedule,,,14,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,14,87.55,
X-RAY SINUSES COMPL MIN 3 VWS,3201190,CDM,70220,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,37.614875,,,fee schedule,,,37.614875,,,fee schedule,,,,,,,,,37.614875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,38.74332125,,,fee schedule,,,30,,,fee schedule,,,30,,,fee schedule,,,,,,,,,37.614875,,,fee schedule,,,30,87.55,
X-RAY ANKLE 3VW RT,3201201,CDM,73610,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,18,87.55,
X-RAY ANKLE 3VW LT,3201202,CDM,73610,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,18,87.55,
X-RAY ANKLE 2VW RT,3201203,CDM,73600,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,30,,,fee schedule,,,30,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,30,87.55,
X-RAY ANKLE 2VW LT,3201204,CDM,73600,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,30,,,fee schedule,,,30,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,30,87.55,
X-RAY ANKLE 2VW BILATERAL,3201205,CDM,73600,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,30,,,fee schedule,,,30,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,30,87.55,
X-RAY CLAVICLE 2VW RT,3201206,CDM,73000,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.6004025,,,fee schedule,,,15,,,fee schedule,,,15,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,15,87.55,
X-RAY CLAVICLE 2VW LT,3201207,CDM,73000,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.6004025,,,fee schedule,,,15,,,fee schedule,,,15,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,15,87.55,
X-RAY CLAVICLE 2VW BILATERAL,3201208,CDM,73000,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.6004025,,,fee schedule,,,15,,,fee schedule,,,15,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,15,87.55,
X-RAY ELBOW 2VW RT,3201209,CDM,73070,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,18,87.55,
X-RAY SKULL LESS THAN 4 VIEWS,3201220,CDM,70250,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,35.9505,,,fee schedule,,,35.9505,,,fee schedule,,,,,,,,,35.9505,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,37.029015,,,fee schedule,,,22,,,fee schedule,,,22,,,fee schedule,,,,,,,,,35.9505,,,fee schedule,,,22,167.375,
X-RAY SKULL COMPLETE MIN 4 VWS,3201230,CDM,70260,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,44.60525,,,fee schedule,,,44.60525,,,fee schedule,,,,,,,,,44.60525,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,45.9434075,,,fee schedule,,,30,,,fee schedule,,,30,,,fee schedule,,,,,,,,,44.60525,,,fee schedule,,,30,167.375,
X-RAY SM BOWEL C/ MULTI SERIAL,3201240,CDM,74250,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,121.499375,,,fee schedule,,,121.499375,,,fee schedule,,,,,,,,,121.499375,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,125.1443563,,,fee schedule,,,35,,,fee schedule,,,35,,,fee schedule,,,,,,,,,121.499375,,,fee schedule,,,35,174.94,
"X-RAY,STERNUM MIN 2 VIEWS",3201270,CDM,71120,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,33.620375,,,fee schedule,,,33.620375,,,fee schedule,,,,,,,,,33.620375,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,34.62898625,,,fee schedule,,,14,,,fee schedule,,,14,,,fee schedule,,,,,,,,,33.620375,,,fee schedule,,,14,87.55,
"XRAY,SPINE,THORACIC,ANTEROPOST",3201290,CDM,72070,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,33.94326375,,,fee schedule,,,24,,,fee schedule,,,24,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,24,167.375,
X-RAY ELBOW 2VW LT,3201301,CDM,73070,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,18,87.55,
X-RAY ELBOW 3VW RT,3201303,CDM,73080,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.94326375,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,19,87.55,
X-RAY ELBOW 3VW LT,3201304,CDM,73080,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.94326375,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,19,87.55,
X-RAY ELBOW 3VW BILATERAL,3201305,CDM,73080,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.94326375,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,19,87.55,
X-RAY FEMUR MIN 2 VIEWS (RT),3201306,CDM,73552,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,35.617625,,,fee schedule,,,35.617625,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,36.68615375,,,fee schedule,,,21.18,,,fee schedule,,,21.18,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,21.18,87.55,
X-RAY FEMUR MIN 2 VIEWS (LT),3201307,CDM,73552,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,35.617625,,,fee schedule,,,35.617625,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,36.68615375,,,fee schedule,,,21.18,,,fee schedule,,,21.18,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,21.18,87.55,
X-RAY FEMUR MIN 2 VIEWS (BIL),3201308,CDM,73552,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,35.617625,,,fee schedule,,,35.617625,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,36.68615375,,,fee schedule,,,21.18,,,fee schedule,,,21.18,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,21.18,87.55,
X-RAY FINGER RT HAND,3201309,CDM,73140,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,38.280625,,,fee schedule,,,38.280625,,,fee schedule,,,,,,,,,38.280625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,39.42904375,,,fee schedule,,,16,,,fee schedule,,,16,,,fee schedule,,,,,,,,,38.280625,,,fee schedule,,,16,87.55,
XRAY UGI W/AIR W/O KUB,3201350,CDM,74246,CPT,320,RC,inpatient,,,,177.572,97.6646,,159.8148,90,percent of total billed charges,,,,177.572,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,,,,,,,,159.8148,90,percent of total billed charges,,,,168.6934,95,percent of total billed charges,,,142.9731413,,,fee schedule,,,41,,,fee schedule,,,41,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,41,177.572,
X-RAY UGI W/SMALL BOWELL,3201370,CDM,74248,CPT,320,RC,inpatient,,,,105.678,58.1229,,95.1102,90,percent of total billed charges,,,,105.678,100,percent of total billed charges,,,44.6,,,fee schedule,,,44.6,,,fee schedule,,,40.14,,,fee schedule,,,82.220125,,,fee schedule,,,82.220125,,,fee schedule,,,,,,,,,82.220125,,,fee schedule,,,,,,,,,,95.1102,90,percent of total billed charges,,,,100.3941,95,percent of total billed charges,,,84.68672875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,82.220125,,,fee schedule,,,40.14,105.678,
X-RAY UPPER GI WITH KUB,3201391,CDM,74240,CPT,320,RC,inpatient,,,,154.294,84.8617,,138.8646,90,percent of total billed charges,,,,154.294,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,122.498,,,fee schedule,,,122.498,,,fee schedule,,,,,,,,,122.498,,,fee schedule,,,,,,,,,,138.8646,90,percent of total billed charges,,,,146.5793,95,percent of total billed charges,,,126.17294,,,fee schedule,,,30,,,fee schedule,,,30,,,fee schedule,,,,,,,,,122.498,,,fee schedule,,,30,174.94,
X-RAY FINGER LT HAND,3201401,CDM,73140,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,38.280625,,,fee schedule,,,38.280625,,,fee schedule,,,,,,,,,38.280625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,39.42904375,,,fee schedule,,,16,,,fee schedule,,,16,,,fee schedule,,,,,,,,,38.280625,,,fee schedule,,,16,87.55,
X-RAY FOREARM 2VW RT,3201402,CDM,73090,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,19,87.55,
X-RAY FOREARM 2VW LT,3201403,CDM,73090,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,19,87.55,
X-RAY FOREARM 2VW BILATERAL,3201404,CDM,73090,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,19,87.55,
X-RAY FOOT 3VW RT,3201405,CDM,73630,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,35.31470875,,,fee schedule,,,28,,,fee schedule,,,28,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,28,87.55,
X-RAY FOOT 3VW LT,3201406,CDM,73630,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,35.31470875,,,fee schedule,,,28,,,fee schedule,,,28,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,28,87.55,
X-RAY FOOT 2VW RT,3201407,CDM,73620,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,29.4860675,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,23,87.55,
X-RAY FOOT 2VW LT,3201408,CDM,73620,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,29.4860675,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,23,87.55,
X-RAY FOOT 2VW BILATERAL,3201409,CDM,73620,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,29.4860675,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,23,87.55,
X-RAY HAND 3VW RT,3201501,CDM,73130,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,37.282,,,fee schedule,,,37.282,,,fee schedule,,,,,,,,,37.282,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,38.40046,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,37.282,,,fee schedule,,,25,87.55,
X-RAY HAND 3VW LT,3201502,CDM,73130,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,37.282,,,fee schedule,,,37.282,,,fee schedule,,,,,,,,,37.282,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,38.40046,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,37.282,,,fee schedule,,,25,87.55,
X-RAY HAND 2VW RT,3201503,CDM,73120,CPT,320,RC,inpatient,,,RT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,17,167.375,
X-RAY HAND 2VW LT,3201504,CDM,73120,CPT,320,RC,inpatient,,,LT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,17,167.375,
X-RAY HAND 2VW BILATERAL,3201505,CDM,73120,CPT,320,RC,inpatient,,,50,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,17,167.375,
HIP ARTHROGRAM RT,3201603,CDM,73525,CPT,320,RC,inpatient,,,RT,642.926,353.6093,,578.6334,90,percent of total billed charges,,,,642.926,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,128.822625,,,fee schedule,,,128.822625,,,fee schedule,,,,,,,,,128.822625,,,fee schedule,,,,,,,,,,578.6334,90,percent of total billed charges,,,,610.7797,95,percent of total billed charges,,,132.6873038,,,fee schedule,,,,,,,,,,,,,,,,,,,,,128.822625,,,fee schedule,,,128.822625,642.926,
INJECTION HIP ARTHROGRAM LT,3201603.1,CDM,27093,CPT,320,RC,inpatient,,,LT,283.147,155.73085,,254.8323,90,percent of total billed charges,,,,283.147,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,66.907875,,,fee schedule,,,66.907875,,,fee schedule,,,,,,,,,66.907875,,,fee schedule,,,,,,,,,,254.8323,90,percent of total billed charges,,,,268.98965,95,percent of total billed charges,,,68.91511125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,66.907875,,,fee schedule,,,66.907875,283.147,
HIP ARTHROGRAM LT,3201604,CDM,73525,CPT,320,RC,inpatient,,,LT,642.926,353.6093,,578.6334,90,percent of total billed charges,,,,642.926,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,128.822625,,,fee schedule,,,128.822625,,,fee schedule,,,,,,,,,128.822625,,,fee schedule,,,,,,,,,,578.6334,90,percent of total billed charges,,,,610.7797,95,percent of total billed charges,,,132.6873038,,,fee schedule,,,,,,,,,,,,,,,,,,,,,128.822625,,,fee schedule,,,128.822625,642.926,
X-RAY HUMERUS RT,3201606,CDM,73060,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,31.956,,,fee schedule,,,31.956,,,fee schedule,,,,,,,,,31.956,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,32.91468,,,fee schedule,,,22,,,fee schedule,,,22,,,fee schedule,,,,,,,,,31.956,,,fee schedule,,,22,87.55,
X-RAY HUMERUS LT,3201607,CDM,73060,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,31.956,,,fee schedule,,,31.956,,,fee schedule,,,,,,,,,31.956,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,32.91468,,,fee schedule,,,22,,,fee schedule,,,22,,,fee schedule,,,,,,,,,31.956,,,fee schedule,,,22,87.55,
X-RAY HUMERUS 2 VIEWS,3201608,CDM,73060,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,31.956,,,fee schedule,,,31.956,,,fee schedule,,,,,,,,,31.956,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,32.91468,,,fee schedule,,,22,,,fee schedule,,,22,,,fee schedule,,,,,,,,,31.956,,,fee schedule,,,22,87.55,
XR ARTHROGRAM INJ HIP RT,3201610,CDM,27093,CPT,320,RC,inpatient,,,RT,283.147,155.73085,,254.8323,90,percent of total billed charges,,,,283.147,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,66.907875,,,fee schedule,,,66.907875,,,fee schedule,,,,,,,,,66.907875,,,fee schedule,,,,,,,,,,254.8323,90,percent of total billed charges,,,,268.98965,95,percent of total billed charges,,,68.91511125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,66.907875,,,fee schedule,,,66.907875,283.147,
X-RAY KNEE 1 OR 2 VW RT,3201701,CDM,73560,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,35.31470875,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,25,87.55,
X-RAY KNEE 1 OR 2 VW LT,3201702,CDM,73560,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,35.31470875,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,25,87.55,
X-RAY KNEE 3VW RT,3201703,CDM,73562,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,40.943625,,,fee schedule,,,40.943625,,,fee schedule,,,,,,,,,40.943625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,42.17193375,,,fee schedule,,,35,,,fee schedule,,,35,,,fee schedule,,,,,,,,,40.943625,,,fee schedule,,,35,87.55,
X-RAY KNEE 3VW LT,3201704,CDM,73562,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,40.943625,,,fee schedule,,,40.943625,,,fee schedule,,,,,,,,,40.943625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,42.17193375,,,fee schedule,,,35,,,fee schedule,,,35,,,fee schedule,,,,,,,,,40.943625,,,fee schedule,,,35,87.55,
 X-RAY KNEE 3VW BILATERAL,3201705,CDM,73562,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,40.943625,,,fee schedule,,,40.943625,,,fee schedule,,,,,,,,,40.943625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,42.17193375,,,fee schedule,,,35,,,fee schedule,,,35,,,fee schedule,,,,,,,,,40.943625,,,fee schedule,,,35,87.55,
X-RAY KNEE 4 VW RT,3201706,CDM,73564,CPT,320,RC,inpatient,,,RT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,48.6862975,,,fee schedule,,,37,,,fee schedule,,,37,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,37,167.375,
X-RAY KNEE 4 VW LT,3201707,CDM,73564,CPT,320,RC,inpatient,,,LT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,48.6862975,,,fee schedule,,,37,,,fee schedule,,,37,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,37,167.375,
X-RAY KNEE 4 VW BILATERAL,3201708,CDM,73564,CPT,320,RC,inpatient,,,50,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,48.6862975,,,fee schedule,,,37,,,fee schedule,,,37,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,37,167.375,
X-RAY LOWER LEG RT,3201801,CDM,73590,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,25,87.55,
X-RAY LOWER LEG LT,3201802,CDM,73590,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,25,87.55,
X-RAY LOWER LEG BILATERAL,3201803,CDM,73590,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,25,87.55,
X-RAY OS CALCANEUS RT,3201804,CDM,73650,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,29.4860675,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,13,87.55,
X-RAY OS CALCANEUS LT,3201805,CDM,73650,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,29.4860675,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,13,87.55,
X-RAY OS CALCANEUS BILATERAL,3201806,CDM,73650,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,29.4860675,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,13,87.55,
X-RAY RIBS 2VW RT,3201807,CDM,71100,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,17,87.55,
X-RAY RIBS 2VW LT,3201808,CDM,71100,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,17,87.55,
X-RAY RIBS 3VW E/CHEST RT,3201809,CDM,71101,CPT,320,RC,inpatient,,,RT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,43.54337875,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,17,167.375,
X-RAY RIBS 3VW W/CHEST LT,3201901,CDM,71101,CPT,320,RC,inpatient,,,LT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,43.54337875,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,17,167.375,
X-RAY SCAPULA RT,3201902,CDM,73010,CPT,320,RC,inpatient,,,RT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,23.967,,,fee schedule,,,23.967,,,fee schedule,,,,,,,,,23.967,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,24.68601,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,23.967,,,fee schedule,,,18,167.375,
 X-RAY SCAPULA LT,3201903,CDM,73010,CPT,320,RC,inpatient,,,LT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,23.967,,,fee schedule,,,23.967,,,fee schedule,,,,,,,,,23.967,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,24.68601,,,fee schedule,,,18,,,fee schedule,,,18,,,fee schedule,,,,,,,,,23.967,,,fee schedule,,,18,167.375,
X-RAY SHOULDER 1VW RT,3201904,CDM,73020,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,21.636875,,,fee schedule,,,21.636875,,,fee schedule,,,,,,,,,21.636875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,22.28598125,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,21.636875,,,fee schedule,,,13,87.55,
X-RAY SHOULDER 1VW LT,3201905,CDM,73020,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,21.636875,,,fee schedule,,,21.636875,,,fee schedule,,,,,,,,,21.636875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,22.28598125,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,21.636875,,,fee schedule,,,13,87.55,
X-RAY SHOULDER 2VW RT,3201907,CDM,73030,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,36.00043125,,,fee schedule,,,20,,,fee schedule,,,20,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,20,87.55,
X-RAY SHOULDER 2VW LT,3201908,CDM,73030,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,36.00043125,,,fee schedule,,,20,,,fee schedule,,,20,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,20,87.55,
X-RAY SHOULDER 2VW BILATERAL,3201909,CDM,73030,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,36.00043125,,,fee schedule,,,20,,,fee schedule,,,20,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,20,87.55,
X-RAY TOES RT,3202000,CDM,73660,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,13,87.55,
X-RAY SHOULDER ARTH RT,3202001,CDM,73040,CPT,320,RC,inpatient,,,RT,156.045,85.82475,,140.4405,90,percent of total billed charges,,,,156.045,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,131.485625,,,fee schedule,,,131.485625,,,fee schedule,,,,,,,,,131.485625,,,fee schedule,,,,,,,,,,140.4405,90,percent of total billed charges,,,,148.24275,95,percent of total billed charges,,,135.4301938,,,fee schedule,,,,,,,,,,,,,,,,,,,,,131.485625,,,fee schedule,,,131.485625,366.59,
X-RAY SHOULDER ARTH LT,3202002,CDM,73040,CPT,320,RC,inpatient,,,LT,642.926,353.6093,,578.6334,90,percent of total billed charges,,,,642.926,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,131.485625,,,fee schedule,,,131.485625,,,fee schedule,,,,,,,,,131.485625,,,fee schedule,,,,,,,,,,578.6334,90,percent of total billed charges,,,,610.7797,95,percent of total billed charges,,,135.4301938,,,fee schedule,,,,,,,,,,,,,,,,,,,,,131.485625,,,fee schedule,,,131.485625,642.926,
X-RAY TOES LT,3202004,CDM,73660,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,13,87.55,
X-RAY TOES BILATERAL,3202005,CDM,73660,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,30.17179,,,fee schedule,,,13,,,fee schedule,,,13,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,13,87.55,
X-RAY WRIST 2VW RT,3202006,CDM,73100,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,33.95325,,,fee schedule,,,33.95325,,,fee schedule,,,,,,,,,33.95325,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,34.9718475,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,33.95325,,,fee schedule,,,19,87.55,
X-RAY WRIST 2VW LT,3202007,CDM,73100,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,33.95325,,,fee schedule,,,33.95325,,,fee schedule,,,,,,,,,33.95325,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,34.9718475,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,33.95325,,,fee schedule,,,19,87.55,
X-RAY WRIST 2VW BILATERAL,3202008,CDM,73100,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,33.95325,,,fee schedule,,,33.95325,,,fee schedule,,,,,,,,,33.95325,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,34.9718475,,,fee schedule,,,19,,,fee schedule,,,19,,,fee schedule,,,,,,,,,33.95325,,,fee schedule,,,19,87.55,
X-RAY WRIST 3VW RT,3202009,CDM,73110,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,42.514795,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,23,87.55,
ARTHOCENTESIS ASPIRATION LT,3202061,CDM,20610,CPT,320,RC,inpatient,,,LT,453.921,249.65655,,408.5289,90,percent of total billed charges,,,,453.921,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,45.271,,,fee schedule,,,45.271,,,fee schedule,,,,,,,,,45.271,,,fee schedule,,,,,,,,,,408.5289,90,percent of total billed charges,,,,431.22495,95,percent of total billed charges,,,46.62913,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,45.271,,,fee schedule,,,45.271,453.921,
ARTHOCENTESIS ASPIRATION RT,3202065,CDM,20610,CPT,320,RC,inpatient,,,RT,453.921,249.65655,,408.5289,90,percent of total billed charges,,,,453.921,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,45.271,,,fee schedule,,,45.271,,,fee schedule,,,,,,,,,45.271,,,fee schedule,,,,,,,,,,408.5289,90,percent of total billed charges,,,,431.22495,95,percent of total billed charges,,,46.62913,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,45.271,,,fee schedule,,,45.271,453.921,
X-RAY SPINE ENTIRE 1 VIEW,3202081,CDM,72081,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,42.608,,,fee schedule,,,42.608,,,fee schedule,,,,,,,,,42.608,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,43.88624,,,fee schedule,,,23.51,,,fee schedule,,,23.51,,,fee schedule,,,,,,,,,42.608,,,fee schedule,,,23.51,87.55,
X-RAY SPINE ENTIRE 2 OR 3 VIEW,3202082,CDM,72082,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,70.236625,,,fee schedule,,,70.236625,,,fee schedule,,,,,,,,,70.236625,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,72.34372375,,,fee schedule,,,42.84,,,fee schedule,,,42.84,,,fee schedule,,,,,,,,,70.236625,,,fee schedule,,,42.84,167.375,
X-RAY SPINE ENTIRE 4 OR 5 VIEW,3202083,CDM,72083,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,79.22425,,,fee schedule,,,79.22425,,,fee schedule,,,,,,,,,79.22425,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,81.6009775,,,fee schedule,,,46.48,,,fee schedule,,,46.48,,,fee schedule,,,,,,,,,79.22425,,,fee schedule,,,46.48,167.375,
X-RAY WRIST 3VW LT,3202109,CDM,73110,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,42.514795,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,23,87.55,
MYLEOGRAM LMBR INJ;LUMBOSACRAL,3202304,CDM,62304,CPT,320,RC,inpatient,,,,978.809,538.34495,,880.9281,90,percent of total billed charges,,,,978.809,100,percent of total billed charges,,,753.3675,,,fee schedule,,,753.3675,,,fee schedule,,,678.03075,,,fee schedule,,,115.507625,,,fee schedule,,,115.507625,,,fee schedule,,,,,,,,,115.507625,,,fee schedule,,,,,,,,,,880.9281,90,percent of total billed charges,,,,929.86855,95,percent of total billed charges,,,118.9728538,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,115.507625,,,fee schedule,,,115.507625,978.809,
thoracentesis without image gu,3202554,CDM,32554,CPT,320,RC,inpatient,,,,346.801,190.74055,,312.1209,90,percent of total billed charges,,,,346.801,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,529.51725,,,fee schedule,,,86.880375,,,fee schedule,,,86.880375,,,fee schedule,,,,,,,,,86.880375,,,fee schedule,,,,,,,,,,312.1209,90,percent of total billed charges,,,,329.46095,95,percent of total billed charges,,,89.48678625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,86.880375,,,fee schedule,,,86.880375,588.3525,
INJ SI JNT ARTHRGRPHY ANES LT,3202709,CDM,G0260,HCPCS,320,RC,inpatient,,,LT,749.634,412.2987,,674.6706,90,percent of total billed charges,,,,749.634,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,674.6706,90,percent of total billed charges,,,,712.1523,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,674.6706,749.634,
INJ SI JNT ARTHRGRPHY RT,3202710,CDM,G0260,HCPCS,320,RC,inpatient,,,RT,749.634,412.2987,,674.6706,90,percent of total billed charges,,,,749.634,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,674.6706,90,percent of total billed charges,,,,712.1523,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,674.6706,749.634,
THORACENTESIS/W/IMAGING GUIDE,3203255,CDM,32555,CPT,320,RC,inpatient,,,,821.116,451.6138,,739.0044,90,percent of total billed charges,,,,821.116,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,529.51725,,,fee schedule,,,106.52,,,fee schedule,,,106.52,,,fee schedule,,,,,,,,,106.52,,,fee schedule,,,,,,,,,,739.0044,90,percent of total billed charges,,,,780.0602,95,percent of total billed charges,,,109.7156,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,106.52,,,fee schedule,,,106.52,821.116,
X-RAY HIP/W/PELVIS 1 VW,3203501,CDM,73501,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.94326375,,,fee schedule,,,18.85,,,fee schedule,,,18.85,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,18.85,87.55,
X-RAY HIP/W/PELVIS 1 VIEW (LT),3203501.1,CDM,73501,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.94326375,,,fee schedule,,,18.85,,,fee schedule,,,18.85,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,18.85,87.55,
X-RAY HIP/W/PELVIS 1 VIEW (RT),3203501.2,CDM,73501,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,33.94326375,,,fee schedule,,,18.85,,,fee schedule,,,18.85,,,fee schedule,,,,,,,,,32.954625,,,fee schedule,,,18.85,87.55,
X-RAY HIP/W/PELVIS 2-3 VW (RT),3203502.1,CDM,73502,CPT,320,RC,inpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,47.601125,,,fee schedule,,,47.601125,,,fee schedule,,,,,,,,,47.601125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,49.02915875,,,fee schedule,,,27.84,,,fee schedule,,,27.84,,,fee schedule,,,,,,,,,47.601125,,,fee schedule,,,27.84,87.55,
X-RAY HIP/W/PELVIS 2-3 VW (LT),3203502.2,CDM,73502,CPT,320,RC,inpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,47.601125,,,fee schedule,,,47.601125,,,fee schedule,,,,,,,,,47.601125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,49.02915875,,,fee schedule,,,27.84,,,fee schedule,,,27.84,,,fee schedule,,,,,,,,,47.601125,,,fee schedule,,,27.84,87.55,
X-RAY HIP/W/PELVIS BIL 2 VIEWS,3203521,CDM,73521,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,42.514795,,,fee schedule,,,26.17,,,fee schedule,,,26.17,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,26.17,167.375,
X-RAY HIP/W/PELVIS BIL 3-4 VW,3203522,CDM,73522,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,53.92575,,,fee schedule,,,53.92575,,,fee schedule,,,,,,,,,53.92575,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,55.5435225,,,fee schedule,,,31.17,,,fee schedule,,,31.17,,,fee schedule,,,,,,,,,53.92575,,,fee schedule,,,31.17,167.375,
X-RAY ABDOMEN 2 VIEWS,3204019,CDM,74019,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,24.26,,,fee schedule,,,24.26,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,24.26,167.375,
X-RAY ABDOMEN 3 OR MORE VIEWS,3204021,CDM,74021,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,42.940875,,,fee schedule,,,42.940875,,,fee schedule,,,,,,,,,42.940875,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,44.22910125,,,fee schedule,,,28.27,,,fee schedule,,,28.27,,,fee schedule,,,,,,,,,42.940875,,,fee schedule,,,28.27,167.375,
ABD PARACENTESIS W/IMAGE GUIDE,3204908,CDM,49083,CPT,320,RC,inpatient,,,,978.809,538.34495,,880.9281,90,percent of total billed charges,,,,978.809,100,percent of total billed charges,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,755.618625,,,fee schedule,,,103.857,,,fee schedule,,,103.857,,,fee schedule,,,,,,,,,103.857,,,fee schedule,,,,,,,,,,880.9281,90,percent of total billed charges,,,,929.86855,95,percent of total billed charges,,,106.97271,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,103.857,,,fee schedule,,,103.857,978.809,
FLOROSCOPY GUIDED LUMBAR PUNC,3206231,CDM,62328,CPT,320,RC,inpatient,,,,117.935,64.86425,,106.1415,90,percent of total billed charges,,,,117.935,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,589.78125,,,fee schedule,,,83.8845,,,fee schedule,,,83.8845,,,fee schedule,,,,,,,,,83.8845,,,fee schedule,,,,,,,,,,106.1415,90,percent of total billed charges,,,,112.03825,95,percent of total billed charges,,,86.401035,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,83.8845,,,fee schedule,,,83.8845,655.3125,
PICC INSERT W/US GUIDANCE,3206573,CDM,36573,CPT,320,RC,inpatient,,,,982.105,540.15775,,883.8945,90,percent of total billed charges,,,,982.105,100,percent of total billed charges,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,1361.87325,,,fee schedule,,,81.2215,,,fee schedule,,,81.2215,,,fee schedule,,,,,,,,,81.2215,,,fee schedule,,,,,,,,,,883.8945,90,percent of total billed charges,,,,932.99975,95,percent of total billed charges,,,83.658145,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,81.2215,,,fee schedule,,,81.2215,1513.1925,
X-RAY MANDIBLE;PART < 4 VIEWS,3207010,CDM,70100,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,38.946375,,,fee schedule,,,38.946375,,,fee schedule,,,,,,,,,38.946375,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,40.11476625,,,fee schedule,,,16,,,fee schedule,,,16,,,fee schedule,,,,,,,,,38.946375,,,fee schedule,,,16,87.55,
X-RAY FACIAL BONES < 3 VIEWS,3207014,CDM,70140,CPT,320,RC,inpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,31.956,,,fee schedule,,,31.956,,,fee schedule,,,,,,,,,31.956,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,32.91468,,,fee schedule,,,20,,,fee schedule,,,20,,,fee schedule,,,,,,,,,31.956,,,fee schedule,,,20,87.55,
PELVIS COMPLETE MIN 3 VIEWS,3207219,CDM,72190,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,43.54337875,,,fee schedule,,,30,,,fee schedule,,,30,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,30,167.375,
X-RAY WRIST BILATERAL,3207311,CDM,73110,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,42.514795,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,23,87.55,
X-RAY KNEE 1/2 VIEWS BILATERAL,3207356,CDM,73560,CPT,320,RC,inpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,,,,,,,,78.795,90,percent of total billed charges,,,,83.1725,95,percent of total billed charges,,,35.31470875,,,fee schedule,,,25,,,fee schedule,,,25,,,fee schedule,,,,,,,,,34.286125,,,fee schedule,,,25,87.55,
FLOUROSCOPY FOR VEIN DEVICE,3207700,CDM,77001,CPT,320,RC,inpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,72.96,,,fee schedule,,,72.96,,,fee schedule,,,65.664,,,fee schedule,,,98.531,,,fee schedule,,,98.531,,,fee schedule,,,,,,,,,98.531,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,101.48693,,,fee schedule,,,66.86,,,fee schedule,,,66.86,,,fee schedule,,,,,,,,,98.531,,,fee schedule,,,65.664,167.375,
PARACENTESIS W/O IMAGE GUIDANC,3209082,CDM,49082,CPT,320,RC,inpatient,,,,710.7,390.885,,639.63,90,percent of total billed charges,,,,710.7,100,percent of total billed charges,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,755.618625,,,fee schedule,,,72.56675,,,fee schedule,,,72.56675,,,fee schedule,,,,,,,,,72.56675,,,fee schedule,,,,,,,,,,639.63,90,percent of total billed charges,,,,675.165,95,percent of total billed charges,,,74.7437525,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,72.56675,,,fee schedule,,,72.56675,839.57625,
"DXA AXIAL/HIPS,PELVIS,SPINE",3290010,CDM,77080,CPT,320,RC,inpatient,,,FY,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,38.946375,,,fee schedule,,,38.946375,,,fee schedule,,,,,,,,,38.946375,,,fee schedule,,,,,,,,,,150.6375,90,percent of total billed charges,,,,159.00625,95,percent of total billed charges,,,40.11476625,,,fee schedule,,,155.08,,,fee schedule,,,155.08,,,fee schedule,,,,,,,,,38.946375,,,fee schedule,,,38.946375,167.375,
ST - SWALLOW EVAL/W/RADIO-OPAQ,4400471,CDM,92611,CPT,320,RC,inpatient,,,,228.66,125.763,,205.794,90,percent of total billed charges,,,,228.66,100,percent of total billed charges,,,88.8405,,,fee schedule,,,88.8405,,,fee schedule,,,79.95645,,,fee schedule,,,91.8735,,,fee schedule,,,91.8735,,,fee schedule,,,,,,,,,91.8735,,,fee schedule,,,,,,,,,,205.794,90,percent of total billed charges,,,,217.227,95,percent of total billed charges,,,94.629705,,,fee schedule,,,46.87,,,fee schedule,,,46.87,,,fee schedule,,,,,,,,,91.8735,,,fee schedule,,,46.87,228.66,
BONE AN/OR JNT SCAN;WHOL BODY,3400020,CDM,78306,CPT,340,RC,inpatient,,,,862.625,474.44375,,776.3625,90,percent of total billed charges,,,,862.625,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,318.069,,,fee schedule,,,268.963,,,fee schedule,,,268.963,,,fee schedule,,,,,,,,,268.963,,,fee schedule,,,,,,,,,,776.3625,90,percent of total billed charges,,,,819.49375,95,percent of total billed charges,,,277.03189,,,fee schedule,,,59,,,fee schedule,,,59,,,fee schedule,,,,,,,,,268.963,,,fee schedule,,,59,862.625,
BONE AND/OR JOINT SCAN;LIMITED,3400030,CDM,78300,CPT,340,RC,inpatient,,,,412.824,227.0532,,371.5416,90,percent of total billed charges,,,,412.824,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,318.069,,,fee schedule,,,206.3825,,,fee schedule,,,206.3825,,,fee schedule,,,,,,,,,206.3825,,,fee schedule,,,,,,,,,,371.5416,90,percent of total billed charges,,,,392.1828,95,percent of total billed charges,,,212.573975,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,206.3825,,,fee schedule,,,23,412.824,
GASTRIC EMPTYING STUDY,3400060,CDM,78264,CPT,340,RC,inpatient,,,,647.664,356.2152,,582.8976,90,percent of total billed charges,,,,647.664,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,318.069,,,fee schedule,,,301.58475,,,fee schedule,,,301.58475,,,fee schedule,,,,,,,,,301.58475,,,fee schedule,,,,,,,,,,582.8976,90,percent of total billed charges,,,,615.2808,95,percent of total billed charges,,,310.6322925,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,301.58475,,,fee schedule,,,23,647.664,
HEPATOBILIARY SYSTEM IMAGING,3400080,CDM,78226,CPT,340,RC,inpatient,,,,1154.012,634.7066,,1038.6108,90,percent of total billed charges,,,,1154.012,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,318.069,,,fee schedule,,,296.25875,,,fee schedule,,,296.25875,,,fee schedule,,,,,,,,,296.25875,,,fee schedule,,,,,,,,,,1038.6108,90,percent of total billed charges,,,,1096.3114,95,percent of total billed charges,,,305.1465125,,,fee schedule,,,312.39,,,fee schedule,,,312.39,,,fee schedule,,,,,,,,,296.25875,,,fee schedule,,,296.25875,1154.012,
HEPATOBILIARY W/PHARM/QUANT,3400081,CDM,78227,CPT,340,RC,inpatient,,,,1154.012,634.7066,,1038.6108,90,percent of total billed charges,,,,1154.012,100,percent of total billed charges,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,407.808,,,fee schedule,,,397.45275,,,fee schedule,,,397.45275,,,fee schedule,,,,,,,,,397.45275,,,fee schedule,,,,,,,,,,1038.6108,90,percent of total billed charges,,,,1096.3114,95,percent of total billed charges,,,409.3763325,,,fee schedule,,,433.79,,,fee schedule,,,433.79,,,fee schedule,,,,,,,,,397.45275,,,fee schedule,,,397.45275,1154.012,
PULMONARY PERFUSION IMAGING,3400120,CDM,78580,CPT,340,RC,inpatient,,,,574.122,315.7671,,516.7098,90,percent of total billed charges,,,,574.122,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,318.069,,,fee schedule,,,216.36875,,,fee schedule,,,216.36875,,,fee schedule,,,,,,,,,216.36875,,,fee schedule,,,,,,,,,,516.7098,90,percent of total billed charges,,,,545.4159,95,percent of total billed charges,,,222.8598125,,,fee schedule,,,63,,,fee schedule,,,63,,,fee schedule,,,,,,,,,216.36875,,,fee schedule,,,63,574.122,
KIDNEY IMAGE/W/FLOW & FUNCTION,3400160,CDM,78707,CPT,340,RC,inpatient,,,,794.336,436.8848,,714.9024,90,percent of total billed charges,,,,794.336,100,percent of total billed charges,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,407.808,,,fee schedule,,,214.704375,,,fee schedule,,,214.704375,,,fee schedule,,,,,,,,,214.704375,,,fee schedule,,,,,,,,,,714.9024,90,percent of total billed charges,,,,754.6192,95,percent of total billed charges,,,221.1455063,,,fee schedule,,,69,,,fee schedule,,,69,,,fee schedule,,,,,,,,,214.704375,,,fee schedule,,,69,794.336,
BONE AND/OR JOINT SCAN;3 PHASE,3400195,CDM,78315,CPT,340,RC,inpatient,,,,836.875,460.28125,,753.1875,90,percent of total billed charges,,,,836.875,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,318.069,,,fee schedule,,,316.23125,,,fee schedule,,,316.23125,,,fee schedule,,,,,,,,,316.23125,,,fee schedule,,,,,,,,,,753.1875,90,percent of total billed charges,,,,795.03125,95,percent of total billed charges,,,325.7181875,,,fee schedule,,,125,,,fee schedule,,,125,,,fee schedule,,,,,,,,,316.23125,,,fee schedule,,,125,836.875,
MYOCARDIAL PERF SPECT; SINGLE,3400220,CDM,78451,CPT,340,RC,inpatient,,,,1096.023,602.81265,,986.4207,90,percent of total billed charges,,,,1096.023,100,percent of total billed charges,,,1221.35,,,fee schedule,,,1221.35,,,fee schedule,,,1099.215,,,fee schedule,,,312.569625,,,fee schedule,,,312.569625,,,fee schedule,,,,,,,,,312.569625,,,fee schedule,,,,,,,,,,986.4207,90,percent of total billed charges,,,,1041.22185,95,percent of total billed charges,,,321.9467138,,,fee schedule,,,138.07,,,fee schedule,,,138.07,,,fee schedule,,,,,,,,,312.569625,,,fee schedule,,,138.07,1221.35,
MYOCARDIAL W/EJECTION FRACTION,3408468,CDM,78468,CPT,340,RC,inpatient,,,,581.95,320.0725,,523.755,90,percent of total billed charges,,,,581.95,100,percent of total billed charges,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,407.808,,,fee schedule,,,183.08125,,,fee schedule,,,183.08125,,,fee schedule,,,,,,,,,183.08125,,,fee schedule,,,,,,,,,,523.755,90,percent of total billed charges,,,,552.8525,95,percent of total billed charges,,,188.5736875,,,fee schedule,,,38,,,fee schedule,,,38,,,fee schedule,,,,,,,,,183.08125,,,fee schedule,,,38,581.95,
PULMONARY VENT & PERFUSION,3408582,CDM,78582,CPT,340,RC,inpatient,,,,615.116,338.3138,,553.6044,90,percent of total billed charges,,,,615.116,100,percent of total billed charges,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,407.808,,,fee schedule,,,302.91625,,,fee schedule,,,302.91625,,,fee schedule,,,,,,,,,302.91625,,,fee schedule,,,,,,,,,,553.6044,90,percent of total billed charges,,,,584.3602,95,percent of total billed charges,,,312.0037375,,,fee schedule,,,289.19,,,fee schedule,,,289.19,,,fee schedule,,,,,,,,,302.91625,,,fee schedule,,,289.19,615.116,
THYROID IMAG/W/UPTAKE;SINGLE,3400180,CDM,78014,CPT,341,RC,inpatient,,,,683.508,375.9294,,615.1572,90,percent of total billed charges,,,,683.508,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,318.069,,,fee schedule,,,217.367375,,,fee schedule,,,217.367375,,,fee schedule,,,,,,,,,217.367375,,,fee schedule,,,,,,,,,,615.1572,90,percent of total billed charges,,,,649.3326,95,percent of total billed charges,,,223.8883963,,,fee schedule,,,195.81,,,fee schedule,,,195.81,,,fee schedule,,,,,,,,,217.367375,,,fee schedule,,,195.81,683.508,
MYOCARADIAL PERF SPECT; MULTI,3400230,CDM,78452,CPT,341,RC,inpatient,,,,2200.286,1210.1573,,1980.2574,90,percent of total billed charges,,,,2200.286,100,percent of total billed charges,,,1221.35,,,fee schedule,,,1221.35,,,fee schedule,,,1099.215,,,fee schedule,,,432.404625,,,fee schedule,,,432.404625,,,fee schedule,,,,,,,,,432.404625,,,fee schedule,,,,,,,,,,1980.2574,90,percent of total billed charges,,,,2090.2717,95,percent of total billed charges,,,445.3767638,,,fee schedule,,,266.71,,,fee schedule,,,266.71,,,fee schedule,,,,,,,,,432.404625,,,fee schedule,,,266.71,2200.286,
PARATHYROID NUCLEAR IMAGING,3410000,CDM,78070,CPT,341,RC,inpatient,,,,395.829,217.70595,,356.2461,90,percent of total billed charges,,,,395.829,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,318.069,,,fee schedule,,,268.963,,,fee schedule,,,268.963,,,fee schedule,,,,,,,,,268.963,,,fee schedule,,,,,,,,,,356.2461,90,percent of total billed charges,,,,376.03755,95,percent of total billed charges,,,277.03189,,,fee schedule,,,24,,,fee schedule,,,24,,,fee schedule,,,,,,,,,268.963,,,fee schedule,,,24,395.829,
"XENON XE 133, PER 10 mCi",3403004,CDM,A9558,HCPCS,343,RC,inpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,35.2,,,fee schedule,,,35.2,,,fee schedule,,,31.68,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,,,,,,,25.6,,,fee schedule,,,25.6,,,fee schedule,,,,,,,,,,,,,,,25.6,40.17,
TECHNETIUM TC 99m OXIDRONATE,3403009,CDM,A9561,HCPCS,343,RC,inpatient,,,,28.634,15.7487,,25.7706,90,percent of total billed charges,,,,28.634,100,percent of total billed charges,,,31.68,,,fee schedule,,,31.68,,,fee schedule,,,28.512,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.7706,90,percent of total billed charges,,,,27.2023,95,percent of total billed charges,,,,,,,,,23.04,,,fee schedule,,,23.04,,,fee schedule,,,,,,,,,,,,,,,23.04,31.68,
TC 99m PERTECHNETATE PER mCi,3409512,CDM,,,343,RC,inpatient,,,,5.562,3.0591,,5.0058,90,percent of total billed charges,,,,5.562,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.0058,90,percent of total billed charges,,,,5.2839,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.0058,5.562,
TC 99m MEBROFENIN UP TO 15mCi,3409513,CDM,,,343,RC,inpatient,,,,51.706,28.4383,,46.5354,90,percent of total billed charges,,,,51.706,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.5354,90,percent of total billed charges,,,,49.1207,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.5354,51.706,
IODINE I-123 PER 100 MICROCURI,3409516,CDM,A9516,HCPCS,343,RC,inpatient,,,,121.54,66.847,,109.386,90,percent of total billed charges,,,,121.54,100,percent of total billed charges,,,28.12,,,fee schedule,,,28.12,,,fee schedule,,,25.308,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.386,90,percent of total billed charges,,,,115.463,95,percent of total billed charges,,,,,,,,,20.45,,,fee schedule,,,20.45,,,fee schedule,,,,,,,,,,,,,,,20.45,121.54,
TC 99m ALBUMIN AGGR UP TO 10,3409519,CDM,,,343,RC,inpatient,,,,6.798,3.7389,,6.1182,90,percent of total billed charges,,,,6.798,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.1182,90,percent of total billed charges,,,,6.4581,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.1182,6.798,
TC 99m SULFUR COLLOID UP TO 20,3409520,CDM,A9541,HCPCS,343,RC,inpatient,,,,34.093,18.75115,,30.6837,90,percent of total billed charges,,,,34.093,100,percent of total billed charges,,,134.56,,,fee schedule,,,134.56,,,fee schedule,,,121.104,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.6837,90,percent of total billed charges,,,,32.38835,95,percent of total billed charges,,,,,,,,,52.88,,,fee schedule,,,52.88,,,fee schedule,,,,,,,,,,,,,,,30.6837,134.56,
TECHNETIUM Tc 99m SESTAMIBI,6360070,CDM,,,343,RC,inpatient,,,,209.605,115.28275,,188.6445,90,percent of total billed charges,,,,209.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.6445,90,percent of total billed charges,,,,199.12475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.6445,209.605,
CT ABDOMEN W/CONTRAST,3500000,CDM,74160,CPT,350,RC,inpatient,,,,1683.741,926.05755,,1515.3669,90,percent of total billed charges,,,,1683.741,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,239.00425,,,fee schedule,,,239.00425,,,fee schedule,,,,,,,,,239.00425,,,fee schedule,,,,,,,,,,1515.3669,90,percent of total billed charges,,,,1599.55395,95,percent of total billed charges,,,246.1743775,,,fee schedule,,,261,,,fee schedule,,,261,,,fee schedule,,,,,,,,,239.00425,,,fee schedule,,,157.446,1683.741,
FNA BIOPSY W/CT 1ST LESION,3500009,CDM,10009,CPT,350,RC,inpatient,,,,826.266,454.4463,,743.6394,90,percent of total billed charges,,,,826.266,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,594.023625,,,fee schedule,,,106.52,,,fee schedule,,,106.52,,,fee schedule,,,,,,,,,106.52,,,fee schedule,,,,,,,,,,743.6394,90,percent of total billed charges,,,,784.9527,95,percent of total billed charges,,,109.7156,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,106.52,,,fee schedule,,,106.52,826.266,
CT ABDOMEN WO/CONTRAST,3500010,CDM,74150,CPT,350,RC,inpatient,,,,1327.979,730.38845,,1195.1811,90,percent of total billed charges,,,,1327.979,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,139.8075,,,fee schedule,,,139.8075,,,fee schedule,,,,,,,,,139.8075,,,fee schedule,,,,,,,,,,1195.1811,90,percent of total billed charges,,,,1261.58005,95,percent of total billed charges,,,144.001725,,,fee schedule,,,218,,,fee schedule,,,218,,,fee schedule,,,,,,,,,139.8075,,,fee schedule,,,96.84,1327.979,
CT ABD W/O FOLLOWED W CONTRAST,3500020,CDM,74170,CPT,350,RC,inpatient,,,,2036.928,1120.3104,,1833.2352,90,percent of total billed charges,,,,2036.928,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,268.630125,,,fee schedule,,,268.630125,,,fee schedule,,,,,,,,,268.630125,,,fee schedule,,,,,,,,,,1833.2352,90,percent of total billed charges,,,,1935.0816,95,percent of total billed charges,,,276.6890288,,,fee schedule,,,317,,,fee schedule,,,317,,,fee schedule,,,,,,,,,268.630125,,,fee schedule,,,157.446,2036.928,
CT SCAN GUIDE NEEDLE PLACEMENT,3500030,CDM,77012,CPT,350,RC,inpatient,,,,578.242,318.0331,,520.4178,90,percent of total billed charges,,,,578.242,100,percent of total billed charges,,,72.29,,,fee schedule,,,72.29,,,fee schedule,,,65.061,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,,,,,,,,520.4178,90,percent of total billed charges,,,,549.3299,95,percent of total billed charges,,,142.9731413,,,fee schedule,,,,,,,,,,,,,,,,,,,,,138.808875,,,fee schedule,,,65.061,578.242,
CT GUIDED ABSCESS DRAINAGE,3500031,CDM,10030,CPT,350,RC,inpatient,,,,768.689,422.77895,,691.8201,90,percent of total billed charges,,,,768.689,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,594.023625,,,fee schedule,,,132.151375,,,fee schedule,,,132.151375,,,fee schedule,,,,,,,,,132.151375,,,fee schedule,,,,,,,,,,691.8201,90,percent of total billed charges,,,,730.25455,95,percent of total billed charges,,,136.1159163,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,132.151375,,,fee schedule,,,132.151375,768.689,
CT CERVICAL SPINE W/O CONT,3500080,CDM,72125,CPT,350,RC,inpatient,,,,1445.193,794.85615,,1300.6737,90,percent of total billed charges,,,,1445.193,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,133.15,,,fee schedule,,,133.15,,,fee schedule,,,,,,,,,133.15,,,fee schedule,,,,,,,,,,1300.6737,90,percent of total billed charges,,,,1372.93335,95,percent of total billed charges,,,137.1445,,,fee schedule,,,215,,,fee schedule,,,215,,,fee schedule,,,,,,,,,133.15,,,fee schedule,,,96.84,1445.193,
CT THORAX W/CONTRAST,3500090,CDM,71260,CPT,350,RC,inpatient,,,,1860.489,1023.26895,,1674.4401,90,percent of total billed charges,,,,1860.489,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,171.09775,,,fee schedule,,,171.09775,,,fee schedule,,,,,,,,,171.09775,,,fee schedule,,,,,,,,,,1674.4401,90,percent of total billed charges,,,,1767.46455,95,percent of total billed charges,,,176.2306825,,,fee schedule,,,264,,,fee schedule,,,264,,,fee schedule,,,,,,,,,171.09775,,,fee schedule,,,157.446,1860.489,
CT THORAX W/& W/O CONTRAST,3500100,CDM,71270,CPT,350,RC,inpatient,,,,1949.172,1072.0446,,1754.2548,90,percent of total billed charges,,,,1949.172,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,201.0565,,,fee schedule,,,201.0565,,,fee schedule,,,,,,,,,201.0565,,,fee schedule,,,,,,,,,,1754.2548,90,percent of total billed charges,,,,1851.7134,95,percent of total billed charges,,,207.088195,,,fee schedule,,,330,,,fee schedule,,,330,,,fee schedule,,,,,,,,,201.0565,,,fee schedule,,,157.446,1949.172,
CT THORAX W/O CONTRAST,3500110,CDM,71250,CPT,350,RC,inpatient,,,,1097.465,603.60575,,987.7185,90,percent of total billed charges,,,,1097.465,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,136.145875,,,fee schedule,,,136.145875,,,fee schedule,,,,,,,,,136.145875,,,fee schedule,,,,,,,,,,987.7185,90,percent of total billed charges,,,,1042.59175,95,percent of total billed charges,,,140.2302513,,,fee schedule,,,215,,,fee schedule,,,215,,,fee schedule,,,,,,,,,136.145875,,,fee schedule,,,96.84,1097.465,
CT THORAX LDCT,3500115,CDM,71271,CPT,350,RC,inpatient,,,,569.487,313.21785,,512.5383,90,percent of total billed charges,,,,569.487,100,percent of total billed charges,,,78.83,,,fee schedule,,,78.83,,,fee schedule,,,70.947,,,fee schedule,,,140.806125,,,fee schedule,,,140.806125,,,fee schedule,,,,,,,,,140.806125,,,fee schedule,,,,,,,,,,512.5383,90,percent of total billed charges,,,,541.01265,95,percent of total billed charges,,,145.0303088,,,fee schedule,,,94.39,,,fee schedule,,,94.39,,,fee schedule,,,,,,,,,140.806125,,,fee schedule,,,70.947,569.487,
CT NECK SOFT TISSUE W/ CONT,3500130,CDM,70491,CPT,350,RC,inpatient,,,,1194.079,656.74345,,1074.6711,90,percent of total billed charges,,,,1194.079,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,188.740125,,,fee schedule,,,188.740125,,,fee schedule,,,,,,,,,188.740125,,,fee schedule,,,,,,,,,,1074.6711,90,percent of total billed charges,,,,1134.37505,95,percent of total billed charges,,,194.4023288,,,fee schedule,,,228,,,fee schedule,,,228,,,fee schedule,,,,,,,,,188.740125,,,fee schedule,,,157.446,1194.079,
CT NECK SOFT TISSUE W/&/WO CON,3500140,CDM,70492,CPT,350,RC,inpatient,,,,1562.51,859.3805,,1406.259,90,percent of total billed charges,,,,1562.51,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,226.355,,,fee schedule,,,226.355,,,fee schedule,,,,,,,,,226.355,,,fee schedule,,,,,,,,,,1406.259,90,percent of total billed charges,,,,1484.3845,95,percent of total billed charges,,,233.14565,,,fee schedule,,,142,,,fee schedule,,,142,,,fee schedule,,,,,,,,,226.355,,,fee schedule,,,142,1562.51,
CT INTRACRANIAL W & W/O CONT,3500190,CDM,70482,CPT,350,RC,inpatient,,,,1165.548,641.0514,,1048.9932,90,percent of total billed charges,,,,1165.548,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,216.035875,,,fee schedule,,,216.035875,,,fee schedule,,,,,,,,,216.035875,,,fee schedule,,,,,,,,,,1048.9932,90,percent of total billed charges,,,,1107.2706,95,percent of total billed charges,,,222.5169513,,,fee schedule,,,257,,,fee schedule,,,257,,,fee schedule,,,,,,,,,216.035875,,,fee schedule,,,157.446,1165.548,
CT NECK SOFT TISSUE W/O CONT,3500200,CDM,70490,CPT,350,RC,inpatient,,,,1196.448,658.0464,,1076.8032,90,percent of total billed charges,,,,1196.448,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,153.455375,,,fee schedule,,,153.455375,,,fee schedule,,,,,,,,,153.455375,,,fee schedule,,,,,,,,,,1076.8032,90,percent of total billed charges,,,,1136.6256,95,percent of total billed charges,,,158.0590363,,,fee schedule,,,188,,,fee schedule,,,188,,,fee schedule,,,,,,,,,153.455375,,,fee schedule,,,96.84,1196.448,
CT LUMBAR SPINE W/O CONTRAST,3500250,CDM,72131,CPT,350,RC,inpatient,,,,1256.909,691.29995,,1131.2181,90,percent of total billed charges,,,,1256.909,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,132.151375,,,fee schedule,,,132.151375,,,fee schedule,,,,,,,,,132.151375,,,fee schedule,,,,,,,,,,1131.2181,90,percent of total billed charges,,,,1194.06355,95,percent of total billed charges,,,136.1159163,,,fee schedule,,,215,,,fee schedule,,,215,,,fee schedule,,,,,,,,,132.151375,,,fee schedule,,,96.84,1256.909,
CT PELVIS W/CONTRAST,3500260,CDM,72193,CPT,350,RC,inpatient,,,,1683.741,926.05755,,1515.3669,90,percent of total billed charges,,,,1683.741,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,234.676875,,,fee schedule,,,234.676875,,,fee schedule,,,,,,,,,234.676875,,,fee schedule,,,,,,,,,,1515.3669,90,percent of total billed charges,,,,1599.55395,95,percent of total billed charges,,,241.7171813,,,fee schedule,,,254,,,fee schedule,,,254,,,fee schedule,,,,,,,,,234.676875,,,fee schedule,,,157.446,1683.741,
CT PELVIS W/O CONTRAST,3500270,CDM,72192,CPT,350,RC,inpatient,,,,1327.979,730.38845,,1195.1811,90,percent of total billed charges,,,,1327.979,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,136.145875,,,fee schedule,,,136.145875,,,fee schedule,,,,,,,,,136.145875,,,fee schedule,,,,,,,,,,1195.1811,90,percent of total billed charges,,,,1261.58005,95,percent of total billed charges,,,140.2302513,,,fee schedule,,,228,,,fee schedule,,,228,,,fee schedule,,,,,,,,,136.145875,,,fee schedule,,,96.84,1327.979,
"CT, PELVIS WO/W CONTRAST",3500280,CDM,72194,CPT,350,RC,inpatient,,,,1463.424,804.8832,,1317.0816,90,percent of total billed charges,,,,1463.424,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,258.97675,,,fee schedule,,,258.97675,,,fee schedule,,,,,,,,,258.97675,,,fee schedule,,,,,,,,,,1317.0816,90,percent of total billed charges,,,,1390.2528,95,percent of total billed charges,,,266.7460525,,,fee schedule,,,310,,,fee schedule,,,310,,,fee schedule,,,,,,,,,258.97675,,,fee schedule,,,157.446,1463.424,
CT MAXILLOFACIAL W/O CONTRAST,3500340,CDM,70486,CPT,350,RC,inpatient,,,,1369.282,753.1051,,1232.3538,90,percent of total billed charges,,,,1369.282,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,131.15275,,,fee schedule,,,131.15275,,,fee schedule,,,,,,,,,131.15275,,,fee schedule,,,,,,,,,,1232.3538,90,percent of total billed charges,,,,1300.8179,95,percent of total billed charges,,,135.0873325,,,fee schedule,,,178,,,fee schedule,,,178,,,fee schedule,,,,,,,,,131.15275,,,fee schedule,,,96.84,1369.282,
CT MAXILLOFACIAL W/WO CONTRAST,3500350,CDM,70488,CPT,350,RC,inpatient,,,,1433.76,788.568,,1290.384,90,percent of total billed charges,,,,1433.76,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,188.740125,,,fee schedule,,,188.740125,,,fee schedule,,,,,,,,,188.740125,,,fee schedule,,,,,,,,,,1290.384,90,percent of total billed charges,,,,1362.072,95,percent of total billed charges,,,194.4023288,,,fee schedule,,,278,,,fee schedule,,,278,,,fee schedule,,,,,,,,,188.740125,,,fee schedule,,,157.446,1433.76,
CTA CHEST W/WO,3500600,CDM,71275,CPT,350,RC,inpatient,,,,936.167,514.89185,,842.5503,90,percent of total billed charges,,,,936.167,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,288.26975,,,fee schedule,,,288.26975,,,fee schedule,,,,,,,,,288.26975,,,fee schedule,,,,,,,,,,842.5503,90,percent of total billed charges,,,,889.35865,95,percent of total billed charges,,,296.9178425,,,fee schedule,,,341.28,,,fee schedule,,,341.28,,,fee schedule,,,,,,,,,288.26975,,,fee schedule,,,157.446,936.167,
CTA ABDOMEN W/WO CONTRAST,3500612,CDM,74175,CPT,350,RC,inpatient,,,,1327.979,730.38845,,1195.1811,90,percent of total billed charges,,,,1327.979,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,313.235375,,,fee schedule,,,313.235375,,,fee schedule,,,,,,,,,313.235375,,,fee schedule,,,,,,,,,,1195.1811,90,percent of total billed charges,,,,1261.58005,95,percent of total billed charges,,,322.6324363,,,fee schedule,,,328.15,,,fee schedule,,,328.15,,,fee schedule,,,,,,,,,313.235375,,,fee schedule,,,157.446,1327.979,
CTA ABD W/BI-ILIOFEMORAL W/WO,3500614,CDM,75635,CPT,350,RC,inpatient,,,,1244.24,684.332,,1119.816,90,percent of total billed charges,,,,1244.24,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,420.754,,,fee schedule,,,420.754,,,fee schedule,,,,,,,,,420.754,,,fee schedule,,,,,,,,,,1119.816,90,percent of total billed charges,,,,1182.028,95,percent of total billed charges,,,433.37662,,,fee schedule,,,328.15,,,fee schedule,,,328.15,,,fee schedule,,,,,,,,,420.754,,,fee schedule,,,157.446,1244.24,
CT ANGIO ABD&PELV W/O&W/CONTR,3500615,CDM,74174,CPT,350,RC,inpatient,,,,1244.24,684.332,,1119.816,90,percent of total billed charges,,,,1244.24,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,389.796625,,,fee schedule,,,389.796625,,,fee schedule,,,,,,,,,389.796625,,,fee schedule,,,,,,,,,,1119.816,90,percent of total billed charges,,,,1182.028,95,percent of total billed charges,,,401.4905238,,,fee schedule,,,429.16,,,fee schedule,,,429.16,,,fee schedule,,,,,,,,,389.796625,,,fee schedule,,,329.931,1244.24,
CT C-SPINE W/O & W CONTRAST,3502127,CDM,72127,CPT,350,RC,inpatient,,,,1339.515,736.73325,,1205.5635,90,percent of total billed charges,,,,1339.515,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,202.388,,,fee schedule,,,202.388,,,fee schedule,,,,,,,,,202.388,,,fee schedule,,,,,,,,,,1205.5635,90,percent of total billed charges,,,,1272.53925,95,percent of total billed charges,,,208.45964,,,fee schedule,,,323,,,fee schedule,,,323,,,fee schedule,,,,,,,,,202.388,,,fee schedule,,,157.446,1339.515,
CT LOW EXT W/CONTRAST RT,3502501,CDM,73701,CPT,350,RC,inpatient,,,RT,793.718,436.5449,,714.3462,90,percent of total billed charges,,,,793.718,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,170.764875,,,fee schedule,,,170.764875,,,fee schedule,,,,,,,,,170.764875,,,fee schedule,,,,,,,,,,714.3462,90,percent of total billed charges,,,,754.0321,95,percent of total billed charges,,,175.8878213,,,fee schedule,,,136,,,fee schedule,,,136,,,fee schedule,,,,,,,,,170.764875,,,fee schedule,,,136,793.718,
CT LOW EXT W/CONTRAST LT,3502502,CDM,73701,CPT,350,RC,inpatient,,,LT,793.718,436.5449,,714.3462,90,percent of total billed charges,,,,793.718,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,170.764875,,,fee schedule,,,170.764875,,,fee schedule,,,,,,,,,170.764875,,,fee schedule,,,,,,,,,,714.3462,90,percent of total billed charges,,,,754.0321,95,percent of total billed charges,,,175.8878213,,,fee schedule,,,136,,,fee schedule,,,136,,,fee schedule,,,,,,,,,170.764875,,,fee schedule,,,136,793.718,
CT LOW EXT W/CONTRAST BIL,3502503,CDM,73701,CPT,350,RC,inpatient,,,50,1587.127,872.91985,,1428.4143,90,percent of total billed charges,,,,1587.127,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,170.764875,,,fee schedule,,,170.764875,,,fee schedule,,,,,,,,,170.764875,,,fee schedule,,,,,,,,,,1428.4143,90,percent of total billed charges,,,,1507.77065,95,percent of total billed charges,,,175.8878213,,,fee schedule,,,136,,,fee schedule,,,136,,,fee schedule,,,,,,,,,170.764875,,,fee schedule,,,136,1587.127,
CT LOW EXT W/O & W/CONTRAST RT,3502601,CDM,73702,CPT,350,RC,inpatient,,,RT,1275.449,701.49695,,1147.9041,90,percent of total billed charges,,,,1275.449,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,200.057875,,,fee schedule,,,200.057875,,,fee schedule,,,,,,,,,200.057875,,,fee schedule,,,,,,,,,,1147.9041,90,percent of total billed charges,,,,1211.67655,95,percent of total billed charges,,,206.0596113,,,fee schedule,,,162,,,fee schedule,,,162,,,fee schedule,,,,,,,,,200.057875,,,fee schedule,,,157.446,1275.449,
CT LOW EXT W/O& W/CONTRAST LT,3502602,CDM,73702,CPT,350,RC,inpatient,,,LT,1275.449,701.49695,,1147.9041,90,percent of total billed charges,,,,1275.449,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,200.057875,,,fee schedule,,,200.057875,,,fee schedule,,,,,,,,,200.057875,,,fee schedule,,,,,,,,,,1147.9041,90,percent of total billed charges,,,,1211.67655,95,percent of total billed charges,,,206.0596113,,,fee schedule,,,162,,,fee schedule,,,162,,,fee schedule,,,,,,,,,200.057875,,,fee schedule,,,157.446,1275.449,
CT UP EXT W/O CONTRAST RT,3502701,CDM,73200,CPT,350,RC,inpatient,,,RT,637.364,350.5502,,573.6276,90,percent of total billed charges,,,,637.364,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,165.106,,,fee schedule,,,165.106,,,fee schedule,,,,,,,,,165.106,,,fee schedule,,,,,,,,,,573.6276,90,percent of total billed charges,,,,605.4958,95,percent of total billed charges,,,170.05918,,,fee schedule,,,185,,,fee schedule,,,185,,,fee schedule,,,,,,,,,165.106,,,fee schedule,,,96.84,637.364,
CT UP EXT W/O CONTRAST LT,3502702,CDM,73200,CPT,350,RC,inpatient,,,LT,637.364,350.5502,,573.6276,90,percent of total billed charges,,,,637.364,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,165.106,,,fee schedule,,,165.106,,,fee schedule,,,,,,,,,165.106,,,fee schedule,,,,,,,,,,573.6276,90,percent of total billed charges,,,,605.4958,95,percent of total billed charges,,,170.05918,,,fee schedule,,,185,,,fee schedule,,,185,,,fee schedule,,,,,,,,,165.106,,,fee schedule,,,96.84,637.364,
CT UP EXT W/O CONTRAST BIL,3502703,CDM,73200,CPT,350,RC,inpatient,,,50,1274.213,700.81715,,1146.7917,90,percent of total billed charges,,,,1274.213,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,165.106,,,fee schedule,,,165.106,,,fee schedule,,,,,,,,,165.106,,,fee schedule,,,,,,,,,,1146.7917,90,percent of total billed charges,,,,1210.50235,95,percent of total billed charges,,,170.05918,,,fee schedule,,,185,,,fee schedule,,,185,,,fee schedule,,,,,,,,,165.106,,,fee schedule,,,96.84,1274.213,
CT UP EXT W/CONTRAST RT,3502801,CDM,73201,CPT,350,RC,inpatient,,,RT,793.718,436.5449,,714.3462,90,percent of total billed charges,,,,793.718,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,205.71675,,,fee schedule,,,205.71675,,,fee schedule,,,,,,,,,205.71675,,,fee schedule,,,,,,,,,,714.3462,90,percent of total billed charges,,,,754.0321,95,percent of total billed charges,,,211.8882525,,,fee schedule,,,136,,,fee schedule,,,136,,,fee schedule,,,,,,,,,205.71675,,,fee schedule,,,136,793.718,
CT UP EXT W/CONTRAST LT,3502802,CDM,73201,CPT,350,RC,inpatient,,,LT,793.718,436.5449,,714.3462,90,percent of total billed charges,,,,793.718,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,205.71675,,,fee schedule,,,205.71675,,,fee schedule,,,,,,,,,205.71675,,,fee schedule,,,,,,,,,,714.3462,90,percent of total billed charges,,,,754.0321,95,percent of total billed charges,,,211.8882525,,,fee schedule,,,136,,,fee schedule,,,136,,,fee schedule,,,,,,,,,205.71675,,,fee schedule,,,136,793.718,
CT UP EXT WOW/CONTRAST RT,3502901,CDM,73202,CPT,350,RC,inpatient,,,RT,1275.449,701.49695,,1147.9041,90,percent of total billed charges,,,,1275.449,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,254.98225,,,fee schedule,,,254.98225,,,fee schedule,,,,,,,,,254.98225,,,fee schedule,,,,,,,,,,1147.9041,90,percent of total billed charges,,,,1211.67655,95,percent of total billed charges,,,262.6317175,,,fee schedule,,,162,,,fee schedule,,,162,,,fee schedule,,,,,,,,,254.98225,,,fee schedule,,,157.446,1275.449,
CT UP EXT W/O & W/CONTRAST LT,3502902,CDM,73202,CPT,350,RC,inpatient,,,LT,1275.449,701.49695,,1147.9041,90,percent of total billed charges,,,,1275.449,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,254.98225,,,fee schedule,,,254.98225,,,fee schedule,,,,,,,,,254.98225,,,fee schedule,,,,,,,,,,1147.9041,90,percent of total billed charges,,,,1211.67655,95,percent of total billed charges,,,262.6317175,,,fee schedule,,,162,,,fee schedule,,,162,,,fee schedule,,,,,,,,,254.98225,,,fee schedule,,,157.446,1275.449,
CT ANGIO UPR EXTRM W/O&W/ DYE,3503210,CDM,73206,CPT,350,RC,inpatient,,,RT,1911.474,1051.3107,,1720.3266,90,percent of total billed charges,,,,1911.474,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,304.24775,,,fee schedule,,,304.24775,,,fee schedule,,,,,,,,,304.24775,,,fee schedule,,,,,,,,,,1720.3266,90,percent of total billed charges,,,,1815.9003,95,percent of total billed charges,,,313.3751825,,,fee schedule,,,288.4,,,fee schedule,,,288.4,,,fee schedule,,,,,,,,,304.24775,,,fee schedule,,,157.446,1911.474,
CT ANGIO UPPER EXTREMITY LEFT,3503220,CDM,73206,CPT,350,RC,inpatient,,,LT,1911.474,1051.3107,,1720.3266,90,percent of total billed charges,,,,1911.474,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,304.24775,,,fee schedule,,,304.24775,,,fee schedule,,,,,,,,,304.24775,,,fee schedule,,,,,,,,,,1720.3266,90,percent of total billed charges,,,,1815.9003,95,percent of total billed charges,,,313.3751825,,,fee schedule,,,288.4,,,fee schedule,,,288.4,,,fee schedule,,,,,,,,,304.24775,,,fee schedule,,,157.446,1911.474,
CT LOW EXT W/O CONTRAST LT,3503700,CDM,73700,CPT,350,RC,inpatient,,,LT,637.364,350.5502,,573.6276,90,percent of total billed charges,,,,637.364,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,132.48425,,,fee schedule,,,132.48425,,,fee schedule,,,,,,,,,132.48425,,,fee schedule,,,,,,,,,,573.6276,90,percent of total billed charges,,,,605.4958,95,percent of total billed charges,,,136.4587775,,,fee schedule,,,182,,,fee schedule,,,182,,,fee schedule,,,,,,,,,132.48425,,,fee schedule,,,96.84,637.364,
CT ABD & PELVIS WITH CONTRAST,3504177,CDM,74177,CPT,350,RC,inpatient,,,,2524.427,1388.43485,,2271.9843,90,percent of total billed charges,,,,2524.427,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,310.90525,,,fee schedule,,,310.90525,,,fee schedule,,,,,,,,,310.90525,,,fee schedule,,,,,,,,,,2271.9843,90,percent of total billed charges,,,,2398.20565,95,percent of total billed charges,,,320.2324075,,,fee schedule,,,206.27,,,fee schedule,,,206.27,,,fee schedule,,,,,,,,,310.90525,,,fee schedule,,,206.27,2524.427,
CT ABD & PELVIS WO/W CONTRAST,3504178,CDM,74178,CPT,350,RC,inpatient,,,,2767.095,1521.90225,,2490.3855,90,percent of total billed charges,,,,2767.095,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,348.853,,,fee schedule,,,348.853,,,fee schedule,,,,,,,,,348.853,,,fee schedule,,,,,,,,,,2490.3855,90,percent of total billed charges,,,,2628.74025,95,percent of total billed charges,,,359.31859,,,fee schedule,,,272.95,,,fee schedule,,,272.95,,,fee schedule,,,,,,,,,348.853,,,fee schedule,,,272.95,2767.095,
CT LOW EXT W/O CONTRAST BIL,3507003,CDM,73200,CPT,350,RC,inpatient,,,50,1274.213,700.81715,,1146.7917,90,percent of total billed charges,,,,1274.213,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,165.106,,,fee schedule,,,165.106,,,fee schedule,,,,,,,,,165.106,,,fee schedule,,,,,,,,,,1146.7917,90,percent of total billed charges,,,,1210.50235,95,percent of total billed charges,,,170.05918,,,fee schedule,,,185,,,fee schedule,,,185,,,fee schedule,,,,,,,,,165.106,,,fee schedule,,,96.84,1274.213,
CTA NECK W/O & W CONTRAST,3507049,CDM,70498,CPT,350,RC,inpatient,,,,1562.51,859.3805,,1406.259,90,percent of total billed charges,,,,1562.51,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,282.278,,,fee schedule,,,282.278,,,fee schedule,,,,,,,,,282.278,,,fee schedule,,,,,,,,,,1406.259,90,percent of total billed charges,,,,1484.3845,95,percent of total billed charges,,,290.74634,,,fee schedule,,,280.9,,,fee schedule,,,280.9,,,fee schedule,,,,,,,,,282.278,,,fee schedule,,,157.446,1562.51,
CT CERVICAL SPINE W/CONTRAST,3507212,CDM,72126,CPT,350,RC,inpatient,,,,1172.14,644.677,,1054.926,90,percent of total billed charges,,,,1172.14,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,172.762125,,,fee schedule,,,172.762125,,,fee schedule,,,,,,,,,172.762125,,,fee schedule,,,,,,,,,,1054.926,90,percent of total billed charges,,,,1113.533,95,percent of total billed charges,,,177.9449888,,,fee schedule,,,261,,,fee schedule,,,261,,,fee schedule,,,,,,,,,172.762125,,,fee schedule,,,172.762125,1172.14,
CT LOW EXT W/O CONTRAST RT,3507370,CDM,73700,CPT,350,RC,inpatient,,,RT,637.364,350.5502,,573.6276,90,percent of total billed charges,,,,637.364,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,132.48425,,,fee schedule,,,132.48425,,,fee schedule,,,,,,,,,132.48425,,,fee schedule,,,,,,,,,,573.6276,90,percent of total billed charges,,,,605.4958,95,percent of total billed charges,,,136.4587775,,,fee schedule,,,182,,,fee schedule,,,182,,,fee schedule,,,,,,,,,132.48425,,,fee schedule,,,96.84,637.364,
CT ABD & PELVIS W/O CONTRAST,3507417,CDM,74176,CPT,350,RC,inpatient,,,,2002.32,1101.276,,1802.088,90,percent of total billed charges,,,,2002.32,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,187.408625,,,fee schedule,,,187.408625,,,fee schedule,,,,,,,,,187.408625,,,fee schedule,,,,,,,,,,1802.088,90,percent of total billed charges,,,,1902.204,95,percent of total billed charges,,,193.0308838,,,fee schedule,,,108.3,,,fee schedule,,,108.3,,,fee schedule,,,,,,,,,187.408625,,,fee schedule,,,108.3,2002.32,
CT GUIDANCE NEEDLE PLCMNT RAD,3507701,CDM,77012,CPT,350,RC,inpatient,,,,578.242,318.0331,,520.4178,90,percent of total billed charges,,,,578.242,100,percent of total billed charges,,,72.29,,,fee schedule,,,72.29,,,fee schedule,,,65.061,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,,,,,,,,520.4178,90,percent of total billed charges,,,,549.3299,95,percent of total billed charges,,,142.9731413,,,fee schedule,,,,,,,,,,,,,,,,,,,,,138.808875,,,fee schedule,,,65.061,578.242,
CT HEAD OR BRAIN W/O CONTRAST,3500050,CDM,70450,CPT,351,RC,inpatient,,,,1368.046,752.4253,,1231.2414,90,percent of total billed charges,,,,1368.046,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,108.51725,,,fee schedule,,,108.51725,,,fee schedule,,,,,,,,,108.51725,,,fee schedule,,,,,,,,,,1231.2414,90,percent of total billed charges,,,,1299.6437,95,percent of total billed charges,,,111.7727675,,,fee schedule,,,165,,,fee schedule,,,165,,,fee schedule,,,,,,,,,108.51725,,,fee schedule,,,96.84,1368.046,
CT HEAD OR BRAIN W/CONTRAST,3500060,CDM,70460,CPT,351,RC,inpatient,,,,1500.607,825.33385,,1350.5463,90,percent of total billed charges,,,,1500.607,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,151.791,,,fee schedule,,,151.791,,,fee schedule,,,,,,,,,151.791,,,fee schedule,,,,,,,,,,1350.5463,90,percent of total billed charges,,,,1425.57665,95,percent of total billed charges,,,156.34473,,,fee schedule,,,208,,,fee schedule,,,208,,,fee schedule,,,,,,,,,151.791,,,fee schedule,,,151.791,1500.607,
CT HEAD OR BRIAN W & W/O CONT,3500070,CDM,70470,CPT,351,RC,inpatient,,,,1580.741,869.40755,,1422.6669,90,percent of total billed charges,,,,1580.741,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,177.75525,,,fee schedule,,,177.75525,,,fee schedule,,,,,,,,,177.75525,,,fee schedule,,,,,,,,,,1422.6669,90,percent of total billed charges,,,,1501.70395,95,percent of total billed charges,,,183.0879075,,,fee schedule,,,251,,,fee schedule,,,251,,,fee schedule,,,,,,,,,177.75525,,,fee schedule,,,157.446,1580.741,
CT INTRACRANIAL W/CONTRAST,3500170,CDM,70481,CPT,351,RC,inpatient,,,,946.57,520.6135,,851.913,90,percent of total billed charges,,,,946.57,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,185.0785,,,fee schedule,,,185.0785,,,fee schedule,,,,,,,,,185.0785,,,fee schedule,,,,,,,,,,851.913,90,percent of total billed charges,,,,899.2415,95,percent of total billed charges,,,190.630855,,,fee schedule,,,221,,,fee schedule,,,221,,,fee schedule,,,,,,,,,185.0785,,,fee schedule,,,157.446,946.57,
CT INTRACRANIAL W/O CONTRAST,3500180,CDM,70480,CPT,351,RC,inpatient,,,,962.02,529.111,,865.818,90,percent of total billed charges,,,,962.02,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,162.775875,,,fee schedule,,,162.775875,,,fee schedule,,,,,,,,,162.775875,,,fee schedule,,,,,,,,,,865.818,90,percent of total billed charges,,,,913.919,95,percent of total billed charges,,,167.6591513,,,fee schedule,,,182,,,fee schedule,,,182,,,fee schedule,,,,,,,,,162.775875,,,fee schedule,,,96.84,962.02,
CT MAXILLOFACIAL W/CONTRAST,3500310,CDM,70487,CPT,351,RC,inpatient,,,,1311.293,721.21115,,1180.1637,90,percent of total billed charges,,,,1311.293,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,155.7855,,,fee schedule,,,155.7855,,,fee schedule,,,,,,,,,155.7855,,,fee schedule,,,,,,,,,,1180.1637,90,percent of total billed charges,,,,1245.72835,95,percent of total billed charges,,,160.459065,,,fee schedule,,,191,,,fee schedule,,,191,,,fee schedule,,,,,,,,,155.7855,,,fee schedule,,,155.7855,1311.293,
CTA HEAD W/O CONTRAST FB CONT,3500580,CDM,70496,CPT,351,RC,inpatient,,,,912.786,502.0323,,821.5074,90,percent of total billed charges,,,,912.786,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,157.446,,,fee schedule,,,282.610875,,,fee schedule,,,282.610875,,,fee schedule,,,,,,,,,282.610875,,,fee schedule,,,,,,,,,,821.5074,90,percent of total billed charges,,,,867.1467,95,percent of total billed charges,,,291.0892013,,,fee schedule,,,280.9,,,fee schedule,,,280.9,,,fee schedule,,,,,,,,,282.610875,,,fee schedule,,,157.446,912.786,
CT THORACIC SPINE W/O CONTRAST,3500290,CDM,72128,CPT,352,RC,inpatient,,,,1256.909,691.29995,,1131.2181,90,percent of total billed charges,,,,1256.909,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,132.817125,,,fee schedule,,,132.817125,,,fee schedule,,,,,,,,,132.817125,,,fee schedule,,,,,,,,,,1131.2181,90,percent of total billed charges,,,,1194.06355,95,percent of total billed charges,,,136.8016388,,,fee schedule,,,215,,,fee schedule,,,215,,,fee schedule,,,,,,,,,132.817125,,,fee schedule,,,96.84,1256.909,
CT LUMBAR SPINE W/CONTRAST,3527213,CDM,72132,CPT,352,RC,inpatient,,,,1577.96,867.878,,1420.164,90,percent of total billed charges,,,,1577.96,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,173.095,,,fee schedule,,,173.095,,,fee schedule,,,,,,,,,173.095,,,fee schedule,,,,,,,,,,1420.164,90,percent of total billed charges,,,,1499.062,95,percent of total billed charges,,,178.28785,,,fee schedule,,,261,,,fee schedule,,,261,,,fee schedule,,,,,,,,,173.095,,,fee schedule,,,173.095,1577.96,
BRONCHOSCOPY,3600030,CDM,,,360,RC,inpatient,,,,1501.74,825.957,,1351.566,90,percent of total billed charges,,,,1501.74,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1351.566,90,percent of total billed charges,,,,1426.653,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1351.566,1501.74,
COLONSCOPY - DIAGNOSTIC,3600060,CDM,,,360,RC,inpatient,,,,1864.712,1025.5916,,1678.2408,90,percent of total billed charges,,,,1864.712,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1678.2408,90,percent of total billed charges,,,,1771.4764,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1678.2408,1864.712,
COLONOSCOPY HIGHRISK SCREENING,3600061,CDM,G0105,HCPCS,360,RC,inpatient,,,,1864.712,1025.5916,,1678.2408,90,percent of total billed charges,,,,1864.712,100,percent of total billed charges,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,760.671,,,fee schedule,,,181.416875,,,fee schedule,,,181.416875,,,fee schedule,,,,,,,,,181.416875,,,fee schedule,,,,,,,,,,1678.2408,90,percent of total billed charges,,,,1771.4764,95,percent of total billed charges,,,186.8593813,,,fee schedule,,,,,,,,,,,,,,,,,,,,,181.416875,,,fee schedule,,,181.416875,1864.712,
COLONOSCOPY - SCREENING,3600062,CDM,G0121,HCPCS,360,RC,inpatient,,,,1864.712,1025.5916,,1678.2408,90,percent of total billed charges,,,,1864.712,100,percent of total billed charges,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,760.671,,,fee schedule,,,181.74975,,,fee schedule,,,181.74975,,,fee schedule,,,,,,,,,181.74975,,,fee schedule,,,,,,,,,,1678.2408,90,percent of total billed charges,,,,1771.4764,95,percent of total billed charges,,,187.2022425,,,fee schedule,,,,,,,,,,,,,,,,,,,,,181.74975,,,fee schedule,,,181.74975,1864.712,
EGD,3600140,CDM,,,360,RC,inpatient,,,,1501.74,825.957,,1351.566,90,percent of total billed charges,,,,1501.74,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1351.566,90,percent of total billed charges,,,,1426.653,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1351.566,1501.74,
FLEX SIGMOIDOSCOPY/SCREENING,3600170,CDM,G0104,HCPCS,360,RC,inpatient,,,,941.317,517.72435,,847.1853,90,percent of total billed charges,,,,941.317,100,percent of total billed charges,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,760.671,,,fee schedule,,,56.255875,,,fee schedule,,,56.255875,,,fee schedule,,,,,,,,,56.255875,,,fee schedule,,,,,,,,,,847.1853,90,percent of total billed charges,,,,894.25115,95,percent of total billed charges,,,57.94355125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.255875,,,fee schedule,,,56.255875,941.317,
SIGMOIDOSCOPY - DIAGNOSTIC,3600175,CDM,,,360,RC,inpatient,,,,941.317,517.72435,,847.1853,90,percent of total billed charges,,,,941.317,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,847.1853,90,percent of total billed charges,,,,894.25115,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,847.1853,941.317,
SURGERY TIME - 1-15 MINUTES,3600300,CDM,,,360,RC,inpatient,,,,1327.773,730.27515,,1194.9957,90,percent of total billed charges,,,,1327.773,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1194.9957,90,percent of total billed charges,,,,1261.38435,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1194.9957,1327.773,
SURGERY TIME - 16-30 MINUTES,3600310,CDM,,,360,RC,inpatient,,,,2655.958,1460.7769,,2390.3622,90,percent of total billed charges,,,,2655.958,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2390.3622,90,percent of total billed charges,,,,2523.1601,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2390.3622,2655.958,
SURGERY TIME - 31-60 MINUTES,3600320,CDM,,,360,RC,inpatient,,,,3983.937,2191.16535,,3585.5433,90,percent of total billed charges,,,,3983.937,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3585.5433,90,percent of total billed charges,,,,3784.74015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3585.5433,3983.937,
SURGERY TIME - 61-90 MINUTES,3600330,CDM,,,360,RC,inpatient,,,,5311.813,2921.49715,,4780.6317,90,percent of total billed charges,,,,5311.813,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4780.6317,90,percent of total billed charges,,,,5046.22235,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4780.6317,5311.813,
SURGERY TIME - 91-120 MINUTES,3600340,CDM,,,360,RC,inpatient,,,,6591.176,3625.1468,,5932.0584,90,percent of total billed charges,,,,6591.176,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5932.0584,90,percent of total billed charges,,,,6261.6172,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5932.0584,6591.176,
SURGERY TIME 121-150 MINUTES,3600350,CDM,,,360,RC,inpatient,,,,7967.771,4382.27405,,7170.9939,90,percent of total billed charges,,,,7967.771,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7170.9939,90,percent of total billed charges,,,,7569.38245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7170.9939,7967.771,
SURGERY TIME 151-180 MINUTES,3600360,CDM,,,360,RC,inpatient,,,,9295.75,5112.6625,,8366.175,90,percent of total billed charges,,,,9295.75,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8366.175,90,percent of total billed charges,,,,8830.9625,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8366.175,9295.75,
SURGERY TIME 181-210 MINUTES,3600370,CDM,,,360,RC,inpatient,,,,10623.626,5842.9943,,9561.2634,90,percent of total billed charges,,,,10623.626,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9561.2634,90,percent of total billed charges,,,,10092.4447,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9561.2634,10623.626,
SURGERY TIME 211-240 MINUTES,3600380,CDM,,,360,RC,inpatient,,,,11951.605,6573.38275,,10756.4445,90,percent of total billed charges,,,,11951.605,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10756.4445,90,percent of total billed charges,,,,11354.02475,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10756.4445,11951.605,
SURGERY TIME 241-270 MINUTES,3600390,CDM,,,360,RC,inpatient,,,,13279.481,7303.71455,,11951.5329,90,percent of total billed charges,,,,13279.481,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11951.5329,90,percent of total billed charges,,,,12615.50695,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11951.5329,13279.481,
SURGERY TIME 271-300 MINUTES,3600400,CDM,,,360,RC,inpatient,,,,14607.46,8034.103,,13146.714,90,percent of total billed charges,,,,14607.46,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13146.714,90,percent of total billed charges,,,,13877.087,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13146.714,14607.46,
SURGERY TIME 301-330 MINUTES,3600410,CDM,,,360,RC,inpatient,,,,15935.439,8764.49145,,14341.8951,90,percent of total billed charges,,,,15935.439,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14341.8951,90,percent of total billed charges,,,,15138.66705,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14341.8951,15935.439,
SURGERY TIME 331-360 MINUTES,3600420,CDM,,,360,RC,inpatient,,,,17263.315,9494.82325,,15536.9835,90,percent of total billed charges,,,,17263.315,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15536.9835,90,percent of total billed charges,,,,16400.14925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15536.9835,17263.315,
SURGERY TIME - 1ST HOUR,3601000,CDM,,,360,RC,inpatient,,,,3306.3,1818.465,,2975.67,90,percent of total billed charges,,,,3306.3,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2975.67,90,percent of total billed charges,,,,3140.985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2975.67,3306.3,
PREOP PLACE/NEEDLE LOCAL WIRE,3601929,CDM,,,360,RC,inpatient,,,,220.626,121.3443,,198.5634,90,percent of total billed charges,,,,220.626,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.5634,90,percent of total billed charges,,,,209.5947,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.5634,220.626,
SURGERY TIME - EA ADDL 30 MINS,3602000,CDM,,,360,RC,inpatient,,,,1653.15,909.2325,,1487.835,90,percent of total billed charges,,,,1653.15,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1487.835,90,percent of total billed charges,,,,1570.4925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1487.835,1653.15,
PROCTOSIGMOIDOSCOPY,3604530,CDM,,,360,RC,inpatient,,,,880.856,484.4708,,792.7704,90,percent of total billed charges,,,,880.856,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,792.7704,90,percent of total billed charges,,,,836.8132,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,792.7704,880.856,
UMBILICAL CATH TRAY,7200000,CDM,,,361,RC,inpatient,,,,39.861,21.92355,,35.8749,90,percent of total billed charges,,,,39.861,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.8749,90,percent of total billed charges,,,,37.86795,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.8749,39.861,
ANESTHESIA TIME (1 MINUTE),3700000,CDM,,,370,RC,inpatient,,,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8065,9.785,
"EYE, BLEPHAROPLASTY-5 UNITS",3700020,CDM,00103,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
EAR; NOS - 5 UNITS,3700030,CDM,00120,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
TYMPANOTOMY - 4 UNITS,3700035,CDM,00126,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
EYE; NOS - 5 UNITS,3700040,CDM,00140,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
IRIDECTOMY - 4 UNITS,3700080,CDM,00147,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
NOSE/SINUSES;NOS - 5 UNITS,3700090,CDM,00160,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
INTRAORAL PROC;NOS - 5 UNITS,3700100,CDM,00170,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
INTEGUMENTARY NECK - 5 UNITS,3700110,CDM,00300,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
NECK/ALL PROCEDURES;NOS-6 UNIT,3700120,CDM,00320,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
THORAX/ANTERIOR - 3 UNITS,3700130,CDM,00400,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
RADICAL/MODIFIED BREAST-5 UNIT,3700140,CDM,00404,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
RAD/MOD BREAST W/NODE-13 UNITS,3700150,CDM,00406,CPT,370,RC,inpatient,,,QZ,1708.255,939.54025,,1537.4295,90,percent of total billed charges,,,,1708.255,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1537.4295,90,percent of total billed charges,,,,1622.84225,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1537.4295,1708.255,
CLOSED CHEST PROCEDURE-6 UNITS,3700170,CDM,00520,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
ACCESS CVC - 4 UNITS,3700190,CDM,00532,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
LUMBAR PUNCTURE - 4 UNITS,3700210,CDM,00635,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
UPPER ANT ABD WALL - 4 UNITS,3700220,CDM,00700,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
UPPER GASTRIC ENDO; NOS 5 UNIT,3700253,CDM,00731,CPT,370,RC,inpatient,,,QZ,660.745,363.40975,,594.6705,90,percent of total billed charges,,,,660.745,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,594.6705,90,percent of total billed charges,,,,627.70775,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,594.6705,660.745,
UPPER ABD/HERNIA REPAIR-4 UNIT,3700260,CDM,00750,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
LUMBAR/VENTRAL HERNIAS-6 UNITS,3700270,CDM,00752,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
INTRAPERITONEAL UP/ABD -7 UNIT,3700290,CDM,00790,CPT,370,RC,inpatient,,,QZ,920.099,506.05445,,828.0891,90,percent of total billed charges,,,,920.099,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.0891,90,percent of total billed charges,,,,874.09405,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.0891,920.099,
LOWER ANT ABD WALL - 4 UNITS,3700310,CDM,00800,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
ANESTHESIA SCREEN COLONOSCOPY,3700321,CDM,00812,CPT,370,RC,inpatient,,,QZ,396.447,218.04585,,356.8023,90,percent of total billed charges,,,,396.447,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,356.8023,90,percent of total billed charges,,,,376.62465,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,356.8023,396.447,
UPPER & LOWER INTESTINAL ENDO,3700322,CDM,00813,CPT,370,RC,inpatient,,,QZ,660.745,363.40975,,594.6705,90,percent of total billed charges,,,,660.745,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,594.6705,90,percent of total billed charges,,,,627.70775,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,594.6705,660.745,
LOWER INTESTINAL ENDO; NOS,3700323,CDM,00811,CPT,370,RC,inpatient,,,QZ,528.596,290.7278,,475.7364,90,percent of total billed charges,,,,528.596,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,475.7364,90,percent of total billed charges,,,,502.1662,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,475.7364,528.596,
LOWER POST ABD WALL - 5 UNITS,3700330,CDM,00820,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
HERNIA REPAIR LOWER ABD-4 UNIT,3700340,CDM,00830,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
VENTRAL/INCIS HERNIAS - 6 UNIT,3700350,CDM,00832,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
INTRAPERITONEAL LOW ABD-6 UNIT,3700360,CDM,00840,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
CESAREAN SECTION ANESTHESIA,3700370,CDM,01961,CPT,370,RC,inpatient,,,QZ,920.099,506.05445,,828.0891,90,percent of total billed charges,,,,920.099,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.0891,90,percent of total billed charges,,,,874.09405,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.0891,920.099,
RADICAL HYSTERECTOMY - 8 UNITS,3700380,CDM,00846,CPT,370,RC,inpatient,,,QZ,1051.321,578.22655,,946.1889,90,percent of total billed charges,,,,1051.321,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.1889,90,percent of total billed charges,,,,998.75495,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.1889,1051.321,
ABDOMINOPERINEAL RESECT-7 UNIT,3700390,CDM,00844,CPT,370,RC,inpatient,,,QZ,920.099,506.05445,,828.0891,90,percent of total billed charges,,,,920.099,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.0891,90,percent of total billed charges,,,,874.09405,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.0891,920.099,
EXTRAPERITONEAL LOW ABD-6 UNIT,3700410,CDM,00860,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
ANORECTAL PROCEDURE - 5 UNITS,3700480,CDM,00902,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
VAGINAL PROCEDURES - 3 UNITS,3700630,CDM,00940,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
"COLPOTOMY,COLPECTOMY - 4 UNITS",3700640,CDM,00942,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
VAGINAL HYSTERECTOMY - 6 UNITS,3700660,CDM,00944,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
CERVICAL CERCLAGE - 4 UNITS,3700680,CDM,00948,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
HYSTEROSCOPY - 4 UNITS,3700700,CDM,00952,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
CLOSED PROC/HIP JOINT - 4 UNIT,3700750,CDM,01200,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
OPEN PROCEDURE/HIP JOINT- 6,3700770,CDM,01210,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
TOTAL HIP REPLACEMENT - 8 UNIT,3700780,CDM,01214,CPT,370,RC,inpatient,,,QZ,1051.321,578.22655,,946.1889,90,percent of total billed charges,,,,1051.321,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.1889,90,percent of total billed charges,,,,998.75495,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.1889,1051.321,
TOTAL HIP ARTH/REVISIO - 10,3700790,CDM,01215,CPT,370,RC,inpatient,,,QZ,1314.074,722.7407,,1182.6666,90,percent of total billed charges,,,,1314.074,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1182.6666,90,percent of total billed charges,,,,1248.3703,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1182.6666,1314.074,
OPEN PROC/UPPER FEMUR - 6 UNIT,3700810,CDM,01230,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
AMPUTATION/UPPER LEG - 5 UNITS,3700820,CDM,01232,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
"NERVES,MUSCLE/UPPER LEG - 4",3700830,CDM,01250,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
VEIN PROCEDURES/UPPER LEG - 3,3700840,CDM,01260,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
ARTERIES UPPER LEG - 8 UNITS,3700850,CDM,01270,CPT,370,RC,inpatient,,,QZ,1051.321,578.22655,,946.1889,90,percent of total billed charges,,,,1051.321,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.1889,90,percent of total billed charges,,,,998.75495,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.1889,1051.321,
TUBAL LIGATION/TRANSECTION - 6,3700851,CDM,00851,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
"NERVES,MUSC,KNEE/POPLITEAL- 4",3700880,CDM,01320,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
OPEN PROC/LOWER FEMUR - 5 UNIT,3700900,CDM,01360,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
ARTHROSCOPIC/KNEE JOINT- 3,3700920,CDM,01382,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
"OPEN/UPPER TIBIA,FIBULA - 4",3700940,CDM,01392,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
OPEN PROC/KNEE JOINT- 4 UNITS,3700950,CDM,01400,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
TOTAL KNEE REPLACEMENT - 7,3700960,CDM,01402,CPT,370,RC,inpatient,,,QZ,920.099,506.05445,,828.0891,90,percent of total billed charges,,,,920.099,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.0891,90,percent of total billed charges,,,,874.09405,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.0891,920.099,
CLOSED PROC/LOWER LEG - 3 UNIT,3700990,CDM,01462,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
"NERVES,MUSCLE/LOWER LEG-3 UNIT",3701000,CDM,01470,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
RUPTURED ACHILLES TEN - 5 UNIT,3701010,CDM,01472,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
OPEN/BONES LOWER LEG - 3 UNITS,3701020,CDM,01480,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
"NERVES,MUSCLES SHOULDER - 5",3701080,CDM,01610,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
CLOSED SHOULDER/AXILLA - 4,3701090,CDM,01620,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
OPEN SHOULDER/AXILLA - 5 UNITS,3701100,CDM,01630,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
"NERVES,MUSCLES/UP-ARM - 3 UNIT",3701120,CDM,01710,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
UPPER ARM/ELBOW TENOTOMY-5 UNI,3701130,CDM,01712,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
CLOSED PR HUMERUS/ELBOW - 3,3701140,CDM,01730,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
OPEN PROC HUMERUS/ELBOW-4 UNIT,3701150,CDM,01740,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
HUMERUS NON/MALUNI0N RPR-5 UNI,3701160,CDM,01744,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
"NERVES,MUSCLE FOREARM - 3 UNIT",3701180,CDM,01810,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
CLOSED F-ARM/WRIST/HAND-3 UNIT,3701190,CDM,01820,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
OPEN F-ARM/WRIST/HAND-3 UNITS,3701200,CDM,01830,CPT,370,RC,inpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,90,percent of total billed charges,,,,374.5698,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.8556,394.284,
ARTERIES UP-ARM/ELBOW-6 UNITS,3701290,CDM,01770,CPT,370,RC,inpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,90,percent of total billed charges,,,,749.1396,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,709.7112,788.568,
PNEUMOCENTESIS - 4 UNITS,3701300,CDM,00524,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
SPINAL PUNCT LUMBAR DX- 5 UNIT,3701310,CDM,62270,CPT,370,RC,inpatient,,,,381.821,210.00155,,343.6389,90,percent of total billed charges,,,,381.821,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,589.78125,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,,,,,,,,343.6389,90,percent of total billed charges,,,,362.72995,95,percent of total billed charges,,,65.1436375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,63.24625,655.3125,
EPIDURAL PATCH INJECTION,3701320,CDM,62273,CPT,370,RC,inpatient,,,,381.821,210.00155,,343.6389,90,percent of total billed charges,,,,381.821,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,589.78125,,,fee schedule,,,112.178875,,,fee schedule,,,112.178875,,,fee schedule,,,,,,,,,112.178875,,,fee schedule,,,,,,,,,,343.6389,90,percent of total billed charges,,,,362.72995,95,percent of total billed charges,,,115.5442413,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,112.178875,,,fee schedule,,,112.178875,655.3125,
"LUMBAR,SACRAL INJECTION",3701330,CDM,0216T,CPT,370,RC,inpatient,,,,608.421,334.63155,,547.5789,90,percent of total billed charges,,,,608.421,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,547.5789,90,percent of total billed charges,,,,577.99995,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,547.5789,608.421,
INTRATHECAL; VAG DEL - 5 UNITS,3701340,CDM,01967,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
C-SECTION; AFTER INTRATHECAL,3701345,CDM,01968,CPT,370,RC,inpatient,,,QZ,263.165,144.74075,,236.8485,90,percent of total billed charges,,,,263.165,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.8485,90,percent of total billed charges,,,,250.00675,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.8485,263.165,
INTUBAT ENDOTRACHEAL/ER-6 UNIT,3701430,CDM,31500,CPT,370,RC,inpatient,,,QZ,664.659,365.56245,,598.1931,90,percent of total billed charges,,,,664.659,100,percent of total billed charges,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,190.2285,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,,,,,,,,598.1931,90,percent of total billed charges,,,,631.42605,95,percent of total billed charges,,,142.9731413,,,fee schedule,,,363,,,fee schedule,,,363,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,138.808875,664.659,
PROCEDURE LOWER LEG - 4 UNITS,3701482,CDM,01482,CPT,370,RC,inpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
MONITORED ANESTHESIA CARE,3701510,CDM,G9654,HCPCS,370,RC,inpatient,,,,8.858,4.8719,,7.9722,90,percent of total billed charges,,,,8.858,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.9722,90,percent of total billed charges,,,,8.4151,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.9722,8.858,
INCOMPLETE OR MISSED ABORTION,3701965,CDM,01965,CPT,370,RC,inpatient,,,,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,90,percent of total billed charges,,,,499.52425,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,473.2335,525.815,
EPIDURAL - VAG DELIVERY - 5,3701967,CDM,01967,CPT,370,RC,inpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,90,percent of total billed charges,,,,624.18515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,591.3333,657.037,
EPIDURAL C-SECTION/ADD ON - 2,3701968,CDM,01968,CPT,370,RC,inpatient,,,QZ,263.165,144.74075,,236.8485,90,percent of total billed charges,,,,263.165,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.8485,90,percent of total billed charges,,,,250.00675,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.8485,263.165,
RBC LEUKOCYTES REDUCED,3910010,CDM,P9016,HCPCS,381,RC,inpatient,,,BL,428.274,235.5507,,385.4466,90,percent of total billed charges,,,,428.274,100,percent of total billed charges,,,194.997,,,fee schedule,,,194.997,,,fee schedule,,,175.4973,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,385.4466,90,percent of total billed charges,,,,406.8603,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,175.4973,428.274,
BLOOD/PLASMA 1 DONOR FRZ,3910030,CDM,P9017,HCPCS,383,RC,inpatient,,,,262.032,144.1176,,235.8288,90,percent of total billed charges,,,,262.032,100,percent of total billed charges,,,88.0764,,,fee schedule,,,88.0764,,,fee schedule,,,79.26876,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,235.8288,90,percent of total billed charges,,,,248.9304,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.26876,262.032,
BLOOD STORAGE AND PROCESSING,3901100,CDM,P9016,HCPCS,390,RC,inpatient,,,BL,365.959,201.27745,,329.3631,90,percent of total billed charges,,,,365.959,100,percent of total billed charges,,,194.997,,,fee schedule,,,194.997,,,fee schedule,,,175.4973,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,329.3631,90,percent of total billed charges,,,,347.66105,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,175.4973,365.959,
PLATELETS EACH UNIT,3910040,CDM,P9019,HCPCS,390,RC,inpatient,,,,1186.457,652.55135,,1067.8113,90,percent of total billed charges,,,,1186.457,100,percent of total billed charges,,,79.5948,,,fee schedule,,,79.5948,,,fee schedule,,,71.63532,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1067.8113,90,percent of total billed charges,,,,1127.13415,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,71.63532,1186.457,
PLATELETS PHERESIS LEUKO REDUC,3910060,CDM,P9035,HCPCS,390,RC,inpatient,,,BL,1186.457,652.55135,,1067.8113,90,percent of total billed charges,,,,1186.457,100,percent of total billed charges,,,500.517,,,fee schedule,,,500.517,,,fee schedule,,,450.4653,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1067.8113,90,percent of total billed charges,,,,1127.13415,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,450.4653,1186.457,
CRYOPRECIPITATE EACH UNIT,3910070,CDM,P9012,HCPCS,390,RC,inpatient,,,,75.396,41.4678,,67.8564,90,percent of total billed charges,,,,75.396,100,percent of total billed charges,,,76.665,,,fee schedule,,,76.665,,,fee schedule,,,68.9985,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.8564,90,percent of total billed charges,,,,71.6262,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.8564,76.665,
TRANSFUSION BLO0D COMPONETS,3610000,CDM,36430,CPT,391,RC,inpatient,,,,752.518,413.8849,,677.2662,90,percent of total billed charges,,,,752.518,100,percent of total billed charges,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,373.22775,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,,,,,,,,677.2662,90,percent of total billed charges,,,,714.8921,95,percent of total billed charges,,,43.54337875,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,42.275125,752.518,
BLOOD TRANSFUSION,3610001,CDM,36430,CPT,391,RC,inpatient,,,,364.517,200.48435,,328.0653,90,percent of total billed charges,,,,364.517,100,percent of total billed charges,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,373.22775,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,,,,,,,,328.0653,90,percent of total billed charges,,,,346.29115,95,percent of total billed charges,,,43.54337875,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,42.275125,414.6975,
BLOOD TRANSFUSION - ADMIN ICU,3910025,CDM,36430,CPT,391,RC,inpatient,,,,752.518,413.8849,,677.2662,90,percent of total billed charges,,,,752.518,100,percent of total billed charges,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,373.22775,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,,,,,,,,677.2662,90,percent of total billed charges,,,,714.8921,95,percent of total billed charges,,,43.54337875,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,42.275125,752.518,
BLOOD TRANSFUSION - ADMIN LDRP,3910027,CDM,36430,CPT,391,RC,inpatient,,,,752.518,413.8849,,677.2662,90,percent of total billed charges,,,,752.518,100,percent of total billed charges,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,373.22775,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,,,,,,,,677.2662,90,percent of total billed charges,,,,714.8921,95,percent of total billed charges,,,43.54337875,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,42.275125,,,fee schedule,,,42.275125,752.518,
IRRADIATION-BLOOD,3990000,CDM,86945,CPT,399,RC,inpatient,,,,119.5315,65.742325,,107.57835,90,percent of total billed charges,,,,119.5315,100,percent of total billed charges,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,31.4982,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,107.57835,90,percent of total billed charges,,,,113.554925,95,percent of total billed charges,,,,,,,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,,,,,,,17,119.5315,
MAMMOGRAPHY DIAG BILATERAL,4010040,CDM,77066,CPT,401,RC,inpatient,,,,301.172,165.6446,,271.0548,90,percent of total billed charges,,,,301.172,100,percent of total billed charges,,,111.86,,,fee schedule,,,111.86,,,fee schedule,,,100.674,,,fee schedule,,,158.4485,,,fee schedule,,,158.4485,,,fee schedule,,,,,,,,,158.4485,,,fee schedule,,,,,,,,,,271.0548,90,percent of total billed charges,,,,286.1134,95,percent of total billed charges,,,163.201955,,,fee schedule,,,126.48,,,fee schedule,,,126.48,,,fee schedule,,,,,,,,,158.4485,,,fee schedule,,,100.674,301.172,
MAMMOGRAM DX UNILATERAL RT,4011001,CDM,77065,CPT,401,RC,inpatient,,,RT,278.1,152.955,,250.29,90,percent of total billed charges,,,,278.1,100,percent of total billed charges,,,87.72,,,fee schedule,,,87.72,,,fee schedule,,,78.948,,,fee schedule,,,125.161,,,fee schedule,,,125.161,,,fee schedule,,,,,,,,,125.161,,,fee schedule,,,,,,,,,,250.29,90,percent of total billed charges,,,,264.195,95,percent of total billed charges,,,128.91583,,,fee schedule,,,104.44,,,fee schedule,,,104.44,,,fee schedule,,,,,,,,,125.161,,,fee schedule,,,78.948,278.1,
MAMMOGRAM DX UNILATERAL LT,4011002,CDM,77065,CPT,401,RC,inpatient,,,LT,278.1,152.955,,250.29,90,percent of total billed charges,,,,278.1,100,percent of total billed charges,,,87.72,,,fee schedule,,,87.72,,,fee schedule,,,78.948,,,fee schedule,,,125.161,,,fee schedule,,,125.161,,,fee schedule,,,,,,,,,125.161,,,fee schedule,,,,,,,,,,250.29,90,percent of total billed charges,,,,264.195,95,percent of total billed charges,,,128.91583,,,fee schedule,,,104.44,,,fee schedule,,,104.44,,,fee schedule,,,,,,,,,125.161,,,fee schedule,,,78.948,278.1,
"ULTRASOUND,ABD SINGLE ORGAN",3200000,CDM,76705,CPT,402,RC,inpatient,,,,400.155,220.08525,,360.1395,90,percent of total billed charges,,,,400.155,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,86.880375,,,fee schedule,,,86.880375,,,fee schedule,,,,,,,,,86.880375,,,fee schedule,,,,,,,,,,360.1395,90,percent of total billed charges,,,,380.14725,95,percent of total billed charges,,,89.48678625,,,fee schedule,,,20,,,fee schedule,,,20,,,fee schedule,,,,,,,,,86.880375,,,fee schedule,,,20,400.155,
ULTRASOUND ABDOMINAL;COMPLETE,3200050,CDM,76700,CPT,402,RC,inpatient,,,,835.021,459.26155,,751.5189,90,percent of total billed charges,,,,835.021,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,116.173375,,,fee schedule,,,116.173375,,,fee schedule,,,,,,,,,116.173375,,,fee schedule,,,,,,,,,,751.5189,90,percent of total billed charges,,,,793.26995,95,percent of total billed charges,,,119.6585763,,,fee schedule,,,56,,,fee schedule,,,56,,,fee schedule,,,,,,,,,116.173375,,,fee schedule,,,56,835.021,
BPP WITH NON-STRESS,3200360,CDM,76818,CPT,402,RC,inpatient,,,,455.26,250.393,,409.734,90,percent of total billed charges,,,,455.26,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,118.5035,,,fee schedule,,,118.5035,,,fee schedule,,,,,,,,,118.5035,,,fee schedule,,,,,,,,,,409.734,90,percent of total billed charges,,,,432.497,95,percent of total billed charges,,,122.058605,,,fee schedule,,,34.68,,,fee schedule,,,34.68,,,fee schedule,,,,,,,,,118.5035,,,fee schedule,,,34.68,455.26,
"ULTRASOUND,PREGNANCY;LIMITED",3200940,CDM,76815,CPT,402,RC,inpatient,,,,285.31,156.9205,,256.779,90,percent of total billed charges,,,,285.31,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,80.888625,,,fee schedule,,,80.888625,,,fee schedule,,,,,,,,,80.888625,,,fee schedule,,,,,,,,,,256.779,90,percent of total billed charges,,,,271.0445,95,percent of total billed charges,,,83.31528375,,,fee schedule,,,26,,,fee schedule,,,26,,,fee schedule,,,,,,,,,80.888625,,,fee schedule,,,26,285.31,
"US, OB >/= 14 WKS;SINGLE GEST",3200990,CDM,76805,CPT,402,RC,inpatient,,,,511.292,281.2106,,460.1628,90,percent of total billed charges,,,,511.292,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,135.480125,,,fee schedule,,,135.480125,,,fee schedule,,,,,,,,,135.480125,,,fee schedule,,,,,,,,,,460.1628,90,percent of total billed charges,,,,485.7274,95,percent of total billed charges,,,139.5445288,,,fee schedule,,,56,,,fee schedule,,,56,,,fee schedule,,,,,,,,,135.480125,,,fee schedule,,,56,511.292,
"ULTRASOUND,PELVIC; COMPLETE",3201000,CDM,76856,CPT,402,RC,inpatient,,,,769.513,423.23215,,692.5617,90,percent of total billed charges,,,,769.513,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,105.1885,,,fee schedule,,,105.1885,,,fee schedule,,,,,,,,,105.1885,,,fee schedule,,,,,,,,,,692.5617,90,percent of total billed charges,,,,731.03735,95,percent of total billed charges,,,108.344155,,,fee schedule,,,40,,,fee schedule,,,40,,,fee schedule,,,,,,,,,105.1885,,,fee schedule,,,40,769.513,
"ULTRASOUND, TRANSVAGINAL",3201001,CDM,76830,CPT,402,RC,inpatient,,,,726.974,399.8357,,654.2766,90,percent of total billed charges,,,,726.974,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,119.16925,,,fee schedule,,,119.16925,,,fee schedule,,,,,,,,,119.16925,,,fee schedule,,,,,,,,,,654.2766,90,percent of total billed charges,,,,690.6253,95,percent of total billed charges,,,122.7443275,,,fee schedule,,,68,,,fee schedule,,,68,,,fee schedule,,,,,,,,,119.16925,,,fee schedule,,,68,726.974,
"ULTRASOUND,SCROTUM & CONTENTS",3201280,CDM,76870,CPT,402,RC,inpatient,,,,491.516,270.3338,,442.3644,90,percent of total billed charges,,,,491.516,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,99.8625,,,fee schedule,,,99.8625,,,fee schedule,,,,,,,,,99.8625,,,fee schedule,,,,,,,,,,442.3644,90,percent of total billed charges,,,,466.9402,95,percent of total billed charges,,,102.858375,,,fee schedule,,,31,,,fee schedule,,,31,,,fee schedule,,,,,,,,,99.8625,,,fee schedule,,,31,491.516,
"ULTRASOUND,NECK,HEAD,THYROID",3201300,CDM,76536,CPT,402,RC,inpatient,,,,415.193,228.35615,,373.6737,90,percent of total billed charges,,,,415.193,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,110.181625,,,fee schedule,,,110.181625,,,fee schedule,,,,,,,,,110.181625,,,fee schedule,,,,,,,,,,373.6737,90,percent of total billed charges,,,,394.43335,95,percent of total billed charges,,,113.4870738,,,fee schedule,,,54,,,fee schedule,,,54,,,fee schedule,,,,,,,,,110.181625,,,fee schedule,,,54,415.193,
US OB DETAILED SINGLE GEST,3206811,CDM,76811,CPT,402,RC,inpatient,,,,489.868,269.4274,,440.8812,90,percent of total billed charges,,,,489.868,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,177.0895,,,fee schedule,,,177.0895,,,fee schedule,,,,,,,,,177.0895,,,fee schedule,,,,,,,,,,440.8812,90,percent of total billed charges,,,,465.3746,95,percent of total billed charges,,,182.402185,,,fee schedule,,,145.14,,,fee schedule,,,145.14,,,fee schedule,,,,,,,,,177.0895,,,fee schedule,,,145.14,489.868,
US EA ADD'L GESTATION,3206812,CDM,76812,CPT,402,RC,inpatient,,,,243.698,134.0339,,219.3282,90,percent of total billed charges,,,,243.698,100,percent of total billed charges,,,103.68,,,fee schedule,,,103.68,,,fee schedule,,,93.312,,,fee schedule,,,191.403125,,,fee schedule,,,191.403125,,,fee schedule,,,,,,,,,191.403125,,,fee schedule,,,,,,,,,,219.3282,90,percent of total billed charges,,,,231.5131,95,percent of total billed charges,,,197.1452188,,,fee schedule,,,51.75,,,fee schedule,,,51.75,,,fee schedule,,,,,,,,,191.403125,,,fee schedule,,,51.75,243.698,
FNA BIOPSY W/US GUIDE 1ST LES,4020005,CDM,10005,CPT,402,RC,inpatient,,,,826.266,454.4463,,743.6394,90,percent of total billed charges,,,,826.266,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,594.023625,,,fee schedule,,,71.901,,,fee schedule,,,71.901,,,fee schedule,,,,,,,,,71.901,,,fee schedule,,,,,,,,,,743.6394,90,percent of total billed charges,,,,784.9527,95,percent of total billed charges,,,74.05803,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,71.901,,,fee schedule,,,71.901,826.266,
"ULTRASOUND,INFANT HIPS;DYNAMIC",4020010,CDM,76885,CPT,402,RC,inpatient,,,,331.454,182.2997,,298.3086,90,percent of total billed charges,,,,331.454,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,135.480125,,,fee schedule,,,135.480125,,,fee schedule,,,,,,,,,135.480125,,,fee schedule,,,,,,,,,,298.3086,90,percent of total billed charges,,,,314.8813,95,percent of total billed charges,,,139.5445288,,,fee schedule,,,58.13,,,fee schedule,,,58.13,,,fee schedule,,,,,,,,,135.480125,,,fee schedule,,,58.13,331.454,
US GUIDE FOR NEEDLE PLACEMENT,4020030,CDM,76942,CPT,402,RC,inpatient,,,,322.39,177.3145,,290.151,90,percent of total billed charges,,,,322.39,100,percent of total billed charges,,,24.01,,,fee schedule,,,24.01,,,fee schedule,,,21.609,,,fee schedule,,,57.92025,,,fee schedule,,,57.92025,,,fee schedule,,,,,,,,,57.92025,,,fee schedule,,,,,,,,,,290.151,90,percent of total billed charges,,,,306.2705,95,percent of total billed charges,,,59.6578575,,,fee schedule,,,,,,,,,,,,,,,,,,,,,57.92025,,,fee schedule,,,21.609,322.39,
"ULTRASOUND, RENAL OR AORTA",4020040,CDM,76770,CPT,402,RC,inpatient,,,,429.51,236.2305,,386.559,90,percent of total billed charges,,,,429.51,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,108.184375,,,fee schedule,,,108.184375,,,fee schedule,,,,,,,,,108.184375,,,fee schedule,,,,,,,,,,386.559,90,percent of total billed charges,,,,408.0345,95,percent of total billed charges,,,111.4299063,,,fee schedule,,,44,,,fee schedule,,,44,,,fee schedule,,,,,,,,,108.184375,,,fee schedule,,,44,429.51,
"US, OB < 14 WKS; SINGLE GEST",4020060,CDM,76801,CPT,402,RC,inpatient,,,,478.435,263.13925,,430.5915,90,percent of total billed charges,,,,478.435,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,117.172,,,fee schedule,,,117.172,,,fee schedule,,,,,,,,,117.172,,,fee schedule,,,,,,,,,,430.5915,90,percent of total billed charges,,,,454.51325,95,percent of total billed charges,,,120.68716,,,fee schedule,,,42.75,,,fee schedule,,,42.75,,,fee schedule,,,,,,,,,117.172,,,fee schedule,,,42.75,478.435,
"US, OB >/= 14 WKS;EA ADD'L GES",4020075,CDM,76810,CPT,402,RC,inpatient,,,,356.38,196.009,,320.742,90,percent of total billed charges,,,,356.38,100,percent of total billed charges,,,39.77,,,fee schedule,,,39.77,,,fee schedule,,,35.793,,,fee schedule,,,87.21325,,,fee schedule,,,87.21325,,,fee schedule,,,,,,,,,87.21325,,,fee schedule,,,,,,,,,,320.742,90,percent of total billed charges,,,,338.561,95,percent of total billed charges,,,89.8296475,,,fee schedule,,,64,,,fee schedule,,,64,,,fee schedule,,,,,,,,,87.21325,,,fee schedule,,,35.793,356.38,
"US, OB TRANSVAGINAL",4020080,CDM,76817,CPT,402,RC,inpatient,,,,478.435,263.13925,,430.5915,90,percent of total billed charges,,,,478.435,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,92.53925,,,fee schedule,,,92.53925,,,fee schedule,,,,,,,,,92.53925,,,fee schedule,,,,,,,,,,430.5915,90,percent of total billed charges,,,,454.51325,95,percent of total billed charges,,,95.3154275,,,fee schedule,,,58.5,,,fee schedule,,,58.5,,,fee schedule,,,,,,,,,92.53925,,,fee schedule,,,58.5,478.435,
BPP WITHOUT NON-STRESS TEST,4020090,CDM,76819,CPT,402,RC,inpatient,,,,254.307,139.86885,,228.8763,90,percent of total billed charges,,,,254.307,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,85.548875,,,fee schedule,,,85.548875,,,fee schedule,,,,,,,,,85.548875,,,fee schedule,,,,,,,,,,228.8763,90,percent of total billed charges,,,,241.59165,95,percent of total billed charges,,,88.11534125,,,fee schedule,,,63.01,,,fee schedule,,,63.01,,,fee schedule,,,,,,,,,85.548875,,,fee schedule,,,63.01,254.307,
US - BREAST RT; 4 QUADS,4021501,CDM,76641,CPT,402,RC,inpatient,,,RT,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,102.5255,,,fee schedule,,,102.5255,,,fee schedule,,,,,,,,,102.5255,,,fee schedule,,,,,,,,,,272.8161,90,percent of total billed charges,,,,287.97255,95,percent of total billed charges,,,105.601265,,,fee schedule,,,63.4,,,fee schedule,,,63.4,,,fee schedule,,,,,,,,,102.5255,,,fee schedule,,,63.4,303.129,
US - BREAST LT; 4 QUADS,4021502,CDM,76641,CPT,402,RC,inpatient,,,LT,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,102.5255,,,fee schedule,,,102.5255,,,fee schedule,,,,,,,,,102.5255,,,fee schedule,,,,,,,,,,272.8161,90,percent of total billed charges,,,,287.97255,95,percent of total billed charges,,,105.601265,,,fee schedule,,,63.4,,,fee schedule,,,63.4,,,fee schedule,,,,,,,,,102.5255,,,fee schedule,,,63.4,303.129,
US BREAST BILATERAL; 8 QUADS,4021503,CDM,76641,CPT,402,RC,inpatient,,,50,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,102.5255,,,fee schedule,,,102.5255,,,fee schedule,,,,,,,,,102.5255,,,fee schedule,,,,,,,,,,272.8161,90,percent of total billed charges,,,,287.97255,95,percent of total billed charges,,,105.601265,,,fee schedule,,,63.4,,,fee schedule,,,63.4,,,fee schedule,,,,,,,,,102.5255,,,fee schedule,,,63.4,303.129,
US EXAM CHEST,4021701,CDM,76604,CPT,402,RC,inpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,56.921625,,,fee schedule,,,56.921625,,,fee schedule,,,,,,,,,56.921625,,,fee schedule,,,,,,,,,,170.3826,90,percent of total billed charges,,,,179.8483,95,percent of total billed charges,,,58.62927375,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,56.921625,,,fee schedule,,,23,189.314,
US EXAM CHEST,4021702,CDM,76604,CPT,402,RC,inpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,56.921625,,,fee schedule,,,56.921625,,,fee schedule,,,,,,,,,56.921625,,,fee schedule,,,,,,,,,,170.3826,90,percent of total billed charges,,,,179.8483,95,percent of total billed charges,,,58.62927375,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,56.921625,,,fee schedule,,,23,189.314,
US - CHEST B-SCAN BILATERAL,4021703,CDM,76604,CPT,402,RC,inpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,56.921625,,,fee schedule,,,56.921625,,,fee schedule,,,,,,,,,56.921625,,,fee schedule,,,,,,,,,,170.3826,90,percent of total billed charges,,,,179.8483,95,percent of total billed charges,,,58.62927375,,,fee schedule,,,23,,,fee schedule,,,23,,,fee schedule,,,,,,,,,56.921625,,,fee schedule,,,23,189.314,
UMBILICAL ARTERY ECHO US,4025500,CDM,76820,CPT,402,RC,inpatient,,,,154.5,84.975,,139.05,90,percent of total billed charges,,,,154.5,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,44.60525,,,fee schedule,,,44.60525,,,fee schedule,,,,,,,,,44.60525,,,fee schedule,,,,,,,,,,139.05,90,percent of total billed charges,,,,146.775,95,percent of total billed charges,,,45.9434075,,,fee schedule,,,57.11,,,fee schedule,,,57.11,,,fee schedule,,,,,,,,,44.60525,,,fee schedule,,,44.60525,154.5,
US BREAST RT LIMITED;< 4 QUADS,4027662,CDM,76642,CPT,402,RC,inpatient,,,RT,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,84.883125,,,fee schedule,,,84.883125,,,fee schedule,,,,,,,,,84.883125,,,fee schedule,,,,,,,,,,272.8161,90,percent of total billed charges,,,,287.97255,95,percent of total billed charges,,,87.42961875,,,fee schedule,,,48.5,,,fee schedule,,,48.5,,,fee schedule,,,,,,,,,84.883125,,,fee schedule,,,48.5,303.129,
US BREAST LT LIMITED;< 4 QUADS,4027664,CDM,76642,CPT,402,RC,inpatient,,,LT,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,84.883125,,,fee schedule,,,84.883125,,,fee schedule,,,,,,,,,84.883125,,,fee schedule,,,,,,,,,,272.8161,90,percent of total billed charges,,,,287.97255,95,percent of total billed charges,,,87.42961875,,,fee schedule,,,48.5,,,fee schedule,,,48.5,,,fee schedule,,,,,,,,,84.883125,,,fee schedule,,,48.5,303.129,
US BREAST LIMITED; BILATERAL,4027665,CDM,76642,CPT,402,RC,inpatient,,,50,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,68.958,,,fee schedule,,,84.883125,,,fee schedule,,,84.883125,,,fee schedule,,,,,,,,,84.883125,,,fee schedule,,,,,,,,,,272.8161,90,percent of total billed charges,,,,287.97255,95,percent of total billed charges,,,87.42961875,,,fee schedule,,,48.5,,,fee schedule,,,48.5,,,fee schedule,,,,,,,,,84.883125,,,fee schedule,,,48.5,303.129,
SCREENING US FOR AAA,4027670,CDM,76706,CPT,402,RC,inpatient,,,,429.51,236.2305,,386.559,90,percent of total billed charges,,,,429.51,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,106.52,,,fee schedule,,,106.52,,,fee schedule,,,,,,,,,106.52,,,fee schedule,,,,,,,,,,386.559,90,percent of total billed charges,,,,408.0345,95,percent of total billed charges,,,109.7156,,,fee schedule,,,72.03,,,fee schedule,,,72.03,,,fee schedule,,,,,,,,,106.52,,,fee schedule,,,72.03,429.51,
US EXTR N/VASCULAR LIMITED,4027688,CDM,76882,CPT,402,RC,inpatient,,,,544.973,299.73515,,490.4757,90,percent of total billed charges,,,,544.973,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,,,,,,,,490.4757,90,percent of total billed charges,,,,517.72435,95,percent of total billed charges,,,65.1436375,,,fee schedule,,,11.99,,,fee schedule,,,11.99,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,11.99,544.973,
US EXTR N/VASCULAR LIMITED RT,4027688.1,CDM,76882,CPT,402,RC,inpatient,,,RT,272.538,149.8959,,245.2842,90,percent of total billed charges,,,,272.538,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,,,,,,,,245.2842,90,percent of total billed charges,,,,258.9111,95,percent of total billed charges,,,65.1436375,,,fee schedule,,,11.99,,,fee schedule,,,11.99,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,11.99,272.538,
US EXTR N/VASCULAR LIMITED LT,4027688.2,CDM,76882,CPT,402,RC,inpatient,,,LT,272.538,149.8959,,245.2842,90,percent of total billed charges,,,,272.538,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,96.84,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,,,,,,,,245.2842,90,percent of total billed charges,,,,258.9111,95,percent of total billed charges,,,65.1436375,,,fee schedule,,,11.99,,,fee schedule,,,11.99,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,11.99,272.538,
"MAMMOGRAPHY SCREEN, BILATERAL",4030010,CDM,77067,CPT,403,RC,inpatient,,,,239.372,131.6546,,215.4348,90,percent of total billed charges,,,,239.372,100,percent of total billed charges,,,92.75,,,fee schedule,,,92.75,,,fee schedule,,,83.475,,,fee schedule,,,127.824,,,fee schedule,,,127.824,,,fee schedule,,,,,,,,,127.824,,,fee schedule,,,,,,,,,,215.4348,90,percent of total billed charges,,,,227.4034,95,percent of total billed charges,,,131.65872,,,fee schedule,,,98.84,,,fee schedule,,,98.84,,,fee schedule,,,,,,,,,127.824,,,fee schedule,,,83.475,239.372,
MDI UPDRAFT INHALATION AIRWAY,4100005,CDM,94640,CPT,410,RC,inpatient,,,,207.751,114.26305,,186.9759,90,percent of total billed charges,,,,207.751,100,percent of total billed charges,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,163.5984,,,fee schedule,,,7.989,,,fee schedule,,,7.989,,,fee schedule,,,,,,,,,7.989,,,fee schedule,,,,,,,,,,186.9759,90,percent of total billed charges,,,,197.36345,95,percent of total billed charges,,,8.22867,,,fee schedule,,,6,,,fee schedule,,,6,,,fee schedule,,,,,,,,,7.989,,,fee schedule,,,6,207.751,
MDI/UPDRAFT TRMT;ADD'L PER DAY,4100025,CDM,94640,CPT,410,RC,inpatient,,,,77.765,42.77075,,69.9885,90,percent of total billed charges,,,,77.765,100,percent of total billed charges,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,163.5984,,,fee schedule,,,7.989,,,fee schedule,,,7.989,,,fee schedule,,,,,,,,,7.989,,,fee schedule,,,,,,,,,,69.9885,90,percent of total billed charges,,,,73.87675,95,percent of total billed charges,,,8.22867,,,fee schedule,,,6,,,fee schedule,,,6,,,fee schedule,,,,,,,,,7.989,,,fee schedule,,,6,181.776,
CPAP/BiPAP INITIATION & MGMT,4100080,CDM,94660,CPT,410,RC,inpatient,,,,514.691,283.08005,,463.2219,90,percent of total billed charges,,,,514.691,100,percent of total billed charges,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,163.5984,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,463.2219,90,percent of total billed charges,,,,488.95645,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.61625,,,fee schedule,,,36.61625,514.691,
NT SUCTION,4100095,CDM,31720,CPT,410,RC,inpatient,,,,82.606,45.4333,,74.3454,90,percent of total billed charges,,,,82.606,100,percent of total billed charges,,,194.76,,,fee schedule,,,194.76,,,fee schedule,,,175.284,,,fee schedule,,,47.601125,,,fee schedule,,,47.601125,,,fee schedule,,,,,,,,,47.601125,,,fee schedule,,,,,,,,,,74.3454,90,percent of total billed charges,,,,78.4757,95,percent of total billed charges,,,49.02915875,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,47.601125,,,fee schedule,,,47.601125,250,
MANIPULATE CHEST WALL;INITIAL,4100130,CDM,94667,CPT,410,RC,inpatient,,,,114.433,62.93815,,102.9897,90,percent of total billed charges,,,,114.433,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,99.19665,,,fee schedule,,,24.965625,,,fee schedule,,,24.965625,,,fee schedule,,,,,,,,,24.965625,,,fee schedule,,,,,,,,,,102.9897,90,percent of total billed charges,,,,108.71135,95,percent of total billed charges,,,25.71459375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.965625,,,fee schedule,,,24.965625,114.433,
MANIPULATE CHEST WALL; SUBSEQ,4100135,CDM,94668,CPT,410,RC,inpatient,,,,89.198,49.0589,,80.2782,90,percent of total billed charges,,,,89.198,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,99.19665,,,fee schedule,,,39.27925,,,fee schedule,,,39.27925,,,fee schedule,,,,,,,,,39.27925,,,fee schedule,,,,,,,,,,80.2782,90,percent of total billed charges,,,,84.7381,95,percent of total billed charges,,,40.4576275,,,fee schedule,,,,,,,,,,,,,,,,,,,,,39.27925,,,fee schedule,,,39.27925,110.2185,
VENTILATOR MGMT;SUBSEQUENT DAY,4100260,CDM,94003,CPT,410,RC,inpatient,,,,491.207,270.16385,,442.0863,90,percent of total billed charges,,,,491.207,100,percent of total billed charges,,,528.4545,,,fee schedule,,,528.4545,,,fee schedule,,,475.60905,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,,,,,,,,442.0863,90,percent of total billed charges,,,,466.64665,95,percent of total billed charges,,,65.1436375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.24625,,,fee schedule,,,63.24625,528.4545,
VENTILATOR MGMT; INITIAL DAY,4100270,CDM,94002,CPT,410,RC,inpatient,,,,1106.426,608.5343,,995.7834,90,percent of total billed charges,,,,1106.426,100,percent of total billed charges,,,528.4545,,,fee schedule,,,528.4545,,,fee schedule,,,475.60905,,,fee schedule,,,89.87625,,,fee schedule,,,89.87625,,,fee schedule,,,,,,,,,89.87625,,,fee schedule,,,,,,,,,,995.7834,90,percent of total billed charges,,,,1051.1047,95,percent of total billed charges,,,92.5725375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,89.87625,,,fee schedule,,,89.87625,1106.426,
ARTERIAL PUNCTURE,9200000,CDM,36600,CPT,410,RC,inpatient,,,,53.766,29.5713,,48.3894,90,percent of total billed charges,,,,53.766,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,,,,,,14.6465,,,fee schedule,,,,,,,,,,48.3894,90,percent of total billed charges,,,,51.0777,95,percent of total billed charges,,,15.085895,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.6465,,,fee schedule,,,14.6465,118.09125,
PT CONSULT,4000020,CDM,,,420,RC,inpatient,,,,57.371,31.55405,790,,,per diem,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,850,,,per diem,,,,,,,,,570,,,per diem,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,700,,,per diem,,,,,,,,,51.6339,850,
PT - SELF/HOME ADL'S EA 15 MIN,4200000,CDM,97535,CPT,420,RC,inpatient,,,GP,55.517,30.53435,790,,,per diem,,,,55.517,100,percent of total billed charges,,,33.495,,,fee schedule,,,33.495,,,fee schedule,,,30.1455,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,850,,,per diem,,,32.62175,,,fee schedule,,,570,,,per diem,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,33.6004025,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,32.62175,,,fee schedule,,,30.1455,850,
PT - AQUATIC THERAPY/W/EXER,4200010,CDM,97113,CPT,420,RC,inpatient,,,GP,89.713,49.34215,790,,,per diem,,,,89.713,100,percent of total billed charges,,,40.884,,,fee schedule,,,40.884,,,fee schedule,,,36.7956,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,850,,,per diem,,,36.61625,,,fee schedule,,,570,,,per diem,,,,80.7417,90,percent of total billed charges,,,,85.22735,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,36.61625,,,fee schedule,,,36.61625,850,
PT - CONTINOUS PASSIVE MOTION,4200130,CDM,97039,CPT,420,RC,inpatient,,,,60.255,33.14025,790,,,per diem,,,,60.255,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,850,,,per diem,,,,,,,,,570,,,per diem,,,,54.2295,90,percent of total billed charges,,,,57.24225,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,700,,,per diem,,,,,,,,,54.2295,850,
DBRDMT OPEN WOUND 1ST 20CM<,4200135,CDM,97597,CPT,420,RC,inpatient,,,GP,143.582,78.9701,790,,,per diem,,,,143.582,100,percent of total billed charges,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,161.6175,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,850,,,per diem,,,34.951875,,,fee schedule,,,570,,,per diem,,,,129.2238,90,percent of total billed charges,,,,136.4029,95,percent of total billed charges,,,36.00043125,,,fee schedule,,,24.06,,,fee schedule,,,24.06,,,fee schedule,,,700,,,per diem,,,34.951875,,,fee schedule,,,24.06,850,
WOUND CARE DBRDB NON-SELECT,4200136,CDM,97602,CPT,420,RC,inpatient,,,,137.711,75.74105,790,,,per diem,,,,137.711,100,percent of total billed charges,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,161.6175,,,fee schedule,,,,,,,,,,,,,,,850,,,per diem,,,,,,,,,570,,,per diem,,,,123.9399,90,percent of total billed charges,,,,130.82545,95,percent of total billed charges,,,,,,,,,67.65,,,fee schedule,,,67.65,,,fee schedule,,,700,,,per diem,,,,,,,,,67.65,850,
PT-ELECT STIMULATION MANUAL/15,4200220,CDM,97032,CPT,420,RC,inpatient,,,GP,51.912,28.5516,790,,,per diem,,,,51.912,100,percent of total billed charges,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,13.4145,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,850,,,per diem,,,14.313625,,,fee schedule,,,570,,,per diem,,,,46.7208,90,percent of total billed charges,,,,49.3164,95,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,14.313625,,,fee schedule,,,13.4145,850,
"ELECT STIM,OTHER THAN WOUND",4200230,CDM,97014,CPT,420,RC,inpatient,,,GP,47.998,26.3989,790,,,per diem,,,,47.998,100,percent of total billed charges,,,15.27,,,fee schedule,,,15.27,,,fee schedule,,,13.743,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,850,,,per diem,,,12.316375,,,fee schedule,,,570,,,per diem,,,,43.1982,90,percent of total billed charges,,,,45.5981,95,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,12.316375,,,fee schedule,,,12.316375,850,
PT - MANUAL THERAPY EA 15 MIN,4200310,CDM,97140,CPT,420,RC,inpatient,,,GP,77.559,42.65745,790,,,per diem,,,,77.559,100,percent of total billed charges,,,27.973,,,fee schedule,,,27.973,,,fee schedule,,,25.1757,,,fee schedule,,,26.962875,,,fee schedule,,,26.962875,,,fee schedule,,,850,,,per diem,,,26.962875,,,fee schedule,,,570,,,per diem,,,,69.8031,90,percent of total billed charges,,,,73.68105,95,percent of total billed charges,,,27.77176125,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,26.962875,,,fee schedule,,,25.1757,850,
PT-NEUROMUSCULAR RE-ED 15 MIN,4200330,CDM,97112,CPT,420,RC,inpatient,,,GP,78.692,43.2806,790,,,per diem,,,,78.692,100,percent of total billed charges,,,34.716,,,fee schedule,,,34.716,,,fee schedule,,,31.2444,,,fee schedule,,,33.620375,,,fee schedule,,,33.620375,,,fee schedule,,,850,,,per diem,,,33.620375,,,fee schedule,,,570,,,per diem,,,,70.8228,90,percent of total billed charges,,,,74.7574,95,percent of total billed charges,,,34.62898625,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,33.620375,,,fee schedule,,,31.2444,850,
PT - RE-EVAL EST PLAN 20 MINS,4200430,CDM,97164,CPT,420,RC,inpatient,,,,83.842,46.1131,790,,,per diem,,,,83.842,100,percent of total billed charges,,,70.862,,,fee schedule,,,70.862,,,fee schedule,,,63.7758,,,fee schedule,,,69.570875,,,fee schedule,,,69.570875,,,fee schedule,,,850,,,per diem,,,69.570875,,,fee schedule,,,570,,,per diem,,,,75.4578,90,percent of total billed charges,,,,79.6499,95,percent of total billed charges,,,71.65800125,,,fee schedule,,,98.88,,,fee schedule,,,98.88,,,fee schedule,,,700,,,per diem,,,69.570875,,,fee schedule,,,63.7758,850,
PT - THERAPUTIC ACTIVITY/15 M,4200460,CDM,97530,CPT,420,RC,inpatient,,,GP,55.517,30.53435,790,,,per diem,,,,55.517,100,percent of total billed charges,,,37.565,,,fee schedule,,,37.565,,,fee schedule,,,33.8085,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,850,,,per diem,,,36.61625,,,fee schedule,,,570,,,per diem,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,21.76,,,fee schedule,,,21.76,,,fee schedule,,,700,,,per diem,,,36.61625,,,fee schedule,,,21.76,850,
PT - GAIT TRAINING EA 15 MIN,4200470,CDM,97116,CPT,420,RC,inpatient,,,GP,62.933,34.61315,790,,,per diem,,,,62.933,100,percent of total billed charges,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,27.2844,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,850,,,per diem,,,29.293,,,fee schedule,,,570,,,per diem,,,,56.6397,90,percent of total billed charges,,,,59.78635,95,percent of total billed charges,,,30.17179,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,29.293,,,fee schedule,,,27.2844,850,
DRY NEEDLING 1-2 MUSCLES,4200560,CDM,20560,CPT,420,RC,inpatient,,,,49.646,27.3053,790,,,per diem,,,,49.646,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,850,,,per diem,,,14.6465,,,fee schedule,,,570,,,per diem,,,,44.6814,90,percent of total billed charges,,,,47.1637,95,percent of total billed charges,,,15.085895,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,700,,,per diem,,,14.6465,,,fee schedule,,,14.6465,850,
DRY NEEDLING 3 OR MORE MUSCLES,4200561,CDM,20561,CPT,420,RC,inpatient,,,,39.758,21.8669,790,,,per diem,,,,39.758,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,21.96975,,,fee schedule,,,21.96975,,,fee schedule,,,850,,,per diem,,,21.96975,,,fee schedule,,,570,,,per diem,,,,35.7822,90,percent of total billed charges,,,,37.7701,95,percent of total billed charges,,,22.6288425,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,700,,,per diem,,,21.96975,,,fee schedule,,,21.96975,850,
PT-THERAPEUTIC EXERCISE/15 MIN,4200760,CDM,97110,CPT,420,RC,inpatient,,,GP,84.975,46.73625,790,,,per diem,,,,84.975,100,percent of total billed charges,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,27.2844,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,850,,,per diem,,,29.293,,,fee schedule,,,570,,,per diem,,,,76.4775,90,percent of total billed charges,,,,80.72625,95,percent of total billed charges,,,30.17179,,,fee schedule,,,21.76,,,fee schedule,,,21.76,,,fee schedule,,,700,,,per diem,,,29.293,,,fee schedule,,,21.76,850,
PT - TRACTION MECHANICAL,4200810,CDM,97012,CPT,420,RC,inpatient,,,GP,49.234,27.0787,790,,,per diem,,,,49.234,100,percent of total billed charges,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,13.4145,,,fee schedule,,,13.98075,,,fee schedule,,,13.98075,,,fee schedule,,,850,,,per diem,,,13.98075,,,fee schedule,,,570,,,per diem,,,,44.3106,90,percent of total billed charges,,,,46.7723,95,percent of total billed charges,,,14.4001725,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,13.98075,,,fee schedule,,,13.4145,850,
PT - ULTRASOUND EACH 15 MIN,4200820,CDM,97035,CPT,420,RC,inpatient,,,GP,54.281,29.85455,790,,,per diem,,,,54.281,100,percent of total billed charges,,,14.685,,,fee schedule,,,14.685,,,fee schedule,,,13.2165,,,fee schedule,,,13.98075,,,fee schedule,,,13.98075,,,fee schedule,,,850,,,per diem,,,13.98075,,,fee schedule,,,570,,,per diem,,,,48.8529,90,percent of total billed charges,,,,51.56695,95,percent of total billed charges,,,14.4001725,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,13.98075,,,fee schedule,,,13.2165,850,
PT - WHIRLPOOL,4200840,CDM,97022,CPT,420,RC,inpatient,,,GP,59.019,32.46045,790,,,per diem,,,,59.019,100,percent of total billed charges,,,17.017,,,fee schedule,,,17.017,,,fee schedule,,,15.3153,,,fee schedule,,,16.976625,,,fee schedule,,,16.976625,,,fee schedule,,,850,,,per diem,,,16.976625,,,fee schedule,,,570,,,per diem,,,,53.1171,90,percent of total billed charges,,,,56.06805,95,percent of total billed charges,,,17.48592375,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,16.976625,,,fee schedule,,,15.3153,850,
PT - WHEELCHAIR MGMT EA 15 MIN,4200850,CDM,97542,CPT,420,RC,inpatient,,,,46.865,25.77575,790,,,per diem,,,,46.865,100,percent of total billed charges,,,32.703,,,fee schedule,,,32.703,,,fee schedule,,,29.4327,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,850,,,per diem,,,31.623125,,,fee schedule,,,570,,,per diem,,,,42.1785,90,percent of total billed charges,,,,44.52175,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,31.623125,,,fee schedule,,,29.4327,850,
APPLICATION FS STATIC,4202913,CDM,29130,CPT,420,RC,inpatient,,,,100.734,55.4037,790,,,per diem,,,,100.734,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,28.960125,,,fee schedule,,,28.960125,,,fee schedule,,,850,,,per diem,,,28.960125,,,fee schedule,,,570,,,per diem,,,,90.6606,90,percent of total billed charges,,,,95.6973,95,percent of total billed charges,,,29.82892875,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,700,,,per diem,,,28.960125,,,fee schedule,,,28.960125,850,
PT - UNNA BOOT,4202958,CDM,29580,CPT,420,RC,inpatient,,,GP,142.037,78.12035,790,,,per diem,,,,142.037,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,133.417125,,,fee schedule,,,25.96425,,,fee schedule,,,25.96425,,,fee schedule,,,850,,,per diem,,,25.96425,,,fee schedule,,,570,,,per diem,,,,127.8333,90,percent of total billed charges,,,,134.93515,95,percent of total billed charges,,,26.7431775,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,25.96425,,,fee schedule,,,25.96425,850,
PT - UNNA BOOT/BILATERAL,4202959,CDM,29580,CPT,420,RC,inpatient,,,GP,284.074,156.2407,790,,,per diem,,,,284.074,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,133.417125,,,fee schedule,,,25.96425,,,fee schedule,,,25.96425,,,fee schedule,,,850,,,per diem,,,25.96425,,,fee schedule,,,570,,,per diem,,,,255.6666,90,percent of total billed charges,,,,269.8703,95,percent of total billed charges,,,26.7431775,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,25.96425,,,fee schedule,,,25.96425,850,
PT EVALUATION; LOW COMPLEXITY,4207161,CDM,97161,CPT,420,RC,inpatient,,,GP,170.774,93.9257,790,,,per diem,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,92.961,,,fee schedule,,,100.195375,,,fee schedule,,,100.195375,,,fee schedule,,,850,,,per diem,,,100.195375,,,fee schedule,,,570,,,per diem,,,,153.6966,90,percent of total billed charges,,,,162.2353,95,percent of total billed charges,,,103.2012363,,,fee schedule,,,98.88,,,fee schedule,,,98.88,,,fee schedule,,,700,,,per diem,,,100.195375,,,fee schedule,,,92.961,850,
PT EVALUATION; MOD COMPLEXITY,4207162,CDM,97162,CPT,420,RC,inpatient,,,GP,170.774,93.9257,790,,,per diem,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,92.961,,,fee schedule,,,100.195375,,,fee schedule,,,100.195375,,,fee schedule,,,850,,,per diem,,,100.195375,,,fee schedule,,,570,,,per diem,,,,153.6966,90,percent of total billed charges,,,,162.2353,95,percent of total billed charges,,,103.2012363,,,fee schedule,,,148.32,,,fee schedule,,,148.32,,,fee schedule,,,700,,,per diem,,,100.195375,,,fee schedule,,,92.961,850,
PT EVAL HIGH COMP 45 MIN,4207163,CDM,97163,CPT,420,RC,inpatient,,,GP,170.774,93.9257,790,,,per diem,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,92.961,,,fee schedule,,,100.195375,,,fee schedule,,,100.195375,,,fee schedule,,,850,,,per diem,,,100.195375,,,fee schedule,,,570,,,per diem,,,,153.6966,90,percent of total billed charges,,,,162.2353,95,percent of total billed charges,,,103.2012363,,,fee schedule,,,197.76,,,fee schedule,,,197.76,,,fee schedule,,,700,,,per diem,,,100.195375,,,fee schedule,,,92.961,850,
PT ESTAB RE-EVAL 20 MINS,4207164,CDM,97164,CPT,420,RC,inpatient,,,GP,83.842,46.1131,790,,,per diem,,,,83.842,100,percent of total billed charges,,,70.862,,,fee schedule,,,70.862,,,fee schedule,,,63.7758,,,fee schedule,,,69.570875,,,fee schedule,,,69.570875,,,fee schedule,,,850,,,per diem,,,69.570875,,,fee schedule,,,570,,,per diem,,,,75.4578,90,percent of total billed charges,,,,79.6499,95,percent of total billed charges,,,71.65800125,,,fee schedule,,,98.88,,,fee schedule,,,98.88,,,fee schedule,,,700,,,per diem,,,69.570875,,,fee schedule,,,63.7758,850,
CANALITH REPOSITIONING,4209599,CDM,95992,CPT,420,RC,inpatient,,,GP,84.254,46.3397,790,,,per diem,,,,84.254,100,percent of total billed charges,,,37.598,,,fee schedule,,,37.598,,,fee schedule,,,33.8382,,,fee schedule,,,35.28475,,,fee schedule,,,35.28475,,,fee schedule,,,850,,,per diem,,,35.28475,,,fee schedule,,,570,,,per diem,,,,75.8286,90,percent of total billed charges,,,,80.0413,95,percent of total billed charges,,,36.3432925,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,35.28475,,,fee schedule,,,33.8382,850,
PT - INFRARED MODALITY,4209702,CDM,97026,CPT,420,RC,inpatient,,,GP,12.566,6.9113,790,,,per diem,,,,12.566,100,percent of total billed charges,,,6.556,,,fee schedule,,,6.556,,,fee schedule,,,5.9004,,,fee schedule,,,6.6575,,,fee schedule,,,6.6575,,,fee schedule,,,850,,,per diem,,,6.6575,,,fee schedule,,,570,,,per diem,,,,11.3094,90,percent of total billed charges,,,,11.9377,95,percent of total billed charges,,,6.857225,,,fee schedule,,,,,,,,,,,,,,,700,,,per diem,,,6.6575,,,fee schedule,,,5.9004,850,
PHYSICAL PERFORMANCE TEST 15/M,4209775,CDM,97750,CPT,420,RC,inpatient,,,GP,94.863,52.17465,790,,,per diem,,,,94.863,100,percent of total billed charges,,,34.441,,,fee schedule,,,34.441,,,fee schedule,,,30.9969,,,fee schedule,,,33.95325,,,fee schedule,,,33.95325,,,fee schedule,,,850,,,per diem,,,33.95325,,,fee schedule,,,570,,,per diem,,,,85.3767,90,percent of total billed charges,,,,90.11985,95,percent of total billed charges,,,34.9718475,,,fee schedule,,,27.35,,,fee schedule,,,27.35,,,fee schedule,,,700,,,per diem,,,33.95325,,,fee schedule,,,27.35,850,
OT - SELF/HOME ADL'S EA 15 MIN,4300000,CDM,97535,CPT,430,RC,inpatient,,,GO,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,33.495,,,fee schedule,,,33.495,,,fee schedule,,,30.1455,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,,,,,,32.62175,,,fee schedule,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,33.6004025,,,fee schedule,,,,,,,,,,,,,,,,,,,,,32.62175,,,fee schedule,,,30.1455,55.517,
OT - AQUATIC THERAPY EA 15 MIN,4300010,CDM,97113,CPT,430,RC,inpatient,,,GO,89.713,49.34215,,80.7417,90,percent of total billed charges,,,,89.713,100,percent of total billed charges,,,40.884,,,fee schedule,,,40.884,,,fee schedule,,,36.7956,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,80.7417,90,percent of total billed charges,,,,85.22735,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.61625,,,fee schedule,,,36.61625,89.713,
SELECT DEBRIDE 1ST 20 SQ CM,4300135,CDM,97597,CPT,430,RC,inpatient,,,GO,117.832,64.8076,,106.0488,90,percent of total billed charges,,,,117.832,100,percent of total billed charges,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,161.6175,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,,,,,,,,106.0488,90,percent of total billed charges,,,,111.9404,95,percent of total billed charges,,,36.00043125,,,fee schedule,,,24.06,,,fee schedule,,,24.06,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,24.06,179.575,
OT - COMMUNITY REINT EA 15 MIN,4300187,CDM,97537,CPT,430,RC,inpatient,,,GO,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,54.2295,90,percent of total billed charges,,,,57.24225,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,31.623125,,,fee schedule,,,31.623125,60.255,
OT-ELECT STIMULATION MANUAL/15,4300220,CDM,97032,CPT,430,RC,inpatient,,,GO,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,13.4145,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,,,,,,14.313625,,,fee schedule,,,,,,,,,,46.7208,90,percent of total billed charges,,,,49.3164,95,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.313625,,,fee schedule,,,13.4145,51.912,
"ELECT STIM, OTHER THAN WOUND",4300230,CDM,97014,CPT,430,RC,inpatient,,,GO,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,15.27,,,fee schedule,,,15.27,,,fee schedule,,,13.743,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,,,,,,12.316375,,,fee schedule,,,,,,,,,,43.1982,90,percent of total billed charges,,,,45.5981,95,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12.316375,,,fee schedule,,,12.316375,47.998,
OT - GROUP THERAPY,4300250,CDM,97150,CPT,430,RC,inpatient,,,G0,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,18.304,,,fee schedule,,,18.304,,,fee schedule,,,16.4736,,,fee schedule,,,17.97525,,,fee schedule,,,17.97525,,,fee schedule,,,,,,,,,17.97525,,,fee schedule,,,,,,,,,,43.1982,90,percent of total billed charges,,,,45.5981,95,percent of total billed charges,,,18.5145075,,,fee schedule,,,5.94,,,fee schedule,,,5.94,,,fee schedule,,,,,,,,,17.97525,,,fee schedule,,,5.94,47.998,
OT - MANUAL THERAPY EA 15 MIN,4300310,CDM,97140,CPT,430,RC,inpatient,,,GO,77.559,42.65745,,69.8031,90,percent of total billed charges,,,,77.559,100,percent of total billed charges,,,27.973,,,fee schedule,,,27.973,,,fee schedule,,,25.1757,,,fee schedule,,,26.962875,,,fee schedule,,,26.962875,,,fee schedule,,,,,,,,,26.962875,,,fee schedule,,,,,,,,,,69.8031,90,percent of total billed charges,,,,73.68105,95,percent of total billed charges,,,27.77176125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,26.962875,,,fee schedule,,,25.1757,77.559,
OT-NEUROMUSCULAR RE-ED 15 MIN,4300330,CDM,97112,CPT,430,RC,inpatient,,,GO,78.692,43.2806,,70.8228,90,percent of total billed charges,,,,78.692,100,percent of total billed charges,,,34.716,,,fee schedule,,,34.716,,,fee schedule,,,31.2444,,,fee schedule,,,33.620375,,,fee schedule,,,33.620375,,,fee schedule,,,,,,,,,33.620375,,,fee schedule,,,,,,,,,,70.8228,90,percent of total billed charges,,,,74.7574,95,percent of total billed charges,,,34.62898625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,33.620375,,,fee schedule,,,31.2444,78.692,
OT - ORTHOTIC FIT/TRAIN 15 MIN,4300390,CDM,97760,CPT,430,RC,inpatient,,,GO,61.388,33.7634,,55.2492,90,percent of total billed charges,,,,61.388,100,percent of total billed charges,,,48.708,,,fee schedule,,,48.708,,,fee schedule,,,43.8372,,,fee schedule,,,47.601125,,,fee schedule,,,47.601125,,,fee schedule,,,,,,,,,47.601125,,,fee schedule,,,,,,,,,,55.2492,90,percent of total billed charges,,,,58.3186,95,percent of total billed charges,,,49.02915875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,47.601125,,,fee schedule,,,43.8372,61.388,
OT - THERAPUTIC ACTIVITY/ 15 M,4300460,CDM,97530,CPT,430,RC,inpatient,,,GO,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,37.565,,,fee schedule,,,37.565,,,fee schedule,,,33.8085,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,49.9653,90,percent of total billed charges,,,,52.74115,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,21.76,,,fee schedule,,,21.76,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,21.76,55.517,
OT - GAIT TRAINING EA 15 MIN,4300470,CDM,97116,CPT,430,RC,inpatient,,,GO,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,27.2844,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,56.6397,90,percent of total billed charges,,,,59.78635,95,percent of total billed charges,,,30.17179,,,fee schedule,,,,,,,,,,,,,,,,,,,,,29.293,,,fee schedule,,,27.2844,62.933,
OT - PROSTHETIC TRAIN 15 MIN,4300660,CDM,97761,CPT,430,RC,inpatient,,,,61.388,33.7634,,55.2492,90,percent of total billed charges,,,,61.388,100,percent of total billed charges,,,42.35,,,fee schedule,,,42.35,,,fee schedule,,,38.115,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,,,,,,,,55.2492,90,percent of total billed charges,,,,58.3186,95,percent of total billed charges,,,42.85765625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,41.609375,,,fee schedule,,,38.115,61.388,
OT - SENSORY INTEGRATION TECH,4300700,CDM,97533,CPT,430,RC,inpatient,,,GO,77.559,42.65745,,69.8031,90,percent of total billed charges,,,,77.559,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,62.247625,,,fee schedule,,,62.247625,,,fee schedule,,,,,,,,,62.247625,,,fee schedule,,,,,,,,,,69.8031,90,percent of total billed charges,,,,73.68105,95,percent of total billed charges,,,64.11505375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,62.247625,,,fee schedule,,,62.247625,77.559,
OT-THERAPUTIC EXER EACH 15 MIN,4300760,CDM,97110,CPT,430,RC,inpatient,,,GO,84.975,46.73625,,76.4775,90,percent of total billed charges,,,,84.975,100,percent of total billed charges,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,27.2844,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,,,,,,,,76.4775,90,percent of total billed charges,,,,80.72625,95,percent of total billed charges,,,30.17179,,,fee schedule,,,21.76,,,fee schedule,,,21.76,,,fee schedule,,,,,,,,,29.293,,,fee schedule,,,21.76,84.975,
OT - ULTRASOUND EACH 15 MIN,4300820,CDM,97035,CPT,430,RC,inpatient,,,GO,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,14.685,,,fee schedule,,,14.685,,,fee schedule,,,13.2165,,,fee schedule,,,13.98075,,,fee schedule,,,13.98075,,,fee schedule,,,,,,,,,13.98075,,,fee schedule,,,,,,,,,,48.8529,90,percent of total billed charges,,,,51.56695,95,percent of total billed charges,,,14.4001725,,,fee schedule,,,,,,,,,,,,,,,,,,,,,13.98075,,,fee schedule,,,13.2165,54.281,
OT - WHEELCHAIR MGMT EA 15 MIN,4300850,CDM,97542,CPT,430,RC,inpatient,,,GO,46.865,25.77575,,42.1785,90,percent of total billed charges,,,,46.865,100,percent of total billed charges,,,32.703,,,fee schedule,,,32.703,,,fee schedule,,,29.4327,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,42.1785,90,percent of total billed charges,,,,44.52175,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,31.623125,,,fee schedule,,,29.4327,46.865,
APPLICATION LAS SHOULDER-HAND,4302910,CDM,29105,CPT,430,RC,inpatient,,,,142.037,78.12035,,127.8333,90,percent of total billed charges,,,,142.037,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,133.417125,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,,,,,,,,127.8333,90,percent of total billed charges,,,,134.93515,95,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,41.609375,250,
APPLICATION SAS FOREARM-HAND,4302912,CDM,29125,CPT,430,RC,inpatient,,,,142.037,78.12035,,127.8333,90,percent of total billed charges,,,,142.037,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,40.61075,,,fee schedule,,,40.61075,,,fee schedule,,,,,,,,,40.61075,,,fee schedule,,,,,,,,,,127.8333,90,percent of total billed charges,,,,134.93515,95,percent of total billed charges,,,41.8290725,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,40.61075,,,fee schedule,,,40.61075,250,
STRAPPING SHOULDER - SS,4302924,CDM,29240,CPT,430,RC,inpatient,,,,100.734,55.4037,,90.6606,90,percent of total billed charges,,,,100.734,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,17.642375,,,fee schedule,,,17.642375,,,fee schedule,,,,,,,,,17.642375,,,fee schedule,,,,,,,,,,90.6606,90,percent of total billed charges,,,,95.6973,95,percent of total billed charges,,,18.17164625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,17.642375,,,fee schedule,,,17.642375,250,
STRAPPING ELBOW OR WRIST - EWS,4302926,CDM,29260,CPT,430,RC,inpatient,,,,100.734,55.4037,,90.6606,90,percent of total billed charges,,,,100.734,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,52.6095,,,fee schedule,,,18.641,,,fee schedule,,,18.641,,,fee schedule,,,,,,,,,18.641,,,fee schedule,,,,,,,,,,90.6606,90,percent of total billed charges,,,,95.6973,95,percent of total billed charges,,,19.20023,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,18.641,,,fee schedule,,,18.641,250,
OT EVALUATION; LOW COMPLEXITY,4307165,CDM,97165,CPT,430,RC,inpatient,,,GO,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,92.961,,,fee schedule,,,101.194,,,fee schedule,,,101.194,,,fee schedule,,,,,,,,,101.194,,,fee schedule,,,,,,,,,,153.6966,90,percent of total billed charges,,,,162.2353,95,percent of total billed charges,,,104.22982,,,fee schedule,,,98.88,,,fee schedule,,,98.88,,,fee schedule,,,,,,,,,101.194,,,fee schedule,,,92.961,170.774,
OT EVALUATION; MOD COMPLEXITY,4307166,CDM,97166,CPT,430,RC,inpatient,,,GO,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,92.961,,,fee schedule,,,101.194,,,fee schedule,,,101.194,,,fee schedule,,,,,,,,,101.194,,,fee schedule,,,,,,,,,,153.6966,90,percent of total billed charges,,,,162.2353,95,percent of total billed charges,,,104.22982,,,fee schedule,,,148.32,,,fee schedule,,,148.32,,,fee schedule,,,,,,,,,101.194,,,fee schedule,,,92.961,170.774,
OT EVAL HIGH COMPLEX 60 MIN,4307167,CDM,97167,CPT,430,RC,inpatient,,,GO,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,92.961,,,fee schedule,,,101.194,,,fee schedule,,,101.194,,,fee schedule,,,,,,,,,101.194,,,fee schedule,,,,,,,,,,153.6966,90,percent of total billed charges,,,,162.2353,95,percent of total billed charges,,,104.22982,,,fee schedule,,,197.76,,,fee schedule,,,197.76,,,fee schedule,,,,,,,,,101.194,,,fee schedule,,,92.961,197.76,
OT RE-EVALUATION,4307168,CDM,97168,CPT,430,RC,inpatient,,,GO,83.842,46.1131,,75.4578,90,percent of total billed charges,,,,83.842,100,percent of total billed charges,,,70.543,,,fee schedule,,,70.543,,,fee schedule,,,63.4887,,,fee schedule,,,69.90375,,,fee schedule,,,69.90375,,,fee schedule,,,,,,,,,69.90375,,,fee schedule,,,,,,,,,,75.4578,90,percent of total billed charges,,,,79.6499,95,percent of total billed charges,,,72.0008625,,,fee schedule,,,98.88,,,fee schedule,,,98.88,,,fee schedule,,,,,,,,,69.90375,,,fee schedule,,,63.4887,98.88,
OT - INFRARED MODALITY,4309702,CDM,97026,CPT,430,RC,inpatient,,,GO,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,6.556,,,fee schedule,,,6.556,,,fee schedule,,,5.9004,,,fee schedule,,,6.6575,,,fee schedule,,,6.6575,,,fee schedule,,,,,,,,,6.6575,,,fee schedule,,,,,,,,,,11.3094,90,percent of total billed charges,,,,11.9377,95,percent of total billed charges,,,6.857225,,,fee schedule,,,,,,,,,,,,,,,,,,,,,6.6575,,,fee schedule,,,5.9004,12.566,
ST - SPEECH THERAPY TREATMENT,4400460,CDM,92507,CPT,440,RC,inpatient,,,GN,156.251,85.93805,,140.6259,90,percent of total billed charges,,,,156.251,100,percent of total billed charges,,,79.079,,,fee schedule,,,79.079,,,fee schedule,,,71.1711,,,fee schedule,,,76.228375,,,fee schedule,,,76.228375,,,fee schedule,,,,,,,,,76.228375,,,fee schedule,,,,,,,,,,140.6259,90,percent of total billed charges,,,,148.43845,95,percent of total billed charges,,,78.51522625,,,fee schedule,,,21.76,,,fee schedule,,,21.76,,,fee schedule,,,,,,,,,76.228375,,,fee schedule,,,21.76,156.251,
ST - SWALLOWING EVALUTATION,4400470,CDM,92610,CPT,440,RC,inpatient,,,GN,194.052,106.7286,,174.6468,90,percent of total billed charges,,,,194.052,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,69.90375,,,fee schedule,,,69.90375,,,fee schedule,,,,,,,,,69.90375,,,fee schedule,,,,,,,,,,174.6468,90,percent of total billed charges,,,,184.3494,95,percent of total billed charges,,,72.0008625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.90375,,,fee schedule,,,69.90375,194.052,
ST - TRMT OF SWALLOWING DYSFUN,4400480,CDM,92526,CPT,440,RC,inpatient,,,GN,89.713,49.34215,,80.7417,90,percent of total billed charges,,,,89.713,100,percent of total billed charges,,,87.252,,,fee schedule,,,87.252,,,fee schedule,,,78.5268,,,fee schedule,,,84.55025,,,fee schedule,,,84.55025,,,fee schedule,,,,,,,,,84.55025,,,fee schedule,,,,,,,,,,80.7417,90,percent of total billed charges,,,,85.22735,95,percent of total billed charges,,,87.0867575,,,fee schedule,,,,,,,,,,,,,,,,,,,,,84.55025,,,fee schedule,,,78.5268,89.713,
ST - LARYNGEAL FUNCTION STUDY,4400500,CDM,92520,CPT,440,RC,inpatient,,,GN,132.664,72.9652,,119.3976,90,percent of total billed charges,,,,132.664,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,99.19665,,,fee schedule,,,39.27925,,,fee schedule,,,39.27925,,,fee schedule,,,,,,,,,39.27925,,,fee schedule,,,,,,,,,,119.3976,90,percent of total billed charges,,,,126.0308,95,percent of total billed charges,,,40.4576275,,,fee schedule,,,7.2,,,fee schedule,,,7.2,,,fee schedule,,,,,,,,,39.27925,,,fee schedule,,,7.2,132.664,
"ST - SCREENING,PURE TONE,AIR",4400510,CDM,92551,CPT,440,RC,inpatient,,,GN,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,12.64925,,,fee schedule,,,12.64925,,,fee schedule,,,,,,,,,12.64925,,,fee schedule,,,,,,,,,,52.0974,90,percent of total billed charges,,,,54.9917,95,percent of total billed charges,,,13.0287275,,,fee schedule,,,4,,,fee schedule,,,4,,,fee schedule,,,,,,,,,12.64925,,,fee schedule,,,4,57.886,
ST - EVAL USE/FITTING VOICE DE,4400520,CDM,92597,CPT,440,RC,inpatient,,,GN,266.77,146.7235,,240.093,90,percent of total billed charges,,,,266.77,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,72.233875,,,fee schedule,,,72.233875,,,fee schedule,,,,,,,,,72.233875,,,fee schedule,,,,,,,,,,240.093,90,percent of total billed charges,,,,253.4315,95,percent of total billed charges,,,74.40089125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,72.233875,,,fee schedule,,,72.233875,266.77,
ST - ASSESSMENT APHASIA PER HR,4400540,CDM,96105,CPT,440,RC,inpatient,,,GN,211.356,116.2458,,190.2204,90,percent of total billed charges,,,,211.356,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,95.868,,,fee schedule,,,95.868,,,fee schedule,,,,,,,,,95.868,,,fee schedule,,,,,,,,,,190.2204,90,percent of total billed charges,,,,200.7882,95,percent of total billed charges,,,98.74404,,,fee schedule,,,,,,,,,,,,,,,,,,,,,95.868,,,fee schedule,,,95.868,211.356,
ST - EVAL FLUENCY (STUTTER,4402521,CDM,92521,CPT,440,RC,inpatient,,,GN,118.553,65.20415,,106.6977,90,percent of total billed charges,,,,118.553,100,percent of total billed charges,,,137.379,,,fee schedule,,,137.379,,,fee schedule,,,123.6411,,,fee schedule,,,132.817125,,,fee schedule,,,132.817125,,,fee schedule,,,,,,,,,132.817125,,,fee schedule,,,,,,,,,,106.6977,90,percent of total billed charges,,,,112.62535,95,percent of total billed charges,,,136.8016388,,,fee schedule,,,49.44,,,fee schedule,,,49.44,,,fee schedule,,,,,,,,,132.817125,,,fee schedule,,,49.44,137.379,
ST - EVAL SOUND PRODUCTION,4402522,CDM,92522,CPT,440,RC,inpatient,,,GN,180.662,99.3641,,162.5958,90,percent of total billed charges,,,,180.662,100,percent of total billed charges,,,114.829,,,fee schedule,,,114.829,,,fee schedule,,,103.3461,,,fee schedule,,,111.18025,,,fee schedule,,,111.18025,,,fee schedule,,,,,,,,,111.18025,,,fee schedule,,,,,,,,,,162.5958,90,percent of total billed charges,,,,171.6289,95,percent of total billed charges,,,114.5156575,,,fee schedule,,,49.44,,,fee schedule,,,49.44,,,fee schedule,,,,,,,,,111.18025,,,fee schedule,,,49.44,180.662,
ST - EVAL SOUND W/LANG COMP/EX,4402523,CDM,92523,CPT,440,RC,inpatient,,,GN,222.171,122.19405,,199.9539,90,percent of total billed charges,,,,222.171,100,percent of total billed charges,,,235.598,,,fee schedule,,,235.598,,,fee schedule,,,212.0382,,,fee schedule,,,227.6865,,,fee schedule,,,227.6865,,,fee schedule,,,,,,,,,227.6865,,,fee schedule,,,,,,,,,,199.9539,90,percent of total billed charges,,,,211.06245,95,percent of total billed charges,,,234.517095,,,fee schedule,,,49.44,,,fee schedule,,,49.44,,,fee schedule,,,,,,,,,227.6865,,,fee schedule,,,49.44,235.598,
BEHAVORIAL QUALITY ANALYSIS,4402524,CDM,92524,CPT,440,RC,inpatient,,,GN,122.673,67.47015,,110.4057,90,percent of total billed charges,,,,122.673,100,percent of total billed charges,,,113.553,,,fee schedule,,,113.553,,,fee schedule,,,102.1977,,,fee schedule,,,109.515875,,,fee schedule,,,109.515875,,,fee schedule,,,,,,,,,109.515875,,,fee schedule,,,,,,,,,,110.4057,90,percent of total billed charges,,,,116.53935,95,percent of total billed charges,,,112.8013513,,,fee schedule,,,49.44,,,fee schedule,,,49.44,,,fee schedule,,,,,,,,,109.515875,,,fee schedule,,,49.44,122.673,
EA ADD'L 30 MIN/SP COMM DEVICE,4402608,CDM,92608,CPT,440,RC,inpatient,,,,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,48.59975,,,fee schedule,,,48.59975,,,fee schedule,,,,,,,,,48.59975,,,fee schedule,,,,,,,,,,52.0974,90,percent of total billed charges,,,,54.9917,95,percent of total billed charges,,,50.0577425,,,fee schedule,,,22.13,,,fee schedule,,,22.13,,,fee schedule,,,,,,,,,48.59975,,,fee schedule,,,22.13,57.886,
THERAPEUTIC SERV/AAC DEVICE,4402609,CDM,92609,CPT,440,RC,inpatient,,,,173.143,95.22865,,155.8287,90,percent of total billed charges,,,,173.143,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,103.19125,,,fee schedule,,,103.19125,,,fee schedule,,,,,,,,,103.19125,,,fee schedule,,,,,,,,,,155.8287,90,percent of total billed charges,,,,164.48585,95,percent of total billed charges,,,106.2869875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,103.19125,,,fee schedule,,,103.19125,173.143,
EVAL RX/SPEECH COMM DEVICE 1HR,4409260,CDM,92607,CPT,440,RC,inpatient,,,,331.763,182.46965,,298.5867,90,percent of total billed charges,,,,331.763,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,123.8295,,,fee schedule,,,123.8295,,,fee schedule,,,,,,,,,123.8295,,,fee schedule,,,,,,,,,,298.5867,90,percent of total billed charges,,,,315.17485,95,percent of total billed charges,,,127.544385,,,fee schedule,,,111.38,,,fee schedule,,,111.38,,,fee schedule,,,,,,,,,123.8295,,,fee schedule,,,111.38,331.763,
OB - LEVEL IV EMERGENT CARE,3100080,CDM,99284,CPT,450,RC,inpatient,,,,407.571,224.16405,,366.8139,90,percent of total billed charges,,,,407.571,100,percent of total billed charges,,,248.05,,,fee schedule,,,248.05,,,fee schedule,,,223.245,,,fee schedule,,,119.502125,,,fee schedule,,,119.502125,,,fee schedule,,,,,,,,,119.502125,,,fee schedule,,,,,,,,,,366.8139,90,percent of total billed charges,,,,387.19245,95,percent of total billed charges,,,123.0871888,,,fee schedule,,,,,,,,,,,,,,,,,,,,,119.502125,,,fee schedule,,,119.502125,407.571,
OB - LEVEL III EMERGENT CARE,3100090,CDM,99283,CPT,450,RC,inpatient,,,,212.695,116.98225,,191.4255,90,percent of total billed charges,,,,212.695,100,percent of total billed charges,,,203.66,,,fee schedule,,,203.66,,,fee schedule,,,183.294,,,fee schedule,,,70.236625,,,fee schedule,,,70.236625,,,fee schedule,,,,,,,,,70.236625,,,fee schedule,,,,,,,,,,191.4255,90,percent of total billed charges,,,,202.06025,95,percent of total billed charges,,,72.34372375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.236625,,,fee schedule,,,70.236625,212.695,
OB - LEVEL II EMERGENT CARE,3100100,CDM,99282,CPT,450,RC,inpatient,,,,152.543,83.89865,,137.2887,90,percent of total billed charges,,,,152.543,100,percent of total billed charges,,,169.42,,,fee schedule,,,169.42,,,fee schedule,,,152.478,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,,,,,,,,137.2887,90,percent of total billed charges,,,,144.91585,95,percent of total billed charges,,,42.514795,,,fee schedule,,,,,,,,,,,,,,,,,,,,,41.2765,,,fee schedule,,,41.2765,169.42,
OB - LEVEL I EMERGENT CARE,3100110,CDM,99281,CPT,450,RC,inpatient,,,,107.532,59.1426,,96.7788,90,percent of total billed charges,,,,107.532,100,percent of total billed charges,,,148.43,,,fee schedule,,,148.43,,,fee schedule,,,133.587,,,fee schedule,,,11.31775,,,fee schedule,,,11.31775,,,fee schedule,,,,,,,,,11.31775,,,fee schedule,,,,,,,,,,96.7788,90,percent of total billed charges,,,,102.1554,95,percent of total billed charges,,,11.6572825,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.31775,,,fee schedule,,,11.31775,148.43,
AVULSION NAIL PLATE; SINGLE,4500021,CDM,11730,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,53.26,,,fee schedule,,,53.26,,,fee schedule,,,,,,,,,53.26,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,54.8578,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,53.26,,,fee schedule,,,53.26,250,
ER FACILITY - LEVEL 5,4500070,CDM,99285,CPT,450,RC,inpatient,,,,1257.321,691.52655,,1131.5889,90,percent of total billed charges,,,,1257.321,100,percent of total billed charges,,,320.24,,,fee schedule,,,320.24,,,fee schedule,,,288.216,,,fee schedule,,,173.095,,,fee schedule,,,173.095,,,fee schedule,,,,,,,,,173.095,,,fee schedule,,,,,,,,,,1131.5889,90,percent of total billed charges,,,,1194.45495,95,percent of total billed charges,,,178.28785,,,fee schedule,,,,,,,,,,,,,,,,,,,,,173.095,,,fee schedule,,,173.095,1257.321,
ER FACILITY - LEVEL 4,4500080,CDM,99284,CPT,450,RC,inpatient,,,,967.17,531.9435,,870.453,90,percent of total billed charges,,,,967.17,100,percent of total billed charges,,,248.05,,,fee schedule,,,248.05,,,fee schedule,,,223.245,,,fee schedule,,,119.502125,,,fee schedule,,,119.502125,,,fee schedule,,,,,,,,,119.502125,,,fee schedule,,,,,,,,,,870.453,90,percent of total billed charges,,,,918.8115,95,percent of total billed charges,,,123.0871888,,,fee schedule,,,,,,,,,,,,,,,,,,,,,119.502125,,,fee schedule,,,119.502125,967.17,
ER FACILTIY - LEVEL 3,4500090,CDM,99283,CPT,450,RC,inpatient,,,,677.431,372.58705,,609.6879,90,percent of total billed charges,,,,677.431,100,percent of total billed charges,,,203.66,,,fee schedule,,,203.66,,,fee schedule,,,183.294,,,fee schedule,,,70.236625,,,fee schedule,,,70.236625,,,fee schedule,,,,,,,,,70.236625,,,fee schedule,,,,,,,,,,609.6879,90,percent of total billed charges,,,,643.55945,95,percent of total billed charges,,,72.34372375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.236625,,,fee schedule,,,70.236625,677.431,
ER FACILITY - LEVEL 2,4500100,CDM,99282,CPT,450,RC,inpatient,,,,290.254,159.6397,,261.2286,90,percent of total billed charges,,,,290.254,100,percent of total billed charges,,,169.42,,,fee schedule,,,169.42,,,fee schedule,,,152.478,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,,,,,,41.2765,,,fee schedule,,,,,,,,,,261.2286,90,percent of total billed charges,,,,275.7413,95,percent of total billed charges,,,42.514795,,,fee schedule,,,,,,,,,,,,,,,,,,,,,41.2765,,,fee schedule,,,41.2765,290.254,
WOUND EXPLORATION EXTREMITY,4500103,CDM,20103,CPT,450,RC,inpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1372.5855,,,fee schedule,,,345.52425,,,fee schedule,,,345.52425,,,fee schedule,,,,,,,,,345.52425,,,fee schedule,,,,,,,,,,590.5917,90,percent of total billed charges,,,,623.40235,95,percent of total billed charges,,,355.8899775,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,345.52425,,,fee schedule,,,250,1525.095,
ER FACILITY - LEVEL I,4500110,CDM,99281,CPT,450,RC,inpatient,,,,180.559,99.30745,,162.5031,90,percent of total billed charges,,,,180.559,100,percent of total billed charges,,,148.43,,,fee schedule,,,148.43,,,fee schedule,,,133.587,,,fee schedule,,,11.31775,,,fee schedule,,,11.31775,,,fee schedule,,,,,,,,,11.31775,,,fee schedule,,,,,,,,,,162.5031,90,percent of total billed charges,,,,171.53105,95,percent of total billed charges,,,11.6572825,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.31775,,,fee schedule,,,11.31775,180.559,
FB REMOVAL TISSUE SIMPLE,4500120,CDM,10120,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,106.187125,,,fee schedule,,,106.187125,,,fee schedule,,,,,,,,,106.187125,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,109.3727388,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,106.187125,,,fee schedule,,,106.187125,412.721,
ER FACIL CRITICAL CARE ADD'L,4500180,CDM,99292,CPT,450,RC,inpatient,,,,275.113,151.31215,,247.6017,90,percent of total billed charges,,,,275.113,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,105.85425,,,fee schedule,,,105.85425,,,fee schedule,,,,,,,,,105.85425,,,fee schedule,,,,,,,,,,247.6017,90,percent of total billed charges,,,,261.35735,95,percent of total billed charges,,,109.0298775,,,fee schedule,,,,,,,,,,,,,,,,,,,,,105.85425,,,fee schedule,,,105.85425,275.113,
ER FACILITY CRITICAL CARE,4500190,CDM,99291,CPT,450,RC,inpatient,,,,1654.489,909.96895,,1489.0401,90,percent of total billed charges,,,,1654.489,100,percent of total billed charges,,,373.53,,,fee schedule,,,373.53,,,fee schedule,,,336.177,,,fee schedule,,,210.044125,,,fee schedule,,,210.044125,,,fee schedule,,,,,,,,,210.044125,,,fee schedule,,,,,,,,,,1489.0401,90,percent of total billed charges,,,,1571.76455,95,percent of total billed charges,,,216.3454488,,,fee schedule,,,,,,,,,,,,,,,,,,,,,210.044125,,,fee schedule,,,210.044125,1654.489,
CERUMEN REMOVAL,4500205,CDM,69210,CPT,450,RC,inpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,52.6095,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,59.8842,90,percent of total billed charges,,,,63.2111,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,32.288875,250,
FB REMOVAL EAR,4500207,CDM,69200,CPT,450,RC,inpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,,,,,,,,59.8842,90,percent of total billed charges,,,,63.2111,95,percent of total billed charges,,,48.6862975,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,47.26825,,,fee schedule,,,47.26825,250,
SUBQ/IM INJECTION - ER,4500220,CDM,96372,CPT,450,RC,inpatient,,,,59.122,32.5171,,53.2098,90,percent of total billed charges,,,,59.122,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,,,,,,14.313625,,,fee schedule,,,,,,,,,,53.2098,90,percent of total billed charges,,,,56.1659,95,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.313625,,,fee schedule,,,14.313625,64.0395,
THER PROPH DIAG INJ IV PUSH SI,4500222,CDM,96374,CPT,450,RC,inpatient,,,,128.853,70.86915,,115.9677,90,percent of total billed charges,,,,128.853,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,115.9677,90,percent of total billed charges,,,,122.41035,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.61625,,,fee schedule,,,36.61625,196.077,
FB REMOVAL NOSE,4500303,CDM,30300,CPT,450,RC,inpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,123.8295,,,fee schedule,,,123.8295,,,fee schedule,,,,,,,,,123.8295,,,fee schedule,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,127.544385,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,123.8295,,,fee schedule,,,103.1751,250,
SIMPLE REPAIR FACE <2.5cm,4500380,CDM,12011,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,55.25725,,,fee schedule,,,55.25725,,,fee schedule,,,,,,,,,55.25725,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,56.9149675,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,55.25725,,,fee schedule,,,55.25725,250,
JAW REDUCTION,4500480,CDM,21480,CPT,450,RC,inpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,30.957375,,,fee schedule,,,30.957375,,,fee schedule,,,,,,,,,30.957375,,,fee schedule,,,,,,,,,,277.2657,90,percent of total billed charges,,,,292.66935,95,percent of total billed charges,,,31.88609625,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,30.957375,,,fee schedule,,,30.957375,308.073,
"TRIGGER PT(S) INJ,1 OR 2 MUSCL",4500552,CDM,20552,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,36.61625,412.721,
ARTHROCENTESIS INTERM JOINT,4500605,CDM,20605,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,36.61625,412.721,
ARTHROCENTESIS MAJOR JOINT,4500610,CDM,20610,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,45.271,,,fee schedule,,,45.271,,,fee schedule,,,,,,,,,45.271,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,46.62913,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,45.271,,,fee schedule,,,45.271,412.721,
HYDRATION IV INFUSION 31m-1hr,4500760,CDM,96360,CPT,450,RC,inpatient,,,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,176.4693,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,93.9051,90,percent of total billed charges,,,,99.12205,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,32.288875,,,fee schedule,,,32.288875,196.077,
IV INFUS HYDRA +HRS S/IV ACCES,4500761,CDM,96361,CPT,450,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,,,,,,12.316375,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12.316375,,,fee schedule,,,12.316375,51.603,
IV INFUS MED/SEQUENT 1 HR - ER,4500767,CDM,96367,CPT,450,RC,inpatient,,,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,28.294375,,,fee schedule,,,28.294375,,,fee schedule,,,,,,,,,28.294375,,,fee schedule,,,,,,,,,,45.5157,90,percent of total billed charges,,,,48.04435,95,percent of total billed charges,,,29.14320625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.294375,,,fee schedule,,,28.294375,64.0395,
IV CONCURRENT INFUSION MED/ER,4500768,CDM,96368,CPT,450,RC,inpatient,,,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,19.64,,,fee schedule,,,19.64,,,fee schedule,,,17.676,,,fee schedule,,,19.639625,,,fee schedule,,,19.639625,,,fee schedule,,,,,,,,,19.639625,,,fee schedule,,,,,,,,,,35.1333,90,percent of total billed charges,,,,37.08515,95,percent of total billed charges,,,20.22881375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,19.639625,,,fee schedule,,,17.676,39.037,
ANTERIOR NASAL PACKING SIMPLE,4500901,CDM,30901,CPT,450,RC,inpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,56.255875,,,fee schedule,,,56.255875,,,fee schedule,,,,,,,,,56.255875,,,fee schedule,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,57.94355125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,56.255875,,,fee schedule,,,56.255875,250,
POSTERIOR NASAL PACK INITIAL,4500905,CDM,30905,CPT,450,RC,inpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,105.1885,,,fee schedule,,,105.1885,,,fee schedule,,,,,,,,,105.1885,,,fee schedule,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,108.344155,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,105.1885,,,fee schedule,,,103.1751,250,
"REPAIR SIMPLE SCALP,ETC <2.5cm",4501000,CDM,12001,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,44.60525,,,fee schedule,,,44.60525,,,fee schedule,,,,,,,,,44.60525,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,45.9434075,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,44.60525,,,fee schedule,,,44.60525,250,
I&D SIMPLE SKIN ABSCESS,4501006,CDM,10060,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,107.18575,,,fee schedule,,,107.18575,,,fee schedule,,,,,,,,,107.18575,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,110.4013225,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,107.18575,,,fee schedule,,,107.18575,250,
I&D PILONIDAL CYST SIMPLE,4501008,CDM,10080,CPT,450,RC,inpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,594.023625,,,fee schedule,,,105.85425,,,fee schedule,,,105.85425,,,fee schedule,,,,,,,,,105.85425,,,fee schedule,,,,,,,,,,590.5917,90,percent of total billed charges,,,,623.40235,95,percent of total billed charges,,,109.0298775,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,105.85425,,,fee schedule,,,105.85425,660.02625,
DEBRIDE ECZE/INFECTED SKIN 10%,4501009,CDM,11000,CPT,450,RC,inpatient,,,,626.137,344.37535,,563.5233,90,percent of total billed charges,,,,626.137,100,percent of total billed charges,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,531.765,,,fee schedule,,,27.29575,,,fee schedule,,,27.29575,,,fee schedule,,,,,,,,,27.29575,,,fee schedule,,,,,,,,,,563.5233,90,percent of total billed charges,,,,594.83015,95,percent of total billed charges,,,28.1146225,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,27.29575,,,fee schedule,,,27.29575,626.137,
"RPR SIMPLE SCALP,ETC 2.6-7.5cm",4501010,CDM,12002,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,58.586,,,fee schedule,,,58.586,,,fee schedule,,,,,,,,,58.586,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,60.34358,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,58.586,,,fee schedule,,,58.586,250,
"RPR SIMPLE SCALP,ETC 7.6-12.5",4501020,CDM,12004,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,73.2325,,,fee schedule,,,73.2325,,,fee schedule,,,,,,,,,73.2325,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,75.429475,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,73.2325,,,fee schedule,,,73.2325,250,
"RPR SIMPLE SCALP,ETC 12.6-2.0",4501030,CDM,12005,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,94.203625,,,fee schedule,,,94.203625,,,fee schedule,,,,,,,,,94.203625,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,97.02973375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,94.203625,,,fee schedule,,,94.203625,412.721,
"RPR SIMPLE SCALP,ETC 20.1-30cm",4501040,CDM,12006,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,115.17475,,,fee schedule,,,115.17475,,,fee schedule,,,,,,,,,115.17475,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,118.6299925,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,115.17475,,,fee schedule,,,115.17475,412.721,
I&D COMPLICATED SKIN ABSCESS,4501061,CDM,10061,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,185.0785,,,fee schedule,,,185.0785,,,fee schedule,,,,,,,,,185.0785,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,190.630855,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,185.0785,,,fee schedule,,,185.0785,412.721,
SIMPLE REPAIR FACE 2.6 - 5cm,4501070,CDM,12013,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,57.587375,,,fee schedule,,,57.587375,,,fee schedule,,,,,,,,,57.587375,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,59.31499625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,57.587375,,,fee schedule,,,57.587375,250,
SIMPLE REPAIR 5.1cm TO 7.5cm,4501080,CDM,12014,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,74.564,,,fee schedule,,,74.564,,,fee schedule,,,,,,,,,74.564,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,76.80092,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,74.564,,,fee schedule,,,74.564,250,
SIMPLE REPAIR FACE 7.6-12.5cm,4501090,CDM,12015,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,93.537875,,,fee schedule,,,93.537875,,,fee schedule,,,,,,,,,93.537875,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,96.34401125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,93.537875,,,fee schedule,,,93.537875,250,
DEBRIDEMENT SQ TISSUE,4501104,CDM,11042,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,60.250375,,,fee schedule,,,60.250375,,,fee schedule,,,,,,,,,60.250375,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,62.05788625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,60.250375,,,fee schedule,,,60.250375,412.721,
DEBRIDEMENT OF NAIL(S) 1-5,4501720,CDM,11720,CPT,450,RC,inpatient,,,,89.507,49.22885,,80.5563,90,percent of total billed charges,,,,89.507,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,52.6095,,,fee schedule,,,13.98075,,,fee schedule,,,13.98075,,,fee schedule,,,,,,,,,13.98075,,,fee schedule,,,,,,,,,,80.5563,90,percent of total billed charges,,,,85.03165,95,percent of total billed charges,,,14.4001725,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,13.98075,,,fee schedule,,,13.98075,250,
EVACUATION SUBUNGAL HEMATOMA,4501740,CDM,11740,CPT,450,RC,inpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,33.25754125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,32.288875,,,fee schedule,,,32.288875,250,
REMOVAL NAILBED AND MATRIX,4501750,CDM,11750,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,101.85975,,,fee schedule,,,101.85975,,,fee schedule,,,,,,,,,101.85975,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,104.9155425,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,101.85975,,,fee schedule,,,101.85975,412.721,
REPAIR NAILBED,4501760,CDM,11760,CPT,450,RC,inpatient,,,,626.137,344.37535,,563.5233,90,percent of total billed charges,,,,626.137,100,percent of total billed charges,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,531.765,,,fee schedule,,,109.515875,,,fee schedule,,,109.515875,,,fee schedule,,,,,,,,,109.515875,,,fee schedule,,,,,,,,,,563.5233,90,percent of total billed charges,,,,594.83015,95,percent of total billed charges,,,112.8013513,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,109.515875,,,fee schedule,,,109.515875,626.137,
INTERMEDIATE RPR S/T/E <2.5cm,4502000,CDM,12031,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,151.12525,,,fee schedule,,,151.12525,,,fee schedule,,,,,,,,,151.12525,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,155.6590075,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,151.12525,,,fee schedule,,,151.12525,412.721,
INTERMEDIATE RPR S/T/E 2.6-7.5,4502010,CDM,12032,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,189.73875,,,fee schedule,,,189.73875,,,fee schedule,,,,,,,,,189.73875,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,195.4309125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,189.73875,,,fee schedule,,,189.73875,412.721,
INTERMEDIATE RPR S/T/E7.6-12.5,4502020,CDM,12034,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,204.718125,,,fee schedule,,,204.718125,,,fee schedule,,,,,,,,,204.718125,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,210.8596688,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,204.718125,,,fee schedule,,,204.718125,412.721,
INTERMEDIATE RPR HFNG 2.6-7.5,4502070,CDM,12042,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,195.06475,,,fee schedule,,,195.06475,,,fee schedule,,,,,,,,,195.06475,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,200.9166925,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,195.06475,,,fee schedule,,,195.06475,412.721,
INTERMEDIATE RPR HFNG 7.6-12.5,4502080,CDM,12044,CPT,450,RC,inpatient,,,,626.137,344.37535,,563.5233,90,percent of total billed charges,,,,626.137,100,percent of total billed charges,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,531.765,,,fee schedule,,,213.70575,,,fee schedule,,,213.70575,,,fee schedule,,,,,,,,,213.70575,,,fee schedule,,,,,,,,,,563.5233,90,percent of total billed charges,,,,594.83015,95,percent of total billed charges,,,220.1169225,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,213.70575,,,fee schedule,,,213.70575,626.137,
INTERMEDIATE REPAIR FACE <2.5,4502120,CDM,12051,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,169.1005,,,fee schedule,,,169.1005,,,fee schedule,,,,,,,,,169.1005,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,174.173515,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,169.1005,,,fee schedule,,,169.1005,412.721,
INTERMEDIATE RPR FACE 2.6-5cm,4502130,CDM,12052,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,198.726375,,,fee schedule,,,198.726375,,,fee schedule,,,,,,,,,198.726375,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,204.6881663,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,198.726375,,,fee schedule,,,198.726375,412.721,
INTERMEDIATE RPR FACE 5.1-7.5,4502140,CDM,12053,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,214.3715,,,fee schedule,,,214.3715,,,fee schedule,,,,,,,,,214.3715,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,220.802645,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,214.3715,,,fee schedule,,,214.3715,412.721,
INTERMEDIATE RPR FACE 7.6-12.5,4502150,CDM,12054,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,219.364625,,,fee schedule,,,219.364625,,,fee schedule,,,,,,,,,219.364625,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,225.9455638,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,219.364625,,,fee schedule,,,219.364625,412.721,
INTERMEDIATE RPR FACE 12.6-20,4502160,CDM,12055,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,301.251875,,,fee schedule,,,301.251875,,,fee schedule,,,,,,,,,301.251875,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,310.2894313,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,301.251875,,,fee schedule,,,250,412.721,
LUMBAR PUNCTURE DIAGNOSTIC,4502270,CDM,62270,CPT,450,RC,inpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,589.78125,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,,,,,,,,590.5917,90,percent of total billed charges,,,,623.40235,95,percent of total billed charges,,,65.1436375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,63.24625,,,fee schedule,,,63.24625,656.213,
SHOULDER REDCUTION/W/MAN/W/ANE,4502365,CDM,23655,CPT,450,RC,inpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,1313.060625,,,fee schedule,,,419.4225,,,fee schedule,,,419.4225,,,fee schedule,,,,,,,,,419.4225,,,fee schedule,,,,,,,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,95,percent of total billed charges,,,432.005175,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,419.4225,,,fee schedule,,,250,1600.414,
TRMT DISL HIP PROSTHES W/ANES,4502726,CDM,27266,CPT,450,RC,inpatient,,,,1600.723,880.39765,,1440.6507,90,percent of total billed charges,,,,1600.723,100,percent of total billed charges,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,1313.060625,,,fee schedule,,,592.184625,,,fee schedule,,,592.184625,,,fee schedule,,,,,,,,,592.184625,,,fee schedule,,,,,,,,,,1440.6507,90,percent of total billed charges,,,,1520.68685,95,percent of total billed charges,,,609.9501638,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,592.184625,,,fee schedule,,,250,1600.723,
FB REMOVAL PHARYNX,4502809,CDM,42809,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,345.596625,,,fee schedule,,,127.824,,,fee schedule,,,127.824,,,fee schedule,,,,,,,,,127.824,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,131.65872,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,127.824,,,fee schedule,,,127.824,412.721,
SHORT ARM SPLINT,4502912,CDM,29125,CPT,450,RC,inpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,40.61075,,,fee schedule,,,40.61075,,,fee schedule,,,,,,,,,40.61075,,,fee schedule,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,41.8290725,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,40.61075,,,fee schedule,,,40.61075,250,
APPLICATION LONG LEG SPLINT,4502950,CDM,29505,CPT,450,RC,inpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,133.417125,,,fee schedule,,,52.59425,,,fee schedule,,,52.59425,,,fee schedule,,,,,,,,,52.59425,,,fee schedule,,,,,,,,,,128.9457,90,percent of total billed charges,,,,136.10935,95,percent of total billed charges,,,54.1720775,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,52.59425,,,fee schedule,,,52.59425,250,
APPLICATION SHORT LEG SPLINT,4502951,CDM,29515,CPT,450,RC,inpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,133.417125,,,fee schedule,,,49.93125,,,fee schedule,,,49.93125,,,fee schedule,,,,,,,,,49.93125,,,fee schedule,,,,,,,,,,128.9457,90,percent of total billed charges,,,,136.10935,95,percent of total billed charges,,,51.4291875,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,49.93125,,,fee schedule,,,49.93125,250,
TRANSUCTANEOUS PACING,4502953,CDM,92953,CPT,450,RC,inpatient,,,,224.746,123.6103,,202.2714,90,percent of total billed charges,,,,224.746,100,percent of total billed charges,,,598.1625,,,fee schedule,,,598.1625,,,fee schedule,,,538.34625,,,fee schedule,,,0.998625,,,fee schedule,,,0.998625,,,fee schedule,,,,,,,,,0.998625,,,fee schedule,,,,,,,,,,202.2714,90,percent of total billed charges,,,,213.5087,95,percent of total billed charges,,,1.02858375,,,fee schedule,,,45,,,fee schedule,,,45,,,fee schedule,,,,,,,,,0.998625,,,fee schedule,,,0.998625,598.1625,
COMPLEX REPAIR FACE 2.6-7.5,4503060,CDM,13132,CPT,450,RC,inpatient,,,,626.137,344.37535,,563.5233,90,percent of total billed charges,,,,626.137,100,percent of total billed charges,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,531.765,,,fee schedule,,,299.5875,,,fee schedule,,,299.5875,,,fee schedule,,,,,,,,,299.5875,,,fee schedule,,,,,,,,,,563.5233,90,percent of total billed charges,,,,594.83015,95,percent of total billed charges,,,308.575125,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,299.5875,,,fee schedule,,,297,626.137,
COMPLEX REPAIR FACE >7.5 + 5,4503133,CDM,13133,CPT,450,RC,inpatient,,,,326.716,179.6938,,294.0444,90,percent of total billed charges,,,,326.716,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,123.8295,,,fee schedule,,,123.8295,,,fee schedule,,,,,,,,,123.8295,,,fee schedule,,,,,,,,,,294.0444,90,percent of total billed charges,,,,310.3802,95,percent of total billed charges,,,127.544385,,,fee schedule,,,,,,,,,,,,,,,,,,,,,123.8295,,,fee schedule,,,123.8295,326.716,
EMERGENT INTUBATION,4503150,CDM,31500,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,190.2285,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,142.9731413,,,fee schedule,,,363,,,fee schedule,,,363,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,138.808875,363,
THORACENTESIS/NEEDLE CHEST W/O,4503242,CDM,32554,CPT,450,RC,inpatient,,,,746.544,410.5992,,671.8896,90,percent of total billed charges,,,,746.544,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,529.51725,,,fee schedule,,,86.880375,,,fee schedule,,,86.880375,,,fee schedule,,,,,,,,,86.880375,,,fee schedule,,,,,,,,,,671.8896,90,percent of total billed charges,,,,709.2168,95,percent of total billed charges,,,89.48678625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,86.880375,,,fee schedule,,,86.880375,746.544,
INSERT CHEST TUBE PNEUMOTHORAX,4503244,CDM,32554,CPT,450,RC,inpatient,,,,746.544,410.5992,,671.8896,90,percent of total billed charges,,,,746.544,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,529.51725,,,fee schedule,,,86.880375,,,fee schedule,,,86.880375,,,fee schedule,,,,,,,,,86.880375,,,fee schedule,,,,,,,,,,671.8896,90,percent of total billed charges,,,,709.2168,95,percent of total billed charges,,,89.48678625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,86.880375,,,fee schedule,,,86.880375,746.544,
TUBE THORACOSTOMY,4503255,CDM,32551,CPT,450,RC,inpatient,,,,1196.345,657.98975,,1076.7105,90,percent of total billed charges,,,,1196.345,100,percent of total billed charges,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,1361.87325,,,fee schedule,,,152.789625,,,fee schedule,,,152.789625,,,fee schedule,,,,,,,,,152.789625,,,fee schedule,,,,,,,,,,1076.7105,90,percent of total billed charges,,,,1136.52775,95,percent of total billed charges,,,157.3733138,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,152.789625,,,fee schedule,,,152.789625,1513.1925,
SHOULDER REDCUTION/W/MAN/WO/A,4503650,CDM,23650,CPT,450,RC,inpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,312.9025,,,fee schedule,,,312.9025,,,fee schedule,,,,,,,,,312.9025,,,fee schedule,,,,,,,,,,277.2657,90,percent of total billed charges,,,,292.66935,95,percent of total billed charges,,,322.289575,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,312.9025,,,fee schedule,,,189.489375,322.289575,
REPLACE G-TUBE W/O REVISION,4503762,CDM,43762,CPT,450,RC,inpatient,,,,331.866,182.5263,,298.6794,90,percent of total billed charges,,,,331.866,100,percent of total billed charges,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,196.678125,,,fee schedule,,,36.949125,,,fee schedule,,,36.949125,,,fee schedule,,,,,,,,,36.949125,,,fee schedule,,,,,,,,,,298.6794,90,percent of total billed charges,,,,315.2727,95,percent of total billed charges,,,38.05759875,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,36.949125,,,fee schedule,,,36.949125,331.866,
I&D UP ARM OR ELBOW ABSC/HEMAT,4503930,CDM,23930,CPT,450,RC,inpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,2364.53175,,,fee schedule,,,217.367375,,,fee schedule,,,217.367375,,,fee schedule,,,,,,,,,217.367375,,,fee schedule,,,,,,,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,95,percent of total billed charges,,,223.8883963,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,217.367375,,,fee schedule,,,217.367375,2627.2575,
FB REMOVAL ARM/ELBOW SQ,4504200,CDM,24200,CPT,450,RC,inpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1372.5855,,,fee schedule,,,143.13625,,,fee schedule,,,143.13625,,,fee schedule,,,,,,,,,143.13625,,,fee schedule,,,,,,,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,95,percent of total billed charges,,,147.4303375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,143.13625,,,fee schedule,,,143.13625,1600.414,
FB REMOVAL ARM/ELBOW DEEP,4504201,CDM,24201,CPT,450,RC,inpatient,,,,3053.229,1679.27595,,2747.9061,90,percent of total billed charges,,,,3053.229,100,percent of total billed charges,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,2364.53175,,,fee schedule,,,408.437625,,,fee schedule,,,408.437625,,,fee schedule,,,,,,,,,408.437625,,,fee schedule,,,,,,,,,,2747.9061,90,percent of total billed charges,,,,2900.56755,95,percent of total billed charges,,,420.6907538,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,408.437625,,,fee schedule,,,250,3053.229,
IRRIG CORPORA CAVERNOSA PRIAPI,4504220,CDM,54220,CPT,450,RC,inpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,196.678125,,,fee schedule,,,133.81575,,,fee schedule,,,133.81575,,,fee schedule,,,,,,,,,133.81575,,,fee schedule,,,,,,,,,,245.0061,90,percent of total billed charges,,,,258.61755,95,percent of total billed charges,,,137.8302225,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,133.81575,,,fee schedule,,,133.81575,272.229,
DENTAL BLOCK,4504400,CDM,64400,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,51.595625,,,fee schedule,,,51.595625,,,fee schedule,,,,,,,,,51.595625,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,53.14349375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,51.595625,,,fee schedule,,,51.595625,412.721,
DIGITAL BLOCK,4504450,CDM,64450,CPT,450,RC,inpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,589.78125,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,,,,,,,,590.5917,90,percent of total billed charges,,,,623.40235,95,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,41.609375,656.213,
PARAPHIMOSIS REDUCTION,4504451,CDM,,,450,RC,inpatient,,,,315.283,173.40565,,283.7547,90,percent of total billed charges,,,,315.283,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.7547,90,percent of total billed charges,,,,299.51885,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.7547,315.283,
CLSD TX HUMERAL SHAFT W/O MANI,4504500,CDM,24500,CPT,450,RC,inpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,348.853,,,fee schedule,,,348.853,,,fee schedule,,,,,,,,,348.853,,,fee schedule,,,,,,,,,,277.2657,90,percent of total billed charges,,,,292.66935,95,percent of total billed charges,,,359.31859,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,348.853,,,fee schedule,,,189.489375,359.31859,
POSTERIOR ELBOW REDUCTION,4504600,CDM,24600,CPT,450,RC,inpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,354.84475,,,fee schedule,,,354.84475,,,fee schedule,,,,,,,,,354.84475,,,fee schedule,,,,,,,,,,277.2657,90,percent of total billed charges,,,,292.66935,95,percent of total billed charges,,,365.4900925,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,354.84475,,,fee schedule,,,189.489375,365.4900925,
REDUCTION NURSEMAIDS ELBOW,4504640,CDM,24640,CPT,450,RC,inpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,80.55575,,,fee schedule,,,80.55575,,,fee schedule,,,,,,,,,80.55575,,,fee schedule,,,,,,,,,,277.2657,90,percent of total billed charges,,,,292.66935,95,percent of total billed charges,,,82.9724225,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,80.55575,,,fee schedule,,,80.55575,308.073,
INSERTION SUPRAPUBIC CATHETER,4505112,CDM,51102,CPT,450,RC,inpatient,,,,1924.246,1058.3353,,1731.8214,90,percent of total billed charges,,,,1924.246,100,percent of total billed charges,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,1697.82075,,,fee schedule,,,140.47325,,,fee schedule,,,140.47325,,,fee schedule,,,,,,,,,140.47325,,,fee schedule,,,,,,,,,,1731.8214,90,percent of total billed charges,,,,1828.0337,95,percent of total billed charges,,,144.6874475,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,140.47325,,,fee schedule,,,140.47325,1924.246,
BLADDER IRRIGATION,4505117,CDM,51700,CPT,450,RC,inpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,196.678125,,,fee schedule,,,29.625875,,,fee schedule,,,29.625875,,,fee schedule,,,,,,,,,29.625875,,,fee schedule,,,,,,,,,,245.0061,90,percent of total billed charges,,,,258.61755,95,percent of total billed charges,,,30.51465125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,29.625875,,,fee schedule,,,29.625875,272.229,
ANCHOR FOLEY CATH SIMPLE,4505170,CDM,51702,CPT,450,RC,inpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,24.965625,,,fee schedule,,,24.965625,,,fee schedule,,,,,,,,,24.965625,,,fee schedule,,,,,,,,,,59.8842,90,percent of total billed charges,,,,63.2111,95,percent of total billed charges,,,25.71459375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,24.965625,,,fee schedule,,,24.965625,250,
ANCHOR FOLEY CATH COMPLICATED,4505173,CDM,51703,CPT,450,RC,inpatient,,,,804.533,442.49315,,724.0797,90,percent of total billed charges,,,,804.533,100,percent of total billed charges,,,147.90375,,,fee schedule,,,147.90375,,,fee schedule,,,133.113375,,,fee schedule,,,75.22975,,,fee schedule,,,75.22975,,,fee schedule,,,,,,,,,75.22975,,,fee schedule,,,,,,,,,,724.0797,90,percent of total billed charges,,,,764.30635,95,percent of total billed charges,,,77.4866425,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,75.22975,,,fee schedule,,,75.22975,804.533,
REMV SUPERFICIAL SUBCONJUNC FB,4505205,CDM,65205,CPT,450,RC,inpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,29.4860675,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,28.62725,,,fee schedule,,,28.62725,250,
REMOVAL EMBEDDED SUBCONJUNCTIV,4505210,CDM,65210,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,345.596625,,,fee schedule,,,35.28475,,,fee schedule,,,35.28475,,,fee schedule,,,,,,,,,35.28475,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,36.3432925,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,35.28475,,,fee schedule,,,35.28475,412.721,
REMOVAL COREAL FB W/O SLIT LAM,4505220,CDM,65220,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,345.596625,,,fee schedule,,,40.943625,,,fee schedule,,,40.943625,,,fee schedule,,,,,,,,,40.943625,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,42.17193375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,40.943625,,,fee schedule,,,40.943625,412.721,
REMOVAL COREAL FB W/SLIT LAM,4505222,CDM,65222,CPT,450,RC,inpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,49.598375,,,fee schedule,,,49.598375,,,fee schedule,,,,,,,,,49.598375,,,fee schedule,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,51.08632625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,49.598375,,,fee schedule,,,49.598375,250,
CLSD TX COLLES FX W/ MANIP,4505605,CDM,25605,CPT,450,RC,inpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,1313.060625,,,fee schedule,,,526.60825,,,fee schedule,,,526.60825,,,fee schedule,,,,,,,,,526.60825,,,fee schedule,,,,,,,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,95,percent of total billed charges,,,542.4064975,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,526.60825,,,fee schedule,,,250,1600.414,
CLSD TX NAVICULAR FX W/O MANIP,4505622,CDM,25622,CPT,450,RC,inpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,296.9245,,,fee schedule,,,296.9245,,,fee schedule,,,,,,,,,296.9245,,,fee schedule,,,,,,,,,,277.2657,90,percent of total billed charges,,,,292.66935,95,percent of total billed charges,,,305.832235,,,fee schedule,,,,,,,,,,,,,,,,,,,,,296.9245,,,fee schedule,,,189.489375,308.073,
I&D VULVA/PERINEUM,4505640,CDM,56405,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,296.9325,,,fee schedule,,,296.9325,,,fee schedule,,,267.23925,,,fee schedule,,,128.156875,,,fee schedule,,,128.156875,,,fee schedule,,,,,,,,,128.156875,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,132.0015813,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,128.156875,,,fee schedule,,,128.156875,412.721,
I&D BARTHOLIN'S GLAND,4505642,CDM,56420,CPT,450,RC,inpatient,,,,159.032,87.4676,,143.1288,90,percent of total billed charges,,,,159.032,100,percent of total billed charges,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,163.042875,,,fee schedule,,,111.513125,,,fee schedule,,,111.513125,,,fee schedule,,,,,,,,,111.513125,,,fee schedule,,,,,,,,,,143.1288,90,percent of total billed charges,,,,151.0804,95,percent of total billed charges,,,114.8585188,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,111.513125,,,fee schedule,,,111.513125,250,
WRIST REDUCTION,4505660,CDM,25660,CPT,450,RC,inpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,463.694875,,,fee schedule,,,463.694875,,,fee schedule,,,,,,,,,463.694875,,,fee schedule,,,,,,,,,,277.2657,90,percent of total billed charges,,,,292.66935,95,percent of total billed charges,,,477.6057213,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,463.694875,,,fee schedule,,,189.489375,477.6057213,
MINOR LOCAL BURN TX,4506000,CDM,16000,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,45.271,,,fee schedule,,,45.271,,,fee schedule,,,,,,,,,45.271,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,46.62913,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,45.271,,,fee schedule,,,45.271,250,
I&D SIMPLE FINGER ABSCESS,4506010,CDM,26010,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,143.13625,,,fee schedule,,,143.13625,,,fee schedule,,,,,,,,,143.13625,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,147.4303375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,143.13625,,,fee schedule,,,143.13625,250,
DRESS/DEBRID P-THICK BURN SM,4506020,CDM,16020,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,55.923,,,fee schedule,,,55.923,,,fee schedule,,,,,,,,,55.923,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,57.60069,,,fee schedule,,,102,,,fee schedule,,,102,,,fee schedule,,,,,,,,,55.923,,,fee schedule,,,55.923,186.327,
DRESS/DEBRID P-THICK BURN MED,4506025,CDM,16025,CPT,450,RC,inpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,111.18025,,,fee schedule,,,111.18025,,,fee schedule,,,,,,,,,111.18025,,,fee schedule,,,,,,,,,,167.6943,90,percent of total billed charges,,,,177.01065,95,percent of total billed charges,,,114.5156575,,,fee schedule,,,205,,,fee schedule,,,205,,,fee schedule,,,,,,,,,111.18025,,,fee schedule,,,111.18025,205,
DRESS/DEBRID P-THICK BURN LGE,4506030,CDM,16030,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,341.47575,,,fee schedule,,,131.485625,,,fee schedule,,,131.485625,,,fee schedule,,,,,,,,,131.485625,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,135.4301938,,,fee schedule,,,308,,,fee schedule,,,308,,,fee schedule,,,,,,,,,131.485625,,,fee schedule,,,131.485625,412.721,
I&D PERIANAL ABCESS,4506050,CDM,46050,CPT,450,RC,inpatient,,,,3053.229,1679.27595,,2747.9061,90,percent of total billed charges,,,,3053.229,100,percent of total billed charges,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,760.671,,,fee schedule,,,102.192625,,,fee schedule,,,102.192625,,,fee schedule,,,,,,,,,102.192625,,,fee schedule,,,,,,,,,,2747.9061,90,percent of total billed charges,,,,2900.56755,95,percent of total billed charges,,,105.2584038,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,102.192625,,,fee schedule,,,102.192625,3053.229,
EPIDURAL INJ OF BLOOD PATCH,4506227,CDM,62273,CPT,450,RC,inpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,589.78125,,,fee schedule,,,112.178875,,,fee schedule,,,112.178875,,,fee schedule,,,,,,,,,112.178875,,,fee schedule,,,,,,,,,,590.5917,90,percent of total billed charges,,,,623.40235,95,percent of total billed charges,,,115.5442413,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,112.178875,,,fee schedule,,,112.178875,656.213,
FINGER EXTENSOR TENDON REPAIR,4506418,CDM,26418,CPT,450,RC,inpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,1313.060625,,,fee schedule,,,633.794,,,fee schedule,,,633.794,,,fee schedule,,,,,,,,,633.794,,,fee schedule,,,,,,,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,95,percent of total billed charges,,,652.80782,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,633.794,,,fee schedule,,,250,1600.414,
CENTRAL LINE INSERTION >5YRS,4506556,CDM,36556,CPT,450,RC,inpatient,,,,1196.345,657.98975,,1076.7105,90,percent of total billed charges,,,,1196.345,100,percent of total billed charges,,,3029.715,,,fee schedule,,,3029.715,,,fee schedule,,,2726.7435,,,fee schedule,,,82.885875,,,fee schedule,,,82.885875,,,fee schedule,,,,,,,,,82.885875,,,fee schedule,,,,,,,,,,1076.7105,90,percent of total billed charges,,,,1136.52775,95,percent of total billed charges,,,85.37245125,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,82.885875,,,fee schedule,,,82.885875,3029.715,
COLLECTION BLOOD VAD,4506591,CDM,36591,CPT,450,RC,inpatient,,,,1111.885,611.53675,,1000.6965,90,percent of total billed charges,,,,1111.885,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,27.628625,,,fee schedule,,,27.628625,,,fee schedule,,,,,,,,,27.628625,,,fee schedule,,,,,,,,,,1000.6965,90,percent of total billed charges,,,,1056.29075,95,percent of total billed charges,,,28.45748375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,27.628625,,,fee schedule,,,27.628625,1111.885,
CLCT BLOOD CENT OR PERIPH CATH,4506592,CDM,36592,CPT,450,RC,inpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,106.282125,,,fee schedule,,,29.95875,,,fee schedule,,,29.95875,,,fee schedule,,,,,,,,,29.95875,,,fee schedule,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,30.8575125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,29.95875,,,fee schedule,,,29.95875,118.09125,
THUMB REDUCTION,4506641,CDM,26641,CPT,450,RC,inpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,396.787,,,fee schedule,,,396.787,,,fee schedule,,,,,,,,,396.787,,,fee schedule,,,,,,,,,,277.2657,90,percent of total billed charges,,,,292.66935,95,percent of total billed charges,,,408.69061,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,396.787,,,fee schedule,,,189.489375,408.69061,
REDUCTION FINGER IP,4506770,CDM,26770,CPT,450,RC,inpatient,,,,747.059,410.88245,,672.3531,90,percent of total billed charges,,,,747.059,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,274.621875,,,fee schedule,,,274.621875,,,fee schedule,,,,,,,,,274.621875,,,fee schedule,,,,,,,,,,672.3531,90,percent of total billed charges,,,,709.70605,95,percent of total billed charges,,,282.8605313,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,274.621875,,,fee schedule,,,189.489375,747.059,
CERUMEN IMPACTION W/IRRIGATION,4506920,CDM,69209,CPT,450,RC,inpatient,,,,30.076,16.5418,,27.0684,90,percent of total billed charges,,,,30.076,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,52.6095,,,fee schedule,,,15.978,,,fee schedule,,,15.978,,,fee schedule,,,,,,,,,15.978,,,fee schedule,,,,,,,,,,27.0684,90,percent of total billed charges,,,,28.5722,95,percent of total billed charges,,,16.45734,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,15.978,,,fee schedule,,,15.978,250,
REDUCTION HIP TRAUMA,4507250,CDM,27250,CPT,450,RC,inpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,178.753875,,,fee schedule,,,178.753875,,,fee schedule,,,,,,,,,178.753875,,,fee schedule,,,,,,,,,,245.0061,90,percent of total billed charges,,,,258.61755,95,percent of total billed charges,,,184.1164913,,,fee schedule,,,,,,,,,,,,,,,,,,,,,178.753875,,,fee schedule,,,178.753875,272.229,
I&D THIGH OR KNEE,4507301,CDM,27301,CPT,450,RC,inpatient,,,,3053.229,1679.27595,,2747.9061,90,percent of total billed charges,,,,3053.229,100,percent of total billed charges,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,2364.53175,,,fee schedule,,,515.623375,,,fee schedule,,,515.623375,,,fee schedule,,,,,,,,,515.623375,,,fee schedule,,,,,,,,,,2747.9061,90,percent of total billed charges,,,,2900.56755,95,percent of total billed charges,,,531.0920763,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,515.623375,,,fee schedule,,,250,3053.229,
REDUCTION KNEE,4507550,CDM,27550,CPT,450,RC,inpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,483.001625,,,fee schedule,,,483.001625,,,fee schedule,,,,,,,,,483.001625,,,fee schedule,,,,,,,,,,245.0061,90,percent of total billed charges,,,,258.61755,95,percent of total billed charges,,,497.4916738,,,fee schedule,,,,,,,,,,,,,,,,,,,,,483.001625,,,fee schedule,,,189.489375,497.4916738,
REDUCTION KNEE PATELLA,4507560,CDM,27560,CPT,450,RC,inpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,354.179,,,fee schedule,,,354.179,,,fee schedule,,,,,,,,,354.179,,,fee schedule,,,,,,,,,,245.0061,90,percent of total billed charges,,,,258.61755,95,percent of total billed charges,,,364.80437,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,354.179,,,fee schedule,,,189.489375,364.80437,
REDUCTION ANKLE,4507840,CDM,27840,CPT,450,RC,inpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,399.45,,,fee schedule,,,399.45,,,fee schedule,,,,,,,,,399.45,,,fee schedule,,,,,,,,,,245.0061,90,percent of total billed charges,,,,258.61755,95,percent of total billed charges,,,411.4335,,,fee schedule,,,,,,,,,,,,,,,,,,,,,399.45,,,fee schedule,,,189.489375,411.4335,
REMOVAL FB EYELID,4507938,CDM,67938,CPT,450,RC,inpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,269.22375,,,fee schedule,,,269.22375,,,fee schedule,,,242.301375,,,fee schedule,,,116.839125,,,fee schedule,,,116.839125,,,fee schedule,,,,,,,,,116.839125,,,fee schedule,,,,,,,,,,371.4489,90,percent of total billed charges,,,,392.08495,95,percent of total billed charges,,,120.3442988,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,116.839125,,,fee schedule,,,116.839125,412.721,
FOREIGN BODY REM SQ FOOT,4508190,CDM,28190,CPT,450,RC,inpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,594.023625,,,fee schedule,,,133.15,,,fee schedule,,,133.15,,,fee schedule,,,,,,,,,133.15,,,fee schedule,,,,,,,,,,590.5917,90,percent of total billed charges,,,,623.40235,95,percent of total billed charges,,,137.1445,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,133.15,,,fee schedule,,,133.15,660.02625,
FOREIGN BODY REM FOOT DEEP,4508192,CDM,28192,CPT,450,RC,inpatient,,,,1600.723,880.39765,,1440.6507,90,percent of total billed charges,,,,1600.723,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1372.5855,,,fee schedule,,,312.23675,,,fee schedule,,,312.23675,,,fee schedule,,,,,,,,,312.23675,,,fee schedule,,,,,,,,,,1440.6507,90,percent of total billed charges,,,,1520.68685,95,percent of total billed charges,,,321.6038525,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,312.23675,,,fee schedule,,,250,1600.723,
REDUCTION TOE MP,4508630,CDM,28630,CPT,450,RC,inpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,189.489375,,,fee schedule,,,112.178875,,,fee schedule,,,112.178875,,,fee schedule,,,,,,,,,112.178875,,,fee schedule,,,,,,,,,,245.0061,90,percent of total billed charges,,,,258.61755,95,percent of total billed charges,,,115.5442413,,,fee schedule,,,,,,,,,,,,,,,,,,,,,112.178875,,,fee schedule,,,112.178875,272.229,
IV PUSH SEQUENT SAME MED - ER,4509077,CDM,96376,CPT,450,RC,inpatient,,,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,29.295,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.2086,90,percent of total billed charges,,,,21.3313,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.2086,32.55,
ABD PARACENTESIS W/O IMA GUIDE,4509082,CDM,49082,CPT,450,RC,inpatient,,,,889.817,489.39935,,800.8353,90,percent of total billed charges,,,,889.817,100,percent of total billed charges,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,755.618625,,,fee schedule,,,72.56675,,,fee schedule,,,72.56675,,,fee schedule,,,,,,,,,72.56675,,,fee schedule,,,,,,,,,,800.8353,90,percent of total billed charges,,,,845.32615,95,percent of total billed charges,,,74.7437525,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,72.56675,,,fee schedule,,,72.56675,889.817,
LONG ARM SPLINT,4509105,CDM,29105,CPT,450,RC,inpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,133.417125,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,,,,,,,,128.9457,90,percent of total billed charges,,,,136.10935,95,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,41.609375,250,
MOD SED INITIAL 15 MIN UNDER 5,4509151,CDM,99151,CPT,450,RC,inpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,23.634125,,,fee schedule,,,23.634125,,,fee schedule,,,,,,,,,23.634125,,,fee schedule,,,,,,,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,24.34314875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,23.634125,,,fee schedule,,,23.634125,57.371,
MOD SED INITIAL 15 MIN OVER 5,4509152,CDM,99152,CPT,450,RC,inpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,11.9835,,,fee schedule,,,11.9835,,,fee schedule,,,,,,,,,11.9835,,,fee schedule,,,,,,,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,12.343005,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.9835,,,fee schedule,,,11.9835,57.371,
MOD SED EA ADD'L 15 MINUTES,4509153,CDM,99153,CPT,450,RC,inpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,11.650625,,,fee schedule,,,11.650625,,,fee schedule,,,,,,,,,11.650625,,,fee schedule,,,,,,,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,12.00014375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.650625,,,fee schedule,,,11.650625,57.371,
CARDIOPULMONARY RESUSCITATION,4509295,CDM,92950,CPT,450,RC,inpatient,,,,233.707,128.53885,,210.3363,90,percent of total billed charges,,,,233.707,100,percent of total billed charges,,,284.8275,,,fee schedule,,,284.8275,,,fee schedule,,,256.34475,,,fee schedule,,,180.085375,,,fee schedule,,,180.085375,,,fee schedule,,,,,,,,,180.085375,,,fee schedule,,,,,,,,,,210.3363,90,percent of total billed charges,,,,222.02165,95,percent of total billed charges,,,185.4879363,,,fee schedule,,,,,,,,,,,,,,,,,,,,,180.085375,,,fee schedule,,,180.085375,284.8275,
CARDIOVERSION; EXTERNAL,4509296,CDM,92960,CPT,450,RC,inpatient,,,,705.035,387.76925,,634.5315,90,percent of total billed charges,,,,705.035,100,percent of total billed charges,,,598.1625,,,fee schedule,,,598.1625,,,fee schedule,,,538.34625,,,fee schedule,,,105.85425,,,fee schedule,,,105.85425,,,fee schedule,,,,,,,,,105.85425,,,fee schedule,,,,,,,,,,634.5315,90,percent of total billed charges,,,,669.78325,95,percent of total billed charges,,,109.0298775,,,fee schedule,,,76,,,fee schedule,,,76,,,fee schedule,,,,,,,,,105.85425,,,fee schedule,,,76,705.035,
AIRWAY INHALATION TXT ER,4509464,CDM,94640,CPT,450,RC,inpatient,,,,196.009,107.80495,,176.4081,90,percent of total billed charges,,,,196.009,100,percent of total billed charges,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,163.5984,,,fee schedule,,,7.989,,,fee schedule,,,7.989,,,fee schedule,,,,,,,,,7.989,,,fee schedule,,,,,,,,,,176.4081,90,percent of total billed charges,,,,186.20855,95,percent of total billed charges,,,8.22867,,,fee schedule,,,6,,,fee schedule,,,6,,,fee schedule,,,,,,,,,7.989,,,fee schedule,,,6,196.009,
ANKLE/FOOT STRAPPING,4509540,CDM,29540,CPT,450,RC,inpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,133.417125,,,fee schedule,,,16.976625,,,fee schedule,,,16.976625,,,fee schedule,,,,,,,,,16.976625,,,fee schedule,,,,,,,,,,128.9457,90,percent of total billed charges,,,,136.10935,95,percent of total billed charges,,,17.48592375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,16.976625,,,fee schedule,,,16.976625,250,
IRRIGATION IMPLANTED VAD,4509652,CDM,96523,CPT,450,RC,inpatient,,,,73.748,40.5614,,66.3732,90,percent of total billed charges,,,,73.748,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,49.1022,,,fee schedule,,,24.965625,,,fee schedule,,,24.965625,,,fee schedule,,,,,,,,,24.965625,,,fee schedule,,,,,,,,,,66.3732,90,percent of total billed charges,,,,70.0606,95,percent of total billed charges,,,25.71459375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.965625,,,fee schedule,,,24.965625,73.748,
DBRDMT OPEN WND 1ST 20CM<SELEC,4509795,CDM,97597,CPT,450,RC,inpatient,,,,150.38,82.709,,135.342,90,percent of total billed charges,,,,150.38,100,percent of total billed charges,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,161.6175,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,,,,,,,,135.342,90,percent of total billed charges,,,,142.861,95,percent of total billed charges,,,36.00043125,,,fee schedule,,,24.06,,,fee schedule,,,24.06,,,fee schedule,,,,,,,,,34.951875,,,fee schedule,,,24.06,179.575,
UNLISTD CASTING/STRAPPING PROC,4509799,CDM,29799,CPT,450,RC,inpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,133.417125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.9457,90,percent of total billed charges,,,,136.10935,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.9457,148.24125,
ER MINOR PROCEDURE,4509999,CDM,,,450,RC,inpatient,,,,151.101,83.10555,,135.9909,90,percent of total billed charges,,,,151.101,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,135.9909,90,percent of total billed charges,,,,143.54595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,135.9909,151.101,
OB - EMERGENT CARE ASSESSMENT,3100015,CDM,,,451,RC,inpatient,,,,23.896,13.1428,,21.5064,90,percent of total billed charges,,,,23.896,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.5064,90,percent of total billed charges,,,,22.7012,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.5064,23.896,
ER FACILITY -  ASSESS/SCREEN,4500015,CDM,,,451,RC,inpatient,,,,139.359,76.64745,,125.4231,90,percent of total billed charges,,,,139.359,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.4231,90,percent of total billed charges,,,,132.39105,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125.4231,139.359,
OB - NON EMERGENT CARE,3100459,CDM,,,459,RC,inpatient,,,,107.532,59.1426,,96.7788,90,percent of total billed charges,,,,107.532,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.7788,90,percent of total billed charges,,,,102.1554,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.7788,107.532,
PFT SPIROMETRY PRE/POST,4600010,CDM,94060,CPT,460,RC,inpatient,,,,293.447,161.39585,,264.1023,90,percent of total billed charges,,,,293.447,100,percent of total billed charges,,,265.839,,,fee schedule,,,265.839,,,fee schedule,,,239.2551,,,fee schedule,,,38.946375,,,fee schedule,,,38.946375,,,fee schedule,,,,,,,,,38.946375,,,fee schedule,,,,,,,,,,264.1023,90,percent of total billed charges,,,,278.77465,95,percent of total billed charges,,,40.11476625,,,fee schedule,,,39,,,fee schedule,,,39,,,fee schedule,,,,,,,,,38.946375,,,fee schedule,,,38.946375,293.447,
PFT SIMPLE SPIROMETRY,4600020,CDM,94010,CPT,460,RC,inpatient,,,,154.809,85.14495,,139.3281,90,percent of total billed charges,,,,154.809,100,percent of total billed charges,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,124.23915,,,fee schedule,,,27.29575,,,fee schedule,,,27.29575,,,fee schedule,,,,,,,,,27.29575,,,fee schedule,,,,,,,,,,139.3281,90,percent of total billed charges,,,,147.06855,95,percent of total billed charges,,,28.1146225,,,fee schedule,,,24,,,fee schedule,,,24,,,fee schedule,,,,,,,,,27.29575,,,fee schedule,,,24,154.809,
INCENTIVE SPIROMETRY,4609420,CDM,94200,CPT,460,RC,inpatient,,,,57.989,31.89395,,52.1901,90,percent of total billed charges,,,,57.989,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,49.1022,,,fee schedule,,,14.979375,,,fee schedule,,,14.979375,,,fee schedule,,,,,,,,,14.979375,,,fee schedule,,,,,,,,,,52.1901,90,percent of total billed charges,,,,55.08955,95,percent of total billed charges,,,15.42875625,,,fee schedule,,,16,,,fee schedule,,,16,,,fee schedule,,,,,,,,,14.979375,,,fee schedule,,,14.979375,57.989,
"PULSE OXIMETRY, SINGLE",4690000,CDM,94760,CPT,460,RC,inpatient,,,,46.865,25.77575,,42.1785,90,percent of total billed charges,,,,46.865,100,percent of total billed charges,,,2.13,,,fee schedule,,,2.13,,,fee schedule,,,1.917,,,fee schedule,,,2.663,,,fee schedule,,,2.663,,,fee schedule,,,,,,,,,2.663,,,fee schedule,,,,,,,,,,42.1785,90,percent of total billed charges,,,,44.52175,95,percent of total billed charges,,,2.74289,,,fee schedule,,,28,,,fee schedule,,,28,,,fee schedule,,,,,,,,,2.663,,,fee schedule,,,1.917,46.865,
"PULSE OX, CONTINOUS OVERNIGHT",4690040,CDM,94762,CPT,460,RC,inpatient,,,,320.948,176.5214,,288.8532,90,percent of total billed charges,,,,320.948,100,percent of total billed charges,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,124.23915,,,fee schedule,,,25.2985,,,fee schedule,,,25.2985,,,fee schedule,,,,,,,,,25.2985,,,fee schedule,,,,,,,,,,288.8532,90,percent of total billed charges,,,,304.9006,95,percent of total billed charges,,,26.057455,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.2985,,,fee schedule,,,25.2985,320.948,
AEP SCR AUDITORY POTENTIAL,4710000,CDM,92650,CPT,471,RC,inpatient,,,,129.677,71.32235,,116.7093,90,percent of total billed charges,,,,129.677,100,percent of total billed charges,,,144.0246178,,,fee schedule,,,144.0246178,,,fee schedule,,,129.622156,,,fee schedule,,,26.962875,,,fee schedule,,,26.962875,,,fee schedule,,,,,,,,,26.962875,,,fee schedule,,,,,,,,,,116.7093,90,percent of total billed charges,,,,123.19315,95,percent of total billed charges,,,27.77176125,,,fee schedule,,,28.74,,,fee schedule,,,28.74,,,fee schedule,,,,,,,,,26.962875,,,fee schedule,,,26.962875,144.0246178,
CARDIAC OUTPUT/DAILY - ICU,7390020,CDM,93598,CPT,480,RC,inpatient,,,,48.513,26.68215,,43.6617,90,percent of total billed charges,,,,48.513,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.6617,90,percent of total billed charges,,,,46.08735,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.6617,48.513,
CARDIAC STRESS TEST(TREADMILL),4820000,CDM,93017,CPT,482,RC,inpatient,,,,322.699,177.48445,,290.4291,90,percent of total billed charges,,,,322.699,100,percent of total billed charges,,,265.839,,,fee schedule,,,265.839,,,fee schedule,,,239.2551,,,fee schedule,,,37.614875,,,fee schedule,,,37.614875,,,fee schedule,,,,,,,,,37.614875,,,fee schedule,,,,,,,,,,290.4291,90,percent of total billed charges,,,,306.56405,95,percent of total billed charges,,,38.74332125,,,fee schedule,,,61,,,fee schedule,,,61,,,fee schedule,,,,,,,,,37.614875,,,fee schedule,,,37.614875,322.699,
TTE W DOPPLER COMPLETE,4803306,CDM,93306,CPT,483,RC,inpatient,,,,1450.755,797.91525,,1305.6795,90,percent of total billed charges,,,,1450.755,100,percent of total billed charges,,,477.582,,,fee schedule,,,477.582,,,fee schedule,,,429.8238,,,fee schedule,,,196.063375,,,fee schedule,,,196.063375,,,fee schedule,,,,,,,,,196.063375,,,fee schedule,,,,,,,,,,1305.6795,90,percent of total billed charges,,,,1378.21725,95,percent of total billed charges,,,201.9452763,,,fee schedule,,,257.51,,,fee schedule,,,257.51,,,fee schedule,,,,,,,,,196.063375,,,fee schedule,,,196.063375,1450.755,
OUTPT ESTABLILSHED LOW MDM 20,5100020,CDM,99213,CPT,510,RC,inpatient,,,,102.691,56.48005,,92.4219,90,percent of total billed charges,,,,102.691,100,percent of total billed charges,,,74.12,,,fee schedule,,,74.12,,,fee schedule,,,66.708,,,fee schedule,,,65.2435,,,fee schedule,,,65.2435,,,fee schedule,,,,,,,,,65.2435,,,fee schedule,,,,,,,,,,92.4219,90,percent of total billed charges,,,,97.55645,95,percent of total billed charges,,,67.200805,,,fee schedule,,,,,,,,,,,,,,,,,,,,,65.2435,,,fee schedule,,,65.2435,102.691,
TRIGGER POINT 1-2,5100552,CDM,20552,CPT,510,RC,inpatient,,,,657.346,361.5403,,591.6114,90,percent of total billed charges,,,,657.346,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,591.6114,90,percent of total billed charges,,,,624.4787,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,36.61625,657.346,
TRIGGER POINT 3+ FACILITY,5100553,CDM,20553,CPT,510,RC,inpatient,,,,657.2842,361.50631,,591.55578,90,percent of total billed charges,,,,657.2842,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,,,,,,,,591.55578,90,percent of total billed charges,,,,624.41999,95,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,41.609375,657.2842,
SMALL JOINT /BURSA TECH COMP,5100600,CDM,20600,CPT,510,RC,inpatient,,,,632.008,347.6044,,568.8072,90,percent of total billed charges,,,,632.008,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,35.617625,,,fee schedule,,,35.617625,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,,,,,,,,568.8072,90,percent of total billed charges,,,,600.4076,95,percent of total billed charges,,,36.68615375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,35.617625,632.008,
Inter Joint/ Bursa Facility,5100605,CDM,20605,CPT,510,RC,inpatient,,,,551.05,303.0775,,495.945,90,percent of total billed charges,,,,551.05,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,248.8725,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,,,,,,,495.945,90,percent of total billed charges,,,,523.4975,95,percent of total billed charges,,,37.7147375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,36.61625,551.05,
Inj Interlaminar Lum/Spine,5102323,CDM,62323,CPT,510,RC,inpatient,,,,1762.021,969.11155,,1585.8189,90,percent of total billed charges,,,,1762.021,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,589.78125,,,fee schedule,,,98.531,,,fee schedule,,,98.531,,,fee schedule,,,,,,,,,98.531,,,fee schedule,,,,,,,,,,1585.8189,90,percent of total billed charges,,,,1673.91995,95,percent of total billed charges,,,101.48693,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,98.531,,,fee schedule,,,98.531,1762.021,
INJ ANEST AGENT/ STEROID EPI,5104483,CDM,64483,CPT,510,RC,inpatient,,,,1361.66,748.913,,1225.494,90,percent of total billed charges,,,,1361.66,100,percent of total billed charges,,,866.68875,,,fee schedule,,,866.68875,,,fee schedule,,,780.019875,,,fee schedule,,,110.5145,,,fee schedule,,,110.5145,,,fee schedule,,,,,,,,,110.5145,,,fee schedule,,,,,,,,,,1225.494,90,percent of total billed charges,,,,1293.577,95,percent of total billed charges,,,113.829935,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,110.5145,,,fee schedule,,,110.5145,1361.66,
INJ ANESTHETIC ADDL LEVEL FAC,5104484,CDM,64484,CPT,510,RC,inpatient,,,,429.819,236.40045,,386.8371,90,percent of total billed charges,,,,429.819,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,50.929875,,,fee schedule,,,50.929875,,,fee schedule,,,,,,,,,50.929875,,,fee schedule,,,,,,,,,,386.8371,90,percent of total billed charges,,,,408.32805,95,percent of total billed charges,,,52.45777125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,50.929875,,,fee schedule,,,50.929875,429.819,
INJ FIRST FACET 1 LEVEL,5104493,CDM,64493,CPT,510,RC,inpatient,,,,1221.683,671.92565,,1099.5147,90,percent of total billed charges,,,,1221.683,100,percent of total billed charges,,,866.68875,,,fee schedule,,,866.68875,,,fee schedule,,,780.019875,,,fee schedule,,,89.87625,,,fee schedule,,,89.87625,,,fee schedule,,,,,,,,,89.87625,,,fee schedule,,,,,,,,,,1099.5147,90,percent of total billed charges,,,,1160.59885,95,percent of total billed charges,,,92.5725375,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,89.87625,,,fee schedule,,,89.87625,1221.683,
INJ PARAVERT F JNT L/S 2 LEVEL,5104494,CDM,64494,CPT,510,RC,inpatient,,,,1221.683,671.92565,,1099.5147,90,percent of total billed charges,,,,1221.683,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,50.264125,,,fee schedule,,,50.264125,,,fee schedule,,,,,,,,,50.264125,,,fee schedule,,,,,,,,,,1099.5147,90,percent of total billed charges,,,,1160.59885,95,percent of total billed charges,,,51.77204875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,50.264125,,,fee schedule,,,50.264125,1221.683,
INJ PARAVERT F JNT L/S 3 LEVEL,5104495,CDM,64495,CPT,510,RC,inpatient,,,,275.525,151.53875,,247.9725,90,percent of total billed charges,,,,275.525,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,51.26275,,,fee schedule,,,51.26275,,,fee schedule,,,,,,,,,51.26275,,,fee schedule,,,,,,,,,,247.9725,90,percent of total billed charges,,,,261.74875,95,percent of total billed charges,,,52.8006325,,,fee schedule,,,,,,,,,,,,,,,,,,,,,51.26275,,,fee schedule,,,51.26275,275.525,
DESTROY LUMB/SAC FACET JOINT,5104635,CDM,64635,CPT,510,RC,inpatient,,,,4308.284,2369.5562,,3877.4556,90,percent of total billed charges,,,,4308.284,100,percent of total billed charges,,,1828.1475,,,fee schedule,,,1828.1475,,,fee schedule,,,1645.33275,,,fee schedule,,,191.403125,,,fee schedule,,,191.403125,,,fee schedule,,,,,,,,,191.403125,,,fee schedule,,,,,,,,,,3877.4556,90,percent of total billed charges,,,,4092.8698,95,percent of total billed charges,,,197.1452188,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,191.403125,,,fee schedule,,,191.403125,4308.284,
DSTR NROLYTC AGNT PARVERT ADDL,5104636,CDM,64636,CPT,510,RC,inpatient,,,,1503.285,826.80675,,1352.9565,90,percent of total billed charges,,,,1503.285,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,57.92025,,,fee schedule,,,57.92025,,,fee schedule,,,,,,,,,57.92025,,,fee schedule,,,,,,,,,,1352.9565,90,percent of total billed charges,,,,1428.12075,95,percent of total billed charges,,,59.6578575,,,fee schedule,,,,,,,,,,,,,,,,,,,,,57.92025,,,fee schedule,,,57.92025,1503.285,
CIRCUMCISION - OUTPATIENT,5105416,CDM,54150,CPT,510,RC,inpatient,,,,2219.65,1220.8075,,1997.685,90,percent of total billed charges,,,,2219.65,100,percent of total billed charges,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,1697.82075,,,fee schedule,,,94.869375,,,fee schedule,,,94.869375,,,fee schedule,,,,,,,,,94.869375,,,fee schedule,,,,,,,,,,1997.685,90,percent of total billed charges,,,,2108.6675,95,percent of total billed charges,,,97.71545625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,94.869375,,,fee schedule,,,94.869375,2219.65,
INJ SACROILIAC JOINT ANES STER,5107096,CDM,G0260,HCPCS,510,RC,inpatient,,,,749.634,412.2987,,674.6706,90,percent of total billed charges,,,,749.634,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,674.6706,90,percent of total billed charges,,,,712.1523,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,674.6706,749.634,
OFFICE VISIT EXP PROBLEM 15-29,5109202,CDM,99202,CPT,510,RC,inpatient,,,,515,283.25,,463.5,90,percent of total billed charges,,,,515,100,percent of total billed charges,,,49.05,,,fee schedule,,,49.05,,,fee schedule,,,44.145,,,fee schedule,,,46.935375,,,fee schedule,,,46.935375,,,fee schedule,,,,,,,,,46.935375,,,fee schedule,,,,,,,,,,463.5,90,percent of total billed charges,,,,489.25,95,percent of total billed charges,,,48.34343625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.935375,,,fee schedule,,,44.145,515,
INJ AA& STRD OTHER PERIPH NERV,7614450,CDM,64450,CPT,510,RC,inpatient,,,,1566.218,861.4199,,1409.5962,90,percent of total billed charges,,,,1566.218,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,589.78125,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,,,,,,,,1409.5962,90,percent of total billed charges,,,,1487.9071,95,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,41.609375,1566.218,
ALS 2 EMERGENCY - RUN #1,5400000,CDM,A0433,HCPCS,540,RC,inpatient,,,,2126.847,1169.76585,,1914.1623,90,percent of total billed charges,,,,2126.847,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1914.1623,90,percent of total billed charges,,,,2020.50465,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1914.1623,2126.847,
ALS 2 EMERGENCY - RUN #2,5400001,CDM,A0433,HCPCS,540,RC,inpatient,,,,706.889,388.78895,,636.2001,90,percent of total billed charges,,,,706.889,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,636.2001,90,percent of total billed charges,,,,671.54455,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,636.2001,706.889,
ALS 1 EMERGENCY - RUN #1,5400010,CDM,A0427,HCPCS,540,RC,inpatient,,,,1469.089,807.99895,,1322.1801,90,percent of total billed charges,,,,1469.089,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1322.1801,90,percent of total billed charges,,,,1395.63455,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1322.1801,1469.089,
ALS 1 EMERGENCY - RUN #2,5400011,CDM,A0427,HCPCS,540,RC,inpatient,,,,1805.281,992.90455,,1624.7529,90,percent of total billed charges,,,,1805.281,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1624.7529,90,percent of total billed charges,,,,1715.01695,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1624.7529,1805.281,
ALS MILEAGE - RUN #1,5400050,CDM,A0425,HCPCS,540,RC,inpatient,,,QN,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,90,percent of total billed charges,,,,24.56035,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.2677,25.853,
ALS MILEAGE - RUN #2,5400050.1,CDM,A0425,HCPCS,540,RC,inpatient,,,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,90,percent of total billed charges,,,,23.97325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,25.235,
ALS1 NON-EMERGENCY - RUN #1,5400070,CDM,A0426,HCPCS,540,RC,inpatient,,,,853.973,469.68515,,768.5757,90,percent of total billed charges,,,,853.973,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,768.5757,90,percent of total billed charges,,,,811.27435,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,768.5757,853.973,
ALS1 NON-EMERGENCY - RUN #2,5400071,CDM,A0426,HCPCS,540,RC,inpatient,,,,853.973,469.68515,,768.5757,90,percent of total billed charges,,,,853.973,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,768.5757,90,percent of total billed charges,,,,811.27435,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,768.5757,853.973,
BLS NON-EMERGENCY - RUN #1,5400090,CDM,A0428,HCPCS,540,RC,inpatient,,,,773.427,425.38485,,696.0843,90,percent of total billed charges,,,,773.427,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,696.0843,90,percent of total billed charges,,,,734.75565,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,696.0843,773.427,
BLS MILEAGE - RUN #1,5400091,CDM,A0425,HCPCS,540,RC,inpatient,,,QN,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,90,percent of total billed charges,,,,23.97325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.7115,25.235,
BLS NON-EMERGENCY - RUN #2,5400092,CDM,A0428,HCPCS,540,RC,inpatient,,,,773.427,425.38485,,696.0843,90,percent of total billed charges,,,,773.427,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,696.0843,90,percent of total billed charges,,,,734.75565,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,696.0843,773.427,
BLS MILEAGE - RUN #2,5400093,CDM,A0425,HCPCS,540,RC,inpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,90,percent of total billed charges,,,,13.699,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.978,14.42,
HH - PRIVATE DUTY RN - HOURLY,5500070,CDM,S9123,HCPCS,551,RC,inpatient,,,,65.096,35.8028,,58.5864,90,percent of total billed charges,,,,65.096,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.5864,90,percent of total billed charges,,,,61.8412,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.5864,65.096,
HH - RN SUPERVISORY VISIT,5500071,CDM,S9123,HCPCS,551,RC,inpatient,,,U1,64.272,35.3496,,57.8448,90,percent of total billed charges,,,,64.272,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.8448,90,percent of total billed charges,,,,61.0584,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.8448,64.272,
HH - PRIVATE DUTY LPN - HOURLY,5500080,CDM,S9124,HCPCS,551,RC,inpatient,,,,45.835,25.20925,,41.2515,90,percent of total billed charges,,,,45.835,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.2515,90,percent of total billed charges,,,,43.54325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.2515,45.835,
"MRI,ABDOMEN",6100000,CDM,74181,CPT,610,RC,inpatient,,,,2344.898,1289.6939,,2110.4082,90,percent of total billed charges,,,,2344.898,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,201.0565,,,fee schedule,,,201.0565,,,fee schedule,,,,,,,,,201.0565,,,fee schedule,,,,,,,,,,2110.4082,90,percent of total billed charges,,,,2227.6531,95,percent of total billed charges,,,207.088195,,,fee schedule,,,409,,,fee schedule,,,409,,,fee schedule,,,,,,,,,201.0565,,,fee schedule,,,201.0565,2344.898,
MRA HEAD W/O CONTRAST,6100025,CDM,70544,CPT,610,RC,inpatient,,,,1585.891,872.24005,,1427.3019,90,percent of total billed charges,,,,1585.891,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,221.361875,,,fee schedule,,,221.361875,,,fee schedule,,,,,,,,,221.361875,,,fee schedule,,,,,,,,,,1427.3019,90,percent of total billed charges,,,,1506.59645,95,percent of total billed charges,,,228.0027313,,,fee schedule,,,435.78,,,fee schedule,,,435.78,,,fee schedule,,,,,,,,,221.361875,,,fee schedule,,,201.357,1585.891,
"MRI,ABDOMEN WO/W GAD",6100122,CDM,74183,CPT,610,RC,inpatient,,,,2297.312,1263.5216,,2067.5808,90,percent of total billed charges,,,,2297.312,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,347.188625,,,fee schedule,,,347.188625,,,fee schedule,,,,,,,,,347.188625,,,fee schedule,,,,,,,,,,2067.5808,90,percent of total billed charges,,,,2182.4464,95,percent of total billed charges,,,357.6042838,,,fee schedule,,,955.2,,,fee schedule,,,955.2,,,fee schedule,,,,,,,,,347.188625,,,fee schedule,,,329.931,2297.312,
"MRI,PELVIS; W/O CONTRAST",6100245,CDM,72195,CPT,610,RC,inpatient,,,,1327.979,730.38845,,1195.1811,90,percent of total billed charges,,,,1327.979,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,235.342625,,,fee schedule,,,235.342625,,,fee schedule,,,,,,,,,235.342625,,,fee schedule,,,,,,,,,,1195.1811,90,percent of total billed charges,,,,1261.58005,95,percent of total billed charges,,,242.4029038,,,fee schedule,,,431.29,,,fee schedule,,,431.29,,,fee schedule,,,,,,,,,235.342625,,,fee schedule,,,201.357,1327.979,
"MRI,PELVIS; WO/W GAD",6100246,CDM,72197,CPT,610,RC,inpatient,,,,2297.312,1263.5216,,2067.5808,90,percent of total billed charges,,,,2297.312,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,345.857125,,,fee schedule,,,345.857125,,,fee schedule,,,,,,,,,345.857125,,,fee schedule,,,,,,,,,,2067.5808,90,percent of total billed charges,,,,2182.4464,95,percent of total billed charges,,,356.2328388,,,fee schedule,,,955.2,,,fee schedule,,,955.2,,,fee schedule,,,,,,,,,345.857125,,,fee schedule,,,329.931,2297.312,
MRA NECK W/O CONTRAST,6100312,CDM,70547,CPT,610,RC,inpatient,,,,1012.387,556.81285,,911.1483,90,percent of total billed charges,,,,1012.387,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,221.69475,,,fee schedule,,,221.69475,,,fee schedule,,,,,,,,,221.69475,,,fee schedule,,,,,,,,,,911.1483,90,percent of total billed charges,,,,961.76765,95,percent of total billed charges,,,228.3455925,,,fee schedule,,,435.78,,,fee schedule,,,435.78,,,fee schedule,,,,,,,,,221.69475,,,fee schedule,,,201.357,1012.387,
MRA NECK W & W/O CONTRAST,6100313,CDM,70549,CPT,610,RC,inpatient,,,,1683.741,926.05755,,1515.3669,90,percent of total billed charges,,,,1683.741,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,354.84475,,,fee schedule,,,354.84475,,,fee schedule,,,,,,,,,354.84475,,,fee schedule,,,,,,,,,,1515.3669,90,percent of total billed charges,,,,1599.55395,95,percent of total billed charges,,,365.4900925,,,fee schedule,,,852.82,,,fee schedule,,,852.82,,,fee schedule,,,,,,,,,354.84475,,,fee schedule,,,329.931,1683.741,
MRA NECK WITH CONTRAST,6100314,CDM,70548,CPT,610,RC,inpatient,,,,1307.379,719.05845,,1176.6411,90,percent of total billed charges,,,,1307.379,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,252.652125,,,fee schedule,,,252.652125,,,fee schedule,,,,,,,,,252.652125,,,fee schedule,,,,,,,,,,1176.6411,90,percent of total billed charges,,,,1242.01005,95,percent of total billed charges,,,260.2316888,,,fee schedule,,,435.78,,,fee schedule,,,435.78,,,fee schedule,,,,,,,,,252.652125,,,fee schedule,,,252.652125,1307.379,
MRI - UP EXT NONJT WOW/GAD RT,6101001,CDM,73220,CPT,610,RC,inpatient,,,RT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,421.086875,,,fee schedule,,,421.086875,,,fee schedule,,,,,,,,,421.086875,,,fee schedule,,,,,,,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,95,percent of total billed charges,,,433.7194813,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,421.086875,,,fee schedule,,,329.931,1989.857,
MRI - UP EXT NONJT WOW/GAD LT,6101002,CDM,73220,CPT,610,RC,inpatient,,,LT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,421.086875,,,fee schedule,,,421.086875,,,fee schedule,,,,,,,,,421.086875,,,fee schedule,,,,,,,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,95,percent of total billed charges,,,433.7194813,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,421.086875,,,fee schedule,,,329.931,1989.857,
MRI - UP EXT JOINT WO/GAD RT,6101101,CDM,73221,CPT,610,RC,inpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,208.37975,,,fee schedule,,,208.37975,,,fee schedule,,,,,,,,,208.37975,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,214.6311425,,,fee schedule,,,380,,,fee schedule,,,380,,,fee schedule,,,,,,,,,208.37975,,,fee schedule,,,201.357,1376.595,
MRI - UP EXT JOINT WO/GAD LT,6101102,CDM,73221,CPT,610,RC,inpatient,,,LT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,208.37975,,,fee schedule,,,208.37975,,,fee schedule,,,,,,,,,208.37975,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,214.6311425,,,fee schedule,,,380,,,fee schedule,,,380,,,fee schedule,,,,,,,,,208.37975,,,fee schedule,,,201.357,1376.595,
MRI - UP EXT JOINT WO/GAD BIL,6101103,CDM,73221,CPT,610,RC,inpatient,,,50,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,208.37975,,,fee schedule,,,208.37975,,,fee schedule,,,,,,,,,208.37975,,,fee schedule,,,,,,,,,,2477.871,90,percent of total billed charges,,,,2615.5305,95,percent of total billed charges,,,214.6311425,,,fee schedule,,,380,,,fee schedule,,,380,,,fee schedule,,,,,,,,,208.37975,,,fee schedule,,,201.357,2753.19,
MRI - LOW EXT NONJT WO/GAD RT,6101201,CDM,73718,CPT,610,RC,inpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,229.350875,,,fee schedule,,,229.350875,,,fee schedule,,,,,,,,,229.350875,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,236.2314013,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,229.350875,,,fee schedule,,,201.357,1376.595,
MRI - LOW EXT NONJT WO/GAD LT,6101202,CDM,73718,CPT,610,RC,inpatient,,,LT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,229.350875,,,fee schedule,,,229.350875,,,fee schedule,,,,,,,,,229.350875,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,236.2314013,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,229.350875,,,fee schedule,,,201.357,1376.595,
MRI - LOW EXT NONJT WO/GAD BIL,6101203,CDM,73718,CPT,610,RC,inpatient,,,50,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,229.350875,,,fee schedule,,,229.350875,,,fee schedule,,,,,,,,,229.350875,,,fee schedule,,,,,,,,,,2477.871,90,percent of total billed charges,,,,2615.5305,95,percent of total billed charges,,,236.2314013,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,229.350875,,,fee schedule,,,201.357,2753.19,
MRI - LOW EXT NONJT WOW/GAD RT,6101401,CDM,73720,CPT,610,RC,inpatient,,,RT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,346.19,,,fee schedule,,,346.19,,,fee schedule,,,,,,,,,346.19,,,fee schedule,,,,,,,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,95,percent of total billed charges,,,356.5757,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,346.19,,,fee schedule,,,329.931,1989.857,
MRI - LOW EXT NONJT WOW/GAD LT,6101402,CDM,73720,CPT,610,RC,inpatient,,,LT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,346.19,,,fee schedule,,,346.19,,,fee schedule,,,,,,,,,346.19,,,fee schedule,,,,,,,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,95,percent of total billed charges,,,356.5757,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,346.19,,,fee schedule,,,329.931,1989.857,
MRI - LOW EXT NONJT WOW/GAD BI,6101403,CDM,73720,CPT,610,RC,inpatient,,,50,3979.714,2188.8427,,3581.7426,90,percent of total billed charges,,,,3979.714,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,346.19,,,fee schedule,,,346.19,,,fee schedule,,,,,,,,,346.19,,,fee schedule,,,,,,,,,,3581.7426,90,percent of total billed charges,,,,3780.7283,95,percent of total billed charges,,,356.5757,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,346.19,,,fee schedule,,,329.931,3979.714,
MRI - LOW EXT JOINT WO/GAD RT,6101501,CDM,73721,CPT,610,RC,inpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,208.046875,,,fee schedule,,,208.046875,,,fee schedule,,,,,,,,,208.046875,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,214.2882813,,,fee schedule,,,380,,,fee schedule,,,380,,,fee schedule,,,,,,,,,208.046875,,,fee schedule,,,201.357,1376.595,
MRI - LOW EXT JOINT WO/GAD LT,6101502,CDM,73721,CPT,610,RC,inpatient,,,LT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,208.046875,,,fee schedule,,,208.046875,,,fee schedule,,,,,,,,,208.046875,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,214.2882813,,,fee schedule,,,380,,,fee schedule,,,380,,,fee schedule,,,,,,,,,208.046875,,,fee schedule,,,201.357,1376.595,
MRI - LOW EXT JOINT WO/GAD BIL,6101503,CDM,73721,CPT,610,RC,inpatient,,,50,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,208.046875,,,fee schedule,,,208.046875,,,fee schedule,,,,,,,,,208.046875,,,fee schedule,,,,,,,,,,2477.871,90,percent of total billed charges,,,,2615.5305,95,percent of total billed charges,,,214.2882813,,,fee schedule,,,380,,,fee schedule,,,380,,,fee schedule,,,,,,,,,208.046875,,,fee schedule,,,201.357,2753.19,
MRI - LOW EXT JOINT W/GAD RT,6101601,CDM,73722,CPT,610,RC,inpatient,,,RT,1558.287,857.05785,,1402.4583,90,percent of total billed charges,,,,1558.287,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,588.249,,,fee schedule,,,322.223,,,fee schedule,,,322.223,,,fee schedule,,,,,,,,,322.223,,,fee schedule,,,,,,,,,,1402.4583,90,percent of total billed charges,,,,1480.37265,95,percent of total billed charges,,,331.88969,,,fee schedule,,,514.92,,,fee schedule,,,514.92,,,fee schedule,,,,,,,,,322.223,,,fee schedule,,,322.223,1558.287,
MRI - LOW EXT JOINT W/GAD LT,6101602,CDM,73722,CPT,610,RC,inpatient,,,LT,1558.287,857.05785,,1402.4583,90,percent of total billed charges,,,,1558.287,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,588.249,,,fee schedule,,,322.223,,,fee schedule,,,322.223,,,fee schedule,,,,,,,,,322.223,,,fee schedule,,,,,,,,,,1402.4583,90,percent of total billed charges,,,,1480.37265,95,percent of total billed charges,,,331.88969,,,fee schedule,,,514.92,,,fee schedule,,,514.92,,,fee schedule,,,,,,,,,322.223,,,fee schedule,,,322.223,1558.287,
MRI - LOW EXT JOINT WOW/GAD RT,6101701,CDM,73723,CPT,610,RC,inpatient,,,RT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,396.12125,,,fee schedule,,,396.12125,,,fee schedule,,,,,,,,,396.12125,,,fee schedule,,,,,,,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,95,percent of total billed charges,,,408.0048875,,,fee schedule,,,952.95,,,fee schedule,,,952.95,,,fee schedule,,,,,,,,,396.12125,,,fee schedule,,,329.931,1989.857,
MRI - LOW EXT JOINT WOW/GAD LT,6101702,CDM,73723,CPT,610,RC,inpatient,,,LT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,396.12125,,,fee schedule,,,396.12125,,,fee schedule,,,,,,,,,396.12125,,,fee schedule,,,,,,,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,95,percent of total billed charges,,,408.0048875,,,fee schedule,,,952.95,,,fee schedule,,,952.95,,,fee schedule,,,,,,,,,396.12125,,,fee schedule,,,329.931,1989.857,
MRI - UP EXT NONJT WO/GAD RT,6101801,CDM,73218,CPT,610,RC,inpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,311.903875,,,fee schedule,,,311.903875,,,fee schedule,,,,,,,,,311.903875,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,321.2609913,,,fee schedule,,,429.41,,,fee schedule,,,429.41,,,fee schedule,,,,,,,,,311.903875,,,fee schedule,,,201.357,1376.595,
MRI - UP EXT NONJT WO/GAD LT,6101802,CDM,73218,CPT,610,RC,inpatient,,,LT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,311.903875,,,fee schedule,,,311.903875,,,fee schedule,,,,,,,,,311.903875,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,321.2609913,,,fee schedule,,,429.41,,,fee schedule,,,429.41,,,fee schedule,,,,,,,,,311.903875,,,fee schedule,,,201.357,1376.595,
MRI - UP EXT NONJT WO/GAD BIL,6101803,CDM,73218,CPT,610,RC,inpatient,,,50,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,311.903875,,,fee schedule,,,311.903875,,,fee schedule,,,,,,,,,311.903875,,,fee schedule,,,,,,,,,,2477.871,90,percent of total billed charges,,,,2615.5305,95,percent of total billed charges,,,321.2609913,,,fee schedule,,,429.41,,,fee schedule,,,429.41,,,fee schedule,,,,,,,,,311.903875,,,fee schedule,,,201.357,2753.19,
MRI - UP EXT JOINT W/GAD RT,6102001,CDM,73222,CPT,610,RC,inpatient,,,RT,1558.287,857.05785,,1402.4583,90,percent of total billed charges,,,,1558.287,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,588.249,,,fee schedule,,,321.890125,,,fee schedule,,,321.890125,,,fee schedule,,,,,,,,,321.890125,,,fee schedule,,,,,,,,,,1402.4583,90,percent of total billed charges,,,,1480.37265,95,percent of total billed charges,,,331.5468288,,,fee schedule,,,514.92,,,fee schedule,,,514.92,,,fee schedule,,,,,,,,,321.890125,,,fee schedule,,,321.890125,1558.287,
MRI - UP EXT JOINT W/GAD LT,6102002,CDM,73222,CPT,610,RC,inpatient,,,LT,1558.287,857.05785,,1402.4583,90,percent of total billed charges,,,,1558.287,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,588.249,,,fee schedule,,,321.890125,,,fee schedule,,,321.890125,,,fee schedule,,,,,,,,,321.890125,,,fee schedule,,,,,,,,,,1402.4583,90,percent of total billed charges,,,,1480.37265,95,percent of total billed charges,,,331.5468288,,,fee schedule,,,514.92,,,fee schedule,,,514.92,,,fee schedule,,,,,,,,,321.890125,,,fee schedule,,,321.890125,1558.287,
MRI - UP EXT JOINT WOW/GAD RT,6102101,CDM,73223,CPT,610,RC,inpatient,,,RT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,397.785625,,,fee schedule,,,397.785625,,,fee schedule,,,,,,,,,397.785625,,,fee schedule,,,,,,,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,95,percent of total billed charges,,,409.7191938,,,fee schedule,,,952.95,,,fee schedule,,,952.95,,,fee schedule,,,,,,,,,397.785625,,,fee schedule,,,329.931,1989.857,
MRI - UP EXT JOINT WOW/GAD LT,6102102,CDM,73223,CPT,610,RC,inpatient,,,LT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,397.785625,,,fee schedule,,,397.785625,,,fee schedule,,,,,,,,,397.785625,,,fee schedule,,,,,,,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,95,percent of total billed charges,,,409.7191938,,,fee schedule,,,952.95,,,fee schedule,,,952.95,,,fee schedule,,,,,,,,,397.785625,,,fee schedule,,,329.931,1989.857,
MRI - TMJ WO/GAD RT,6102201,CDM,70336,CPT,610,RC,inpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,271.293125,,,fee schedule,,,271.293125,,,fee schedule,,,,,,,,,271.293125,,,fee schedule,,,,,,,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,95,percent of total billed charges,,,279.4319188,,,fee schedule,,,343,,,fee schedule,,,343,,,fee schedule,,,,,,,,,271.293125,,,fee schedule,,,201.357,1376.595,
 MRI - TMJ WO/GAD,6102203,CDM,70336,CPT,610,RC,inpatient,,,,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,271.293125,,,fee schedule,,,271.293125,,,fee schedule,,,,,,,,,271.293125,,,fee schedule,,,,,,,,,,2477.871,90,percent of total billed charges,,,,2615.5305,95,percent of total billed charges,,,279.4319188,,,fee schedule,,,343,,,fee schedule,,,343,,,fee schedule,,,,,,,,,271.293125,,,fee schedule,,,201.357,2753.19,
"MRI,ORBIT,FACE,NECK WO/W CONT",6107054,CDM,70543,CPT,610,RC,inpatient,,,,1827.014,1004.8577,,1644.3126,90,percent of total billed charges,,,,1827.014,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,347.854375,,,fee schedule,,,347.854375,,,fee schedule,,,,,,,,,347.854375,,,fee schedule,,,,,,,,,,1644.3126,90,percent of total billed charges,,,,1735.6633,95,percent of total billed charges,,,358.2900063,,,fee schedule,,,952.95,,,fee schedule,,,952.95,,,fee schedule,,,,,,,,,347.854375,,,fee schedule,,,329.931,1827.014,
MRA ABDOMEN W OR W/O CONTRAST,6107418,CDM,74185,CPT,610,RC,inpatient,,,,1294.607,712.03385,,1165.1463,90,percent of total billed charges,,,,1294.607,100,percent of total billed charges,,,280.59,,,fee schedule,,,280.59,,,fee schedule,,,252.531,,,fee schedule,,,345.857125,,,fee schedule,,,345.857125,,,fee schedule,,,,,,,,,345.857125,,,fee schedule,,,,,,,,,,1165.1463,90,percent of total billed charges,,,,1229.87665,95,percent of total billed charges,,,356.2328388,,,fee schedule,,,447.41,,,fee schedule,,,447.41,,,fee schedule,,,,,,,,,345.857125,,,fee schedule,,,252.531,1294.607,
"MRI,BRAIN & STEM W/O & W CONT",6100030,CDM,70553,CPT,611,RC,inpatient,,,,2970.005,1633.50275,,2673.0045,90,percent of total billed charges,,,,2970.005,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,326.88325,,,fee schedule,,,326.88325,,,fee schedule,,,,,,,,,326.88325,,,fee schedule,,,,,,,,,,2673.0045,90,percent of total billed charges,,,,2821.50475,95,percent of total billed charges,,,336.6897475,,,fee schedule,,,578,,,fee schedule,,,578,,,fee schedule,,,,,,,,,326.88325,,,fee schedule,,,326.88325,2970.005,
"MRI,BRAIN & STEM W/O CONTRAST",6100040,CDM,70551,CPT,611,RC,inpatient,,,,2157.85,1186.8175,,1942.065,90,percent of total billed charges,,,,2157.85,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,201.389375,,,fee schedule,,,201.389375,,,fee schedule,,,,,,,,,201.389375,,,fee schedule,,,,,,,,,,1942.065,90,percent of total billed charges,,,,2049.9575,95,percent of total billed charges,,,207.4310563,,,fee schedule,,,403,,,fee schedule,,,403,,,fee schedule,,,,,,,,,201.389375,,,fee schedule,,,201.357,2157.85,
"MRI,SPINAL CANAL CERV WO/W GAD",6100050,CDM,72156,CPT,612,RC,inpatient,,,,3099.064,1704.4852,,2789.1576,90,percent of total billed charges,,,,3099.064,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,328.547625,,,fee schedule,,,328.547625,,,fee schedule,,,,,,,,,328.547625,,,fee schedule,,,,,,,,,,2789.1576,90,percent of total billed charges,,,,2944.1108,95,percent of total billed charges,,,338.4040538,,,fee schedule,,,578,,,fee schedule,,,578,,,fee schedule,,,,,,,,,328.547625,,,fee schedule,,,328.547625,3099.064,
"MRI,SPINAL CANAL CERVICAL; WO",6100060,CDM,72141,CPT,612,RC,inpatient,,,,3013.78,1657.579,,2712.402,90,percent of total billed charges,,,,3013.78,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,195.7305,,,fee schedule,,,195.7305,,,fee schedule,,,,,,,,,195.7305,,,fee schedule,,,,,,,,,,2712.402,90,percent of total billed charges,,,,2863.091,95,percent of total billed charges,,,201.602415,,,fee schedule,,,406,,,fee schedule,,,406,,,fee schedule,,,,,,,,,195.7305,,,fee schedule,,,195.7305,3013.78,
"MRI,SPINAL CANAL LUMBAR WO/W G",6100130,CDM,72158,CPT,612,RC,inpatient,,,,2709.724,1490.3482,,2438.7516,90,percent of total billed charges,,,,2709.724,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,327.881875,,,fee schedule,,,327.881875,,,fee schedule,,,,,,,,,327.881875,,,fee schedule,,,,,,,,,,2438.7516,90,percent of total billed charges,,,,2574.2378,95,percent of total billed charges,,,337.7183313,,,fee schedule,,,578,,,fee schedule,,,578,,,fee schedule,,,,,,,,,327.881875,,,fee schedule,,,327.881875,2709.724,
"MRI, LUMBAR SPINE W/O CONTRAST",6100140,CDM,72148,CPT,612,RC,inpatient,,,,2646.585,1455.62175,,2381.9265,90,percent of total billed charges,,,,2646.585,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,196.39625,,,fee schedule,,,196.39625,,,fee schedule,,,,,,,,,196.39625,,,fee schedule,,,,,,,,,,2381.9265,90,percent of total billed charges,,,,2514.25575,95,percent of total billed charges,,,202.2881375,,,fee schedule,,,432,,,fee schedule,,,432,,,fee schedule,,,,,,,,,196.39625,,,fee schedule,,,196.39625,2646.585,
"MRI,SPINAL THORACIC W/WO GAD",6100250,CDM,72157,CPT,612,RC,inpatient,,,,2892.858,1591.0719,,2603.5722,90,percent of total billed charges,,,,2892.858,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.931,,,fee schedule,,,329.213375,,,fee schedule,,,329.213375,,,fee schedule,,,,,,,,,329.213375,,,fee schedule,,,,,,,,,,2603.5722,90,percent of total billed charges,,,,2748.2151,95,percent of total billed charges,,,339.0897763,,,fee schedule,,,578,,,fee schedule,,,578,,,fee schedule,,,,,,,,,329.213375,,,fee schedule,,,329.213375,2892.858,
"MRI,SPINAL CANAL THORACIC; WO",6100260,CDM,72146,CPT,612,RC,inpatient,,,,2754.941,1515.21755,,2479.4469,90,percent of total billed charges,,,,2754.941,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,195.397625,,,fee schedule,,,195.397625,,,fee schedule,,,,,,,,,195.397625,,,fee schedule,,,,,,,,,,2479.4469,90,percent of total billed charges,,,,2617.19395,95,percent of total billed charges,,,201.2595538,,,fee schedule,,,446,,,fee schedule,,,446,,,fee schedule,,,,,,,,,195.397625,,,fee schedule,,,195.397625,2754.941,
MRI BREAST W/O CONTRAST BILAT,6147047,CDM,77047,CPT,614,RC,inpatient,,,,291.387,160.26285,,262.2483,90,percent of total billed charges,,,,291.387,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.357,,,fee schedule,,,224.690625,,,fee schedule,,,224.690625,,,fee schedule,,,,,,,,,224.690625,,,fee schedule,,,,,,,,,,262.2483,90,percent of total billed charges,,,,276.81765,95,percent of total billed charges,,,231.4313438,,,fee schedule,,,185.79,,,fee schedule,,,185.79,,,fee schedule,,,,,,,,,224.690625,,,fee schedule,,,185.79,291.387,
NEO-SYNEPHRINE 1% 10MG/ML INJ,2500055,CDM,J2371,HCPCS,636,RC,inpatient,10,ME,,16.48,9.064,,14.832,90,percent of total billed charges,,,,16.48,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,14.832,90,percent of total billed charges,,,,15.656,95,percent of total billed charges,,,,,,,,,0.01,,,fee schedule,,,0.01,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.01,500,
ACTIVASE 100mg VIAL,2500070,CDM,J2997,HCPCS,636,RC,inpatient,100,ME,,9575.292,5266.4106,,8617.7628,90,percent of total billed charges,,,,9575.292,100,percent of total billed charges,,,100.09,,,fee schedule,,,100.09,,,fee schedule,,,90.081,,,fee schedule,,,,,,,,,,,,,,,,4787.646,50,percent of total billed charges,,,,,,,,,,,,,,,,8617.7628,90,percent of total billed charges,,,,9096.5274,95,percent of total billed charges,,,,,,,,,35.63,,,fee schedule,,,35.63,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,35.63,9575.292,
ADENOCARD 6mg  - OP,2500100,CDM,J0153,HCPCS,636,RC,inpatient,65,ME,,87.138,47.9259,,78.4242,90,percent of total billed charges,,,,87.138,100,percent of total billed charges,,,0.72,,,fee schedule,,,0.72,,,fee schedule,,,0.648,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,78.4242,90,percent of total billed charges,,,,82.7811,95,percent of total billed charges,,,,,,,,,0.85,,,fee schedule,,,0.85,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.648,500,
EPINEPHRINE 1:1000 1 MG INJ,2500110,CDM,J0171,HCPCS,636,RC,inpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,0.882,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,1.64,,,fee schedule,,,1.64,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.882,500,
AMINOPHYLLIN UP TO 250mg,2500490,CDM,J0280,HCPCS,636,RC,inpatient,250,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,8.37,,,fee schedule,,,8.37,,,fee schedule,,,7.533,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,14.64,,,fee schedule,,,14.64,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,7.533,500,
NORFLEX 30mg/1ml 2ml INJ,2500515,CDM,J2360,HCPCS,636,RC,inpatient,2,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,7.33,,,fee schedule,,,7.33,,,fee schedule,,,6.597,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,6.48,,,fee schedule,,,6.48,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,6.48,500,
ANCEF/CEFAZOLIN 1 gr,2500760,CDM,J0690,HCPCS,636,RC,inpatient,1,GR,,15.965,8.78075,,14.3685,90,percent of total billed charges,,,,15.965,100,percent of total billed charges,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,0.774,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,14.3685,90,percent of total billed charges,,,,15.16675,95,percent of total billed charges,,,,,,,,,4.55,,,fee schedule,,,4.55,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.774,500,
SUCCINYLCHOLINE UP TO 20mg,2500800,CDM,J0330,HCPCS,636,RC,inpatient,20,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.18,,,fee schedule,,,0.18,,,fee schedule,,,0.162,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,2.39,,,fee schedule,,,2.39,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.162,500,
APRESOLINE 20MG/ML INJ,2500970,CDM,J0360,HCPCS,636,RC,inpatient,20,ME,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,4.64,,,fee schedule,,,4.64,,,fee schedule,,,4.176,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,45.5157,90,percent of total billed charges,,,,48.04435,95,percent of total billed charges,,,,,,,,,7.01,,,fee schedule,,,7.01,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,4.176,500,
VITAMIN K PER 1 MG,2501000,CDM,J3430,HCPCS,636,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,4.311,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,4.18,,,fee schedule,,,4.18,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,4.1715,500,
AREDIA 30mg,2501020,CDM,J2430,HCPCS,636,RC,inpatient,30,ME,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,14.23,,,fee schedule,,,14.23,,,fee schedule,,,12.807,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,103.1751,90,percent of total billed charges,,,,108.90705,95,percent of total billed charges,,,,,,,,,254.81,,,fee schedule,,,254.81,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,12.807,500,
ATIVAN PER 2mg,2501170,CDM,J2060,HCPCS,636,RC,inpatient,2,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.84,,,fee schedule,,,0.84,,,fee schedule,,,0.756,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,4.64,,,fee schedule,,,4.64,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.756,500,
ATROPINE 1mg INJ,2501190,CDM,J0461,HCPCS,636,RC,inpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.08,,,fee schedule,,,0.08,,,fee schedule,,,0.072,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,0.03,,,fee schedule,,,0.03,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.03,500,
ATROPINE SULFATE 1mg INJ,2501210,CDM,J0461,HCPCS,636,RC,inpatient,1,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.08,,,fee schedule,,,0.08,,,fee schedule,,,0.072,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,0.03,,,fee schedule,,,0.03,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.03,500,
PHENERGAN 25mg,2501355,CDM,J2550,HCPCS,636,RC,inpatient,25,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,2.77,,,fee schedule,,,2.77,,,fee schedule,,,2.493,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,5.44,,,fee schedule,,,5.44,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.493,500,
BENADRYL UP TO 50mg - OP,2501540,CDM,J1200,HCPCS,636,RC,inpatient,50,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,0.882,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,3.12,,,fee schedule,,,3.12,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.882,500,
PITOCIN 10u/ml 1ml,2501585,CDM,J2590,HCPCS,636,RC,inpatient,10,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.61,,,fee schedule,,,0.61,,,fee schedule,,,0.549,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,2.55,,,fee schedule,,,2.55,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.549,500,
PNU-IMUNE 23 25U INJ,2501655,CDM,90732,CPT,636,RC,inpatient,1,EA,,236.385,130.01175,,212.7465,90,percent of total billed charges,,,,236.385,100,percent of total billed charges,,,130.37,,,fee schedule,,,130.37,,,fee schedule,,,117.333,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,212.7465,90,percent of total billed charges,,,,224.56575,95,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,13.14,500,
PENICILLIN G BENZ 600000u/ml 2,2501720,CDM,J0561,HCPCS,636,RC,inpatient,2,ML,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,15.81,,,fee schedule,,,15.81,,,fee schedule,,,14.229,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,,,,,,,5.66,,,fee schedule,,,5.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,5.66,500,
BRETHINE UP TO 1MG INJ,2501790,CDM,J3105,HCPCS,636,RC,inpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.93,,,fee schedule,,,2.93,,,fee schedule,,,2.637,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,3.6,,,fee schedule,,,3.6,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.637,500,
LOVENOX 40mg INJ,2501912,CDM,J1650,HCPCS,636,RC,inpatient,40,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,0.864,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,17.613,90,percent of total billed charges,,,,18.5915,95,percent of total billed charges,,,,,,,,,17.66,,,fee schedule,,,17.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.864,500,
PROLIXIN DECANOATE UP TO 25mg,2501939,CDM,J2680,HCPCS,636,RC,inpatient,25,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,13.08,,,fee schedule,,,13.08,,,fee schedule,,,11.772,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,20.51,,,fee schedule,,,20.51,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,11.4021,500,
PRIMAXIN 500mg VIAL,2501955,CDM,J0743,HCPCS,636,RC,inpatient,500,ME,,93.627,51.49485,,84.2643,90,percent of total billed charges,,,,93.627,100,percent of total billed charges,,,6.68,,,fee schedule,,,6.68,,,fee schedule,,,6.012,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,84.2643,90,percent of total billed charges,,,,88.94565,95,percent of total billed charges,,,,,,,,,15.22,,,fee schedule,,,15.22,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,6.012,500,
LEVAQUIN 500mg DUPLEX IV,2501974,CDM,J1956,HCPCS,636,RC,inpatient,500,ME,,104.751,57.61305,,94.2759,90,percent of total billed charges,,,,104.751,100,percent of total billed charges,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,1.107,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,94.2759,90,percent of total billed charges,,,,99.51345,95,percent of total billed charges,,,,,,,,,18.62,,,fee schedule,,,18.62,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.107,500,
LEVAQUIN 250mg IV DUPLEX,2501976,CDM,J1956,HCPCS,636,RC,inpatient,250,ME,,52.427,28.83485,,47.1843,90,percent of total billed charges,,,,52.427,100,percent of total billed charges,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,1.107,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,47.1843,90,percent of total billed charges,,,,49.80565,95,percent of total billed charges,,,,,,,,,18.62,,,fee schedule,,,18.62,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.107,500,
TENECTEPLASE PER 50mg,2501998,CDM,J3101,HCPCS,636,RC,inpatient,50,ME,,6687.996,3678.3978,,6019.1964,90,percent of total billed charges,,,,6687.996,100,percent of total billed charges,,,139.02,,,fee schedule,,,139.02,,,fee schedule,,,125.118,,,fee schedule,,,,,,,,,,,,,,,,3343.998,50,percent of total billed charges,,,,,,,,,,,,,,,,6019.1964,90,percent of total billed charges,,,,6353.5962,95,percent of total billed charges,,,,,,,,,41.06,,,fee schedule,,,41.06,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,41.06,6687.996,
LEVAQUIN 750mg DUPLEX,2502127,CDM,J1956,HCPCS,636,RC,inpatient,750,ME,,157.075,86.39125,,141.3675,90,percent of total billed charges,,,,157.075,100,percent of total billed charges,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,1.107,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,141.3675,90,percent of total billed charges,,,,149.22125,95,percent of total billed charges,,,,,,,,,18.62,,,fee schedule,,,18.62,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.107,500,
CALCIUM GLUCONATE 10ML INJ,2502130,CDM,J0610,HCPCS,636,RC,inpatient,10,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,3.67,,,fee schedule,,,3.67,,,fee schedule,,,3.303,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,3.303,500,
HUMALOG 75/25,2502141,CDM,J1817,HCPCS,636,RC,inpatient,1,EA,,128.029,70.41595,,115.2261,90,percent of total billed charges,,,,128.029,100,percent of total billed charges,,,12.54,,,fee schedule,,,12.54,,,fee schedule,,,11.286,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,115.2261,90,percent of total billed charges,,,,121.62755,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,11.286,500,
RABAVERT RABIES VACCINE,2502148,CDM,90675,CPT,636,RC,inpatient,1,EA,,443.415,243.87825,,399.0735,90,percent of total billed charges,,,,443.415,100,percent of total billed charges,,,336.2,,,fee schedule,,,336.2,,,fee schedule,,,302.58,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,399.0735,90,percent of total billed charges,,,,421.24425,95,percent of total billed charges,,,,,,,,,262.98,,,fee schedule,,,262.98,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,262.98,500,
CROFAB UP TO Igr IV,2502163,CDM,J0840,HCPCS,636,RC,inpatient,1,GR,,3367.07,1851.8885,,3030.363,90,percent of total billed charges,,,,3367.07,100,percent of total billed charges,,,3695.08,,,fee schedule,,,3695.08,,,fee schedule,,,3325.572,,,fee schedule,,,,,,,,,,,,,,,,1683.535,50,percent of total billed charges,,,,,,,,,,,,,,,,3030.363,90,percent of total billed charges,,,,3198.7165,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1683.535,3695.08,
METHOTREXATE ORAL 2.5mg,2502191,CDM,J8610,HCPCS,636,RC,inpatient,2.5,ME,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,0.18,,,fee schedule,,,0.18,,,fee schedule,,,0.162,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,12.4218,90,percent of total billed charges,,,,13.1119,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.162,500,
LOVENOX 150mg INJ,2502193,CDM,J1650,HCPCS,636,RC,inpatient,150,ME,,403.863,222.12465,,363.4767,90,percent of total billed charges,,,,403.863,100,percent of total billed charges,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,0.864,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,363.4767,90,percent of total billed charges,,,,383.66985,95,percent of total billed charges,,,,,,,,,17.66,,,fee schedule,,,17.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.864,500,
ZYVOX IV PER 200mg - OP,2502213,CDM,J2020,HCPCS,636,RC,inpatient,200,ME,,62.727,34.49985,,56.4543,90,percent of total billed charges,,,,62.727,100,percent of total billed charges,,,7.89,,,fee schedule,,,7.89,,,fee schedule,,,7.101,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,56.4543,90,percent of total billed charges,,,,59.59065,95,percent of total billed charges,,,,,,,,,32.93,,,fee schedule,,,32.93,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,7.101,500,
PROSTIGMINE 1mg INJECTION,2502295,CDM,J2710,HCPCS,636,RC,inpatient,1,ME,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,0.1,,,fee schedule,,,0.1,,,fee schedule,,,0.09,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,20.6721,90,percent of total billed charges,,,,21.82055,95,percent of total billed charges,,,,,,,,,3.22,,,fee schedule,,,3.22,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.09,500,
DEXAMETHASONE SOD PHOS 4mg/ml,2502298,CDM,J1100,HCPCS,636,RC,inpatient,4,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.126,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,7.4,,,fee schedule,,,7.4,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.126,500,
ANCEF 1gr DUPLEX,2502307,CDM,J0690,HCPCS,636,RC,inpatient,1,GR,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,0.774,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,46.7208,90,percent of total billed charges,,,,49.3164,95,percent of total billed charges,,,,,,,,,4.55,,,fee schedule,,,4.55,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.774,500,
XYLOCAINE MPF 2% 10mg,2502314,CDM,J2001,HCPCS,636,RC,inpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.036,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.036,500,
VERSED 5mg/ml VIAL,2502336,CDM,J2250,HCPCS,636,RC,inpatient,5,ME,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.126,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,51.6339,90,percent of total billed charges,,,,54.50245,95,percent of total billed charges,,,,,,,,,3.89,,,fee schedule,,,3.89,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.126,500,
ZOFRAN SOLUTION 4mg/5ml UNIT,2502367,CDM,J2405,HCPCS,636,RC,inpatient,4,ME,,55.002,30.2511,,49.5018,90,percent of total billed charges,,,,55.002,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.126,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,49.5018,90,percent of total billed charges,,,,52.2519,95,percent of total billed charges,,,,,,,,,6.79,,,fee schedule,,,6.79,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.126,500,
LIDOCAINE 10mg/ml 10ml VIAL,2502368,CDM,J2001,HCPCS,636,RC,inpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.036,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.036,500,
ZOSYN 4.5gr VIAL,2502374,CDM,,,636,RC,inpatient,4.5,GR,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,59.8842,90,percent of total billed charges,,,,63.2111,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,59.8842,500,
HEPARIN SODIUM 100u/ml 5ml,2502388,CDM,J1642,HCPCS,636,RC,inpatient,5,ML,,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,0.19,,,fee schedule,,,0.19,,,fee schedule,,,0.171,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,11.3094,90,percent of total billed charges,,,,11.9377,95,percent of total billed charges,,,,,,,,,1.01,,,fee schedule,,,1.01,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.171,500,
ROCEPHIN 1gr DUPLEX,2502391,CDM,J0696,HCPCS,636,RC,inpatient,1,GR,,34.196,18.8078,,30.7764,90,percent of total billed charges,,,,34.196,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.504,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,30.7764,90,percent of total billed charges,,,,32.4862,95,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,11.84,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.504,500,
MAGNESIUM SULFATE 1gr/2ml VIAL,2502422,CDM,J3475,HCPCS,636,RC,inpatient,2,GR,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.78,,,fee schedule,,,0.78,,,fee schedule,,,0.702,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,1.91,,,fee schedule,,,1.91,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.702,500,
HEP B PF VACCINE ADULT 20mcg,2502548,CDM,90739,CPT,636,RC,inpatient,1,EA,,118.656,65.2608,,106.7904,90,percent of total billed charges,,,,118.656,100,percent of total billed charges,,,149.66,,,fee schedule,,,149.66,,,fee schedule,,,134.694,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,106.7904,90,percent of total billed charges,,,,112.7232,95,percent of total billed charges,,,,,,,,,160.28,,,fee schedule,,,160.28,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,106.7904,500,
CELESTONE PHOS PER 4 MG INJ,2502550,CDM,,,636,RC,inpatient,4,ME,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,30.9618,90,percent of total billed charges,,,,32.6819,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,30.9618,500,
"MEASLES,MUMPS,RUBELLA (MMR)",2502551,CDM,90707,CPT,636,RC,inpatient,1,EA,,114.33,62.8815,,102.897,90,percent of total billed charges,,,,114.33,100,percent of total billed charges,,,82.54,,,fee schedule,,,82.54,,,fee schedule,,,74.286,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,102.897,90,percent of total billed charges,,,,108.6135,95,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,13.14,500,
TENIVAC TETANUS & DIPTHERIA,2502552,CDM,90714,CPT,636,RC,inpatient,1,EA,,123.909,68.14995,,111.5181,90,percent of total billed charges,,,,123.909,100,percent of total billed charges,,,26.96,,,fee schedule,,,26.96,,,fee schedule,,,24.264,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,111.5181,90,percent of total billed charges,,,,117.71355,95,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,13.14,500,
DEXAMETHASONE SOD/PHOS 10mg,2502558,CDM,J1100,HCPCS,636,RC,inpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.126,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,7.4,,,fee schedule,,,7.4,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.126,500,
CELESTONE SOLUSPAN PER 3mg INJ,2502570,CDM,J0702,HCPCS,636,RC,inpatient,3,ME,,23.69,13.0295,,21.321,90,percent of total billed charges,,,,23.69,100,percent of total billed charges,,,7.89,,,fee schedule,,,7.89,,,fee schedule,,,7.101,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,21.321,90,percent of total billed charges,,,,22.5055,95,percent of total billed charges,,,,,,,,,3.46,,,fee schedule,,,3.46,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,3.46,500,
CEFEPIME 2 GRAM INJECTION,2502573,CDM,J0692,HCPCS,636,RC,inpatient,2,GR,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,2.15,,,fee schedule,,,2.15,,,fee schedule,,,1.935,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,23.8239,90,percent of total billed charges,,,,25.14745,95,percent of total billed charges,,,,,,,,,7.28,,,fee schedule,,,7.28,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.935,500,
REGITINE UP TO 5mg INJ,2502635,CDM,J2760,HCPCS,636,RC,inpatient,5,ME,,175.409,96.47495,,157.8681,90,percent of total billed charges,,,,175.409,100,percent of total billed charges,,,447.65,,,fee schedule,,,447.65,,,fee schedule,,,402.885,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,157.8681,90,percent of total billed charges,,,,166.63855,95,percent of total billed charges,,,,,,,,,27.37,,,fee schedule,,,27.37,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,27.37,500,
MEROPENEM 1gr INJ,2502649,CDM,J2185,HCPCS,636,RC,inpatient,1,GR,,19.879,10.93345,,17.8911,90,percent of total billed charges,,,,19.879,100,percent of total billed charges,,,1.12,,,fee schedule,,,1.12,,,fee schedule,,,1.008,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,17.8911,90,percent of total billed charges,,,,18.88505,95,percent of total billed charges,,,,,,,,,4.4,,,fee schedule,,,4.4,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.008,500,
REGLAN 5mg/ml 2ml VIAL,2502655,CDM,J2765,HCPCS,636,RC,inpatient,2,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,1.43,,,fee schedule,,,1.43,,,fee schedule,,,1.287,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,3.95,,,fee schedule,,,3.95,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.287,500,
DOBUTAMINE/D5W 500mg/250ml,2502681,CDM,J1250,HCPCS,636,RC,inpatient,250,ME,,19.261,10.59355,,17.3349,90,percent of total billed charges,,,,19.261,100,percent of total billed charges,,,9.74,,,fee schedule,,,9.74,,,fee schedule,,,8.766,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,17.3349,90,percent of total billed charges,,,,18.29795,95,percent of total billed charges,,,,,,,,,21.55,,,fee schedule,,,21.55,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,8.766,500,
LEVETIRACETAM 500mg/5ml INJ,2502690,CDM,J1953,HCPCS,636,RC,inpatient,5,ME,,18.54,10.197,,16.686,90,percent of total billed charges,,,,18.54,100,percent of total billed charges,,,0.12,,,fee schedule,,,0.12,,,fee schedule,,,0.108,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,16.686,90,percent of total billed charges,,,,17.613,95,percent of total billed charges,,,,,,,,,0.43,,,fee schedule,,,0.43,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.108,500,
RISPERDAL CONSTA MICRO 25mg,2502692,CDM,J2794,HCPCS,636,RC,inpatient,25,ME,,835.845,459.71475,,752.2605,90,percent of total billed charges,,,,835.845,100,percent of total billed charges,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,10.224,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,752.2605,90,percent of total billed charges,,,,794.05275,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,10.224,835.845,
RISPERIDONE MICRO 50mg,2502693,CDM,J2794,HCPCS,636,RC,inpatient,50,ME,,1324.683,728.57565,,1192.2147,90,percent of total billed charges,,,,1324.683,100,percent of total billed charges,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,10.224,,,fee schedule,,,,,,,,,,,,,,,,662.3415,50,percent of total billed charges,,,,,,,,,,,,,,,,1192.2147,90,percent of total billed charges,,,,1258.44885,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,10.224,1324.683,
ADENOCARD 12mg/4ml,2502694,CDM,J0153,HCPCS,636,RC,inpatient,12,ME,,188.078,103.4429,,169.2702,90,percent of total billed charges,,,,188.078,100,percent of total billed charges,,,0.72,,,fee schedule,,,0.72,,,fee schedule,,,0.648,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,169.2702,90,percent of total billed charges,,,,178.6741,95,percent of total billed charges,,,,,,,,,0.85,,,fee schedule,,,0.85,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.648,500,
DEXTROSE 5%-1/4 NS 1000ml,2502696,CDM,J7042,HCPCS,636,RC,inpatient,1000,ML,,19.982,10.9901,,17.9838,90,percent of total billed charges,,,,19.982,100,percent of total billed charges,,,1.1,,,fee schedule,,,1.1,,,fee schedule,,,0.99,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,17.9838,90,percent of total billed charges,,,,18.9829,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.99,500,
RH IG FULL DOSE 300mcg IM,2502795,CDM,90384,CPT,636,RC,inpatient,1,EA,,260.281,143.15455,,234.2529,90,percent of total billed charges,,,,260.281,100,percent of total billed charges,,,96.4,,,fee schedule,,,96.4,,,fee schedule,,,86.76,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,234.2529,90,percent of total billed charges,,,,247.26695,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,86.76,500,
CEFTRIAXONE 1gr VIAL,2502985,CDM,J0696,HCPCS,636,RC,inpatient,1,GR,,127.308,70.0194,,114.5772,90,percent of total billed charges,,,,127.308,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.504,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,114.5772,90,percent of total billed charges,,,,120.9426,95,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,11.84,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.504,500,
CEFTRIAXONE 250mg VIAL,2503005,CDM,J0696,HCPCS,636,RC,inpatient,250,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.504,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,11.84,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.504,500,
CEFTRIAXONE 500mg VIAL,2503015,CDM,J0696,HCPCS,636,RC,inpatient,500,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.504,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,17.613,90,percent of total billed charges,,,,18.5915,95,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,11.84,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.504,500,
COMPAZINE 5mg/ml 2ml VIAL,2503090,CDM,J0780,HCPCS,636,RC,inpatient,2,ME,,10.815,5.94825,,9.7335,90,percent of total billed charges,,,,10.815,100,percent of total billed charges,,,11.8,,,fee schedule,,,11.8,,,fee schedule,,,10.62,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.7335,90,percent of total billed charges,,,,10.27425,95,percent of total billed charges,,,,,,,,,3.28,,,fee schedule,,,3.28,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,3.28,500,
OCTREOTIDE 500mcg IV,2503106,CDM,J2354,HCPCS,636,RC,inpatient,1,EA,,33.887,18.63785,,30.4983,90,percent of total billed charges,,,,33.887,100,percent of total billed charges,,,0.94,,,fee schedule,,,0.94,,,fee schedule,,,0.846,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,30.4983,90,percent of total billed charges,,,,32.19265,95,percent of total billed charges,,,,,,,,,3.81,,,fee schedule,,,3.81,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.846,500,
CORTROSYN 0.25mg - OP,2503230,CDM,J0834,HCPCS,636,RC,inpatient,0.25,ME,,305.498,168.0239,,274.9482,90,percent of total billed charges,,,,305.498,100,percent of total billed charges,,,50.31,,,fee schedule,,,50.31,,,fee schedule,,,45.279,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,274.9482,90,percent of total billed charges,,,,290.2231,95,percent of total billed charges,,,,,,,,,91.2,,,fee schedule,,,91.2,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,45.279,500,
A HYDROCORT UP TO 100 MG INJ,2503535,CDM,J1720,HCPCS,636,RC,inpatient,100,ME,,84.872,46.6796,,76.3848,90,percent of total billed charges,,,,84.872,100,percent of total billed charges,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,13.392,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,76.3848,90,percent of total billed charges,,,,80.6284,95,percent of total billed charges,,,,,,,,,4.94,,,fee schedule,,,4.94,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,4.94,500,
SOLU-CORTEF UP TO 100MG INJ,2503545,CDM,J1720,HCPCS,636,RC,inpatient,100,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,13.392,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,4.94,,,fee schedule,,,4.94,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,4.94,500,
INJ METHYLPRED SOD SUCC 5 MG,2503565,CDM,J2919,HCPCS,636,RC,inpatient,5,ME,,58.401,32.12055,,52.5609,90,percent of total billed charges,,,,58.401,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,52.5609,90,percent of total billed charges,,,,55.48095,95,percent of total billed charges,,,,,,,,,0.27,,,fee schedule,,,0.27,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.27,500,
INJ.METHYLPRED SOD SUCC 5 MG,2503575,CDM,J2919,HCPCS,636,RC,inpatient,5,ME,,17.51,9.6305,,15.759,90,percent of total billed charges,,,,17.51,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,15.759,90,percent of total billed charges,,,,16.6345,95,percent of total billed charges,,,,,,,,,0.27,,,fee schedule,,,0.27,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.27,500,
STADOL 1MG/ML INJ,2503655,CDM,J0595,HCPCS,636,RC,inpatient,1,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,2.59,,,fee schedule,,,2.59,,,fee schedule,,,2.331,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,3.94,,,fee schedule,,,3.94,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.331,500,
STADOL 2MG/ML INJ,2503665,CDM,J0595,HCPCS,636,RC,inpatient,2,ME,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,2.59,,,fee schedule,,,2.59,,,fee schedule,,,2.331,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,28.9224,90,percent of total billed charges,,,,30.5292,95,percent of total billed charges,,,,,,,,,3.94,,,fee schedule,,,3.94,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.331,500,
SUBLIMAZE 0.1mg INJ (2cc),2503765,CDM,J3010,HCPCS,636,RC,inpatient,0.1,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,0.92,,,fee schedule,,,0.92,,,fee schedule,,,0.828,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,3.66,,,fee schedule,,,3.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.828,500,
SUBLIMAZE 50mcg/ml,2503775,CDM,J3010,HCPCS,636,RC,inpatient,50,ML,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,0.92,,,fee schedule,,,0.92,,,fee schedule,,,0.828,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,3.66,,,fee schedule,,,3.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.828,500,
DEMEROL PER 100mg INJ,2503950,CDM,J2175,HCPCS,636,RC,inpatient,100,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,6.14,,,fee schedule,,,6.14,,,fee schedule,,,5.526,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,2.19,,,fee schedule,,,2.19,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.19,500,
INJ. METHYLPRED ACETATE 1 MG,2504020,CDM,J1010,HCPCS,636,RC,inpatient,1,ME,,72.924,40.1082,,65.6316,90,percent of total billed charges,,,,72.924,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,65.6316,90,percent of total billed charges,,,,69.2778,95,percent of total billed charges,,,,,,,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.13,500,
DEPO-PROVERA 150mg/ml,2504080,CDM,J1050,HCPCS,636,RC,inpatient,150,ME,,111.755,61.46525,,100.5795,90,percent of total billed charges,,,,111.755,100,percent of total billed charges,,,0.64,,,fee schedule,,,0.64,,,fee schedule,,,0.576,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,100.5795,90,percent of total billed charges,,,,106.16725,95,percent of total billed charges,,,,,,,,,0.47,,,fee schedule,,,0.47,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.47,500,
TdaP 0.5ml VIAL,2504275,CDM,90715,CPT,636,RC,inpatient,0.5,ML,,55.105,30.30775,,49.5945,90,percent of total billed charges,,,,55.105,100,percent of total billed charges,,,37.49,,,fee schedule,,,37.49,,,fee schedule,,,33.741,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,49.5945,90,percent of total billed charges,,,,52.34975,95,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,13.14,500,
DIFLUCAN 200mg,2504300,CDM,J1450,HCPCS,636,RC,inpatient,200,ME,,301.481,165.81455,,271.3329,90,percent of total billed charges,,,,301.481,100,percent of total billed charges,,,5.91,,,fee schedule,,,5.91,,,fee schedule,,,5.319,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,271.3329,90,percent of total billed charges,,,,286.40695,95,percent of total billed charges,,,,,,,,,85.83,,,fee schedule,,,85.83,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,5.319,500,
DIGIBIND 40ml VIAL,2504310,CDM,J1162,HCPCS,636,RC,inpatient,40,ML,,4024.519,2213.48545,,3622.0671,90,percent of total billed charges,,,,4024.519,100,percent of total billed charges,,,4315.2,,,fee schedule,,,4315.2,,,fee schedule,,,3883.68,,,fee schedule,,,,,,,,,,,,,,,,2012.2595,50,percent of total billed charges,,,,,,,,,,,,,,,,3622.0671,90,percent of total billed charges,,,,3823.29305,95,percent of total billed charges,,,,,,,,,540.91,,,fee schedule,,,540.91,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,540.91,4315.2,
DILANTIN 100mg/2ml,2504320,CDM,J1165,HCPCS,636,RC,inpatient,100,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,0.774,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,2.44,,,fee schedule,,,2.44,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.774,500,
DILANTIN 250MG INJ.,2504350,CDM,J1165,HCPCS,636,RC,inpatient,250,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,0.774,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,2.44,,,fee schedule,,,2.44,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.774,500,
DILAUDID UP TO 2mg/ml INJ,2504390,CDM,J1170,HCPCS,636,RC,inpatient,2,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,4.311,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,2.67,,,fee schedule,,,2.67,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.67,500,
THIAMINE HCL 100MG/ML INJ,2504405,CDM,J3411,HCPCS,636,RC,inpatient,100,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.93,,,fee schedule,,,2.93,,,fee schedule,,,2.637,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.637,500,
"TETANUS,DIPTERIA",2504450,CDM,90714,CPT,636,RC,inpatient,1,EA,,123.909,68.14995,,111.5181,90,percent of total billed charges,,,,123.909,100,percent of total billed charges,,,26.96,,,fee schedule,,,26.96,,,fee schedule,,,24.264,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,111.5181,90,percent of total billed charges,,,,117.71355,95,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,13.14,500,
THORAZINE UP TO 50MG INJ,2504465,CDM,J3230,HCPCS,636,RC,inpatient,50,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,37.9,,,fee schedule,,,37.9,,,fee schedule,,,34.11,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,10.33,,,fee schedule,,,10.33,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,9.3627,500,
DURAMORPH 10MG/10ML INJ,2504720,CDM,J2274,HCPCS,636,RC,inpatient,10,ME,,23.793,13.08615,,21.4137,90,percent of total billed charges,,,,23.793,100,percent of total billed charges,,,13.37,,,fee schedule,,,13.37,,,fee schedule,,,12.033,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,21.4137,90,percent of total billed charges,,,,22.60335,95,percent of total billed charges,,,,,,,,,9.28,,,fee schedule,,,9.28,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,9.28,500,
TORADOL 15mg INJ,2504775,CDM,J1885,HCPCS,636,RC,inpatient,15,ME,,12.978,7.1379,,11.6802,90,percent of total billed charges,,,,12.978,100,percent of total billed charges,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,0.684,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,11.6802,90,percent of total billed charges,,,,12.3291,95,percent of total billed charges,,,,,,,,,9.74,,,fee schedule,,,9.74,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.684,500,
TORADOL 30mg INJ,2504785,CDM,J1885,HCPCS,636,RC,inpatient,30,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,0.684,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,17.613,90,percent of total billed charges,,,,18.5915,95,percent of total billed charges,,,,,,,,,9.74,,,fee schedule,,,9.74,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.684,500,
TORADOL 60MG INJ,2504795,CDM,J1885,HCPCS,636,RC,inpatient,60,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,0.684,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,9.74,,,fee schedule,,,9.74,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.684,500,
EPINEPHRINE 0.1mg,2505140,CDM,J0171,HCPCS,636,RC,inpatient,0.1,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,0.882,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,1.64,,,fee schedule,,,1.64,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.882,500,
"INJ, EPOGEN 1,000u - NON-ESRD",2505180,CDM,J0885,HCPCS,636,RC,inpatient,1,EA,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,13.08,,,fee schedule,,,13.08,,,fee schedule,,,11.772,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,,,,,,,11.7,,,fee schedule,,,11.7,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,11.7,500,
UUNASYN 3gr VIAL,2505315,CDM,J0295,HCPCS,636,RC,inpatient,3,GR,,56.65,31.1575,,50.985,90,percent of total billed charges,,,,56.65,100,percent of total billed charges,,,3.78,,,fee schedule,,,3.78,,,fee schedule,,,3.402,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,50.985,90,percent of total billed charges,,,,53.8175,95,percent of total billed charges,,,,,,,,,8.7,,,fee schedule,,,8.7,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,3.402,500,
VALIUM UP TO 5mg,2505475,CDM,J3360,HCPCS,636,RC,inpatient,5,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,11.54,,,fee schedule,,,11.54,,,fee schedule,,,10.386,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,6.15,,,fee schedule,,,6.15,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,6.15,500,
VANCOMYCIN HCl 1gr VIAL,2505535,CDM,J3370,HCPCS,636,RC,inpatient,1,GR,,44.187,24.30285,,39.7683,90,percent of total billed charges,,,,44.187,100,percent of total billed charges,,,4.16,,,fee schedule,,,4.16,,,fee schedule,,,3.744,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,39.7683,90,percent of total billed charges,,,,41.97765,95,percent of total billed charges,,,,,,,,,9.4,,,fee schedule,,,9.4,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,3.744,500,
VANCOCIN 500mg - OP,2505575,CDM,J3370,HCPCS,636,RC,inpatient,500,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,4.16,,,fee schedule,,,4.16,,,fee schedule,,,3.744,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,9.4,,,fee schedule,,,9.4,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,3.744,500,
VERSED 1mg 1ml,2505735,CDM,J2250,HCPCS,636,RC,inpatient,1,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.126,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,3.89,,,fee schedule,,,3.89,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.126,500,
VISTARIL 50MG/ML INJ,2505865,CDM,J3410,HCPCS,636,RC,inpatient,50,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,8.31,,,fee schedule,,,8.31,,,fee schedule,,,7.479,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,2.19,,,fee schedule,,,2.19,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.19,500,
"VITAMIN B-12 UP TO 1,000 mcg",2505905,CDM,J3420,HCPCS,636,RC,inpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.09,,,fee schedule,,,2.09,,,fee schedule,,,1.881,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,2.23,,,fee schedule,,,2.23,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.881,500,
GARAMYCIN UP TO 80mg ADD-VAN,2505940,CDM,J1580,HCPCS,636,RC,inpatient,80,ME,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,1.872,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,36.153,90,percent of total billed charges,,,,38.1615,95,percent of total billed charges,,,,,,,,,5.05,,,fee schedule,,,5.05,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.872,500,
GARAMYCIN 20MG/2ML INJ,2505960,CDM,J1580,HCPCS,636,RC,inpatient,20,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,1.872,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,5.05,,,fee schedule,,,5.05,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.872,500,
GARAMYCIN UP TO 80mg,2505980,CDM,J1580,HCPCS,636,RC,inpatient,80,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,1.872,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,5.05,,,fee schedule,,,5.05,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.872,500,
GLUCAGON 1MG/ML INJ,2506050,CDM,J1610,HCPCS,636,RC,inpatient,1,ME,,216.712,119.1916,,195.0408,90,percent of total billed charges,,,,216.712,100,percent of total billed charges,,,228.6,,,fee schedule,,,228.6,,,fee schedule,,,205.74,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,195.0408,90,percent of total billed charges,,,,205.8764,95,percent of total billed charges,,,,,,,,,38.55,,,fee schedule,,,38.55,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,38.55,500,
HALDOL UP TO 5mg,2506300,CDM,J1630,HCPCS,636,RC,inpatient,5,ME,,23.793,13.08615,,21.4137,90,percent of total billed charges,,,,23.793,100,percent of total billed charges,,,1.29,,,fee schedule,,,1.29,,,fee schedule,,,1.161,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,21.4137,90,percent of total billed charges,,,,22.60335,95,percent of total billed charges,,,,,,,,,6.78,,,fee schedule,,,6.78,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.161,500,
ZOFRAN PER 4mg/1ml 2ml INJ,2506395,CDM,J2405,HCPCS,636,RC,inpatient,4,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.126,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,6.79,,,fee schedule,,,6.79,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.126,500,
IMITREX 6MG INJ,2506750,CDM,J3030,HCPCS,636,RC,inpatient,6,ME,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,59.36,,,fee schedule,,,59.36,,,fee schedule,,,53.424,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,93.9051,90,percent of total billed charges,,,,99.12205,95,percent of total billed charges,,,,,,,,,30.02,,,fee schedule,,,30.02,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,30.02,500,
INJ METHYLPRED ACETATE 1 MG,2506775,CDM,J1010,HCPCS,636,RC,inpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.13,500,
IRON DEXTRAN 50mg,2506970,CDM,J1750,HCPCS,636,RC,inpatient,50,ME,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,16.45,,,fee schedule,,,16.45,,,fee schedule,,,14.805,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,43.3836,90,percent of total billed charges,,,,45.7938,95,percent of total billed charges,,,,,,,,,12.25,,,fee schedule,,,12.25,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,12.25,500,
ZITHROMAX 500mg VIAL,2506995,CDM,J0456,HCPCS,636,RC,inpatient,500,ME,,68.701,37.78555,,61.8309,90,percent of total billed charges,,,,68.701,100,percent of total billed charges,,,3.15,,,fee schedule,,,3.15,,,fee schedule,,,2.835,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,61.8309,90,percent of total billed charges,,,,65.26595,95,percent of total billed charges,,,,,,,,,24.32,,,fee schedule,,,24.32,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.835,500,
HUMULIN N INSULIN 3ml VIAL,2507040,CDM,J1815,HCPCS,636,RC,inpatient,3,ML,,16.48,9.064,,14.832,90,percent of total billed charges,,,,16.48,100,percent of total billed charges,,,1.03,,,fee schedule,,,1.03,,,fee schedule,,,0.927,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,14.832,90,percent of total billed charges,,,,15.656,95,percent of total billed charges,,,,,,,,,3.23,,,fee schedule,,,3.23,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.927,500,
LOVENOX 100mg INJ,2507085,CDM,J1650,HCPCS,636,RC,inpatient,100,ME,,205.485,113.01675,,184.9365,90,percent of total billed charges,,,,205.485,100,percent of total billed charges,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,0.864,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,184.9365,90,percent of total billed charges,,,,195.21075,95,percent of total billed charges,,,,,,,,,17.66,,,fee schedule,,,17.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.864,500,
DIGOXIN 500mcg INJ,2507790,CDM,J1160,HCPCS,636,RC,inpatient,1,EA,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,5.95,,,fee schedule,,,5.95,,,fee schedule,,,5.355,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,3.47,,,fee schedule,,,3.47,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,3.47,500,
LASIX 100mg INJ,2507820,CDM,J1940,HCPCS,636,RC,inpatient,100,ME,,48.719,26.79545,,43.8471,90,percent of total billed charges,,,,48.719,100,percent of total billed charges,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,0.792,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,43.8471,90,percent of total billed charges,,,,46.28305,95,percent of total billed charges,,,,,,,,,3.67,,,fee schedule,,,3.67,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.792,500,
LASIX 40MG,2507850,CDM,J1940,HCPCS,636,RC,inpatient,40,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,0.792,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,17.613,90,percent of total billed charges,,,,18.5915,95,percent of total billed charges,,,,,,,,,3.67,,,fee schedule,,,3.67,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.792,500,
LASIX 40mg VIAL,2507860,CDM,J1940,HCPCS,636,RC,inpatient,40,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,0.792,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,3.67,,,fee schedule,,,3.67,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.792,500,
LIDOCAINE HCL 2% 20mg/ml,2508090,CDM,J2001,HCPCS,636,RC,inpatient,20,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.036,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.036,500,
LIDOCAINE HCL 1% ABBJ 10mg/ml,2508130,CDM,J2001,HCPCS,636,RC,inpatient,10,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.036,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.036,500,
LOVENOX 30mg INJ,2508500,CDM,J1650,HCPCS,636,RC,inpatient,30,ME,,80.855,44.47025,,72.7695,90,percent of total billed charges,,,,80.855,100,percent of total billed charges,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,0.864,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,72.7695,90,percent of total billed charges,,,,76.81225,95,percent of total billed charges,,,,,,,,,17.66,,,fee schedule,,,17.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.864,500,
MAG SULFATE PER 500MG INJ,2508680,CDM,J3475,HCPCS,636,RC,inpatient,500,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.78,,,fee schedule,,,0.78,,,fee schedule,,,0.702,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,1.91,,,fee schedule,,,1.91,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.702,500,
MANNITOL 25% IN 50ML INJ,2508710,CDM,J2150,HCPCS,636,RC,inpatient,50,ML,,12.36,6.798,,11.124,90,percent of total billed charges,,,,12.36,100,percent of total billed charges,,,2.41,,,fee schedule,,,2.41,,,fee schedule,,,2.169,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,11.124,90,percent of total billed charges,,,,11.742,95,percent of total billed charges,,,,,,,,,6.09,,,fee schedule,,,6.09,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.169,500,
MEFOXIN 1gr VIAL,2508890,CDM,J0694,HCPCS,636,RC,inpatient,1,GR,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,5.67,,,fee schedule,,,5.67,,,fee schedule,,,5.103,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,23.2677,90,percent of total billed charges,,,,24.56035,95,percent of total billed charges,,,,,,,,,10.88,,,fee schedule,,,10.88,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,5.103,500,
MEFOXIN 2gr VIAL,2508910,CDM,J0694,HCPCS,636,RC,inpatient,2,GR,,103.206,56.7633,,92.8854,90,percent of total billed charges,,,,103.206,100,percent of total billed charges,,,5.67,,,fee schedule,,,5.67,,,fee schedule,,,5.103,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,92.8854,90,percent of total billed charges,,,,98.0457,95,percent of total billed charges,,,,,,,,,10.88,,,fee schedule,,,10.88,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,5.103,500,
METHOTREXATE 50MG INJ,2509060,CDM,J9260,HCPCS,636,RC,inpatient,50,ME,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,2.74,,,fee schedule,,,2.74,,,fee schedule,,,2.466,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,13.63,,,fee schedule,,,13.63,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.466,500,
MORPHINE 10mg,2509420,CDM,J2270,HCPCS,636,RC,inpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,4.86,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,2.12,,,fee schedule,,,2.12,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.12,500,
"INJ, METHYLPRED SOD 5MG",2509802,CDM,J2919,HCPCS,636,RC,inpatient,5,ME,,17.51,9.6305,,15.759,90,percent of total billed charges,,,,17.51,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,15.759,90,percent of total billed charges,,,,16.6345,95,percent of total billed charges,,,,,,,,,0.27,,,fee schedule,,,0.27,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.27,500,
INJ METHYLPRED ACETATE 1MG,2509803,CDM,J1010,HCPCS,636,RC,inpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.13,500,
NARCAN 1mg INJ,2509910,CDM,J2310,HCPCS,636,RC,inpatient,1,ME,,21.012,11.5566,,18.9108,90,percent of total billed charges,,,,21.012,100,percent of total billed charges,,,19.93,,,fee schedule,,,19.93,,,fee schedule,,,17.937,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,18.9108,90,percent of total billed charges,,,,19.9614,95,percent of total billed charges,,,,,,,,,4.84,,,fee schedule,,,4.84,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,4.84,500,
ATRIXTA 2.5mg,2510050,CDM,J1652,HCPCS,636,RC,inpatient,2.5,ME,,76.632,42.1476,,68.9688,90,percent of total billed charges,,,,76.632,100,percent of total billed charges,,,1.99,,,fee schedule,,,1.99,,,fee schedule,,,1.791,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,68.9688,90,percent of total billed charges,,,,72.8004,95,percent of total billed charges,,,,,,,,,7.4,,,fee schedule,,,7.4,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.791,500,
MORPHINE SULFATE 2mg/ml,2510110,CDM,J2270,HCPCS,636,RC,inpatient,2,ME,,5.15,2.8325,,4.635,90,percent of total billed charges,,,,5.15,100,percent of total billed charges,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,4.86,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,4.635,90,percent of total billed charges,,,,4.8925,95,percent of total billed charges,,,,,,,,,2.12,,,fee schedule,,,2.12,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.12,500,
HYDROMORPHONE HCL/PF 1mg/ml,2510120,CDM,J1170,HCPCS,636,RC,inpatient,1,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,4.311,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,2.67,,,fee schedule,,,2.67,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.67,500,
OFIRMEV 1000mg/100ml VIAL INJ,2510130,CDM,J0131,HCPCS,636,RC,inpatient,100,ME,,98.674,54.2707,,88.8066,90,percent of total billed charges,,,,98.674,100,percent of total billed charges,,,0.39,,,fee schedule,,,0.39,,,fee schedule,,,0.351,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,88.8066,90,percent of total billed charges,,,,93.7403,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.351,500,
ERTAPENEM 1gr INJ,2510161,CDM,J1335,HCPCS,636,RC,inpatient,1,GR,,193.228,106.2754,,173.9052,90,percent of total billed charges,,,,193.228,100,percent of total billed charges,,,50.94,,,fee schedule,,,50.94,,,fee schedule,,,45.846,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,173.9052,90,percent of total billed charges,,,,183.5666,95,percent of total billed charges,,,,,,,,,21.24,,,fee schedule,,,21.24,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,21.24,500,
ROPIVACAINE Hcl 150mg,2510170,CDM,J2795,HCPCS,636,RC,inpatient,150,ME,,38.934,21.4137,,35.0406,90,percent of total billed charges,,,,38.934,100,percent of total billed charges,,,0.09,,,fee schedule,,,0.09,,,fee schedule,,,0.081,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,35.0406,90,percent of total billed charges,,,,36.9873,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.081,500,
CLONIDINE HCL/PF 10ml 1 VIAL,2510190,CDM,J0735,HCPCS,636,RC,inpatient,10,ML,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,13.21,,,fee schedule,,,13.21,,,fee schedule,,,11.889,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,30.9618,90,percent of total billed charges,,,,32.6819,95,percent of total billed charges,,,,,,,,,6.45,,,fee schedule,,,6.45,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,6.45,500,
KCI 20 mEq IN 1/2 NS 1000ml,2510310,CDM,J3480,HCPCS,636,RC,inpatient,1000,ML,,31.518,17.3349,,28.3662,90,percent of total billed charges,,,,31.518,100,percent of total billed charges,,,0.21,,,fee schedule,,,0.21,,,fee schedule,,,0.189,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,28.3662,90,percent of total billed charges,,,,29.9421,95,percent of total billed charges,,,,,,,,,1.62,,,fee schedule,,,1.62,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.189,500,
KENALOG 40mg/1ml,2510320,CDM,J3301,HCPCS,636,RC,inpatient,1,ME,,26.883,14.78565,,24.1947,90,percent of total billed charges,,,,26.883,100,percent of total billed charges,,,1.82,,,fee schedule,,,1.82,,,fee schedule,,,1.638,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,24.1947,90,percent of total billed charges,,,,25.53885,95,percent of total billed charges,,,,,,,,,2.02,,,fee schedule,,,2.02,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.638,500,
PREVNAR 13 0.5ml,2510350,CDM,90670,CPT,636,RC,inpatient,0.5,ML,,448.771,246.82405,,403.8939,90,percent of total billed charges,,,,448.771,100,percent of total billed charges,,,245.81,,,fee schedule,,,245.81,,,fee schedule,,,221.229,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,403.8939,90,percent of total billed charges,,,,426.33245,95,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,13.14,500,
EXPAREL 1.3% 226 mg/20ml,2510360,CDM,C9290,HCPCS,636,RC,inpatient,20,ME,,789.083,433.99565,,710.1747,90,percent of total billed charges,,,,789.083,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,710.1747,90,percent of total billed charges,,,,749.62885,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,500,789.083,
CALDOLOR 800mg/8ml,2510370,CDM,J1741,HCPCS,636,RC,inpatient,8,ME,,18.128,9.9704,,16.3152,90,percent of total billed charges,,,,18.128,100,percent of total billed charges,,,1.82,,,fee schedule,,,1.82,,,fee schedule,,,1.638,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,16.3152,90,percent of total billed charges,,,,17.2216,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.638,500,
MORPHINE 4mg (UP TO 10mg),2510400,CDM,J2270,HCPCS,636,RC,inpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,4.86,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,2.12,,,fee schedule,,,2.12,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.12,500,
MIDAZOLAM 2mg,2510440,CDM,J2250,HCPCS,636,RC,inpatient,2,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.126,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,3.89,,,fee schedule,,,3.89,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.126,500,
OMNIPAQUE 300mg 100ml,2510460,CDM,Q9967,HCPCS,636,RC,inpatient,100,ME,,195.185,107.35175,,175.6665,90,percent of total billed charges,,,,195.185,100,percent of total billed charges,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,0.117,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,175.6665,90,percent of total billed charges,,,,185.42575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.117,500,
INVEGA SUSTENNA 234 MG,2510628,CDM,J2426,HCPCS,636,RC,inpatient,234,ME,,3969.62,2183.291,,3572.658,90,percent of total billed charges,,,,3969.62,100,percent of total billed charges,,,13.1,,,fee schedule,,,13.1,,,fee schedule,,,11.79,,,fee schedule,,,,,,,,,,,,,,,,1984.81,50,percent of total billed charges,,,,,,,,,,,,,,,,3572.658,90,percent of total billed charges,,,,3771.139,95,percent of total billed charges,,,,,,,,,7.24,,,fee schedule,,,7.24,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,7.24,3969.62,
PROTAMINE SULFATE INJ 250MG,2510632,CDM,J2720,HCPCS,636,RC,inpatient,250,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,1.36,,,fee schedule,,,1.36,,,fee schedule,,,1.224,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,5.66,,,fee schedule,,,5.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.224,500,
"Injection, daptomycin,500 mg",2510650,CDM,,,636,RC,inpatient,500,ME,,280.984,154.5412,,252.8856,90,percent of total billed charges,,,,280.984,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,252.8856,90,percent of total billed charges,,,,266.9348,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,252.8856,500,
Acyclovir 50 MG/ML,2510652,CDM,J0133,HCPCS,636,RC,inpatient,50,ME,,18.849,10.36695,,16.9641,90,percent of total billed charges,,,,18.849,100,percent of total billed charges,,,0.06,,,fee schedule,,,0.06,,,fee schedule,,,0.054,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,16.9641,90,percent of total billed charges,,,,17.90655,95,percent of total billed charges,,,,,,,,,0.02,,,fee schedule,,,0.02,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.02,500,
"BICILLIN CA 600,000 UNIT/ML",2510661,CDM,J0561,HCPCS,636,RC,inpatient,600,ML,,225.879,124.23345,,203.2911,90,percent of total billed charges,,,,225.879,100,percent of total billed charges,,,15.81,,,fee schedule,,,15.81,,,fee schedule,,,14.229,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,203.2911,90,percent of total billed charges,,,,214.58505,95,percent of total billed charges,,,,,,,,,5.66,,,fee schedule,,,5.66,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,5.66,500,
 RECOMBIVAX HB HEP B pediatric,2510672,CDM,90744,CPT,636,RC,inpatient,1,EA,,28.222,15.5221,,25.3998,90,percent of total billed charges,,,,28.222,100,percent of total billed charges,,,30.7,,,fee schedule,,,30.7,,,fee schedule,,,27.63,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,25.3998,90,percent of total billed charges,,,,26.8109,95,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,13.14,500,
NEUPGEN 300 MCG/0.5ML,2510677,CDM,J1442,HCPCS,636,RC,inpatient,300,ML,,756.741,416.20755,,681.0669,90,percent of total billed charges,,,,756.741,100,percent of total billed charges,,,1.12,,,fee schedule,,,1.12,,,fee schedule,,,1.008,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,681.0669,90,percent of total billed charges,,,,718.90395,95,percent of total billed charges,,,,,,,,,0.99,,,fee schedule,,,0.99,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.99,756.741,
HEPAGAM-B IM INJ .5 ML,2510684,CDM,J1571,HCPCS,636,RC,inpatient,0.5,ML,,342.063,188.13465,,307.8567,90,percent of total billed charges,,,,342.063,100,percent of total billed charges,,,68.89,,,fee schedule,,,68.89,,,fee schedule,,,62.001,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,307.8567,90,percent of total billed charges,,,,324.95985,95,percent of total billed charges,,,,,,,,,59.25,,,fee schedule,,,59.25,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,59.25,500,
DALVANCE 500MG INJECTION,2510696,CDM,,,636,RC,inpatient,500,ME,,4649.214,2557.0677,,4184.2926,90,percent of total billed charges,,,,4649.214,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2324.607,50,percent of total billed charges,,,,,,,,,,,,,,,,4184.2926,90,percent of total billed charges,,,,4416.7533,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2324.607,4649.214,
REGEN-COV 1200MG,2510722,CDM,Q0244,HCPCS,636,RC,inpatient,1200,ME,,0.103,0.05665,,0.0927,90,percent of total billed charges,,,,0.103,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,0.0927,90,percent of total billed charges,,,,0.09785,95,percent of total billed charges,,,,,,,,,0.01,,,fee schedule,,,0.01,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.01,500,
FLUZONE QUADRIVALENT 2021-2022,2510726,CDM,90686,CPT,636,RC,inpatient,1,EA,,37.801,20.79055,,34.0209,90,percent of total billed charges,,,,37.801,100,percent of total billed charges,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,19.557,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,34.0209,90,percent of total billed charges,,,,35.91095,95,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,15.45,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,15.45,500,
INJ.METHYLPRED ACETATE 1 MG,2510729,CDM,J1010,HCPCS,636,RC,inpatient,1,ME,,32.754,18.0147,,29.4786,90,percent of total billed charges,,,,32.754,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,29.4786,90,percent of total billed charges,,,,31.1163,95,percent of total billed charges,,,,,,,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.13,500,
CEFTRIAXONE 2000MG VIAL,2510744,CDM,J0696,HCPCS,636,RC,inpatient,2000,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.504,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,11.84,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.504,500,
FLUZONE QUADRIVALENT 2022-2023,2510748,CDM,90686,CPT,636,RC,inpatient,1,EA,,37.286,20.5073,,33.5574,90,percent of total billed charges,,,,37.286,100,percent of total billed charges,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,19.557,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,33.5574,90,percent of total billed charges,,,,35.4217,95,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,15.45,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,15.45,500,
Methocarbamol 10 ML Injection,2510764,CDM,J2800,HCPCS,636,RC,inpatient,10,ML,,97.438,53.5909,,87.6942,90,percent of total billed charges,,,,97.438,100,percent of total billed charges,,,14.29,,,fee schedule,,,14.29,,,fee schedule,,,12.861,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,87.6942,90,percent of total billed charges,,,,92.5661,95,percent of total billed charges,,,,,,,,,6.33,,,fee schedule,,,6.33,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,6.33,500,
Cefuroxime 1.5 g vial,2510766,CDM,J0697,HCPCS,636,RC,inpatient,1,EA,,11.433,6.28815,,10.2897,90,percent of total billed charges,,,,11.433,100,percent of total billed charges,,,2.09,,,fee schedule,,,2.09,,,fee schedule,,,1.881,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,10.2897,90,percent of total billed charges,,,,10.86135,95,percent of total billed charges,,,,,,,,,8.84,,,fee schedule,,,8.84,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.881,500,
Fluzone Quadrivalent 2023-2024,2510768,CDM,90686,CPT,636,RC,inpatient,1,EA,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,19.557,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,33.0939,90,percent of total billed charges,,,,34.93245,95,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,15.45,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,15.45,500,
Prevnar 20 Syringe,2510769,CDM,90677,CPT,636,RC,inpatient,1,EA,,512.322,281.7771,,461.0898,90,percent of total billed charges,,,,512.322,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,461.0898,90,percent of total billed charges,,,,486.7059,95,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,13.14,512.322,
HYLENEX 150U/ ML INJECTION,2510775,CDM,J3470,HCPCS,636,RC,inpatient,150,ML,,110.107,60.55885,,99.0963,90,percent of total billed charges,,,,110.107,100,percent of total billed charges,,,24.26,,,fee schedule,,,24.26,,,fee schedule,,,21.834,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,99.0963,90,percent of total billed charges,,,,104.60165,95,percent of total billed charges,,,,,,,,,7.05,,,fee schedule,,,7.05,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,7.05,500,
Nitroglycerin 50mg/10 ml Vial,2510778,CDM,J2305,HCPCS,636,RC,inpatient,10,ME,,35.329,19.43095,,31.7961,90,percent of total billed charges,,,,35.329,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,31.7961,90,percent of total billed charges,,,,33.56255,95,percent of total billed charges,,,,,,,,,1.3,,,fee schedule,,,1.3,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.3,500,
"Retacrit 40,000 Units/ML Inj",2510800,CDM,Q5106,HCPCS,636,RC,inpatient,40,ML,,833.682,458.5251,,750.3138,90,percent of total billed charges,,,,833.682,100,percent of total billed charges,,,11.63,,,fee schedule,,,11.63,,,fee schedule,,,10.467,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,750.3138,90,percent of total billed charges,,,,791.9979,95,percent of total billed charges,,,,,,,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,10.467,833.682,
"Anastrozole, oral, 1 mg",2510809,CDM,J8999,HCPCS,636,RC,inpatient,1,ME,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,2.1321,90,percent of total billed charges,,,,2.25055,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,2.1321,500,
FLUZONE TRIVALENT 2024-2025,2510817,CDM,90656,CPT,636,RC,inpatient,1,EA,,19.5803,10.769165,,17.62227,90,percent of total billed charges,,,,19.5803,100,percent of total billed charges,,,22.57,,,fee schedule,,,22.57,,,fee schedule,,,20.313,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,17.62227,90,percent of total billed charges,,,,18.601285,95,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,15.45,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,15.45,500,
TECHNETIUM TC 99m MERTIATIDE,3403005,CDM,A9562,HCPCS,636,RC,inpatient,1,EA,,362.457,199.35135,,326.2113,90,percent of total billed charges,,,,362.457,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,326.2113,90,percent of total billed charges,,,,344.33415,95,percent of total billed charges,,,,,,,,,31.27,,,fee schedule,,,31.27,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,31.27,500,
LYMPHOSEEK UP TO 0.5 MCI,3439520,CDM,,,636,RC,inpatient,1,EA,,306.219,168.42045,,275.5971,90,percent of total billed charges,,,,306.219,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,275.5971,90,percent of total billed charges,,,,290.90805,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,275.5971,500,
OPTIMARK - MRI - PER ML,6360050,CDM,A9579,HCPCS,636,RC,inpatient,1,ML,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,1.78,,,fee schedule,,,1.78,,,fee schedule,,,1.602,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,6.7671,90,percent of total billed charges,,,,7.14305,95,percent of total billed charges,,,,,,,,,2.55,,,fee schedule,,,2.55,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,1.602,500,
LEXISCAN 0.1mg,6362785,CDM,J2785,HCPCS,636,RC,inpatient,0.1,ME,,248.745,136.80975,,223.8705,90,percent of total billed charges,,,,248.745,100,percent of total billed charges,,,67.66,,,fee schedule,,,67.66,,,fee schedule,,,60.894,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,223.8705,90,percent of total billed charges,,,,236.30775,95,percent of total billed charges,,,,,,,,,56.55,,,fee schedule,,,56.55,,,fee schedule,,,,,,,,"$4,450 DRG Base Rate",,,,,,,56.55,500,
"CT LOCM 200-249 mg/ml ""PER ML""",6369947,CDM,Q9966,HCPCS,636,RC,inpatient,200,ME,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,0.36,,,fee schedule,,,0.36,,,fee schedule,,,0.324,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.324,500,
"LOCM 200-249 mg/ml ""PER ML""",6369947.1,CDM,Q9966,HCPCS,636,RC,inpatient,200,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.36,,,fee schedule,,,0.36,,,fee schedule,,,0.324,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,8.8065,90,percent of total billed charges,,,,9.29575,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.324,500,
"CT LOCM 300-399 mg/ml ""PER ML""",6369949,CDM,Q9967,HCPCS,636,RC,inpatient,300,ME,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,0.117,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.117,500,
"LOCM 300-399 mg/ml ""PER ML""",6369949.1,CDM,Q9967,HCPCS,636,RC,inpatient,300,ME,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,0.117,,,fee schedule,,,,,,,,,,,,,,,,500,50,percent of total billed charges,,,,,,,,,,,,,,,,3.708,90,percent of total billed charges,,,,3.914,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,"$4,450 DRG Base Rate",,,,,,,0.117,500,
ACTIGALL 300mg CAPSULE,2500060,CDM,,,637,RC,inpatient,300,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
NEO-SYNEPHRINE 2.5% 2ML DROPS,2500095,CDM,,,637,RC,inpatient,2,ML,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
NEOMYCIN 500MG TAB,2500105,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
AEROBID (AEROSOL),2500200,CDM,,,637,RC,inpatient,1,EA,,151.41,83.2755,,136.269,90,percent of total billed charges,,,,151.41,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,136.269,90,percent of total billed charges,,,,143.8395,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,136.269,151.41,
ALDACTONE 25MG TAB.,2500260,CDM,,,637,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
NITRO DUR 0.4MG/HR (10MG) TOP,2500345,CDM,,,637,RC,inpatient,0.4,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
NITROSTAT 1/150 (0.4MG) TAB,2500415,CDM,,,637,RC,inpatient,0.4,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
NORGESIC FORTE 100MG TAB,2500525,CDM,,,637,RC,inpatient,100,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
AMOXIL 500MG CAP,2500570,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
OSCAL 500MG TAB,2500865,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ANTIVERT 25MG TAB.,2500880,CDM,,,637,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PAPAVERINE 150MG TAB,2500945,CDM,,,637,RC,inpatient,150,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
APRESOLINE 10mg TABLET,2500960,CDM,,,637,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
APRESOLINE 25MG TABLET,2500980,CDM,,,637,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ARTANE 2MG TAB,2501040,CDM,,,637,RC,inpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ASPIRIN 81MG TAB,2501110,CDM,,,637,RC,inpatient,81,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
PENICILLIN 500MG TAB,2501125,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ATARAX 25MG TAB,2501140,CDM,,,637,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PERIACTIN 4MG TABLET,2501245,CDM,,,637,RC,inpatient,4,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PERSANTINE 25MG TABLET,2501285,CDM,,,637,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PHENERGAN 25MG TAB,2501335,CDM,,,637,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PHENOBARBITAL 100MG (1 1/2 GR),2501415,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
BACTRIM DS  800MG/160MG  TAB,2501460,CDM,,,637,RC,inpatient,800,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
BENADRYL 25MG  CAPSULE,2501520,CDM,,,637,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
BENEMID 500MG TAB,2501550,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
BENTYL 10MG CAP,2501560,CDM,,,637,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PLAQUENIL 200MG TAB,2501625,CDM,,,637,RC,inpatient,200,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
BETAPACE 80MG TAB,2501660,CDM,,,637,RC,inpatient,80,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
BIAXIN 500MG TAB,2501710,CDM,,,637,RC,inpatient,500,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,16.171,
PREDNISONE 5MG TABLET,2501795,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PREDNISONE 1MG TABLET,2501805,CDM,,,637,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PREDNISONE 20MG TAB,2501825,CDM,,,637,RC,inpatient,20,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
BUMEX 1 MG TAB,2501900,CDM,,,637,RC,inpatient,1,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
PLAVIX 75MG TABLET,2501906,CDM,,,637,RC,inpatient,75,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
WELLBUTRIN 150 MG SR,2501907,CDM,,,637,RC,inpatient,150,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
REQUIP 0.25MG TABLET,2501908,CDM,,,637,RC,inpatient,0.25,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
DEPAKETE 500 MG TABLET,2501909,CDM,,,637,RC,inpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
NEURONTIN 100MG CAPSULE,2501911,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
HYDROXYUREA 500MG,2501924,CDM,,,637,RC,inpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
COZAAR 25MG TABLET,2501929,CDM,,,637,RC,inpatient,25,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
CALAN SR 120 TABLET,2501931,CDM,,,637,RC,inpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
COREG 6.25MG TABLET,2501932,CDM,,,637,RC,inpatient,6.25,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
MS CONTIN 15MG TABLET,2501936,CDM,,,637,RC,inpatient,15,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
LOXITANE 25MG TABLET,2501938,CDM,,,637,RC,inpatient,25,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
ZYPREXA 5MG TABLET,2501943,CDM,,,637,RC,inpatient,5,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.613,90,percent of total billed charges,,,,18.5915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.613,19.57,
PAXIL 10MG TABLET,2501951,CDM,,,637,RC,inpatient,10,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
ASACOL 400MG TAB,2501968,CDM,,,637,RC,inpatient,400,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
EVISTA 60 MG TAB,2501969,CDM,,,637,RC,inpatient,60,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
AGGRENOX CAPSULE,2501978,CDM,,,637,RC,inpatient,1,EA,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
PROZAC 10MG,2501991,CDM,,,637,RC,inpatient,10,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
GUAIFENESIN LA 600MG TABLET,2502002,CDM,,,637,RC,inpatient,600,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
CHG CALAN 80MG TAG,2502010,CDM,,,637,RC,inpatient,80,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TOPROL XL 50mg TABLET,2502016,CDM,,,637,RC,inpatient,50,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
PROCAN SR 750MG SR SLOW REL,2502035,CDM,,,637,RC,inpatient,750,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
GLUCOPHAGE XR 500MG TABLET,2502037,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
GLUCOTROL XL 2.5MG TABLET,2502038,CDM,,,637,RC,inpatient,2.5,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
GEODON 20MG CAPSULE,2502039,CDM,,,637,RC,inpatient,20,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,16.171,
PLETAL 100MG TABLET,2502044,CDM,,,637,RC,inpatient,100,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
PROCARDIA 10MG CAP,2502045,CDM,,,637,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
FOSAMAX 70mg TABLET,2502046,CDM,,,637,RC,inpatient,70,ME,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,90,percent of total billed charges,,,,39.23785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.1727,41.303,
ZANAFLEX 4MG TABLET,2502047,CDM,,,637,RC,inpatient,4,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
CALAN SR 180MG SR SLOW REL,2502050,CDM,,,637,RC,inpatient,180,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
OXYCONTIN 10MG TABLET,2502053,CDM,,,637,RC,inpatient,10,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
OXYCONTIN 20MG TABLET,2502054,CDM,,,637,RC,inpatient,20,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
PROCARDIA XL 30MG SLOW REL,2502055,CDM,,,637,RC,inpatient,30,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
TAMIFLU 75mg CAPSULE,2502059,CDM,,,637,RC,inpatient,75,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
COMTAN 200mg TABLET,2502078,CDM,,,637,RC,inpatient,200,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
ZOCOR 40mg TABLET,2502089,CDM,,,637,RC,inpatient,40,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
TRILEPTAL 300mg TABLET,2502111,CDM,,,637,RC,inpatient,300,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
TOPAMAX 25mg TAB,2502122,CDM,,,637,RC,inpatient,25,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
TOPAMAX 100mg TABLET,2502123,CDM,,,637,RC,inpatient,100,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
DETROL LA 2mg CAPSULE,2502128,CDM,,,637,RC,inpatient,2,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
KEPPRA 500mg TABLET,2502136,CDM,,,637,RC,inpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
PROLIXIN 5MG TAB,2502155,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ZEBETA 5mg TABLET,2502156,CDM,,,637,RC,inpatient,5,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
ZETRA 10mg TABLET,2502157,CDM,,,637,RC,inpatient,10,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
PRIMIDONE 50mg TABLET,2502158,CDM,,,637,RC,inpatient,50,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,90,percent of total billed charges,,,,3.3269,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.1518,3.502,
NORCO 10/325 TABLET,2502161,CDM,,,637,RC,inpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
PROTONIX 20mg TABLET,2502176,CDM,,,637,RC,inpatient,20,ME,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,90,percent of total billed charges,,,,14.18825,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.4415,14.935,
CLOZARIL 100mg TABLET,2502183,CDM,,,637,RC,inpatient,100,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
DEPAKOTE 500mg TABLET - ER,2502184,CDM,,,637,RC,inpatient,500,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
LYRICA 25mg TABLET,2502187,CDM,,,637,RC,inpatient,25,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
DEPAKOTE 250mg TABLET - ER,2502198,CDM,,,637,RC,inpatient,250,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
NORMODYNE 100mg TAB (LABETALOL,2502204,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PERCOCET 5/325 TABLET,2502216,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LAMICTAL 25mg TABLET,2502219,CDM,,,637,RC,inpatient,25,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,90,percent of total billed charges,,,,10.9592,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.3824,11.536,
SEROQUEL 200mg TABLET,2502229,CDM,,,637,RC,inpatient,200,ME,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,90,percent of total billed charges,,,,20.7442,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.6524,21.836,
REQUIP 1mg TABLET,2502231,CDM,,,637,RC,inpatient,1,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
JANUVIA 100mg,2502233,CDM,,,637,RC,inpatient,100,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
LAMICTOL 100mg,2502238,CDM,,,637,RC,inpatient,100,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
LAMISIL 250mg,2502239,CDM,,,637,RC,inpatient,250,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,90,percent of total billed charges,,,,29.45285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.9027,31.003,
FIORICET,2502243,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
AVODART 0.5mg,2502244,CDM,,,637,RC,inpatient,0.5,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
CARDIZEM 30MG TAB,2502250,CDM,,,637,RC,inpatient,30,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
MINOXIDIL 10mg,2502252,CDM,,,637,RC,inpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
NIACINAMIDE 500mg,2502253,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LYRICA 75,2502264,CDM,,,637,RC,inpatient,1,EA,,18.231,10.02705,,16.4079,90,percent of total billed charges,,,,18.231,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.4079,90,percent of total billed charges,,,,17.31945,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.4079,18.231,
PROSCAR 5MG TAB,2502265,CDM,,,637,RC,inpatient,5,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
EXELON 3mg CAPSULE,2502277,CDM,,,637,RC,inpatient,3,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
CARDIZEM CD 120MG SLOW REL,2502310,CDM,,,637,RC,inpatient,120,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
CARDIZEM CD 180MG SLOW REL,2502320,CDM,,,637,RC,inpatient,180,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
CLOZAPINE 25mg TABLET,2502322,CDM,,,637,RC,inpatient,25,ME,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,90,percent of total billed charges,,,,5.77315,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.4693,6.077,
PHENYLEPHRINE 10mg TAB,2502326,CDM,,,637,RC,inpatient,10,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
PERCOCET 10/325 TABLET,2502328,CDM,,,637,RC,inpatient,1,EA,,8.24,4.532,,7.416,90,percent of total billed charges,,,,8.24,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.416,90,percent of total billed charges,,,,7.828,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.416,8.24,
CHOLECALCIFEROL 1000u TAB,2502333,CDM,,,637,RC,inpatient,1,EA,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
CARDURA 2MG TAB,2502360,CDM,,,637,RC,inpatient,2,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
CATAPRES/CLONIDINE 0.1MG TAB,2502380,CDM,,,637,RC,inpatient,0.1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PROVERA 5MG TAB,2502445,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
PYRIDIUM 100MG TAB,2502485,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ORAGEL 1 TUBE,2502505,CDM,,,637,RC,inpatient,1,EA,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,90,percent of total billed charges,,,,19.66785,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.6327,20.703,
CEFTIN 250 MG TAB,2502520,CDM,,,637,RC,inpatient,250,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,16.171,
REGLAN 5MG TAB,2502665,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
RENESE-R 2/0.25MG TAB,2502725,CDM,,,637,RC,inpatient,0.25,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
RESTORIL 15MG CAP,2502745,CDM,,,637,RC,inpatient,15,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
CIPRO 500MG TAB,2502770,CDM,,,637,RC,inpatient,500,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
CLEOCIN 150MG CAP.,2502850,CDM,,,637,RC,inpatient,150,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
RITALIN 5MG TAB,2502865,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ROBAXIN 500MG TAB,2502885,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ROBINUL 1MG TAB,2502925,CDM,,,637,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ROBITUSSIN 100mg/5ml Unit Dose,2502935,CDM,,,637,RC,inpatient,100,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
ROBITUSSIN AC SYRUP,2502955,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ROCALTROL 0.25MCG CAP,2502975,CDM,,,637,RC,inpatient,1,EA,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
COLACE/DIOCTO 20MG/5ML,2502990,CDM,,,637,RC,inpatient,20,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
COLCHICINE 0.6MG TAB.,2503000,CDM,,,637,RC,inpatient,0.6,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
LIDODERM 5% 700mg PATCH,2503001,CDM,,,637,RC,inpatient,700,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.613,90,percent of total billed charges,,,,18.5915,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.613,19.57,
ROXANOL SOLUTION 20MG/ML LIQ,2503065,CDM,,,637,RC,inpatient,20,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
RYTHMOL 150MG TAB,2503075,CDM,,,637,RC,inpatient,150,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
CORDARONE 200MG TABLET,2503130,CDM,,,637,RC,inpatient,200,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,90,percent of total billed charges,,,,15.36245,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.5539,16.171,
COUMADIN 1MG TAB.,2503240,CDM,,,637,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
COUMADIN 2MG TAB,2503250,CDM,,,637,RC,inpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
COUMADIN 5MG TAB,2503280,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SINEMET 10-100 TAB,2503285,CDM,,,637,RC,inpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
SINEMET 25-100 TAB,2503295,CDM,,,637,RC,inpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
SINEMET 25-250 TAB,2503305,CDM,,,637,RC,inpatient,1,EA,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
SINEQUAN 10MG CAP,2503325,CDM,,,637,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
CYTOTEC 100MCG TAB,2503350,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SINEQUAN 50MG CAP,2503355,CDM,,,637,RC,inpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SODIUM BICARBONATE 10GR TAB,2503405,CDM,,,637,RC,inpatient,10,GR,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SODIUM CHLORIDE 1GM TAB,2503465,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SPEC-T DM 10MG LOZENGE,2503625,CDM,,,637,RC,inpatient,10,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
DANOCRINE 200MG CAP.,2503650,CDM,,,637,RC,inpatient,200,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
STELAZINE 2MG TAB,2503675,CDM,,,637,RC,inpatient,2,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
STUARTNATAL 1+1 TAB,2503755,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DECADRON 4 MG TAB,2503820,CDM,,,637,RC,inpatient,4,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SURMONTIL 25MG CAP,2503865,CDM,,,637,RC,inpatient,25,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
DECLOMYCIN 150MG CAP,2503880,CDM,,,637,RC,inpatient,150,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
SYMMETREL 100MG CAP,2503895,CDM,,,637,RC,inpatient,100,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
SYNTHROID 0.025MG TAB,2503955,CDM,,,637,RC,inpatient,0.025,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
SYNTHROID 0.05MG TAB,2503965,CDM,,,637,RC,inpatient,0.05,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DEMEROL 50MG/5ML SYRUP,2503970,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DEPAKENE 250MG CAP,2503990,CDM,,,637,RC,inpatient,250,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
SYNTHROID 0.112MG TAB,2503995,CDM,,,637,RC,inpatient,0.112,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DEPAKENE 250MG/5ML SYRUP,2504000,CDM,,,637,RC,inpatient,250,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
DEPAKOTE 250MG CAP.,2504010,CDM,,,637,RC,inpatient,250,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
DESYREL 100MG TAB,2504140,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TAMBOCOR 50MG TAB,2504145,CDM,,,637,RC,inpatient,50,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
TEGRETOL 200MG TAB,2504195,CDM,,,637,RC,inpatient,200,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TENEX 1MG TAB,2504205,CDM,,,637,RC,inpatient,1,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
TENORMIN 50MG TAB,2504225,CDM,,,637,RC,inpatient,50,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
DIAMOX 250MG TAB,2504250,CDM,,,637,RC,inpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TESSALON PERLES 100MG CAP,2504255,CDM,,,637,RC,inpatient,100,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
TETRACYCLINE 250MG CAP,2504295,CDM,,,637,RC,inpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DILANTIN 100MG CAP,2504330,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DILANTIN 50MG CHEWABLE,2504370,CDM,,,637,RC,inpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DILAUDID 2MG TAB,2504380,CDM,,,637,RC,inpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
THIAMINE 100MG TAB,2504415,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
THORAZINE 25MG TAB,2504445,CDM,,,637,RC,inpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DISALCID 500MG TAB,2504460,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DITROPAN 5MG TAB,2504480,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
Diuril 250mg tab,2504490,CDM,,,637,RC,inpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DONNATAL 5ML ELIXIR,2504560,CDM,,,637,RC,inpatient,5,ML,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
DYAZIDE 50MG/25MG CAP,2504760,CDM,,,637,RC,inpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TORADOL 10MG TAB,2504765,CDM,,,637,RC,inpatient,10,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
ECOTRIN 325MG TAB,2504850,CDM,,,637,RC,inpatient,325,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
EFFEXOR 37.5MG TAB,2504890,CDM,,,637,RC,inpatient,37.5,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
TRENTAL 400MG TAB,2504925,CDM,,,637,RC,inpatient,400,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ELAVIL 10MG TAB,2504930,CDM,,,637,RC,inpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ELAVIL 50MG TAB,2504950,CDM,,,637,RC,inpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TUCKS MEDICATED PADS - BOX,2505045,CDM,,,637,RC,inpatient,1,EA,,23.896,13.1428,,21.5064,90,percent of total billed charges,,,,23.896,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.5064,90,percent of total billed charges,,,,22.7012,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.5064,23.896,
ENTEX CAP,2505100,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
TYLENOL 160MG/EML ELIXIR,2505145,CDM,,,637,RC,inpatient,160,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
TYLENOL 325MG TAB,2505175,CDM,,,637,RC,inpatient,325,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
TYLENOL 500MG TAB,2505185,CDM,,,637,RC,inpatient,500,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,90,percent of total billed charges,,,,3.62045,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3.4299,3.811,
TYLENOL #3 TABLET,2505245,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ERYTHROMYCIN BASE 250MG TAB,2505260,CDM,,,637,RC,inpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ERYTHROMYCIN BASE 500MG TAB,2505270,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ULTRAM 50MG TAB,2505285,CDM,,,637,RC,inpatient,50,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
ESTRACE 1MG TAB,2505320,CDM,,,637,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
FEOSOL 220MG/5ML ELIXIR,2505440,CDM,,,637,RC,inpatient,220,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
FERRO-SEQUELS 150MG/100MG CAP,2505480,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
VALIUM 2MG TAB,2505485,CDM,,,637,RC,inpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
VALIUM 5MG TAB,2505495,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
FIBERCON TAB,2505510,CDM,,,637,RC,inpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
FLAGYL 500MG TAB,2505570,CDM,,,637,RC,inpatient,500,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,90,percent of total billed charges,,,,8.8065,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.343,9.27,
FLEXERIL 10MG TAB,2505620,CDM,,,637,RC,inpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
FLORINEF 0.1MG TAB,2505640,CDM,,,637,RC,inpatient,0.4,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
FLOXIN 300MG TAB,2505670,CDM,,,637,RC,inpatient,300,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,90,percent of total billed charges,,,,17.51515,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.5933,18.437,
VIBRAMYCIN 100mg VIAL,2505755,CDM,,,637,RC,inpatient,100,ME,,58.504,32.1772,,52.6536,90,percent of total billed charges,,,,58.504,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.6536,90,percent of total billed charges,,,,55.5788,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.6536,58.504,
FOLVITE 1MG TAB,2505760,CDM,,,637,RC,inpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
VIBRAMYCIN 25MG/5ML SUSP,2505775,CDM,,,637,RC,inpatient,25,ME,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,90,percent of total billed charges,,,,31.7034,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.0348,33.372,
FURADANTIN 5MG/ML SUSP,2505850,CDM,,,637,RC,inpatient,5,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
VIT B-12 500MCG TAB,2505915,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
VIT C 500MG TAB,2505935,CDM,,,637,RC,inpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
"VIT-D 50,000 UNITS TAB",2505955,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
VIT-E 400 IU CAP,2505965,CDM,,,637,RC,inpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
VOLTAREN 50MG TAB,2506005,CDM,,,637,RC,inpatient,50,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,90,percent of total billed charges,,,,7.73015,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.3233,8.137,
WELLBUTRIN 100MG TAB,2506015,CDM,,,637,RC,inpatient,100,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,90,percent of total billed charges,,,,5.4796,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.1912,5.768,
GLUCOTROL 5MG TAB,2506080,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
HABITROL 7MG TOPICAL,2506200,CDM,,,637,RC,inpatient,7,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,90,percent of total billed charges,,,,16.34095,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15.4809,17.201,
ZAROXOLYN/DIULO 5MG TAB,2506225,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
HALDOL 5MG TAB,2506280,CDM,,,637,RC,inpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
ZOLOFT 50MG TAB,2506425,CDM,,,637,RC,inpatient,50,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,90,percent of total billed charges,,,,12.03555,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.4021,12.669,
ZOVIRAX 200MG CAP,2506445,CDM,,,637,RC,inpatient,200,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,90,percent of total billed charges,,,,6.55595,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.2109,6.901,
ZYLOPRIM 100MG TAB,2506495,CDM,,,637,RC,inpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,90,percent of total billed charges,,,,4.40325,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.1715,4.635,
CEPHALEXIN SUSP 250MG/5CC,2507480,CDM,,,637,RC,inpatient,250,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,90,percent of total billed charges,,,,9.88285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.3627,10.403,
TRAUMA RESP W CRITICAL CARE,6840390,CDM,G0390,HCPCS,684,RC,inpatient,,,,1389.779,764.37845,,1250.8011,90,percent of total billed charges,,,,1389.779,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1250.8011,90,percent of total billed charges,,,,1320.29005,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1250.8011,1389.779,
POST OP RECOVERY  1-30 MIN,7100000,CDM,,,710,RC,inpatient,,,,166.551,91.60305,,149.8959,90,percent of total billed charges,,,,166.551,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,149.8959,90,percent of total billed charges,,,,158.22345,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,149.8959,166.551,
POST OP RECOVERY 31-60 MIN,7100010,CDM,,,710,RC,inpatient,,,,279.233,153.57815,,251.3097,90,percent of total billed charges,,,,279.233,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,251.3097,90,percent of total billed charges,,,,265.27135,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,251.3097,279.233,
POST OP RECOVERY 61-90 MIN,7100020,CDM,,,710,RC,inpatient,,,,340.518,187.2849,,306.4662,90,percent of total billed charges,,,,340.518,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,306.4662,90,percent of total billed charges,,,,323.4921,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,306.4662,340.518,
POST OP RECOVERY 91-120 MI,7100030,CDM,,,710,RC,inpatient,,,,380.688,209.3784,,342.6192,90,percent of total billed charges,,,,380.688,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,342.6192,90,percent of total billed charges,,,,361.6536,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,342.6192,380.688,
POST OP RECOVERY 121-150 MIN,7100040,CDM,,,710,RC,inpatient,,,,420.446,231.2453,,378.4014,90,percent of total billed charges,,,,420.446,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.4014,90,percent of total billed charges,,,,399.4237,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.4014,420.446,
POST OP RECOVERY 151-180 MIN,7100050,CDM,,,710,RC,inpatient,,,,485.439,266.99145,,436.8951,90,percent of total billed charges,,,,485.439,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,436.8951,90,percent of total billed charges,,,,461.16705,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,436.8951,485.439,
POST OP RECOVERY 241-270 MIN,7100080,CDM,,,710,RC,inpatient,,,,751.179,413.14845,,676.0611,90,percent of total billed charges,,,,751.179,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,676.0611,90,percent of total billed charges,,,,713.62005,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,676.0611,751.179,
AMBULATORY SURG RECOVERY/HRLY,7100130,CDM,,,710,RC,inpatient,,,,618,339.9,,556.2,90,percent of total billed charges,,,,618,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,556.2,90,percent of total billed charges,,,,587.1,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,556.2,618,
POSTOP RECOVERY TO ONE HOUR PA,7101000,CDM,,,710,RC,inpatient,,,,661.26,363.693,,595.134,90,percent of total billed charges,,,,661.26,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,595.134,90,percent of total billed charges,,,,628.197,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,595.134,661.26,
POSTOP RECOVERY ADDL 30MINS PA,7102000,CDM,,,710,RC,inpatient,,,,330.63,181.8465,,297.567,90,percent of total billed charges,,,,330.63,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.567,90,percent of total billed charges,,,,314.0985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.567,330.63,
POSTOP RECOVERY ADDL 30MINS GY,7103000,CDM,,,710,RC,inpatient,,,,330.63,181.8465,,297.567,90,percent of total billed charges,,,,330.63,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.567,90,percent of total billed charges,,,,314.0985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.567,330.63,
POSTOP RECOVERY ADDL 30MINS MS,7104000,CDM,,,710,RC,inpatient,,,,330.63,181.8465,,297.567,90,percent of total billed charges,,,,330.63,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.567,90,percent of total billed charges,,,,314.0985,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.567,330.63,
POST OP RECOV ADDL 30 MINS ICU,7105000,CDM,,,710,RC,inpatient,,,,551.05,303.0775,,495.945,90,percent of total billed charges,,,,551.05,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,495.945,90,percent of total billed charges,,,,523.4975,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,495.945,551.05,
FETAL NON-STRESS TEST,7200020,CDM,59025,CPT,720,RC,inpatient,,,,158.002,86.9011,,142.2018,90,percent of total billed charges,,,,158.002,100,percent of total billed charges,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,163.042875,,,fee schedule,,,49.2655,,,fee schedule,,,49.2655,,,fee schedule,,,,,,,,,49.2655,,,fee schedule,,,,,,,,,,142.2018,90,percent of total billed charges,,,,150.1019,95,percent of total billed charges,,,50.743465,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,49.2655,,,fee schedule,,,49.2655,250,
LABOR,7210000,CDM,,,720,RC,inpatient,,,,506.657,278.66135,,455.9913,90,percent of total billed charges,,,,506.657,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,455.9913,90,percent of total billed charges,,,,481.32415,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,455.9913,506.657,
DELIVERY,7220000,CDM,,,720,RC,inpatient,,,,405.717,223.14435,,365.1453,90,percent of total billed charges,,,,405.717,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.1453,90,percent of total billed charges,,,,385.43115,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.1453,405.717,
FETAL STRESS TEST,7200030,CDM,59020,CPT,721,RC,inpatient,,,,295.404,162.4722,,265.8636,90,percent of total billed charges,,,,295.404,100,percent of total billed charges,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,163.042875,,,fee schedule,,,71.568125,,,fee schedule,,,71.568125,,,fee schedule,,,,,,,,,71.568125,,,fee schedule,,,,,,,,,,265.8636,90,percent of total billed charges,,,,280.6338,95,percent of total billed charges,,,73.71516875,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,71.568125,,,fee schedule,,,71.568125,295.404,
CIRCUMCISION NB IP W/BLOCK,7230000,CDM,54150,CPT,723,RC,inpatient,,,,2083.69,1146.0295,,1875.321,90,percent of total billed charges,,,,2083.69,100,percent of total billed charges,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,1697.82075,,,fee schedule,,,94.869375,,,fee schedule,,,94.869375,,,fee schedule,,,,,,,,,94.869375,,,fee schedule,,,,,,,,,,1875.321,90,percent of total billed charges,,,,1979.5055,95,percent of total billed charges,,,97.71545625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,94.869375,,,fee schedule,,,94.869375,2083.69,
CIRCUMCISION NB IP W/O BLOCK,7230001,CDM,54150,CPT,723,RC,inpatient,,,52,447.02,245.861,,402.318,90,percent of total billed charges,,,,447.02,100,percent of total billed charges,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,1697.82075,,,fee schedule,,,94.869375,,,fee schedule,,,94.869375,,,fee schedule,,,,,,,,,94.869375,,,fee schedule,,,,,,,,,,402.318,90,percent of total billed charges,,,,424.669,95,percent of total billed charges,,,97.71545625,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,94.869375,,,fee schedule,,,94.869375,1886.4675,
DEFIBRILLATION - MED/SURG,4590040,CDM,93799,CPT,730,RC,inpatient,,,,44.187,24.30285,,39.7683,90,percent of total billed charges,,,,44.187,100,percent of total billed charges,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,124.23915,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.7683,90,percent of total billed charges,,,,41.97765,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.7683,138.0435,
ELECTROCARDIOGRAM (EKG),7300000,CDM,93005,CPT,730,RC,inpatient,,,,158.62,87.241,,142.758,90,percent of total billed charges,,,,158.62,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,49.1022,,,fee schedule,,,6.324625,,,fee schedule,,,6.324625,,,fee schedule,,,,,,,,,6.324625,,,fee schedule,,,,,,,,,,142.758,90,percent of total billed charges,,,,150.689,95,percent of total billed charges,,,6.51436375,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,6.324625,,,fee schedule,,,6.324625,158.62,
12 LEAD EKG - ER,7300001,CDM,93005,CPT,730,RC,inpatient,,,,174.276,95.8518,,156.8484,90,percent of total billed charges,,,,174.276,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,49.1022,,,fee schedule,,,6.324625,,,fee schedule,,,6.324625,,,fee schedule,,,,,,,,,6.324625,,,fee schedule,,,,,,,,,,156.8484,90,percent of total billed charges,,,,165.5622,95,percent of total billed charges,,,6.51436375,,,fee schedule,,,17,,,fee schedule,,,17,,,fee schedule,,,,,,,,,6.324625,,,fee schedule,,,6.324625,174.276,
TELEMETRY/MED-SURG,7320110,CDM,93041,CPT,730,RC,inpatient,,,,195.803,107.69165,,176.2227,90,percent of total billed charges,,,,195.803,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,49.1022,,,fee schedule,,,6.324625,,,fee schedule,,,6.324625,,,fee schedule,,,,,,,,,6.324625,,,fee schedule,,,,,,,,,,176.2227,90,percent of total billed charges,,,,186.01285,95,percent of total billed charges,,,6.51436375,,,fee schedule,,,6,,,fee schedule,,,6,,,fee schedule,,,,,,,,,6.324625,,,fee schedule,,,6,195.803,
Holter Monitor Set Up & Record,7313242,CDM,93242,CPT,731,RC,inpatient,,,,151.204,83.1622,,136.0836,90,percent of total billed charges,,,,151.204,100,percent of total billed charges,,,32.235,,,fee schedule,,,32.235,,,fee schedule,,,29.0115,,,fee schedule,,,11.9835,,,fee schedule,,,11.9835,,,fee schedule,,,,,,,,,11.9835,,,fee schedule,,,,,,,,,,136.0836,90,percent of total billed charges,,,,143.6438,95,percent of total billed charges,,,12.343005,,,fee schedule,,,14.67,,,fee schedule,,,14.67,,,fee schedule,,,,,,,,,11.9835,,,fee schedule,,,11.9835,151.204,
DRESS/DEBRID P-THICK BURN MED,4200200,CDM,16025,CPT,761,RC,inpatient,,,GP,335.265,184.39575,,301.7385,90,percent of total billed charges,,,,335.265,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,111.18025,,,fee schedule,,,111.18025,,,fee schedule,,,,,,,,,111.18025,,,fee schedule,,,,,,,,,,301.7385,90,percent of total billed charges,,,,318.50175,95,percent of total billed charges,,,114.5156575,,,fee schedule,,,205,,,fee schedule,,,205,,,fee schedule,,,,,,,,,111.18025,,,fee schedule,,,111.18025,335.265,
DRESS/DEBRID P-THICK BURN SM,4200210,CDM,16020,CPT,761,RC,inpatient,,,GP,196.524,108.0882,,176.8716,90,percent of total billed charges,,,,196.524,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,165.290625,,,fee schedule,,,55.923,,,fee schedule,,,55.923,,,fee schedule,,,,,,,,,55.923,,,fee schedule,,,,,,,,,,176.8716,90,percent of total billed charges,,,,186.6978,95,percent of total billed charges,,,57.60069,,,fee schedule,,,102,,,fee schedule,,,102,,,fee schedule,,,,,,,,,55.923,,,fee schedule,,,55.923,196.524,
OP PROCEDURE -,7610000,CDM,,,761,RC,inpatient,,,,164.285,90.35675,,147.8565,90,percent of total billed charges,,,,164.285,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.8565,90,percent of total billed charges,,,,156.07075,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.8565,164.285,
OP PROCEDURE -,7610001,CDM,,,761,RC,inpatient,,,,262.238,144.2309,,236.0142,90,percent of total billed charges,,,,262.238,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.0142,90,percent of total billed charges,,,,249.1261,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.0142,262.238,
CENTRAL LINE PLCMNT >5 YRS,7613655,CDM,36558,CPT,761,RC,inpatient,,,,4645.403,2554.97165,,4180.8627,90,percent of total billed charges,,,,4645.403,100,percent of total billed charges,,,3029.715,,,fee schedule,,,3029.715,,,fee schedule,,,2726.7435,,,fee schedule,,,253.983625,,,fee schedule,,,253.983625,,,fee schedule,,,,,,,,,253.983625,,,fee schedule,,,,,,,,,,4180.8627,90,percent of total billed charges,,,,4413.13285,95,percent of total billed charges,,,261.6031338,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,253.983625,,,fee schedule,,,250,4645.403,
DX BONE MARROW NEEDLE BIOPSY,7613822,CDM,38221,CPT,761,RC,inpatient,,,,2026.319,1114.47545,,1823.6871,90,percent of total billed charges,,,,2026.319,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1372.5855,,,fee schedule,,,69.238,,,fee schedule,,,69.238,,,fee schedule,,,,,,,,,69.238,,,fee schedule,,,,,,,,,,1823.6871,90,percent of total billed charges,,,,1925.00305,95,percent of total billed charges,,,71.31514,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,69.238,,,fee schedule,,,69.238,2026.319,
ARTERIAL LINE PLACEMENT,7614000,CDM,36620,CPT,761,RC,inpatient,,,,1147.523,631.13765,,1032.7707,90,percent of total billed charges,,,,1147.523,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,43.27375,,,fee schedule,,,43.27375,,,fee schedule,,,,,,,,,43.27375,,,fee schedule,,,,,,,,,,1032.7707,90,percent of total billed charges,,,,1090.14685,95,percent of total billed charges,,,44.5719625,,,fee schedule,,,363,,,fee schedule,,,363,,,fee schedule,,,,,,,,,43.27375,,,fee schedule,,,43.27375,1147.523,
INTUBATION BEDSIDE,7614100,CDM,31500,CPT,761,RC,inpatient,,,,1405.744,773.1592,,1265.1696,90,percent of total billed charges,,,,1405.744,100,percent of total billed charges,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,190.2285,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,,,,,,,,1265.1696,90,percent of total billed charges,,,,1335.4568,95,percent of total billed charges,,,142.9731413,,,fee schedule,,,363,,,fee schedule,,,363,,,fee schedule,,,,,,,,,138.808875,,,fee schedule,,,138.808875,1405.744,
CHEST TUBE PLACEMENT,7614150,CDM,32551,CPT,761,RC,inpatient,,,,1196.345,657.98975,,1076.7105,90,percent of total billed charges,,,,1196.345,100,percent of total billed charges,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,1361.87325,,,fee schedule,,,152.789625,,,fee schedule,,,152.789625,,,fee schedule,,,,,,,,,152.789625,,,fee schedule,,,,,,,,,,1076.7105,90,percent of total billed charges,,,,1136.52775,95,percent of total billed charges,,,157.3733138,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,152.789625,,,fee schedule,,,152.789625,1513.1925,
CHEST TUBE REMOVAL,7614155,CDM,32552,CPT,761,RC,inpatient,,,,969.848,533.4164,,872.8632,90,percent of total billed charges,,,,969.848,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,529.51725,,,fee schedule,,,155.11975,,,fee schedule,,,155.11975,,,fee schedule,,,,,,,,,155.11975,,,fee schedule,,,,,,,,,,872.8632,90,percent of total billed charges,,,,921.3556,95,percent of total billed charges,,,159.7733425,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,155.11975,,,fee schedule,,,155.11975,969.848,
PICC LINE PLCMT W/O IMAGING,7614200,CDM,36569,CPT,761,RC,inpatient,,,,1755.738,965.6559,,1580.1642,90,percent of total billed charges,,,,1755.738,100,percent of total billed charges,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,1361.87325,,,fee schedule,,,92.872125,,,fee schedule,,,92.872125,,,fee schedule,,,,,,,,,92.872125,,,fee schedule,,,,,,,,,,1580.1642,90,percent of total billed charges,,,,1667.9511,95,percent of total billed charges,,,95.65828875,,,fee schedule,,,297,,,fee schedule,,,297,,,fee schedule,,,,,,,,,92.872125,,,fee schedule,,,92.872125,1755.738,
BLADDER SCAN US - NON IMAGE,7615179,CDM,51798,CPT,761,RC,inpatient,,,,484.924,266.7082,,436.4316,90,percent of total billed charges,,,,484.924,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,52.6095,,,fee schedule,,,11.31775,,,fee schedule,,,11.31775,,,fee schedule,,,,,,,,,11.31775,,,fee schedule,,,,,,,,,,436.4316,90,percent of total billed charges,,,,460.6778,95,percent of total billed charges,,,11.6572825,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,11.31775,,,fee schedule,,,11.31775,484.924,
BONE MARROW ASPIRATIONS & BX,7618222,CDM,38222,CPT,761,RC,inpatient,,,,2905.115,1597.81325,,2614.6035,90,percent of total billed charges,,,,2905.115,100,percent of total billed charges,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,2364.53175,,,fee schedule,,,73.89825,,,fee schedule,,,73.89825,,,fee schedule,,,,,,,,,73.89825,,,fee schedule,,,,,,,,,,2614.6035,90,percent of total billed charges,,,,2759.85925,95,percent of total billed charges,,,76.1151975,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,73.89825,,,fee schedule,,,73.89825,2905.115,
BLADDER SCAN,7618500,CDM,51798,CPT,761,RC,inpatient,,,,484.924,266.7082,,436.4316,90,percent of total billed charges,,,,484.924,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,52.6095,,,fee schedule,,,11.31775,,,fee schedule,,,11.31775,,,fee schedule,,,,,,,,,11.31775,,,fee schedule,,,,,,,,,,436.4316,90,percent of total billed charges,,,,460.6778,95,percent of total billed charges,,,11.6572825,,,fee schedule,,,250,,,fee schedule,,,250,,,fee schedule,,,,,,,,,11.31775,,,fee schedule,,,11.31775,484.924,
OBSERVATION - DIRECT ADMISSION,7620379,CDM,G0379,HCPCS,762,RC,inpatient,,,,555.273,305.40015,,499.7457,90,percent of total billed charges,,,,555.273,100,percent of total billed charges,,,520.2855,,,fee schedule,,,520.2855,,,fee schedule,,,468.25695,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,499.7457,90,percent of total billed charges,,,,527.50935,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,468.25695,555.273,
OBSERVATION PER HOUR (60 MIN),7629999,CDM,G0378,HCPCS,762,RC,inpatient,,,,39.552,21.7536,,35.5968,90,percent of total billed charges,,,,39.552,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.5968,90,percent of total billed charges,,,,37.5744,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.5968,39.552,
REGENERON INFUSION & MONITOR,2600240,CDM,M0243,HCPCS,771,RC,inpatient,,,,709.773,390.37515,,638.7957,90,percent of total billed charges,,,,709.773,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,638.7957,90,percent of total billed charges,,,,674.28435,95,percent of total billed charges,,,,,,,,,450,,,fee schedule,,,450,,,fee schedule,,,,,,,,,,,,,,,450,709.773,
IM IMMUNIZATION INITIAL,7710000,CDM,90471,CPT,771,RC,inpatient,,,,77.456,42.6008,,69.7104,90,percent of total billed charges,,,,77.456,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,69.7104,90,percent of total billed charges,,,,73.5832,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,77.456,
ADMIN PNEUMONIA VACCINE - OBS,7710001,CDM,G0009,HCPCS,771,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,36.20295,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,36.20295,51.603,
IM IMMUNIZATION ADD'L,7710002,CDM,90472,CPT,771,RC,inpatient,,,,58.504,32.1772,,52.6536,90,percent of total billed charges,,,,58.504,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,,,,,,14.6465,,,fee schedule,,,,,,,,,,52.6536,90,percent of total billed charges,,,,55.5788,95,percent of total billed charges,,,15.085895,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,14.6465,,,fee schedule,,,13.14,58.504,
ADMIN FLU VACCINE LDRP,7710008,CDM,90471,CPT,771,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN FLU VACCINE- OBS,7710010,CDM,90471,CPT,771,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN FLU VACCINE - MED/SURG,7710020,CDM,90471,CPT,771,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN PNEUMONIA VACCINE - M/S,7710030,CDM,90471,CPT,771,RC,inpatient,,,,53.354,29.3447,,48.0186,90,percent of total billed charges,,,,53.354,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,48.0186,90,percent of total billed charges,,,,50.6863,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,64.0395,
VACCINE/TOXOID ADMIN - OP,7710040,CDM,90471,CPT,771,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN FLU VACCINE - GERO,7710070,CDM,90471,CPT,771,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN PNEUMONIA VAC - GERO,7710071,CDM,90472,CPT,771,RC,inpatient,,,,53.354,29.3447,,48.0186,90,percent of total billed charges,,,,53.354,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,,,,,,14.6465,,,fee schedule,,,,,,,,,,48.0186,90,percent of total billed charges,,,,50.6863,95,percent of total billed charges,,,15.085895,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,14.6465,,,fee schedule,,,13.14,53.354,
ADMIN FLU VACCINE - REHAB,7710080,CDM,90471,CPT,771,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN FLU VACCINE - ICU,7710090,CDM,90471,CPT,771,RC,inpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,57.63555,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,,,,,,,,46.4427,90,percent of total billed charges,,,,49.02285,95,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN PNEUMONIA VACCINE - ICU,7710091,CDM,90472,CPT,771,RC,inpatient,,,,53.354,29.3447,,48.0186,90,percent of total billed charges,,,,53.354,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,,,,,,14.6465,,,fee schedule,,,,,,,,,,48.0186,90,percent of total billed charges,,,,50.6863,95,percent of total billed charges,,,15.085895,,,fee schedule,,,13.14,,,fee schedule,,,13.14,,,fee schedule,,,,,,,,,14.6465,,,fee schedule,,,13.14,53.354,
ADMIN HEP B VACCINE/NEWBORN,7713090,CDM,,,771,RC,inpatient,,,,33.681,18.52455,,30.3129,90,percent of total billed charges,,,,33.681,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.3129,90,percent of total billed charges,,,,31.99695,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.3129,33.681,
INITIAL ASSESSMENT - IOP,9009080,CDM,90791,CPT,900,RC,inpatient,,,,309.721,170.34655,,278.7489,90,percent of total billed charges,,,,309.721,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,124.4754,,,fee schedule,,,147.463625,,,fee schedule,,,147.463625,,,fee schedule,,,,,,,,,147.463625,,,fee schedule,,,,,,,,,,278.7489,90,percent of total billed charges,,,,294.23495,95,percent of total billed charges,,,151.8875338,,,fee schedule,,,,,,,,,,,,,,,,,,,,,147.463625,,,fee schedule,,,124.4754,309.721,
PSYCH THERAPY 30 MIN W/WO FAM,9140816,CDM,90832,CPT,914,RC,inpatient,,,,163.358,89.8469,,147.0222,90,percent of total billed charges,,,,163.358,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,124.4754,,,fee schedule,,,68.239375,,,fee schedule,,,68.239375,,,fee schedule,,,,,,,,,68.239375,,,fee schedule,,,,,,,,,,147.0222,90,percent of total billed charges,,,,155.1901,95,percent of total billed charges,,,70.28655625,,,fee schedule,,,,,,,,,,,,,,,,,,,,,68.239375,,,fee schedule,,,68.239375,163.358,
PSYCH THERAPY 45 MIN W/WO FAM,9140818,CDM,90834,CPT,914,RC,inpatient,,,,223.51,122.9305,,201.159,90,percent of total billed charges,,,,223.51,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,124.4754,,,fee schedule,,,90.209125,,,fee schedule,,,90.209125,,,fee schedule,,,,,,,,,90.209125,,,fee schedule,,,,,,,,,,201.159,90,percent of total billed charges,,,,212.3345,95,percent of total billed charges,,,92.91539875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,90.209125,,,fee schedule,,,90.209125,223.51,
PSYCH THERAPY 60 MIN W/WO FAM,9140821,CDM,90837,CPT,914,RC,inpatient,,,,223.51,122.9305,,201.159,90,percent of total billed charges,,,,223.51,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,124.4754,,,fee schedule,,,133.15,,,fee schedule,,,133.15,,,fee schedule,,,,,,,,,133.15,,,fee schedule,,,,,,,,,,201.159,90,percent of total billed charges,,,,212.3345,95,percent of total billed charges,,,137.1445,,,fee schedule,,,,,,,,,,,,,,,,,,,,,133.15,,,fee schedule,,,124.4754,223.51,
IOP GROUP THERAPY PER SESION,9159085,CDM,90853,CPT,915,RC,inpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,71.9985,,,fee schedule,,,71.9985,,,fee schedule,,,64.79865,,,fee schedule,,,23.967,,,fee schedule,,,23.967,,,fee schedule,,,,,,,,,23.967,,,fee schedule,,,,,,,,,,143.7777,90,percent of total billed charges,,,,151.76535,95,percent of total billed charges,,,24.68601,,,fee schedule,,,,,,,,,,,,,,,,,,,,,23.967,,,fee schedule,,,23.967,159.753,
FAMILY PSYTX W/PT PER SESSION,9160847,CDM,90847,CPT,916,RC,inpatient,,,,280.16,154.088,,252.144,90,percent of total billed charges,,,,280.16,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,124.4754,,,fee schedule,,,101.526875,,,fee schedule,,,101.526875,,,fee schedule,,,,,,,,,101.526875,,,fee schedule,,,,,,,,,,252.144,90,percent of total billed charges,,,,266.152,95,percent of total billed charges,,,104.5726813,,,fee schedule,,,,,,,,,,,,,,,,,,,,,101.526875,,,fee schedule,,,101.526875,280.16,
POLYSOM 6 YRS>,7409580,CDM,95810,CPT,920,RC,inpatient,,,TC,2360.039,1298.02145,,2124.0351,90,percent of total billed charges,,,,2360.039,100,percent of total billed charges,,,886.9455,,,fee schedule,,,886.9455,,,fee schedule,,,798.25095,,,fee schedule,,,623.142,,,fee schedule,,,623.142,,,fee schedule,,,,,,,,,623.142,,,fee schedule,,,,,,,,,,2124.0351,90,percent of total billed charges,,,,2242.03705,95,percent of total billed charges,,,641.83626,,,fee schedule,,,122,,,fee schedule,,,122,,,fee schedule,,,,,,,,,623.142,,,fee schedule,,,122,2360.039,
POLYSOMNOGRAM W/CPAP,7409581,CDM,95811,CPT,920,RC,inpatient,,,TC,2832.294,1557.7617,,2549.0646,90,percent of total billed charges,,,,2832.294,100,percent of total billed charges,,,886.9455,,,fee schedule,,,886.9455,,,fee schedule,,,798.25095,,,fee schedule,,,651.436375,,,fee schedule,,,651.436375,,,fee schedule,,,,,,,,,651.436375,,,fee schedule,,,,,,,,,,2549.0646,90,percent of total billed charges,,,,2690.6793,95,percent of total billed charges,,,670.9794663,,,fee schedule,,,205.37,,,fee schedule,,,205.37,,,fee schedule,,,,,,,,,651.436375,,,fee schedule,,,205.37,2832.294,
MULTIPLE SLEEP LATENCY TEST,9290000,CDM,95805,CPT,920,RC,inpatient,,,TC,1318.4,725.12,,1186.56,90,percent of total billed charges,,,,1318.4,100,percent of total billed charges,,,458.8815,,,fee schedule,,,458.8815,,,fee schedule,,,412.99335,,,fee schedule,,,431.406,,,fee schedule,,,431.406,,,fee schedule,,,,,,,,,431.406,,,fee schedule,,,,,,,,,,1186.56,90,percent of total billed charges,,,,1252.48,95,percent of total billed charges,,,444.34818,,,fee schedule,,,101,,,fee schedule,,,101,,,fee schedule,,,,,,,,,431.406,,,fee schedule,,,101,1318.4,
STD EXT ART 2 LEVEL,9200010,CDM,93922,CPT,921,RC,inpatient,,,,243.183,133.75065,,218.8647,90,percent of total billed charges,,,,243.183,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,99.19665,,,fee schedule,,,82.220125,,,fee schedule,,,82.220125,,,fee schedule,,,,,,,,,82.220125,,,fee schedule,,,,,,,,,,218.8647,90,percent of total billed charges,,,,231.02385,95,percent of total billed charges,,,84.68672875,,,fee schedule,,,27.3,,,fee schedule,,,27.3,,,fee schedule,,,,,,,,,82.220125,,,fee schedule,,,27.3,243.183,
US - LOW EXT ARTERIAL RT,9201501,CDM,93926,CPT,921,RC,inpatient,,,RT,302.202,166.2111,,271.9818,90,percent of total billed charges,,,,302.202,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,91.3059,,,fee schedule,,,143.802,,,fee schedule,,,143.802,,,fee schedule,,,,,,,,,143.802,,,fee schedule,,,,,,,,,,271.9818,90,percent of total billed charges,,,,287.0919,95,percent of total billed charges,,,148.11606,,,fee schedule,,,73,,,fee schedule,,,73,,,fee schedule,,,,,,,,,143.802,,,fee schedule,,,73,302.202,
US - LOW EXT ARTERIAL LT,9201502,CDM,93926,CPT,921,RC,inpatient,,,LT,302.202,166.2111,,271.9818,90,percent of total billed charges,,,,302.202,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,91.3059,,,fee schedule,,,143.802,,,fee schedule,,,143.802,,,fee schedule,,,,,,,,,143.802,,,fee schedule,,,,,,,,,,271.9818,90,percent of total billed charges,,,,287.0919,95,percent of total billed charges,,,148.11606,,,fee schedule,,,73,,,fee schedule,,,73,,,fee schedule,,,,,,,,,143.802,,,fee schedule,,,73,302.202,
DUP SCAN ART/ARTL BPGS UNI,9201602,CDM,93931,CPT,921,RC,inpatient,,,LT,304.571,167.51405,,274.1139,90,percent of total billed charges,,,,304.571,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,91.3059,,,fee schedule,,,123.496625,,,fee schedule,,,123.496625,,,fee schedule,,,,,,,,,123.496625,,,fee schedule,,,,,,,,,,274.1139,90,percent of total billed charges,,,,289.34245,95,percent of total billed charges,,,127.2015238,,,fee schedule,,,73,,,fee schedule,,,73,,,fee schedule,,,,,,,,,123.496625,,,fee schedule,,,73,304.571,
US - VENOUS DOPPLER RT,9201701,CDM,93971,CPT,921,RC,inpatient,,,RT,406.541,223.59755,,365.8869,90,percent of total billed charges,,,,406.541,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,91.3059,,,fee schedule,,,118.836375,,,fee schedule,,,118.836375,,,fee schedule,,,,,,,,,118.836375,,,fee schedule,,,,,,,,,,365.8869,90,percent of total billed charges,,,,386.21395,95,percent of total billed charges,,,122.4014663,,,fee schedule,,,73,,,fee schedule,,,73,,,fee schedule,,,,,,,,,118.836375,,,fee schedule,,,73,406.541,
US - VENOUS DOPPLER LT,9201702,CDM,93971,CPT,921,RC,inpatient,,,LT,406.541,223.59755,,365.8869,90,percent of total billed charges,,,,406.541,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,91.3059,,,fee schedule,,,118.836375,,,fee schedule,,,118.836375,,,fee schedule,,,,,,,,,118.836375,,,fee schedule,,,,,,,,,,365.8869,90,percent of total billed charges,,,,386.21395,95,percent of total billed charges,,,122.4014663,,,fee schedule,,,73,,,fee schedule,,,73,,,fee schedule,,,,,,,,,118.836375,,,fee schedule,,,73,406.541,
DUPLEX SCAN LOW-EXTR ART;BILAT,9210000,CDM,93925,CPT,921,RC,inpatient,,,,570.723,313.89765,,513.6507,90,percent of total billed charges,,,,570.723,100,percent of total billed charges,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,199.49895,,,fee schedule,,,240.002875,,,fee schedule,,,240.002875,,,fee schedule,,,,,,,,,240.002875,,,fee schedule,,,,,,,,,,513.6507,90,percent of total billed charges,,,,542.18685,95,percent of total billed charges,,,247.2029613,,,fee schedule,,,73,,,fee schedule,,,73,,,fee schedule,,,,,,,,,240.002875,,,fee schedule,,,73,570.723,
DUP SCAN UP-EXTR ART BIL092724,9210010,CDM,93930,CPT,921,RC,inpatient,,,,690.7901,379.934555,,621.71109,90,percent of total billed charges,,,,690.7901,100,percent of total billed charges,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,199.49895,,,fee schedule,,,197.72775,,,fee schedule,,,197.72775,,,fee schedule,,,,,,,,,197.72775,,,fee schedule,,,,,,,,,,621.71109,90,percent of total billed charges,,,,656.250595,95,percent of total billed charges,,,203.6595825,,,fee schedule,,,33,,,fee schedule,,,33,,,fee schedule,,,,,,,,,197.72775,,,fee schedule,,,33,690.7901,
DUPLEX EXTRACRANIAL; BILATERAL,9210020,CDM,93880,CPT,921,RC,inpatient,,,,670.53,368.7915,,603.477,90,percent of total billed charges,,,,670.53,100,percent of total billed charges,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,199.49895,,,fee schedule,,,189.73875,,,fee schedule,,,189.73875,,,fee schedule,,,,,,,,,189.73875,,,fee schedule,,,,,,,,,,603.477,90,percent of total billed charges,,,,637.0035,95,percent of total billed charges,,,195.4309125,,,fee schedule,,,70,,,fee schedule,,,70,,,fee schedule,,,,,,,,,189.73875,,,fee schedule,,,70,670.53,
DUPLEX SCAN EXTR VEINS; BILAT,9210040,CDM,93970,CPT,921,RC,inpatient,,,,563.307,309.81885,,506.9763,90,percent of total billed charges,,,,563.307,100,percent of total billed charges,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,199.49895,,,fee schedule,,,186.742875,,,fee schedule,,,186.742875,,,fee schedule,,,,,,,,,186.742875,,,fee schedule,,,,,,,,,,506.9763,90,percent of total billed charges,,,,535.14165,95,percent of total billed charges,,,192.3451613,,,fee schedule,,,42,,,fee schedule,,,42,,,fee schedule,,,,,,,,,186.742875,,,fee schedule,,,42,563.307,
HOME SLEEP TEST TYPE III >6 HR,9290020,CDM,95806,CPT,929,RC,inpatient,,,,298.082,163.9451,,268.2738,90,percent of total billed charges,,,,298.082,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,94.203625,,,fee schedule,,,94.203625,,,fee schedule,,,,,,,,,94.203625,,,fee schedule,,,,,,,,,,268.2738,90,percent of total billed charges,,,,283.1779,95,percent of total billed charges,,,97.02973375,,,fee schedule,,,,,,,,,,,,,,,,,,,,,94.203625,,,fee schedule,,,94.203625,298.082,
"PHLEBOTOMY, THERAPEUTIC",9409919,CDM,99195,CPT,940,RC,inpatient,,,,139.977,76.98735,,125.9793,90,percent of total billed charges,,,,139.977,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,99.19665,,,fee schedule,,,95.535125,,,fee schedule,,,95.535125,,,fee schedule,,,,,,,,,95.535125,,,fee schedule,,,,,,,,,,125.9793,90,percent of total billed charges,,,,132.97815,95,percent of total billed charges,,,98.40117875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,95.535125,,,fee schedule,,,95.535125,139.977,
MEDICAL NUTRITION THERAPY 15M,9429780,CDM,97802,CPT,942,RC,inpatient,,,,71.585,39.37175,,64.4265,90,percent of total billed charges,,,,71.585,100,percent of total billed charges,,,31.7835,,,fee schedule,,,31.7835,,,fee schedule,,,28.60515,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,,,,,,31.623125,,,fee schedule,,,,,,,,,,64.4265,90,percent of total billed charges,,,,68.00575,95,percent of total billed charges,,,32.57181875,,,fee schedule,,,,,,,,,,,,,,,,,,,,,31.623125,,,fee schedule,,,28.60515,71.585,
MED NUTRITION REASSESS 15MIN,9429781,CDM,97803,CPT,942,RC,inpatient,,,,53.766,29.5713,,48.3894,90,percent of total billed charges,,,,53.766,100,percent of total billed charges,,,26.8065,,,fee schedule,,,26.8065,,,fee schedule,,,24.12585,,,fee schedule,,,26.962875,,,fee schedule,,,26.962875,,,fee schedule,,,,,,,,,26.962875,,,fee schedule,,,,,,,,,,48.3894,90,percent of total billed charges,,,,51.0777,95,percent of total billed charges,,,27.77176125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,26.962875,,,fee schedule,,,24.12585,53.766,
ANESTHESIA 1ST HOUR-FACILITY,3703000,CDM,,,370F,RC,inpatient,,,,1653.15,909.2325,,1487.835,90,percent of total billed charges,,,,1653.15,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1487.835,90,percent of total billed charges,,,,1570.4925,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1487.835,1653.15,
ANESTHESIA-EA ADDL 30 MINS FAC,3704000,CDM,,,370F,RC,inpatient,,,,661.26,363.693,,595.134,90,percent of total billed charges,,,,661.26,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,595.134,90,percent of total billed charges,,,,628.197,95,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,595.134,661.26,
PR MED/SURG OUTPATIENT - NORTH,1101200,CDM,,,111,RC,outpatient,,,,1032.06,567.633,,928.854,90,percent of total billed charges,,,,1032.06,100,percent of total billed charges,,,,,,,,,928.854,,,fee schedule,,,825.648,,,fee schedule,,,,,,,,,,,,,,,,877.251,85,percent of total billed charges,,,,,,,,,,513.656262,49.77,percent of total billed charges,,,,928.854,90,percent of total billed charges,,,,980.457,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,877.251,85,percent of total billed charges,,,,,,,,,513.656262,1032.06,
PRIVATE ROOM MED/SURG - NORTH,1111200,CDM,,,111,RC,outpatient,,,,1031.648,567.4064,,928.4832,90,percent of total billed charges,,,,1031.648,100,percent of total billed charges,,,,,,,,,928.4832,,,fee schedule,,,825.3184,,,fee schedule,,,,,,,,,,,,,,,,876.9008,85,percent of total billed charges,,,,,,,,,,513.4512096,49.77,percent of total billed charges,,,,928.4832,90,percent of total billed charges,,,,980.0656,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,876.9008,85,percent of total billed charges,,,,,,,,,513.4512096,1031.648,
PRIVATE ROOM OB - CENTRAL,1121100,CDM,,,112,RC,outpatient,,,,1032.06,567.633,,928.854,90,percent of total billed charges,,,,1032.06,100,percent of total billed charges,,,,,,,,,928.854,,,fee schedule,,,825.648,,,fee schedule,,,,,,,,,,,,,,,,877.251,85,percent of total billed charges,,,,,,,,,,513.656262,49.77,percent of total billed charges,,,,928.854,90,percent of total billed charges,,,,980.457,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,877.251,85,percent of total billed charges,,,,,,,,,513.656262,1032.06,
PRIVATE ROOM PSYCH,1140000,CDM,,,114,RC,outpatient,,,,1461.57,803.8635,,1315.413,90,percent of total billed charges,,,,1461.57,100,percent of total billed charges,,,,,,,,,1315.413,,,fee schedule,,,1169.256,,,fee schedule,,,,,,,,,,,,,,,,1242.3345,85,percent of total billed charges,,,,,,,,,,727.423389,49.77,percent of total billed charges,,,,1315.413,90,percent of total billed charges,,,,1388.4915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1242.3345,85,percent of total billed charges,,,,,,,,,727.423389,1461.57,
REHAB - PRIVATE ROOM,1180000,CDM,,,118,RC,outpatient,,,,1013.52,557.436,,912.168,90,percent of total billed charges,,,,1013.52,100,percent of total billed charges,,,,,,,,,912.168,,,fee schedule,,,810.816,,,fee schedule,,,,,,,,,,,,,,,,861.492,85,percent of total billed charges,,,,,,,,,,504.428904,49.77,percent of total billed charges,,,,912.168,90,percent of total billed charges,,,,962.844,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,861.492,85,percent of total billed charges,,,,,,,,,504.428904,1013.52,
SEMI-PRIVATE ROOM PSYCH,1240000,CDM,,,124,RC,outpatient,,,,1013.52,557.436,,912.168,90,percent of total billed charges,,,,1013.52,100,percent of total billed charges,,,,,,,,,912.168,,,fee schedule,,,810.816,,,fee schedule,,,,,,,,,,,,,,,,861.492,85,percent of total billed charges,,,,,,,,,,504.428904,49.77,percent of total billed charges,,,,912.168,90,percent of total billed charges,,,,962.844,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,861.492,85,percent of total billed charges,,,,,,,,,504.428904,1013.52,
NEWBORN NURSERY,1700000,CDM,,,170,RC,outpatient,,,,860.05,473.0275,,774.045,90,percent of total billed charges,,,,860.05,100,percent of total billed charges,,,,,,,,,774.045,,,fee schedule,,,688.04,,,fee schedule,,,,,,,,,,,,,,,,731.0425,85,percent of total billed charges,,,,,,,,,,428.046885,49.77,percent of total billed charges,,,,774.045,90,percent of total billed charges,,,,817.0475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,731.0425,85,percent of total billed charges,,,,,,,,,428.046885,860.05,
INTENSIVE CARE UNIT,2000000,CDM,,,200,RC,outpatient,,,,1833.4,1008.37,,1650.06,90,percent of total billed charges,,,,1833.4,100,percent of total billed charges,,,,,,,,,1650.06,,,fee schedule,,,1466.72,,,fee schedule,,,,,,,,,,,,,,,,1558.39,85,percent of total billed charges,,,,,,,,,,912.48318,49.77,percent of total billed charges,,,,1650.06,90,percent of total billed charges,,,,1741.73,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1558.39,85,percent of total billed charges,,,,,,,,,912.48318,1833.4,
POTASSIUM PHOSPATES 3mmol/ml,2500007,CDM,,,250,RC,outpatient,3,ML,,10.609,5.83495,,9.5481,90,percent of total billed charges,,,,10.609,100,percent of total billed charges,,,,,,,,,9.5481,,,fee schedule,,,8.4872,,,fee schedule,,,,,,,,,,,,,,,,9.01765,85,percent of total billed charges,,,,,,,,,,5.2800993,49.77,percent of total billed charges,,,,9.5481,90,percent of total billed charges,,,,10.07855,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.01765,85,percent of total billed charges,,,,,,,,,5.2800993,10.609,
LIDOCAINE 1%/EPI 1:100000 20ml,2500008,CDM,,,250,RC,outpatient,20,ML,,9.7644,5.37042,,8.78796,90,percent of total billed charges,,,,9.7644,100,percent of total billed charges,,,,,,,,,8.78796,,,fee schedule,,,7.81152,,,fee schedule,,,,,,,,,,,,,,,,8.29974,85,percent of total billed charges,,,,,,,,,,4.85974188,49.77,percent of total billed charges,,,,8.78796,90,percent of total billed charges,,,,9.27618,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.29974,85,percent of total billed charges,,,,,,,,,4.85974188,9.7644,
LIDOCAINE 1% EPI/1:100000 10ml,2500009,CDM,,,250,RC,outpatient,10,ML,,9.1052,5.00786,,8.19468,90,percent of total billed charges,,,,9.1052,100,percent of total billed charges,,,,,,,,,8.19468,,,fee schedule,,,7.28416,,,fee schedule,,,,,,,,,,,,,,,,7.73942,85,percent of total billed charges,,,,,,,,,,4.53165804,49.77,percent of total billed charges,,,,8.19468,90,percent of total billed charges,,,,8.64994,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.73942,85,percent of total billed charges,,,,,,,,,4.53165804,9.1052,
ACTIVATED CHARCOAL 25GM,2500080,CDM,,,250,RC,outpatient,25,GR,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,19.6524,,,fee schedule,,,17.4688,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,10.8677772,21.836,
NEPHRAMINE 5.4% INJ,2500155,CDM,,,250,RC,outpatient,1,EA,,209.811,115.39605,,188.8299,90,percent of total billed charges,,,,209.811,100,percent of total billed charges,,,,,,,,,188.8299,,,fee schedule,,,167.8488,,,fee schedule,,,,,,,,,,,,,,,,178.33935,85,percent of total billed charges,,,,,,,,,,104.4229347,49.77,percent of total billed charges,,,,188.8299,90,percent of total billed charges,,,,199.32045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,178.33935,85,percent of total billed charges,,,,,,,,,104.4229347,209.811,
NEURONTIN 300MG CAPSULE PO,2500205,CDM,,,250,RC,outpatient,300,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
AFRIN 0.05% SPRAY 15ML,2500210,CDM,,,250,RC,outpatient,15,ML,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
NEUT 4% 5ML INJ,2500215,CDM,,,250,RC,outpatient,5,ML,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,14.5539,,,fee schedule,,,12.9368,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,8.0483067,16.171,
ALBUMINAR 25% 10 ML INJ,2500230,CDM,,,250,RC,outpatient,10,ML,,516.957,284.32635,,465.2613,90,percent of total billed charges,,,,516.957,100,percent of total billed charges,,,,,,,,,465.2613,,,fee schedule,,,413.5656,,,fee schedule,,,,,,,,,,,,,,,,439.41345,85,percent of total billed charges,,,,,,,,,,257.2894989,49.77,percent of total billed charges,,,,465.2613,90,percent of total billed charges,,,,491.10915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,439.41345,85,percent of total billed charges,,,,,,,,,257.2894989,516.957,
AMARYL  2MG TAB,2500420,CDM,,,250,RC,outpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
AMBIEN 10mg TABLET,2500430,CDM,,,250,RC,outpatient,10,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
KETOCONAZOLE 2% 60gr CREAM,2500445,CDM,,,250,RC,outpatient,60,GR,,96.511,53.08105,,86.8599,90,percent of total billed charges,,,,96.511,100,percent of total billed charges,,,,,,,,,86.8599,,,fee schedule,,,77.2088,,,fee schedule,,,,,,,,,,,,,,,,82.03435,85,percent of total billed charges,,,,,,,,,,48.0335247,49.77,percent of total billed charges,,,,86.8599,90,percent of total billed charges,,,,91.68545,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,82.03435,85,percent of total billed charges,,,,,,,,,48.0335247,96.511,
AMINOCAPROIC ACID 250ML 5GRAM,2500450,CDM,,,250,RC,outpatient,250,ml,,21.321,11.72655,,19.1889,90,percent of total billed charges,,,,21.321,100,percent of total billed charges,,,,,,,,,19.1889,,,fee schedule,,,17.0568,,,fee schedule,,,,,,,,,,,,,,,,18.12285,85,percent of total billed charges,,,,,,,,,,10.6114617,49.77,percent of total billed charges,,,,19.1889,90,percent of total billed charges,,,,20.25495,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.12285,85,percent of total billed charges,,,,,,,,,10.6114617,21.321,
NORCURON 10MG VIAL POWDER,2500495,CDM,,,250,RC,outpatient,10,ME,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,,,,,,,60.9039,,,fee schedule,,,54.1368,,,fee schedule,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,,33.6798567,49.77,percent of total billed charges,,,,60.9039,90,percent of total billed charges,,,,64.28745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,33.6798567,67.671,
AMMONIA INHALANT 15%,2500500,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
AMOXIL 125MG/5MLSUSP.(5ML),2500510,CDM,,,250,RC,outpatient,125,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
NORMAL SALINE 250ML SOLUTION,2500535,CDM,,,250,RC,outpatient,250,ML,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,,,,,,,20.6721,,,fee schedule,,,18.3752,,,fee schedule,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,,11.4316713,49.77,percent of total billed charges,,,,20.6721,90,percent of total billed charges,,,,21.82055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,11.4316713,22.969,
NORMAL SALINE  50ml SOLUTION,2500545,CDM,,,250,RC,outpatient,50,ML,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,27.9027,,,fee schedule,,,24.8024,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,15.4301931,31.003,
AMOXIL PER 1ml (50mg),2500550,CDM,,,250,RC,outpatient,1,ME,,6.489,3.56895,,5.8401,90,percent of total billed charges,,,,6.489,100,percent of total billed charges,,,,,,,,,5.8401,,,fee schedule,,,5.1912,,,fee schedule,,,,,,,,,,,,,,,,5.51565,85,percent of total billed charges,,,,,,,,,,3.2295753,49.77,percent of total billed charges,,,,5.8401,90,percent of total billed charges,,,,6.16455,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.51565,85,percent of total billed charges,,,,,,,,,3.2295753,6.489,
NORMAL SALINE 100ml SOLUTION,2500555,CDM,,,250,RC,outpatient,100,ML,,37.904,20.8472,,34.1136,90,percent of total billed charges,,,,37.904,100,percent of total billed charges,,,,,,,,,34.1136,,,fee schedule,,,30.3232,,,fee schedule,,,,,,,,,,,,,,,,32.2184,85,percent of total billed charges,,,,,,,,,,18.8648208,49.77,percent of total billed charges,,,,34.1136,90,percent of total billed charges,,,,36.0088,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.2184,85,percent of total billed charges,,,,,,,,,18.8648208,37.904,
NORMAL SALINE 500ML SOLUTION,2500565,CDM,,,250,RC,outpatient,500,ML,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,30.0348,,,fee schedule,,,26.6976,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,16.6092444,33.372,
NORMAL SALINE 0.9% 3ML INJ,2500575,CDM,,,250,RC,outpatient,3,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
NORMAL SALINE 1000ML SOLUTION,2500585,CDM,,,250,RC,outpatient,1000,ML,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,23.8239,,,fee schedule,,,21.1768,,,fee schedule,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,,13.1746167,49.77,percent of total billed charges,,,,23.8239,90,percent of total billed charges,,,,25.14745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,13.1746167,26.471,
AMPHOGEL/ALTERNAGEL SUSP.,2500590,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SODIUM CHLORIDE 0.9% 10ml SYR,2500595,CDM,A4216,HCPCS,250,RC,outpatient,10,ML,,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,,,,,,,11.3094,,,fee schedule,,,10.0528,,,fee schedule,,,,,,,,,,,,,,,,10.6811,85,percent of total billed charges,,,,,,,,,,6.2540982,49.77,percent of total billed charges,,,,11.3094,90,percent of total billed charges,,,,11.9377,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.6811,85,percent of total billed charges,,,,,,,,,6.2540982,12.566,
RIFAXIMIN 550mg TABLET,2500616,CDM,,,250,RC,outpatient,550,ME,,83.224,45.7732,,74.9016,90,percent of total billed charges,,,,83.224,100,percent of total billed charges,,,,,,,,,74.9016,,,fee schedule,,,66.5792,,,fee schedule,,,,,,,,,,,,,,,,70.7404,85,percent of total billed charges,,,,,,,,,,41.4205848,49.77,percent of total billed charges,,,,74.9016,90,percent of total billed charges,,,,79.0628,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,70.7404,85,percent of total billed charges,,,,,,,,,41.4205848,83.224,
NORMAL SALINE IRRIG 1000ML,2500645,CDM,,,250,RC,outpatient,1000,ML,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,30.0348,,,fee schedule,,,26.6976,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,16.6092444,33.372,
AMPICILLIN 250MG INJ,2500660,CDM,,,250,RC,outpatient,250,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
NORVASC 5MG TAB,2500715,CDM,,,250,RC,outpatient,5,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
OCUFEN 0.03% DROPS OPHT,2500745,CDM,,,250,RC,outpatient,1,EA,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,41.3442,,,fee schedule,,,36.7504,,,fee schedule,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,,22.8633426,49.77,percent of total billed charges,,,,41.3442,90,percent of total billed charges,,,,43.6411,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,22.8633426,45.938,
ANUSOL HC 30gr TUBE,2500910,CDM,,,250,RC,outpatient,30,GR,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,,,,,,,150.6375,,,fee schedule,,,133.9,,,fee schedule,,,,,,,,,,,,,,,,142.26875,85,percent of total billed charges,,,,,,,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,142.26875,85,percent of total billed charges,,,,,,,,,83.3025375,167.375,
ANUSOL HC SUPP.,2500920,CDM,,,250,RC,outpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
AQUAMEPHYTON 1MG/0.5ML INJ.,2500990,CDM,,,250,RC,outpatient,1,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
ASPIRIN 325mg TAB,2501070,CDM,,,250,RC,outpatient,325,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
PENICILLIN 5MIL UNITS INJ,2501115,CDM,,,250,RC,outpatient,5,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
ATARAX 10MG/5ML SYRUP,2501130,CDM,,,250,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ATIVAN 0.5mg TABLET,2501150,CDM,,,250,RC,outpatient,0.5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ATIVAN 1mg TAB,2501160,CDM,,,250,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PEPCID 20MG TAB,2501165,CDM,,,250,RC,outpatient,20,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
PEPCID 20MG/2ML INJ,2501175,CDM,,,250,RC,outpatient,20,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
ATROPINE 0.8mg/2ml INJ,2501200,CDM,,,250,RC,outpatient,0.8,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
PEPTO BISMOL 262MG/15ML LIQ,2501205,CDM,,,250,RC,outpatient,262,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
ATROVENT 0.02% LIQUID,2501230,CDM,,,250,RC,outpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
AUGMENTIN 875MG/125MG TAB,2501290,CDM,,,250,RC,outpatient,875,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
AVITENE SHEET,2501320,CDM,,,250,RC,outpatient,1,EA,,353.084,194.1962,,317.7756,90,percent of total billed charges,,,,353.084,100,percent of total billed charges,,,,,,,,,317.7756,,,fee schedule,,,282.4672,,,fee schedule,,,,,,,,,,,,,,,,300.1214,85,percent of total billed charges,,,,,,,,,,175.7299068,49.77,percent of total billed charges,,,,317.7756,90,percent of total billed charges,,,,335.4298,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,300.1214,85,percent of total billed charges,,,,,,,,,175.7299068,353.084,
PHENERGAN 12.5MG SUPPOS,2501325,CDM,,,250,RC,outpatient,12.5,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
AZACTAM 1GM 15ML INJ,2501340,CDM,,,250,RC,outpatient,15,ML,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,41.3442,,,fee schedule,,,36.7504,,,fee schedule,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,,22.8633426,49.77,percent of total billed charges,,,,41.3442,90,percent of total billed charges,,,,43.6411,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,22.8633426,45.938,
PHENERGAN 25MG SUPPOS,2501345,CDM,,,250,RC,outpatient,25,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
PHENERGAN 50mg,2501375,CDM,,,250,RC,outpatient,50,ME,,11.845,6.51475,,10.6605,90,percent of total billed charges,,,,11.845,100,percent of total billed charges,,,,,,,,,10.6605,,,fee schedule,,,9.476,,,fee schedule,,,,,,,,,,,,,,,,10.06825,85,percent of total billed charges,,,,,,,,,,5.8952565,49.77,percent of total billed charges,,,,10.6605,90,percent of total billed charges,,,,11.25275,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.06825,85,percent of total billed charges,,,,,,,,,5.8952565,11.845,
BENADRYL 12.5MG/5ML  ELIXIR,2501500,CDM,,,250,RC,outpatient,12.5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
BENADRYL 2% TOPICAL,2501510,CDM,,,250,RC,outpatient,1,EA,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,13.4415,,,fee schedule,,,11.948,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,14.935,
PILOCAR 1% DROPS,2501515,CDM,,,250,RC,outpatient,1,EA,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,36.153,,,fee schedule,,,32.136,,,fee schedule,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,19.992609,40.17,
VASOPRESSIN 20u/1ml 1ml VIAL,2501595,CDM,,,250,RC,outpatient,1,ML,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,,,,,,,20.6721,,,fee schedule,,,18.3752,,,fee schedule,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,,11.4316713,49.77,percent of total billed charges,,,,20.6721,90,percent of total billed charges,,,,21.82055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,11.4316713,22.969,
BETADINE 30 GR  OINTMENT,2501600,CDM,,,250,RC,outpatient,30,GR,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
POVIDINE-IODINE OPHTHALMIC,2501610,CDM,,,250,RC,outpatient,1,EA,,16.995,9.34725,,15.2955,90,percent of total billed charges,,,,16.995,100,percent of total billed charges,,,,,,,,,15.2955,,,fee schedule,,,13.596,,,fee schedule,,,,,,,,,,,,,,,,14.44575,85,percent of total billed charges,,,,,,,,,,8.4584115,49.77,percent of total billed charges,,,,15.2955,90,percent of total billed charges,,,,16.14525,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.44575,85,percent of total billed charges,,,,,,,,,8.4584115,16.995,
LEVOBUNOLOL 0.5% OPTHALMIC,2501640,CDM,,,250,RC,outpatient,1,EA,,15.45,8.4975,,13.905,90,percent of total billed charges,,,,15.45,100,percent of total billed charges,,,,,,,,,13.905,,,fee schedule,,,12.36,,,fee schedule,,,,,,,,,,,,,,,,13.1325,85,percent of total billed charges,,,,,,,,,,7.689465,49.77,percent of total billed charges,,,,13.905,90,percent of total billed charges,,,,14.6775,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.1325,85,percent of total billed charges,,,,,,,,,7.689465,15.45,
BETOPTIC 0.5%  DROPS,2501670,CDM,,,250,RC,outpatient,1,EA,,60.873,33.48015,,54.7857,90,percent of total billed charges,,,,60.873,100,percent of total billed charges,,,,,,,,,54.7857,,,fee schedule,,,48.6984,,,fee schedule,,,,,,,,,,,,,,,,51.74205,85,percent of total billed charges,,,,,,,,,,30.2964921,49.77,percent of total billed charges,,,,54.7857,90,percent of total billed charges,,,,57.82935,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,51.74205,85,percent of total billed charges,,,,,,,,,30.2964921,60.873,
BIAXIN 125MG/5ML SUSP,2501690,CDM,,,250,RC,outpatient,125,ME,,80.237,44.13035,,72.2133,90,percent of total billed charges,,,,80.237,100,percent of total billed charges,,,,,,,,,72.2133,,,fee schedule,,,64.1896,,,fee schedule,,,,,,,,,,,,,,,,68.20145,85,percent of total billed charges,,,,,,,,,,39.9339549,49.77,percent of total billed charges,,,,72.2133,90,percent of total billed charges,,,,76.22515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,68.20145,85,percent of total billed charges,,,,,,,,,39.9339549,80.237,
BIC/SHOHL SOL 550MG/334MG/5ML,2501730,CDM,,,250,RC,outpatient,550,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
BLEPH-10/BLEPHAMIDE 15CC DROPS,2501740,CDM,,,250,RC,outpatient,1,EA,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,,,,,,,45.5157,,,fee schedule,,,40.4584,,,fee schedule,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,,,,,,,,25.1701821,49.77,percent of total billed charges,,,,45.5157,90,percent of total billed charges,,,,48.04435,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,,,,,,,25.1701821,50.573,
PPD SKIN TEST INJECTION,2501745,CDM,,,250,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
PRED FORTE OPTH 1% 5ML DROPS,2501785,CDM,,,250,RC,outpatient,5,ML,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,,,,,,,45.5157,,,fee schedule,,,40.4584,,,fee schedule,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,,,,,,,,25.1701821,49.77,percent of total billed charges,,,,45.5157,90,percent of total billed charges,,,,48.04435,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,,,,,,,25.1701821,50.573,
BREVIBLOC 10MG/ML INJ,2501830,CDM,,,250,RC,outpatient,10,ME,,86.005,47.30275,,77.4045,90,percent of total billed charges,,,,86.005,100,percent of total billed charges,,,,,,,,,77.4045,,,fee schedule,,,68.804,,,fee schedule,,,,,,,,,,,,,,,,73.10425,85,percent of total billed charges,,,,,,,,,,42.8046885,49.77,percent of total billed charges,,,,77.4045,90,percent of total billed charges,,,,81.70475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,73.10425,85,percent of total billed charges,,,,,,,,,42.8046885,86.005,
PRELONE 15MG/5ML ELIXIR,2501835,CDM,,,250,RC,outpatient,15,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
BSS 15 ML INJ,2501880,CDM,,,250,RC,outpatient,15,ML,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,21.6918,,,fee schedule,,,19.2816,,,fee schedule,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,,11.9955654,49.77,percent of total billed charges,,,,21.6918,90,percent of total billed charges,,,,22.8969,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,11.9955654,24.102,
PREMARIN 25MG/5ML INJ,2501885,CDM,,,250,RC,outpatient,25,ME,,99.807,54.89385,,89.8263,90,percent of total billed charges,,,,99.807,100,percent of total billed charges,,,,,,,,,89.8263,,,fee schedule,,,79.8456,,,fee schedule,,,,,,,,,,,,,,,,84.83595,85,percent of total billed charges,,,,,,,,,,49.6739439,49.77,percent of total billed charges,,,,89.8263,90,percent of total billed charges,,,,94.81665,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,84.83595,85,percent of total billed charges,,,,,,,,,49.6739439,99.807,
PREMARIN VAG 42.5 GR CREAM,2501895,CDM,,,250,RC,outpatient,42.5,GR,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,,,,,,,93.9051,,,fee schedule,,,83.4712,,,fee schedule,,,,,,,,,,,,,,,,88.68815,85,percent of total billed charges,,,,,,,,,,51.9295203,49.77,percent of total billed charges,,,,93.9051,90,percent of total billed charges,,,,99.12205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,88.68815,85,percent of total billed charges,,,,,,,,,51.9295203,104.339,
CLEOCIN SUSPENSION,2501913,CDM,,,250,RC,outpatient,1,EA,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,33.0939,,,fee schedule,,,29.4168,,,fee schedule,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,,18.3009267,49.77,percent of total billed charges,,,,33.0939,90,percent of total billed charges,,,,34.93245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,18.3009267,36.771,
STERILE WATER FOR INJ 500ml,2501923,CDM,,,250,RC,outpatient,500,ML,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,33.0939,,,fee schedule,,,29.4168,,,fee schedule,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,,18.3009267,49.77,percent of total billed charges,,,,33.0939,90,percent of total billed charges,,,,34.93245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,18.3009267,36.771,
BUSPAR 5MG TAB,2501930,CDM,,,250,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
AMIDATE INJECTION 20MG AMPULE,2501934,CDM,,,250,RC,outpatient,20,ME,,64.272,35.3496,,57.8448,90,percent of total billed charges,,,,64.272,100,percent of total billed charges,,,,,,,,,57.8448,,,fee schedule,,,51.4176,,,fee schedule,,,,,,,,,,,,,,,,54.6312,85,percent of total billed charges,,,,,,,,,,31.9881744,49.77,percent of total billed charges,,,,57.8448,90,percent of total billed charges,,,,61.0584,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,54.6312,85,percent of total billed charges,,,,,,,,,31.9881744,64.272,
LAMISIL 1% CREAM 30gr TUBE,2501942,CDM,,,250,RC,outpatient,30,GR,,27.089,14.89895,,24.3801,90,percent of total billed charges,,,,27.089,100,percent of total billed charges,,,,,,,,,24.3801,,,fee schedule,,,21.6712,,,fee schedule,,,,,,,,,,,,,,,,23.02565,85,percent of total billed charges,,,,,,,,,,13.4821953,49.77,percent of total billed charges,,,,24.3801,90,percent of total billed charges,,,,25.73455,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.02565,85,percent of total billed charges,,,,,,,,,13.4821953,27.089,
SEROQUEL 100MG,2501948,CDM,,,250,RC,outpatient,100,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
IPRATROPIUM ALBUTERAL SULF 4gr,2501962,CDM,,,250,RC,outpatient,4,GR,,822.764,452.5202,,740.4876,90,percent of total billed charges,,,,822.764,100,percent of total billed charges,,,,,,,,,740.4876,,,fee schedule,,,658.2112,,,fee schedule,,,,,,,,,,,,,,,,699.3494,85,percent of total billed charges,,,,,,,,,,409.4896428,49.77,percent of total billed charges,,,,740.4876,90,percent of total billed charges,,,,781.6258,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,699.3494,85,percent of total billed charges,,,,,,,,,409.4896428,822.764,
TYPHOID INJECTION,2501971,CDM,,,250,RC,outpatient,1,EA,,100.94,55.517,,90.846,90,percent of total billed charges,,,,100.94,100,percent of total billed charges,,,,,,,,,90.846,,,fee schedule,,,80.752,,,fee schedule,,,,,,,,,,,,,,,,85.799,85,percent of total billed charges,,,,,,,,,,50.237838,49.77,percent of total billed charges,,,,90.846,90,percent of total billed charges,,,,95.893,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,85.799,85,percent of total billed charges,,,,,,,,,50.237838,100.94,
PRISCOLINE 100MG/4ML INJ,2501975,CDM,,,250,RC,outpatient,100,ME,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,33.0939,,,fee schedule,,,29.4168,,,fee schedule,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,,18.3009267,49.77,percent of total billed charges,,,,33.0939,90,percent of total billed charges,,,,34.93245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,18.3009267,36.771,
CORDARONE/AMIODARONE 50mg/1ml,2501977,CDM,,,250,RC,outpatient,50,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
PROCTFOAM,2501984,CDM,,,250,RC,outpatient,1,EA,,56.238,30.9309,,50.6142,90,percent of total billed charges,,,,56.238,100,percent of total billed charges,,,,,,,,,50.6142,,,fee schedule,,,44.9904,,,fee schedule,,,,,,,,,,,,,,,,47.8023,85,percent of total billed charges,,,,,,,,,,27.9896526,49.77,percent of total billed charges,,,,50.6142,90,percent of total billed charges,,,,53.4261,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,47.8023,85,percent of total billed charges,,,,,,,,,27.9896526,56.238,
PIOGLITAZONE Hcl 15MG TABLET,2501993,CDM,,,250,RC,outpatient,15,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
CALAMINE LOTION,2502000,CDM,,,250,RC,outpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
FLOMAX 0.4MG CAPSULE,2502001,CDM,,,250,RC,outpatient,0.4,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
AUGMENTIN 400MG/5ML SUSPENSION,2502003,CDM,,,250,RC,outpatient,400,ME,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,,,,,,,107.3466,,,fee schedule,,,95.4192,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,59.3626698,119.274,
FLOVENT 44 MCG INHALER,2502007,CDM,,,250,RC,outpatient,1,EA,,88.374,48.6057,,79.5366,90,percent of total billed charges,,,,88.374,100,percent of total billed charges,,,,,,,,,79.5366,,,fee schedule,,,70.6992,,,fee schedule,,,,,,,,,,,,,,,,75.1179,85,percent of total billed charges,,,,,,,,,,43.9837398,49.77,percent of total billed charges,,,,79.5366,90,percent of total billed charges,,,,83.9553,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,75.1179,85,percent of total billed charges,,,,,,,,,43.9837398,88.374,
FLOVENT 110 MCG INHALER,2502008,CDM,,,250,RC,outpatient,1,EA,,512.94,282.117,,461.646,90,percent of total billed charges,,,,512.94,100,percent of total billed charges,,,,,,,,,461.646,,,fee schedule,,,410.352,,,fee schedule,,,,,,,,,,,,,,,,435.999,85,percent of total billed charges,,,,,,,,,,255.290238,49.77,percent of total billed charges,,,,461.646,90,percent of total billed charges,,,,487.293,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,435.999,85,percent of total billed charges,,,,,,,,,255.290238,512.94,
FLOVENT 220 MCG INHALER,2502009,CDM,,,250,RC,outpatient,1,EA,,478.435,263.13925,,430.5915,90,percent of total billed charges,,,,478.435,100,percent of total billed charges,,,,,,,,,430.5915,,,fee schedule,,,382.748,,,fee schedule,,,,,,,,,,,,,,,,406.66975,85,percent of total billed charges,,,,,,,,,,238.1170995,49.77,percent of total billed charges,,,,430.5915,90,percent of total billed charges,,,,454.51325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,406.66975,85,percent of total billed charges,,,,,,,,,238.1170995,478.435,
DUONEB INHALATIONAL SOLUTION,2502012,CDM,,,250,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
VALPROATE SODIUM 500MG/5ML INJ,2502013,CDM,,,250,RC,outpatient,500,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
LANTUS INSULIN,2502014,CDM,,,250,RC,outpatient,1,EA,,103.206,56.7633,,92.8854,90,percent of total billed charges,,,,103.206,100,percent of total billed charges,,,,,,,,,92.8854,,,fee schedule,,,82.5648,,,fee schedule,,,,,,,,,,,,,,,,87.7251,85,percent of total billed charges,,,,,,,,,,51.3656262,49.77,percent of total billed charges,,,,92.8854,90,percent of total billed charges,,,,98.0457,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,87.7251,85,percent of total billed charges,,,,,,,,,51.3656262,103.206,
ZYVOX 600mg TABLET,2502017,CDM,,,250,RC,outpatient,600,ME,,120.51,66.2805,,108.459,90,percent of total billed charges,,,,120.51,100,percent of total billed charges,,,,,,,,,108.459,,,fee schedule,,,96.408,,,fee schedule,,,,,,,,,,,,,,,,102.4335,85,percent of total billed charges,,,,,,,,,,59.977827,49.77,percent of total billed charges,,,,108.459,90,percent of total billed charges,,,,114.4845,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,102.4335,85,percent of total billed charges,,,,,,,,,59.977827,120.51,
"ADVAIR 15,000mcg INHALER",2502018,CDM,,,250,RC,outpatient,1,EA,,506.657,278.66135,,455.9913,90,percent of total billed charges,,,,506.657,100,percent of total billed charges,,,,,,,,,455.9913,,,fee schedule,,,405.3256,,,fee schedule,,,,,,,,,,,,,,,,430.65845,85,percent of total billed charges,,,,,,,,,,252.1631889,49.77,percent of total billed charges,,,,455.9913,90,percent of total billed charges,,,,481.32415,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,430.65845,85,percent of total billed charges,,,,,,,,,252.1631889,506.657,
"ADVAIR 7,500mcg INHALER",2502019,CDM,,,250,RC,outpatient,1,EA,,362.251,199.23805,,326.0259,90,percent of total billed charges,,,,362.251,100,percent of total billed charges,,,,,,,,,326.0259,,,fee schedule,,,289.8008,,,fee schedule,,,,,,,,,,,,,,,,307.91335,85,percent of total billed charges,,,,,,,,,,180.2923227,49.77,percent of total billed charges,,,,326.0259,90,percent of total billed charges,,,,344.13845,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,307.91335,85,percent of total billed charges,,,,,,,,,180.2923227,362.251,
VERAPAMIL 2.5mg/ml 4ml INJ,2502020,CDM,,,250,RC,outpatient,2.5,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
"ADVAIR 3,000mcg MD INHALER",2502021,CDM,,,250,RC,outpatient,1,EA,,311.781,171.47955,,280.6029,90,percent of total billed charges,,,,311.781,100,percent of total billed charges,,,,,,,,,280.6029,,,fee schedule,,,249.4248,,,fee schedule,,,,,,,,,,,,,,,,265.01385,85,percent of total billed charges,,,,,,,,,,155.1734037,49.77,percent of total billed charges,,,,280.6029,90,percent of total billed charges,,,,296.19195,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,265.01385,85,percent of total billed charges,,,,,,,,,155.1734037,311.781,
MEGALE 40mg,2502026,CDM,,,250,RC,outpatient,40,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
CILOXAN 0.3% EYE DROPS,2502029,CDM,,,250,RC,outpatient,1,EA,,56.238,30.9309,,50.6142,90,percent of total billed charges,,,,56.238,100,percent of total billed charges,,,,,,,,,50.6142,,,fee schedule,,,44.9904,,,fee schedule,,,,,,,,,,,,,,,,47.8023,85,percent of total billed charges,,,,,,,,,,27.9896526,49.77,percent of total billed charges,,,,50.6142,90,percent of total billed charges,,,,53.4261,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,47.8023,85,percent of total billed charges,,,,,,,,,27.9896526,56.238,
REMINYL 4MG TABLET,2502033,CDM,,,250,RC,outpatient,4,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
LEXAPRO 10MG TABLET,2502034,CDM,,,250,RC,outpatient,10,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
BRIMONIDINE TARTRATE 5ml BOTTL,2502066,CDM,,,250,RC,outpatient,5,ML,,41.612,22.8866,,37.4508,90,percent of total billed charges,,,,41.612,100,percent of total billed charges,,,,,,,,,37.4508,,,fee schedule,,,33.2896,,,fee schedule,,,,,,,,,,,,,,,,35.3702,85,percent of total billed charges,,,,,,,,,,20.7102924,49.77,percent of total billed charges,,,,37.4508,90,percent of total billed charges,,,,39.5314,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.3702,85,percent of total billed charges,,,,,,,,,20.7102924,41.612,
CALCIMAR 200 I.U./ML INJ,2502070,CDM,,,250,RC,outpatient,200,ML,,129.574,71.2657,,116.6166,90,percent of total billed charges,,,,129.574,100,percent of total billed charges,,,,,,,,,116.6166,,,fee schedule,,,103.6592,,,fee schedule,,,,,,,,,,,,,,,,110.1379,85,percent of total billed charges,,,,,,,,,,64.4889798,49.77,percent of total billed charges,,,,116.6166,90,percent of total billed charges,,,,123.0953,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,110.1379,85,percent of total billed charges,,,,,,,,,64.4889798,129.574,
PROTONIX 40mg INJ,2502072,CDM,,,250,RC,outpatient,40,ME,,65.405,35.97275,,58.8645,90,percent of total billed charges,,,,65.405,100,percent of total billed charges,,,,,,,,,58.8645,,,fee schedule,,,52.324,,,fee schedule,,,,,,,,,,,,,,,,55.59425,85,percent of total billed charges,,,,,,,,,,32.5520685,49.77,percent of total billed charges,,,,58.8645,90,percent of total billed charges,,,,62.13475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,55.59425,85,percent of total billed charges,,,,,,,,,32.5520685,65.405,
GEODON 20 mg INJ,2502073,CDM,,,250,RC,outpatient,20,ME,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,,,,,,,93.9051,,,fee schedule,,,83.4712,,,fee schedule,,,,,,,,,,,,,,,,88.68815,85,percent of total billed charges,,,,,,,,,,51.9295203,49.77,percent of total billed charges,,,,93.9051,90,percent of total billed charges,,,,99.12205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,88.68815,85,percent of total billed charges,,,,,,,,,51.9295203,104.339,
XOPENEX 0.5mg,2502083,CDM,,,250,RC,outpatient,0.5,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
LEVAQUIN 500mg TABLET,2502088,CDM,,,250,RC,outpatient,500,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,22.7115,,,fee schedule,,,20.188,,,fee schedule,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,,12.5594595,49.77,percent of total billed charges,,,,22.7115,90,percent of total billed charges,,,,23.97325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,12.5594595,25.235,
NAMENDA 5mg TABLET,2502091,CDM,,,250,RC,outpatient,5,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
FLONASE NASAL SPRAY,2502096,CDM,,,250,RC,outpatient,1,EA,,161.71,88.9405,,145.539,90,percent of total billed charges,,,,161.71,100,percent of total billed charges,,,,,,,,,145.539,,,fee schedule,,,129.368,,,fee schedule,,,,,,,,,,,,,,,,137.4535,85,percent of total billed charges,,,,,,,,,,80.483067,49.77,percent of total billed charges,,,,145.539,90,percent of total billed charges,,,,153.6245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,137.4535,85,percent of total billed charges,,,,,,,,,80.483067,161.71,
PULMICORT RESPULES 0.5mg/2ml,2502097,CDM,,,250,RC,outpatient,0.5,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
POLYETHYLENE GLYCOL 3350 PKT,2502099,CDM,,,250,RC,outpatient,1,EA,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
CALCIUM CHLORIDE 10ML INJ,2502100,CDM,,,250,RC,outpatient,10,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
CAL CHLOR ABBJ 10% 100MG.ML IN,2502110,CDM,,,250,RC,outpatient,100,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
TOPROL XL 5mg TABLET,2502117,CDM,,,250,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LOPRESSOR/METOPROLOL 25mg TAB,2502118,CDM,,,250,RC,outpatient,25,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
LIPITOR 40mg TABLET,2502119,CDM,,,250,RC,outpatient,40,ME,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,,,,,,,12.4218,,,fee schedule,,,11.0416,,,fee schedule,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,,6.8692554,49.77,percent of total billed charges,,,,12.4218,90,percent of total billed charges,,,,13.1119,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,6.8692554,13.802,
SPIRIVA INHALER,2502121,CDM,,,250,RC,outpatient,1,EA,,284.383,156.41065,,255.9447,90,percent of total billed charges,,,,284.383,100,percent of total billed charges,,,,,,,,,255.9447,,,fee schedule,,,227.5064,,,fee schedule,,,,,,,,,,,,,,,,241.72555,85,percent of total billed charges,,,,,,,,,,141.5374191,49.77,percent of total billed charges,,,,255.9447,90,percent of total billed charges,,,,270.16385,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,241.72555,85,percent of total billed charges,,,,,,,,,141.5374191,284.383,
ROXICODONE 5mg TABLET,2502132,CDM,,,250,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
COREG 25mg TABLET,2502137,CDM,,,250,RC,outpatient,25,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
CYMBALTA 30mg CAPSULE,2502139,CDM,,,250,RC,outpatient,30,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
ABILIFY 5mg TABLET,2502151,CDM,,,250,RC,outpatient,5,ME,,35.638,19.6009,,32.0742,90,percent of total billed charges,,,,35.638,100,percent of total billed charges,,,,,,,,,32.0742,,,fee schedule,,,28.5104,,,fee schedule,,,,,,,,,,,,,,,,30.2923,85,percent of total billed charges,,,,,,,,,,17.7370326,49.77,percent of total billed charges,,,,32.0742,90,percent of total billed charges,,,,33.8561,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.2923,85,percent of total billed charges,,,,,,,,,17.7370326,35.638,
NORCO 7.5/325 TABLET,2502162,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PROTONIX 40mg DELAYED REL TAB,2502168,CDM,,,250,RC,outpatient,40,ME,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,13.4415,,,fee schedule,,,11.948,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,14.935,
BOUDREAUX BUTT PASTE 60gr,2502169,CDM,,,250,RC,outpatient,60,GR,,18.849,10.36695,,16.9641,90,percent of total billed charges,,,,18.849,100,percent of total billed charges,,,,,,,,,16.9641,,,fee schedule,,,15.0792,,,fee schedule,,,,,,,,,,,,,,,,16.02165,85,percent of total billed charges,,,,,,,,,,9.3811473,49.77,percent of total billed charges,,,,16.9641,90,percent of total billed charges,,,,17.90655,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.02165,85,percent of total billed charges,,,,,,,,,9.3811473,18.849,
TRANS DERM SCOPOLAMINE PATCH,2502177,CDM,,,250,RC,outpatient,1,EA,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,,,,,,,20.6721,,,fee schedule,,,18.3752,,,fee schedule,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,,11.4316713,49.77,percent of total billed charges,,,,20.6721,90,percent of total billed charges,,,,21.82055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,11.4316713,22.969,
CARAFATE 1GR TAB,2502190,CDM,,,250,RC,outpatient,1,GR,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
ZYDIS 5mg TABLET,2502199,CDM,,,250,RC,outpatient,5,ME,,27.604,15.1822,,24.8436,90,percent of total billed charges,,,,27.604,100,percent of total billed charges,,,,,,,,,24.8436,,,fee schedule,,,22.0832,,,fee schedule,,,,,,,,,,,,,,,,23.4634,85,percent of total billed charges,,,,,,,,,,13.7385108,49.77,percent of total billed charges,,,,24.8436,90,percent of total billed charges,,,,26.2238,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.4634,85,percent of total billed charges,,,,,,,,,13.7385108,27.604,
ZOFRAN 4mg ORAL DISINTEGRATING,2502201,CDM,,,250,RC,outpatient,4,ME,,59.637,32.80035,,53.6733,90,percent of total billed charges,,,,59.637,100,percent of total billed charges,,,,,,,,,53.6733,,,fee schedule,,,47.7096,,,fee schedule,,,,,,,,,,,,,,,,50.69145,85,percent of total billed charges,,,,,,,,,,29.6813349,49.77,percent of total billed charges,,,,53.6733,90,percent of total billed charges,,,,56.65515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,50.69145,85,percent of total billed charges,,,,,,,,,29.6813349,59.637,
RISPERDAL 0.5mg TABLET,2502207,CDM,,,250,RC,outpatient,0.5,ME,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,13.4415,,,fee schedule,,,11.948,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,14.935,
VICODIN/LORECT 5/325 TAB,2502208,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
CARAFATE SUSPENSION 1gr,2502214,CDM,,,250,RC,outpatient,1,GR,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
MANNITOL 20% PREMIX IN 500ml,2502217,CDM,,,250,RC,outpatient,500,ML,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,43.3836,,,fee schedule,,,38.5632,,,fee schedule,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,,23.9911308,49.77,percent of total billed charges,,,,43.3836,90,percent of total billed charges,,,,45.7938,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,23.9911308,48.204,
FEMARA 2.5mg TABLET,2502222,CDM,,,250,RC,outpatient,2.5,ME,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,,,,,,,26.883,,,fee schedule,,,23.896,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,14.866299,29.87,
KWELL CREAM 5% 60gr,2502223,CDM,,,250,RC,outpatient,60,GR,,69.937,38.46535,,62.9433,90,percent of total billed charges,,,,69.937,100,percent of total billed charges,,,,,,,,,62.9433,,,fee schedule,,,55.9496,,,fee schedule,,,,,,,,,,,,,,,,59.44645,85,percent of total billed charges,,,,,,,,,,34.8076449,49.77,percent of total billed charges,,,,62.9433,90,percent of total billed charges,,,,66.44015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,59.44645,85,percent of total billed charges,,,,,,,,,34.8076449,69.937,
ESTRACE CREAM 0.01%,2502224,CDM,,,250,RC,outpatient,1,EA,,212.077,116.64235,,190.8693,90,percent of total billed charges,,,,212.077,100,percent of total billed charges,,,,,,,,,190.8693,,,fee schedule,,,169.6616,,,fee schedule,,,,,,,,,,,,,,,,180.26545,85,percent of total billed charges,,,,,,,,,,105.5507229,49.77,percent of total billed charges,,,,190.8693,90,percent of total billed charges,,,,201.47315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,180.26545,85,percent of total billed charges,,,,,,,,,105.5507229,212.077,
ZYRTEC (CETIRIZINE) 10mg,2502232,CDM,,,250,RC,outpatient,10,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
VITAMIN D 400 I.U.,2502247,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PREDNISOLONE 5ml UNIT DOSE,2502278,CDM,,,250,RC,outpatient,5,ML,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
NEUIONTIN 400mg CAPSULE,2502282,CDM,,,250,RC,outpatient,400,ME,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,6.7671,,,fee schedule,,,6.0152,,,fee schedule,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,,3.7422063,49.77,percent of total billed charges,,,,6.7671,90,percent of total billed charges,,,,7.14305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,3.7422063,7.519,
VRAYLAR 1.5 MG CAPSULE,2502293,CDM,,,250,RC,outpatient,1.5,ME,,90.949,50.02195,,81.8541,90,percent of total billed charges,,,,90.949,100,percent of total billed charges,,,,,,,,,81.8541,,,fee schedule,,,72.7592,,,fee schedule,,,,,,,,,,,,,,,,77.30665,85,percent of total billed charges,,,,,,,,,,45.2653173,49.77,percent of total billed charges,,,,81.8541,90,percent of total billed charges,,,,86.40155,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,77.30665,85,percent of total billed charges,,,,,,,,,45.2653173,90.949,
TRINTELLIX 5MG TABLET,2502297,CDM,,,250,RC,outpatient,5,ME,,28.84,15.862,,25.956,90,percent of total billed charges,,,,28.84,100,percent of total billed charges,,,,,,,,,25.956,,,fee schedule,,,23.072,,,fee schedule,,,,,,,,,,,,,,,,24.514,85,percent of total billed charges,,,,,,,,,,14.353668,49.77,percent of total billed charges,,,,25.956,90,percent of total billed charges,,,,27.398,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.514,85,percent of total billed charges,,,,,,,,,14.353668,28.84,
VALACYCLOVIR 1000mg TABLET,2502303,CDM,,,250,RC,outpatient,1000,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
METHADONE 10mg TABLETS,2502321,CDM,,,250,RC,outpatient,10,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
KAYEXALATE 15gr/60ml SUSPEN,2502324,CDM,,,250,RC,outpatient,15,GR,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
VENTOLIN HFA 8gr,2502329,CDM,,,250,RC,outpatient,8,GR,,41.406,22.7733,,37.2654,90,percent of total billed charges,,,,41.406,100,percent of total billed charges,,,,,,,,,37.2654,,,fee schedule,,,33.1248,,,fee schedule,,,,,,,,,,,,,,,,35.1951,85,percent of total billed charges,,,,,,,,,,20.6077662,49.77,percent of total billed charges,,,,37.2654,90,percent of total billed charges,,,,39.3357,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.1951,85,percent of total billed charges,,,,,,,,,20.6077662,41.406,
FERROUS SULFATE 325mg,2502334,CDM,,,250,RC,outpatient,325,ME,,5.253,2.88915,,4.7277,90,percent of total billed charges,,,,5.253,100,percent of total billed charges,,,,,,,,,4.7277,,,fee schedule,,,4.2024,,,fee schedule,,,,,,,,,,,,,,,,4.46505,85,percent of total billed charges,,,,,,,,,,2.6144181,49.77,percent of total billed charges,,,,4.7277,90,percent of total billed charges,,,,4.99035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.46505,85,percent of total billed charges,,,,,,,,,2.6144181,5.253,
TRIPLE ANTIBIOTIC OINT PACKET,2502337,CDM,,,250,RC,outpatient,1,EA,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
ATROVENT HFA INHALER 12.9gr,2502342,CDM,,,250,RC,outpatient,12.9,GR,,933.798,513.5889,,840.4182,90,percent of total billed charges,,,,933.798,100,percent of total billed charges,,,,,,,,,840.4182,,,fee schedule,,,747.0384,,,fee schedule,,,,,,,,,,,,,,,,793.7283,85,percent of total billed charges,,,,,,,,,,464.7512646,49.77,percent of total billed charges,,,,840.4182,90,percent of total billed charges,,,,887.1081,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,793.7283,85,percent of total billed charges,,,,,,,,,464.7512646,933.798,
SENOKOT 8.6mg TABLET,2502343,CDM,,,250,RC,outpatient,8.6,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
MELATONIN 3mg TABLET,2502348,CDM,,,250,RC,outpatient,3,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
EXELON 935 PATCH,2502349,CDM,,,250,RC,outpatient,1,EA,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,,,,,,,20.2086,,,fee schedule,,,17.9632,,,fee schedule,,,,,,,,,,,,,,,,19.0859,85,percent of total billed charges,,,,,,,,,,11.1753558,49.77,percent of total billed charges,,,,20.2086,90,percent of total billed charges,,,,21.3313,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.0859,85,percent of total billed charges,,,,,,,,,11.1753558,22.454,
POTASSIUM CHLORIDE 20meg/15ml,2502356,CDM,,,250,RC,outpatient,15,ML,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
NYSTATIN ORAL SUSPENSION 5ml,2502357,CDM,,,250,RC,outpatient,5,ML,,5.562,3.0591,,5.0058,90,percent of total billed charges,,,,5.562,100,percent of total billed charges,,,,,,,,,5.0058,,,fee schedule,,,4.4496,,,fee schedule,,,,,,,,,,,,,,,,4.7277,85,percent of total billed charges,,,,,,,,,,2.7682074,49.77,percent of total billed charges,,,,5.0058,90,percent of total billed charges,,,,5.2839,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.7277,85,percent of total billed charges,,,,,,,,,2.7682074,5.562,
LACTULOSE 10gr/15ml UNIT DOSE,2502358,CDM,,,250,RC,outpatient,10,GR,,8.652,4.7586,,7.7868,90,percent of total billed charges,,,,8.652,100,percent of total billed charges,,,,,,,,,7.7868,,,fee schedule,,,6.9216,,,fee schedule,,,,,,,,,,,,,,,,7.3542,85,percent of total billed charges,,,,,,,,,,4.3061004,49.77,percent of total billed charges,,,,7.7868,90,percent of total billed charges,,,,8.2194,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.3542,85,percent of total billed charges,,,,,,,,,4.3061004,8.652,
ROBITUSSIN DM 5ml UD CUPS,2502361,CDM,,,250,RC,outpatient,5,ML,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
BENADRYL 12.5mg/5ml,2502362,CDM,,,250,RC,outpatient,12.5,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
SILVADENE CREAM 20gr TUBE,2502363,CDM,,,250,RC,outpatient,20,GR,,13.699,7.53445,,12.3291,90,percent of total billed charges,,,,13.699,100,percent of total billed charges,,,,,,,,,12.3291,,,fee schedule,,,10.9592,,,fee schedule,,,,,,,,,,,,,,,,11.64415,85,percent of total billed charges,,,,,,,,,,6.8179923,49.77,percent of total billed charges,,,,12.3291,90,percent of total billed charges,,,,13.01405,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.64415,85,percent of total billed charges,,,,,,,,,6.8179923,13.699,
BACTRIM SUSPENSION,2502366,CDM,,,250,RC,outpatient,1,EA,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
MEGACE 400mg/10ml UNIT DOSE,2502369,CDM,,,250,RC,outpatient,400,ME,,27.913,15.35215,,25.1217,90,percent of total billed charges,,,,27.913,100,percent of total billed charges,,,,,,,,,25.1217,,,fee schedule,,,22.3304,,,fee schedule,,,,,,,,,,,,,,,,23.72605,85,percent of total billed charges,,,,,,,,,,13.8923001,49.77,percent of total billed charges,,,,25.1217,90,percent of total billed charges,,,,26.51735,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.72605,85,percent of total billed charges,,,,,,,,,13.8923001,27.913,
LIDOCAINE HCl VISCOUS 20ml,2502371,CDM,,,250,RC,outpatient,20,ML,,5.871,3.22905,,5.2839,90,percent of total billed charges,,,,5.871,100,percent of total billed charges,,,,,,,,,5.2839,,,fee schedule,,,4.6968,,,fee schedule,,,,,,,,,,,,,,,,4.99035,85,percent of total billed charges,,,,,,,,,,2.9219967,49.77,percent of total billed charges,,,,5.2839,90,percent of total billed charges,,,,5.57745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.99035,85,percent of total billed charges,,,,,,,,,2.9219967,5.871,
ERYTHROMYCIN BASE 1gr OINT,2502373,CDM,,,250,RC,outpatient,1,GR,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,23.8239,,,fee schedule,,,21.1768,,,fee schedule,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,,13.1746167,49.77,percent of total billed charges,,,,23.8239,90,percent of total billed charges,,,,25.14745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,13.1746167,26.471,
PROVENTIL/ALBUTEROL UNIT DOSE,2502375,CDM,,,250,RC,outpatient,1,EA,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
MIRAPEX 0.5mg TABLET,2502376,CDM,,,250,RC,outpatient,0.5,ME,,12.36,6.798,,11.124,90,percent of total billed charges,,,,12.36,100,percent of total billed charges,,,,,,,,,11.124,,,fee schedule,,,9.888,,,fee schedule,,,,,,,,,,,,,,,,10.506,85,percent of total billed charges,,,,,,,,,,6.151572,49.77,percent of total billed charges,,,,11.124,90,percent of total billed charges,,,,11.742,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.506,85,percent of total billed charges,,,,,,,,,6.151572,12.36,
HUMALOG INSULIN 3ml VIAL,2502383,CDM,,,250,RC,outpatient,3,ML,,82.297,45.26335,,74.0673,90,percent of total billed charges,,,,82.297,100,percent of total billed charges,,,,,,,,,74.0673,,,fee schedule,,,65.8376,,,fee schedule,,,,,,,,,,,,,,,,69.95245,85,percent of total billed charges,,,,,,,,,,40.9592169,49.77,percent of total billed charges,,,,74.0673,90,percent of total billed charges,,,,78.18215,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,69.95245,85,percent of total billed charges,,,,,,,,,40.9592169,82.297,
HUMULIN R INSULIN 3ml VIAL,2502384,CDM,,,250,RC,outpatient,3,ML,,36.668,20.1674,,33.0012,90,percent of total billed charges,,,,36.668,100,percent of total billed charges,,,,,,,,,33.0012,,,fee schedule,,,29.3344,,,fee schedule,,,,,,,,,,,,,,,,31.1678,85,percent of total billed charges,,,,,,,,,,18.2496636,49.77,percent of total billed charges,,,,33.0012,90,percent of total billed charges,,,,34.8346,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.1678,85,percent of total billed charges,,,,,,,,,18.2496636,36.668,
LICE SHAMPOO,2502386,CDM,,,250,RC,outpatient,1,EA,,22.042,12.1231,,19.8378,90,percent of total billed charges,,,,22.042,100,percent of total billed charges,,,,,,,,,19.8378,,,fee schedule,,,17.6336,,,fee schedule,,,,,,,,,,,,,,,,18.7357,85,percent of total billed charges,,,,,,,,,,10.9703034,49.77,percent of total billed charges,,,,19.8378,90,percent of total billed charges,,,,20.9399,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.7357,85,percent of total billed charges,,,,,,,,,10.9703034,22.042,
DURAGESIC 12mcg/hr PATCT,2502387,CDM,,,250,RC,outpatient,1,EA,,31.724,17.4482,,28.5516,90,percent of total billed charges,,,,31.724,100,percent of total billed charges,,,,,,,,,28.5516,,,fee schedule,,,25.3792,,,fee schedule,,,,,,,,,,,,,,,,26.9654,85,percent of total billed charges,,,,,,,,,,15.7890348,49.77,percent of total billed charges,,,,28.5516,90,percent of total billed charges,,,,30.1378,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.9654,85,percent of total billed charges,,,,,,,,,15.7890348,31.724,
DEPAKOTE SPRINKLE 125mg CAP,2502393,CDM,,,250,RC,outpatient,125,ME,,5.047,2.77585,,4.5423,90,percent of total billed charges,,,,5.047,100,percent of total billed charges,,,,,,,,,4.5423,,,fee schedule,,,4.0376,,,fee schedule,,,,,,,,,,,,,,,,4.28995,85,percent of total billed charges,,,,,,,,,,2.5118919,49.77,percent of total billed charges,,,,4.5423,90,percent of total billed charges,,,,4.79465,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.28995,85,percent of total billed charges,,,,,,,,,2.5118919,5.047,
BACTROBAN 22gr OINTMENT TUBE,2502396,CDM,,,250,RC,outpatient,22,GR,,102.382,56.3101,,92.1438,90,percent of total billed charges,,,,102.382,100,percent of total billed charges,,,,,,,,,92.1438,,,fee schedule,,,81.9056,,,fee schedule,,,,,,,,,,,,,,,,87.0247,85,percent of total billed charges,,,,,,,,,,50.9555214,49.77,percent of total billed charges,,,,92.1438,90,percent of total billed charges,,,,97.2629,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,87.0247,85,percent of total billed charges,,,,,,,,,50.9555214,102.382,
CEFEPIME 1gr VIAL,2502397,CDM,,,250,RC,outpatient,1,GR,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,25.8633,,,fee schedule,,,22.9896,,,fee schedule,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,,14.3024049,49.77,percent of total billed charges,,,,25.8633,90,percent of total billed charges,,,,27.30015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,14.3024049,28.737,
BUMETANIDE 2.5mg/10ml VIAL,2502398,CDM,,,250,RC,outpatient,2.5,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
CYTOTEC 200mcg TABLET,2502399,CDM,,,250,RC,outpatient,1,EA,,7.828,4.3054,,7.0452,90,percent of total billed charges,,,,7.828,100,percent of total billed charges,,,,,,,,,7.0452,,,fee schedule,,,6.2624,,,fee schedule,,,,,,,,,,,,,,,,6.6538,85,percent of total billed charges,,,,,,,,,,3.8959956,49.77,percent of total billed charges,,,,7.0452,90,percent of total billed charges,,,,7.4366,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.6538,85,percent of total billed charges,,,,,,,,,3.8959956,7.828,
CATAPRES TTS1  TTS1 TOPICAL,2502400,CDM,,,250,RC,outpatient,1,EA,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,25.8633,,,fee schedule,,,22.9896,,,fee schedule,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,,14.3024049,49.77,percent of total billed charges,,,,25.8633,90,percent of total billed charges,,,,27.30015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,14.3024049,28.737,
OMNICEF 300mg CAPSULE,2502402,CDM,,,250,RC,outpatient,300,ME,,14.729,8.10095,,13.2561,90,percent of total billed charges,,,,14.729,100,percent of total billed charges,,,,,,,,,13.2561,,,fee schedule,,,11.7832,,,fee schedule,,,,,,,,,,,,,,,,12.51965,85,percent of total billed charges,,,,,,,,,,7.3306233,49.77,percent of total billed charges,,,,13.2561,90,percent of total billed charges,,,,13.99255,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.51965,85,percent of total billed charges,,,,,,,,,7.3306233,14.729,
ZONISAMIDE 100mg CAPSULE,2502409,CDM,,,250,RC,outpatient,100,ME,,4.944,2.7192,,4.4496,90,percent of total billed charges,,,,4.944,100,percent of total billed charges,,,,,,,,,4.4496,,,fee schedule,,,3.9552,,,fee schedule,,,,,,,,,,,,,,,,4.2024,85,percent of total billed charges,,,,,,,,,,2.4606288,49.77,percent of total billed charges,,,,4.4496,90,percent of total billed charges,,,,4.6968,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.2024,85,percent of total billed charges,,,,,,,,,2.4606288,4.944,
CATAPRES TTS 2  TTS2 TOPICAL,2502410,CDM,,,250,RC,outpatient,1,EA,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,,,,,,,35.1333,,,fee schedule,,,31.2296,,,fee schedule,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,,,,,,,,19.4287149,49.77,percent of total billed charges,,,,35.1333,90,percent of total billed charges,,,,37.08515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,,,,,,,19.4287149,39.037,
ENTERIC COATED ASPIRIN 81mg,2502413,CDM,,,250,RC,outpatient,81,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
LITHIUM CARBONATE 300mg IR TAB,2502414,CDM,,,250,RC,outpatient,300,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
MARCAINE 0.5% EPINEPHRINE 10ml,2502417,CDM,,,250,RC,outpatient,10,ML,,11.33,6.2315,,10.197,90,percent of total billed charges,,,,11.33,100,percent of total billed charges,,,,,,,,,10.197,,,fee schedule,,,9.064,,,fee schedule,,,,,,,,,,,,,,,,9.6305,85,percent of total billed charges,,,,,,,,,,5.638941,49.77,percent of total billed charges,,,,10.197,90,percent of total billed charges,,,,10.7635,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.6305,85,percent of total billed charges,,,,,,,,,5.638941,11.33,
LIDOCAINE 2% JELLY 30ml TUBE,2502419,CDM,,,250,RC,outpatient,30,ML,,48.719,26.79545,,43.8471,90,percent of total billed charges,,,,48.719,100,percent of total billed charges,,,,,,,,,43.8471,,,fee schedule,,,38.9752,,,fee schedule,,,,,,,,,,,,,,,,41.41115,85,percent of total billed charges,,,,,,,,,,24.2474463,49.77,percent of total billed charges,,,,43.8471,90,percent of total billed charges,,,,46.28305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,41.41115,85,percent of total billed charges,,,,,,,,,24.2474463,48.719,
POLYTRIM OPTHALMIC DROPS 10ml,2502429,CDM,,,250,RC,outpatient,10,ML,,39.964,21.9802,,35.9676,90,percent of total billed charges,,,,39.964,100,percent of total billed charges,,,,,,,,,35.9676,,,fee schedule,,,31.9712,,,fee schedule,,,,,,,,,,,,,,,,33.9694,85,percent of total billed charges,,,,,,,,,,19.8900828,49.77,percent of total billed charges,,,,35.9676,90,percent of total billed charges,,,,37.9658,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.9694,85,percent of total billed charges,,,,,,,,,19.8900828,39.964,
LIDOCAINE 5% CREAM 30gr TUBE,2502443,CDM,,,250,RC,outpatient,30,GR,,125.042,68.7731,,112.5378,90,percent of total billed charges,,,,125.042,100,percent of total billed charges,,,,,,,,,112.5378,,,fee schedule,,,100.0336,,,fee schedule,,,,,,,,,,,,,,,,106.2857,85,percent of total billed charges,,,,,,,,,,62.2334034,49.77,percent of total billed charges,,,,112.5378,90,percent of total billed charges,,,,118.7899,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,106.2857,85,percent of total billed charges,,,,,,,,,62.2334034,125.042,
OMNICEF 250mg/5ml SUSPENSION,2502451,CDM,,,250,RC,outpatient,250,ME,,18.128,9.9704,,16.3152,90,percent of total billed charges,,,,18.128,100,percent of total billed charges,,,,,,,,,16.3152,,,fee schedule,,,14.5024,,,fee schedule,,,,,,,,,,,,,,,,15.4088,85,percent of total billed charges,,,,,,,,,,9.0223056,49.77,percent of total billed charges,,,,16.3152,90,percent of total billed charges,,,,17.2216,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.4088,85,percent of total billed charges,,,,,,,,,9.0223056,18.128,
AMOXIL 100/5 5ml BOTTLE,2502453,CDM,,,250,RC,outpatient,5,ML,,21.115,11.61325,,19.0035,90,percent of total billed charges,,,,21.115,100,percent of total billed charges,,,,,,,,,19.0035,,,fee schedule,,,16.892,,,fee schedule,,,,,,,,,,,,,,,,17.94775,85,percent of total billed charges,,,,,,,,,,10.5089355,49.77,percent of total billed charges,,,,19.0035,90,percent of total billed charges,,,,20.05925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.94775,85,percent of total billed charges,,,,,,,,,10.5089355,21.115,
PROZAC 20MG CAP,2502455,CDM,,,250,RC,outpatient,20,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
PYRIDOSTIGMINE 60mg TABLET,2502473,CDM,,,250,RC,outpatient,60,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
ZINC SULFATE 220 mg TABS,2502481,CDM,,,250,RC,outpatient,220,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
ZOSYN 2.25gr,2502494,CDM,,,250,RC,outpatient,2.25,GR,,35.02,19.261,,31.518,90,percent of total billed charges,,,,35.02,100,percent of total billed charges,,,,,,,,,31.518,,,fee schedule,,,28.016,,,fee schedule,,,,,,,,,,,,,,,,29.767,85,percent of total billed charges,,,,,,,,,,17.429454,49.77,percent of total billed charges,,,,31.518,90,percent of total billed charges,,,,33.269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.767,85,percent of total billed charges,,,,,,,,,17.429454,35.02,
ZOSYN 3.375gr VIAL,2502496,CDM,J2543,HCPCS,250,RC,outpatient,3.375,GR,,72.203,39.71165,,64.9827,90,percent of total billed charges,,,,72.203,100,percent of total billed charges,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,,,,,,,,,,,,,,61.37255,85,percent of total billed charges,,,,,,,,,,35.9354331,49.77,percent of total billed charges,,,,64.9827,90,percent of total billed charges,,,,68.59285,90,percent of total billed charges,,,,,,,,,4.36,,,fee schedule,,,5.5372,,,fee schedule,,,,61.37255,85,percent of total billed charges,,,,,,,,,2.08,72.203,
MIDODRINE 5mg TABLET,2502497,CDM,,,250,RC,outpatient,5,ME,,7.107,3.90885,,6.3963,90,percent of total billed charges,,,,7.107,100,percent of total billed charges,,,,,,,,,6.3963,,,fee schedule,,,5.6856,,,fee schedule,,,,,,,,,,,,,,,,6.04095,85,percent of total billed charges,,,,,,,,,,3.5371539,49.77,percent of total billed charges,,,,6.3963,90,percent of total billed charges,,,,6.75165,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.04095,85,percent of total billed charges,,,,,,,,,3.5371539,7.107,
NAFCILLIN 2gr VIAL,2502499,CDM,,,250,RC,outpatient,2,GR,,89.301,49.11555,,80.3709,90,percent of total billed charges,,,,89.301,100,percent of total billed charges,,,,,,,,,80.3709,,,fee schedule,,,71.4408,,,fee schedule,,,,,,,,,,,,,,,,75.90585,85,percent of total billed charges,,,,,,,,,,44.4451077,49.77,percent of total billed charges,,,,80.3709,90,percent of total billed charges,,,,84.83595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,75.90585,85,percent of total billed charges,,,,,,,,,44.4451077,89.301,
HALDOL DECANOATE 100mg/ml VIAL,2502501,CDM,,,250,RC,outpatient,100,ME,,113.609,62.48495,,102.2481,90,percent of total billed charges,,,,113.609,100,percent of total billed charges,,,,,,,,,102.2481,,,fee schedule,,,90.8872,,,fee schedule,,,,,,,,,,,,,,,,96.56765,85,percent of total billed charges,,,,,,,,,,56.5431993,49.77,percent of total billed charges,,,,102.2481,90,percent of total billed charges,,,,107.92855,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,96.56765,85,percent of total billed charges,,,,,,,,,56.5431993,113.609,
DOPAMINE 400mg/250ml DSW,2502519,CDM,,,250,RC,outpatient,400,ME,,68.701,37.78555,,61.8309,90,percent of total billed charges,,,,68.701,100,percent of total billed charges,,,,,,,,,61.8309,,,fee schedule,,,54.9608,,,fee schedule,,,,,,,,,,,,,,,,58.39585,85,percent of total billed charges,,,,,,,,,,34.1924877,49.77,percent of total billed charges,,,,61.8309,90,percent of total billed charges,,,,65.26595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,58.39585,85,percent of total billed charges,,,,,,,,,34.1924877,68.701,
MOBIC 15mg TABLET,2502524,CDM,,,250,RC,outpatient,15,ME,,16.686,9.1773,,15.0174,90,percent of total billed charges,,,,16.686,100,percent of total billed charges,,,,,,,,,15.0174,,,fee schedule,,,13.3488,,,fee schedule,,,,,,,,,,,,,,,,14.1831,85,percent of total billed charges,,,,,,,,,,8.3046222,49.77,percent of total billed charges,,,,15.0174,90,percent of total billed charges,,,,15.8517,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.1831,85,percent of total billed charges,,,,,,,,,8.3046222,16.686,
QUESTRAN LIGHT 1 PKT POWDER,2502525,CDM,,,250,RC,outpatient,1,EA,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
BUPIVACCINE 0.51 PF 10ml VIAL,2502531,CDM,,,250,RC,outpatient,10,ML,,10.094,5.5517,,9.0846,90,percent of total billed charges,,,,10.094,100,percent of total billed charges,,,,,,,,,9.0846,,,fee schedule,,,8.0752,,,fee schedule,,,,,,,,,,,,,,,,8.5799,85,percent of total billed charges,,,,,,,,,,5.0237838,49.77,percent of total billed charges,,,,9.0846,90,percent of total billed charges,,,,9.5893,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.5799,85,percent of total billed charges,,,,,,,,,5.0237838,10.094,
MAGNESIUM SULFATE 20gr/500ml,2502534,CDM,,,250,RC,outpatient,20,GR,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
ZEMURIN 10mg/ml 5 ml VIAL,2502541,CDM,,,250,RC,outpatient,10,ME,,30.385,16.71175,,27.3465,90,percent of total billed charges,,,,30.385,100,percent of total billed charges,,,,,,,,,27.3465,,,fee schedule,,,24.308,,,fee schedule,,,,,,,,,,,,,,,,25.82725,85,percent of total billed charges,,,,,,,,,,15.1226145,49.77,percent of total billed charges,,,,27.3465,90,percent of total billed charges,,,,28.86575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,25.82725,85,percent of total billed charges,,,,,,,,,15.1226145,30.385,
TAMIFLU 6mg/ml,2502542,CDM,,,250,RC,outpatient,6,ME,,8.549,4.70195,,7.6941,90,percent of total billed charges,,,,8.549,100,percent of total billed charges,,,,,,,,,7.6941,,,fee schedule,,,6.8392,,,fee schedule,,,,,,,,,,,,,,,,7.26665,85,percent of total billed charges,,,,,,,,,,4.2548373,49.77,percent of total billed charges,,,,7.6941,90,percent of total billed charges,,,,8.12155,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.26665,85,percent of total billed charges,,,,,,,,,4.2548373,8.549,
ETHAMBUTOL HCL 400 MG TABLET,2502563,CDM,,,250,RC,outpatient,400,ME,,8.24,4.532,,7.416,90,percent of total billed charges,,,,8.24,100,percent of total billed charges,,,,,,,,,7.416,,,fee schedule,,,6.592,,,fee schedule,,,,,,,,,,,,,,,,7.004,85,percent of total billed charges,,,,,,,,,,4.101048,49.77,percent of total billed charges,,,,7.416,90,percent of total billed charges,,,,7.828,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.004,85,percent of total billed charges,,,,,,,,,4.101048,8.24,
NEBIVOLOL HCL 5mg TABLET,2502564,CDM,,,250,RC,outpatient,5,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
ACETYLCYSTEINE 20% INJECTION,2502567,CDM,,,250,RC,outpatient,1,EA,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
RIVASTIGMINE 4.6mg PATCH TD24,2502579,CDM,,,250,RC,outpatient,4.6,ME,,26.265,14.44575,,23.6385,90,percent of total billed charges,,,,26.265,100,percent of total billed charges,,,,,,,,,23.6385,,,fee schedule,,,21.012,,,fee schedule,,,,,,,,,,,,,,,,22.32525,85,percent of total billed charges,,,,,,,,,,13.0720905,49.77,percent of total billed charges,,,,23.6385,90,percent of total billed charges,,,,24.95175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.32525,85,percent of total billed charges,,,,,,,,,13.0720905,26.265,
RACEPINEPHRINE 2.25% AEROSOL,2502605,CDM,,,250,RC,outpatient,1,EA,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,30.9618,,,fee schedule,,,27.5216,,,fee schedule,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,,17.1218754,49.77,percent of total billed charges,,,,30.9618,90,percent of total billed charges,,,,32.6819,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,17.1218754,34.402,
METHYL SALICYLATE/MENTHOL 35.4,2502623,CDM,,,250,RC,outpatient,1,EA,,8.446,4.6453,,7.6014,90,percent of total billed charges,,,,8.446,100,percent of total billed charges,,,,,,,,,7.6014,,,fee schedule,,,6.7568,,,fee schedule,,,,,,,,,,,,,,,,7.1791,85,percent of total billed charges,,,,,,,,,,4.2035742,49.77,percent of total billed charges,,,,7.6014,90,percent of total billed charges,,,,8.0237,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.1791,85,percent of total billed charges,,,,,,,,,4.2035742,8.446,
CHIBROXIN 0.3% DROPS,2502640,CDM,,,250,RC,outpatient,1,EA,,55.105,30.30775,,49.5945,90,percent of total billed charges,,,,55.105,100,percent of total billed charges,,,,,,,,,49.5945,,,fee schedule,,,44.084,,,fee schedule,,,,,,,,,,,,,,,,46.83925,85,percent of total billed charges,,,,,,,,,,27.4257585,49.77,percent of total billed charges,,,,49.5945,90,percent of total billed charges,,,,52.34975,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,46.83925,85,percent of total billed charges,,,,,,,,,27.4257585,55.105,
TRANEXAMIC ACID 1000mg/10ml IN,2502648,CDM,,,250,RC,outpatient,1000,ME,,19.467,10.70685,,17.5203,90,percent of total billed charges,,,,19.467,100,percent of total billed charges,,,,,,,,,17.5203,,,fee schedule,,,15.5736,,,fee schedule,,,,,,,,,,,,,,,,16.54695,85,percent of total billed charges,,,,,,,,,,9.6887259,49.77,percent of total billed charges,,,,17.5203,90,percent of total billed charges,,,,18.49365,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.54695,85,percent of total billed charges,,,,,,,,,9.6887259,19.467,
CHLORASEPTIC SPRAY  AEROSOL,2502650,CDM,,,250,RC,outpatient,1,EA,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
NICARDIPINE 25mg/10ml INJ,2502652,CDM,,,250,RC,outpatient,25,ME,,36.359,19.99745,,32.7231,90,percent of total billed charges,,,,36.359,100,percent of total billed charges,,,,,,,,,32.7231,,,fee schedule,,,29.0872,,,fee schedule,,,,,,,,,,,,,,,,30.90515,85,percent of total billed charges,,,,,,,,,,18.0958743,49.77,percent of total billed charges,,,,32.7231,90,percent of total billed charges,,,,34.54105,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.90515,85,percent of total billed charges,,,,,,,,,18.0958743,36.359,
ENTRESTO 24/26 mg TAB,2502653,CDM,,,250,RC,outpatient,24,ME,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,19.6524,,,fee schedule,,,17.4688,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,10.8677772,21.836,
BUPROPION XL 150mg TAB,2502654,CDM,,,250,RC,outpatient,150,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
RISPERIDONE MICRO 37.5mg,2502658,CDM,J2794,HCPCS,250,RC,outpatient,37.5,ME,,1408.113,774.46215,,1267.3017,90,percent of total billed charges,,,,1408.113,100,percent of total billed charges,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,,,,,,,,,,,,,,1196.89605,85,percent of total billed charges,,,,,,,,,,700.8178401,49.77,percent of total billed charges,,,,1267.3017,90,percent of total billed charges,,,,1337.70735,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1196.89605,85,percent of total billed charges,,,,,,,,,11.36,1408.113,
DABIGATRAN ETEXLIATE MESYLATE,2502671,CDM,,,250,RC,outpatient,1,EA,,15.244,8.3842,,13.7196,90,percent of total billed charges,,,,15.244,100,percent of total billed charges,,,,,,,,,13.7196,,,fee schedule,,,12.1952,,,fee schedule,,,,,,,,,,,,,,,,12.9574,85,percent of total billed charges,,,,,,,,,,7.5869388,49.77,percent of total billed charges,,,,13.7196,90,percent of total billed charges,,,,14.4818,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.9574,85,percent of total billed charges,,,,,,,,,7.5869388,15.244,
TOLTERODINE TARTRATE 2mg TAB,2502677,CDM,,,250,RC,outpatient,2,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
FOSPHENYTOIN 50mg/ml VIAL,2502683,CDM,,,250,RC,outpatient,50,ME,,37.595,20.67725,,33.8355,90,percent of total billed charges,,,,37.595,100,percent of total billed charges,,,,,,,,,33.8355,,,fee schedule,,,30.076,,,fee schedule,,,,,,,,,,,,,,,,31.95575,85,percent of total billed charges,,,,,,,,,,18.7110315,49.77,percent of total billed charges,,,,33.8355,90,percent of total billed charges,,,,35.71525,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.95575,85,percent of total billed charges,,,,,,,,,18.7110315,37.595,
HEP B VACCINE 5mcg/0.5ml,2502684,CDM,,,250,RC,outpatient,0.5,ML,,51.5,28.325,,46.35,90,percent of total billed charges,,,,51.5,100,percent of total billed charges,,,,,,,,,46.35,,,fee schedule,,,41.2,,,fee schedule,,,,,,,,,,,,,,,,43.775,85,percent of total billed charges,,,,,,,,,,25.63155,49.77,percent of total billed charges,,,,46.35,90,percent of total billed charges,,,,48.925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,43.775,85,percent of total billed charges,,,,,,,,,25.63155,51.5,
RISPERIDONE MICRO 12.5mg,2502687,CDM,,,250,RC,outpatient,12.5,ME,,413.442,227.3931,,372.0978,90,percent of total billed charges,,,,413.442,100,percent of total billed charges,,,,,,,,,372.0978,,,fee schedule,,,330.7536,,,fee schedule,,,,,,,,,,,,,,,,351.4257,85,percent of total billed charges,,,,,,,,,,205.7700834,49.77,percent of total billed charges,,,,372.0978,90,percent of total billed charges,,,,392.7699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,351.4257,85,percent of total billed charges,,,,,,,,,205.7700834,413.442,
CEFAZOLIN/ DEXTROSE 2gr,2502689,CDM,,,250,RC,outpatient,2,GR,,10.094,5.5517,,9.0846,90,percent of total billed charges,,,,10.094,100,percent of total billed charges,,,,,,,,,9.0846,,,fee schedule,,,8.0752,,,fee schedule,,,,,,,,,,,,,,,,8.5799,85,percent of total billed charges,,,,,,,,,,5.0237838,49.77,percent of total billed charges,,,,9.0846,90,percent of total billed charges,,,,9.5893,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.5799,85,percent of total billed charges,,,,,,,,,5.0237838,10.094,
DILTIAZEM HCL 5mg/ml VIAL,2502701,CDM,,,250,RC,outpatient,5,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,22.7115,,,fee schedule,,,20.188,,,fee schedule,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,,12.5594595,49.77,percent of total billed charges,,,,22.7115,90,percent of total billed charges,,,,23.97325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,12.5594595,25.235,
DILTIAZEM 5mg/ml 10ml VIAL,2502702,CDM,,,250,RC,outpatient,5,ME,,18.025,9.91375,,16.2225,90,percent of total billed charges,,,,18.025,100,percent of total billed charges,,,,,,,,,16.2225,,,fee schedule,,,14.42,,,fee schedule,,,,,,,,,,,,,,,,15.32125,85,percent of total billed charges,,,,,,,,,,8.9710425,49.77,percent of total billed charges,,,,16.2225,90,percent of total billed charges,,,,17.12375,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.32125,85,percent of total billed charges,,,,,,,,,8.9710425,18.025,
GENTAMICIN SULFATE CR 15GM TUB,2502709,CDM,,,250,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
LEVOTHYROXINE 100mcg  VIAL,2502714,CDM,J0650,HCPCS,250,RC,outpatient,1,EA,,105.266,57.8963,,94.7394,90,percent of total billed charges,,,,105.266,100,percent of total billed charges,,,,,,,,,94.7394,,,fee schedule,,,84.2128,,,fee schedule,,,,,,,,,,,,,,,,89.4761,85,percent of total billed charges,,,,,,,,,,52.3908882,49.77,percent of total billed charges,,,,94.7394,90,percent of total billed charges,,,,100.0027,90,percent of total billed charges,,,,,,,,,12.04,,,fee schedule,,,15.2908,,,fee schedule,,,,89.4761,85,percent of total billed charges,,,,,,,,,12.04,105.266,
OLANZAPINE 10mg TAB,2502722,CDM,,,250,RC,outpatient,10,ME,,44.599,24.52945,,40.1391,90,percent of total billed charges,,,,44.599,100,percent of total billed charges,,,,,,,,,40.1391,,,fee schedule,,,35.6792,,,fee schedule,,,,,,,,,,,,,,,,37.90915,85,percent of total billed charges,,,,,,,,,,22.1969223,49.77,percent of total billed charges,,,,40.1391,90,percent of total billed charges,,,,42.36905,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.90915,85,percent of total billed charges,,,,,,,,,22.1969223,44.599,
GLUTOSE 15 ORAL GEL,2502739,CDM,,,250,RC,outpatient,1,EA,,13.699,7.53445,,12.3291,90,percent of total billed charges,,,,13.699,100,percent of total billed charges,,,,,,,,,12.3291,,,fee schedule,,,10.9592,,,fee schedule,,,,,,,,,,,,,,,,11.64415,85,percent of total billed charges,,,,,,,,,,6.8179923,49.77,percent of total billed charges,,,,12.3291,90,percent of total billed charges,,,,13.01405,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.64415,85,percent of total billed charges,,,,,,,,,6.8179923,13.699,
CLEOCIN 300MG/2ML INJ.,2502860,CDM,,,250,RC,outpatient,300,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
ROBINUL 0.2mg/ml INJ,2502905,CDM,,,250,RC,outpatient,0.2,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
ROBINUL 0.2MG/ML 20ML INJ,2502915,CDM,,,250,RC,outpatient,0.2,ME,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,19.6524,,,fee schedule,,,17.4688,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,10.8677772,21.836,
COCCIODIN 1:100 INJ.,2502930,CDM,,,250,RC,outpatient,1,EA,,102.073,56.14015,,91.8657,90,percent of total billed charges,,,,102.073,100,percent of total billed charges,,,,,,,,,91.8657,,,fee schedule,,,81.6584,,,fee schedule,,,,,,,,,,,,,,,,86.76205,85,percent of total billed charges,,,,,,,,,,50.8017321,49.77,percent of total billed charges,,,,91.8657,90,percent of total billed charges,,,,96.96935,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,86.76205,85,percent of total billed charges,,,,,,,,,50.8017321,102.073,
COGENTIN 1MG TAB.,2502950,CDM,,,250,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
COGENTIN PER MG/ML (2ML),2502960,CDM,,,250,RC,outpatient,1,ME,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,25.8633,,,fee schedule,,,22.9896,,,fee schedule,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,,14.3024049,49.77,percent of total billed charges,,,,25.8633,90,percent of total billed charges,,,,27.30015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,14.3024049,28.737,
COLACE 100mg CAP,2502980,CDM,,,250,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
COLYTE POWDER,2503040,CDM,,,250,RC,outpatient,1,EA,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,41.3442,,,fee schedule,,,36.7504,,,fee schedule,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,,22.8633426,49.77,percent of total billed charges,,,,41.3442,90,percent of total billed charges,,,,43.6411,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,22.8633426,45.938,
ROMAZICON 0.5MG/ML,2503045,CDM,,,250,RC,outpatient,0.5,ME,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,,,,,,,103.1751,,,fee schedule,,,91.7112,,,fee schedule,,,,,,,,,,,,,,,,97.44315,85,percent of total billed charges,,,,,,,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,97.44315,85,percent of total billed charges,,,,,,,,,57.0558303,114.639,
COMPAZINE 5MG TAB,2503070,CDM,,,250,RC,outpatient,5,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
SANDOSTATIN 50MCG/ML 1ML INJ,2503105,CDM,,,250,RC,outpatient,50,ML,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,19.6524,,,fee schedule,,,17.4688,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,10.8677772,21.836,
CORTISPORIN OPTH SUSP.,2503200,CDM,,,250,RC,outpatient,1,EA,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,,,,,,,28.9224,,,fee schedule,,,25.7088,,,fee schedule,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,,15.9940872,49.77,percent of total billed charges,,,,28.9224,90,percent of total billed charges,,,,30.5292,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,15.9940872,32.136,
CORTISPORIN OTIC SUSP.,2503220,CDM,,,250,RC,outpatient,1,EA,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,,,,,,,28.9224,,,fee schedule,,,25.7088,,,fee schedule,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,,15.9940872,49.77,percent of total billed charges,,,,28.9224,90,percent of total billed charges,,,,30.5292,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,15.9940872,32.136,
SILVADENE 85GR CREAM,2503265,CDM,,,250,RC,outpatient,85,GR,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,33.0939,,,fee schedule,,,29.4168,,,fee schedule,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,,18.3009267,49.77,percent of total billed charges,,,,33.0939,90,percent of total billed charges,,,,34.93245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,18.3009267,36.771,
SILVER NITRATE STICK 10EA TOP,2503275,CDM,,,250,RC,outpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
CYCLOGYL OPTH 1% GTTS.,2503320,CDM,,,250,RC,outpatient,1,EA,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,25.8633,,,fee schedule,,,22.9896,,,fee schedule,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,,14.3024049,49.77,percent of total billed charges,,,,25.8633,90,percent of total billed charges,,,,27.30015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,14.3024049,28.737,
D10W 1000ML,2503420,CDM,,,250,RC,outpatient,1000,ML,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,27.9027,,,fee schedule,,,24.8024,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,15.4301931,31.003,
SODIUM BICARBONATE 8.4% 50ML,2503425,CDM,,,250,RC,outpatient,50,ML,,55.105,30.30775,,49.5945,90,percent of total billed charges,,,,55.105,100,percent of total billed charges,,,,,,,,,49.5945,,,fee schedule,,,44.084,,,fee schedule,,,,,,,,,,,,,,,,46.83925,85,percent of total billed charges,,,,,,,,,,27.4257585,49.77,percent of total billed charges,,,,49.5945,90,percent of total billed charges,,,,52.34975,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,46.83925,85,percent of total billed charges,,,,,,,,,27.4257585,55.105,
SODIUM BICARB 4.2% 5ML INJ,2503435,CDM,,,250,RC,outpatient,5,ML,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
SODIUM BICARB 8.4%/10MEQ/10ML,2503445,CDM,,,250,RC,outpatient,10,ML,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,30.0348,,,fee schedule,,,26.6976,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,16.6092444,33.372,
SODIUM CHLORIDE 0.45% 1000ML,2503455,CDM,,,250,RC,outpatient,1000,ML,,31.518,17.3349,,28.3662,90,percent of total billed charges,,,,31.518,100,percent of total billed charges,,,,,,,,,28.3662,,,fee schedule,,,25.2144,,,fee schedule,,,,,,,,,,,,,,,,26.7903,85,percent of total billed charges,,,,,,,,,,15.6865086,49.77,percent of total billed charges,,,,28.3662,90,percent of total billed charges,,,,29.9421,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.7903,85,percent of total billed charges,,,,,,,,,15.6865086,31.518,
D5 NORMAL SALINE 1000ML,2503470,CDM,,,250,RC,outpatient,1000,ML,,35.638,19.6009,,32.0742,90,percent of total billed charges,,,,35.638,100,percent of total billed charges,,,,,,,,,32.0742,,,fee schedule,,,28.5104,,,fee schedule,,,,,,,,,,,,,,,,30.2923,85,percent of total billed charges,,,,,,,,,,17.7370326,49.77,percent of total billed charges,,,,32.0742,90,percent of total billed charges,,,,33.8561,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.2923,85,percent of total billed charges,,,,,,,,,17.7370326,35.638,
SODIUM CHLORIDE 500ML 3% SOL,2503475,CDM,,,250,RC,outpatient,500,ML,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
D51/2 NORMAL SALINE 1000ML,2503490,CDM,,,250,RC,outpatient,1000,ML,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,37.1727,,,fee schedule,,,33.0424,,,fee schedule,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,,20.5565031,49.77,percent of total billed charges,,,,37.1727,90,percent of total billed charges,,,,39.23785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,20.5565031,41.303,
SODIUM CHLOR CONC 23.4% INJ,2503495,CDM,,,250,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
D5RL 1000ML,2503510,CDM,,,250,RC,outpatient,1000,ML,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,43.3836,,,fee schedule,,,38.5632,,,fee schedule,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,,23.9911308,49.77,percent of total billed charges,,,,43.3836,90,percent of total billed charges,,,,45.7938,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,23.9911308,48.204,
D5W 50ML,2503520,CDM,,,250,RC,outpatient,50,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
SODIUM PHOSP 60mEq na/15ml INJ,2503525,CDM,,,250,RC,outpatient,15,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
D5W 100ML,2503530,CDM,,,250,RC,outpatient,100,ML,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,,,,,,,35.1333,,,fee schedule,,,31.2296,,,fee schedule,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,,,,,,,,19.4287149,49.77,percent of total billed charges,,,,35.1333,90,percent of total billed charges,,,,37.08515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,,,,,,,19.4287149,39.037,
D5W 250ML,2503540,CDM,,,250,RC,outpatient,250,ML,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,,,,,,,20.6721,,,fee schedule,,,18.3752,,,fee schedule,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,,11.4316713,49.77,percent of total billed charges,,,,20.6721,90,percent of total billed charges,,,,21.82055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,11.4316713,22.969,
D5W 500ML,2503550,CDM,,,250,RC,outpatient,500,ML,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,37.1727,,,fee schedule,,,33.0424,,,fee schedule,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,,20.5565031,49.77,percent of total billed charges,,,,37.1727,90,percent of total billed charges,,,,39.23785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,20.5565031,41.303,
D5W 1000ML,2503560,CDM,,,250,RC,outpatient,1000,ML,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,41.3442,,,fee schedule,,,36.7504,,,fee schedule,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,,22.8633426,49.77,percent of total billed charges,,,,41.3442,90,percent of total billed charges,,,,43.6411,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,22.8633426,45.938,
D5W ADD-VAN 50ML,2503570,CDM,,,250,RC,outpatient,50,ML,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
D5W ADD-VAN 100ML,2503580,CDM,,,250,RC,outpatient,100,ML,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
D5W ADD-VAN 250ML,2503590,CDM,,,250,RC,outpatient,250,ML,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
DAKIN'S SOLUTION 0.25%,2503620,CDM,,,250,RC,outpatient,1,EA,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
STERILE WATER 20ml INJ,2503695,CDM,,,250,RC,outpatient,20,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
DEBROX 14ML GTTS.,2503770,CDM,,,250,RC,outpatient,14,ML,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
SUFENTA INJ,2503805,CDM,,,250,RC,outpatient,1,EA,,72.306,39.7683,,65.0754,90,percent of total billed charges,,,,72.306,100,percent of total billed charges,,,,,,,,,65.0754,,,fee schedule,,,57.8448,,,fee schedule,,,,,,,,,,,,,,,,61.4601,85,percent of total billed charges,,,,,,,,,,35.9866962,49.77,percent of total billed charges,,,,65.0754,90,percent of total billed charges,,,,68.6907,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,61.4601,85,percent of total billed charges,,,,,,,,,35.9866962,72.306,
SUPRANE CHG PER MIN LIQUID,2503835,CDM,,,250,RC,outpatient,1,EA,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,2.1321,,,fee schedule,,,1.8952,,,fee schedule,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,,1.1790513,49.77,percent of total billed charges,,,,2.1321,90,percent of total billed charges,,,,2.25055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,1.1790513,2.369,
DEXAMETH SOD PHOS 4mg/ml,2503840,CDM,,,250,RC,outpatient,4,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
SUSPHRINE 1:200/0.3ML INJ,2503885,CDM,,,250,RC,outpatient,0.3,ML,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,19.6524,,,fee schedule,,,17.4688,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,10.8677772,21.836,
DEMEROL 25mg/ml,2503920,CDM,,,250,RC,outpatient,25,ME,,17.819,9.80045,,16.0371,90,percent of total billed charges,,,,17.819,100,percent of total billed charges,,,,,,,,,16.0371,,,fee schedule,,,14.2552,,,fee schedule,,,,,,,,,,,,,,,,15.14615,85,percent of total billed charges,,,,,,,,,,8.8685163,49.77,percent of total billed charges,,,,16.0371,90,percent of total billed charges,,,,16.92805,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.14615,85,percent of total billed charges,,,,,,,,,8.8685163,17.819,
DEMEROL 50mg/ml INJ,2503930,CDM,,,250,RC,outpatient,50,ME,,4.944,2.7192,,4.4496,90,percent of total billed charges,,,,4.944,100,percent of total billed charges,,,,,,,,,4.4496,,,fee schedule,,,3.9552,,,fee schedule,,,,,,,,,,,,,,,,4.2024,85,percent of total billed charges,,,,,,,,,,2.4606288,49.77,percent of total billed charges,,,,4.4496,90,percent of total billed charges,,,,4.6968,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.2024,85,percent of total billed charges,,,,,,,,,2.4606288,4.944,
SYNTHROID 0.088MG TAB,2503975,CDM,,,250,RC,outpatient,0.088,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DEXTROSE ABBOJECT 50%/50ML INJ,2504180,CDM,,,250,RC,outpatient,50,ML,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,,,,,,,46.4427,,,fee schedule,,,41.2824,,,fee schedule,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,,,,,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,,,,,,,25.6828131,51.603,
DIFLUCAN 100MG TAB,2504290,CDM,,,250,RC,outpatient,100,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,22.7115,,,fee schedule,,,20.188,,,fee schedule,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,,12.5594595,49.77,percent of total billed charges,,,,22.7115,90,percent of total billed charges,,,,23.97325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,12.5594595,25.235,
DIPRIVAN 10MG/ML (100ML) INJ,2504410,CDM,,,250,RC,outpatient,10,ME,,200.644,110.3542,,180.5796,90,percent of total billed charges,,,,200.644,100,percent of total billed charges,,,,,,,,,180.5796,,,fee schedule,,,160.5152,,,fee schedule,,,,,,,,,,,,,,,,170.5474,85,percent of total billed charges,,,,,,,,,,99.8605188,49.77,percent of total billed charges,,,,180.5796,90,percent of total billed charges,,,,190.6118,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,170.5474,85,percent of total billed charges,,,,,,,,,99.8605188,200.644,
DIPRIVAN 20ML INJ,2504430,CDM,,,250,RC,outpatient,20,ML,,37.904,20.8472,,34.1136,90,percent of total billed charges,,,,37.904,100,percent of total billed charges,,,,,,,,,34.1136,,,fee schedule,,,30.3232,,,fee schedule,,,,,,,,,,,,,,,,32.2184,85,percent of total billed charges,,,,,,,,,,18.8648208,49.77,percent of total billed charges,,,,34.1136,90,percent of total billed charges,,,,36.0088,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.2184,85,percent of total billed charges,,,,,,,,,18.8648208,37.904,
"THROMBIN 20,000 UNITS TOPICAL",2504485,CDM,,,250,RC,outpatient,1,EA,,172.01,94.6055,,154.809,90,percent of total billed charges,,,,172.01,100,percent of total billed charges,,,,,,,,,154.809,,,fee schedule,,,137.608,,,fee schedule,,,,,,,,,,,,,,,,146.2085,85,percent of total billed charges,,,,,,,,,,85.609377,49.77,percent of total billed charges,,,,154.809,90,percent of total billed charges,,,,163.4095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,146.2085,85,percent of total billed charges,,,,,,,,,85.609377,172.01,
TIMOPTIC 0.5% DROPS,2504605,CDM,,,250,RC,outpatient,1,EA,,53.972,29.6846,,48.5748,90,percent of total billed charges,,,,53.972,100,percent of total billed charges,,,,,,,,,48.5748,,,fee schedule,,,43.1776,,,fee schedule,,,,,,,,,,,,,,,,45.8762,85,percent of total billed charges,,,,,,,,,,26.8618644,49.77,percent of total billed charges,,,,48.5748,90,percent of total billed charges,,,,51.2734,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,45.8762,85,percent of total billed charges,,,,,,,,,26.8618644,53.972,
DULCOLAX/BISACODYL 5MG TAB,2504660,CDM,,,250,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DULCOLAX 10MG SUPPOS,2504670,CDM,,,250,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DURAGESIC 100MCG/HR TOPICAL,2504680,CDM,,,250,RC,outpatient,1,EA,,86.005,47.30275,,77.4045,90,percent of total billed charges,,,,86.005,100,percent of total billed charges,,,,,,,,,77.4045,,,fee schedule,,,68.804,,,fee schedule,,,,,,,,,,,,,,,,73.10425,85,percent of total billed charges,,,,,,,,,,42.8046885,49.77,percent of total billed charges,,,,77.4045,90,percent of total billed charges,,,,81.70475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,73.10425,85,percent of total billed charges,,,,,,,,,42.8046885,86.005,
DURAGESIC 25MCG/HR TOPICAL,2504690,CDM,,,250,RC,outpatient,1,EA,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,,,,,,,28.9224,,,fee schedule,,,25.7088,,,fee schedule,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,,15.9940872,49.77,percent of total billed charges,,,,28.9224,90,percent of total billed charges,,,,30.5292,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,15.9940872,32.136,
DURAGESIC 50MCG/HR TOPICAL,2504700,CDM,,,250,RC,outpatient,1,EA,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,41.3442,,,fee schedule,,,36.7504,,,fee schedule,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,,22.8633426,49.77,percent of total billed charges,,,,41.3442,90,percent of total billed charges,,,,43.6411,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,22.8633426,45.938,
DURAGESIC 75MCG/HR TOPICAL,2504710,CDM,,,250,RC,outpatient,1,EA,,69.937,38.46535,,62.9433,90,percent of total billed charges,,,,69.937,100,percent of total billed charges,,,,,,,,,62.9433,,,fee schedule,,,55.9496,,,fee schedule,,,,,,,,,,,,,,,,59.44645,85,percent of total billed charges,,,,,,,,,,34.8076449,49.77,percent of total billed charges,,,,62.9433,90,percent of total billed charges,,,,66.44015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,59.44645,85,percent of total billed charges,,,,,,,,,34.8076449,69.937,
LABETALOL HCL 100MG/20ML,2504865,CDM,,,250,RC,outpatient,100,ME,,98.674,54.2707,,88.8066,90,percent of total billed charges,,,,98.674,100,percent of total billed charges,,,,,,,,,88.8066,,,fee schedule,,,78.9392,,,fee schedule,,,,,,,,,,,,,,,,83.8729,85,percent of total billed charges,,,,,,,,,,49.1100498,49.77,percent of total billed charges,,,,88.8066,90,percent of total billed charges,,,,93.7403,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,83.8729,85,percent of total billed charges,,,,,,,,,49.1100498,98.674,
TRIDIL/NITRO 25MG/5ML INJ,2504965,CDM,,,250,RC,outpatient,25,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
TRUSOPT 2% 10ml OPTHALMIC DROP,2505035,CDM,,,250,RC,outpatient,10,ML,,153.161,84.23855,,137.8449,90,percent of total billed charges,,,,153.161,100,percent of total billed charges,,,,,,,,,137.8449,,,fee schedule,,,122.5288,,,fee schedule,,,,,,,,,,,,,,,,130.18685,85,percent of total billed charges,,,,,,,,,,76.2282297,49.77,percent of total billed charges,,,,137.8449,90,percent of total billed charges,,,,145.50295,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,130.18685,85,percent of total billed charges,,,,,,,,,76.2282297,153.161,
EPHEDRINE 50MG/ML INJ,2505120,CDM,,,250,RC,outpatient,50,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
"EPINEPHRINE 1:1,000 INJ",2505130,CDM,,,250,RC,outpatient,1,EA,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,27.9027,,,fee schedule,,,24.8024,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,15.4301931,31.003,
TYLENOL 10GR (650MG) SUPPOS,2505135,CDM,,,250,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
"EPINEPHRINE 1:10,000 AB3.5 INJ",2505150,CDM,,,250,RC,outpatient,1,EA,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,37.1727,,,fee schedule,,,33.0424,,,fee schedule,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,,20.5565031,49.77,percent of total billed charges,,,,37.1727,90,percent of total billed charges,,,,39.23785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,20.5565031,41.303,
EPSOM SALT POWDER,2505190,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TYLENOL 5GR (325MG) SUPPOS,2505205,CDM,,,250,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TYLENOL W/COD ELIX 5CC,2505235,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ERYTHROCIN 500MG VIAL POWDER,2505250,CDM,,,250,RC,outpatient,500,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,14.5539,,,fee schedule,,,12.9368,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,8.0483067,16.171,
UNIPEN 2GM ADD-VAN INJ,2505345,CDM,,,250,RC,outpatient,1,EA,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,33.0939,,,fee schedule,,,29.4168,,,fee schedule,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,,18.3009267,49.77,percent of total billed charges,,,,33.0939,90,percent of total billed charges,,,,34.93245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,18.3009267,36.771,
VALISONE 0.05% CREAM,2505415,CDM,,,250,RC,outpatient,1,EA,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
FLAGYL 500MG PRE-MIX INJ,2505560,CDM,,,250,RC,outpatient,500,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,27.9027,,,fee schedule,,,24.8024,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,15.4301931,31.003,
FLEETS ENEMA,2505580,CDM,,,250,RC,outpatient,1,EA,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,6.3036,,,fee schedule,,,5.6032,,,fee schedule,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,,3.4858908,49.77,percent of total billed charges,,,,6.3036,90,percent of total billed charges,,,,6.6538,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,3.4858908,7.004,
FLEETS OIL RETENTION  ENEMA,2505600,CDM,,,250,RC,outpatient,1,EA,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
VASOTEC 1.25MG/ML INJ,2505635,CDM,,,250,RC,outpatient,1.25,ME,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,37.1727,,,fee schedule,,,33.0424,,,fee schedule,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,,20.5565031,49.77,percent of total billed charges,,,,37.1727,90,percent of total billed charges,,,,39.23785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,20.5565031,41.303,
VIBRAMYCIN 100mg VIAL,2505765,CDM,,,250,RC,outpatient,100,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
FOLVITE INJ 5MG/ML INJ,2505770,CDM,,,250,RC,outpatient,5,ME,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,33.0939,,,fee schedule,,,29.4168,,,fee schedule,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,,18.3009267,49.77,percent of total billed charges,,,,33.0939,90,percent of total billed charges,,,,34.93245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,18.3009267,36.771,
VIOFORM MILD CREAM,2505805,CDM,,,250,RC,outpatient,1,EA,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,,,,,,,33.0939,,,fee schedule,,,29.4168,,,fee schedule,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,,18.3009267,49.77,percent of total billed charges,,,,33.0939,90,percent of total billed charges,,,,34.93245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,18.3009267,36.771,
VISINE/COLLYRIUM FRESH 0.05%,2505825,CDM,,,250,RC,outpatient,1,EA,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,13.4415,,,fee schedule,,,11.948,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,14.935,
GARAMYCIN 5ML DROPS,2505970,CDM,,,250,RC,outpatient,5,ML,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,36.153,,,fee schedule,,,32.136,,,fee schedule,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,19.992609,40.17,
GLUCOPHAGE 500MG TAB,2506060,CDM,,,250,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
GLUCOPHAGE 850MG TAB,2506070,CDM,,,250,RC,outpatient,850,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
XANAX 0.5MG TAB,2506115,CDM,,,250,RC,outpatient,0.5,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
GLYCERIN SUPP ADULT  SUPPOSIT,2506140,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
GLYCER SUPP PED INFANT SUPPOS,2506150,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
HABITROL PATCH 14MG TOPICAL,2506210,CDM,,,250,RC,outpatient,14,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
HABITROL PATCH 21MG TOPICAL,2506220,CDM,,,250,RC,outpatient,21,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,,,,,,,17.613,,,fee schedule,,,15.656,,,fee schedule,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,,9.739989,49.77,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,18.5915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,9.739989,19.57,
ZEMURON 50mg,2506245,CDM,,,250,RC,outpatient,50,ME,,101.558,55.8569,,91.4022,90,percent of total billed charges,,,,101.558,100,percent of total billed charges,,,,,,,,,91.4022,,,fee schedule,,,81.2464,,,fee schedule,,,,,,,,,,,,,,,,86.3243,85,percent of total billed charges,,,,,,,,,,50.5454166,49.77,percent of total billed charges,,,,91.4022,90,percent of total billed charges,,,,96.4801,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,86.3243,85,percent of total billed charges,,,,,,,,,50.5454166,101.558,
HALDOL 1MG TAB,2506260,CDM,,,250,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LISINOPRIL 20mg TAB,2506285,CDM,,,250,RC,outpatient,20,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
LISINOPRIL  5mg TAB,2506295,CDM,,,250,RC,outpatient,5,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
HCTZ/ESIDRIX 25MG TAB,2506320,CDM,,,250,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
HEMABATE (PROSTIN 15M) 250MCG,2506360,CDM,,,250,RC,outpatient,1,EA,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,,,,,,,60.9039,,,fee schedule,,,54.1368,,,fee schedule,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,,33.6798567,49.77,percent of total billed charges,,,,60.9039,90,percent of total billed charges,,,,64.28745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,33.6798567,67.671,
ZITHROMAX 200MG/5ML SUSP,2506365,CDM,,,250,RC,outpatient,200,ME,,74.572,41.0146,,67.1148,90,percent of total billed charges,,,,74.572,100,percent of total billed charges,,,,,,,,,67.1148,,,fee schedule,,,59.6576,,,fee schedule,,,,,,,,,,,,,,,,63.3862,85,percent of total billed charges,,,,,,,,,,37.1144844,49.77,percent of total billed charges,,,,67.1148,90,percent of total billed charges,,,,70.8434,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,63.3862,85,percent of total billed charges,,,,,,,,,37.1144844,74.572,
ZOCOR 10MG TAB,2506385,CDM,,,250,RC,outpatient,10,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
HEPARIN 5000 UNITS/CC INJECT,2506410,CDM,,,250,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
"HEPARIN PREMIX 25,000 UNTS INJ",2506440,CDM,,,250,RC,outpatient,1,EA,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,30.0348,,,fee schedule,,,26.6976,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,16.6092444,33.372,
HESPAN 6% INJ,2506450,CDM,,,250,RC,outpatient,1,EA,,153.676,84.5218,,138.3084,90,percent of total billed charges,,,,153.676,100,percent of total billed charges,,,,,,,,,138.3084,,,fee schedule,,,122.9408,,,fee schedule,,,,,,,,,,,,,,,,130.6246,85,percent of total billed charges,,,,,,,,,,76.4845452,49.77,percent of total billed charges,,,,138.3084,90,percent of total billed charges,,,,145.9922,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,130.6246,85,percent of total billed charges,,,,,,,,,76.4845452,153.676,
HUMIST DROPS SALINE,2506510,CDM,,,250,RC,outpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
HYDROCORTISONE 2.5% CREAM,2506570,CDM,,,250,RC,outpatient,1,EA,,7.622,4.1921,,6.8598,90,percent of total billed charges,,,,7.622,100,percent of total billed charges,,,,,,,,,6.8598,,,fee schedule,,,6.0976,,,fee schedule,,,,,,,,,,,,,,,,6.4787,85,percent of total billed charges,,,,,,,,,,3.7934694,49.77,percent of total billed charges,,,,6.8598,90,percent of total billed charges,,,,7.2409,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.4787,85,percent of total billed charges,,,,,,,,,3.7934694,7.622,
AMPICILLIN 2 GR VIAL INJECTION,2506595,CDM,,,250,RC,outpatient,2,GR,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
ARICEPT 5MG TABLET,2506605,CDM,,,250,RC,outpatient,5,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
HYGROTON 25MG TAB,2506620,CDM,,,250,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
HYTRIN 1MG CAP,2506670,CDM,,,250,RC,outpatient,1,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
HYTRIN 5MG CAP,2506690,CDM,,,250,RC,outpatient,5,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
MIACALCIN NASAL SPRAY,2506695,CDM,,,250,RC,outpatient,1,EA,,76.838,42.2609,,69.1542,90,percent of total billed charges,,,,76.838,100,percent of total billed charges,,,,,,,,,69.1542,,,fee schedule,,,61.4704,,,fee schedule,,,,,,,,,,,,,,,,65.3123,85,percent of total billed charges,,,,,,,,,,38.2422726,49.77,percent of total billed charges,,,,69.1542,90,percent of total billed charges,,,,72.9961,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,65.3123,85,percent of total billed charges,,,,,,,,,38.2422726,76.838,
CLEOCIN 900mg PREMIX IV,2506715,CDM,,,250,RC,outpatient,900,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,22.7115,,,fee schedule,,,20.188,,,fee schedule,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,,12.5594595,49.77,percent of total billed charges,,,,22.7115,90,percent of total billed charges,,,,23.97325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,12.5594595,25.235,
CLEOCIN 600mg PREMIX IV,2506725,CDM,,,250,RC,outpatient,600,ME,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,21.6918,,,fee schedule,,,19.2816,,,fee schedule,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,,11.9955654,49.77,percent of total billed charges,,,,21.6918,90,percent of total billed charges,,,,22.8969,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,11.9955654,24.102,
IMDUR 30MG SLOW RELEASE,2506730,CDM,,,250,RC,outpatient,30,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
MAGNESIUM 40mg in D5W IV,2506765,CDM,,,250,RC,outpatient,40,ME,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,23.8239,,,fee schedule,,,21.1768,,,fee schedule,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,,13.1746167,49.77,percent of total billed charges,,,,23.8239,90,percent of total billed charges,,,,25.14745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,13.1746167,26.471,
IMODIUM 2MG CAP,2506770,CDM,,,250,RC,outpatient,2,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
IMURAN 50MG TAB,2506780,CDM,,,250,RC,outpatient,50,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
AMBIEN 5 MG,2506795,CDM,,,250,RC,outpatient,5,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
REMERON 15MG,2506805,CDM,,,250,RC,outpatient,15,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
RISPERDAL 1 MG,2506815,CDM,,,250,RC,outpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
INDERAL 20MG TAB,2506820,CDM,,,250,RC,outpatient,20,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ZYPREXA 2.5 MG,2506825,CDM,,,250,RC,outpatient,2.5,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
SEROQUEL 25 MG TABLET,2506855,CDM,,,250,RC,outpatient,25,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
EFFEXOR 25 MG TABLET,2506865,CDM,,,250,RC,outpatient,25,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
LUVOX 50 MG TABLET,2506885,CDM,,,250,RC,outpatient,50,ME,,8.6005,4.730275,,7.74045,90,percent of total billed charges,,,,8.6005,100,percent of total billed charges,,,,,,,,,7.74045,,,fee schedule,,,6.8804,,,fee schedule,,,,,,,,,,,,,,,,7.310425,85,percent of total billed charges,,,,,,,,,,4.28046885,49.77,percent of total billed charges,,,,7.74045,90,percent of total billed charges,,,,8.170475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.310425,85,percent of total billed charges,,,,,,,,,4.28046885,8.6005,
DDAVP 4 MCG/1ML,2506905,CDM,,,250,RC,outpatient,1,ML,,77.971,42.88405,,70.1739,90,percent of total billed charges,,,,77.971,100,percent of total billed charges,,,,,,,,,70.1739,,,fee schedule,,,62.3768,,,fee schedule,,,,,,,,,,,,,,,,66.27535,85,percent of total billed charges,,,,,,,,,,38.8061667,49.77,percent of total billed charges,,,,70.1739,90,percent of total billed charges,,,,74.07245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,66.27535,85,percent of total billed charges,,,,,,,,,38.8061667,77.971,
LIPITOR 10 MG TABLET,2506915,CDM,,,250,RC,outpatient,10,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
INDOCIN 25MG CAP,2506920,CDM,,,250,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
KLONOPIN 1MG TABLET,2506955,CDM,,,250,RC,outpatient,1,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
IMITREX 25 MG TABLET,2506985,CDM,,,250,RC,outpatient,25,ME,,37.904,20.8472,,34.1136,90,percent of total billed charges,,,,37.904,100,percent of total billed charges,,,,,,,,,34.1136,,,fee schedule,,,30.3232,,,fee schedule,,,,,,,,,,,,,,,,32.2184,85,percent of total billed charges,,,,,,,,,,18.8648208,49.77,percent of total billed charges,,,,34.1136,90,percent of total billed charges,,,,36.0088,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.2184,85,percent of total billed charges,,,,,,,,,18.8648208,37.904,
ZITHROMAX 250 MG TABLET,2507005,CDM,,,250,RC,outpatient,250,ME,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,21.6918,,,fee schedule,,,19.2816,,,fee schedule,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,,11.9955654,49.77,percent of total billed charges,,,,21.6918,90,percent of total billed charges,,,,22.8969,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,11.9955654,24.102,
XALATAN .005% 2.5ML BOTTLE,2507035,CDM,,,250,RC,outpatient,2.5,ML,,160.474,88.2607,,144.4266,90,percent of total billed charges,,,,160.474,100,percent of total billed charges,,,,,,,,,144.4266,,,fee schedule,,,128.3792,,,fee schedule,,,,,,,,,,,,,,,,136.4029,85,percent of total billed charges,,,,,,,,,,79.8679098,49.77,percent of total billed charges,,,,144.4266,90,percent of total billed charges,,,,152.4503,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,136.4029,85,percent of total billed charges,,,,,,,,,79.8679098,160.474,
SANTYL 30 GM OINTMENT,2507055,CDM,,,250,RC,outpatient,1,EA,,498.623,274.24265,,448.7607,90,percent of total billed charges,,,,498.623,100,percent of total billed charges,,,,,,,,,448.7607,,,fee schedule,,,398.8984,,,fee schedule,,,,,,,,,,,,,,,,423.82955,85,percent of total billed charges,,,,,,,,,,248.1646671,49.77,percent of total billed charges,,,,448.7607,90,percent of total billed charges,,,,473.69185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,423.82955,85,percent of total billed charges,,,,,,,,,248.1646671,498.623,
INSULIN NPH INJ,2507060,CDM,,,250,RC,outpatient,1,EA,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,43.3836,,,fee schedule,,,38.5632,,,fee schedule,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,,23.9911308,49.77,percent of total billed charges,,,,43.3836,90,percent of total billed charges,,,,45.7938,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,23.9911308,48.204,
EFFEXOR XR 75 MG TABLET,2507065,CDM,,,250,RC,outpatient,75,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
INSUL REG U-100 INJ,2507070,CDM,,,250,RC,outpatient,1,EA,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,43.3836,,,fee schedule,,,38.5632,,,fee schedule,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,,23.9911308,49.77,percent of total billed charges,,,,43.3836,90,percent of total billed charges,,,,45.7938,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,23.9911308,48.204,
RISPERDAL 1 MG/ML LIQUID,2507115,CDM,,,250,RC,outpatient,1,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
ISMO 20MG TAB,2507120,CDM,,,250,RC,outpatient,20,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
OCUFLOX SOLUTION,2507125,CDM,,,250,RC,outpatient,1,EA,,74.572,41.0146,,67.1148,90,percent of total billed charges,,,,74.572,100,percent of total billed charges,,,,,,,,,67.1148,,,fee schedule,,,59.6576,,,fee schedule,,,,,,,,,,,,,,,,63.3862,85,percent of total billed charges,,,,,,,,,,37.1144844,49.77,percent of total billed charges,,,,67.1148,90,percent of total billed charges,,,,70.8434,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,63.3862,85,percent of total billed charges,,,,,,,,,37.1144844,74.572,
ISOPTO ATROPINE % DROPS,2507150,CDM,,,250,RC,outpatient,1,EA,,45.938,25.2659,,41.3442,90,percent of total billed charges,,,,45.938,100,percent of total billed charges,,,,,,,,,41.3442,,,fee schedule,,,36.7504,,,fee schedule,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,,22.8633426,49.77,percent of total billed charges,,,,41.3442,90,percent of total billed charges,,,,43.6411,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,39.0473,85,percent of total billed charges,,,,,,,,,22.8633426,45.938,
MARCAINE SPINAL 7.5MG/ML INJ,2507155,CDM,,,250,RC,outpatient,7.5,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
EFFEXOR 37.5 MG CAPSULE,2507185,CDM,,,250,RC,outpatient,37.5,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
SINGULAIR 10 MG TABLET,2507215,CDM,,,250,RC,outpatient,10,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
ISORDIL 10MG TAB,2507220,CDM,,,250,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
WELLBUTRIN SR 100MG TABLET,2507225,CDM,,,250,RC,outpatient,100,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
DETROL 1MG TABLET,2507235,CDM,,,250,RC,outpatient,1,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
K-DUR 20MEQ SLOW RELEASE,2507270,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
CELEXA 20 MG TABLET,2507305,CDM,,,250,RC,outpatient,20,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
KCL 20MEQ/1000ML INJ,2507330,CDM,,,250,RC,outpatient,1000,ML,,47.071,25.88905,,42.3639,90,percent of total billed charges,,,,47.071,100,percent of total billed charges,,,,,,,,,42.3639,,,fee schedule,,,37.6568,,,fee schedule,,,,,,,,,,,,,,,,40.01035,85,percent of total billed charges,,,,,,,,,,23.4272367,49.77,percent of total billed charges,,,,42.3639,90,percent of total billed charges,,,,44.71745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.01035,85,percent of total billed charges,,,,,,,,,23.4272367,47.071,
ULTANE 250 ML CHG PER MIN LIQ,2507335,CDM,,,250,RC,outpatient,250,ML,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,2.1321,,,fee schedule,,,1.8952,,,fee schedule,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,,1.1790513,49.77,percent of total billed charges,,,,2.1321,90,percent of total billed charges,,,,2.25055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,1.1790513,2.369,
KCL 20MEQ D5NS 20MEQ/1000ML IN,2507350,CDM,,,250,RC,outpatient,1000,ML,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,,,,,,,56.7324,,,fee schedule,,,50.4288,,,fee schedule,,,,,,,,,,,,,,,,53.5806,85,percent of total billed charges,,,,,,,,,,31.3730172,49.77,percent of total billed charges,,,,56.7324,90,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,53.5806,85,percent of total billed charges,,,,,,,,,31.3730172,63.036,
KCL 20MEQ D5W 20MEQ/1000ML INJ,2507360,CDM,,,250,RC,outpatient,1000,ML,,47.071,25.88905,,42.3639,90,percent of total billed charges,,,,47.071,100,percent of total billed charges,,,,,,,,,42.3639,,,fee schedule,,,37.6568,,,fee schedule,,,,,,,,,,,,,,,,40.01035,85,percent of total billed charges,,,,,,,,,,23.4272367,49.77,percent of total billed charges,,,,42.3639,90,percent of total billed charges,,,,44.71745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.01035,85,percent of total billed charges,,,,,,,,,23.4272367,47.071,
KCL 20MEQ NS 20MEQ/1000ML INJ,2507370,CDM,,,250,RC,outpatient,1000,ML,,65.405,35.97275,,58.8645,90,percent of total billed charges,,,,65.405,100,percent of total billed charges,,,,,,,,,58.8645,,,fee schedule,,,52.324,,,fee schedule,,,,,,,,,,,,,,,,55.59425,85,percent of total billed charges,,,,,,,,,,32.5520685,49.77,percent of total billed charges,,,,58.8645,90,percent of total billed charges,,,,62.13475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,55.59425,85,percent of total billed charges,,,,,,,,,32.5520685,65.405,
KCL 40MEQ D51/2NS 40MEQ/1000ML,2507380,CDM,,,250,RC,outpatient,1000,ML,,47.071,25.88905,,42.3639,90,percent of total billed charges,,,,47.071,100,percent of total billed charges,,,,,,,,,42.3639,,,fee schedule,,,37.6568,,,fee schedule,,,,,,,,,,,,,,,,40.01035,85,percent of total billed charges,,,,,,,,,,23.4272367,49.77,percent of total billed charges,,,,42.3639,90,percent of total billed charges,,,,44.71745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.01035,85,percent of total billed charges,,,,,,,,,23.4272367,47.071,
KCL 40MEQ D5NS 40MEQ/1000ML,2507400,CDM,,,250,RC,outpatient,1000,ML,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,,,,,,,56.7324,,,fee schedule,,,50.4288,,,fee schedule,,,,,,,,,,,,,,,,53.5806,85,percent of total billed charges,,,,,,,,,,31.3730172,49.77,percent of total billed charges,,,,56.7324,90,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,53.5806,85,percent of total billed charges,,,,,,,,,31.3730172,63.036,
KCL 40MEQ NS 40MEQ/1000ML INJ,2507420,CDM,,,250,RC,outpatient,1000,ML,,65.405,35.97275,,58.8645,90,percent of total billed charges,,,,65.405,100,percent of total billed charges,,,,,,,,,58.8645,,,fee schedule,,,52.324,,,fee schedule,,,,,,,,,,,,,,,,55.59425,85,percent of total billed charges,,,,,,,,,,32.5520685,49.77,percent of total billed charges,,,,58.8645,90,percent of total billed charges,,,,62.13475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,55.59425,85,percent of total billed charges,,,,,,,,,32.5520685,65.405,
KCL CONCENTRATE 20MEQ INJ,2507430,CDM,,,250,RC,outpatient,1,EA,,16.892,9.2906,,15.2028,90,percent of total billed charges,,,,16.892,100,percent of total billed charges,,,,,,,,,15.2028,,,fee schedule,,,13.5136,,,fee schedule,,,,,,,,,,,,,,,,14.3582,85,percent of total billed charges,,,,,,,,,,8.4071484,49.77,percent of total billed charges,,,,15.2028,90,percent of total billed charges,,,,16.0474,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.3582,85,percent of total billed charges,,,,,,,,,8.4071484,16.892,
KCL CONCENTRATE 40MEQ INJ,2507440,CDM,,,250,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
KELFEX 250MG CAP,2507460,CDM,,,250,RC,outpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
KEFLEX PER 1ml (50mg),2507470,CDM,,,250,RC,outpatient,50,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
KEFLEX 500MG CAP,2507490,CDM,,,250,RC,outpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
KENALOG CREAM 0.1% 15 GR CREAM,2507540,CDM,,,250,RC,outpatient,15,GR,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
KETALAR 50MG/ML INJ,2507580,CDM,,,250,RC,outpatient,50,ME,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,51.6339,,,fee schedule,,,45.8968,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,28.5535467,57.371,
KLONOPIN 0.5MG TAB,2507600,CDM,,,250,RC,outpatient,0.5,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
LACTATED RINGERS 500ML SOL,2507680,CDM,,,250,RC,outpatient,500,ML,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,,,,,,,35.1333,,,fee schedule,,,31.2296,,,fee schedule,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,,,,,,,,19.4287149,49.77,percent of total billed charges,,,,35.1333,90,percent of total billed charges,,,,37.08515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,,,,,,,19.4287149,39.037,
LACTATED RINGERS 1000ML SOL,2507690,CDM,,,250,RC,outpatient,1000,ML,,43.672,24.0196,,39.3048,90,percent of total billed charges,,,,43.672,100,percent of total billed charges,,,,,,,,,39.3048,,,fee schedule,,,34.9376,,,fee schedule,,,,,,,,,,,,,,,,37.1212,85,percent of total billed charges,,,,,,,,,,21.7355544,49.77,percent of total billed charges,,,,39.3048,90,percent of total billed charges,,,,41.4884,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.1212,85,percent of total billed charges,,,,,,,,,21.7355544,43.672,
LACTINEX GRANULES POWDER,2507700,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LANOLIN 30GM OINTMENT,2507730,CDM,,,250,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
LANOXIN 0.125MG TAB,2507770,CDM,,,250,RC,outpatient,0.125,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LASIX 20MG TABLET,2507830,CDM,,,250,RC,outpatient,20,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LESCOL 20MG CAP,2507890,CDM,,,250,RC,outpatient,20,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
LEVOPHED 1MG/4ML INJ,2507940,CDM,,,250,RC,outpatient,1,ME,,35.638,19.6009,,32.0742,90,percent of total billed charges,,,,35.638,100,percent of total billed charges,,,,,,,,,32.0742,,,fee schedule,,,28.5104,,,fee schedule,,,,,,,,,,,,,,,,30.2923,85,percent of total billed charges,,,,,,,,,,17.7370326,49.77,percent of total billed charges,,,,32.0742,90,percent of total billed charges,,,,33.8561,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.2923,85,percent of total billed charges,,,,,,,,,17.7370326,35.638,
LEVSIN 0.125MG TAB,2507950,CDM,,,250,RC,outpatient,0.125,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LIBRIUM 25MG CAP,2508000,CDM,,,250,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
INJ LIDOCAINE 10 MG,2508050,CDM,J2001,HCPCS,250,RC,outpatient,10,ME,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,1.1176,,,fee schedule,,,,28.3662,85,percent of total billed charges,,,,,,,,,0.04,33.372,
LIDOCAINE 1% INJ 2ml,2508060,CDM,,,250,RC,outpatient,2,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
LIDOCAINE 1% PER 10CC,2508070,CDM,,,250,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
LIDOCAINE 2%,2508080,CDM,,,250,RC,outpatient,1,EA,,43.672,24.0196,,39.3048,90,percent of total billed charges,,,,43.672,100,percent of total billed charges,,,,,,,,,39.3048,,,fee schedule,,,34.9376,,,fee schedule,,,,,,,,,,,,,,,,37.1212,85,percent of total billed charges,,,,,,,,,,21.7355544,49.77,percent of total billed charges,,,,39.3048,90,percent of total billed charges,,,,41.4884,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.1212,85,percent of total billed charges,,,,,,,,,21.7355544,43.672,
LIDOCAINE 4% 50ML TOPICAL,2508120,CDM,,,250,RC,outpatient,50,ML,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,22.7115,,,fee schedule,,,20.188,,,fee schedule,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,,12.5594595,49.77,percent of total billed charges,,,,22.7115,90,percent of total billed charges,,,,23.97325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,12.5594595,25.235,
LIDOCAINE 100<mg/5ml INJ,2508150,CDM,,,250,RC,outpatient,100,ME,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,,,,,,,28.9224,,,fee schedule,,,25.7088,,,fee schedule,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,,15.9940872,49.77,percent of total billed charges,,,,28.9224,90,percent of total billed charges,,,,30.5292,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,15.9940872,32.136,
LIDOCAINE VISCOUS 20ml GEL,2508180,CDM,,,250,RC,outpatient,20,ML,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
LIDOCAINE W/EPI PER 10CC,2508200,CDM,,,250,RC,outpatient,1,EA,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
LIORESAL 10MG TAB,2508250,CDM,,,250,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LIPOSYN II 20% 200ML INJ,2508270,CDM,,,250,RC,outpatient,200,ML,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,,,,,,,46.4427,,,fee schedule,,,41.2824,,,fee schedule,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,,,,,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,,,,,,,25.6828131,51.603,
LIQUIFILM TEARS 1.4% OPHTH,2508290,CDM,,,250,RC,outpatient,1,EA,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,27.9027,,,fee schedule,,,24.8024,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,15.4301931,31.003,
LITHIUM CARBONATE 300MG TAB,2508300,CDM,,,250,RC,outpatient,300,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LOMOTIL 2.5MG/0.025MG TAB,2508330,CDM,,,250,RC,outpatient,2.5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LOPID 600MG TAB,2508360,CDM,,,250,RC,outpatient,600,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
LOPRESSOR 50MG TAB,2508370,CDM,,,250,RC,outpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
METOPOLOL TARTRATE 5 MG/5ML,2508390,CDM,,,250,RC,outpatient,5,ME,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,22.7115,,,fee schedule,,,20.188,,,fee schedule,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,,12.5594595,49.77,percent of total billed charges,,,,22.7115,90,percent of total billed charges,,,,23.97325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,12.5594595,25.235,
LOTRIMIN 1% 30 GR CREAM,2508460,CDM,,,250,RC,outpatient,30,GR,,62.006,34.1033,,55.8054,90,percent of total billed charges,,,,62.006,100,percent of total billed charges,,,,,,,,,55.8054,,,fee schedule,,,49.6048,,,fee schedule,,,,,,,,,,,,,,,,52.7051,85,percent of total billed charges,,,,,,,,,,30.8603862,49.77,percent of total billed charges,,,,55.8054,90,percent of total billed charges,,,,58.9057,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,52.7051,85,percent of total billed charges,,,,,,,,,30.8603862,62.006,
LOTRIMIN SOLUTION 1% 10ML TOP,2508480,CDM,,,250,RC,outpatient,10,ML,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,30.0348,,,fee schedule,,,26.6976,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,16.6092444,33.372,
LOTRISONE COMB CREAM,2508490,CDM,,,250,RC,outpatient,1,EA,,56.238,30.9309,,50.6142,90,percent of total billed charges,,,,56.238,100,percent of total billed charges,,,,,,,,,50.6142,,,fee schedule,,,44.9904,,,fee schedule,,,,,,,,,,,,,,,,47.8023,85,percent of total billed charges,,,,,,,,,,27.9896526,49.77,percent of total billed charges,,,,50.6142,90,percent of total billed charges,,,,53.4261,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,47.8023,85,percent of total billed charges,,,,,,,,,27.9896526,56.238,
LOXITANE 10MG TAB,2508510,CDM,,,250,RC,outpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
MACROBID 100MG SLOW REL,2508600,CDM,,,250,RC,outpatient,100,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
MAG-OX 400 400MG TAB,2508640,CDM,,,250,RC,outpatient,400,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MAGNESIUM CITRATE 10OZ ELIXIR,2508670,CDM,,,250,RC,outpatient,1,EA,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
MARCNE/SENSOR 0.25% INJ INTRAV,2508730,CDM,,,250,RC,outpatient,1,EA,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,19.6524,,,fee schedule,,,17.4688,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,10.8677772,21.836,
MARCANE/SENSOR 0.25% MPF W/EPI,2508740,CDM,,,250,RC,outpatient,1,EA,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,23.8239,,,fee schedule,,,21.1768,,,fee schedule,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,,13.1746167,49.77,percent of total billed charges,,,,23.8239,90,percent of total billed charges,,,,25.14745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,13.1746167,26.471,
MARCAINE/SENSOR 0.5% MPF W EPI,2508750,CDM,,,250,RC,outpatient,1,EA,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,25.8633,,,fee schedule,,,22.9896,,,fee schedule,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,,14.3024049,49.77,percent of total billed charges,,,,25.8633,90,percent of total billed charges,,,,27.30015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,14.3024049,28.737,
MARCAINE/SENSOR PER 30ML INJ,2508770,CDM,,,250,RC,outpatient,30,ML,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
MARCAINE SENSOR 1/2% 30ML MPF,2508780,CDM,,,250,RC,outpatient,30,ML,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,19.6524,,,fee schedule,,,17.4688,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,10.8677772,21.836,
MAXITROL 3.5MG/10000U .1 DROPS,2508820,CDM,,,250,RC,outpatient,3.5,ME,,65.405,35.97275,,58.8645,90,percent of total billed charges,,,,65.405,100,percent of total billed charges,,,,,,,,,58.8645,,,fee schedule,,,52.324,,,fee schedule,,,,,,,,,,,,,,,,55.59425,85,percent of total billed charges,,,,,,,,,,32.5520685,49.77,percent of total billed charges,,,,58.8645,90,percent of total billed charges,,,,62.13475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,55.59425,85,percent of total billed charges,,,,,,,,,32.5520685,65.405,
MECLOMEN 50MG CAP,2508850,CDM,,,250,RC,outpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MEDROL 4MG TAB,2508870,CDM,,,250,RC,outpatient,4,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MEPHYTON 5MG TAB,2508990,CDM,,,250,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
METAMUCIL/HYDROCIL PKG PWDR,2509010,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
METHERGINE 0.2 MG/ML INJ,2509040,CDM,,,250,RC,outpatient,0.2,ME,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,13.4415,,,fee schedule,,,11.948,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,14.935,
MEVACOR 20MG TAB,2509120,CDM,,,250,RC,outpatient,20,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
MEXITIL 200MG CAP,2509140,CDM,,,250,RC,outpatient,200,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
MEXITIL 250MG CAP,2509150,CDM,,,250,RC,outpatient,250,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
MICRO-K 10MEQ (750 MG) SLOW RE,2509180,CDM,,,250,RC,outpatient,750,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MIDAMOR 5MG TAB,2509200,CDM,,,250,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MILK OF MAGNESIA 30ML SUSP,2509230,CDM,,,250,RC,outpatient,30,ML,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
OLANZAPINE 1MG,2509235,CDM,J2359,HCPCS,250,RC,outpatient,1,ME,,2.06,1.133,,1.854,90,percent of total billed charges,,,,2.06,100,percent of total billed charges,,,,,,,,,1.854,,,fee schedule,,,1.648,,,fee schedule,,,,,,,,,,,,,,,,1.751,85,percent of total billed charges,,,,,,,,,,1.025262,49.77,percent of total billed charges,,,,1.854,90,percent of total billed charges,,,,1.957,90,percent of total billed charges,,,,,,,,,0.89,,,fee schedule,,,1.1303,,,fee schedule,,,,1.751,85,percent of total billed charges,,,,,,,,,0.89,2.06,
MINERAL OIL 10ML ELIXIR,2509240,CDM,,,250,RC,outpatient,10,ML,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
MINIPRES 1MG CAP,2509260,CDM,,,250,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MONISTAT 7 45 GR CREAM,2509380,CDM,,,250,RC,outpatient,45,GR,,47.071,25.88905,,42.3639,90,percent of total billed charges,,,,47.071,100,percent of total billed charges,,,,,,,,,42.3639,,,fee schedule,,,37.6568,,,fee schedule,,,,,,,,,,,,,,,,40.01035,85,percent of total billed charges,,,,,,,,,,23.4272367,49.77,percent of total billed charges,,,,42.3639,90,percent of total billed charges,,,,44.71745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.01035,85,percent of total billed charges,,,,,,,,,23.4272367,47.071,
MORPHINE 15MG TAB,2509430,CDM,,,250,RC,outpatient,15,ME,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,6.7671,,,fee schedule,,,6.0152,,,fee schedule,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,,3.7422063,49.77,percent of total billed charges,,,,6.7671,90,percent of total billed charges,,,,7.14305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,3.7422063,7.519,
MORPHINE PCA 1MG/ML PCA INJ,2509450,CDM,,,250,RC,outpatient,1,ME,,26.265,14.44575,,23.6385,90,percent of total billed charges,,,,26.265,100,percent of total billed charges,,,,,,,,,23.6385,,,fee schedule,,,21.012,,,fee schedule,,,,,,,,,,,,,,,,22.32525,85,percent of total billed charges,,,,,,,,,,13.0720905,49.77,percent of total billed charges,,,,23.6385,90,percent of total billed charges,,,,24.95175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.32525,85,percent of total billed charges,,,,,,,,,13.0720905,26.265,
MUCOSIL-20 20% 30ML LIQUID,2509510,CDM,,,250,RC,outpatient,30,ML,,128.441,70.64255,,115.5969,90,percent of total billed charges,,,,128.441,100,percent of total billed charges,,,,,,,,,115.5969,,,fee schedule,,,102.7528,,,fee schedule,,,,,,,,,,,,,,,,109.17485,85,percent of total billed charges,,,,,,,,,,63.9250857,49.77,percent of total billed charges,,,,115.5969,90,percent of total billed charges,,,,122.01895,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,109.17485,85,percent of total billed charges,,,,,,,,,63.9250857,128.441,
MULTI VIT W/MINERAL TAB,2509540,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MVI 10ML INJ INTRAVENOUS,2509570,CDM,,,250,RC,outpatient,10,ML,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,13.4415,,,fee schedule,,,11.948,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,14.935,
MYCELEX TROCHE 10MG LOZENGE,2509580,CDM,,,250,RC,outpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
"MYCOSTATIN 100,000  U/GM CREAM",2509630,CDM,,,250,RC,outpatient,1,EA,,68.804,37.8422,,61.9236,90,percent of total billed charges,,,,68.804,100,percent of total billed charges,,,,,,,,,61.9236,,,fee schedule,,,55.0432,,,fee schedule,,,,,,,,,,,,,,,,58.4834,85,percent of total billed charges,,,,,,,,,,34.2437508,49.77,percent of total billed charges,,,,61.9236,90,percent of total billed charges,,,,65.3638,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,58.4834,85,percent of total billed charges,,,,,,,,,34.2437508,68.804,
MYLANTA CHEW TABLET,2509700,CDM,,,250,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MYLICON DROPS 40mg/0.6ml DROPS,2509730,CDM,,,250,RC,outpatient,40,ME,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,21.6918,,,fee schedule,,,19.2816,,,fee schedule,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,,11.9955654,49.77,percent of total billed charges,,,,21.6918,90,percent of total billed charges,,,,22.8969,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,11.9955654,24.102,
MYLICON-80 MYLAN GAS 80MG TAB,2509740,CDM,,,250,RC,outpatient,80,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
NAPROSYN 500MG TAB,2509890,CDM,,,250,RC,outpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
RANEXA 500mg TAB,2510030,CDM,,,250,RC,outpatient,500,ME,,15.965,8.78075,,14.3685,90,percent of total billed charges,,,,15.965,100,percent of total billed charges,,,,,,,,,14.3685,,,fee schedule,,,12.772,,,fee schedule,,,,,,,,,,,,,,,,13.57025,85,percent of total billed charges,,,,,,,,,,7.9457805,49.77,percent of total billed charges,,,,14.3685,90,percent of total billed charges,,,,15.16675,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.57025,85,percent of total billed charges,,,,,,,,,7.9457805,15.965,
XARELTO 70mg,2510070,CDM,,,250,RC,outpatient,70,ME,,14.523,7.98765,,13.0707,90,percent of total billed charges,,,,14.523,100,percent of total billed charges,,,,,,,,,13.0707,,,fee schedule,,,11.6184,,,fee schedule,,,,,,,,,,,,,,,,12.34455,85,percent of total billed charges,,,,,,,,,,7.2280971,49.77,percent of total billed charges,,,,13.0707,90,percent of total billed charges,,,,13.79685,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.34455,85,percent of total billed charges,,,,,,,,,7.2280971,14.523,
BRILINTA 90 TABLET,2510160,CDM,,,250,RC,outpatient,1,EA,,10.609,5.83495,,9.5481,90,percent of total billed charges,,,,10.609,100,percent of total billed charges,,,,,,,,,9.5481,,,fee schedule,,,8.4872,,,fee schedule,,,,,,,,,,,,,,,,9.01765,85,percent of total billed charges,,,,,,,,,,5.2800993,49.77,percent of total billed charges,,,,9.5481,90,percent of total billed charges,,,,10.07855,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.01765,85,percent of total billed charges,,,,,,,,,5.2800993,10.609,
LIDOCAINE HCL JEL 2% Mml,2510260,CDM,,,250,RC,outpatient,2,ML,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
VANCOMYCIN 750mg,2510380,CDM,,,250,RC,outpatient,750,ME,,26.677,14.67235,,24.0093,90,percent of total billed charges,,,,26.677,100,percent of total billed charges,,,,,,,,,24.0093,,,fee schedule,,,21.3416,,,fee schedule,,,,,,,,,,,,,,,,22.67545,85,percent of total billed charges,,,,,,,,,,13.2771429,49.77,percent of total billed charges,,,,24.0093,90,percent of total billed charges,,,,25.34315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.67545,85,percent of total billed charges,,,,,,,,,13.2771429,26.677,
LIDOCAINE HCl/PF 200mg,2510430,CDM,,,250,RC,outpatient,200,ME,,14.626,8.0443,,13.1634,90,percent of total billed charges,,,,14.626,100,percent of total billed charges,,,,,,,,,13.1634,,,fee schedule,,,11.7008,,,fee schedule,,,,,,,,,,,,,,,,12.4321,85,percent of total billed charges,,,,,,,,,,7.2793602,49.77,percent of total billed charges,,,,13.1634,90,percent of total billed charges,,,,13.8947,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.4321,85,percent of total billed charges,,,,,,,,,7.2793602,14.626,
BETHANOCHOL 10mg TABLET,2510480,CDM,,,250,RC,outpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
SUGAMMADEX SODIUM 200MG/2ML VI,2510490,CDM,,,250,RC,outpatient,200,ME,,130.707,71.88885,,117.6363,90,percent of total billed charges,,,,130.707,100,percent of total billed charges,,,,,,,,,117.6363,,,fee schedule,,,104.5656,,,fee schedule,,,,,,,,,,,,,,,,111.10095,85,percent of total billed charges,,,,,,,,,,65.0528739,49.77,percent of total billed charges,,,,117.6363,90,percent of total billed charges,,,,124.17165,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,111.10095,85,percent of total billed charges,,,,,,,,,65.0528739,130.707,
FISH OIL 1000mg SOFTGEL CAP,2510560,CDM,,,250,RC,outpatient,1000,ME,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,3.9861,,,fee schedule,,,3.5432,,,fee schedule,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,,2.2043133,49.77,percent of total billed charges,,,,3.9861,90,percent of total billed charges,,,,4.20755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,2.2043133,4.429,
LEVEMIR 100u/1mgl,2510570,CDM,,,250,RC,outpatient,100,ME,,699.473,384.71015,,629.5257,90,percent of total billed charges,,,,699.473,100,percent of total billed charges,,,,,,,,,629.5257,,,fee schedule,,,559.5784,,,fee schedule,,,,,,,,,,,,,,,,594.55205,85,percent of total billed charges,,,,,,,,,,348.1277121,49.77,percent of total billed charges,,,,629.5257,90,percent of total billed charges,,,,664.49935,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,594.55205,85,percent of total billed charges,,,,,,,,,348.1277121,699.473,
ELIQUIS 5mg TABLET,2510580,CDM,,,250,RC,outpatient,5,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
NYSTATIN POWDER 15gr BOTTLE,2510590,CDM,,,250,RC,outpatient,15,GR,,31.518,17.3349,,28.3662,90,percent of total billed charges,,,,31.518,100,percent of total billed charges,,,,,,,,,28.3662,,,fee schedule,,,25.2144,,,fee schedule,,,,,,,,,,,,,,,,26.7903,85,percent of total billed charges,,,,,,,,,,15.6865086,49.77,percent of total billed charges,,,,28.3662,90,percent of total billed charges,,,,29.9421,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.7903,85,percent of total billed charges,,,,,,,,,15.6865086,31.518,
AMIODARONE 50mg/ml,2510610,CDM,,,250,RC,outpatient,50,ME,,34.196,18.8078,,30.7764,90,percent of total billed charges,,,,34.196,100,percent of total billed charges,,,,,,,,,30.7764,,,fee schedule,,,27.3568,,,fee schedule,,,,,,,,,,,,,,,,29.0666,85,percent of total billed charges,,,,,,,,,,17.0193492,49.77,percent of total billed charges,,,,30.7764,90,percent of total billed charges,,,,32.4862,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.0666,85,percent of total billed charges,,,,,,,,,17.0193492,34.196,
METHYLENE BLUE 0.5% INJ,2510611,CDM,,,250,RC,outpatient,1,EA,,256.47,141.0585,,230.823,90,percent of total billed charges,,,,256.47,100,percent of total billed charges,,,,,,,,,230.823,,,fee schedule,,,205.176,,,fee schedule,,,,,,,,,,,,,,,,217.9995,85,percent of total billed charges,,,,,,,,,,127.645119,49.77,percent of total billed charges,,,,230.823,90,percent of total billed charges,,,,243.6465,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,217.9995,85,percent of total billed charges,,,,,,,,,127.645119,256.47,
CLINIMIX E 5%/20% 2L IV BAG,2510621,CDM,,,250,RC,outpatient,1,EA,,84.151,46.28305,,75.7359,90,percent of total billed charges,,,,84.151,100,percent of total billed charges,,,,,,,,,75.7359,,,fee schedule,,,67.3208,,,fee schedule,,,,,,,,,,,,,,,,71.52835,85,percent of total billed charges,,,,,,,,,,41.8819527,49.77,percent of total billed charges,,,,75.7359,90,percent of total billed charges,,,,79.94345,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,71.52835,85,percent of total billed charges,,,,,,,,,41.8819527,84.151,
NALOXEGOL 25MG TABLET,2510622,CDM,,,250,RC,outpatient,25,ME,,26.162,14.3891,,23.5458,90,percent of total billed charges,,,,26.162,100,percent of total billed charges,,,,,,,,,23.5458,,,fee schedule,,,20.9296,,,fee schedule,,,,,,,,,,,,,,,,22.2377,85,percent of total billed charges,,,,,,,,,,13.0208274,49.77,percent of total billed charges,,,,23.5458,90,percent of total billed charges,,,,24.8539,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.2377,85,percent of total billed charges,,,,,,,,,13.0208274,26.162,
VANCOMYCIN ORAL SOLUTION,2510624,CDM,,,250,RC,outpatient,1,EA,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
ROPIVACAINE .2%/EPIDURAL,2510625,CDM,,,250,RC,outpatient,1,EA,,93.833,51.60815,,84.4497,90,percent of total billed charges,,,,93.833,100,percent of total billed charges,,,,,,,,,84.4497,,,fee schedule,,,75.0664,,,fee schedule,,,,,,,,,,,,,,,,79.75805,85,percent of total billed charges,,,,,,,,,,46.7006841,49.77,percent of total billed charges,,,,84.4497,90,percent of total billed charges,,,,89.14135,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,79.75805,85,percent of total billed charges,,,,,,,,,46.7006841,93.833,
KETOTIFEN .025% OPTHALMIC DROP,2510629,CDM,,,250,RC,outpatient,1,EA,,15.759,8.66745,,14.1831,90,percent of total billed charges,,,,15.759,100,percent of total billed charges,,,,,,,,,14.1831,,,fee schedule,,,12.6072,,,fee schedule,,,,,,,,,,,,,,,,13.39515,85,percent of total billed charges,,,,,,,,,,7.8432543,49.77,percent of total billed charges,,,,14.1831,90,percent of total billed charges,,,,14.97105,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.39515,85,percent of total billed charges,,,,,,,,,7.8432543,15.759,
HYDROCODONE/ACETAMIN 7.5mg,2510630,CDM,,,250,RC,outpatient,7.5,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
HUMULIN 70/30 3ML VIAL,2510633,CDM,,,250,RC,outpatient,3,ML,,16.48,9.064,,14.832,90,percent of total billed charges,,,,16.48,100,percent of total billed charges,,,,,,,,,14.832,,,fee schedule,,,13.184,,,fee schedule,,,,,,,,,,,,,,,,14.008,85,percent of total billed charges,,,,,,,,,,8.202096,49.77,percent of total billed charges,,,,14.832,90,percent of total billed charges,,,,15.656,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.008,85,percent of total billed charges,,,,,,,,,8.202096,16.48,
PALIPERIDONE ER 6MG TABLET,2510635,CDM,,,250,RC,outpatient,6,ME,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,,,,,,,29.0151,,,fee schedule,,,25.7912,,,fee schedule,,,,,,,,,,,,,,,,27.40315,85,percent of total billed charges,,,,,,,,,,16.0453503,49.77,percent of total billed charges,,,,29.0151,90,percent of total billed charges,,,,30.62705,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.40315,85,percent of total billed charges,,,,,,,,,16.0453503,32.239,
LACOSAMIDE 100MG TABLET,2510636,CDM,,,250,RC,outpatient,100,ME,,32.754,18.0147,,29.4786,90,percent of total billed charges,,,,32.754,100,percent of total billed charges,,,,,,,,,29.4786,,,fee schedule,,,26.2032,,,fee schedule,,,,,,,,,,,,,,,,27.8409,85,percent of total billed charges,,,,,,,,,,16.3016658,49.77,percent of total billed charges,,,,29.4786,90,percent of total billed charges,,,,31.1163,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.8409,85,percent of total billed charges,,,,,,,,,16.3016658,32.754,
PALIPERIDONE ER 3MG TABLET,2510637,CDM,,,250,RC,outpatient,3,ME,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,,,,,,,29.0151,,,fee schedule,,,25.7912,,,fee schedule,,,,,,,,,,,,,,,,27.40315,85,percent of total billed charges,,,,,,,,,,16.0453503,49.77,percent of total billed charges,,,,29.0151,90,percent of total billed charges,,,,30.62705,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.40315,85,percent of total billed charges,,,,,,,,,16.0453503,32.239,
CLINIMIX 5% / 20%,2510638,CDM,,,250,RC,outpatient,1,EA,,161.813,88.99715,,145.6317,90,percent of total billed charges,,,,161.813,100,percent of total billed charges,,,,,,,,,145.6317,,,fee schedule,,,129.4504,,,fee schedule,,,,,,,,,,,,,,,,137.54105,85,percent of total billed charges,,,,,,,,,,80.5343301,49.77,percent of total billed charges,,,,145.6317,90,percent of total billed charges,,,,153.72235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,137.54105,85,percent of total billed charges,,,,,,,,,80.5343301,161.813,
DICLOFENAC SODIUM 1% GEL,2510639,CDM,,,250,RC,outpatient,1,EA,,61.388,33.7634,,55.2492,90,percent of total billed charges,,,,61.388,100,percent of total billed charges,,,,,,,,,55.2492,,,fee schedule,,,49.1104,,,fee schedule,,,,,,,,,,,,,,,,52.1798,85,percent of total billed charges,,,,,,,,,,30.5528076,49.77,percent of total billed charges,,,,55.2492,90,percent of total billed charges,,,,58.3186,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,52.1798,85,percent of total billed charges,,,,,,,,,30.5528076,61.388,
LETS GEL,2510642,CDM,,,250,RC,outpatient,1,EA,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,23.2677,,,fee schedule,,,20.6824,,,fee schedule,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,,12.8670381,49.77,percent of total billed charges,,,,23.2677,90,percent of total billed charges,,,,24.56035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,12.8670381,25.853,
KEDRAB 300UNIT/2ML (150UNI/ML),2510644,CDM,,,250,RC,outpatient,2,ML,,558.878,307.3829,,502.9902,90,percent of total billed charges,,,,558.878,100,percent of total billed charges,,,,,,,,,502.9902,,,fee schedule,,,447.1024,,,fee schedule,,,,,,,,,,,,,,,,475.0463,85,percent of total billed charges,,,,,,,,,,278.1535806,49.77,percent of total billed charges,,,,502.9902,90,percent of total billed charges,,,,530.9341,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,475.0463,85,percent of total billed charges,,,,,,,,,278.1535806,558.878,
LACOSAMIDE 50MG TABLET,2510646,CDM,,,250,RC,outpatient,50,ME,,26.265,14.44575,,23.6385,90,percent of total billed charges,,,,26.265,100,percent of total billed charges,,,,,,,,,23.6385,,,fee schedule,,,21.012,,,fee schedule,,,,,,,,,,,,,,,,22.32525,85,percent of total billed charges,,,,,,,,,,13.0720905,49.77,percent of total billed charges,,,,23.6385,90,percent of total billed charges,,,,24.95175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.32525,85,percent of total billed charges,,,,,,,,,13.0720905,26.265,
OLMESARTAN 40MG TABLET,2510647,CDM,,,250,RC,outpatient,40,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
SORBITOL SOLUTION 30 ML,2510649,CDM,,,250,RC,outpatient,30,ML,,7.21,3.9655,,6.489,90,percent of total billed charges,,,,7.21,100,percent of total billed charges,,,,,,,,,6.489,,,fee schedule,,,5.768,,,fee schedule,,,,,,,,,,,,,,,,6.1285,85,percent of total billed charges,,,,,,,,,,3.588417,49.77,percent of total billed charges,,,,6.489,90,percent of total billed charges,,,,6.8495,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.1285,85,percent of total billed charges,,,,,,,,,3.588417,7.21,
PRAVASTATIN 20 MG,2510651,CDM,,,250,RC,outpatient,20,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
JARDIANCE 10 MG TABLET,2510653,CDM,,,250,RC,outpatient,10,ME,,45.011,24.75605,,40.5099,90,percent of total billed charges,,,,45.011,100,percent of total billed charges,,,,,,,,,40.5099,,,fee schedule,,,36.0088,,,fee schedule,,,,,,,,,,,,,,,,38.25935,85,percent of total billed charges,,,,,,,,,,22.4019747,49.77,percent of total billed charges,,,,40.5099,90,percent of total billed charges,,,,42.76045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,38.25935,85,percent of total billed charges,,,,,,,,,22.4019747,45.011,
FINASTERIDE 1 MG TABLET,2510657,CDM,,,250,RC,outpatient,1,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
ARIPIPRAZOLE 2MG TABLET,2510658,CDM,,,250,RC,outpatient,2,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
MYRBETRIQ ER 25 MG TABLET,2510659,CDM,,,250,RC,outpatient,25,ME,,30.694,16.8817,,27.6246,90,percent of total billed charges,,,,30.694,100,percent of total billed charges,,,,,,,,,27.6246,,,fee schedule,,,24.5552,,,fee schedule,,,,,,,,,,,,,,,,26.0899,85,percent of total billed charges,,,,,,,,,,15.2764038,49.77,percent of total billed charges,,,,27.6246,90,percent of total billed charges,,,,29.1593,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.0899,85,percent of total billed charges,,,,,,,,,15.2764038,30.694,
RELISTOR 12 MG SYRINGE,2510669,CDM,,,250,RC,outpatient,12,ME,,283.25,155.7875,,254.925,90,percent of total billed charges,,,,283.25,100,percent of total billed charges,,,,,,,,,254.925,,,fee schedule,,,226.6,,,fee schedule,,,,,,,,,,,,,,,,240.7625,85,percent of total billed charges,,,,,,,,,,140.973525,49.77,percent of total billed charges,,,,254.925,90,percent of total billed charges,,,,269.0875,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,240.7625,85,percent of total billed charges,,,,,,,,,140.973525,283.25,
Tobramycin 0.3% EYE DROPS 5ML,2510671,CDM,,,250,RC,outpatient,5,ML,,23.278,12.8029,,20.9502,90,percent of total billed charges,,,,23.278,100,percent of total billed charges,,,,,,,,,20.9502,,,fee schedule,,,18.6224,,,fee schedule,,,,,,,,,,,,,,,,19.7863,85,percent of total billed charges,,,,,,,,,,11.5854606,49.77,percent of total billed charges,,,,20.9502,90,percent of total billed charges,,,,22.1141,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.7863,85,percent of total billed charges,,,,,,,,,11.5854606,23.278,
Nitroglycerin 25 mg,2510675,CDM,,,250,RC,outpatient,25,ME,,38.934,21.4137,,35.0406,90,percent of total billed charges,,,,38.934,100,percent of total billed charges,,,,,,,,,35.0406,,,fee schedule,,,31.1472,,,fee schedule,,,,,,,,,,,,,,,,33.0939,85,percent of total billed charges,,,,,,,,,,19.3774518,49.77,percent of total billed charges,,,,35.0406,90,percent of total billed charges,,,,36.9873,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.0939,85,percent of total billed charges,,,,,,,,,19.3774518,38.934,
CHLORHEXIDINE ORAL RINSE 473ML,2510676,CDM,,,250,RC,outpatient,473,ML,,74.572,41.0146,,67.1148,90,percent of total billed charges,,,,74.572,100,percent of total billed charges,,,,,,,,,67.1148,,,fee schedule,,,59.6576,,,fee schedule,,,,,,,,,,,,,,,,63.3862,85,percent of total billed charges,,,,,,,,,,37.1144844,49.77,percent of total billed charges,,,,67.1148,90,percent of total billed charges,,,,70.8434,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,63.3862,85,percent of total billed charges,,,,,,,,,37.1144844,74.572,
"CREON 12,0000 UNIT CAPSULE",2510678,CDM,,,250,RC,outpatient,1,EA,,11.639,6.40145,,10.4751,90,percent of total billed charges,,,,11.639,100,percent of total billed charges,,,,,,,,,10.4751,,,fee schedule,,,9.3112,,,fee schedule,,,,,,,,,,,,,,,,9.89315,85,percent of total billed charges,,,,,,,,,,5.7927303,49.77,percent of total billed charges,,,,10.4751,90,percent of total billed charges,,,,11.05705,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.89315,85,percent of total billed charges,,,,,,,,,5.7927303,11.639,
CORTEF 5 MG TABLET,2510679,CDM,,,250,RC,outpatient,5,ME,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,4.0788,,,fee schedule,,,3.6256,,,fee schedule,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,,2.2555764,49.77,percent of total billed charges,,,,4.0788,90,percent of total billed charges,,,,4.3054,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,2.2555764,4.532,
Latuda 20 mg tablet,2510680,CDM,,,250,RC,outpatient,20,ME,,95.584,52.5712,,86.0256,90,percent of total billed charges,,,,95.584,100,percent of total billed charges,,,,,,,,,86.0256,,,fee schedule,,,76.4672,,,fee schedule,,,,,,,,,,,,,,,,81.2464,85,percent of total billed charges,,,,,,,,,,47.5721568,49.77,percent of total billed charges,,,,86.0256,90,percent of total billed charges,,,,90.8048,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,81.2464,85,percent of total billed charges,,,,,,,,,47.5721568,95.584,
Polysporin ointment 30 Gram TU,2510681,CDM,,,250,RC,outpatient,30,GR,,15.656,8.6108,,14.0904,90,percent of total billed charges,,,,15.656,100,percent of total billed charges,,,,,,,,,14.0904,,,fee schedule,,,12.5248,,,fee schedule,,,,,,,,,,,,,,,,13.3076,85,percent of total billed charges,,,,,,,,,,7.7919912,49.77,percent of total billed charges,,,,14.0904,90,percent of total billed charges,,,,14.8732,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.3076,85,percent of total billed charges,,,,,,,,,7.7919912,15.656,
OFLOXACIN 0.3% OTIC DROPS 5ML,2510685,CDM,,,250,RC,outpatient,5,ML,,147.599,81.17945,,132.8391,90,percent of total billed charges,,,,147.599,100,percent of total billed charges,,,,,,,,,132.8391,,,fee schedule,,,118.0792,,,fee schedule,,,,,,,,,,,,,,,,125.45915,85,percent of total billed charges,,,,,,,,,,73.4600223,49.77,percent of total billed charges,,,,132.8391,90,percent of total billed charges,,,,140.21905,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,125.45915,85,percent of total billed charges,,,,,,,,,73.4600223,147.599,
GLYDE 6ML SYRINGE,2510686,CDM,,,250,RC,outpatient,6,ML,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
REMDESIVIR 100MG/20ML VIAL,2510688,CDM,,,250,RC,outpatient,20,ME,,1192.122,655.6671,,1072.9098,90,percent of total billed charges,,,,1192.122,100,percent of total billed charges,,,,,,,,,1072.9098,,,fee schedule,,,953.6976,,,fee schedule,,,,,,,,,,,,,,,,1013.3037,85,percent of total billed charges,,,,,,,,,,593.3191194,49.77,percent of total billed charges,,,,1072.9098,90,percent of total billed charges,,,,1132.5159,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1013.3037,85,percent of total billed charges,,,,,,,,,593.3191194,1192.122,
MIRALAX 238 GRAM BOTTLE,2510689,CDM,,,250,RC,outpatient,238,GR,,16.377,9.00735,,14.7393,90,percent of total billed charges,,,,16.377,100,percent of total billed charges,,,,,,,,,14.7393,,,fee schedule,,,13.1016,,,fee schedule,,,,,,,,,,,,,,,,13.92045,85,percent of total billed charges,,,,,,,,,,8.1508329,49.77,percent of total billed charges,,,,14.7393,90,percent of total billed charges,,,,15.55815,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.92045,85,percent of total billed charges,,,,,,,,,8.1508329,16.377,
D51/3NS 500mL,2510700,CDM,,,250,RC,outpatient,3500,ML,,31.518,17.3349,,28.3662,90,percent of total billed charges,,,,31.518,100,percent of total billed charges,,,,,,,,,28.3662,,,fee schedule,,,25.2144,,,fee schedule,,,,,,,,,,,,,,,,26.7903,85,percent of total billed charges,,,,,,,,,,15.6865086,49.77,percent of total billed charges,,,,28.3662,90,percent of total billed charges,,,,29.9421,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.7903,85,percent of total billed charges,,,,,,,,,15.6865086,31.518,
RESTASIS 0.05% OPTHALMIC DROPS,2510702,CDM,,,250,RC,outpatient,1,EA,,626.034,344.3187,,563.4306,90,percent of total billed charges,,,,626.034,100,percent of total billed charges,,,,,,,,,563.4306,,,fee schedule,,,500.8272,,,fee schedule,,,,,,,,,,,,,,,,532.1289,85,percent of total billed charges,,,,,,,,,,311.5771218,49.77,percent of total billed charges,,,,563.4306,90,percent of total billed charges,,,,594.7323,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,532.1289,85,percent of total billed charges,,,,,,,,,311.5771218,626.034,
SENSORCAINE-MPF0.25% 10ML VIAL,2510704,CDM,,,250,RC,outpatient,10,ML,,36.668,20.1674,,33.0012,90,percent of total billed charges,,,,36.668,100,percent of total billed charges,,,,,,,,,33.0012,,,fee schedule,,,29.3344,,,fee schedule,,,,,,,,,,,,,,,,31.1678,85,percent of total billed charges,,,,,,,,,,18.2496636,49.77,percent of total billed charges,,,,33.0012,90,percent of total billed charges,,,,34.8346,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.1678,85,percent of total billed charges,,,,,,,,,18.2496636,36.668,
FENOFIBRATE 160 MG TABLET,2510718,CDM,,,250,RC,outpatient,160,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
ACYCLOVIR 5% OINTMENT (15GRAM),2510719,CDM,,,250,RC,outpatient,15,GR,,64.375,35.40625,,57.9375,90,percent of total billed charges,,,,64.375,100,percent of total billed charges,,,,,,,,,57.9375,,,fee schedule,,,51.5,,,fee schedule,,,,,,,,,,,,,,,,54.71875,85,percent of total billed charges,,,,,,,,,,32.0394375,49.77,percent of total billed charges,,,,57.9375,90,percent of total billed charges,,,,61.15625,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,54.71875,85,percent of total billed charges,,,,,,,,,32.0394375,64.375,
AZTREONAM 2 GRAM VIAL,2510720,CDM,,,250,RC,outpatient,2,GR,,121.746,66.9603,,109.5714,90,percent of total billed charges,,,,121.746,100,percent of total billed charges,,,,,,,,,109.5714,,,fee schedule,,,97.3968,,,fee schedule,,,,,,,,,,,,,,,,103.4841,85,percent of total billed charges,,,,,,,,,,60.5929842,49.77,percent of total billed charges,,,,109.5714,90,percent of total billed charges,,,,115.6587,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,103.4841,85,percent of total billed charges,,,,,,,,,60.5929842,121.746,
LINZESS 290 MCG CAPSULE,2510723,CDM,,,250,RC,outpatient,1,EA,,33.475,18.41125,,30.1275,90,percent of total billed charges,,,,33.475,100,percent of total billed charges,,,,,,,,,30.1275,,,fee schedule,,,26.78,,,fee schedule,,,,,,,,,,,,,,,,28.45375,85,percent of total billed charges,,,,,,,,,,16.6605075,49.77,percent of total billed charges,,,,30.1275,90,percent of total billed charges,,,,31.80125,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.45375,85,percent of total billed charges,,,,,,,,,16.6605075,33.475,
METHENAMINE 1 GRAM TABLET,2510724,CDM,,,250,RC,outpatient,1,GR,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
HYDROMORPHONE 0.2MG/ML 6MC PCA,2510727,CDM,,,250,RC,outpatient,0.2,ME,,44.187,24.30285,,39.7683,90,percent of total billed charges,,,,44.187,100,percent of total billed charges,,,,,,,,,39.7683,,,fee schedule,,,35.3496,,,fee schedule,,,,,,,,,,,,,,,,37.55895,85,percent of total billed charges,,,,,,,,,,21.9918699,49.77,percent of total billed charges,,,,39.7683,90,percent of total billed charges,,,,41.97765,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.55895,85,percent of total billed charges,,,,,,,,,21.9918699,44.187,
NUPLAZID 34 MG CAPSULE,2510732,CDM,,,250,RC,outpatient,34,ME,,310.442,170.7431,,279.3978,90,percent of total billed charges,,,,310.442,100,percent of total billed charges,,,,,,,,,279.3978,,,fee schedule,,,248.3536,,,fee schedule,,,,,,,,,,,,,,,,263.8757,85,percent of total billed charges,,,,,,,,,,154.5069834,49.77,percent of total billed charges,,,,279.3978,90,percent of total billed charges,,,,294.9199,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,263.8757,85,percent of total billed charges,,,,,,,,,154.5069834,310.442,
TETRACYCLINE 500MG CAPSULE,2510735,CDM,,,250,RC,outpatient,500,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
CLINDAMYCIN 600MG/4mL VIAL,2510740,CDM,,,250,RC,outpatient,600,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
HYDROCORT SODIUM SUCC 500MG V,2510741,CDM,J1720,HCPCS,250,RC,outpatient,500,ME,,122.261,67.24355,,110.0349,90,percent of total billed charges,,,,122.261,100,percent of total billed charges,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,,,,,,,,,,,,,,103.92185,85,percent of total billed charges,,,,,,,,,,60.8492997,49.77,percent of total billed charges,,,,110.0349,90,percent of total billed charges,,,,116.14795,90,percent of total billed charges,,,,,,,,,4.94,,,fee schedule,,,6.2738,,,fee schedule,,,,103.92185,85,percent of total billed charges,,,,,,,,,4.94,122.261,
TRIAMCINOLONE 0.05% OINTMENT,2510743,CDM,,,250,RC,outpatient,1,EA,,332.484,182.8662,,299.2356,90,percent of total billed charges,,,,332.484,100,percent of total billed charges,,,,,,,,,299.2356,,,fee schedule,,,265.9872,,,fee schedule,,,,,,,,,,,,,,,,282.6114,85,percent of total billed charges,,,,,,,,,,165.4772868,49.77,percent of total billed charges,,,,299.2356,90,percent of total billed charges,,,,315.8598,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,282.6114,85,percent of total billed charges,,,,,,,,,165.4772868,332.484,
JARDIANCE 25MG TABLET,2510745,CDM,,,250,RC,outpatient,25,ME,,32.96,18.128,,29.664,90,percent of total billed charges,,,,32.96,100,percent of total billed charges,,,,,,,,,29.664,,,fee schedule,,,26.368,,,fee schedule,,,,,,,,,,,,,,,,28.016,85,percent of total billed charges,,,,,,,,,,16.404192,49.77,percent of total billed charges,,,,29.664,90,percent of total billed charges,,,,31.312,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.016,85,percent of total billed charges,,,,,,,,,16.404192,32.96,
TRELEGY E 100MCG/62.5MCG/25MCG,2510746,CDM,,,250,RC,outpatient,1,EA,,336.501,185.07555,,302.8509,90,percent of total billed charges,,,,336.501,100,percent of total billed charges,,,,,,,,,302.8509,,,fee schedule,,,269.2008,,,fee schedule,,,,,,,,,,,,,,,,286.02585,85,percent of total billed charges,,,,,,,,,,167.4765477,49.77,percent of total billed charges,,,,302.8509,90,percent of total billed charges,,,,319.67595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,286.02585,85,percent of total billed charges,,,,,,,,,167.4765477,336.501,
SILDENAFIL 20MG TABLET,2510747,CDM,,,250,RC,outpatient,20,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
ARMODAFINIL 50MG TABLET,2510749,CDM,,,250,RC,outpatient,50,ME,,24.411,13.42605,,21.9699,90,percent of total billed charges,,,,24.411,100,percent of total billed charges,,,,,,,,,21.9699,,,fee schedule,,,19.5288,,,fee schedule,,,,,,,,,,,,,,,,20.74935,85,percent of total billed charges,,,,,,,,,,12.1493547,49.77,percent of total billed charges,,,,21.9699,90,percent of total billed charges,,,,23.19045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.74935,85,percent of total billed charges,,,,,,,,,12.1493547,24.411,
DESVENLAFAXINE ER 50MG TAB,2510750,CDM,,,250,RC,outpatient,50,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
TADALAFIL 5MG TAB,2510751,CDM,,,250,RC,outpatient,5,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
ATOMOXETINE 60 MG CAP,2510752,CDM,,,250,RC,outpatient,60,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
TOBRADEX OPTHALMIC OINT 3.5G,2510753,CDM,,,250,RC,outpatient,1,EA,,536.63,295.1465,,482.967,90,percent of total billed charges,,,,536.63,100,percent of total billed charges,,,,,,,,,482.967,,,fee schedule,,,429.304,,,fee schedule,,,,,,,,,,,,,,,,456.1355,85,percent of total billed charges,,,,,,,,,,267.080751,49.77,percent of total billed charges,,,,482.967,90,percent of total billed charges,,,,509.7985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,456.1355,85,percent of total billed charges,,,,,,,,,267.080751,536.63,
Mineral Oil 30ML Unit Dose Cup,2510755,CDM,,,250,RC,outpatient,30,ML,,5.047,2.77585,,4.5423,90,percent of total billed charges,,,,5.047,100,percent of total billed charges,,,,,,,,,4.5423,,,fee schedule,,,4.0376,,,fee schedule,,,,,,,,,,,,,,,,4.28995,85,percent of total billed charges,,,,,,,,,,2.5118919,49.77,percent of total billed charges,,,,4.5423,90,percent of total billed charges,,,,4.79465,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.28995,85,percent of total billed charges,,,,,,,,,2.5118919,5.047,
Dofetilide 125 mcg Capsule,2510756,CDM,,,250,RC,outpatient,1,EA,,8.652,4.7586,,7.7868,90,percent of total billed charges,,,,8.652,100,percent of total billed charges,,,,,,,,,7.7868,,,fee schedule,,,6.9216,,,fee schedule,,,,,,,,,,,,,,,,7.3542,85,percent of total billed charges,,,,,,,,,,4.3061004,49.77,percent of total billed charges,,,,7.7868,90,percent of total billed charges,,,,8.2194,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.3542,85,percent of total billed charges,,,,,,,,,4.3061004,8.652,
Omnipaque 300 ML Vial,2510757,CDM,,,250,RC,outpatient,300,ML,,86.314,47.4727,,77.6826,90,percent of total billed charges,,,,86.314,100,percent of total billed charges,,,,,,,,,77.6826,,,fee schedule,,,69.0512,,,fee schedule,,,,,,,,,,,,,,,,73.3669,85,percent of total billed charges,,,,,,,,,,42.9584778,49.77,percent of total billed charges,,,,77.6826,90,percent of total billed charges,,,,81.9983,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,73.3669,85,percent of total billed charges,,,,,,,,,42.9584778,86.314,
Normal Saline 10 ML Vial,2510758,CDM,,,250,RC,outpatient,10,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
PRECEDEX 80 MCG/ML 20 ML VIAL,2510759,CDM,,,250,RC,outpatient,80,ML,,54.693,30.08115,,49.2237,90,percent of total billed charges,,,,54.693,100,percent of total billed charges,,,,,,,,,49.2237,,,fee schedule,,,43.7544,,,fee schedule,,,,,,,,,,,,,,,,46.48905,85,percent of total billed charges,,,,,,,,,,27.2207061,49.77,percent of total billed charges,,,,49.2237,90,percent of total billed charges,,,,51.95835,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,46.48905,85,percent of total billed charges,,,,,,,,,27.2207061,54.693,
LIDOCAINE 1% 5 ML INJECTION,2510760,CDM,J2001,HCPCS,250,RC,outpatient,5,ML,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,1.1176,,,fee schedule,,,,3.502,85,percent of total billed charges,,,,,,,,,0.04,4.12,
DEXTROSE 5% 25 ML BAG,2510761,CDM,,,250,RC,outpatient,25,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
Actidose-Aqua 25g /120 ML Tube,2510762,CDM,,,250,RC,outpatient,120,ML,,32.754,18.0147,,29.4786,90,percent of total billed charges,,,,32.754,100,percent of total billed charges,,,,,,,,,29.4786,,,fee schedule,,,26.2032,,,fee schedule,,,,,,,,,,,,,,,,27.8409,85,percent of total billed charges,,,,,,,,,,16.3016658,49.77,percent of total billed charges,,,,29.4786,90,percent of total billed charges,,,,31.1163,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.8409,85,percent of total billed charges,,,,,,,,,16.3016658,32.754,
Ketamine 50mg/ml 1ml Syringe,2510763,CDM,,,250,RC,outpatient,1,ME,,15.553,8.55415,,13.9977,90,percent of total billed charges,,,,15.553,100,percent of total billed charges,,,,,,,,,13.9977,,,fee schedule,,,12.4424,,,fee schedule,,,,,,,,,,,,,,,,13.22005,85,percent of total billed charges,,,,,,,,,,7.7407281,49.77,percent of total billed charges,,,,13.9977,90,percent of total billed charges,,,,14.77535,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.22005,85,percent of total billed charges,,,,,,,,,7.7407281,15.553,
Clindamycin 900mg/6ml vial,2510765,CDM,J0736,HCPCS,250,RC,outpatient,6,ME,,80.958,44.5269,,72.8622,90,percent of total billed charges,,,,80.958,100,percent of total billed charges,,,,,,,,,72.8622,,,fee schedule,,,64.7664,,,fee schedule,,,,,,,,,,,,,,,,68.8143,85,percent of total billed charges,,,,,,,,,,40.2927966,49.77,percent of total billed charges,,,,72.8622,90,percent of total billed charges,,,,76.9101,90,percent of total billed charges,,,,,,,,,1.61,,,fee schedule,,,2.0447,,,fee schedule,,,,68.8143,85,percent of total billed charges,,,,,,,,,1.61,80.958,
ITRACONAZOLE 100 MG CAPSULE,2510767,CDM,,,250,RC,outpatient,100,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
FENTANYL 50MCG/1ML VIAL,2510803,CDM,,,250,RC,outpatient,50,ML,,2.163,1.18965,,1.9467,90,percent of total billed charges,,,,2.163,100,percent of total billed charges,,,,,,,,,1.9467,,,fee schedule,,,1.7304,,,fee schedule,,,,,,,,,,,,,,,,1.83855,85,percent of total billed charges,,,,,,,,,,1.0765251,49.77,percent of total billed charges,,,,1.9467,90,percent of total billed charges,,,,2.05485,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1.83855,85,percent of total billed charges,,,,,,,,,1.0765251,2.163,
KETOCONAZOLE SHAMPOO 120ML,2510804,CDM,,,250,RC,outpatient,120,ML,,44.702,24.5861,,40.2318,90,percent of total billed charges,,,,44.702,100,percent of total billed charges,,,,,,,,,40.2318,,,fee schedule,,,35.7616,,,fee schedule,,,,,,,,,,,,,,,,37.9967,85,percent of total billed charges,,,,,,,,,,22.2481854,49.77,percent of total billed charges,,,,40.2318,90,percent of total billed charges,,,,42.4669,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.9967,85,percent of total billed charges,,,,,,,,,22.2481854,44.702,
VANCOMYCIN 1.5G VIAL,2510805,CDM,J3371,HCPCS,250,RC,outpatient,1,EA,,38.419,21.13045,,34.5771,90,percent of total billed charges,,,,38.419,100,percent of total billed charges,,,,,,,,,34.5771,,,fee schedule,,,30.7352,,,fee schedule,,,,,,,,,,,,,,,,32.65615,85,percent of total billed charges,,,,,,,,,,19.1211363,49.77,percent of total billed charges,,,,34.5771,90,percent of total billed charges,,,,36.49805,90,percent of total billed charges,,,,,,,,,6.4,,,fee schedule,,,8.128,,,fee schedule,,,,32.65615,85,percent of total billed charges,,,,,,,,,6.4,38.419,
CLOBETASOL PROPIONATE OINT 60G,2510806,CDM,,,250,RC,outpatient,1,EA,,26.368,14.5024,,23.7312,90,percent of total billed charges,,,,26.368,100,percent of total billed charges,,,,,,,,,23.7312,,,fee schedule,,,21.0944,,,fee schedule,,,,,,,,,,,,,,,,22.4128,85,percent of total billed charges,,,,,,,,,,13.1233536,49.77,percent of total billed charges,,,,23.7312,90,percent of total billed charges,,,,25.0496,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.4128,85,percent of total billed charges,,,,,,,,,13.1233536,26.368,
Exemestane 25mg,2510807,CDM,J8999,HCPCS,250,RC,outpatient,25,ME,,22.351,12.29305,,20.1159,90,percent of total billed charges,,,,22.351,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.99835,85,percent of total billed charges,,,,,,,,,,11.1240927,49.77,percent of total billed charges,,,,20.1159,90,percent of total billed charges,,,,21.23345,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19,85,percent of total billed charges,,,,,,,,,11.1240927,22.351,
duloxetine 20mg capsule,2510808,CDM,,,250,RC,outpatient,20,ME,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
Olanzapine 10mg inj,2510811,CDM,J2359,HCPCS,250,RC,outpatient,10,ME,,32.857,18.07135,,29.5713,90,percent of total billed charges,,,,32.857,100,percent of total billed charges,,,,,,,,,29.5713,,,fee schedule,,,26.2856,,,fee schedule,,,,,,,,,,,,,,,,27.92845,85,percent of total billed charges,,,,,,,,,,16.3529289,49.77,percent of total billed charges,,,,29.5713,90,percent of total billed charges,,,,31.21415,90,percent of total billed charges,,,,,,,,,0.89,,,fee schedule,,,1.1303,,,fee schedule,,,,27.92845,85,percent of total billed charges,,,,,,,,,0.89,32.857,
METFORMIN ER 750,2510812,CDM,,,250,RC,outpatient,1,EA,,1.339,0.73645,,1.2051,90,percent of total billed charges,,,,1.339,100,percent of total billed charges,,,,,,,,,1.2051,,,fee schedule,,,1.0712,,,fee schedule,,,,,,,,,,,,,,,,1.13815,85,percent of total billed charges,,,,,,,,,,0.6664203,49.77,percent of total billed charges,,,,1.2051,90,percent of total billed charges,,,,1.27205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1.13815,85,percent of total billed charges,,,,,,,,,0.6664203,1.339,
DEXMEDTOMIDINE 4CG/ML 100ML,2518013,CDM,,,250,RC,outpatient,100,ML,,92.494,50.8717,,83.2446,90,percent of total billed charges,,,,92.494,100,percent of total billed charges,,,,,,,,,83.2446,,,fee schedule,,,73.9952,,,fee schedule,,,,,,,,,,,,,,,,78.6199,85,percent of total billed charges,,,,,,,,,,46.0342638,49.77,percent of total billed charges,,,,83.2446,90,percent of total billed charges,,,,87.8693,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,78.6199,85,percent of total billed charges,,,,,,,,,46.0342638,92.494,
NACL 5000 CC,2705250,CDM,,,250,RC,outpatient,1,EA,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,27.9027,,,fee schedule,,,24.8024,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,15.4301931,31.003,
NITROGLYCERIN 1gr OINT,25002500,CDM,,,250,RC,outpatient,1,GR,,8.652,4.7586,,7.7868,90,percent of total billed charges,,,,8.652,100,percent of total billed charges,,,,,,,,,7.7868,,,fee schedule,,,6.9216,,,fee schedule,,,,,,,,,,,,,,,,7.3542,85,percent of total billed charges,,,,,,,,,,4.3061004,49.77,percent of total billed charges,,,,7.7868,90,percent of total billed charges,,,,8.2194,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.3542,85,percent of total billed charges,,,,,,,,,4.3061004,8.652,
anastrozole 1mg,25810809,CDM,J8999,HCPCS,250,RC,outpatient,1,ME,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,,1.1790513,49.77,percent of total billed charges,,,,2.1321,90,percent of total billed charges,,,,2.25055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,1.1790513,2.369,
TETRABENAZINE 12.5MG TABLET,2510801,CDM,,,251,RC,outpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,3.2445,,,fee schedule,,,2.884,,,fee schedule,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,,1.7942085,49.77,percent of total billed charges,,,,3.2445,90,percent of total billed charges,,,,3.42475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,1.7942085,3.605,
TOLVAPTAN 30MG TAB,2510802,CDM,,,251,RC,outpatient,,,,161.916,89.0538,,145.7244,90,percent of total billed charges,,,,161.916,100,percent of total billed charges,,,,,,,,,145.7244,,,fee schedule,,,129.5328,,,fee schedule,,,,,,,,,,,,,,,,137.6286,85,percent of total billed charges,,,,,,,,,,80.5855932,49.77,percent of total billed charges,,,,145.7244,90,percent of total billed charges,,,,153.8202,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,137.6286,85,percent of total billed charges,,,,,,,,,80.5855932,161.916,
IV SOLUTION D20W,2704430,CDM,,,258,RC,outpatient,,,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,6.7671,,,fee schedule,,,6.0152,,,fee schedule,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,,3.7422063,49.77,percent of total billed charges,,,,6.7671,90,percent of total billed charges,,,,7.14305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,3.7422063,7.519,
IV SOLUTION 1000ML,2709690,CDM,,,258,RC,outpatient,,,,5.356,2.9458,,4.8204,90,percent of total billed charges,,,,5.356,100,percent of total billed charges,,,,,,,,,4.8204,,,fee schedule,,,4.2848,,,fee schedule,,,,,,,,,,,,,,,,4.5526,85,percent of total billed charges,,,,,,,,,,2.6656812,49.77,percent of total billed charges,,,,4.8204,90,percent of total billed charges,,,,5.0882,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.5526,85,percent of total billed charges,,,,,,,,,2.6656812,5.356,
IV SOLUTION 500ML,2709700,CDM,,,258,RC,outpatient,,,,5.665,3.11575,,5.0985,90,percent of total billed charges,,,,5.665,100,percent of total billed charges,,,,,,,,,5.0985,,,fee schedule,,,4.532,,,fee schedule,,,,,,,,,,,,,,,,4.81525,85,percent of total billed charges,,,,,,,,,,2.8194705,49.77,percent of total billed charges,,,,5.0985,90,percent of total billed charges,,,,5.38175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.81525,85,percent of total billed charges,,,,,,,,,2.8194705,5.665,
IV SOLUTION 250ML,2709710,CDM,,,258,RC,outpatient,,,,24.72,13.596,,22.248,90,percent of total billed charges,,,,24.72,100,percent of total billed charges,,,,,,,,,22.248,,,fee schedule,,,19.776,,,fee schedule,,,,,,,,,,,,,,,,21.012,85,percent of total billed charges,,,,,,,,,,12.303144,49.77,percent of total billed charges,,,,22.248,90,percent of total billed charges,,,,23.484,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.012,85,percent of total billed charges,,,,,,,,,12.303144,24.72,
IV SOLUTION 150ML,2709720,CDM,,,258,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
HYDRATION IV INFUS INIT HR LDR,2600002,CDM,96360,CPT,260,RC,outpatient,,,,181.177,99.64735,,163.0593,90,percent of total billed charges,,,,181.177,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,154.00045,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,90.1717929,49.77,percent of total billed charges,,,,163.0593,90,percent of total billed charges,,,,172.11815,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,,,,,,,,,,,,,,154.00045,85,percent of total billed charges,,,32.288875,,,fee schedule,,,32.288875,196.077,
HYDRATION IV INF ADD'L HR LDRP,2600003,CDM,96361,CPT,260,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,12.316375,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,12.316375,,,fee schedule,,,12.316375,51.603,
ADMIN SUBQ/IM INJECTION LDRP,2600004,CDM,96372,CPT,260,RC,outpatient,,,,59.122,32.5171,,53.2098,90,percent of total billed charges,,,,59.122,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,50.2537,85,percent of total billed charges,,,14.313625,,,fee schedule,,,,29.4250194,49.77,percent of total billed charges,,,,53.2098,90,percent of total billed charges,,,,56.1659,90,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,50.2537,85,percent of total billed charges,,,14.313625,,,fee schedule,,,14.313625,64.0395,
IV PUSH INITIAL LDRP,2600005,CDM,96374,CPT,260,RC,outpatient,,,,128.853,70.86915,,115.9677,90,percent of total billed charges,,,,128.853,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,109.52505,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,64.1301381,49.77,percent of total billed charges,,,,115.9677,90,percent of total billed charges,,,,122.41035,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,109.52505,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,196.077,
IV PUSH EA ADD'L NEW MED LDRP,2600006,CDM,96375,CPT,260,RC,outpatient,,,,90.022,49.5121,,81.0198,90,percent of total billed charges,,,,90.022,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,15.31225,,,fee schedule,,,15.31225,,,fee schedule,,,,76.5187,85,percent of total billed charges,,,15.31225,,,fee schedule,,,,44.8039494,49.77,percent of total billed charges,,,,81.0198,90,percent of total billed charges,,,,85.5209,90,percent of total billed charges,,,15.7716175,,,fee schedule,,,,,,,,,,,,,,,,76.5187,85,percent of total billed charges,,,15.31225,,,fee schedule,,,15.31225,90.022,
IV PUSH SEQUENT SAME MED LDRP,2600007,CDM,96376,CPT,260,RC,outpatient,,,,21.527,11.83985,,19.3743,90,percent of total billed charges,,,,21.527,100,percent of total billed charges,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,,,,,,,,,,,,,,18.29795,85,percent of total billed charges,,,,,,,,,,10.7139879,49.77,percent of total billed charges,,,,19.3743,90,percent of total billed charges,,,,20.45065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.29795,85,percent of total billed charges,,,,,,,,,10.7139879,32.55,
IV INFUSION INITIAL HR - OP,2600020,CDM,96365,CPT,260,RC,outpatient,,,,190.344,104.6892,,171.3096,90,percent of total billed charges,,,,190.344,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,161.7924,85,percent of total billed charges,,,62.5805,,,fee schedule,,,,94.7342088,49.77,percent of total billed charges,,,,171.3096,90,percent of total billed charges,,,,180.8268,90,percent of total billed charges,,,64.457915,,,fee schedule,,,90.58,,,fee schedule,,,115.0366,,,fee schedule,,,,161.7924,85,percent of total billed charges,,,62.5805,,,fee schedule,,,62.5805,196.077,
IV INFUSION EACH ADD'L HR - OP,2600021,CDM,96366,CPT,260,RC,outpatient,,,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,53.5806,85,percent of total billed charges,,,20.305375,,,fee schedule,,,,31.3730172,49.77,percent of total billed charges,,,,56.7324,90,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,20.91453625,,,fee schedule,,,,,,,,,,,,,,,,53.5806,85,percent of total billed charges,,,20.305375,,,fee schedule,,,20.305375,63.036,
HYDRATION IV INFUS INIT HR -OP,2600022,CDM,96360,CPT,260,RC,outpatient,,,,181.177,99.64735,,163.0593,90,percent of total billed charges,,,,181.177,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,154.00045,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,90.1717929,49.77,percent of total billed charges,,,,163.0593,90,percent of total billed charges,,,,172.11815,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,,,,,,,,,,,,,,154.00045,85,percent of total billed charges,,,32.288875,,,fee schedule,,,32.288875,196.077,
HYDRATION IV INFUS EA + HR- OP,2600023,CDM,96361,CPT,260,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,12.316375,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,12.316375,,,fee schedule,,,12.316375,51.603,
IV INFUSION INITIAL HOUR - OBS,2600030,CDM,96365,CPT,260,RC,outpatient,,,,190.344,104.6892,,171.3096,90,percent of total billed charges,,,,190.344,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,161.7924,85,percent of total billed charges,,,62.5805,,,fee schedule,,,,94.7342088,49.77,percent of total billed charges,,,,171.3096,90,percent of total billed charges,,,,180.8268,90,percent of total billed charges,,,64.457915,,,fee schedule,,,90.58,,,fee schedule,,,115.0366,,,fee schedule,,,,161.7924,85,percent of total billed charges,,,62.5805,,,fee schedule,,,62.5805,196.077,
IV INFUSION EA ADD'L HR - OBS,2600040,CDM,96366,CPT,260,RC,outpatient,,,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,53.5806,85,percent of total billed charges,,,20.305375,,,fee schedule,,,,31.3730172,49.77,percent of total billed charges,,,,56.7324,90,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,20.91453625,,,fee schedule,,,,,,,,,,,,,,,,53.5806,85,percent of total billed charges,,,20.305375,,,fee schedule,,,20.305375,63.036,
HYDRATION IV INFUS INIT HR-OBS,2600050,CDM,96360,CPT,260,RC,outpatient,,,,218.978,120.4379,,197.0802,90,percent of total billed charges,,,,218.978,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,186.1313,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,108.9853506,49.77,percent of total billed charges,,,,197.0802,90,percent of total billed charges,,,,208.0291,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,,,,,,,,,,,,,,186.1313,85,percent of total billed charges,,,32.288875,,,fee schedule,,,32.288875,218.978,
IV INFUS SEQUENTIAL 1 HR - OP,2600070,CDM,96367,CPT,260,RC,outpatient,,,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,28.294375,,,fee schedule,,,28.294375,,,fee schedule,,,,28.3662,85,percent of total billed charges,,,28.294375,,,fee schedule,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,29.14320625,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,28.294375,,,fee schedule,,,16.6092444,64.0395,
IV INFUS SEQUENTIAL 1 HR - OBS,2600767,CDM,96367,CPT,260,RC,outpatient,,,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,28.294375,,,fee schedule,,,28.294375,,,fee schedule,,,,28.3662,85,percent of total billed charges,,,28.294375,,,fee schedule,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,29.14320625,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,28.294375,,,fee schedule,,,16.6092444,64.0395,
IV INFUSION INITIAL HR - LDRP,2603100,CDM,96365,CPT,260,RC,outpatient,,,,190.344,104.6892,,171.3096,90,percent of total billed charges,,,,190.344,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,161.7924,85,percent of total billed charges,,,62.5805,,,fee schedule,,,,94.7342088,49.77,percent of total billed charges,,,,171.3096,90,percent of total billed charges,,,,180.8268,90,percent of total billed charges,,,64.457915,,,fee schedule,,,90.58,,,fee schedule,,,115.0366,,,fee schedule,,,,161.7924,85,percent of total billed charges,,,62.5805,,,fee schedule,,,62.5805,196.077,
IV INFUSION EA ADD'L HR - LDRP,2603101,CDM,96366,CPT,260,RC,outpatient,,,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,53.5806,85,percent of total billed charges,,,20.305375,,,fee schedule,,,,31.3730172,49.77,percent of total billed charges,,,,56.7324,90,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,20.91453625,,,fee schedule,,,,,,,,,,,,,,,,53.5806,85,percent of total billed charges,,,20.305375,,,fee schedule,,,20.305375,63.036,
IV INFUSION 1ST HOUR ER,4500081,CDM,96365,CPT,260,RC,outpatient,,,,190.344,104.6892,,171.3096,90,percent of total billed charges,,,,190.344,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,161.7924,85,percent of total billed charges,,,62.5805,,,fee schedule,,,,94.7342088,49.77,percent of total billed charges,,,,171.3096,90,percent of total billed charges,,,,180.8268,90,percent of total billed charges,,,64.457915,,,fee schedule,,,90.58,,,fee schedule,,,115.0366,,,fee schedule,,,,161.7924,85,percent of total billed charges,,,62.5805,,,fee schedule,,,62.5805,196.077,
IV INFUSION THERAPY EA ADDL HR,4500082,CDM,96366,CPT,260,RC,outpatient,,,,63.036,34.6698,,56.7324,90,percent of total billed charges,,,,63.036,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,53.5806,85,percent of total billed charges,,,20.305375,,,fee schedule,,,,31.3730172,49.77,percent of total billed charges,,,,56.7324,90,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,20.91453625,,,fee schedule,,,,,,,,,,,,,,,,53.5806,85,percent of total billed charges,,,20.305375,,,fee schedule,,,20.305375,63.036,
IV PUSH EACH NEW MED -  ER,4500225,CDM,96375,CPT,260,RC,outpatient,,,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,15.31225,,,fee schedule,,,15.31225,,,fee schedule,,,,42.98705,85,percent of total billed charges,,,15.31225,,,fee schedule,,,,25.1701821,49.77,percent of total billed charges,,,,45.5157,90,percent of total billed charges,,,,48.04435,90,percent of total billed charges,,,15.7716175,,,fee schedule,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,15.31225,,,fee schedule,,,15.31225,50.573,
INJECTION ADMIN SUBQ/IM - OP,9490000,CDM,96372,CPT,260,RC,outpatient,,,,61.388,33.7634,,55.2492,90,percent of total billed charges,,,,61.388,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,52.1798,85,percent of total billed charges,,,14.313625,,,fee schedule,,,,30.5528076,49.77,percent of total billed charges,,,,55.2492,90,percent of total billed charges,,,,58.3186,90,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,52.1798,85,percent of total billed charges,,,14.313625,,,fee schedule,,,14.313625,64.0395,
THER PROPH DIAG INJ INV PUSH,9490010,CDM,96374,CPT,260,RC,outpatient,,,,134.106,73.7583,,120.6954,90,percent of total billed charges,,,,134.106,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,113.9901,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,66.7445562,49.77,percent of total billed charges,,,,120.6954,90,percent of total billed charges,,,,127.4007,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,113.9901,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,196.077,
TXT PRO DX INJ NEW DRUG ADD ON,9490020,CDM,96375,CPT,260,RC,outpatient,,,,93.627,51.49485,,84.2643,90,percent of total billed charges,,,,93.627,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,15.31225,,,fee schedule,,,15.31225,,,fee schedule,,,,79.58295,85,percent of total billed charges,,,15.31225,,,fee schedule,,,,46.5981579,49.77,percent of total billed charges,,,,84.2643,90,percent of total billed charges,,,,88.94565,90,percent of total billed charges,,,15.7716175,,,fee schedule,,,,,,,,,,,,,,,,79.58295,85,percent of total billed charges,,,15.31225,,,fee schedule,,,15.31225,93.627,
INJECTION SUB Q/IM - OBS,9490030,CDM,96372,CPT,260,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,63.9115,85,percent of total billed charges,,,14.313625,,,fee schedule,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,14.313625,,,fee schedule,,,14.313625,75.19,
IV PUSH INITIAL - OP,9490040,CDM,96374,CPT,260,RC,outpatient,,,,134.106,73.7583,,120.6954,90,percent of total billed charges,,,,134.106,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,113.9901,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,66.7445562,49.77,percent of total billed charges,,,,120.6954,90,percent of total billed charges,,,,127.4007,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,113.9901,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,196.077,
IV PUSH EA ADD'L NEW MED - OP,9490050,CDM,96375,CPT,260,RC,outpatient,,,,93.627,51.49485,,84.2643,90,percent of total billed charges,,,,93.627,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,15.31225,,,fee schedule,,,15.31225,,,fee schedule,,,,79.58295,85,percent of total billed charges,,,15.31225,,,fee schedule,,,,46.5981579,49.77,percent of total billed charges,,,,84.2643,90,percent of total billed charges,,,,88.94565,90,percent of total billed charges,,,15.7716175,,,fee schedule,,,,,,,,,,,,,,,,79.58295,85,percent of total billed charges,,,15.31225,,,fee schedule,,,15.31225,93.627,
IV PUSH SEQUENT SAME MED - OBS,9499077,CDM,96376,CPT,260,RC,outpatient,,,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,,,,,,,,,,,,,,19.0859,85,percent of total billed charges,,,,,,,,,,11.1753558,49.77,percent of total billed charges,,,,20.2086,90,percent of total billed charges,,,,21.3313,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.0859,85,percent of total billed charges,,,,,,,,,11.1753558,32.55,
ARM COMPRESSION SLEEVE,013272,CDM,,,270,RC,outpatient,,,,46.35,25.4925,,41.715,90,percent of total billed charges,,,,46.35,100,percent of total billed charges,,,,,,,,,41.715,,,fee schedule,,,37.08,,,fee schedule,,,,,,,,,,,,,,,,39.3975,85,percent of total billed charges,,,,,,,,,,23.068395,49.77,percent of total billed charges,,,,41.715,90,percent of total billed charges,,,,44.0325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,39.3975,85,percent of total billed charges,,,,,,,,,23.068395,46.35,
MASIMO PULSE OX ADHES SENSOR,2700002,CDM,,,270,RC,outpatient,,,,24.823,13.65265,,22.3407,90,percent of total billed charges,,,,24.823,100,percent of total billed charges,,,,,,,,,22.3407,,,fee schedule,,,19.8584,,,fee schedule,,,,,,,,,,,,,,,,21.09955,85,percent of total billed charges,,,,,,,,,,12.3544071,49.77,percent of total billed charges,,,,22.3407,90,percent of total billed charges,,,,23.58185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.09955,85,percent of total billed charges,,,,,,,,,12.3544071,24.823,
ALLEVYN DRESSING,2700004,CDM,,,270,RC,outpatient,,,,10.197,5.60835,,9.1773,90,percent of total billed charges,,,,10.197,100,percent of total billed charges,,,,,,,,,9.1773,,,fee schedule,,,8.1576,,,fee schedule,,,,,,,,,,,,,,,,8.66745,85,percent of total billed charges,,,,,,,,,,5.0750469,49.77,percent of total billed charges,,,,9.1773,90,percent of total billed charges,,,,9.68715,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.66745,85,percent of total billed charges,,,,,,,,,5.0750469,10.197,
DISP PEAK FLOW - RT,2700010,CDM,,,270,RC,outpatient,,,,2.987,1.64285,,2.6883,90,percent of total billed charges,,,,2.987,100,percent of total billed charges,,,,,,,,,2.6883,,,fee schedule,,,2.3896,,,fee schedule,,,,,,,,,,,,,,,,2.53895,85,percent of total billed charges,,,,,,,,,,1.4866299,49.77,percent of total billed charges,,,,2.6883,90,percent of total billed charges,,,,2.83765,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.53895,85,percent of total billed charges,,,,,,,,,1.4866299,2.987,
C-ARM DRAPE #DYNJE4400,2700044,CDM,,,270,RC,outpatient,,,,18.952,10.4236,,17.0568,90,percent of total billed charges,,,,18.952,100,percent of total billed charges,,,,,,,,,17.0568,,,fee schedule,,,15.1616,,,fee schedule,,,,,,,,,,,,,,,,16.1092,85,percent of total billed charges,,,,,,,,,,9.4324104,49.77,percent of total billed charges,,,,17.0568,90,percent of total billed charges,,,,18.0044,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.1092,85,percent of total billed charges,,,,,,,,,9.4324104,18.952,
DENTAL UNIT,2700055,CDM,,,270,RC,outpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,,,,,,,32.2596,,,fee schedule,,,28.6752,,,fee schedule,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,,17.8395588,49.77,percent of total billed charges,,,,32.2596,90,percent of total billed charges,,,,34.0518,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,17.8395588,35.844,
OXYGEN PER HOUR,2700080,CDM,,,270,RC,outpatient,,,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
CEEA 25MM,2700085,CDM,,,270,RC,outpatient,,,,1695.071,932.28905,,1525.5639,90,percent of total billed charges,,,,1695.071,100,percent of total billed charges,,,,,,,,,1525.5639,,,fee schedule,,,1356.0568,,,fee schedule,,,,,,,,,,,,,,,,1440.81035,85,percent of total billed charges,,,,,,,,,,843.6368367,49.77,percent of total billed charges,,,,1525.5639,90,percent of total billed charges,,,,1610.31745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1440.81035,85,percent of total billed charges,,,,,,,,,843.6368367,1695.071,
SUPER SPONGES,2700095,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
MEDIPORE,2700104,CDM,,,270,RC,outpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
PNEUMOTHORAX TRAY,2700106,CDM,,,270,RC,outpatient,,,,220.729,121.40095,,198.6561,90,percent of total billed charges,,,,220.729,100,percent of total billed charges,,,,,,,,,198.6561,,,fee schedule,,,176.5832,,,fee schedule,,,,,,,,,,,,,,,,187.61965,85,percent of total billed charges,,,,,,,,,,109.8568233,49.77,percent of total billed charges,,,,198.6561,90,percent of total billed charges,,,,209.69255,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,187.61965,85,percent of total billed charges,,,,,,,,,109.8568233,220.729,
O2 TUBING CONNECTOR - RT,2700110,CDM,,,270,RC,outpatient,,,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,6.3036,,,fee schedule,,,5.6032,,,fee schedule,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,,3.4858908,49.77,percent of total billed charges,,,,6.3036,90,percent of total billed charges,,,,6.6538,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,3.4858908,7.004,
TRACH TRAY,2700115,CDM,,,270,RC,outpatient,,,,49.955,27.47525,,44.9595,90,percent of total billed charges,,,,49.955,100,percent of total billed charges,,,,,,,,,44.9595,,,fee schedule,,,39.964,,,fee schedule,,,,,,,,,,,,,,,,42.46175,85,percent of total billed charges,,,,,,,,,,24.8626035,49.77,percent of total billed charges,,,,44.9595,90,percent of total billed charges,,,,47.45725,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.46175,85,percent of total billed charges,,,,,,,,,24.8626035,49.955,
HORIZ0N IV BLOOD TUBING,2700116,CDM,,,270,RC,outpatient,,,,12.051,6.62805,,10.8459,90,percent of total billed charges,,,,12.051,100,percent of total billed charges,,,,,,,,,10.8459,,,fee schedule,,,9.6408,,,fee schedule,,,,,,,,,,,,,,,,10.24335,85,percent of total billed charges,,,,,,,,,,5.9977827,49.77,percent of total billed charges,,,,10.8459,90,percent of total billed charges,,,,11.44845,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.24335,85,percent of total billed charges,,,,,,,,,5.9977827,12.051,
RESUS BAG/DISPOSABLE ADULT,2700140,CDM,,,270,RC,outpatient,,,,69.525,38.23875,,62.5725,90,percent of total billed charges,,,,69.525,100,percent of total billed charges,,,,,,,,,62.5725,,,fee schedule,,,55.62,,,fee schedule,,,,,,,,,,,,,,,,59.09625,85,percent of total billed charges,,,,,,,,,,34.6025925,49.77,percent of total billed charges,,,,62.5725,90,percent of total billed charges,,,,66.04875,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,59.09625,85,percent of total billed charges,,,,,,,,,34.6025925,69.525,
CATH SUPRAPUBIC,2700145,CDM,,,270,RC,outpatient,,,,38.728,21.3004,,34.8552,90,percent of total billed charges,,,,38.728,100,percent of total billed charges,,,,,,,,,34.8552,,,fee schedule,,,30.9824,,,fee schedule,,,,,,,,,,,,,,,,32.9188,85,percent of total billed charges,,,,,,,,,,19.2749256,49.77,percent of total billed charges,,,,34.8552,90,percent of total billed charges,,,,36.7916,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.9188,85,percent of total billed charges,,,,,,,,,19.2749256,38.728,
INSUFFLATION TUBING,2700155,CDM,,,270,RC,outpatient,,,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,,,,,,,23.8239,,,fee schedule,,,21.1768,,,fee schedule,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,,13.1746167,49.77,percent of total billed charges,,,,23.8239,90,percent of total billed charges,,,,25.14745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,13.1746167,26.471,
LIGACLIP 10MM #ER320,2700164,CDM,,,270,RC,outpatient,,,,134.209,73.81495,,120.7881,90,percent of total billed charges,,,,134.209,100,percent of total billed charges,,,,,,,,,120.7881,,,fee schedule,,,107.3672,,,fee schedule,,,,,,,,,,,,,,,,114.07765,85,percent of total billed charges,,,,,,,,,,66.7958193,49.77,percent of total billed charges,,,,120.7881,90,percent of total billed charges,,,,127.49855,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,114.07765,85,percent of total billed charges,,,,,,,,,66.7958193,134.209,
CHUX EACH,2700185,CDM,,,270,RC,outpatient,,,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,2.1321,,,fee schedule,,,1.8952,,,fee schedule,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,,1.1790513,49.77,percent of total billed charges,,,,2.1321,90,percent of total billed charges,,,,2.25055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,1.1790513,2.369,
ALCOHOL 4 OZ,2700195,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
BLUNT TROCAR 10MM,2700267,CDM,,,270,RC,outpatient,,,,407.777,224.27735,,366.9993,90,percent of total billed charges,,,,407.777,100,percent of total billed charges,,,,,,,,,366.9993,,,fee schedule,,,326.2216,,,fee schedule,,,,,,,,,,,,,,,,346.61045,85,percent of total billed charges,,,,,,,,,,202.9506129,49.77,percent of total billed charges,,,,366.9993,90,percent of total billed charges,,,,387.38815,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,346.61045,85,percent of total billed charges,,,,,,,,,202.9506129,407.777,
ENDOSTITCH 10MM,2700275,CDM,,,270,RC,outpatient,,,,661.981,364.08955,,595.7829,90,percent of total billed charges,,,,661.981,100,percent of total billed charges,,,,,,,,,595.7829,,,fee schedule,,,529.5848,,,fee schedule,,,,,,,,,,,,,,,,562.68385,85,percent of total billed charges,,,,,,,,,,329.4679437,49.77,percent of total billed charges,,,,595.7829,90,percent of total billed charges,,,,628.88195,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,562.68385,85,percent of total billed charges,,,,,,,,,329.4679437,661.981,
BETADINE 4 OZ.,2700280,CDM,,,270,RC,outpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,3.9861,,,fee schedule,,,3.5432,,,fee schedule,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,,2.2043133,49.77,percent of total billed charges,,,,3.9861,90,percent of total billed charges,,,,4.20755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,2.2043133,4.429,
CATHETER STRAIGHT,2700365,CDM,,,270,RC,outpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,24.5655,,,fee schedule,,,21.836,,,fee schedule,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,,13.5847215,49.77,percent of total billed charges,,,,24.5655,90,percent of total billed charges,,,,25.93025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,13.5847215,27.295,
AUTO SUTURE PROTACK 5MM,2700372,CDM,,,270,RC,outpatient,,,,1078.513,593.18215,,970.6617,90,percent of total billed charges,,,,1078.513,100,percent of total billed charges,,,,,,,,,970.6617,,,fee schedule,,,862.8104,,,fee schedule,,,,,,,,,,,,,,,,916.73605,85,percent of total billed charges,,,,,,,,,,536.7759201,49.77,percent of total billed charges,,,,970.6617,90,percent of total billed charges,,,,1024.58735,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,916.73605,85,percent of total billed charges,,,,,,,,,536.7759201,1078.513,
DYNAGRAFT BONE PUTTY 5CC,2700387,CDM,,,270,RC,outpatient,,,,1050.394,577.7167,,945.3546,90,percent of total billed charges,,,,1050.394,100,percent of total billed charges,,,,,,,,,945.3546,,,fee schedule,,,840.3152,,,fee schedule,,,,,,,,,,,,,,,,892.8349,85,percent of total billed charges,,,,,,,,,,522.7810938,49.77,percent of total billed charges,,,,945.3546,90,percent of total billed charges,,,,997.8743,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,892.8349,85,percent of total billed charges,,,,,,,,,522.7810938,1050.394,
SALEM SUMP TUBE,2700405,CDM,,,270,RC,outpatient,,,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
NACL IRRIGATION 1000cc,2700420,CDM,,,270,RC,outpatient,,,,21.527,11.83985,,19.3743,90,percent of total billed charges,,,,21.527,100,percent of total billed charges,,,,,,,,,19.3743,,,fee schedule,,,17.2216,,,fee schedule,,,,,,,,,,,,,,,,18.29795,85,percent of total billed charges,,,,,,,,,,10.7139879,49.77,percent of total billed charges,,,,19.3743,90,percent of total billed charges,,,,20.45065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.29795,85,percent of total billed charges,,,,,,,,,10.7139879,21.527,
ARROW TWIN CATH,2700425,CDM,,,270,RC,outpatient,,,,32.96,18.128,,29.664,90,percent of total billed charges,,,,32.96,100,percent of total billed charges,,,,,,,,,29.664,,,fee schedule,,,26.368,,,fee schedule,,,,,,,,,,,,,,,,28.016,85,percent of total billed charges,,,,,,,,,,16.404192,49.77,percent of total billed charges,,,,29.664,90,percent of total billed charges,,,,31.312,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.016,85,percent of total billed charges,,,,,,,,,16.404192,32.96,
ABDOMINAL PAD,2700460,CDM,,,270,RC,outpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,3.2445,,,fee schedule,,,2.884,,,fee schedule,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,,1.7942085,49.77,percent of total billed charges,,,,3.2445,90,percent of total billed charges,,,,3.42475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,1.7942085,3.605,
PULSE OX PROBE,2700469,CDM,,,270,RC,outpatient,,,,44.187,24.30285,,39.7683,90,percent of total billed charges,,,,44.187,100,percent of total billed charges,,,,,,,,,39.7683,,,fee schedule,,,35.3496,,,fee schedule,,,,,,,,,,,,,,,,37.55895,85,percent of total billed charges,,,,,,,,,,21.9918699,49.77,percent of total billed charges,,,,39.7683,90,percent of total billed charges,,,,41.97765,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.55895,85,percent of total billed charges,,,,,,,,,21.9918699,44.187,
ABDOMINAL BINDER-UN,2700470,CDM,,,270,RC,outpatient,,,,22.351,12.29305,,20.1159,90,percent of total billed charges,,,,22.351,100,percent of total billed charges,,,,,,,,,20.1159,,,fee schedule,,,17.8808,,,fee schedule,,,,,,,,,,,,,,,,18.99835,85,percent of total billed charges,,,,,,,,,,11.1240927,49.77,percent of total billed charges,,,,20.1159,90,percent of total billed charges,,,,21.23345,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.99835,85,percent of total billed charges,,,,,,,,,11.1240927,22.351,
ABDUCTION PILLOW (LG),2700490,CDM,,,270,RC,outpatient,,,,42.436,23.3398,,38.1924,90,percent of total billed charges,,,,42.436,100,percent of total billed charges,,,,,,,,,38.1924,,,fee schedule,,,33.9488,,,fee schedule,,,,,,,,,,,,,,,,36.0706,85,percent of total billed charges,,,,,,,,,,21.1203972,49.77,percent of total billed charges,,,,38.1924,90,percent of total billed charges,,,,40.3142,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,36.0706,85,percent of total billed charges,,,,,,,,,21.1203972,42.436,
Wound Vac Canister Large,2700502,CDM,,,270,RC,outpatient,,,,75.087,41.29785,,67.5783,90,percent of total billed charges,,,,75.087,100,percent of total billed charges,,,,,,,,,67.5783,,,fee schedule,,,60.0696,,,fee schedule,,,,,,,,,,,,,,,,63.82395,85,percent of total billed charges,,,,,,,,,,37.3707999,49.77,percent of total billed charges,,,,67.5783,90,percent of total billed charges,,,,71.33265,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,63.82395,85,percent of total billed charges,,,,,,,,,37.3707999,75.087,
DISPOSABLE MYRINGOTOMY KNIFE,2700513,CDM,,,270,RC,outpatient,,,,49.646,27.3053,,44.6814,90,percent of total billed charges,,,,49.646,100,percent of total billed charges,,,,,,,,,44.6814,,,fee schedule,,,39.7168,,,fee schedule,,,,,,,,,,,,,,,,42.1991,85,percent of total billed charges,,,,,,,,,,24.7088142,49.77,percent of total billed charges,,,,44.6814,90,percent of total billed charges,,,,47.1637,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.1991,85,percent of total billed charges,,,,,,,,,24.7088142,49.646,
C-SECTION TRAY,2700525,CDM,,,270,RC,outpatient,,,,104.648,57.5564,,94.1832,90,percent of total billed charges,,,,104.648,100,percent of total billed charges,,,,,,,,,94.1832,,,fee schedule,,,83.7184,,,fee schedule,,,,,,,,,,,,,,,,88.9508,85,percent of total billed charges,,,,,,,,,,52.0833096,49.77,percent of total billed charges,,,,94.1832,90,percent of total billed charges,,,,99.4156,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,88.9508,85,percent of total billed charges,,,,,,,,,52.0833096,104.648,
ACE BANDAGE 2-6 INC,2700530,CDM,,,270,RC,outpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,4.0788,,,fee schedule,,,3.6256,,,fee schedule,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,,2.2555764,49.77,percent of total billed charges,,,,4.0788,90,percent of total billed charges,,,,4.3054,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,2.2555764,4.532,
ACE BANDAGE,2700531,CDM,,,270,RC,outpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,3.5226,,,fee schedule,,,3.1312,,,fee schedule,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,,1.9479978,49.77,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,3.7183,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,1.9479978,3.914,
TUBING; BLOOD/FLUID WARMER,2700535,CDM,,,270,RC,outpatient,,,,17.613,9.68715,,15.8517,90,percent of total billed charges,,,,17.613,100,percent of total billed charges,,,,,,,,,15.8517,,,fee schedule,,,14.0904,,,fee schedule,,,,,,,,,,,,,,,,14.97105,85,percent of total billed charges,,,,,,,,,,8.7659901,49.77,percent of total billed charges,,,,15.8517,90,percent of total billed charges,,,,16.73235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.97105,85,percent of total billed charges,,,,,,,,,8.7659901,17.613,
HEEL LIFT BOOT,2700555,CDM,,,270,RC,outpatient,,,,70.555,38.80525,,63.4995,90,percent of total billed charges,,,,70.555,100,percent of total billed charges,,,,,,,,,63.4995,,,fee schedule,,,56.444,,,fee schedule,,,,,,,,,,,,,,,,59.97175,85,percent of total billed charges,,,,,,,,,,35.1152235,49.77,percent of total billed charges,,,,63.4995,90,percent of total billed charges,,,,67.02725,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,59.97175,85,percent of total billed charges,,,,,,,,,35.1152235,70.555,
UMBILICAL VESSEL TRAY,2700565,CDM,,,270,RC,outpatient,,,,141.11,77.6105,,126.999,90,percent of total billed charges,,,,141.11,100,percent of total billed charges,,,,,,,,,126.999,,,fee schedule,,,112.888,,,fee schedule,,,,,,,,,,,,,,,,119.9435,85,percent of total billed charges,,,,,,,,,,70.230447,49.77,percent of total billed charges,,,,126.999,90,percent of total billed charges,,,,134.0545,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,119.9435,85,percent of total billed charges,,,,,,,,,70.230447,141.11,
DIAPER AND PULLUPS ADULT,2700570,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
ARROW JUGULAR IV KIT,2700575,CDM,,,270,RC,outpatient,,,,64.272,35.3496,,57.8448,90,percent of total billed charges,,,,64.272,100,percent of total billed charges,,,,,,,,,57.8448,,,fee schedule,,,51.4176,,,fee schedule,,,,,,,,,,,,,,,,54.6312,85,percent of total billed charges,,,,,,,,,,31.9881744,49.77,percent of total billed charges,,,,57.8448,90,percent of total billed charges,,,,61.0584,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,54.6312,85,percent of total billed charges,,,,,,,,,31.9881744,64.272,
AMNIHOOK,2700590,CDM,,,270,RC,outpatient,,,,8.343,4.58865,,7.5087,90,percent of total billed charges,,,,8.343,100,percent of total billed charges,,,,,,,,,7.5087,,,fee schedule,,,6.6744,,,fee schedule,,,,,,,,,,,,,,,,7.09155,85,percent of total billed charges,,,,,,,,,,4.1523111,49.77,percent of total billed charges,,,,7.5087,90,percent of total billed charges,,,,7.92585,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.09155,85,percent of total billed charges,,,,,,,,,4.1523111,8.343,
ANGLE NEEDLE - 90 DEGREE,2700600,CDM,,,270,RC,outpatient,,,,34.814,19.1477,,31.3326,90,percent of total billed charges,,,,34.814,100,percent of total billed charges,,,,,,,,,31.3326,,,fee schedule,,,27.8512,,,fee schedule,,,,,,,,,,,,,,,,29.5919,85,percent of total billed charges,,,,,,,,,,17.3269278,49.77,percent of total billed charges,,,,31.3326,90,percent of total billed charges,,,,33.0733,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.5919,85,percent of total billed charges,,,,,,,,,17.3269278,34.814,
Aggressive Plus Cutter,2700603,CDM,,,270,RC,outpatient,,,,85.49,47.0195,,76.941,90,percent of total billed charges,,,,85.49,100,percent of total billed charges,,,,,,,,,76.941,,,fee schedule,,,68.392,,,fee schedule,,,,,,,,,,,,,,,,72.6665,85,percent of total billed charges,,,,,,,,,,42.548373,49.77,percent of total billed charges,,,,76.941,90,percent of total billed charges,,,,81.2155,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,72.6665,85,percent of total billed charges,,,,,,,,,42.548373,85.49,
Vac Drape,2700615,CDM,,,270,RC,outpatient,,,,13.184,7.2512,,11.8656,90,percent of total billed charges,,,,13.184,100,percent of total billed charges,,,,,,,,,11.8656,,,fee schedule,,,10.5472,,,fee schedule,,,,,,,,,,,,,,,,11.2064,85,percent of total billed charges,,,,,,,,,,6.5616768,49.77,percent of total billed charges,,,,11.8656,90,percent of total billed charges,,,,12.5248,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.2064,85,percent of total billed charges,,,,,,,,,6.5616768,13.184,
ANTI REFLUX VALVE,2700620,CDM,,,270,RC,outpatient,,,,18.231,10.02705,,16.4079,90,percent of total billed charges,,,,18.231,100,percent of total billed charges,,,,,,,,,16.4079,,,fee schedule,,,14.5848,,,fee schedule,,,,,,,,,,,,,,,,15.49635,85,percent of total billed charges,,,,,,,,,,9.0735687,49.77,percent of total billed charges,,,,16.4079,90,percent of total billed charges,,,,17.31945,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.49635,85,percent of total billed charges,,,,,,,,,9.0735687,18.231,
GAIT BELT,2700625,CDM,,,270,RC,outpatient,,,,13.39,7.3645,,12.051,90,percent of total billed charges,,,,13.39,100,percent of total billed charges,,,,,,,,,12.051,,,fee schedule,,,10.712,,,fee schedule,,,,,,,,,,,,,,,,11.3815,85,percent of total billed charges,,,,,,,,,,6.664203,49.77,percent of total billed charges,,,,12.051,90,percent of total billed charges,,,,12.7205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.3815,85,percent of total billed charges,,,,,,,,,6.664203,13.39,
AQUACEL DRESSING,2700635,CDM,,,270,RC,outpatient,,,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,6.3036,,,fee schedule,,,5.6032,,,fee schedule,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,,3.4858908,49.77,percent of total billed charges,,,,6.3036,90,percent of total billed charges,,,,6.6538,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,3.4858908,7.004,
AQUACEL DRESSING AG 4x5,2700636,CDM,,,270,RC,outpatient,,,,20.085,11.04675,,18.0765,90,percent of total billed charges,,,,20.085,100,percent of total billed charges,,,,,,,,,18.0765,,,fee schedule,,,16.068,,,fee schedule,,,,,,,,,,,,,,,,17.07225,85,percent of total billed charges,,,,,,,,,,9.9963045,49.77,percent of total billed charges,,,,18.0765,90,percent of total billed charges,,,,19.08075,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.07225,85,percent of total billed charges,,,,,,,,,9.9963045,20.085,
ARM SLING S-M-LG-XLG,2700650,CDM,A4565,HCPCS,270,RC,outpatient,,,,8.549,4.70195,,7.6941,90,percent of total billed charges,,,,8.549,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.26665,85,percent of total billed charges,,,,,,,,,,4.2548373,49.77,percent of total billed charges,,,,7.6941,90,percent of total billed charges,,,,8.12155,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.26665,85,percent of total billed charges,,,,,,,,,4.2548373,8.549,
ARROW ART. CATH SET,2700670,CDM,,,270,RC,outpatient,,,,31.827,17.50485,,28.6443,90,percent of total billed charges,,,,31.827,100,percent of total billed charges,,,,,,,,,28.6443,,,fee schedule,,,25.4616,,,fee schedule,,,,,,,,,,,,,,,,27.05295,85,percent of total billed charges,,,,,,,,,,15.8402979,49.77,percent of total billed charges,,,,28.6443,90,percent of total billed charges,,,,30.23565,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.05295,85,percent of total billed charges,,,,,,,,,15.8402979,31.827,
ARROW DRAINAGE TRAY,2700680,CDM,,,270,RC,outpatient,,,,281.705,154.93775,,253.5345,90,percent of total billed charges,,,,281.705,100,percent of total billed charges,,,,,,,,,253.5345,,,fee schedule,,,225.364,,,fee schedule,,,,,,,,,,,,,,,,239.44925,85,percent of total billed charges,,,,,,,,,,140.2045785,49.77,percent of total billed charges,,,,253.5345,90,percent of total billed charges,,,,267.61975,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,239.44925,85,percent of total billed charges,,,,,,,,,140.2045785,281.705,
ARROW PERC INTRO KT,2700690,CDM,,,270,RC,outpatient,,,,129.883,71.43565,,116.8947,90,percent of total billed charges,,,,129.883,100,percent of total billed charges,,,,,,,,,116.8947,,,fee schedule,,,103.9064,,,fee schedule,,,,,,,,,,,,,,,,110.40055,85,percent of total billed charges,,,,,,,,,,64.6427691,49.77,percent of total billed charges,,,,116.8947,90,percent of total billed charges,,,,123.38885,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,110.40055,85,percent of total billed charges,,,,,,,,,64.6427691,129.883,
ARROW TWIN CATH,2700700,CDM,,,270,RC,outpatient,,,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,30.9618,,,fee schedule,,,27.5216,,,fee schedule,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,,17.1218754,49.77,percent of total billed charges,,,,30.9618,90,percent of total billed charges,,,,32.6819,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,17.1218754,34.402,
ART PRESSURE MONITO,2700710,CDM,,,270,RC,outpatient,,,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,14.5539,,,fee schedule,,,12.9368,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,8.0483067,16.171,
ARTERIAL LINE SETUP,2700720,CDM,,,270,RC,outpatient,,,,204.97,112.7335,,184.473,90,percent of total billed charges,,,,204.97,100,percent of total billed charges,,,,,,,,,184.473,,,fee schedule,,,163.976,,,fee schedule,,,,,,,,,,,,,,,,174.2245,85,percent of total billed charges,,,,,,,,,,102.013569,49.77,percent of total billed charges,,,,184.473,90,percent of total billed charges,,,,194.7215,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,174.2245,85,percent of total billed charges,,,,,,,,,102.013569,204.97,
ASEPTO-DISP,2700740,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
BABY LOTION,2700770,CDM,,,270,RC,outpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
Granufoam Lg Wound Vac,2700811,CDM,,,270,RC,outpatient,,,,109.9731,60.485205,,98.97579,90,percent of total billed charges,,,,109.9731,100,percent of total billed charges,,,,,,,,,98.97579,,,fee schedule,,,87.97848,,,fee schedule,,,,,,,,,,,,,,,,93.477135,85,percent of total billed charges,,,,,,,,,,54.73361187,49.77,percent of total billed charges,,,,98.97579,90,percent of total billed charges,,,,104.474445,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,93.477135,85,percent of total billed charges,,,,,,,,,54.73361187,109.9731,
Granufoam Small Wound Vac,2700817,CDM,,,270,RC,outpatient,,,,77.2191,42.470505,,69.49719,90,percent of total billed charges,,,,77.2191,100,percent of total billed charges,,,,,,,,,69.49719,,,fee schedule,,,61.77528,,,fee schedule,,,,,,,,,,,,,,,,65.636235,85,percent of total billed charges,,,,,,,,,,38.43194607,49.77,percent of total billed charges,,,,69.49719,90,percent of total billed charges,,,,73.358145,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,65.636235,85,percent of total billed charges,,,,,,,,,38.43194607,77.2191,
BEAVER BLADE,2700860,CDM,,,270,RC,outpatient,,,,51.809,28.49495,,46.6281,90,percent of total billed charges,,,,51.809,100,percent of total billed charges,,,,,,,,,46.6281,,,fee schedule,,,41.4472,,,fee schedule,,,,,,,,,,,,,,,,44.03765,85,percent of total billed charges,,,,,,,,,,25.7853393,49.77,percent of total billed charges,,,,46.6281,90,percent of total billed charges,,,,49.21855,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,44.03765,85,percent of total billed charges,,,,,,,,,25.7853393,51.809,
DEPUY OSCILLATING SAW BLADE,2700902,CDM,,,270,RC,outpatient,,,,378.834,208.3587,,340.9506,90,percent of total billed charges,,,,378.834,100,percent of total billed charges,,,,,,,,,340.9506,,,fee schedule,,,303.0672,,,fee schedule,,,,,,,,,,,,,,,,322.0089,85,percent of total billed charges,,,,,,,,,,188.5456818,49.77,percent of total billed charges,,,,340.9506,90,percent of total billed charges,,,,359.8923,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,322.0089,85,percent of total billed charges,,,,,,,,,188.5456818,378.834,
Granuforam Med- Wound Vac,2700903,CDM,,,270,RC,outpatient,,,,97.2732,53.50026,,87.54588,90,percent of total billed charges,,,,97.2732,100,percent of total billed charges,,,,,,,,,87.54588,,,fee schedule,,,77.81856,,,fee schedule,,,,,,,,,,,,,,,,82.68222,85,percent of total billed charges,,,,,,,,,,48.41287164,49.77,percent of total billed charges,,,,87.54588,90,percent of total billed charges,,,,92.40954,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,82.68222,85,percent of total billed charges,,,,,,,,,48.41287164,97.2732,
ACCUFORM NASAL SPLINT KIT,2700912,CDM,,,270,RC,outpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,,,,,,,30.4056,,,fee schedule,,,27.0272,,,fee schedule,,,,,,,,,,,,,,,,28.7164,85,percent of total billed charges,,,,,,,,,,16.8142968,49.77,percent of total billed charges,,,,30.4056,90,percent of total billed charges,,,,32.0948,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.7164,85,percent of total billed charges,,,,,,,,,16.8142968,33.784,
SURGITIE 2-0 POLYSORB,2700914,CDM,,,270,RC,outpatient,,,,161.195,88.65725,,145.0755,90,percent of total billed charges,,,,161.195,100,percent of total billed charges,,,,,,,,,145.0755,,,fee schedule,,,128.956,,,fee schedule,,,,,,,,,,,,,,,,137.01575,85,percent of total billed charges,,,,,,,,,,80.2267515,49.77,percent of total billed charges,,,,145.0755,90,percent of total billed charges,,,,153.13525,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,137.01575,85,percent of total billed charges,,,,,,,,,80.2267515,161.195,
BEDPAN,2700920,CDM,,,270,RC,outpatient,,,,3.193,1.75615,,2.8737,90,percent of total billed charges,,,,3.193,100,percent of total billed charges,,,,,,,,,2.8737,,,fee schedule,,,2.5544,,,fee schedule,,,,,,,,,,,,,,,,2.71405,85,percent of total billed charges,,,,,,,,,,1.5891561,49.77,percent of total billed charges,,,,2.8737,90,percent of total billed charges,,,,3.03335,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.71405,85,percent of total billed charges,,,,,,,,,1.5891561,3.193,
BAIR HUGGER THERAPY BLANKET,2700930,CDM,,,270,RC,outpatient,,,,68.495,37.67225,,61.6455,90,percent of total billed charges,,,,68.495,100,percent of total billed charges,,,,,,,,,61.6455,,,fee schedule,,,54.796,,,fee schedule,,,,,,,,,,,,,,,,58.22075,85,percent of total billed charges,,,,,,,,,,34.0899615,49.77,percent of total billed charges,,,,61.6455,90,percent of total billed charges,,,,65.07025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,58.22075,85,percent of total billed charges,,,,,,,,,34.0899615,68.495,
BIB PACK,2700960,CDM,,,270,RC,outpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,,,,,,,32.2596,,,fee schedule,,,28.6752,,,fee schedule,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,,17.8395588,49.77,percent of total billed charges,,,,32.2596,90,percent of total billed charges,,,,34.0518,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,17.8395588,35.844,
BILI MASKS,2700970,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
COTTON UMBILICAL TAPE,2700996,CDM,,,270,RC,outpatient,,,,12.772,7.0246,,11.4948,90,percent of total billed charges,,,,12.772,100,percent of total billed charges,,,,,,,,,11.4948,,,fee schedule,,,10.2176,,,fee schedule,,,,,,,,,,,,,,,,10.8562,85,percent of total billed charges,,,,,,,,,,6.3566244,49.77,percent of total billed charges,,,,11.4948,90,percent of total billed charges,,,,12.1334,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.8562,85,percent of total billed charges,,,,,,,,,6.3566244,12.772,
BLOOD ADMIN SET,2701020,CDM,,,270,RC,outpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,,,,,,,32.2596,,,fee schedule,,,28.6752,,,fee schedule,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,,17.8395588,49.77,percent of total billed charges,,,,32.2596,90,percent of total billed charges,,,,34.0518,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,17.8395588,35.844,
TONSIL SPONGE,2701041,CDM,,,270,RC,outpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,3.5226,,,fee schedule,,,3.1312,,,fee schedule,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,,1.9479978,49.77,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,3.7183,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,1.9479978,3.914,
BLOOD WARMER - USE CH,2701050,CDM,,,270,RC,outpatient,,,,57.062,31.3841,,51.3558,90,percent of total billed charges,,,,57.062,100,percent of total billed charges,,,,,,,,,51.3558,,,fee schedule,,,45.6496,,,fee schedule,,,,,,,,,,,,,,,,48.5027,85,percent of total billed charges,,,,,,,,,,28.3997574,49.77,percent of total billed charges,,,,51.3558,90,percent of total billed charges,,,,54.2089,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,48.5027,85,percent of total billed charges,,,,,,,,,28.3997574,57.062,
BLOOD ADMIN SET,2701060,CDM,,,270,RC,outpatient,,,,8.858,4.8719,,7.9722,90,percent of total billed charges,,,,8.858,100,percent of total billed charges,,,,,,,,,7.9722,,,fee schedule,,,7.0864,,,fee schedule,,,,,,,,,,,,,,,,7.5293,85,percent of total billed charges,,,,,,,,,,4.4086266,49.77,percent of total billed charges,,,,7.9722,90,percent of total billed charges,,,,8.4151,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.5293,85,percent of total billed charges,,,,,,,,,4.4086266,8.858,
BONE MARROW TRAY,2701080,CDM,,,270,RC,outpatient,,,,76.323,41.97765,,68.6907,90,percent of total billed charges,,,,76.323,100,percent of total billed charges,,,,,,,,,68.6907,,,fee schedule,,,61.0584,,,fee schedule,,,,,,,,,,,,,,,,64.87455,85,percent of total billed charges,,,,,,,,,,37.9859571,49.77,percent of total billed charges,,,,68.6907,90,percent of total billed charges,,,,72.50685,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,64.87455,85,percent of total billed charges,,,,,,,,,37.9859571,76.323,
BONE WAX,2701090,CDM,,,270,RC,outpatient,,,,10.609,5.83495,,9.5481,90,percent of total billed charges,,,,10.609,100,percent of total billed charges,,,,,,,,,9.5481,,,fee schedule,,,8.4872,,,fee schedule,,,,,,,,,,,,,,,,9.01765,85,percent of total billed charges,,,,,,,,,,5.2800993,49.77,percent of total billed charges,,,,9.5481,90,percent of total billed charges,,,,10.07855,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.01765,85,percent of total billed charges,,,,,,,,,5.2800993,10.609,
POST-OP SHOE,2701100,CDM,,,270,RC,outpatient,,,,11.021,6.06155,,9.9189,90,percent of total billed charges,,,,11.021,100,percent of total billed charges,,,,,,,,,9.9189,,,fee schedule,,,8.8168,,,fee schedule,,,,,,,,,,,,,,,,9.36785,85,percent of total billed charges,,,,,,,,,,5.4851517,49.77,percent of total billed charges,,,,9.9189,90,percent of total billed charges,,,,10.46995,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.36785,85,percent of total billed charges,,,,,,,,,5.4851517,11.021,
FLEX-IT STYLET,2701102,CDM,,,270,RC,outpatient,,,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
FOAM HEAD REST,2701103,CDM,,,270,RC,outpatient,,,,8.343,4.58865,,7.5087,90,percent of total billed charges,,,,8.343,100,percent of total billed charges,,,,,,,,,7.5087,,,fee schedule,,,6.6744,,,fee schedule,,,,,,,,,,,,,,,,7.09155,85,percent of total billed charges,,,,,,,,,,4.1523111,49.77,percent of total billed charges,,,,7.5087,90,percent of total billed charges,,,,7.92585,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.09155,85,percent of total billed charges,,,,,,,,,4.1523111,8.343,
BREATHING CIR PED,2701150,CDM,,,270,RC,outpatient,,,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,,,,,,,12.4218,,,fee schedule,,,11.0416,,,fee schedule,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,,6.8692554,49.77,percent of total billed charges,,,,12.4218,90,percent of total billed charges,,,,13.1119,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,6.8692554,13.802,
BREATHING CIRCUIT,2701160,CDM,,,270,RC,outpatient,,,,69.937,38.46535,,62.9433,90,percent of total billed charges,,,,69.937,100,percent of total billed charges,,,,,,,,,62.9433,,,fee schedule,,,55.9496,,,fee schedule,,,,,,,,,,,,,,,,59.44645,85,percent of total billed charges,,,,,,,,,,34.8076449,49.77,percent of total billed charges,,,,62.9433,90,percent of total billed charges,,,,66.44015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,59.44645,85,percent of total billed charges,,,,,,,,,34.8076449,69.937,
BRIEFS-MESH PANTIES,2701170,CDM,,,270,RC,outpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,3.8007,,,fee schedule,,,3.3784,,,fee schedule,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,,2.1017871,49.77,percent of total billed charges,,,,3.8007,90,percent of total billed charges,,,,4.01185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,2.1017871,4.223,
HH - DIAL-A-FLOW,2701185,CDM,,,270,RC,outpatient,,,,13.287,7.30785,,11.9583,90,percent of total billed charges,,,,13.287,100,percent of total billed charges,,,,,,,,,11.9583,,,fee schedule,,,10.6296,,,fee schedule,,,,,,,,,,,,,,,,11.29395,85,percent of total billed charges,,,,,,,,,,6.6129399,49.77,percent of total billed charges,,,,11.9583,90,percent of total billed charges,,,,12.62265,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.29395,85,percent of total billed charges,,,,,,,,,6.6129399,13.287,
BURR,2701230,CDM,,,270,RC,outpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
UNNA BOOT DRESSING (SUPPLY),2701241,CDM,,,270,RC,outpatient,,,,6.798,3.7389,,6.1182,90,percent of total billed charges,,,,6.798,100,percent of total billed charges,,,,,,,,,6.1182,,,fee schedule,,,5.4384,,,fee schedule,,,,,,,,,,,,,,,,5.7783,85,percent of total billed charges,,,,,,,,,,3.3833646,49.77,percent of total billed charges,,,,6.1182,90,percent of total billed charges,,,,6.4581,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.7783,85,percent of total billed charges,,,,,,,,,3.3833646,6.798,
CAST PADDING 2-6 IN,2701320,CDM,,,270,RC,outpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,3.8007,,,fee schedule,,,3.3784,,,fee schedule,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,,2.1017871,49.77,percent of total billed charges,,,,3.8007,90,percent of total billed charges,,,,4.01185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,2.1017871,4.223,
DBM BONE PUTTY 2.5cc #APUT02,2701333,CDM,,,270,RC,outpatient,,,,779.401,428.67055,,701.4609,90,percent of total billed charges,,,,779.401,100,percent of total billed charges,,,,,,,,,701.4609,,,fee schedule,,,623.5208,,,fee schedule,,,,,,,,,,,,,,,,662.49085,85,percent of total billed charges,,,,,,,,,,387.9078777,49.77,percent of total billed charges,,,,701.4609,90,percent of total billed charges,,,,740.43095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,662.49085,85,percent of total billed charges,,,,,,,,,387.9078777,779.401,
BREAST PUMP KIT - DOUBLE,2701335,CDM,,,270,RC,outpatient,,,,84.048,46.2264,,75.6432,90,percent of total billed charges,,,,84.048,100,percent of total billed charges,,,,,,,,,75.6432,,,fee schedule,,,67.2384,,,fee schedule,,,,,,,,,,,,,,,,71.4408,85,percent of total billed charges,,,,,,,,,,41.8306896,49.77,percent of total billed charges,,,,75.6432,90,percent of total billed charges,,,,79.8456,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,71.4408,85,percent of total billed charges,,,,,,,,,41.8306896,84.048,
NITRO TUBING,2701345,CDM,,,270,RC,outpatient,,,,32.754,18.0147,,29.4786,90,percent of total billed charges,,,,32.754,100,percent of total billed charges,,,,,,,,,29.4786,,,fee schedule,,,26.2032,,,fee schedule,,,,,,,,,,,,,,,,27.8409,85,percent of total billed charges,,,,,,,,,,16.3016658,49.77,percent of total billed charges,,,,29.4786,90,percent of total billed charges,,,,31.1163,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.8409,85,percent of total billed charges,,,,,,,,,16.3016658,32.754,
PREMIUM SURGICLIP,2701355,CDM,,,270,RC,outpatient,,,,125.351,68.94305,,112.8159,90,percent of total billed charges,,,,125.351,100,percent of total billed charges,,,,,,,,,112.8159,,,fee schedule,,,100.2808,,,fee schedule,,,,,,,,,,,,,,,,106.54835,85,percent of total billed charges,,,,,,,,,,62.3871927,49.77,percent of total billed charges,,,,112.8159,90,percent of total billed charges,,,,119.08345,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,106.54835,85,percent of total billed charges,,,,,,,,,62.3871927,125.351,
ACCLARENT INFLATION DEVICE,2701362,CDM,,,270,RC,outpatient,,,,149.556,82.2558,,134.6004,90,percent of total billed charges,,,,149.556,100,percent of total billed charges,,,,,,,,,134.6004,,,fee schedule,,,119.6448,,,fee schedule,,,,,,,,,,,,,,,,127.1226,85,percent of total billed charges,,,,,,,,,,74.4340212,49.77,percent of total billed charges,,,,134.6004,90,percent of total billed charges,,,,142.0782,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,127.1226,85,percent of total billed charges,,,,,,,,,74.4340212,149.556,
EYEGUARD S2020,2701367,CDM,,,270,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,,,,,,,107.3466,,,fee schedule,,,95.4192,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,59.3626698,119.274,
CAST-LEG LONG,2701390,CDM,,,270,RC,outpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,,,,,,,88.5285,,,fee schedule,,,78.692,,,fee schedule,,,,,,,,,,,,,,,,83.61025,85,percent of total billed charges,,,,,,,,,,48.9562605,49.77,percent of total billed charges,,,,88.5285,90,percent of total billed charges,,,,93.44675,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,83.61025,85,percent of total billed charges,,,,,,,,,48.9562605,98.365,
CASTING TAPE 3M SCOTCH CAST +,2701430,CDM,,,270,RC,outpatient,,,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
CATH DRAIN BAG,2701460,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
ISLAND DRESSING,2701461,CDM,,,270,RC,outpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
CATH PLUG & DRAIN TUB,2701470,CDM,,,270,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
CATH SECURE TUBE HOLDER,2701480,CDM,,,270,RC,outpatient,,,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,6.3036,,,fee schedule,,,5.6032,,,fee schedule,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,,3.4858908,49.77,percent of total billed charges,,,,6.3036,90,percent of total billed charges,,,,6.6538,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,3.4858908,7.004,
MYOSURE CANISTER KIT,2701481,CDM,,,270,RC,outpatient,,,,22.351,12.29305,,20.1159,90,percent of total billed charges,,,,22.351,100,percent of total billed charges,,,,,,,,,20.1159,,,fee schedule,,,17.8808,,,fee schedule,,,,,,,,,,,,,,,,18.99835,85,percent of total billed charges,,,,,,,,,,11.1240927,49.77,percent of total billed charges,,,,20.1159,90,percent of total billed charges,,,,21.23345,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.99835,85,percent of total billed charges,,,,,,,,,11.1240927,22.351,
EPIDURAL TUBING SET,2701512,CDM,,,270,RC,outpatient,,,,18.54,10.197,,16.686,90,percent of total billed charges,,,,18.54,100,percent of total billed charges,,,,,,,,,16.686,,,fee schedule,,,14.832,,,fee schedule,,,,,,,,,,,,,,,,15.759,85,percent of total billed charges,,,,,,,,,,9.227358,49.77,percent of total billed charges,,,,16.686,90,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.759,85,percent of total billed charges,,,,,,,,,9.227358,18.54,
BODY MESH,2701521,CDM,,,270,RC,outpatient,,,,54.487,29.96785,,49.0383,90,percent of total billed charges,,,,54.487,100,percent of total billed charges,,,,,,,,,49.0383,,,fee schedule,,,43.5896,,,fee schedule,,,,,,,,,,,,,,,,46.31395,85,percent of total billed charges,,,,,,,,,,27.1181799,49.77,percent of total billed charges,,,,49.0383,90,percent of total billed charges,,,,51.76265,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,46.31395,85,percent of total billed charges,,,,,,,,,27.1181799,54.487,
CEMENT MIXING BOWL,2701540,CDM,,,270,RC,outpatient,,,,20.394,11.2167,,18.3546,90,percent of total billed charges,,,,20.394,100,percent of total billed charges,,,,,,,,,18.3546,,,fee schedule,,,16.3152,,,fee schedule,,,,,,,,,,,,,,,,17.3349,85,percent of total billed charges,,,,,,,,,,10.1500938,49.77,percent of total billed charges,,,,18.3546,90,percent of total billed charges,,,,19.3743,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.3349,85,percent of total billed charges,,,,,,,,,10.1500938,20.394,
MATERNIMATES HYDROGEL PACKS,2701563,CDM,,,270,RC,outpatient,,,,24.72,13.596,,22.248,90,percent of total billed charges,,,,24.72,100,percent of total billed charges,,,,,,,,,22.248,,,fee schedule,,,19.776,,,fee schedule,,,,,,,,,,,,,,,,21.012,85,percent of total billed charges,,,,,,,,,,12.303144,49.77,percent of total billed charges,,,,22.248,90,percent of total billed charges,,,,23.484,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.012,85,percent of total billed charges,,,,,,,,,12.303144,24.72,
MASTISOL 3CC,2701571,CDM,,,270,RC,outpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
"CEMENT, HOWMEDICA",2701580,CDM,,,270,RC,outpatient,,,,209.605,115.28275,,188.6445,90,percent of total billed charges,,,,209.605,100,percent of total billed charges,,,,,,,,,188.6445,,,fee schedule,,,167.684,,,fee schedule,,,,,,,,,,,,,,,,178.16425,85,percent of total billed charges,,,,,,,,,,104.3204085,49.77,percent of total billed charges,,,,188.6445,90,percent of total billed charges,,,,199.12475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,178.16425,85,percent of total billed charges,,,,,,,,,104.3204085,209.605,
CENTRAL VENOUS SET,2701590,CDM,,,270,RC,outpatient,,,,73.13,40.2215,,65.817,90,percent of total billed charges,,,,73.13,100,percent of total billed charges,,,,,,,,,65.817,,,fee schedule,,,58.504,,,fee schedule,,,,,,,,,,,,,,,,62.1605,85,percent of total billed charges,,,,,,,,,,36.396801,49.77,percent of total billed charges,,,,65.817,90,percent of total billed charges,,,,69.4735,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,62.1605,85,percent of total billed charges,,,,,,,,,36.396801,73.13,
TX 60 RELOAD,2701591,CDM,,,270,RC,outpatient,,,,235.87,129.7285,,212.283,90,percent of total billed charges,,,,235.87,100,percent of total billed charges,,,,,,,,,212.283,,,fee schedule,,,188.696,,,fee schedule,,,,,,,,,,,,,,,,200.4895,85,percent of total billed charges,,,,,,,,,,117.392499,49.77,percent of total billed charges,,,,212.283,90,percent of total billed charges,,,,224.0765,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,200.4895,85,percent of total billed charges,,,,,,,,,117.392499,235.87,
TX 60 LINEAR STAPLER,2701593,CDM,,,270,RC,outpatient,,,,220.935,121.51425,,198.8415,90,percent of total billed charges,,,,220.935,100,percent of total billed charges,,,,,,,,,198.8415,,,fee schedule,,,176.748,,,fee schedule,,,,,,,,,,,,,,,,187.79475,85,percent of total billed charges,,,,,,,,,,109.9593495,49.77,percent of total billed charges,,,,198.8415,90,percent of total billed charges,,,,209.88825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,187.79475,85,percent of total billed charges,,,,,,,,,109.9593495,220.935,
TCR 55 RELOAD,2701594,CDM,,,270,RC,outpatient,,,,129.986,71.4923,,116.9874,90,percent of total billed charges,,,,129.986,100,percent of total billed charges,,,,,,,,,116.9874,,,fee schedule,,,103.9888,,,fee schedule,,,,,,,,,,,,,,,,110.4881,85,percent of total billed charges,,,,,,,,,,64.6940322,49.77,percent of total billed charges,,,,116.9874,90,percent of total billed charges,,,,123.4867,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,110.4881,85,percent of total billed charges,,,,,,,,,64.6940322,129.986,
CERCLAGE WIRES/W/EYES,2701595,CDM,,,270,RC,outpatient,,,,23.278,12.8029,,20.9502,90,percent of total billed charges,,,,23.278,100,percent of total billed charges,,,,,,,,,20.9502,,,fee schedule,,,18.6224,,,fee schedule,,,,,,,,,,,,,,,,19.7863,85,percent of total billed charges,,,,,,,,,,11.5854606,49.77,percent of total billed charges,,,,20.9502,90,percent of total billed charges,,,,22.1141,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.7863,85,percent of total billed charges,,,,,,,,,11.5854606,23.278,
ECHELON 60 RELOAD GST60B,2701596,CDM,,,270,RC,outpatient,,,,236.797,130.23835,,213.1173,90,percent of total billed charges,,,,236.797,100,percent of total billed charges,,,,,,,,,213.1173,,,fee schedule,,,189.4376,,,fee schedule,,,,,,,,,,,,,,,,201.27745,85,percent of total billed charges,,,,,,,,,,117.8538669,49.77,percent of total billed charges,,,,213.1173,90,percent of total billed charges,,,,224.95715,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,201.27745,85,percent of total billed charges,,,,,,,,,117.8538669,236.797,
55 MM LINEAR CUTTER,2701599,CDM,,,270,RC,outpatient,,,,242.462,133.3541,,218.2158,90,percent of total billed charges,,,,242.462,100,percent of total billed charges,,,,,,,,,218.2158,,,fee schedule,,,193.9696,,,fee schedule,,,,,,,,,,,,,,,,206.0927,85,percent of total billed charges,,,,,,,,,,120.6733374,49.77,percent of total billed charges,,,,218.2158,90,percent of total billed charges,,,,230.3389,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,206.0927,85,percent of total billed charges,,,,,,,,,120.6733374,242.462,
SUTURE BOLSTER,2701602,CDM,,,270,RC,outpatient,,,,33.269,18.29795,,29.9421,90,percent of total billed charges,,,,33.269,100,percent of total billed charges,,,,,,,,,29.9421,,,fee schedule,,,26.6152,,,fee schedule,,,,,,,,,,,,,,,,28.27865,85,percent of total billed charges,,,,,,,,,,16.5579813,49.77,percent of total billed charges,,,,29.9421,90,percent of total billed charges,,,,31.60555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.27865,85,percent of total billed charges,,,,,,,,,16.5579813,33.269,
CERVICAL COLLAR,2701610,CDM,,,270,RC,outpatient,,,,9.888,5.4384,,8.8992,90,percent of total billed charges,,,,9.888,100,percent of total billed charges,,,,,,,,,8.8992,,,fee schedule,,,7.9104,,,fee schedule,,,,,,,,,,,,,,,,8.4048,85,percent of total billed charges,,,,,,,,,,4.9212576,49.77,percent of total billed charges,,,,8.8992,90,percent of total billed charges,,,,9.3936,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.4048,85,percent of total billed charges,,,,,,,,,4.9212576,9.888,
CHEST DRAINAGE DEVICE UNIT,2701620,CDM,A7041,HCPCS,270,RC,outpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,,,,,,,60.9039,,,fee schedule,,,54.1368,,,fee schedule,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,,33.6798567,49.77,percent of total billed charges,,,,60.9039,90,percent of total billed charges,,,,64.28745,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,33.6798567,67.671,
BLAKE SILICONE DRAIN 15fr/19fr,2701624,CDM,,,270,RC,outpatient,,,,38.522,21.1871,,34.6698,90,percent of total billed charges,,,,38.522,100,percent of total billed charges,,,,,,,,,34.6698,,,fee schedule,,,30.8176,,,fee schedule,,,,,,,,,,,,,,,,32.7437,85,percent of total billed charges,,,,,,,,,,19.1723994,49.77,percent of total billed charges,,,,34.6698,90,percent of total billed charges,,,,36.5959,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.7437,85,percent of total billed charges,,,,,,,,,19.1723994,38.522,
CHEST TUBE,2701630,CDM,,,270,RC,outpatient,,,,14.214,7.8177,,12.7926,90,percent of total billed charges,,,,14.214,100,percent of total billed charges,,,,,,,,,12.7926,,,fee schedule,,,11.3712,,,fee schedule,,,,,,,,,,,,,,,,12.0819,85,percent of total billed charges,,,,,,,,,,7.0743078,49.77,percent of total billed charges,,,,12.7926,90,percent of total billed charges,,,,13.5033,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.0819,85,percent of total billed charges,,,,,,,,,7.0743078,14.214,
GYNEX MONSELS,2701632,CDM,,,270,RC,outpatient,,,,35.638,19.6009,,32.0742,90,percent of total billed charges,,,,35.638,100,percent of total billed charges,,,,,,,,,32.0742,,,fee schedule,,,28.5104,,,fee schedule,,,,,,,,,,,,,,,,30.2923,85,percent of total billed charges,,,,,,,,,,17.7370326,49.77,percent of total billed charges,,,,32.0742,90,percent of total billed charges,,,,33.8561,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.2923,85,percent of total billed charges,,,,,,,,,17.7370326,35.638,
GYNEX LOOP ELECTRODES,2701634,CDM,,,270,RC,outpatient,,,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,30.9618,,,fee schedule,,,27.5216,,,fee schedule,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,,17.1218754,49.77,percent of total billed charges,,,,30.9618,90,percent of total billed charges,,,,32.6819,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,17.1218754,34.402,
CHUX,2701650,CDM,,,270,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
HH - EAKIN SEAL,2701657,CDM,A4404,HCPCS,270,RC,outpatient,,,,10.918,6.0049,,9.8262,90,percent of total billed charges,,,,10.918,100,percent of total billed charges,,,,,,,,,9.8262,,,fee schedule,,,8.7344,,,fee schedule,,,,,,,,,,,,,,,,9.2803,85,percent of total billed charges,,,,,,,,,,5.4338886,49.77,percent of total billed charges,,,,9.8262,90,percent of total billed charges,,,,10.3721,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.2803,85,percent of total billed charges,,,,,,,,,5.4338886,10.918,
EXTENDED SHOE HORNES,2701659,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
CIRCUMCISION TRAY,2701660,CDM,,,270,RC,outpatient,,,,42.539,23.39645,,38.2851,90,percent of total billed charges,,,,42.539,100,percent of total billed charges,,,,,,,,,38.2851,,,fee schedule,,,34.0312,,,fee schedule,,,,,,,,,,,,,,,,36.15815,85,percent of total billed charges,,,,,,,,,,21.1716603,49.77,percent of total billed charges,,,,38.2851,90,percent of total billed charges,,,,40.41205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,36.15815,85,percent of total billed charges,,,,,,,,,21.1716603,42.539,
CUSTOM CUT POUCH,2701667,CDM,,,270,RC,outpatient,,,,13.596,7.4778,,12.2364,90,percent of total billed charges,,,,13.596,100,percent of total billed charges,,,,,,,,,12.2364,,,fee schedule,,,10.8768,,,fee schedule,,,,,,,,,,,,,,,,11.5566,85,percent of total billed charges,,,,,,,,,,6.7667292,49.77,percent of total billed charges,,,,12.2364,90,percent of total billed charges,,,,12.9162,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.5566,85,percent of total billed charges,,,,,,,,,6.7667292,13.596,
CLAVE PIGGYBACK,2701670,CDM,,,270,RC,outpatient,,,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,14.5539,,,fee schedule,,,12.9368,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,8.0483067,16.171,
CLAVICAL SPLINT,2701680,CDM,,,270,RC,outpatient,,,,13.184,7.2512,,11.8656,90,percent of total billed charges,,,,13.184,100,percent of total billed charges,,,,,,,,,11.8656,,,fee schedule,,,10.5472,,,fee schedule,,,,,,,,,,,,,,,,11.2064,85,percent of total billed charges,,,,,,,,,,6.5616768,49.77,percent of total billed charges,,,,11.8656,90,percent of total billed charges,,,,12.5248,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.2064,85,percent of total billed charges,,,,,,,,,6.5616768,13.184,
HY-N-DRY STOCKINETTE,2701689,CDM,,,270,RC,outpatient,,,,10.094,5.5517,,9.0846,90,percent of total billed charges,,,,10.094,100,percent of total billed charges,,,,,,,,,9.0846,,,fee schedule,,,8.0752,,,fee schedule,,,,,,,,,,,,,,,,8.5799,85,percent of total billed charges,,,,,,,,,,5.0237838,49.77,percent of total billed charges,,,,9.0846,90,percent of total billed charges,,,,9.5893,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.5799,85,percent of total billed charges,,,,,,,,,5.0237838,10.094,
CLOSED DRAINAGE BAG,2701700,CDM,,,270,RC,outpatient,,,,15.862,8.7241,,14.2758,90,percent of total billed charges,,,,15.862,100,percent of total billed charges,,,,,,,,,14.2758,,,fee schedule,,,12.6896,,,fee schedule,,,,,,,,,,,,,,,,13.4827,85,percent of total billed charges,,,,,,,,,,7.8945174,49.77,percent of total billed charges,,,,14.2758,90,percent of total billed charges,,,,15.0689,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.4827,85,percent of total billed charges,,,,,,,,,7.8945174,15.862,
JP DRAIN FLAT ROUND SILICONE.,2701717,CDM,,,270,RC,outpatient,,,,12.772,7.0246,,11.4948,90,percent of total billed charges,,,,12.772,100,percent of total billed charges,,,,,,,,,11.4948,,,fee schedule,,,10.2176,,,fee schedule,,,,,,,,,,,,,,,,10.8562,85,percent of total billed charges,,,,,,,,,,6.3566244,49.77,percent of total billed charges,,,,11.4948,90,percent of total billed charges,,,,12.1334,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.8562,85,percent of total billed charges,,,,,,,,,6.3566244,12.772,
COBAN WRAP,2701720,CDM,,,270,RC,outpatient,,,,5.459,3.00245,,4.9131,90,percent of total billed charges,,,,5.459,100,percent of total billed charges,,,,,,,,,4.9131,,,fee schedule,,,4.3672,,,fee schedule,,,,,,,,,,,,,,,,4.64015,85,percent of total billed charges,,,,,,,,,,2.7169443,49.77,percent of total billed charges,,,,4.9131,90,percent of total billed charges,,,,5.18605,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.64015,85,percent of total billed charges,,,,,,,,,2.7169443,5.459,
"COBAN WRAP 4""",2701730,CDM,,,270,RC,outpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,3.6153,,,fee schedule,,,3.2136,,,fee schedule,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,,1.9992609,49.77,percent of total billed charges,,,,3.6153,90,percent of total billed charges,,,,3.81615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,1.9992609,4.017,
COOPER UTERINE MANIPULATOR,2701745,CDM,,,270,RC,outpatient,,,,88.58,48.719,,79.722,90,percent of total billed charges,,,,88.58,100,percent of total billed charges,,,,,,,,,79.722,,,fee schedule,,,70.864,,,fee schedule,,,,,,,,,,,,,,,,75.293,85,percent of total billed charges,,,,,,,,,,44.086266,49.77,percent of total billed charges,,,,79.722,90,percent of total billed charges,,,,84.151,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,75.293,85,percent of total billed charges,,,,,,,,,44.086266,88.58,
COLD PACK,2701760,CDM,,,270,RC,outpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,3.6153,,,fee schedule,,,3.2136,,,fee schedule,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,,1.9992609,49.77,percent of total billed charges,,,,3.6153,90,percent of total billed charges,,,,3.81615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,1.9992609,4.017,
COLLECTION SOCK,2701790,CDM,,,270,RC,outpatient,,,,41.612,22.8866,,37.4508,90,percent of total billed charges,,,,41.612,100,percent of total billed charges,,,,,,,,,37.4508,,,fee schedule,,,33.2896,,,fee schedule,,,,,,,,,,,,,,,,35.3702,85,percent of total billed charges,,,,,,,,,,20.7102924,49.77,percent of total billed charges,,,,37.4508,90,percent of total billed charges,,,,39.5314,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.3702,85,percent of total billed charges,,,,,,,,,20.7102924,41.612,
CEMENT CUP CURRETTE (YELLOW),2701829,CDM,,,270,RC,outpatient,,,,112.373,61.80515,,101.1357,90,percent of total billed charges,,,,112.373,100,percent of total billed charges,,,,,,,,,101.1357,,,fee schedule,,,89.8984,,,fee schedule,,,,,,,,,,,,,,,,95.51705,85,percent of total billed charges,,,,,,,,,,55.9280421,49.77,percent of total billed charges,,,,101.1357,90,percent of total billed charges,,,,106.75435,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,95.51705,85,percent of total billed charges,,,,,,,,,55.9280421,112.373,
STRYKER 5.5 BUR #375-950-000,2701842,CDM,,,270,RC,outpatient,,,,182.001,100.10055,,163.8009,90,percent of total billed charges,,,,182.001,100,percent of total billed charges,,,,,,,,,163.8009,,,fee schedule,,,145.6008,,,fee schedule,,,,,,,,,,,,,,,,154.70085,85,percent of total billed charges,,,,,,,,,,90.5818977,49.77,percent of total billed charges,,,,163.8009,90,percent of total billed charges,,,,172.90095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,154.70085,85,percent of total billed charges,,,,,,,,,90.5818977,182.001,
SAFE SHEATH INTRODUCER,2701845,CDM,,,270,RC,outpatient,,,,139.668,76.8174,,125.7012,90,percent of total billed charges,,,,139.668,100,percent of total billed charges,,,,,,,,,125.7012,,,fee schedule,,,111.7344,,,fee schedule,,,,,,,,,,,,,,,,118.7178,85,percent of total billed charges,,,,,,,,,,69.5127636,49.77,percent of total billed charges,,,,125.7012,90,percent of total billed charges,,,,132.6846,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,118.7178,85,percent of total billed charges,,,,,,,,,69.5127636,139.668,
SECTION CONNECT TUBING,2701890,CDM,,,270,RC,outpatient,,,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
CONNECT TUBE SUCTION,2701910,CDM,,,270,RC,outpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MEPILEX DRESSING 4x12,2701918,CDM,,,270,RC,outpatient,,,,63.448,34.8964,,57.1032,90,percent of total billed charges,,,,63.448,100,percent of total billed charges,,,,,,,,,57.1032,,,fee schedule,,,50.7584,,,fee schedule,,,,,,,,,,,,,,,,53.9308,85,percent of total billed charges,,,,,,,,,,31.5780696,49.77,percent of total billed charges,,,,57.1032,90,percent of total billed charges,,,,60.2756,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,53.9308,85,percent of total billed charges,,,,,,,,,31.5780696,63.448,
RAYTECS,2701940,CDM,,,270,RC,outpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,3.9861,,,fee schedule,,,3.5432,,,fee schedule,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,,2.2043133,49.77,percent of total billed charges,,,,3.9861,90,percent of total billed charges,,,,4.20755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,2.2043133,4.429,
ROBINSIN RED RUBBER CATH - ALL,2701971,CDM,,,270,RC,outpatient,,,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
BARD FOLEY CATH 30cc; ALL,2701972,CDM,,,270,RC,outpatient,,,,11.227,6.17485,,10.1043,90,percent of total billed charges,,,,11.227,100,percent of total billed charges,,,,,,,,,10.1043,,,fee schedule,,,8.9816,,,fee schedule,,,,,,,,,,,,,,,,9.54295,85,percent of total billed charges,,,,,,,,,,5.5876779,49.77,percent of total billed charges,,,,10.1043,90,percent of total billed charges,,,,10.66565,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.54295,85,percent of total billed charges,,,,,,,,,5.5876779,11.227,
BARD FOLEY CATH 5cc; ALL,2701974,CDM,,,270,RC,outpatient,,,,8.24,4.532,,7.416,90,percent of total billed charges,,,,8.24,100,percent of total billed charges,,,,,,,,,7.416,,,fee schedule,,,6.592,,,fee schedule,,,,,,,,,,,,,,,,7.004,85,percent of total billed charges,,,,,,,,,,4.101048,49.77,percent of total billed charges,,,,7.416,90,percent of total billed charges,,,,7.828,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.004,85,percent of total billed charges,,,,,,,,,4.101048,8.24,
CVP MAN SETUP,2702050,CDM,,,270,RC,outpatient,,,,121.025,66.56375,,108.9225,90,percent of total billed charges,,,,121.025,100,percent of total billed charges,,,,,,,,,108.9225,,,fee schedule,,,96.82,,,fee schedule,,,,,,,,,,,,,,,,102.87125,85,percent of total billed charges,,,,,,,,,,60.2341425,49.77,percent of total billed charges,,,,108.9225,90,percent of total billed charges,,,,114.97375,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,102.87125,85,percent of total billed charges,,,,,,,,,60.2341425,121.025,
CYSTO PACK,2702090,CDM,,,270,RC,outpatient,,,,12.36,6.798,,11.124,90,percent of total billed charges,,,,12.36,100,percent of total billed charges,,,,,,,,,11.124,,,fee schedule,,,9.888,,,fee schedule,,,,,,,,,,,,,,,,10.506,85,percent of total billed charges,,,,,,,,,,6.151572,49.77,percent of total billed charges,,,,11.124,90,percent of total billed charges,,,,11.742,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.506,85,percent of total billed charges,,,,,,,,,6.151572,12.36,
CYSTO STRAIGHT TUBI,2702100,CDM,,,270,RC,outpatient,,,,16.789,9.23395,,15.1101,90,percent of total billed charges,,,,16.789,100,percent of total billed charges,,,,,,,,,15.1101,,,fee schedule,,,13.4312,,,fee schedule,,,,,,,,,,,,,,,,14.27065,85,percent of total billed charges,,,,,,,,,,8.3558853,49.77,percent of total billed charges,,,,15.1101,90,percent of total billed charges,,,,15.94955,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.27065,85,percent of total billed charges,,,,,,,,,8.3558853,16.789,
CYSTO Y TUBING,2702110,CDM,,,270,RC,outpatient,,,,33.681,18.52455,,30.3129,90,percent of total billed charges,,,,33.681,100,percent of total billed charges,,,,,,,,,30.3129,,,fee schedule,,,26.9448,,,fee schedule,,,,,,,,,,,,,,,,28.62885,85,percent of total billed charges,,,,,,,,,,16.7630337,49.77,percent of total billed charges,,,,30.3129,90,percent of total billed charges,,,,31.99695,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.62885,85,percent of total billed charges,,,,,,,,,16.7630337,33.681,
90S CRUISE SUC PROBE 4.0X135MM,2702124,CDM,,,270,RC,outpatient,,,,362.56,199.408,,326.304,90,percent of total billed charges,,,,362.56,100,percent of total billed charges,,,,,,,,,326.304,,,fee schedule,,,290.048,,,fee schedule,,,,,,,,,,,,,,,,308.176,85,percent of total billed charges,,,,,,,,,,180.446112,49.77,percent of total billed charges,,,,326.304,90,percent of total billed charges,,,,344.432,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,308.176,85,percent of total billed charges,,,,,,,,,180.446112,362.56,
LITHOTOMY PACK,2702140,CDM,,,270,RC,outpatient,,,,88.58,48.719,,79.722,90,percent of total billed charges,,,,88.58,100,percent of total billed charges,,,,,,,,,79.722,,,fee schedule,,,70.864,,,fee schedule,,,,,,,,,,,,,,,,75.293,85,percent of total billed charges,,,,,,,,,,44.086266,49.77,percent of total billed charges,,,,79.722,90,percent of total billed charges,,,,84.151,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,75.293,85,percent of total billed charges,,,,,,,,,44.086266,88.58,
DEBRIEDMENT KIT,2702170,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
JACKSON PRATT RESERVOIR,2702184,CDM,,,270,RC,outpatient,,,,10.609,5.83495,,9.5481,90,percent of total billed charges,,,,10.609,100,percent of total billed charges,,,,,,,,,9.5481,,,fee schedule,,,8.4872,,,fee schedule,,,,,,,,,,,,,,,,9.01765,85,percent of total billed charges,,,,,,,,,,5.2800993,49.77,percent of total billed charges,,,,9.5481,90,percent of total billed charges,,,,10.07855,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.01765,85,percent of total billed charges,,,,,,,,,5.2800993,10.609,
DELEE MUCOUS TRAP,2702190,CDM,,,270,RC,outpatient,,,,14.111,7.76105,,12.6999,90,percent of total billed charges,,,,14.111,100,percent of total billed charges,,,,,,,,,12.6999,,,fee schedule,,,11.2888,,,fee schedule,,,,,,,,,,,,,,,,11.99435,85,percent of total billed charges,,,,,,,,,,7.0230447,49.77,percent of total billed charges,,,,12.6999,90,percent of total billed charges,,,,13.40545,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.99435,85,percent of total billed charges,,,,,,,,,7.0230447,14.111,
ACU PUNCH 3+5mm,2702233,CDM,,,270,RC,outpatient,,,,7.313,4.02215,,6.5817,90,percent of total billed charges,,,,7.313,100,percent of total billed charges,,,,,,,,,6.5817,,,fee schedule,,,5.8504,,,fee schedule,,,,,,,,,,,,,,,,6.21605,85,percent of total billed charges,,,,,,,,,,3.6396801,49.77,percent of total billed charges,,,,6.5817,90,percent of total billed charges,,,,6.94735,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.21605,85,percent of total billed charges,,,,,,,,,3.6396801,7.313,
DERMABOND ADHESIVE,2702243,CDM,,,270,RC,outpatient,,,,45.629,25.09595,,41.0661,90,percent of total billed charges,,,,45.629,100,percent of total billed charges,,,,,,,,,41.0661,,,fee schedule,,,36.5032,,,fee schedule,,,,,,,,,,,,,,,,38.78465,85,percent of total billed charges,,,,,,,,,,22.7095533,49.77,percent of total billed charges,,,,41.0661,90,percent of total billed charges,,,,43.34755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,38.78465,85,percent of total billed charges,,,,,,,,,22.7095533,45.629,
JONES COTTON,2702251,CDM,,,270,RC,outpatient,,,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,,,,,,,12.4218,,,fee schedule,,,11.0416,,,fee schedule,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,,6.8692554,49.77,percent of total billed charges,,,,12.4218,90,percent of total billed charges,,,,13.1119,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,6.8692554,13.802,
WHITE RIGID SOCK AID,2702266,CDM,,,270,RC,outpatient,,,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
DIAPERS BABY,2702310,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
DIAPERS-DISP PER 60,2702320,CDM,,,270,RC,outpatient,,,,18.952,10.4236,,17.0568,90,percent of total billed charges,,,,18.952,100,percent of total billed charges,,,,,,,,,17.0568,,,fee schedule,,,15.1616,,,fee schedule,,,,,,,,,,,,,,,,16.1092,85,percent of total billed charges,,,,,,,,,,9.4324104,49.77,percent of total billed charges,,,,17.0568,90,percent of total billed charges,,,,18.0044,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.1092,85,percent of total billed charges,,,,,,,,,9.4324104,18.952,
DISP EMESIS BASIS,2702360,CDM,,,270,RC,outpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,3.2445,,,fee schedule,,,2.884,,,fee schedule,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,,1.7942085,49.77,percent of total billed charges,,,,3.2445,90,percent of total billed charges,,,,3.42475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,1.7942085,3.605,
DISP GRADUATE 1000,2702470,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
DRESSING-ADAPTIC PK,2702570,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
DUO DERM,2702610,CDM,,,270,RC,outpatient,,,,5.253,2.88915,,4.7277,90,percent of total billed charges,,,,5.253,100,percent of total billed charges,,,,,,,,,4.7277,,,fee schedule,,,4.2024,,,fee schedule,,,,,,,,,,,,,,,,4.46505,85,percent of total billed charges,,,,,,,,,,2.6144181,49.77,percent of total billed charges,,,,4.7277,90,percent of total billed charges,,,,4.99035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.46505,85,percent of total billed charges,,,,,,,,,2.6144181,5.253,
DUO-TUBE/KEOFEED,2702630,CDM,,,270,RC,outpatient,,,,45.423,24.98265,,40.8807,90,percent of total billed charges,,,,45.423,100,percent of total billed charges,,,,,,,,,40.8807,,,fee schedule,,,36.3384,,,fee schedule,,,,,,,,,,,,,,,,38.60955,85,percent of total billed charges,,,,,,,,,,22.6070271,49.77,percent of total billed charges,,,,40.8807,90,percent of total billed charges,,,,43.15185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,38.60955,85,percent of total billed charges,,,,,,,,,22.6070271,45.423,
DURA PREP 3M 8630,2702640,CDM,,,270,RC,outpatient,,,,10.506,5.7783,,9.4554,90,percent of total billed charges,,,,10.506,100,percent of total billed charges,,,,,,,,,9.4554,,,fee schedule,,,8.4048,,,fee schedule,,,,,,,,,,,,,,,,8.9301,85,percent of total billed charges,,,,,,,,,,5.2288362,49.77,percent of total billed charges,,,,9.4554,90,percent of total billed charges,,,,9.9807,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.9301,85,percent of total billed charges,,,,,,,,,5.2288362,10.506,
TRIGGER SWITCH BOVEY E0520,2702642,CDM,,,270,RC,outpatient,,,,63.139,34.72645,,56.8251,90,percent of total billed charges,,,,63.139,100,percent of total billed charges,,,,,,,,,56.8251,,,fee schedule,,,50.5112,,,fee schedule,,,,,,,,,,,,,,,,53.66815,85,percent of total billed charges,,,,,,,,,,31.4242803,49.77,percent of total billed charges,,,,56.8251,90,percent of total billed charges,,,,59.98205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,53.66815,85,percent of total billed charges,,,,,,,,,31.4242803,63.139,
E-Z TEMP,2702650,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
FOGARTY CHOLANGIOCATHETER,2702670,CDM,,,270,RC,outpatient,,,,78.589,43.22395,,70.7301,90,percent of total billed charges,,,,78.589,100,percent of total billed charges,,,,,,,,,70.7301,,,fee schedule,,,62.8712,,,fee schedule,,,,,,,,,,,,,,,,66.80065,85,percent of total billed charges,,,,,,,,,,39.1137453,49.77,percent of total billed charges,,,,70.7301,90,percent of total billed charges,,,,74.65955,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,66.80065,85,percent of total billed charges,,,,,,,,,39.1137453,78.589,
ELASTO-GEL DRESSING,2702710,CDM,,,270,RC,outpatient,,,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
ENDO BAG,2702730,CDM,,,270,RC,outpatient,,,,67.362,37.0491,,60.6258,90,percent of total billed charges,,,,67.362,100,percent of total billed charges,,,,,,,,,60.6258,,,fee schedule,,,53.8896,,,fee schedule,,,,,,,,,,,,,,,,57.2577,85,percent of total billed charges,,,,,,,,,,33.5260674,49.77,percent of total billed charges,,,,60.6258,90,percent of total billed charges,,,,63.9939,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,57.2577,85,percent of total billed charges,,,,,,,,,33.5260674,67.362,
ENDOTRACH TUBE,2702770,CDM,,,270,RC,outpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,3.5226,,,fee schedule,,,3.1312,,,fee schedule,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,,1.9479978,49.77,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,3.7183,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,1.9479978,3.914,
ENEMA ADMIN SET,2702780,CDM,,,270,RC,outpatient,,,,5.047,2.77585,,4.5423,90,percent of total billed charges,,,,5.047,100,percent of total billed charges,,,,,,,,,4.5423,,,fee schedule,,,4.0376,,,fee schedule,,,,,,,,,,,,,,,,4.28995,85,percent of total billed charges,,,,,,,,,,2.5118919,49.77,percent of total billed charges,,,,4.5423,90,percent of total billed charges,,,,4.79465,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.28995,85,percent of total billed charges,,,,,,,,,2.5118919,5.047,
ENEMA BUCKET,2702790,CDM,,,270,RC,outpatient,,,,4.738,2.6059,,4.2642,90,percent of total billed charges,,,,4.738,100,percent of total billed charges,,,,,,,,,4.2642,,,fee schedule,,,3.7904,,,fee schedule,,,,,,,,,,,,,,,,4.0273,85,percent of total billed charges,,,,,,,,,,2.3581026,49.77,percent of total billed charges,,,,4.2642,90,percent of total billed charges,,,,4.5011,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.0273,85,percent of total billed charges,,,,,,,,,2.3581026,4.738,
EPIDURAL TRAY,2702840,CDM,,,270,RC,outpatient,,,,64.89,35.6895,,58.401,90,percent of total billed charges,,,,64.89,100,percent of total billed charges,,,,,,,,,58.401,,,fee schedule,,,51.912,,,fee schedule,,,,,,,,,,,,,,,,55.1565,85,percent of total billed charges,,,,,,,,,,32.295753,49.77,percent of total billed charges,,,,58.401,90,percent of total billed charges,,,,61.6455,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,55.1565,85,percent of total billed charges,,,,,,,,,32.295753,64.89,
ERU TIEMANN CATH,2702850,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
ESMARK BANDAGE,2702860,CDM,,,270,RC,outpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ESOPH STETH TEMP,2702870,CDM,,,270,RC,outpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,3.6153,,,fee schedule,,,3.2136,,,fee schedule,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,,1.9992609,49.77,percent of total billed charges,,,,3.6153,90,percent of total billed charges,,,,3.81615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,1.9992609,4.017,
EXTREMITY SHEET,2702960,CDM,,,270,RC,outpatient,,,,16.48,9.064,,14.832,90,percent of total billed charges,,,,16.48,100,percent of total billed charges,,,,,,,,,14.832,,,fee schedule,,,13.184,,,fee schedule,,,,,,,,,,,,,,,,14.008,85,percent of total billed charges,,,,,,,,,,8.202096,49.77,percent of total billed charges,,,,14.832,90,percent of total billed charges,,,,15.656,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.008,85,percent of total billed charges,,,,,,,,,8.202096,16.48,
MEGADYNE ELECTRODE #0113M,2702977,CDM,,,270,RC,outpatient,,,,14.729,8.10095,,13.2561,90,percent of total billed charges,,,,14.729,100,percent of total billed charges,,,,,,,,,13.2561,,,fee schedule,,,11.7832,,,fee schedule,,,,,,,,,,,,,,,,12.51965,85,percent of total billed charges,,,,,,,,,,7.3306233,49.77,percent of total billed charges,,,,13.2561,90,percent of total billed charges,,,,13.99255,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.51965,85,percent of total billed charges,,,,,,,,,7.3306233,14.729,
EYE PADS,2702980,CDM,,,270,RC,outpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,3.2445,,,fee schedule,,,2.884,,,fee schedule,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,,1.7942085,49.77,percent of total billed charges,,,,3.2445,90,percent of total billed charges,,,,3.42475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,1.7942085,3.605,
LARYN AIRWAY #KLTSD404,2702983,CDM,,,270,RC,outpatient,,,,92.391,50.81505,,83.1519,90,percent of total billed charges,,,,92.391,100,percent of total billed charges,,,,,,,,,83.1519,,,fee schedule,,,73.9128,,,fee schedule,,,,,,,,,,,,,,,,78.53235,85,percent of total billed charges,,,,,,,,,,45.9830007,49.77,percent of total billed charges,,,,83.1519,90,percent of total billed charges,,,,87.77145,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,78.53235,85,percent of total billed charges,,,,,,,,,45.9830007,92.391,
LARYN AIRWAY #KLTSD405,2702984,CDM,,,270,RC,outpatient,,,,92.391,50.81505,,83.1519,90,percent of total billed charges,,,,92.391,100,percent of total billed charges,,,,,,,,,83.1519,,,fee schedule,,,73.9128,,,fee schedule,,,,,,,,,,,,,,,,78.53235,85,percent of total billed charges,,,,,,,,,,45.9830007,49.77,percent of total billed charges,,,,83.1519,90,percent of total billed charges,,,,87.77145,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,78.53235,85,percent of total billed charges,,,,,,,,,45.9830007,92.391,
FEEDING TUBE - 5 FR,2703020,CDM,,,270,RC,outpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,4.0788,,,fee schedule,,,3.6256,,,fee schedule,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,,2.2555764,49.77,percent of total billed charges,,,,4.0788,90,percent of total billed charges,,,,4.3054,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,2.2555764,4.532,
"FEEDING TUBE, VIVONE",2703030,CDM,,,270,RC,outpatient,,,,57.062,31.3841,,51.3558,90,percent of total billed charges,,,,57.062,100,percent of total billed charges,,,,,,,,,51.3558,,,fee schedule,,,45.6496,,,fee schedule,,,,,,,,,,,,,,,,48.5027,85,percent of total billed charges,,,,,,,,,,28.3997574,49.77,percent of total billed charges,,,,51.3558,90,percent of total billed charges,,,,54.2089,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,48.5027,85,percent of total billed charges,,,,,,,,,28.3997574,57.062,
FEMALE CATH KIT,2703050,CDM,,,270,RC,outpatient,,,,8.446,4.6453,,7.6014,90,percent of total billed charges,,,,8.446,100,percent of total billed charges,,,,,,,,,7.6014,,,fee schedule,,,6.7568,,,fee schedule,,,,,,,,,,,,,,,,7.1791,85,percent of total billed charges,,,,,,,,,,4.2035742,49.77,percent of total billed charges,,,,7.6014,90,percent of total billed charges,,,,8.0237,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.1791,85,percent of total billed charges,,,,,,,,,4.2035742,8.446,
FEMORAL SUCTION TAM,2703090,CDM,,,270,RC,outpatient,,,,43.054,23.6797,,38.7486,90,percent of total billed charges,,,,43.054,100,percent of total billed charges,,,,,,,,,38.7486,,,fee schedule,,,34.4432,,,fee schedule,,,,,,,,,,,,,,,,36.5959,85,percent of total billed charges,,,,,,,,,,21.4279758,49.77,percent of total billed charges,,,,38.7486,90,percent of total billed charges,,,,40.9013,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,36.5959,85,percent of total billed charges,,,,,,,,,21.4279758,43.054,
MEDLINE ABDOMEN DRAPE/W/POUCH,2703103,CDM,,,270,RC,outpatient,,,,23.072,12.6896,,20.7648,90,percent of total billed charges,,,,23.072,100,percent of total billed charges,,,,,,,,,20.7648,,,fee schedule,,,18.4576,,,fee schedule,,,,,,,,,,,,,,,,19.6112,85,percent of total billed charges,,,,,,,,,,11.4829344,49.77,percent of total billed charges,,,,20.7648,90,percent of total billed charges,,,,21.9184,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.6112,85,percent of total billed charges,,,,,,,,,11.4829344,23.072,
FIBEROPTIC CHARGE,2703120,CDM,,,270,RC,outpatient,,,,90.022,49.5121,,81.0198,90,percent of total billed charges,,,,90.022,100,percent of total billed charges,,,,,,,,,81.0198,,,fee schedule,,,72.0176,,,fee schedule,,,,,,,,,,,,,,,,76.5187,85,percent of total billed charges,,,,,,,,,,44.8039494,49.77,percent of total billed charges,,,,81.0198,90,percent of total billed charges,,,,85.5209,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,76.5187,85,percent of total billed charges,,,,,,,,,44.8039494,90.022,
PENTAX SCISSORS #3142,2703142,CDM,,,270,RC,outpatient,,,,86.005,47.30275,,77.4045,90,percent of total billed charges,,,,86.005,100,percent of total billed charges,,,,,,,,,77.4045,,,fee schedule,,,68.804,,,fee schedule,,,,,,,,,,,,,,,,73.10425,85,percent of total billed charges,,,,,,,,,,42.8046885,49.77,percent of total billed charges,,,,77.4045,90,percent of total billed charges,,,,81.70475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,73.10425,85,percent of total billed charges,,,,,,,,,42.8046885,86.005,
VISCERAL RETAINER FISH,2703150,CDM,,,270,RC,outpatient,,,,120.716,66.3938,,108.6444,90,percent of total billed charges,,,,120.716,100,percent of total billed charges,,,,,,,,,108.6444,,,fee schedule,,,96.5728,,,fee schedule,,,,,,,,,,,,,,,,102.6086,85,percent of total billed charges,,,,,,,,,,60.0803532,49.77,percent of total billed charges,,,,108.6444,90,percent of total billed charges,,,,114.6802,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,102.6086,85,percent of total billed charges,,,,,,,,,60.0803532,120.716,
PERIWASH,2703175,CDM,,,270,RC,outpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,3.8007,,,fee schedule,,,3.3784,,,fee schedule,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,,2.1017871,49.77,percent of total billed charges,,,,3.8007,90,percent of total billed charges,,,,4.01185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,2.1017871,4.223,
FOAM BEDPAD EGGCRATE,2703210,CDM,,,270,RC,outpatient,,,,49.646,27.3053,,44.6814,90,percent of total billed charges,,,,49.646,100,percent of total billed charges,,,,,,,,,44.6814,,,fee schedule,,,39.7168,,,fee schedule,,,,,,,,,,,,,,,,42.1991,85,percent of total billed charges,,,,,,,,,,24.7088142,49.77,percent of total billed charges,,,,44.6814,90,percent of total billed charges,,,,47.1637,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.1991,85,percent of total billed charges,,,,,,,,,24.7088142,49.646,
FOLEY LATEX FREE CATH,2703290,CDM,,,270,RC,outpatient,,,,17.613,9.68715,,15.8517,90,percent of total billed charges,,,,17.613,100,percent of total billed charges,,,,,,,,,15.8517,,,fee schedule,,,14.0904,,,fee schedule,,,,,,,,,,,,,,,,14.97105,85,percent of total billed charges,,,,,,,,,,8.7659901,49.77,percent of total billed charges,,,,15.8517,90,percent of total billed charges,,,,16.73235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.97105,85,percent of total billed charges,,,,,,,,,8.7659901,17.613,
CATH PUREWICK,2703291,CDM,,,270,RC,outpatient,,,,8.961,4.92855,,8.0649,90,percent of total billed charges,,,,8.961,100,percent of total billed charges,,,,,,,,,8.0649,,,fee schedule,,,7.1688,,,fee schedule,,,,,,,,,,,,,,,,7.61685,85,percent of total billed charges,,,,,,,,,,4.4598897,49.77,percent of total billed charges,,,,8.0649,90,percent of total billed charges,,,,8.51295,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.61685,85,percent of total billed charges,,,,,,,,,4.4598897,8.961,
FOLEY PRECONNECT - ADULT,2703300,CDM,,,270,RC,outpatient,,,,38.316,21.0738,,34.4844,90,percent of total billed charges,,,,38.316,100,percent of total billed charges,,,,,,,,,34.4844,,,fee schedule,,,30.6528,,,fee schedule,,,,,,,,,,,,,,,,32.5686,85,percent of total billed charges,,,,,,,,,,19.0698732,49.77,percent of total billed charges,,,,34.4844,90,percent of total billed charges,,,,36.4002,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.5686,85,percent of total billed charges,,,,,,,,,19.0698732,38.316,
GASTRIC EASI-LAVAGE,2703360,CDM,,,270,RC,outpatient,,,,156.56,86.108,,140.904,90,percent of total billed charges,,,,156.56,100,percent of total billed charges,,,,,,,,,140.904,,,fee schedule,,,125.248,,,fee schedule,,,,,,,,,,,,,,,,133.076,85,percent of total billed charges,,,,,,,,,,77.919912,49.77,percent of total billed charges,,,,140.904,90,percent of total billed charges,,,,148.732,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,133.076,85,percent of total billed charges,,,,,,,,,77.919912,156.56,
GASTROSTOMY KIT-FLX,2703380,CDM,,,270,RC,outpatient,,,,385.22,211.871,,346.698,90,percent of total billed charges,,,,385.22,100,percent of total billed charges,,,,,,,,,346.698,,,fee schedule,,,308.176,,,fee schedule,,,,,,,,,,,,,,,,327.437,85,percent of total billed charges,,,,,,,,,,191.723994,49.77,percent of total billed charges,,,,346.698,90,percent of total billed charges,,,,365.959,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,327.437,85,percent of total billed charges,,,,,,,,,191.723994,385.22,
GAUZE-ADAPTIC ROLL,2703390,CDM,,,270,RC,outpatient,,,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,6.7671,,,fee schedule,,,6.0152,,,fee schedule,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,,3.7422063,49.77,percent of total billed charges,,,,6.7671,90,percent of total billed charges,,,,7.14305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,3.7422063,7.519,
GAUZE - IDOFORM,2703400,CDM,,,270,RC,outpatient,,,,6.798,3.7389,,6.1182,90,percent of total billed charges,,,,6.798,100,percent of total billed charges,,,,,,,,,6.1182,,,fee schedule,,,5.4384,,,fee schedule,,,,,,,,,,,,,,,,5.7783,85,percent of total billed charges,,,,,,,,,,3.3833646,49.77,percent of total billed charges,,,,6.1182,90,percent of total billed charges,,,,6.4581,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.7783,85,percent of total billed charges,,,,,,,,,3.3833646,6.798,
GAUZE-TUBE,2703410,CDM,,,270,RC,outpatient,,,,35.02,19.261,,31.518,90,percent of total billed charges,,,,35.02,100,percent of total billed charges,,,,,,,,,31.518,,,fee schedule,,,28.016,,,fee schedule,,,,,,,,,,,,,,,,29.767,85,percent of total billed charges,,,,,,,,,,17.429454,49.77,percent of total billed charges,,,,31.518,90,percent of total billed charges,,,,33.269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.767,85,percent of total billed charges,,,,,,,,,17.429454,35.02,
SURGIFOAM SZ 12-7 1972,2703470,CDM,,,270,RC,outpatient,,,,10.3,5.665,,9.27,90,percent of total billed charges,,,,10.3,100,percent of total billed charges,,,,,,,,,9.27,,,fee schedule,,,8.24,,,fee schedule,,,,,,,,,,,,,,,,8.755,85,percent of total billed charges,,,,,,,,,,5.12631,49.77,percent of total billed charges,,,,9.27,90,percent of total billed charges,,,,9.785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.755,85,percent of total billed charges,,,,,,,,,5.12631,10.3,
GELFOAM SIZE 50,2703480,CDM,,,270,RC,outpatient,,,,49.955,27.47525,,44.9595,90,percent of total billed charges,,,,49.955,100,percent of total billed charges,,,,,,,,,44.9595,,,fee schedule,,,39.964,,,fee schedule,,,,,,,,,,,,,,,,42.46175,85,percent of total billed charges,,,,,,,,,,24.8626035,49.77,percent of total billed charges,,,,44.9595,90,percent of total billed charges,,,,47.45725,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.46175,85,percent of total billed charges,,,,,,,,,24.8626035,49.955,
LEG LIFTER,2703514,CDM,,,270,RC,outpatient,,,,12.36,6.798,,11.124,90,percent of total billed charges,,,,12.36,100,percent of total billed charges,,,,,,,,,11.124,,,fee schedule,,,9.888,,,fee schedule,,,,,,,,,,,,,,,,10.506,85,percent of total billed charges,,,,,,,,,,6.151572,49.77,percent of total billed charges,,,,11.124,90,percent of total billed charges,,,,11.742,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.506,85,percent of total billed charges,,,,,,,,,6.151572,12.36,
GIA LOAD UNIT,2703530,CDM,,,270,RC,outpatient,,,,197.76,108.768,,177.984,90,percent of total billed charges,,,,197.76,100,percent of total billed charges,,,,,,,,,177.984,,,fee schedule,,,158.208,,,fee schedule,,,,,,,,,,,,,,,,168.096,85,percent of total billed charges,,,,,,,,,,98.425152,49.77,percent of total billed charges,,,,177.984,90,percent of total billed charges,,,,187.872,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,168.096,85,percent of total billed charges,,,,,,,,,98.425152,197.76,
GIGLI SAW,2703540,CDM,,,270,RC,outpatient,,,,20.085,11.04675,,18.0765,90,percent of total billed charges,,,,20.085,100,percent of total billed charges,,,,,,,,,18.0765,,,fee schedule,,,16.068,,,fee schedule,,,,,,,,,,,,,,,,17.07225,85,percent of total billed charges,,,,,,,,,,9.9963045,49.77,percent of total billed charges,,,,18.0765,90,percent of total billed charges,,,,19.08075,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.07225,85,percent of total billed charges,,,,,,,,,9.9963045,20.085,
GLOVE HYPOALERGENIC,2703550,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
"GLOVES, STERILE SURGEON",2703570,CDM,,,270,RC,outpatient,,,,9.579,5.26845,,8.6211,90,percent of total billed charges,,,,9.579,100,percent of total billed charges,,,,,,,,,8.6211,,,fee schedule,,,7.6632,,,fee schedule,,,,,,,,,,,,,,,,8.14215,85,percent of total billed charges,,,,,,,,,,4.7674683,49.77,percent of total billed charges,,,,8.6211,90,percent of total billed charges,,,,9.10005,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.14215,85,percent of total billed charges,,,,,,,,,4.7674683,9.579,
GLYCINE - 3000ML BAG,2703600,CDM,,,270,RC,outpatient,,,,55.62,30.591,,50.058,90,percent of total billed charges,,,,55.62,100,percent of total billed charges,,,,,,,,,50.058,,,fee schedule,,,44.496,,,fee schedule,,,,,,,,,,,,,,,,47.277,85,percent of total billed charges,,,,,,,,,,27.682074,49.77,percent of total billed charges,,,,50.058,90,percent of total billed charges,,,,52.839,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,47.277,85,percent of total billed charges,,,,,,,,,27.682074,55.62,
CATH NAT LATEX - ALL,2703623,CDM,,,270,RC,outpatient,,,,91.155,50.13525,,82.0395,90,percent of total billed charges,,,,91.155,100,percent of total billed charges,,,,,,,,,82.0395,,,fee schedule,,,72.924,,,fee schedule,,,,,,,,,,,,,,,,77.48175,85,percent of total billed charges,,,,,,,,,,45.3678435,49.77,percent of total billed charges,,,,82.0395,90,percent of total billed charges,,,,86.59725,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,77.48175,85,percent of total billed charges,,,,,,,,,45.3678435,91.155,
"GOWN-ISOLATION, DISP - SINGLE",2703650,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
RC NEEDLE BIOMET 35 & 24MM,2703674,CDM,,,270,RC,outpatient,,,,288.915,158.90325,,260.0235,90,percent of total billed charges,,,,288.915,100,percent of total billed charges,,,,,,,,,260.0235,,,fee schedule,,,231.132,,,fee schedule,,,,,,,,,,,,,,,,245.57775,85,percent of total billed charges,,,,,,,,,,143.7929955,49.77,percent of total billed charges,,,,260.0235,90,percent of total billed charges,,,,274.46925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,245.57775,85,percent of total billed charges,,,,,,,,,143.7929955,288.915,
DRESSING STICK,2703689,CDM,,,270,RC,outpatient,,,,4.944,2.7192,,4.4496,90,percent of total billed charges,,,,4.944,100,percent of total billed charges,,,,,,,,,4.4496,,,fee schedule,,,3.9552,,,fee schedule,,,,,,,,,,,,,,,,4.2024,85,percent of total billed charges,,,,,,,,,,2.4606288,49.77,percent of total billed charges,,,,4.4496,90,percent of total billed charges,,,,4.6968,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.2024,85,percent of total billed charges,,,,,,,,,2.4606288,4.944,
DIABETIC SHOE NWB,2703691,CDM,,,270,RC,outpatient,,,,35.535,19.54425,,31.9815,90,percent of total billed charges,,,,35.535,100,percent of total billed charges,,,,,,,,,31.9815,,,fee schedule,,,28.428,,,fee schedule,,,,,,,,,,,,,,,,30.20475,85,percent of total billed charges,,,,,,,,,,17.6857695,49.77,percent of total billed charges,,,,31.9815,90,percent of total billed charges,,,,33.75825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.20475,85,percent of total billed charges,,,,,,,,,17.6857695,35.535,
HEEL PROTECTOR - FOAM,2703770,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
HEEL PROTECTOR - SHEEPSKIN,2703775,CDM,,,270,RC,outpatient,,,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,6.7671,,,fee schedule,,,6.0152,,,fee schedule,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,,3.7422063,49.77,percent of total billed charges,,,,6.7671,90,percent of total billed charges,,,,7.14305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,3.7422063,7.519,
PROBE COVER #PC 3787,2703787,CDM,,,270,RC,outpatient,,,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,,,,,,,12.4218,,,fee schedule,,,11.0416,,,fee schedule,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,,6.8692554,49.77,percent of total billed charges,,,,12.4218,90,percent of total billed charges,,,,13.1119,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,6.8692554,13.802,
HEMOVAC-MEDIUM,2703840,CDM,,,270,RC,outpatient,,,,104.133,57.27315,,93.7197,90,percent of total billed charges,,,,104.133,100,percent of total billed charges,,,,,,,,,93.7197,,,fee schedule,,,83.3064,,,fee schedule,,,,,,,,,,,,,,,,88.51305,85,percent of total billed charges,,,,,,,,,,51.8269941,49.77,percent of total billed charges,,,,93.7197,90,percent of total billed charges,,,,98.92635,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,88.51305,85,percent of total billed charges,,,,,,,,,51.8269941,104.133,
HIBICLENS 4OZ,2703860,CDM,,,270,RC,outpatient,,,,7.828,4.3054,,7.0452,90,percent of total billed charges,,,,7.828,100,percent of total billed charges,,,,,,,,,7.0452,,,fee schedule,,,6.2624,,,fee schedule,,,,,,,,,,,,,,,,6.6538,85,percent of total billed charges,,,,,,,,,,3.8959956,49.77,percent of total billed charges,,,,7.0452,90,percent of total billed charges,,,,7.4366,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.6538,85,percent of total billed charges,,,,,,,,,3.8959956,7.828,
IOBAN ISOLATION DRAPE,2703870,CDM,,,270,RC,outpatient,,,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,,,,,,,43.3836,,,fee schedule,,,38.5632,,,fee schedule,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,,23.9911308,49.77,percent of total billed charges,,,,43.3836,90,percent of total billed charges,,,,45.7938,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,23.9911308,48.204,
HOT-LINE FLUID WARMER SET,2703893,CDM,,,270,RC,outpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,24.5655,,,fee schedule,,,21.836,,,fee schedule,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,,13.5847215,49.77,percent of total billed charges,,,,24.5655,90,percent of total billed charges,,,,25.93025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,13.5847215,27.295,
HYDROGEN PEROXIDE 4 0,2703930,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
SUCTION/IRRIGATOR ASC1201,2703961,CDM,,,270,RC,outpatient,,,,86.314,47.4727,,77.6826,90,percent of total billed charges,,,,86.314,100,percent of total billed charges,,,,,,,,,77.6826,,,fee schedule,,,69.0512,,,fee schedule,,,,,,,,,,,,,,,,73.3669,85,percent of total billed charges,,,,,,,,,,42.9584778,49.77,percent of total billed charges,,,,77.6826,90,percent of total billed charges,,,,81.9983,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,73.3669,85,percent of total billed charges,,,,,,,,,42.9584778,86.314,
ILEOSTOMY APPLIANCE,2704010,CDM,,,270,RC,outpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
SHOULDER IMMOBILIZER,2704030,CDM,,,270,RC,outpatient,,,,12.463,6.85465,,11.2167,90,percent of total billed charges,,,,12.463,100,percent of total billed charges,,,,,,,,,11.2167,,,fee schedule,,,9.9704,,,fee schedule,,,,,,,,,,,,,,,,10.59355,85,percent of total billed charges,,,,,,,,,,6.2028351,49.77,percent of total billed charges,,,,11.2167,90,percent of total billed charges,,,,11.83985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.59355,85,percent of total billed charges,,,,,,,,,6.2028351,12.463,
IRRIGATOR,2704096,CDM,,,270,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,,,,,,,67.671,,,fee schedule,,,60.152,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,37.422063,75.19,
INPERSOL 1.5%,2704100,CDM,,,270,RC,outpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,42.5493,,,fee schedule,,,37.8216,,,fee schedule,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,,23.5297629,49.77,percent of total billed charges,,,,42.5493,90,percent of total billed charges,,,,44.91315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,23.5297629,47.277,
INTRODUCER SET - 7 FR,2704160,CDM,,,270,RC,outpatient,,,,99.807,54.89385,,89.8263,90,percent of total billed charges,,,,99.807,100,percent of total billed charges,,,,,,,,,89.8263,,,fee schedule,,,79.8456,,,fee schedule,,,,,,,,,,,,,,,,84.83595,85,percent of total billed charges,,,,,,,,,,49.6739439,49.77,percent of total billed charges,,,,89.8263,90,percent of total billed charges,,,,94.81665,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,84.83595,85,percent of total billed charges,,,,,,,,,49.6739439,99.807,
INTUBATING STYLET,2704170,CDM,,,270,RC,outpatient,,,,18.952,10.4236,,17.0568,90,percent of total billed charges,,,,18.952,100,percent of total billed charges,,,,,,,,,17.0568,,,fee schedule,,,15.1616,,,fee schedule,,,,,,,,,,,,,,,,16.1092,85,percent of total billed charges,,,,,,,,,,9.4324104,49.77,percent of total billed charges,,,,17.0568,90,percent of total billed charges,,,,18.0044,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.1092,85,percent of total billed charges,,,,,,,,,9.4324104,18.952,
IOBAN LARGE,2704180,CDM,,,270,RC,outpatient,,,,71.379,39.25845,,64.2411,90,percent of total billed charges,,,,71.379,100,percent of total billed charges,,,,,,,,,64.2411,,,fee schedule,,,57.1032,,,fee schedule,,,,,,,,,,,,,,,,60.67215,85,percent of total billed charges,,,,,,,,,,35.5253283,49.77,percent of total billed charges,,,,64.2411,90,percent of total billed charges,,,,67.81005,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,60.67215,85,percent of total billed charges,,,,,,,,,35.5253283,71.379,
IOBAN MEDIUM,2704190,CDM,,,270,RC,outpatient,,,,19.158,10.5369,,17.2422,90,percent of total billed charges,,,,19.158,100,percent of total billed charges,,,,,,,,,17.2422,,,fee schedule,,,15.3264,,,fee schedule,,,,,,,,,,,,,,,,16.2843,85,percent of total billed charges,,,,,,,,,,9.5349366,49.77,percent of total billed charges,,,,17.2422,90,percent of total billed charges,,,,18.2001,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.2843,85,percent of total billed charges,,,,,,,,,9.5349366,19.158,
IRRIGATION TRAY,2704220,CDM,,,270,RC,outpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,3.9861,,,fee schedule,,,3.5432,,,fee schedule,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,,2.2043133,49.77,percent of total billed charges,,,,3.9861,90,percent of total billed charges,,,,4.20755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,2.2043133,4.429,
ISOMIL 32 OZ CAN,2704250,CDM,,,270,RC,outpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
LONG HANDLED BATH SPONGE,2704251,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
IV BURETTE/ VOLUTROL,2704280,CDM,,,270,RC,outpatient,,,,35.329,19.43095,,31.7961,90,percent of total billed charges,,,,35.329,100,percent of total billed charges,,,,,,,,,31.7961,,,fee schedule,,,28.2632,,,fee schedule,,,,,,,,,,,,,,,,30.02965,85,percent of total billed charges,,,,,,,,,,17.5832433,49.77,percent of total billed charges,,,,31.7961,90,percent of total billed charges,,,,33.56255,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.02965,85,percent of total billed charges,,,,,,,,,17.5832433,35.329,
IV CATH JELCO,2704290,CDM,,,270,RC,outpatient,,,,7.931,4.36205,,7.1379,90,percent of total billed charges,,,,7.931,100,percent of total billed charges,,,,,,,,,7.1379,,,fee schedule,,,6.3448,,,fee schedule,,,,,,,,,,,,,,,,6.74135,85,percent of total billed charges,,,,,,,,,,3.9472587,49.77,percent of total billed charges,,,,7.1379,90,percent of total billed charges,,,,7.53445,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.74135,85,percent of total billed charges,,,,,,,,,3.9472587,7.931,
IV EXTENSION SET,2704300,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
IV FLOW CONTROL,2704310,CDM,,,270,RC,outpatient,,,,10.815,5.94825,,9.7335,90,percent of total billed charges,,,,10.815,100,percent of total billed charges,,,,,,,,,9.7335,,,fee schedule,,,8.652,,,fee schedule,,,,,,,,,,,,,,,,9.19275,85,percent of total billed charges,,,,,,,,,,5.3826255,49.77,percent of total billed charges,,,,9.7335,90,percent of total billed charges,,,,10.27425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.19275,85,percent of total billed charges,,,,,,,,,5.3826255,10.815,
"DERMATOME CUTTINGHEAD, BARD",2704367,CDM,,,270,RC,outpatient,,,,66.744,36.7092,,60.0696,90,percent of total billed charges,,,,66.744,100,percent of total billed charges,,,,,,,,,60.0696,,,fee schedule,,,53.3952,,,fee schedule,,,,,,,,,,,,,,,,56.7324,85,percent of total billed charges,,,,,,,,,,33.2184888,49.77,percent of total billed charges,,,,60.0696,90,percent of total billed charges,,,,63.4068,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,56.7324,85,percent of total billed charges,,,,,,,,,33.2184888,66.744,
IV SET V1464 PRIMARY,2704370,CDM,,,270,RC,outpatient,,,,6.592,3.6256,,5.9328,90,percent of total billed charges,,,,6.592,100,percent of total billed charges,,,,,,,,,5.9328,,,fee schedule,,,5.2736,,,fee schedule,,,,,,,,,,,,,,,,5.6032,85,percent of total billed charges,,,,,,,,,,3.2808384,49.77,percent of total billed charges,,,,5.9328,90,percent of total billed charges,,,,6.2624,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.6032,85,percent of total billed charges,,,,,,,,,3.2808384,6.592,
IV SET V1912 SECONDARY,2704380,CDM,,,270,RC,outpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,4.0788,,,fee schedule,,,3.6256,,,fee schedule,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,,2.2555764,49.77,percent of total billed charges,,,,4.0788,90,percent of total billed charges,,,,4.3054,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,2.2555764,4.532,
IV SET 805-25 DONOR,2704390,CDM,,,270,RC,outpatient,,,,7.004,3.8522,,6.3036,90,percent of total billed charges,,,,7.004,100,percent of total billed charges,,,,,,,,,6.3036,,,fee schedule,,,5.6032,,,fee schedule,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,,3.4858908,49.77,percent of total billed charges,,,,6.3036,90,percent of total billed charges,,,,6.6538,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.9534,85,percent of total billed charges,,,,,,,,,3.4858908,7.004,
IV SET 8955 BACKCHK,2704410,CDM,,,270,RC,outpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,3.8007,,,fee schedule,,,3.3784,,,fee schedule,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,,2.1017871,49.77,percent of total billed charges,,,,3.8007,90,percent of total billed charges,,,,4.01185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,2.1017871,4.223,
VIASYS STACKHOUSE VACCUM TUBE,2704422,CDM,,,270,RC,outpatient,,,,13.39,7.3645,,12.051,90,percent of total billed charges,,,,13.39,100,percent of total billed charges,,,,,,,,,12.051,,,fee schedule,,,10.712,,,fee schedule,,,,,,,,,,,,,,,,11.3815,85,percent of total billed charges,,,,,,,,,,6.664203,49.77,percent of total billed charges,,,,12.051,90,percent of total billed charges,,,,12.7205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.3815,85,percent of total billed charges,,,,,,,,,6.664203,13.39,
VIASYS STACKHOUSE TUBE REDUCER,2704423,CDM,,,270,RC,outpatient,,,,29.252,16.0886,,26.3268,90,percent of total billed charges,,,,29.252,100,percent of total billed charges,,,,,,,,,26.3268,,,fee schedule,,,23.4016,,,fee schedule,,,,,,,,,,,,,,,,24.8642,85,percent of total billed charges,,,,,,,,,,14.5587204,49.77,percent of total billed charges,,,,26.3268,90,percent of total billed charges,,,,27.7894,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.8642,85,percent of total billed charges,,,,,,,,,14.5587204,29.252,
IV START/CARE KIT,2704450,CDM,,,270,RC,outpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,4.0788,,,fee schedule,,,3.6256,,,fee schedule,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,,2.2555764,49.77,percent of total billed charges,,,,4.0788,90,percent of total billed charges,,,,4.3054,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,2.2555764,4.532,
IVAC BURETTE IV SET,2704460,CDM,,,270,RC,outpatient,,,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,23.2677,,,fee schedule,,,20.6824,,,fee schedule,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,,12.8670381,49.77,percent of total billed charges,,,,23.2677,90,percent of total billed charges,,,,24.56035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,12.8670381,25.853,
IVAC PUMP CASSETTE,2704470,CDM,,,270,RC,outpatient,,,,23.175,12.74625,,20.8575,90,percent of total billed charges,,,,23.175,100,percent of total billed charges,,,,,,,,,20.8575,,,fee schedule,,,18.54,,,fee schedule,,,,,,,,,,,,,,,,19.69875,85,percent of total billed charges,,,,,,,,,,11.5341975,49.77,percent of total billed charges,,,,20.8575,90,percent of total billed charges,,,,22.01625,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.69875,85,percent of total billed charges,,,,,,,,,11.5341975,23.175,
MAX CORE BIOPSY NEEDLE #MC1410,2704502,CDM,,,270,RC,outpatient,,,,105.163,57.83965,,94.6467,90,percent of total billed charges,,,,105.163,100,percent of total billed charges,,,,,,,,,94.6467,,,fee schedule,,,84.1304,,,fee schedule,,,,,,,,,,,,,,,,89.38855,85,percent of total billed charges,,,,,,,,,,52.3396251,49.77,percent of total billed charges,,,,94.6467,90,percent of total billed charges,,,,99.90485,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,89.38855,85,percent of total billed charges,,,,,,,,,52.3396251,105.163,
DISPOSABLE TOURNIQUET,2704515,CDM,,,270,RC,outpatient,,,,272.2805,149.754275,,245.05245,90,percent of total billed charges,,,,272.2805,100,percent of total billed charges,,,,,,,,,245.05245,,,fee schedule,,,217.8244,,,fee schedule,,,,,,,,,,,,,,,,231.438425,85,percent of total billed charges,,,,,,,,,,135.5140049,49.77,percent of total billed charges,,,,245.05245,90,percent of total billed charges,,,,258.666475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,231.438425,85,percent of total billed charges,,,,,,,,,135.5140049,272.2805,
SALINE HEPLOCK,2704520,CDM,,,270,RC,outpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,4.0788,,,fee schedule,,,3.6256,,,fee schedule,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,,2.2555764,49.77,percent of total billed charges,,,,4.0788,90,percent of total billed charges,,,,4.3054,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,2.2555764,4.532,
ARTHREX TWIST-IN-CANNULA,2704521,CDM,,,270,RC,outpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,51.6339,,,fee schedule,,,45.8968,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,28.5535467,57.371,
PE TUBE #240072,2704539,CDM,,,270,RC,outpatient,,,,97.335,53.53425,,87.6015,90,percent of total billed charges,,,,97.335,100,percent of total billed charges,,,,,,,,,87.6015,,,fee schedule,,,77.868,,,fee schedule,,,,,,,,,,,,,,,,82.73475,85,percent of total billed charges,,,,,,,,,,48.4436295,49.77,percent of total billed charges,,,,87.6015,90,percent of total billed charges,,,,92.46825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,82.73475,85,percent of total billed charges,,,,,,,,,48.4436295,97.335,
K-THERMIA UNIT (LARGE),2704540,CDM,,,270,RC,outpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,,,,,,,32.2596,,,fee schedule,,,28.6752,,,fee schedule,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,,17.8395588,49.77,percent of total billed charges,,,,32.2596,90,percent of total billed charges,,,,34.0518,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,17.8395588,35.844,
K WIRES,2704550,CDM,,,270,RC,outpatient,,,,64.272,35.3496,,57.8448,90,percent of total billed charges,,,,64.272,100,percent of total billed charges,,,,,,,,,57.8448,,,fee schedule,,,51.4176,,,fee schedule,,,,,,,,,,,,,,,,54.6312,85,percent of total billed charges,,,,,,,,,,31.9881744,49.77,percent of total billed charges,,,,57.8448,90,percent of total billed charges,,,,61.0584,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,54.6312,85,percent of total billed charges,,,,,,,,,31.9881744,64.272,
K WIRES THREADED,2704560,CDM,,,270,RC,outpatient,,,,194.052,106.7286,,174.6468,90,percent of total billed charges,,,,194.052,100,percent of total billed charges,,,,,,,,,174.6468,,,fee schedule,,,155.2416,,,fee schedule,,,,,,,,,,,,,,,,164.9442,85,percent of total billed charges,,,,,,,,,,96.5796804,49.77,percent of total billed charges,,,,174.6468,90,percent of total billed charges,,,,184.3494,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,164.9442,85,percent of total billed charges,,,,,,,,,96.5796804,194.052,
K-THERMIA PAD 24X69,2704580,CDM,,,270,RC,outpatient,,,,43.878,24.1329,,39.4902,90,percent of total billed charges,,,,43.878,100,percent of total billed charges,,,,,,,,,39.4902,,,fee schedule,,,35.1024,,,fee schedule,,,,,,,,,,,,,,,,37.2963,85,percent of total billed charges,,,,,,,,,,21.8380806,49.77,percent of total billed charges,,,,39.4902,90,percent of total billed charges,,,,41.6841,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.2963,85,percent of total billed charges,,,,,,,,,21.8380806,43.878,
K-THERMIA DISP PAD 18X24,2704590,CDM,,,270,RC,outpatient,,,,21.939,12.06645,,19.7451,90,percent of total billed charges,,,,21.939,100,percent of total billed charges,,,,,,,,,19.7451,,,fee schedule,,,17.5512,,,fee schedule,,,,,,,,,,,,,,,,18.64815,85,percent of total billed charges,,,,,,,,,,10.9190403,49.77,percent of total billed charges,,,,19.7451,90,percent of total billed charges,,,,20.84205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.64815,85,percent of total billed charges,,,,,,,,,10.9190403,21.939,
K-THERMIA LEG PAD 12X12,2704600,CDM,,,270,RC,outpatient,,,,21.939,12.06645,,19.7451,90,percent of total billed charges,,,,21.939,100,percent of total billed charges,,,,,,,,,19.7451,,,fee schedule,,,17.5512,,,fee schedule,,,,,,,,,,,,,,,,18.64815,85,percent of total billed charges,,,,,,,,,,10.9190403,49.77,percent of total billed charges,,,,19.7451,90,percent of total billed charges,,,,20.84205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.64815,85,percent of total billed charges,,,,,,,,,10.9190403,21.939,
MAX CORE BIOPSY #MC1410,2704601,CDM,,,270,RC,outpatient,,,,53.354,29.3447,,48.0186,90,percent of total billed charges,,,,53.354,100,percent of total billed charges,,,,,,,,,48.0186,,,fee schedule,,,42.6832,,,fee schedule,,,,,,,,,,,,,,,,45.3509,85,percent of total billed charges,,,,,,,,,,26.5542858,49.77,percent of total billed charges,,,,48.0186,90,percent of total billed charges,,,,50.6863,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,45.3509,85,percent of total billed charges,,,,,,,,,26.5542858,53.354,
K-WIRE COVERS,2704610,CDM,,,270,RC,outpatient,,,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
LIGHTWEIGHT REACHER,2704613,CDM,,,270,RC,outpatient,,,,12.978,7.1379,,11.6802,90,percent of total billed charges,,,,12.978,100,percent of total billed charges,,,,,,,,,11.6802,,,fee schedule,,,10.3824,,,fee schedule,,,,,,,,,,,,,,,,11.0313,85,percent of total billed charges,,,,,,,,,,6.4591506,49.77,percent of total billed charges,,,,11.6802,90,percent of total billed charges,,,,12.3291,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.0313,85,percent of total billed charges,,,,,,,,,6.4591506,12.978,
KARAYA PASTE & POWDER,2704620,CDM,A4406,HCPCS,270,RC,outpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
"STOMAHESIVE WAFER, ALL",2704631,CDM,,,270,RC,outpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,3.8007,,,fee schedule,,,3.3784,,,fee schedule,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,,2.1017871,49.77,percent of total billed charges,,,,3.8007,90,percent of total billed charges,,,,4.01185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,2.1017871,4.223,
KERLIX,2704650,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
KIDNEY STONE FILTER,2704660,CDM,,,270,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
PEANUTS,2704670,CDM,,,270,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
MEDTRONIC DOYLE II INTRANAS AS,2704671,CDM,,,270,RC,outpatient,,,,69.422,38.1821,,62.4798,90,percent of total billed charges,,,,69.422,100,percent of total billed charges,,,,,,,,,62.4798,,,fee schedule,,,55.5376,,,fee schedule,,,,,,,,,,,,,,,,59.0087,85,percent of total billed charges,,,,,,,,,,34.5513294,49.77,percent of total billed charges,,,,62.4798,90,percent of total billed charges,,,,65.9509,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,59.0087,85,percent of total billed charges,,,,,,,,,34.5513294,69.422,
KLING - ALL SIZES,2704690,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
KNEE SPLINT,2704710,CDM,,,270,RC,outpatient,,,,38.625,21.24375,,34.7625,90,percent of total billed charges,,,,38.625,100,percent of total billed charges,,,,,,,,,34.7625,,,fee schedule,,,30.9,,,fee schedule,,,,,,,,,,,,,,,,32.83125,85,percent of total billed charges,,,,,,,,,,19.2236625,49.77,percent of total billed charges,,,,34.7625,90,percent of total billed charges,,,,36.69375,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.83125,85,percent of total billed charges,,,,,,,,,19.2236625,38.625,
LACERATION TRAY,2704715,CDM,,,270,RC,outpatient,,,,12.772,7.0246,,11.4948,90,percent of total billed charges,,,,12.772,100,percent of total billed charges,,,,,,,,,11.4948,,,fee schedule,,,10.2176,,,fee schedule,,,,,,,,,,,,,,,,10.8562,85,percent of total billed charges,,,,,,,,,,6.3566244,49.77,percent of total billed charges,,,,11.4948,90,percent of total billed charges,,,,12.1334,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.8562,85,percent of total billed charges,,,,,,,,,6.3566244,12.772,
KOPAN LOCALIZER NEEDLE,2704730,CDM,,,270,RC,outpatient,,,,73.13,40.2215,,65.817,90,percent of total billed charges,,,,73.13,100,percent of total billed charges,,,,,,,,,65.817,,,fee schedule,,,58.504,,,fee schedule,,,,,,,,,,,,,,,,62.1605,85,percent of total billed charges,,,,,,,,,,36.396801,49.77,percent of total billed charges,,,,65.817,90,percent of total billed charges,,,,69.4735,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,62.1605,85,percent of total billed charges,,,,,,,,,36.396801,73.13,
KUGEL HERNIA PATCH; LGE OVAL,2704741,CDM,,,270,RC,outpatient,,,,658.582,362.2201,,592.7238,90,percent of total billed charges,,,,658.582,100,percent of total billed charges,,,,,,,,,592.7238,,,fee schedule,,,526.8656,,,fee schedule,,,,,,,,,,,,,,,,559.7947,85,percent of total billed charges,,,,,,,,,,327.7762614,49.77,percent of total billed charges,,,,592.7238,90,percent of total billed charges,,,,625.6529,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,559.7947,85,percent of total billed charges,,,,,,,,,327.7762614,658.582,
LACRIMAL SET/JACKSON,2704750,CDM,,,270,RC,outpatient,,,,136.99,75.3445,,123.291,90,percent of total billed charges,,,,136.99,100,percent of total billed charges,,,,,,,,,123.291,,,fee schedule,,,109.592,,,fee schedule,,,,,,,,,,,,,,,,116.4415,85,percent of total billed charges,,,,,,,,,,68.179923,49.77,percent of total billed charges,,,,123.291,90,percent of total billed charges,,,,130.1405,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,116.4415,85,percent of total billed charges,,,,,,,,,68.179923,136.99,
LAP CHOLECYSTECTOMY PACK,2704752,CDM,,,270,RC,outpatient,,,,136.784,75.2312,,123.1056,90,percent of total billed charges,,,,136.784,100,percent of total billed charges,,,,,,,,,123.1056,,,fee schedule,,,109.4272,,,fee schedule,,,,,,,,,,,,,,,,116.2664,85,percent of total billed charges,,,,,,,,,,68.0773968,49.77,percent of total billed charges,,,,123.1056,90,percent of total billed charges,,,,129.9448,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,116.2664,85,percent of total billed charges,,,,,,,,,68.0773968,136.784,
LAPARTOMY PACKS VI,2704770,CDM,,,270,RC,outpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,,,,,,,30.4056,,,fee schedule,,,27.0272,,,fee schedule,,,,,,,,,,,,,,,,28.7164,85,percent of total billed charges,,,,,,,,,,16.8142968,49.77,percent of total billed charges,,,,30.4056,90,percent of total billed charges,,,,32.0948,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.7164,85,percent of total billed charges,,,,,,,,,16.8142968,33.784,
LAP SPONGES,2704780,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
GRANEE NEEDLE,2704841,CDM,,,270,RC,outpatient,,,,108.356,59.5958,,97.5204,90,percent of total billed charges,,,,108.356,100,percent of total billed charges,,,,,,,,,97.5204,,,fee schedule,,,86.6848,,,fee schedule,,,,,,,,,,,,,,,,92.1026,85,percent of total billed charges,,,,,,,,,,53.9287812,49.77,percent of total billed charges,,,,97.5204,90,percent of total billed charges,,,,102.9382,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,92.1026,85,percent of total billed charges,,,,,,,,,53.9287812,108.356,
LIGAMENT PROSTHESIS,2704890,CDM,,,270,RC,outpatient,,,,58.813,32.34715,,52.9317,90,percent of total billed charges,,,,58.813,100,percent of total billed charges,,,,,,,,,52.9317,,,fee schedule,,,47.0504,,,fee schedule,,,,,,,,,,,,,,,,49.99105,85,percent of total billed charges,,,,,,,,,,29.2712301,49.77,percent of total billed charges,,,,52.9317,90,percent of total billed charges,,,,55.87235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,49.99105,85,percent of total billed charges,,,,,,,,,29.2712301,58.813,
LIMB HOLDER,2704900,CDM,,,270,RC,outpatient,,,,3.09,1.6995,,2.781,90,percent of total billed charges,,,,3.09,100,percent of total billed charges,,,,,,,,,2.781,,,fee schedule,,,2.472,,,fee schedule,,,,,,,,,,,,,,,,2.6265,85,percent of total billed charges,,,,,,,,,,1.537893,49.77,percent of total billed charges,,,,2.781,90,percent of total billed charges,,,,2.9355,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.6265,85,percent of total billed charges,,,,,,,,,1.537893,3.09,
LUKI TUBE,2704990,CDM,,,270,RC,outpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,3.8007,,,fee schedule,,,3.3784,,,fee schedule,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,,2.1017871,49.77,percent of total billed charges,,,,3.8007,90,percent of total billed charges,,,,4.01185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,2.1017871,4.223,
LUMBAR PUNCTURE TRAY,2705000,CDM,,,270,RC,outpatient,,,,41.715,22.94325,,37.5435,90,percent of total billed charges,,,,41.715,100,percent of total billed charges,,,,,,,,,37.5435,,,fee schedule,,,33.372,,,fee schedule,,,,,,,,,,,,,,,,35.45775,85,percent of total billed charges,,,,,,,,,,20.7615555,49.77,percent of total billed charges,,,,37.5435,90,percent of total billed charges,,,,39.62925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.45775,85,percent of total billed charges,,,,,,,,,20.7615555,41.715,
MAJOR BASIN,2705030,CDM,,,270,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,,,,,,,107.3466,,,fee schedule,,,95.4192,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,59.3626698,119.274,
MALICOT CATHETER,2705040,CDM,,,270,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,,,,,,,46.4427,,,fee schedule,,,41.2824,,,fee schedule,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,,,,,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,,,,,,,25.6828131,51.603,
LARGE TOWEL DRAPE (DYNJSD1010),2705095,CDM,,,270,RC,outpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,3.9861,,,fee schedule,,,3.5432,,,fee schedule,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,,2.2043133,49.77,percent of total billed charges,,,,3.9861,90,percent of total billed charges,,,,4.20755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,2.2043133,4.429,
TABLE COVER 24X53 & 44X76,2705100,CDM,,,270,RC,outpatient,,,,4.532,2.4926,,4.0788,90,percent of total billed charges,,,,4.532,100,percent of total billed charges,,,,,,,,,4.0788,,,fee schedule,,,3.6256,,,fee schedule,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,,2.2555764,49.77,percent of total billed charges,,,,4.0788,90,percent of total billed charges,,,,4.3054,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.8522,85,percent of total billed charges,,,,,,,,,2.2555764,4.532,
MEDICAL ADHESIVE,2705120,CDM,,,270,RC,outpatient,,,,81.473,44.81015,,73.3257,90,percent of total billed charges,,,,81.473,100,percent of total billed charges,,,,,,,,,73.3257,,,fee schedule,,,65.1784,,,fee schedule,,,,,,,,,,,,,,,,69.25205,85,percent of total billed charges,,,,,,,,,,40.5491121,49.77,percent of total billed charges,,,,73.3257,90,percent of total billed charges,,,,77.39935,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,69.25205,85,percent of total billed charges,,,,,,,,,40.5491121,81.473,
CHLORA PREP 26ml,2705123,CDM,,,270,RC,outpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,24.5655,,,fee schedule,,,21.836,,,fee schedule,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,,13.5847215,49.77,percent of total billed charges,,,,24.5655,90,percent of total billed charges,,,,25.93025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,13.5847215,27.295,
MINOR BASIN,2705170,CDM,,,270,RC,outpatient,,,,52.633,28.94815,,47.3697,90,percent of total billed charges,,,,52.633,100,percent of total billed charges,,,,,,,,,47.3697,,,fee schedule,,,42.1064,,,fee schedule,,,,,,,,,,,,,,,,44.73805,85,percent of total billed charges,,,,,,,,,,26.1954441,49.77,percent of total billed charges,,,,47.3697,90,percent of total billed charges,,,,50.00135,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,44.73805,85,percent of total billed charges,,,,,,,,,26.1954441,52.633,
BASIC PACK,2705180,CDM,,,270,RC,outpatient,,,,22.557,12.40635,,20.3013,90,percent of total billed charges,,,,22.557,100,percent of total billed charges,,,,,,,,,20.3013,,,fee schedule,,,18.0456,,,fee schedule,,,,,,,,,,,,,,,,19.17345,85,percent of total billed charges,,,,,,,,,,11.2266189,49.77,percent of total billed charges,,,,20.3013,90,percent of total billed charges,,,,21.42915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.17345,85,percent of total billed charges,,,,,,,,,11.2266189,22.557,
"CATHETER,FOLEY 16F/10CC",2705185,CDM,,,270,RC,outpatient,,,,5.562,3.0591,,5.0058,90,percent of total billed charges,,,,5.562,100,percent of total billed charges,,,,,,,,,5.0058,,,fee schedule,,,4.4496,,,fee schedule,,,,,,,,,,,,,,,,4.7277,85,percent of total billed charges,,,,,,,,,,2.7682074,49.77,percent of total billed charges,,,,5.0058,90,percent of total billed charges,,,,5.2839,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.7277,85,percent of total billed charges,,,,,,,,,2.7682074,5.562,
MONITOR ELECTRODES,2705190,CDM,,,270,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
MULTI LIMEN CATH KIT 30,2705200,CDM,,,270,RC,outpatient,,,,189.108,104.0094,,170.1972,90,percent of total billed charges,,,,189.108,100,percent of total billed charges,,,,,,,,,170.1972,,,fee schedule,,,151.2864,,,fee schedule,,,,,,,,,,,,,,,,160.7418,85,percent of total billed charges,,,,,,,,,,94.1190516,49.77,percent of total billed charges,,,,170.1972,90,percent of total billed charges,,,,179.6526,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,160.7418,85,percent of total billed charges,,,,,,,,,94.1190516,189.108,
NASO-PHARYN AIRWAY,2705270,CDM,,,270,RC,outpatient,,,,55.62,30.591,,50.058,90,percent of total billed charges,,,,55.62,100,percent of total billed charges,,,,,,,,,50.058,,,fee schedule,,,44.496,,,fee schedule,,,,,,,,,,,,,,,,47.277,85,percent of total billed charges,,,,,,,,,,27.682074,49.77,percent of total billed charges,,,,50.058,90,percent of total billed charges,,,,52.839,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,47.277,85,percent of total billed charges,,,,,,,,,27.682074,55.62,
PERINEAL COLD PACK,2705275,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
SPOT INK #GIS-44,2705286,CDM,,,270,RC,outpatient,,,,57.989,31.89395,,52.1901,90,percent of total billed charges,,,,57.989,100,percent of total billed charges,,,,,,,,,52.1901,,,fee schedule,,,46.3912,,,fee schedule,,,,,,,,,,,,,,,,49.29065,85,percent of total billed charges,,,,,,,,,,28.8611253,49.77,percent of total billed charges,,,,52.1901,90,percent of total billed charges,,,,55.08955,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,49.29065,85,percent of total billed charges,,,,,,,,,28.8611253,57.989,
SPINAL NEEDLE,2705290,CDM,,,270,RC,outpatient,,,,34.608,19.0344,,31.1472,90,percent of total billed charges,,,,34.608,100,percent of total billed charges,,,,,,,,,31.1472,,,fee schedule,,,27.6864,,,fee schedule,,,,,,,,,,,,,,,,29.4168,85,percent of total billed charges,,,,,,,,,,17.2244016,49.77,percent of total billed charges,,,,31.1472,90,percent of total billed charges,,,,32.8776,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.4168,85,percent of total billed charges,,,,,,,,,17.2244016,34.608,
NEEDLE COUNTERS,2705300,CDM,,,270,RC,outpatient,,,,4.223,2.32265,,3.8007,90,percent of total billed charges,,,,4.223,100,percent of total billed charges,,,,,,,,,3.8007,,,fee schedule,,,3.3784,,,fee schedule,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,,2.1017871,49.77,percent of total billed charges,,,,3.8007,90,percent of total billed charges,,,,4.01185,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.58955,85,percent of total billed charges,,,,,,,,,2.1017871,4.223,
NEEDLES,2705320,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
FOLEY CATHETER TRAY,2705321,CDM,,,270,RC,outpatient,,,,32.96,18.128,,29.664,90,percent of total billed charges,,,,32.96,100,percent of total billed charges,,,,,,,,,29.664,,,fee schedule,,,26.368,,,fee schedule,,,,,,,,,,,,,,,,28.016,85,percent of total billed charges,,,,,,,,,,16.404192,49.77,percent of total billed charges,,,,29.664,90,percent of total billed charges,,,,31.312,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.016,85,percent of total billed charges,,,,,,,,,16.404192,32.96,
UNIVERSAL BREATHING CIRCUIT,2705325,CDM,,,270,RC,outpatient,,,,13.905,7.64775,,12.5145,90,percent of total billed charges,,,,13.905,100,percent of total billed charges,,,,,,,,,12.5145,,,fee schedule,,,11.124,,,fee schedule,,,,,,,,,,,,,,,,11.81925,85,percent of total billed charges,,,,,,,,,,6.9205185,49.77,percent of total billed charges,,,,12.5145,90,percent of total billed charges,,,,13.20975,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.81925,85,percent of total billed charges,,,,,,,,,6.9205185,13.905,
NEPHROSTOMY SET,2705340,CDM,,,270,RC,outpatient,,,,263.371,144.85405,,237.0339,90,percent of total billed charges,,,,263.371,100,percent of total billed charges,,,,,,,,,237.0339,,,fee schedule,,,210.6968,,,fee schedule,,,,,,,,,,,,,,,,223.86535,85,percent of total billed charges,,,,,,,,,,131.0797467,49.77,percent of total billed charges,,,,237.0339,90,percent of total billed charges,,,,250.20245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,223.86535,85,percent of total billed charges,,,,,,,,,131.0797467,263.371,
ENDO GIA UNIVERSAL STAPLER,2705345,CDM,,,270,RC,outpatient,,,,240.711,132.39105,,216.6399,90,percent of total billed charges,,,,240.711,100,percent of total billed charges,,,,,,,,,216.6399,,,fee schedule,,,192.5688,,,fee schedule,,,,,,,,,,,,,,,,204.60435,85,percent of total billed charges,,,,,,,,,,119.8018647,49.77,percent of total billed charges,,,,216.6399,90,percent of total billed charges,,,,228.67545,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,204.60435,85,percent of total billed charges,,,,,,,,,119.8018647,240.711,
NG TUBE HOLDER,2705360,CDM,,,270,RC,outpatient,,,,6.489,3.56895,,5.8401,90,percent of total billed charges,,,,6.489,100,percent of total billed charges,,,,,,,,,5.8401,,,fee schedule,,,5.1912,,,fee schedule,,,,,,,,,,,,,,,,5.51565,85,percent of total billed charges,,,,,,,,,,3.2295753,49.77,percent of total billed charges,,,,5.8401,90,percent of total billed charges,,,,6.16455,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.51565,85,percent of total billed charges,,,,,,,,,3.2295753,6.489,
NIPPLE SHIELD,2705370,CDM,,,270,RC,outpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,24.5655,,,fee schedule,,,21.836,,,fee schedule,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,,13.5847215,49.77,percent of total billed charges,,,,24.5655,90,percent of total billed charges,,,,25.93025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,13.5847215,27.295,
MASIMO SENSOR PEDI #1767,2705373,CDM,,,270,RC,outpatient,,,,49.955,27.47525,,44.9595,90,percent of total billed charges,,,,49.955,100,percent of total billed charges,,,,,,,,,44.9595,,,fee schedule,,,39.964,,,fee schedule,,,,,,,,,,,,,,,,42.46175,85,percent of total billed charges,,,,,,,,,,24.8626035,49.77,percent of total billed charges,,,,44.9595,90,percent of total billed charges,,,,47.45725,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.46175,85,percent of total billed charges,,,,,,,,,24.8626035,49.955,
MEROCEL NASAL PACKING,2705390,CDM,,,270,RC,outpatient,,,,32.342,17.7881,,29.1078,90,percent of total billed charges,,,,32.342,100,percent of total billed charges,,,,,,,,,29.1078,,,fee schedule,,,25.8736,,,fee schedule,,,,,,,,,,,,,,,,27.4907,85,percent of total billed charges,,,,,,,,,,16.0966134,49.77,percent of total billed charges,,,,29.1078,90,percent of total billed charges,,,,30.7249,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.4907,85,percent of total billed charges,,,,,,,,,16.0966134,32.342,
NUGAUZE,2705400,CDM,,,270,RC,outpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
OB/GYN PACK III,2705420,CDM,,,270,RC,outpatient,,,,46.865,25.77575,,42.1785,90,percent of total billed charges,,,,46.865,100,percent of total billed charges,,,,,,,,,42.1785,,,fee schedule,,,37.492,,,fee schedule,,,,,,,,,,,,,,,,39.83525,85,percent of total billed charges,,,,,,,,,,23.3247105,49.77,percent of total billed charges,,,,42.1785,90,percent of total billed charges,,,,44.52175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,39.83525,85,percent of total billed charges,,,,,,,,,23.3247105,46.865,
HORIZON PRIMARY TUBING,2705430,CDM,,,270,RC,outpatient,,,,12.875,7.08125,,11.5875,90,percent of total billed charges,,,,12.875,100,percent of total billed charges,,,,,,,,,11.5875,,,fee schedule,,,10.3,,,fee schedule,,,,,,,,,,,,,,,,10.94375,85,percent of total billed charges,,,,,,,,,,6.4078875,49.77,percent of total billed charges,,,,11.5875,90,percent of total billed charges,,,,12.23125,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.94375,85,percent of total billed charges,,,,,,,,,6.4078875,12.875,
HORIZON TNG TUBING,2705440,CDM,,,270,RC,outpatient,,,,22.042,12.1231,,19.8378,90,percent of total billed charges,,,,22.042,100,percent of total billed charges,,,,,,,,,19.8378,,,fee schedule,,,17.6336,,,fee schedule,,,,,,,,,,,,,,,,18.7357,85,percent of total billed charges,,,,,,,,,,10.9703034,49.77,percent of total billed charges,,,,19.8378,90,percent of total billed charges,,,,20.9399,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.7357,85,percent of total billed charges,,,,,,,,,10.9703034,22.042,
OP-SITE,2705460,CDM,,,270,RC,outpatient,,,,24.102,13.2561,,21.6918,90,percent of total billed charges,,,,24.102,100,percent of total billed charges,,,,,,,,,21.6918,,,fee schedule,,,19.2816,,,fee schedule,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,,11.9955654,49.77,percent of total billed charges,,,,21.6918,90,percent of total billed charges,,,,22.8969,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.4867,85,percent of total billed charges,,,,,,,,,11.9955654,24.102,
ORAL/NASAL AIRWAY,2705480,CDM,,,270,RC,outpatient,,,,5.253,2.88915,,4.7277,90,percent of total billed charges,,,,5.253,100,percent of total billed charges,,,,,,,,,4.7277,,,fee schedule,,,4.2024,,,fee schedule,,,,,,,,,,,,,,,,4.46505,85,percent of total billed charges,,,,,,,,,,2.6144181,49.77,percent of total billed charges,,,,4.7277,90,percent of total billed charges,,,,4.99035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.46505,85,percent of total billed charges,,,,,,,,,2.6144181,5.253,
ORTHO BLUE CURETTE,2705490,CDM,,,270,RC,outpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,36.153,,,fee schedule,,,32.136,,,fee schedule,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,19.992609,40.17,
MIC KEY FEEDING TUBE 2.7,2705497,CDM,,,270,RC,outpatient,,,,176.645,97.15475,,158.9805,90,percent of total billed charges,,,,176.645,100,percent of total billed charges,,,,,,,,,158.9805,,,fee schedule,,,141.316,,,fee schedule,,,,,,,,,,,,,,,,150.14825,85,percent of total billed charges,,,,,,,,,,87.9162165,49.77,percent of total billed charges,,,,158.9805,90,percent of total billed charges,,,,167.81275,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,150.14825,85,percent of total billed charges,,,,,,,,,87.9162165,176.645,
ORTHO SORB K WIRES,2705510,CDM,,,270,RC,outpatient,,,,264.813,145.64715,,238.3317,90,percent of total billed charges,,,,264.813,100,percent of total billed charges,,,,,,,,,238.3317,,,fee schedule,,,211.8504,,,fee schedule,,,,,,,,,,,,,,,,225.09105,85,percent of total billed charges,,,,,,,,,,131.7974301,49.77,percent of total billed charges,,,,238.3317,90,percent of total billed charges,,,,251.57235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,225.09105,85,percent of total billed charges,,,,,,,,,131.7974301,264.813,
UNDERBUTTOCKS DRAPE DYNJP6002,2705552,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
O2 MASK,2705560,CDM,,,270,RC,outpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,3.6153,,,fee schedule,,,3.2136,,,fee schedule,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,,1.9992609,49.77,percent of total billed charges,,,,3.6153,90,percent of total billed charges,,,,3.81615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,1.9992609,4.017,
VAC CANNISTER SET,2705562,CDM,,,270,RC,outpatient,,,,92.391,50.81505,,83.1519,90,percent of total billed charges,,,,92.391,100,percent of total billed charges,,,,,,,,,83.1519,,,fee schedule,,,73.9128,,,fee schedule,,,,,,,,,,,,,,,,78.53235,85,percent of total billed charges,,,,,,,,,,45.9830007,49.77,percent of total billed charges,,,,83.1519,90,percent of total billed charges,,,,87.77145,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,78.53235,85,percent of total billed charges,,,,,,,,,45.9830007,92.391,
SUTURE PER PACK,2705599,CDM,,,270,RC,outpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,,,,,,,49.9653,,,fee schedule,,,44.4136,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,27.6308109,55.517,
PARACENTESIS TRAY,2705620,CDM,,,270,RC,outpatient,,,,120.716,66.3938,,108.6444,90,percent of total billed charges,,,,120.716,100,percent of total billed charges,,,,,,,,,108.6444,,,fee schedule,,,96.5728,,,fee schedule,,,,,,,,,,,,,,,,102.6086,85,percent of total billed charges,,,,,,,,,,60.0803532,49.77,percent of total billed charges,,,,108.6444,90,percent of total billed charges,,,,114.6802,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,102.6086,85,percent of total billed charges,,,,,,,,,60.0803532,120.716,
PARR IRRIGATION SYS,2705630,CDM,,,270,RC,outpatient,,,,87.138,47.9259,,78.4242,90,percent of total billed charges,,,,87.138,100,percent of total billed charges,,,,,,,,,78.4242,,,fee schedule,,,69.7104,,,fee schedule,,,,,,,,,,,,,,,,74.0673,85,percent of total billed charges,,,,,,,,,,43.3685826,49.77,percent of total billed charges,,,,78.4242,90,percent of total billed charges,,,,82.7811,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,74.0673,85,percent of total billed charges,,,,,,,,,43.3685826,87.138,
PAS AIR PUMP SYSTEM,2705650,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
PAS STOCKING,2705670,CDM,,,270,RC,outpatient,,,,36.977,20.33735,,33.2793,90,percent of total billed charges,,,,36.977,100,percent of total billed charges,,,,,,,,,33.2793,,,fee schedule,,,29.5816,,,fee schedule,,,,,,,,,,,,,,,,31.43045,85,percent of total billed charges,,,,,,,,,,18.4034529,49.77,percent of total billed charges,,,,33.2793,90,percent of total billed charges,,,,35.12815,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,31.43045,85,percent of total billed charges,,,,,,,,,18.4034529,36.977,
CRE 18-20mm #M00558380,2705697,CDM,,,270,RC,outpatient,,,,346.183,190.40065,,311.5647,90,percent of total billed charges,,,,346.183,100,percent of total billed charges,,,,,,,,,311.5647,,,fee schedule,,,276.9464,,,fee schedule,,,,,,,,,,,,,,,,294.25555,85,percent of total billed charges,,,,,,,,,,172.2952791,49.77,percent of total billed charges,,,,311.5647,90,percent of total billed charges,,,,328.87385,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,294.25555,85,percent of total billed charges,,,,,,,,,172.2952791,346.183,
GOLD PROBE #M00560070,2705698,CDM,,,270,RC,outpatient,,,,346.183,190.40065,,311.5647,90,percent of total billed charges,,,,346.183,100,percent of total billed charges,,,,,,,,,311.5647,,,fee schedule,,,276.9464,,,fee schedule,,,,,,,,,,,,,,,,294.25555,85,percent of total billed charges,,,,,,,,,,172.2952791,49.77,percent of total billed charges,,,,311.5647,90,percent of total billed charges,,,,328.87385,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,294.25555,85,percent of total billed charges,,,,,,,,,172.2952791,346.183,
PEDI BAG,2705700,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
TEVDEK - ALL,2705701,CDM,,,270,RC,outpatient,,,,21.733,11.95315,,19.5597,90,percent of total billed charges,,,,21.733,100,percent of total billed charges,,,,,,,,,19.5597,,,fee schedule,,,17.3864,,,fee schedule,,,,,,,,,,,,,,,,18.47305,85,percent of total billed charges,,,,,,,,,,10.8165141,49.77,percent of total billed charges,,,,19.5597,90,percent of total billed charges,,,,20.64635,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.47305,85,percent of total billed charges,,,,,,,,,10.8165141,21.733,
U-DRAPE,2705734,CDM,,,270,RC,outpatient,,,,54.487,29.96785,,49.0383,90,percent of total billed charges,,,,54.487,100,percent of total billed charges,,,,,,,,,49.0383,,,fee schedule,,,43.5896,,,fee schedule,,,,,,,,,,,,,,,,46.31395,85,percent of total billed charges,,,,,,,,,,27.1181799,49.77,percent of total billed charges,,,,49.0383,90,percent of total billed charges,,,,51.76265,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,46.31395,85,percent of total billed charges,,,,,,,,,27.1181799,54.487,
PNEUPAC VENT CIRCUIT,2705735,CDM,,,270,RC,outpatient,,,,54.487,29.96785,,49.0383,90,percent of total billed charges,,,,54.487,100,percent of total billed charges,,,,,,,,,49.0383,,,fee schedule,,,43.5896,,,fee schedule,,,,,,,,,,,,,,,,46.31395,85,percent of total billed charges,,,,,,,,,,27.1181799,49.77,percent of total billed charges,,,,49.0383,90,percent of total billed charges,,,,51.76265,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,46.31395,85,percent of total billed charges,,,,,,,,,27.1181799,54.487,
ENSEAL 35cm #ETSDC-01,2705743,CDM,,,270,RC,outpatient,,,,753.342,414.3381,,678.0078,90,percent of total billed charges,,,,753.342,100,percent of total billed charges,,,,,,,,,678.0078,,,fee schedule,,,602.6736,,,fee schedule,,,,,,,,,,,,,,,,640.3407,85,percent of total billed charges,,,,,,,,,,374.9383134,49.77,percent of total billed charges,,,,678.0078,90,percent of total billed charges,,,,715.6749,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,640.3407,85,percent of total billed charges,,,,,,,,,374.9383134,753.342,
PENROSE DRAIN,2705770,CDM,,,270,RC,outpatient,,,,7.931,4.36205,,7.1379,90,percent of total billed charges,,,,7.931,100,percent of total billed charges,,,,,,,,,7.1379,,,fee schedule,,,6.3448,,,fee schedule,,,,,,,,,,,,,,,,6.74135,85,percent of total billed charges,,,,,,,,,,3.9472587,49.77,percent of total billed charges,,,,7.1379,90,percent of total billed charges,,,,7.53445,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.74135,85,percent of total billed charges,,,,,,,,,3.9472587,7.931,
NOVASURE DEVICE KIT #NS2000,2705795,CDM,,,270,RC,outpatient,,,,2063.811,1135.09605,,1857.4299,90,percent of total billed charges,,,,2063.811,100,percent of total billed charges,,,,,,,,,1857.4299,,,fee schedule,,,1651.0488,,,fee schedule,,,,,,,,,,,,,,,,1754.23935,85,percent of total billed charges,,,,,,,,,,1027.158735,49.77,percent of total billed charges,,,,1857.4299,90,percent of total billed charges,,,,1960.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1754.23935,85,percent of total billed charges,,,,,,,,,1027.158735,2063.811,
PERINEAL SOLUTION,2705800,CDM,,,270,RC,outpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
HYDRO-SURG #0026870,2705805,CDM,,,270,RC,outpatient,,,,186.636,102.6498,,167.9724,90,percent of total billed charges,,,,186.636,100,percent of total billed charges,,,,,,,,,167.9724,,,fee schedule,,,149.3088,,,fee schedule,,,,,,,,,,,,,,,,158.6406,85,percent of total billed charges,,,,,,,,,,92.8887372,49.77,percent of total billed charges,,,,167.9724,90,percent of total billed charges,,,,177.3042,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,158.6406,85,percent of total billed charges,,,,,,,,,92.8887372,186.636,
ENDO PEANUT #173019,2705808,CDM,,,270,RC,outpatient,,,,67.362,37.0491,,60.6258,90,percent of total billed charges,,,,67.362,100,percent of total billed charges,,,,,,,,,60.6258,,,fee schedule,,,53.8896,,,fee schedule,,,,,,,,,,,,,,,,57.2577,85,percent of total billed charges,,,,,,,,,,33.5260674,49.77,percent of total billed charges,,,,60.6258,90,percent of total billed charges,,,,63.9939,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,57.2577,85,percent of total billed charges,,,,,,,,,33.5260674,67.362,
PERITONEAL CATH CON,2705820,CDM,,,270,RC,outpatient,,,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
XEROFORM PADS,2705850,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
INSPACE LARGE,2705857,CDM,,,270,RC,outpatient,,,,14832,8157.6,,13348.8,90,percent of total billed charges,,,,14832,100,percent of total billed charges,,,,,,,,,13348.8,,,fee schedule,,,11865.6,,,fee schedule,,,,,,,,,,,,,,,,12607.2,85,percent of total billed charges,,,,,,,,,,7381.8864,49.77,percent of total billed charges,,,,13348.8,90,percent of total billed charges,,,,14090.4,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12607.2,85,percent of total billed charges,,,,,,,,,7381.8864,14832,
PEZZAR STYLET,2705870,CDM,,,270,RC,outpatient,,,,108.665,59.76575,,97.7985,90,percent of total billed charges,,,,108.665,100,percent of total billed charges,,,,,,,,,97.7985,,,fee schedule,,,86.932,,,fee schedule,,,,,,,,,,,,,,,,92.36525,85,percent of total billed charges,,,,,,,,,,54.0825705,49.77,percent of total billed charges,,,,97.7985,90,percent of total billed charges,,,,103.23175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,92.36525,85,percent of total billed charges,,,,,,,,,54.0825705,108.665,
APPLIED 15MM #COR37,2705896,CDM,,,270,RC,outpatient,,,,107.841,59.31255,,97.0569,90,percent of total billed charges,,,,107.841,100,percent of total billed charges,,,,,,,,,97.0569,,,fee schedule,,,86.2728,,,fee schedule,,,,,,,,,,,,,,,,91.66485,85,percent of total billed charges,,,,,,,,,,53.6724657,49.77,percent of total billed charges,,,,97.0569,90,percent of total billed charges,,,,102.44895,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,91.66485,85,percent of total billed charges,,,,,,,,,53.6724657,107.841,
"FIBERWIRE C-13 38""",2705898,CDM,,,270,RC,outpatient,,,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,,,,,,,45.5157,,,fee schedule,,,40.4584,,,fee schedule,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,,,,,,,,25.1701821,49.77,percent of total billed charges,,,,45.5157,90,percent of total billed charges,,,,48.04435,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,,,,,,,25.1701821,50.573,
ARTHROSCOPY DRAIN/W/FLUID COLL,2705932,CDM,,,270,RC,outpatient,,,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,,,,,,,93.9051,,,fee schedule,,,83.4712,,,fee schedule,,,,,,,,,,,,,,,,88.68815,85,percent of total billed charges,,,,,,,,,,51.9295203,49.77,percent of total billed charges,,,,93.9051,90,percent of total billed charges,,,,99.12205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,88.68815,85,percent of total billed charges,,,,,,,,,51.9295203,104.339,
APPLIED HUSSAN TROCAR,2705939,CDM,,,270,RC,outpatient,,,,65.096,35.8028,,58.5864,90,percent of total billed charges,,,,65.096,100,percent of total billed charges,,,,,,,,,58.5864,,,fee schedule,,,52.0768,,,fee schedule,,,,,,,,,,,,,,,,55.3316,85,percent of total billed charges,,,,,,,,,,32.3982792,49.77,percent of total billed charges,,,,58.5864,90,percent of total billed charges,,,,61.8412,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,55.3316,85,percent of total billed charges,,,,,,,,,32.3982792,65.096,
BOVIE PAD,2705940,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
APPLIED BAG #CD001,2705942,CDM,,,270,RC,outpatient,,,,42.539,23.39645,,38.2851,90,percent of total billed charges,,,,42.539,100,percent of total billed charges,,,,,,,,,38.2851,,,fee schedule,,,34.0312,,,fee schedule,,,,,,,,,,,,,,,,36.15815,85,percent of total billed charges,,,,,,,,,,21.1716603,49.77,percent of total billed charges,,,,38.2851,90,percent of total billed charges,,,,40.41205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,36.15815,85,percent of total billed charges,,,,,,,,,21.1716603,42.539,
APPLIED 13GA #C2201,2705943,CDM,,,270,RC,outpatient,,,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,,,,,,,35.1333,,,fee schedule,,,31.2296,,,fee schedule,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,,,,,,,,19.4287149,49.77,percent of total billed charges,,,,35.1333,90,percent of total billed charges,,,,37.08515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,,,,,,,19.4287149,39.037,
POST-OP SHOE ALL,2705950,CDM,,,270,RC,outpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,42.5493,,,fee schedule,,,37.8216,,,fee schedule,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,,23.5297629,49.77,percent of total billed charges,,,,42.5493,90,percent of total billed charges,,,,44.91315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,23.5297629,47.277,
QUICKTRACH 4MM,2705953,CDM,,,270,RC,outpatient,,,,271.714,149.4427,,244.5426,90,percent of total billed charges,,,,271.714,100,percent of total billed charges,,,,,,,,,244.5426,,,fee schedule,,,217.3712,,,fee schedule,,,,,,,,,,,,,,,,230.9569,85,percent of total billed charges,,,,,,,,,,135.2320578,49.77,percent of total billed charges,,,,244.5426,90,percent of total billed charges,,,,258.1283,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,230.9569,85,percent of total billed charges,,,,,,,,,135.2320578,271.714,
POSTOP STER ELECTRO,2705960,CDM,,,270,RC,outpatient,,,,38.728,21.3004,,34.8552,90,percent of total billed charges,,,,38.728,100,percent of total billed charges,,,,,,,,,34.8552,,,fee schedule,,,30.9824,,,fee schedule,,,,,,,,,,,,,,,,32.9188,85,percent of total billed charges,,,,,,,,,,19.2749256,49.77,percent of total billed charges,,,,34.8552,90,percent of total billed charges,,,,36.7916,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.9188,85,percent of total billed charges,,,,,,,,,19.2749256,38.728,
UNI STAPLER ROTIC 60 LOAD,2705998,CDM,,,270,RC,outpatient,,,,402.112,221.1616,,361.9008,90,percent of total billed charges,,,,402.112,100,percent of total billed charges,,,,,,,,,361.9008,,,fee schedule,,,321.6896,,,fee schedule,,,,,,,,,,,,,,,,341.7952,85,percent of total billed charges,,,,,,,,,,200.1311424,49.77,percent of total billed charges,,,,361.9008,90,percent of total billed charges,,,,382.0064,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,341.7952,85,percent of total billed charges,,,,,,,,,200.1311424,402.112,
APPLIED GELPORT #C8XX2,2706006,CDM,,,270,RC,outpatient,,,,988.594,543.7267,,889.7346,90,percent of total billed charges,,,,988.594,100,percent of total billed charges,,,,,,,,,889.7346,,,fee schedule,,,790.8752,,,fee schedule,,,,,,,,,,,,,,,,840.3049,85,percent of total billed charges,,,,,,,,,,492.0232338,49.77,percent of total billed charges,,,,889.7346,90,percent of total billed charges,,,,939.1643,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,840.3049,85,percent of total billed charges,,,,,,,,,492.0232338,988.594,
COUDE CATH W/5CC BALLOON 16FR,2706009,CDM,,,270,RC,outpatient,,,,23.999,13.19945,,21.5991,90,percent of total billed charges,,,,23.999,100,percent of total billed charges,,,,,,,,,21.5991,,,fee schedule,,,19.1992,,,fee schedule,,,,,,,,,,,,,,,,20.39915,85,percent of total billed charges,,,,,,,,,,11.9443023,49.77,percent of total billed charges,,,,21.5991,90,percent of total billed charges,,,,22.79905,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.39915,85,percent of total billed charges,,,,,,,,,11.9443023,23.999,
PREP TRAY,2706020,CDM,,,270,RC,outpatient,,,,11.845,6.51475,,10.6605,90,percent of total billed charges,,,,11.845,100,percent of total billed charges,,,,,,,,,10.6605,,,fee schedule,,,9.476,,,fee schedule,,,,,,,,,,,,,,,,10.06825,85,percent of total billed charges,,,,,,,,,,5.8952565,49.77,percent of total billed charges,,,,10.6605,90,percent of total billed charges,,,,11.25275,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.06825,85,percent of total billed charges,,,,,,,,,5.8952565,11.845,
PREPERITONEAL DISTENT BALLOON,2706025,CDM,,,270,RC,outpatient,,,,666.616,366.6388,,599.9544,90,percent of total billed charges,,,,666.616,100,percent of total billed charges,,,,,,,,,599.9544,,,fee schedule,,,533.2928,,,fee schedule,,,,,,,,,,,,,,,,566.6236,85,percent of total billed charges,,,,,,,,,,331.7747832,49.77,percent of total billed charges,,,,599.9544,90,percent of total billed charges,,,,633.2852,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,566.6236,85,percent of total billed charges,,,,,,,,,331.7747832,666.616,
PROVIDONE SWABSTICK,2706060,CDM,,,270,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
FEEDING PUMP BAG,2706070,CDM,,,270,RC,outpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,36.153,,,fee schedule,,,32.136,,,fee schedule,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,19.992609,40.17,
NEURO PATTY #DMA1003,2706073,CDM,,,270,RC,outpatient,,,,4.017,2.20935,,3.6153,90,percent of total billed charges,,,,4.017,100,percent of total billed charges,,,,,,,,,3.6153,,,fee schedule,,,3.2136,,,fee schedule,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,,1.9992609,49.77,percent of total billed charges,,,,3.6153,90,percent of total billed charges,,,,3.81615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.41445,85,percent of total billed charges,,,,,,,,,1.9992609,4.017,
BAG FLOW #650,2706075,CDM,,,270,RC,outpatient,,,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
PUMP SET,2706080,CDM,,,270,RC,outpatient,,,,13.39,7.3645,,12.051,90,percent of total billed charges,,,,13.39,100,percent of total billed charges,,,,,,,,,12.051,,,fee schedule,,,10.712,,,fee schedule,,,,,,,,,,,,,,,,11.3815,85,percent of total billed charges,,,,,,,,,,6.664203,49.77,percent of total billed charges,,,,12.051,90,percent of total billed charges,,,,12.7205,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.3815,85,percent of total billed charges,,,,,,,,,6.664203,13.39,
PUMP TUBING,2706090,CDM,,,270,RC,outpatient,,,,144.2,79.31,,129.78,90,percent of total billed charges,,,,144.2,100,percent of total billed charges,,,,,,,,,129.78,,,fee schedule,,,115.36,,,fee schedule,,,,,,,,,,,,,,,,122.57,85,percent of total billed charges,,,,,,,,,,71.76834,49.77,percent of total billed charges,,,,129.78,90,percent of total billed charges,,,,136.99,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,122.57,85,percent of total billed charges,,,,,,,,,71.76834,144.2,
CONTOUR STAPLER #CS40G,2706094,CDM,,,270,RC,outpatient,,,,442.694,243.4817,,398.4246,90,percent of total billed charges,,,,442.694,100,percent of total billed charges,,,,,,,,,398.4246,,,fee schedule,,,354.1552,,,fee schedule,,,,,,,,,,,,,,,,376.2899,85,percent of total billed charges,,,,,,,,,,220.3288038,49.77,percent of total billed charges,,,,398.4246,90,percent of total billed charges,,,,420.5593,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,376.2899,85,percent of total billed charges,,,,,,,,,220.3288038,442.694,
CONTOUR LOAD #CR40G,2706095,CDM,,,270,RC,outpatient,,,,296.331,162.98205,,266.6979,90,percent of total billed charges,,,,296.331,100,percent of total billed charges,,,,,,,,,266.6979,,,fee schedule,,,237.0648,,,fee schedule,,,,,,,,,,,,,,,,251.88135,85,percent of total billed charges,,,,,,,,,,147.4839387,49.77,percent of total billed charges,,,,266.6979,90,percent of total billed charges,,,,281.51445,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,251.88135,85,percent of total billed charges,,,,,,,,,147.4839387,296.331,
PURSE STRING,2706100,CDM,,,270,RC,outpatient,,,,318.682,175.2751,,286.8138,90,percent of total billed charges,,,,318.682,100,percent of total billed charges,,,,,,,,,286.8138,,,fee schedule,,,254.9456,,,fee schedule,,,,,,,,,,,,,,,,270.8797,85,percent of total billed charges,,,,,,,,,,158.6080314,49.77,percent of total billed charges,,,,286.8138,90,percent of total billed charges,,,,302.7479,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,270.8797,85,percent of total billed charges,,,,,,,,,158.6080314,318.682,
ABLATOR 90o 4m,2706146,CDM,,,270,RC,outpatient,,,,355.35,195.4425,,319.815,90,percent of total billed charges,,,,355.35,100,percent of total billed charges,,,,,,,,,319.815,,,fee schedule,,,284.28,,,fee schedule,,,,,,,,,,,,,,,,302.0475,85,percent of total billed charges,,,,,,,,,,176.857695,49.77,percent of total billed charges,,,,319.815,90,percent of total billed charges,,,,337.5825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,302.0475,85,percent of total billed charges,,,,,,,,,176.857695,355.35,
LAVH DRAPE - MEDLINE,2706152,CDM,,,270,RC,outpatient,,,,39.243,21.58365,,35.3187,90,percent of total billed charges,,,,39.243,100,percent of total billed charges,,,,,,,,,35.3187,,,fee schedule,,,31.3944,,,fee schedule,,,,,,,,,,,,,,,,33.35655,85,percent of total billed charges,,,,,,,,,,19.5312411,49.77,percent of total billed charges,,,,35.3187,90,percent of total billed charges,,,,37.28085,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.35655,85,percent of total billed charges,,,,,,,,,19.5312411,39.243,
LINVATEC 9mm SAWBLADE,2706158,CDM,,,270,RC,outpatient,,,,238.754,131.3147,,214.8786,90,percent of total billed charges,,,,238.754,100,percent of total billed charges,,,,,,,,,214.8786,,,fee schedule,,,191.0032,,,fee schedule,,,,,,,,,,,,,,,,202.9409,85,percent of total billed charges,,,,,,,,,,118.8278658,49.77,percent of total billed charges,,,,214.8786,90,percent of total billed charges,,,,226.8163,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,202.9409,85,percent of total billed charges,,,,,,,,,118.8278658,238.754,
REINF STRIPS 4X30,2706160,CDM,,,270,RC,outpatient,,,,31.93,17.5615,,28.737,90,percent of total billed charges,,,,31.93,100,percent of total billed charges,,,,,,,,,28.737,,,fee schedule,,,25.544,,,fee schedule,,,,,,,,,,,,,,,,27.1405,85,percent of total billed charges,,,,,,,,,,15.891561,49.77,percent of total billed charges,,,,28.737,90,percent of total billed charges,,,,30.3335,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.1405,85,percent of total billed charges,,,,,,,,,15.891561,31.93,
4-PORT MANIFOLD (FILTER),2706162,CDM,,,270,RC,outpatient,,,,63.86,35.123,,57.474,90,percent of total billed charges,,,,63.86,100,percent of total billed charges,,,,,,,,,57.474,,,fee schedule,,,51.088,,,fee schedule,,,,,,,,,,,,,,,,54.281,85,percent of total billed charges,,,,,,,,,,31.783122,49.77,percent of total billed charges,,,,57.474,90,percent of total billed charges,,,,60.667,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,54.281,85,percent of total billed charges,,,,,,,,,31.783122,63.86,
RIB BELT ELASTIC-AL,2706180,CDM,,,270,RC,outpatient,,,,10.3,5.665,,9.27,90,percent of total billed charges,,,,10.3,100,percent of total billed charges,,,,,,,,,9.27,,,fee schedule,,,8.24,,,fee schedule,,,,,,,,,,,,,,,,8.755,85,percent of total billed charges,,,,,,,,,,5.12631,49.77,percent of total billed charges,,,,9.27,90,percent of total billed charges,,,,9.785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.755,85,percent of total billed charges,,,,,,,,,5.12631,10.3,
TRICUT 4mm #1884004HR,2706193,CDM,,,270,RC,outpatient,,,,365.238,200.8809,,328.7142,90,percent of total billed charges,,,,365.238,100,percent of total billed charges,,,,,,,,,328.7142,,,fee schedule,,,292.1904,,,fee schedule,,,,,,,,,,,,,,,,310.4523,85,percent of total billed charges,,,,,,,,,,181.7789526,49.77,percent of total billed charges,,,,328.7142,90,percent of total billed charges,,,,346.9761,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,310.4523,85,percent of total billed charges,,,,,,,,,181.7789526,365.238,
SINUS BLADE,2706196,CDM,,,270,RC,outpatient,,,,566.294,311.4617,,509.6646,90,percent of total billed charges,,,,566.294,100,percent of total billed charges,,,,,,,,,509.6646,,,fee schedule,,,453.0352,,,fee schedule,,,,,,,,,,,,,,,,481.3499,85,percent of total billed charges,,,,,,,,,,281.8445238,49.77,percent of total billed charges,,,,509.6646,90,percent of total billed charges,,,,537.9793,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,481.3499,85,percent of total billed charges,,,,,,,,,281.8445238,566.294,
SINUS SHEATH,2706197,CDM,,,270,RC,outpatient,,,,126.484,69.5662,,113.8356,90,percent of total billed charges,,,,126.484,100,percent of total billed charges,,,,,,,,,113.8356,,,fee schedule,,,101.1872,,,fee schedule,,,,,,,,,,,,,,,,107.5114,85,percent of total billed charges,,,,,,,,,,62.9510868,49.77,percent of total billed charges,,,,113.8356,90,percent of total billed charges,,,,120.1598,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,107.5114,85,percent of total billed charges,,,,,,,,,62.9510868,126.484,
ROLLER BALL ELEC,2706210,CDM,,,270,RC,outpatient,,,,77.147,42.43085,,69.4323,90,percent of total billed charges,,,,77.147,100,percent of total billed charges,,,,,,,,,69.4323,,,fee schedule,,,61.7176,,,fee schedule,,,,,,,,,,,,,,,,65.57495,85,percent of total billed charges,,,,,,,,,,38.3960619,49.77,percent of total billed charges,,,,69.4323,90,percent of total billed charges,,,,73.28965,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,65.57495,85,percent of total billed charges,,,,,,,,,38.3960619,77.147,
ROTH RETRIEVAL,2706220,CDM,,,270,RC,outpatient,,,,111.24,61.182,,100.116,90,percent of total billed charges,,,,111.24,100,percent of total billed charges,,,,,,,,,100.116,,,fee schedule,,,88.992,,,fee schedule,,,,,,,,,,,,,,,,94.554,85,percent of total billed charges,,,,,,,,,,55.364148,49.77,percent of total billed charges,,,,100.116,90,percent of total billed charges,,,,105.678,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,94.554,85,percent of total billed charges,,,,,,,,,55.364148,111.24,
ROUTINE DRESSING TR,2706240,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
SANITARY PAD,2706280,CDM,,,270,RC,outpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,3.2445,,,fee schedule,,,2.884,,,fee schedule,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,,1.7942085,49.77,percent of total billed charges,,,,3.2445,90,percent of total billed charges,,,,3.42475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,1.7942085,3.605,
SCALPEL BLADE - DISPOSABLE,2706310,CDM,,,270,RC,outpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
MAGNETIC DRAPE #DYNJMDS1,2706318,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
SCROTAL SUPPORT,2706350,CDM,,,270,RC,outpatient,,,,29.046,15.9753,,26.1414,90,percent of total billed charges,,,,29.046,100,percent of total billed charges,,,,,,,,,26.1414,,,fee schedule,,,23.2368,,,fee schedule,,,,,,,,,,,,,,,,24.6891,85,percent of total billed charges,,,,,,,,,,14.4561942,49.77,percent of total billed charges,,,,26.1414,90,percent of total billed charges,,,,27.5937,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.6891,85,percent of total billed charges,,,,,,,,,14.4561942,29.046,
SENSOR GUARD,2706400,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
"GEL PACK LG 9X12"" ACCURATE MFG",2706405,CDM,,,270,RC,outpatient,,,,6.695,3.68225,,6.0255,90,percent of total billed charges,,,,6.695,100,percent of total billed charges,,,,,,,,,6.0255,,,fee schedule,,,5.356,,,fee schedule,,,,,,,,,,,,,,,,5.69075,85,percent of total billed charges,,,,,,,,,,3.3321015,49.77,percent of total billed charges,,,,6.0255,90,percent of total billed charges,,,,6.36025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.69075,85,percent of total billed charges,,,,,,,,,3.3321015,6.695,
"GEL PACK SM 5x9""",2706406,CDM,,,270,RC,outpatient,,,,4.944,2.7192,,4.4496,90,percent of total billed charges,,,,4.944,100,percent of total billed charges,,,,,,,,,4.4496,,,fee schedule,,,3.9552,,,fee schedule,,,,,,,,,,,,,,,,4.2024,85,percent of total billed charges,,,,,,,,,,2.4606288,49.77,percent of total billed charges,,,,4.4496,90,percent of total billed charges,,,,4.6968,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.2024,85,percent of total billed charges,,,,,,,,,2.4606288,4.944,
APPLIED RETRACTOR LG #G6313,2706412,CDM,,,270,RC,outpatient,,,,172.628,94.9454,,155.3652,90,percent of total billed charges,,,,172.628,100,percent of total billed charges,,,,,,,,,155.3652,,,fee schedule,,,138.1024,,,fee schedule,,,,,,,,,,,,,,,,146.7338,85,percent of total billed charges,,,,,,,,,,85.9169556,49.77,percent of total billed charges,,,,155.3652,90,percent of total billed charges,,,,163.9966,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,146.7338,85,percent of total billed charges,,,,,,,,,85.9169556,172.628,
SHEET 3/4 TABLE COVER,2706460,CDM,,,270,RC,outpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
ENDOCLIP APPLIER ALL,2706566,CDM,,,270,RC,outpatient,,,,389.752,214.3636,,350.7768,90,percent of total billed charges,,,,389.752,100,percent of total billed charges,,,,,,,,,350.7768,,,fee schedule,,,311.8016,,,fee schedule,,,,,,,,,,,,,,,,331.2892,85,percent of total billed charges,,,,,,,,,,193.9795704,49.77,percent of total billed charges,,,,350.7768,90,percent of total billed charges,,,,370.2644,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,331.2892,85,percent of total billed charges,,,,,,,,,193.9795704,389.752,
SILICON SUMP TUBE,2706590,CDM,,,270,RC,outpatient,,,,48.307,26.56885,,43.4763,90,percent of total billed charges,,,,48.307,100,percent of total billed charges,,,,,,,,,43.4763,,,fee schedule,,,38.6456,,,fee schedule,,,,,,,,,,,,,,,,41.06095,85,percent of total billed charges,,,,,,,,,,24.0423939,49.77,percent of total billed charges,,,,43.4763,90,percent of total billed charges,,,,45.89165,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,41.06095,85,percent of total billed charges,,,,,,,,,24.0423939,48.307,
SILVERLON 4X12,2706603,CDM,,,270,RC,outpatient,,,,76.941,42.31755,,69.2469,90,percent of total billed charges,,,,76.941,100,percent of total billed charges,,,,,,,,,69.2469,,,fee schedule,,,61.5528,,,fee schedule,,,,,,,,,,,,,,,,65.39985,85,percent of total billed charges,,,,,,,,,,38.2935357,49.77,percent of total billed charges,,,,69.2469,90,percent of total billed charges,,,,73.09395,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,65.39985,85,percent of total billed charges,,,,,,,,,38.2935357,76.941,
SLINGSHOT 2 A&A SLING,2706624,CDM,,,270,RC,outpatient,,,,139.874,76.9307,,125.8866,90,percent of total billed charges,,,,139.874,100,percent of total billed charges,,,,,,,,,125.8866,,,fee schedule,,,111.8992,,,fee schedule,,,,,,,,,,,,,,,,118.8929,85,percent of total billed charges,,,,,,,,,,69.6152898,49.77,percent of total billed charges,,,,125.8866,90,percent of total billed charges,,,,132.8803,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,118.8929,85,percent of total billed charges,,,,,,,,,69.6152898,139.874,
SINGLE SLOT HD SCRE,2706660,CDM,,,270,RC,outpatient,,,,38.728,21.3004,,34.8552,90,percent of total billed charges,,,,38.728,100,percent of total billed charges,,,,,,,,,34.8552,,,fee schedule,,,30.9824,,,fee schedule,,,,,,,,,,,,,,,,32.9188,85,percent of total billed charges,,,,,,,,,,19.2749256,49.77,percent of total billed charges,,,,34.8552,90,percent of total billed charges,,,,36.7916,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.9188,85,percent of total billed charges,,,,,,,,,19.2749256,38.728,
SITZ BATH,2706670,CDM,,,270,RC,outpatient,,,,6.489,3.56895,,5.8401,90,percent of total billed charges,,,,6.489,100,percent of total billed charges,,,,,,,,,5.8401,,,fee schedule,,,5.1912,,,fee schedule,,,,,,,,,,,,,,,,5.51565,85,percent of total billed charges,,,,,,,,,,3.2295753,49.77,percent of total billed charges,,,,5.8401,90,percent of total billed charges,,,,6.16455,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.51565,85,percent of total billed charges,,,,,,,,,3.2295753,6.489,
SKIN BARRIER BIK 8X,2706690,CDM,,,270,RC,outpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,,,,,,,36.153,,,fee schedule,,,32.136,,,fee schedule,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,19.992609,40.17,
SKIN STAPLE REMOVER,2706750,CDM,,,270,RC,outpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
SLING & SWATHE,2706810,CDM,,,270,RC,outpatient,,,,68.495,37.67225,,61.6455,90,percent of total billed charges,,,,68.495,100,percent of total billed charges,,,,,,,,,61.6455,,,fee schedule,,,54.796,,,fee schedule,,,,,,,,,,,,,,,,58.22075,85,percent of total billed charges,,,,,,,,,,34.0899615,49.77,percent of total billed charges,,,,61.6455,90,percent of total billed charges,,,,65.07025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,58.22075,85,percent of total billed charges,,,,,,,,,34.0899615,68.495,
SNAP COVER C-ARM DRAPE,2706840,CDM,,,270,RC,outpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SORBAVIEW DRESSING,2706910,CDM,,,270,RC,outpatient,,,,7.622,4.1921,,6.8598,90,percent of total billed charges,,,,7.622,100,percent of total billed charges,,,,,,,,,6.8598,,,fee schedule,,,6.0976,,,fee schedule,,,,,,,,,,,,,,,,6.4787,85,percent of total billed charges,,,,,,,,,,3.7934694,49.77,percent of total billed charges,,,,6.8598,90,percent of total billed charges,,,,7.2409,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.4787,85,percent of total billed charges,,,,,,,,,3.7934694,7.622,
TRANSPEC CONTAINER,2706940,CDM,,,270,RC,outpatient,,,,51.397,28.26835,,46.2573,90,percent of total billed charges,,,,51.397,100,percent of total billed charges,,,,,,,,,46.2573,,,fee schedule,,,41.1176,,,fee schedule,,,,,,,,,,,,,,,,43.68745,85,percent of total billed charges,,,,,,,,,,25.5802869,49.77,percent of total billed charges,,,,46.2573,90,percent of total billed charges,,,,48.82715,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,43.68745,85,percent of total billed charges,,,,,,,,,25.5802869,51.397,
SPINAL ANES. SET,2706950,CDM,,,270,RC,outpatient,,,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,23.2677,,,fee schedule,,,20.6824,,,fee schedule,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,,12.8670381,49.77,percent of total billed charges,,,,23.2677,90,percent of total billed charges,,,,24.56035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,12.8670381,25.853,
APPLIED ACCESS SHEATH B7016,2707016,CDM,,,270,RC,outpatient,,,,190.55,104.8025,,171.495,90,percent of total billed charges,,,,190.55,100,percent of total billed charges,,,,,,,,,171.495,,,fee schedule,,,152.44,,,fee schedule,,,,,,,,,,,,,,,,161.9675,85,percent of total billed charges,,,,,,,,,,94.836735,49.77,percent of total billed charges,,,,171.495,90,percent of total billed charges,,,,181.0225,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,161.9675,85,percent of total billed charges,,,,,,,,,94.836735,190.55,
SPLINT POST FEMUR S,2707020,CDM,,,270,RC,outpatient,,,,131.325,72.22875,,118.1925,90,percent of total billed charges,,,,131.325,100,percent of total billed charges,,,,,,,,,118.1925,,,fee schedule,,,105.06,,,fee schedule,,,,,,,,,,,,,,,,111.62625,85,percent of total billed charges,,,,,,,,,,65.3604525,49.77,percent of total billed charges,,,,118.1925,90,percent of total billed charges,,,,124.75875,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,111.62625,85,percent of total billed charges,,,,,,,,,65.3604525,131.325,
CHOLANG KIT# CS-01700,2707021,CDM,,,270,RC,outpatient,,,,209.811,115.39605,,188.8299,90,percent of total billed charges,,,,209.811,100,percent of total billed charges,,,,,,,,,188.8299,,,fee schedule,,,167.8488,,,fee schedule,,,,,,,,,,,,,,,,178.33935,85,percent of total billed charges,,,,,,,,,,104.4229347,49.77,percent of total billed charges,,,,188.8299,90,percent of total billed charges,,,,199.32045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,178.33935,85,percent of total billed charges,,,,,,,,,104.4229347,209.811,
ENDO CLIP LG# 176625,2707022,CDM,,,270,RC,outpatient,,,,239.063,131.48465,,215.1567,90,percent of total billed charges,,,,239.063,100,percent of total billed charges,,,,,,,,,215.1567,,,fee schedule,,,191.2504,,,fee schedule,,,,,,,,,,,,,,,,203.20355,85,percent of total billed charges,,,,,,,,,,118.9816551,49.77,percent of total billed charges,,,,215.1567,90,percent of total billed charges,,,,227.10985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,203.20355,85,percent of total billed charges,,,,,,,,,118.9816551,239.063,
SURETRANS $8592000,2707031,CDM,,,270,RC,outpatient,,,,697.207,383.46385,,627.4863,90,percent of total billed charges,,,,697.207,100,percent of total billed charges,,,,,,,,,627.4863,,,fee schedule,,,557.7656,,,fee schedule,,,,,,,,,,,,,,,,592.62595,85,percent of total billed charges,,,,,,,,,,346.9999239,49.77,percent of total billed charges,,,,627.4863,90,percent of total billed charges,,,,662.34665,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,592.62595,85,percent of total billed charges,,,,,,,,,346.9999239,697.207,
SPLINT FOREARM,2707075,CDM,,,270,RC,outpatient,,,,15.656,8.6108,,14.0904,90,percent of total billed charges,,,,15.656,100,percent of total billed charges,,,,,,,,,14.0904,,,fee schedule,,,12.5248,,,fee schedule,,,,,,,,,,,,,,,,13.3076,85,percent of total billed charges,,,,,,,,,,7.7919912,49.77,percent of total billed charges,,,,14.0904,90,percent of total billed charges,,,,14.8732,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.3076,85,percent of total billed charges,,,,,,,,,7.7919912,15.656,
GELFOAM SPONGE SZ 100,2707087,CDM,,,270,RC,outpatient,,,,36.153,19.88415,,32.5377,90,percent of total billed charges,,,,36.153,100,percent of total billed charges,,,,,,,,,32.5377,,,fee schedule,,,28.9224,,,fee schedule,,,,,,,,,,,,,,,,30.73005,85,percent of total billed charges,,,,,,,,,,17.9933481,49.77,percent of total billed charges,,,,32.5377,90,percent of total billed charges,,,,34.34535,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.73005,85,percent of total billed charges,,,,,,,,,17.9933481,36.153,
TALON GRASPING DEVICE,2707111,CDM,,,270,RC,outpatient,,,,149.041,81.97255,,134.1369,90,percent of total billed charges,,,,149.041,100,percent of total billed charges,,,,,,,,,134.1369,,,fee schedule,,,119.2328,,,fee schedule,,,,,,,,,,,,,,,,126.68485,85,percent of total billed charges,,,,,,,,,,74.1777057,49.77,percent of total billed charges,,,,134.1369,90,percent of total billed charges,,,,141.58895,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,126.68485,85,percent of total billed charges,,,,,,,,,74.1777057,149.041,
PLASTER BANDAGE J&J,2707120,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
SPLIT SHEET ENT,2707125,CDM,,,270,RC,outpatient,,,,12.978,7.1379,,11.6802,90,percent of total billed charges,,,,12.978,100,percent of total billed charges,,,,,,,,,11.6802,,,fee schedule,,,10.3824,,,fee schedule,,,,,,,,,,,,,,,,11.0313,85,percent of total billed charges,,,,,,,,,,6.4591506,49.77,percent of total billed charges,,,,11.6802,90,percent of total billed charges,,,,12.3291,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.0313,85,percent of total billed charges,,,,,,,,,6.4591506,12.978,
SPRING CLIP (BULLDOG),2707130,CDM,,,270,RC,outpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,24.5655,,,fee schedule,,,21.836,,,fee schedule,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,,13.5847215,49.77,percent of total billed charges,,,,24.5655,90,percent of total billed charges,,,,25.93025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,13.5847215,27.295,
ARTHREX FIBERWIRE #AR7201,2707201,CDM,,,270,RC,outpatient,,,,80.237,44.13035,,72.2133,90,percent of total billed charges,,,,80.237,100,percent of total billed charges,,,,,,,,,72.2133,,,fee schedule,,,64.1896,,,fee schedule,,,,,,,,,,,,,,,,68.20145,85,percent of total billed charges,,,,,,,,,,39.9339549,49.77,percent of total billed charges,,,,72.2133,90,percent of total billed charges,,,,76.22515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,68.20145,85,percent of total billed charges,,,,,,,,,39.9339549,80.237,
STERI-STRIP,2707220,CDM,,,270,RC,outpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,3.9861,,,fee schedule,,,3.5432,,,fee schedule,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,,2.2043133,49.77,percent of total billed charges,,,,3.9861,90,percent of total billed charges,,,,4.20755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,2.2043133,4.429,
STERILE CONNECTOR S,2707240,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
STERILE IRRIG SOLUTION,2707250,CDM,,,270,RC,outpatient,,,,14.626,8.0443,,13.1634,90,percent of total billed charges,,,,14.626,100,percent of total billed charges,,,,,,,,,13.1634,,,fee schedule,,,11.7008,,,fee schedule,,,,,,,,,,,,,,,,12.4321,85,percent of total billed charges,,,,,,,,,,7.2793602,49.77,percent of total billed charges,,,,13.1634,90,percent of total billed charges,,,,13.8947,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.4321,85,percent of total billed charges,,,,,,,,,7.2793602,14.626,
STERILE TUBN POST-O,2707290,CDM,,,270,RC,outpatient,,,,95.79,52.6845,,86.211,90,percent of total billed charges,,,,95.79,100,percent of total billed charges,,,,,,,,,86.211,,,fee schedule,,,76.632,,,fee schedule,,,,,,,,,,,,,,,,81.4215,85,percent of total billed charges,,,,,,,,,,47.674683,49.77,percent of total billed charges,,,,86.211,90,percent of total billed charges,,,,91.0005,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,81.4215,85,percent of total billed charges,,,,,,,,,47.674683,95.79,
STERILE WATER 1000 CC,2707300,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
STERILE WATER 500cc,2707301,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
BIOPATCH PROTECTIVE DISK W/CHG,2707304,CDM,,,270,RC,outpatient,,,,16.377,9.00735,,14.7393,90,percent of total billed charges,,,,16.377,100,percent of total billed charges,,,,,,,,,14.7393,,,fee schedule,,,13.1016,,,fee schedule,,,,,,,,,,,,,,,,13.92045,85,percent of total billed charges,,,,,,,,,,8.1508329,49.77,percent of total billed charges,,,,14.7393,90,percent of total billed charges,,,,15.55815,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.92045,85,percent of total billed charges,,,,,,,,,8.1508329,16.377,
STERILE WATER 3000cc,2707310,CDM,,,270,RC,outpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,42.5493,,,fee schedule,,,37.8216,,,fee schedule,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,,23.5297629,49.77,percent of total billed charges,,,,42.5493,90,percent of total billed charges,,,,44.91315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,23.5297629,47.277,
STERILE 2X2,2707320,CDM,,,270,RC,outpatient,,,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
STERILE 4X4 SINGLE,2707330,CDM,,,270,RC,outpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,3.2445,,,fee schedule,,,2.884,,,fee schedule,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,,1.7942085,49.77,percent of total billed charges,,,,3.2445,90,percent of total billed charges,,,,3.42475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,1.7942085,3.605,
STERILE 4X4 10 PACK,2707340,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
MCGRATH MAC3 350-005-000,2707356,CDM,,,270,RC,outpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,42.5493,,,fee schedule,,,37.8216,,,fee schedule,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,,23.5297629,49.77,percent of total billed charges,,,,42.5493,90,percent of total billed charges,,,,44.91315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,23.5297629,47.277,
HARMONIC CURVED SHEARS ACE36E,2707358,CDM,,,270,RC,outpatient,,,,646.325,355.47875,,581.6925,90,percent of total billed charges,,,,646.325,100,percent of total billed charges,,,,,,,,,581.6925,,,fee schedule,,,517.06,,,fee schedule,,,,,,,,,,,,,,,,549.37625,85,percent of total billed charges,,,,,,,,,,321.6759525,49.77,percent of total billed charges,,,,581.6925,90,percent of total billed charges,,,,614.00875,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,549.37625,85,percent of total billed charges,,,,,,,,,321.6759525,646.325,
ENSEAL TISSUE SEALER G2,2707359,CDM,,,270,RC,outpatient,,,,1203.555,661.95525,,1083.1995,90,percent of total billed charges,,,,1203.555,100,percent of total billed charges,,,,,,,,,1083.1995,,,fee schedule,,,962.844,,,fee schedule,,,,,,,,,,,,,,,,1023.02175,85,percent of total billed charges,,,,,,,,,,599.0093235,49.77,percent of total billed charges,,,,1083.1995,90,percent of total billed charges,,,,1143.37725,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1023.02175,85,percent of total billed charges,,,,,,,,,599.0093235,1203.555,
STOCKINETTE,2707360,CDM,,,270,RC,outpatient,,,,20.497,11.27335,,18.4473,90,percent of total billed charges,,,,20.497,100,percent of total billed charges,,,,,,,,,18.4473,,,fee schedule,,,16.3976,,,fee schedule,,,,,,,,,,,,,,,,17.42245,85,percent of total billed charges,,,,,,,,,,10.2013569,49.77,percent of total billed charges,,,,18.4473,90,percent of total billed charges,,,,19.47215,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.42245,85,percent of total billed charges,,,,,,,,,10.2013569,20.497,
STOMA BAG,2707370,CDM,,,270,RC,outpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
STOMA BAG CLAMP,2707380,CDM,,,270,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
STOMAHESIVE PASTE,2707410,CDM,,,270,RC,outpatient,,,,27.295,15.01225,,24.5655,90,percent of total billed charges,,,,27.295,100,percent of total billed charges,,,,,,,,,24.5655,,,fee schedule,,,21.836,,,fee schedule,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,,13.5847215,49.77,percent of total billed charges,,,,24.5655,90,percent of total billed charges,,,,25.93025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.20075,85,percent of total billed charges,,,,,,,,,13.5847215,27.295,
STOMAHESIVE 4X4,2707420,CDM,,,270,RC,outpatient,,,,11.845,6.51475,,10.6605,90,percent of total billed charges,,,,11.845,100,percent of total billed charges,,,,,,,,,10.6605,,,fee schedule,,,9.476,,,fee schedule,,,,,,,,,,,,,,,,10.06825,85,percent of total billed charges,,,,,,,,,,5.8952565,49.77,percent of total billed charges,,,,10.6605,90,percent of total billed charges,,,,11.25275,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.06825,85,percent of total billed charges,,,,,,,,,5.8952565,11.845,
STONE BASKET-JOHNSON,2707430,CDM,,,270,RC,outpatient,,,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,25.8633,,,fee schedule,,,22.9896,,,fee schedule,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,,14.3024049,49.77,percent of total billed charges,,,,25.8633,90,percent of total billed charges,,,,27.30015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,14.3024049,28.737,
STOPCOCK 3WAY,2707440,CDM,,,270,RC,outpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,3.5226,,,fee schedule,,,3.1312,,,fee schedule,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,,1.9479978,49.77,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,3.7183,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,1.9479978,3.914,
SUBCLAB/JUGULAR CAT,2707450,CDM,,,270,RC,outpatient,,,,31.93,17.5615,,28.737,90,percent of total billed charges,,,,31.93,100,percent of total billed charges,,,,,,,,,28.737,,,fee schedule,,,25.544,,,fee schedule,,,,,,,,,,,,,,,,27.1405,85,percent of total billed charges,,,,,,,,,,15.891561,49.77,percent of total billed charges,,,,28.737,90,percent of total billed charges,,,,30.3335,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.1405,85,percent of total billed charges,,,,,,,,,15.891561,31.93,
SUCTION CANNISTER 1000/150,2707460,CDM,,,270,RC,outpatient,,,,4.738,2.6059,,4.2642,90,percent of total billed charges,,,,4.738,100,percent of total billed charges,,,,,,,,,4.2642,,,fee schedule,,,3.7904,,,fee schedule,,,,,,,,,,,,,,,,4.0273,85,percent of total billed charges,,,,,,,,,,2.3581026,49.77,percent of total billed charges,,,,4.2642,90,percent of total billed charges,,,,4.5011,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.0273,85,percent of total billed charges,,,,,,,,,2.3581026,4.738,
SUCTION CATH,2707470,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
SUCTION POLYP TRAP,2707480,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
SUPPLEMENTAL FEEDING,2707490,CDM,,,270,RC,outpatient,,,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
SURGICAL CLIPPER,2707550,CDM,,,270,RC,outpatient,,,,30.488,16.7684,,27.4392,90,percent of total billed charges,,,,30.488,100,percent of total billed charges,,,,,,,,,27.4392,,,fee schedule,,,24.3904,,,fee schedule,,,,,,,,,,,,,,,,25.9148,85,percent of total billed charges,,,,,,,,,,15.1738776,49.77,percent of total billed charges,,,,27.4392,90,percent of total billed charges,,,,28.9636,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,25.9148,85,percent of total billed charges,,,,,,,,,15.1738776,30.488,
SURGICEL 1/2 X2 #1955,2707580,CDM,,,270,RC,outpatient,,,,59.122,32.5171,,53.2098,90,percent of total billed charges,,,,59.122,100,percent of total billed charges,,,,,,,,,53.2098,,,fee schedule,,,47.2976,,,fee schedule,,,,,,,,,,,,,,,,50.2537,85,percent of total billed charges,,,,,,,,,,29.4250194,49.77,percent of total billed charges,,,,53.2098,90,percent of total billed charges,,,,56.1659,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,50.2537,85,percent of total billed charges,,,,,,,,,29.4250194,59.122,
SURGICEL,2707590,CDM,,,270,RC,outpatient,,,,215.888,118.7384,,194.2992,90,percent of total billed charges,,,,215.888,100,percent of total billed charges,,,,,,,,,194.2992,,,fee schedule,,,172.7104,,,fee schedule,,,,,,,,,,,,,,,,183.5048,85,percent of total billed charges,,,,,,,,,,107.4474576,49.77,percent of total billed charges,,,,194.2992,90,percent of total billed charges,,,,205.0936,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,183.5048,85,percent of total billed charges,,,,,,,,,107.4474576,215.888,
SUTURE REMOVAL TRAY,2707670,CDM,,,270,RC,outpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
"SUTURE CHROMIC 36""",2707690,CDM,,,270,RC,outpatient,,,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
SYRINGE-EARBULB,2707820,CDM,,,270,RC,outpatient,,,,24.72,13.596,,22.248,90,percent of total billed charges,,,,24.72,100,percent of total billed charges,,,,,,,,,22.248,,,fee schedule,,,19.776,,,fee schedule,,,,,,,,,,,,,,,,21.012,85,percent of total billed charges,,,,,,,,,,12.303144,49.77,percent of total billed charges,,,,22.248,90,percent of total billed charges,,,,23.484,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.012,85,percent of total billed charges,,,,,,,,,12.303144,24.72,
SYRINGE (ALL),2707830,CDM,,,270,RC,outpatient,,,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
TRANSPORE TAPE,2707870,CDM,,,270,RC,outpatient,,,,27.398,15.0689,,24.6582,90,percent of total billed charges,,,,27.398,100,percent of total billed charges,,,,,,,,,24.6582,,,fee schedule,,,21.9184,,,fee schedule,,,,,,,,,,,,,,,,23.2883,85,percent of total billed charges,,,,,,,,,,13.6359846,49.77,percent of total billed charges,,,,24.6582,90,percent of total billed charges,,,,26.0281,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.2883,85,percent of total billed charges,,,,,,,,,13.6359846,27.398,
TED HOSE-ALL,2707890,CDM,,,270,RC,outpatient,,,,6.592,3.6256,,5.9328,90,percent of total billed charges,,,,6.592,100,percent of total billed charges,,,,,,,,,5.9328,,,fee schedule,,,5.2736,,,fee schedule,,,,,,,,,,,,,,,,5.6032,85,percent of total billed charges,,,,,,,,,,3.2808384,49.77,percent of total billed charges,,,,5.9328,90,percent of total billed charges,,,,6.2624,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.6032,85,percent of total billed charges,,,,,,,,,3.2808384,6.592,
PTFE PLEDGETS #007975,2707900,CDM,,,270,RC,outpatient,,,,73.439,40.39145,,66.0951,90,percent of total billed charges,,,,73.439,100,percent of total billed charges,,,,,,,,,66.0951,,,fee schedule,,,58.7512,,,fee schedule,,,,,,,,,,,,,,,,62.42315,85,percent of total billed charges,,,,,,,,,,36.5505903,49.77,percent of total billed charges,,,,66.0951,90,percent of total billed charges,,,,69.76705,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,62.42315,85,percent of total billed charges,,,,,,,,,36.5505903,73.439,
TEGADERM,2707920,CDM,A6258,HCPCS,270,RC,outpatient,,,,5.356,2.9458,,4.8204,90,percent of total billed charges,,,,5.356,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4.5526,85,percent of total billed charges,,,,,,,,,,2.6656812,49.77,percent of total billed charges,,,,4.8204,90,percent of total billed charges,,,,5.0882,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.5526,85,percent of total billed charges,,,,,,,,,2.6656812,5.356,
CAESAREAN DRAPE #7965,2707965,CDM,,,270,RC,outpatient,,,,51.191,28.15505,,46.0719,90,percent of total billed charges,,,,51.191,100,percent of total billed charges,,,,,,,,,46.0719,,,fee schedule,,,40.9528,,,fee schedule,,,,,,,,,,,,,,,,43.51235,85,percent of total billed charges,,,,,,,,,,25.4777607,49.77,percent of total billed charges,,,,46.0719,90,percent of total billed charges,,,,48.63145,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,43.51235,85,percent of total billed charges,,,,,,,,,25.4777607,51.191,
TELFA PADS,2707980,CDM,,,270,RC,outpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,3.5226,,,fee schedule,,,3.1312,,,fee schedule,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,,1.9479978,49.77,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,3.7183,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,1.9479978,3.914,
DSE TUBING,2708009,CDM,,,270,RC,outpatient,,,,5.15,2.8325,,4.635,90,percent of total billed charges,,,,5.15,100,percent of total billed charges,,,,,,,,,4.635,,,fee schedule,,,4.12,,,fee schedule,,,,,,,,,,,,,,,,4.3775,85,percent of total billed charges,,,,,,,,,,2.563155,49.77,percent of total billed charges,,,,4.635,90,percent of total billed charges,,,,4.8925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.3775,85,percent of total billed charges,,,,,,,,,2.563155,5.15,
TENS ELECTRODES,2708020,CDM,,,270,RC,outpatient,,,,69.937,38.46535,,62.9433,90,percent of total billed charges,,,,69.937,100,percent of total billed charges,,,,,,,,,62.9433,,,fee schedule,,,55.9496,,,fee schedule,,,,,,,,,,,,,,,,59.44645,85,percent of total billed charges,,,,,,,,,,34.8076449,49.77,percent of total billed charges,,,,62.9433,90,percent of total billed charges,,,,66.44015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,59.44645,85,percent of total billed charges,,,,,,,,,34.8076449,69.937,
TEXAS CATHETER,2708070,CDM,,,270,RC,outpatient,,,,4.326,2.3793,,3.8934,90,percent of total billed charges,,,,4.326,100,percent of total billed charges,,,,,,,,,3.8934,,,fee schedule,,,3.4608,,,fee schedule,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,,2.1530502,49.77,percent of total billed charges,,,,3.8934,90,percent of total billed charges,,,,4.1097,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.6771,85,percent of total billed charges,,,,,,,,,2.1530502,4.326,
THERMO HEAD COVER,2708090,CDM,,,270,RC,outpatient,,,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
THERMODRAPE BLANKET,2708120,CDM,,,270,RC,outpatient,,,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,23.2677,,,fee schedule,,,20.6824,,,fee schedule,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,,12.8670381,49.77,percent of total billed charges,,,,23.2677,90,percent of total billed charges,,,,24.56035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,12.8670381,25.853,
THOMAS SPLINT PAD,2708150,CDM,,,270,RC,outpatient,,,,18.952,10.4236,,17.0568,90,percent of total billed charges,,,,18.952,100,percent of total billed charges,,,,,,,,,17.0568,,,fee schedule,,,15.1616,,,fee schedule,,,,,,,,,,,,,,,,16.1092,85,percent of total billed charges,,,,,,,,,,9.4324104,49.77,percent of total billed charges,,,,17.0568,90,percent of total billed charges,,,,18.0044,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.1092,85,percent of total billed charges,,,,,,,,,9.4324104,18.952,
THORACENTESIS TRAY,2708170,CDM,,,270,RC,outpatient,,,,141.11,77.6105,,126.999,90,percent of total billed charges,,,,141.11,100,percent of total billed charges,,,,,,,,,126.999,,,fee schedule,,,112.888,,,fee schedule,,,,,,,,,,,,,,,,119.9435,85,percent of total billed charges,,,,,,,,,,70.230447,49.77,percent of total billed charges,,,,126.999,90,percent of total billed charges,,,,134.0545,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,119.9435,85,percent of total billed charges,,,,,,,,,70.230447,141.11,
TOE CAP,2708180,CDM,,,270,RC,outpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
TONSIL SNARES,2708190,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
COLOSTOMY/ILEOSTOMY KIT,2708199,CDM,,,270,RC,outpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,3.9861,,,fee schedule,,,3.5432,,,fee schedule,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,,2.2043133,49.77,percent of total billed charges,,,,3.9861,90,percent of total billed charges,,,,4.20755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,2.2043133,4.429,
TOOTHBRUSH,2708200,CDM,,,270,RC,outpatient,,,,3.605,1.98275,,3.2445,90,percent of total billed charges,,,,3.605,100,percent of total billed charges,,,,,,,,,3.2445,,,fee schedule,,,2.884,,,fee schedule,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,,1.7942085,49.77,percent of total billed charges,,,,3.2445,90,percent of total billed charges,,,,3.42475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.06425,85,percent of total billed charges,,,,,,,,,1.7942085,3.605,
TRACHEAL TUBES,2708250,CDM,,,270,RC,outpatient,,,,195.7,107.635,,176.13,90,percent of total billed charges,,,,195.7,100,percent of total billed charges,,,,,,,,,176.13,,,fee schedule,,,156.56,,,fee schedule,,,,,,,,,,,,,,,,166.345,85,percent of total billed charges,,,,,,,,,,97.39989,49.77,percent of total billed charges,,,,176.13,90,percent of total billed charges,,,,185.915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,166.345,85,percent of total billed charges,,,,,,,,,97.39989,195.7,
TRACHEOST CLEAN TRA,2708260,CDM,,,270,RC,outpatient,,,,4.429,2.43595,,3.9861,90,percent of total billed charges,,,,4.429,100,percent of total billed charges,,,,,,,,,3.9861,,,fee schedule,,,3.5432,,,fee schedule,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,,2.2043133,49.77,percent of total billed charges,,,,3.9861,90,percent of total billed charges,,,,4.20755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.76465,85,percent of total billed charges,,,,,,,,,2.2043133,4.429,
SPILLPROOF URINAL,2708312,CDM,,,270,RC,outpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,42.5493,,,fee schedule,,,37.8216,,,fee schedule,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,,23.5297629,49.77,percent of total billed charges,,,,42.5493,90,percent of total billed charges,,,,44.91315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,23.5297629,47.277,
TUBING CONNECTOR Y,2708320,CDM,,,270,RC,outpatient,,,,11.845,6.51475,,10.6605,90,percent of total billed charges,,,,11.845,100,percent of total billed charges,,,,,,,,,10.6605,,,fee schedule,,,9.476,,,fee schedule,,,,,,,,,,,,,,,,10.06825,85,percent of total billed charges,,,,,,,,,,5.8952565,49.77,percent of total billed charges,,,,10.6605,90,percent of total billed charges,,,,11.25275,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.06825,85,percent of total billed charges,,,,,,,,,5.8952565,11.845,
TUBING CONNECTORS,2708330,CDM,,,270,RC,outpatient,,,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
X-SPAN NET DRESSING SZ 8,2708340,CDM,,,270,RC,outpatient,,,,29.458,16.2019,,26.5122,90,percent of total billed charges,,,,29.458,100,percent of total billed charges,,,,,,,,,26.5122,,,fee schedule,,,23.5664,,,fee schedule,,,,,,,,,,,,,,,,25.0393,85,percent of total billed charges,,,,,,,,,,14.6612466,49.77,percent of total billed charges,,,,26.5122,90,percent of total billed charges,,,,27.9851,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,25.0393,85,percent of total billed charges,,,,,,,,,14.6612466,29.458,
UMBILICAL CATHETER,2708380,CDM,,,270,RC,outpatient,,,,47.277,26.00235,,42.5493,90,percent of total billed charges,,,,47.277,100,percent of total billed charges,,,,,,,,,42.5493,,,fee schedule,,,37.8216,,,fee schedule,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,,23.5297629,49.77,percent of total billed charges,,,,42.5493,90,percent of total billed charges,,,,44.91315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.18545,85,percent of total billed charges,,,,,,,,,23.5297629,47.277,
URETERAL STINT,2708440,CDM,,,270,RC,outpatient,,,,294.683,162.07565,,265.2147,90,percent of total billed charges,,,,294.683,100,percent of total billed charges,,,,,,,,,265.2147,,,fee schedule,,,235.7464,,,fee schedule,,,,,,,,,,,,,,,,250.48055,85,percent of total billed charges,,,,,,,,,,146.6637291,49.77,percent of total billed charges,,,,265.2147,90,percent of total billed charges,,,,279.94885,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,250.48055,85,percent of total billed charges,,,,,,,,,146.6637291,294.683,
URETHAL CATH TRAY,2708450,CDM,,,270,RC,outpatient,,,,15.862,8.7241,,14.2758,90,percent of total billed charges,,,,15.862,100,percent of total billed charges,,,,,,,,,14.2758,,,fee schedule,,,12.6896,,,fee schedule,,,,,,,,,,,,,,,,13.4827,85,percent of total billed charges,,,,,,,,,,7.8945174,49.77,percent of total billed charges,,,,14.2758,90,percent of total billed charges,,,,15.0689,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.4827,85,percent of total billed charges,,,,,,,,,7.8945174,15.862,
URETHRAL CATHETER,2708470,CDM,,,270,RC,outpatient,,,,32.033,17.61815,,28.8297,90,percent of total billed charges,,,,32.033,100,percent of total billed charges,,,,,,,,,28.8297,,,fee schedule,,,25.6264,,,fee schedule,,,,,,,,,,,,,,,,27.22805,85,percent of total billed charges,,,,,,,,,,15.9428241,49.77,percent of total billed charges,,,,28.8297,90,percent of total billed charges,,,,30.43135,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,27.22805,85,percent of total billed charges,,,,,,,,,15.9428241,32.033,
URI PAN (HAT) 800cc,2708480,CDM,,,270,RC,outpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,3.5226,,,fee schedule,,,3.1312,,,fee schedule,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,,1.9479978,49.77,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,3.7183,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,1.9479978,3.914,
URINAL-MALE,2708510,CDM,,,270,RC,outpatient,,,,3.914,2.1527,,3.5226,90,percent of total billed charges,,,,3.914,100,percent of total billed charges,,,,,,,,,3.5226,,,fee schedule,,,3.1312,,,fee schedule,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,,1.9479978,49.77,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,3.7183,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.3269,85,percent of total billed charges,,,,,,,,,1.9479978,3.914,
URINE LEG BAG,2708540,CDM,,,270,RC,outpatient,,,,5.356,2.9458,,4.8204,90,percent of total billed charges,,,,5.356,100,percent of total billed charges,,,,,,,,,4.8204,,,fee schedule,,,4.2848,,,fee schedule,,,,,,,,,,,,,,,,4.5526,85,percent of total billed charges,,,,,,,,,,2.6656812,49.77,percent of total billed charges,,,,4.8204,90,percent of total billed charges,,,,5.0882,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.5526,85,percent of total billed charges,,,,,,,,,2.6656812,5.356,
VACCUUM CURETTE,2708610,CDM,,,270,RC,outpatient,,,,6.18,3.399,,5.562,90,percent of total billed charges,,,,6.18,100,percent of total billed charges,,,,,,,,,5.562,,,fee schedule,,,4.944,,,fee schedule,,,,,,,,,,,,,,,,5.253,85,percent of total billed charges,,,,,,,,,,3.075786,49.77,percent of total billed charges,,,,5.562,90,percent of total billed charges,,,,5.871,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.253,85,percent of total billed charges,,,,,,,,,3.075786,6.18,
BOVIE PENCIL,2708630,CDM,,,270,RC,outpatient,,,,11.227,6.17485,,10.1043,90,percent of total billed charges,,,,11.227,100,percent of total billed charges,,,,,,,,,10.1043,,,fee schedule,,,8.9816,,,fee schedule,,,,,,,,,,,,,,,,9.54295,85,percent of total billed charges,,,,,,,,,,5.5876779,49.77,percent of total billed charges,,,,10.1043,90,percent of total billed charges,,,,10.66565,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.54295,85,percent of total billed charges,,,,,,,,,5.5876779,11.227,
BOVIE SUCTION E2610-6,2708640,CDM,,,270,RC,outpatient,,,,36.153,19.88415,,32.5377,90,percent of total billed charges,,,,36.153,100,percent of total billed charges,,,,,,,,,32.5377,,,fee schedule,,,28.9224,,,fee schedule,,,,,,,,,,,,,,,,30.73005,85,percent of total billed charges,,,,,,,,,,17.9933481,49.77,percent of total billed charges,,,,32.5377,90,percent of total billed charges,,,,34.34535,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,30.73005,85,percent of total billed charges,,,,,,,,,17.9933481,36.153,
VARICES INJ NEEDLE,2708650,CDM,,,270,RC,outpatient,,,,125.557,69.05635,,113.0013,90,percent of total billed charges,,,,125.557,100,percent of total billed charges,,,,,,,,,113.0013,,,fee schedule,,,100.4456,,,fee schedule,,,,,,,,,,,,,,,,106.72345,85,percent of total billed charges,,,,,,,,,,62.4897189,49.77,percent of total billed charges,,,,113.0013,90,percent of total billed charges,,,,119.27915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,106.72345,85,percent of total billed charges,,,,,,,,,62.4897189,125.557,
DRAPE IMPERVIOUS,2708675,CDM,,,270,RC,outpatient,,,,6.0461,3.325355,,5.44149,90,percent of total billed charges,,,,6.0461,100,percent of total billed charges,,,,,,,,,5.44149,,,fee schedule,,,4.83688,,,fee schedule,,,,,,,,,,,,,,,,5.139185,85,percent of total billed charges,,,,,,,,,,3.00914397,49.77,percent of total billed charges,,,,5.44149,90,percent of total billed charges,,,,5.743795,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.139185,85,percent of total billed charges,,,,,,,,,3.00914397,6.0461,
VASCULAR GRAFT BIFURCATED,2708690,CDM,,,270,RC,outpatient,,,,859.638,472.8009,,773.6742,90,percent of total billed charges,,,,859.638,100,percent of total billed charges,,,,,,,,,773.6742,,,fee schedule,,,687.7104,,,fee schedule,,,,,,,,,,,,,,,,730.6923,85,percent of total billed charges,,,,,,,,,,427.8418326,49.77,percent of total billed charges,,,,773.6742,90,percent of total billed charges,,,,816.6561,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,730.6923,85,percent of total billed charges,,,,,,,,,427.8418326,859.638,
VASELINE 0.6OZ,2708700,CDM,,,270,RC,outpatient,,,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,,,,,,,3.708,,,fee schedule,,,3.296,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,2.050524,4.12,
VASELINE GAUZE,2708710,CDM,,,270,RC,outpatient,,,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,,,,,,,6.7671,,,fee schedule,,,6.0152,,,fee schedule,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,,3.7422063,49.77,percent of total billed charges,,,,6.7671,90,percent of total billed charges,,,,7.14305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,3.7422063,7.519,
HELMET CUSHIONED INSERT,2708725,CDM,,,270,RC,outpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,51.6339,,,fee schedule,,,45.8968,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,28.5535467,57.371,
VESSEL LOOPS,2708750,CDM,,,270,RC,outpatient,,,,6.18,3.399,,5.562,90,percent of total billed charges,,,,6.18,100,percent of total billed charges,,,,,,,,,5.562,,,fee schedule,,,4.944,,,fee schedule,,,,,,,,,,,,,,,,5.253,85,percent of total billed charges,,,,,,,,,,3.075786,49.77,percent of total billed charges,,,,5.562,90,percent of total billed charges,,,,5.871,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.253,85,percent of total billed charges,,,,,,,,,3.075786,6.18,
VIAL ADAPTER,2708760,CDM,,,270,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
VITAL SIGNS MASK,2708790,CDM,,,270,RC,outpatient,,,,7.107,3.90885,,6.3963,90,percent of total billed charges,,,,7.107,100,percent of total billed charges,,,,,,,,,6.3963,,,fee schedule,,,5.6856,,,fee schedule,,,,,,,,,,,,,,,,6.04095,85,percent of total billed charges,,,,,,,,,,3.5371539,49.77,percent of total billed charges,,,,6.3963,90,percent of total billed charges,,,,6.75165,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.04095,85,percent of total billed charges,,,,,,,,,3.5371539,7.107,
DRI-LOCK CANNULA,2708925,CDM,,,270,RC,outpatient,,,,39.3975,21.668625,,35.45775,90,percent of total billed charges,,,,39.3975,100,percent of total billed charges,,,,,,,,,35.45775,,,fee schedule,,,31.518,,,fee schedule,,,,,,,,,,,,,,,,33.487875,85,percent of total billed charges,,,,,,,,,,19.60813575,49.77,percent of total billed charges,,,,35.45775,90,percent of total billed charges,,,,37.427625,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.487875,85,percent of total billed charges,,,,,,,,,19.60813575,39.3975,
WIRE 28 GAUGE,2708940,CDM,,,270,RC,outpatient,,,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
YANKAUER SUCTION,2708950,CDM,,,270,RC,outpatient,,,,4.738,2.6059,,4.2642,90,percent of total billed charges,,,,4.738,100,percent of total billed charges,,,,,,,,,4.2642,,,fee schedule,,,3.7904,,,fee schedule,,,,,,,,,,,,,,,,4.0273,85,percent of total billed charges,,,,,,,,,,2.3581026,49.77,percent of total billed charges,,,,4.2642,90,percent of total billed charges,,,,4.5011,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.0273,85,percent of total billed charges,,,,,,,,,2.3581026,4.738,
"TACH, CIFFED, D.I.C. SZ 9",2708985,CDM,,,270,RC,outpatient,,,,6.695,3.68225,,6.0255,90,percent of total billed charges,,,,6.695,100,percent of total billed charges,,,,,,,,,6.0255,,,fee schedule,,,5.356,,,fee schedule,,,,,,,,,,,,,,,,5.69075,85,percent of total billed charges,,,,,,,,,,3.3321015,49.77,percent of total billed charges,,,,6.0255,90,percent of total billed charges,,,,6.36025,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.69075,85,percent of total billed charges,,,,,,,,,3.3321015,6.695,
Synthes 2.5 Reaming Rod Ball,2708986,CDM,,,270,RC,outpatient,,,,227.63,125.1965,,204.867,90,percent of total billed charges,,,,227.63,100,percent of total billed charges,,,,,,,,,204.867,,,fee schedule,,,182.104,,,fee schedule,,,,,,,,,,,,,,,,193.4855,85,percent of total billed charges,,,,,,,,,,113.291451,49.77,percent of total billed charges,,,,204.867,90,percent of total billed charges,,,,216.2485,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,193.4855,85,percent of total billed charges,,,,,,,,,113.291451,227.63,
Slingshot 70 DEG Suture Passr,2708987,CDM,,,270,RC,outpatient,,,,680.83,374.4565,,612.747,90,percent of total billed charges,,,,680.83,100,percent of total billed charges,,,,,,,,,612.747,,,fee schedule,,,544.664,,,fee schedule,,,,,,,,,,,,,,,,578.7055,85,percent of total billed charges,,,,,,,,,,338.849091,49.77,percent of total billed charges,,,,612.747,90,percent of total billed charges,,,,646.7885,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,578.7055,85,percent of total billed charges,,,,,,,,,338.849091,680.83,
Slingshot 45 Deg Sut Passr,2708988,CDM,,,270,RC,outpatient,,,,680.83,374.4565,,612.747,90,percent of total billed charges,,,,680.83,100,percent of total billed charges,,,,,,,,,612.747,,,fee schedule,,,544.664,,,fee schedule,,,,,,,,,,,,,,,,578.7055,85,percent of total billed charges,,,,,,,,,,338.849091,49.77,percent of total billed charges,,,,612.747,90,percent of total billed charges,,,,646.7885,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,578.7055,85,percent of total billed charges,,,,,,,,,338.849091,680.83,
Oxygen Reservoir,2708989,CDM,,,270,RC,outpatient,,,,100.94,55.517,,90.846,90,percent of total billed charges,,,,100.94,100,percent of total billed charges,,,,,,,,,90.846,,,fee schedule,,,80.752,,,fee schedule,,,,,,,,,,,,,,,,85.799,85,percent of total billed charges,,,,,,,,,,50.237838,49.77,percent of total billed charges,,,,90.846,90,percent of total billed charges,,,,95.893,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,85.799,85,percent of total billed charges,,,,,,,,,50.237838,100.94,
PUREWICK EXT FEMALE CATHETER,2709001,CDM,,,270,RC,outpatient,,,,33.063,18.18465,,29.7567,90,percent of total billed charges,,,,33.063,100,percent of total billed charges,,,,,,,,,29.7567,,,fee schedule,,,26.4504,,,fee schedule,,,,,,,,,,,,,,,,28.10355,85,percent of total billed charges,,,,,,,,,,16.4554551,49.77,percent of total billed charges,,,,29.7567,90,percent of total billed charges,,,,31.40985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.10355,85,percent of total billed charges,,,,,,,,,16.4554551,33.063,
STERILE EVAC. CONTAINER,2709080,CDM,,,270,RC,outpatient,,,,42.024,23.1132,,37.8216,90,percent of total billed charges,,,,42.024,100,percent of total billed charges,,,,,,,,,37.8216,,,fee schedule,,,33.6192,,,fee schedule,,,,,,,,,,,,,,,,35.7204,85,percent of total billed charges,,,,,,,,,,20.9153448,49.77,percent of total billed charges,,,,37.8216,90,percent of total billed charges,,,,39.9228,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.7204,85,percent of total billed charges,,,,,,,,,20.9153448,42.024,
"5"" ONE CONNECTOR",2709090,CDM,,,270,RC,outpatient,,,,3.708,2.0394,,3.3372,90,percent of total billed charges,,,,3.708,100,percent of total billed charges,,,,,,,,,3.3372,,,fee schedule,,,2.9664,,,fee schedule,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,,1.8454716,49.77,percent of total billed charges,,,,3.3372,90,percent of total billed charges,,,,3.5226,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.1518,85,percent of total billed charges,,,,,,,,,1.8454716,3.708,
TROCAR 5mm,2709110,CDM,,,270,RC,outpatient,,,,202.395,111.31725,,182.1555,90,percent of total billed charges,,,,202.395,100,percent of total billed charges,,,,,,,,,182.1555,,,fee schedule,,,161.916,,,fee schedule,,,,,,,,,,,,,,,,172.03575,85,percent of total billed charges,,,,,,,,,,100.7319915,49.77,percent of total billed charges,,,,182.1555,90,percent of total billed charges,,,,192.27525,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,172.03575,85,percent of total billed charges,,,,,,,,,100.7319915,202.395,
"ORTHO GLASS SPLINT 2""",2709120,CDM,,,270,RC,outpatient,,,,74.469,40.95795,,67.0221,90,percent of total billed charges,,,,74.469,100,percent of total billed charges,,,,,,,,,67.0221,,,fee schedule,,,59.5752,,,fee schedule,,,,,,,,,,,,,,,,63.29865,85,percent of total billed charges,,,,,,,,,,37.0632213,49.77,percent of total billed charges,,,,67.0221,90,percent of total billed charges,,,,70.74555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,63.29865,85,percent of total billed charges,,,,,,,,,37.0632213,74.469,
SILCONE CANNULA,2709225,CDM,,,270,RC,outpatient,,,,64.89,35.6895,,58.401,90,percent of total billed charges,,,,64.89,100,percent of total billed charges,,,,,,,,,58.401,,,fee schedule,,,51.912,,,fee schedule,,,,,,,,,,,,,,,,55.1565,85,percent of total billed charges,,,,,,,,,,32.295753,49.77,percent of total billed charges,,,,58.401,90,percent of total billed charges,,,,61.6455,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,55.1565,85,percent of total billed charges,,,,,,,,,32.295753,64.89,
STAY FIX EPIDURAL DRESSING,2709228,CDM,,,270,RC,outpatient,,,,18.54,10.197,,16.686,90,percent of total billed charges,,,,18.54,100,percent of total billed charges,,,,,,,,,16.686,,,fee schedule,,,14.832,,,fee schedule,,,,,,,,,,,,,,,,15.759,85,percent of total billed charges,,,,,,,,,,9.227358,49.77,percent of total billed charges,,,,16.686,90,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.759,85,percent of total billed charges,,,,,,,,,9.227358,18.54,
BARRIER HOODS - DEPUY,2709286,CDM,,,270,RC,outpatient,,,,84.048,46.2264,,75.6432,90,percent of total billed charges,,,,84.048,100,percent of total billed charges,,,,,,,,,75.6432,,,fee schedule,,,67.2384,,,fee schedule,,,,,,,,,,,,,,,,71.4408,85,percent of total billed charges,,,,,,,,,,41.8306896,49.77,percent of total billed charges,,,,75.6432,90,percent of total billed charges,,,,79.8456,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,71.4408,85,percent of total billed charges,,,,,,,,,41.8306896,84.048,
EMPTY EVACUATED CONT 2000ML,2709406,CDM,,,270,RC,outpatient,,,,43.157,23.73635,,38.8413,90,percent of total billed charges,,,,43.157,100,percent of total billed charges,,,,,,,,,38.8413,,,fee schedule,,,34.5256,,,fee schedule,,,,,,,,,,,,,,,,36.68345,85,percent of total billed charges,,,,,,,,,,21.4792389,49.77,percent of total billed charges,,,,38.8413,90,percent of total billed charges,,,,40.99915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,36.68345,85,percent of total billed charges,,,,,,,,,21.4792389,43.157,
PALL BLOOD FILTER,2709510,CDM,,,270,RC,outpatient,,,,121.025,66.56375,,108.9225,90,percent of total billed charges,,,,121.025,100,percent of total billed charges,,,,,,,,,108.9225,,,fee schedule,,,96.82,,,fee schedule,,,,,,,,,,,,,,,,102.87125,85,percent of total billed charges,,,,,,,,,,60.2341425,49.77,percent of total billed charges,,,,108.9225,90,percent of total billed charges,,,,114.97375,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,102.87125,85,percent of total billed charges,,,,,,,,,60.2341425,121.025,
PLATELET ADMINISTRATION KIT,2709530,CDM,,,270,RC,outpatient,,,,13.287,7.30785,,11.9583,90,percent of total billed charges,,,,13.287,100,percent of total billed charges,,,,,,,,,11.9583,,,fee schedule,,,10.6296,,,fee schedule,,,,,,,,,,,,,,,,11.29395,85,percent of total billed charges,,,,,,,,,,6.6129399,49.77,percent of total billed charges,,,,11.9583,90,percent of total billed charges,,,,12.62265,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.29395,85,percent of total billed charges,,,,,,,,,6.6129399,13.287,
SUTURE GUN/DISPOSABLE - OR,2709560,CDM,,,270,RC,outpatient,,,,111.24,61.182,,100.116,90,percent of total billed charges,,,,111.24,100,percent of total billed charges,,,,,,,,,100.116,,,fee schedule,,,88.992,,,fee schedule,,,,,,,,,,,,,,,,94.554,85,percent of total billed charges,,,,,,,,,,55.364148,49.77,percent of total billed charges,,,,100.116,90,percent of total billed charges,,,,105.678,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,94.554,85,percent of total billed charges,,,,,,,,,55.364148,111.24,
ENEMA/PER USAGE - OR,2709590,CDM,,,270,RC,outpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
EYE TRAY - OR,2709600,CDM,,,270,RC,outpatient,,,,21.527,11.83985,,19.3743,90,percent of total billed charges,,,,21.527,100,percent of total billed charges,,,,,,,,,19.3743,,,fee schedule,,,17.2216,,,fee schedule,,,,,,,,,,,,,,,,18.29795,85,percent of total billed charges,,,,,,,,,,10.7139879,49.77,percent of total billed charges,,,,19.3743,90,percent of total billed charges,,,,20.45065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.29795,85,percent of total billed charges,,,,,,,,,10.7139879,21.527,
UTERINE ASPIRATING TUBING,2709616,CDM,,,270,RC,outpatient,,,,17.613,9.68715,,15.8517,90,percent of total billed charges,,,,17.613,100,percent of total billed charges,,,,,,,,,15.8517,,,fee schedule,,,14.0904,,,fee schedule,,,,,,,,,,,,,,,,14.97105,85,percent of total billed charges,,,,,,,,,,8.7659901,49.77,percent of total billed charges,,,,15.8517,90,percent of total billed charges,,,,16.73235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.97105,85,percent of total billed charges,,,,,,,,,8.7659901,17.613,
VACCUM EXTRACTOR,2709620,CDM,,,270,RC,outpatient,,,,74.263,40.84465,,66.8367,90,percent of total billed charges,,,,74.263,100,percent of total billed charges,,,,,,,,,66.8367,,,fee schedule,,,59.4104,,,fee schedule,,,,,,,,,,,,,,,,63.12355,85,percent of total billed charges,,,,,,,,,,36.9606951,49.77,percent of total billed charges,,,,66.8367,90,percent of total billed charges,,,,70.54985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,63.12355,85,percent of total billed charges,,,,,,,,,36.9606951,74.263,
SUTURE SUPRAMID LOOPED 3-0,2709630,CDM,,,270,RC,outpatient,,,,71.07,39.0885,,63.963,90,percent of total billed charges,,,,71.07,100,percent of total billed charges,,,,,,,,,63.963,,,fee schedule,,,56.856,,,fee schedule,,,,,,,,,,,,,,,,60.4095,85,percent of total billed charges,,,,,,,,,,35.371539,49.77,percent of total billed charges,,,,63.963,90,percent of total billed charges,,,,67.5165,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,60.4095,85,percent of total billed charges,,,,,,,,,35.371539,71.07,
SURTURE GUN - OR,2709660,CDM,,,270,RC,outpatient,,,,57.062,31.3841,,51.3558,90,percent of total billed charges,,,,57.062,100,percent of total billed charges,,,,,,,,,51.3558,,,fee schedule,,,45.6496,,,fee schedule,,,,,,,,,,,,,,,,48.5027,85,percent of total billed charges,,,,,,,,,,28.3997574,49.77,percent of total billed charges,,,,51.3558,90,percent of total billed charges,,,,54.2089,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,48.5027,85,percent of total billed charges,,,,,,,,,28.3997574,57.062,
TROCAR 5MM,2709860,CDM,,,270,RC,outpatient,,,,202.395,111.31725,,182.1555,90,percent of total billed charges,,,,202.395,100,percent of total billed charges,,,,,,,,,182.1555,,,fee schedule,,,161.916,,,fee schedule,,,,,,,,,,,,,,,,172.03575,85,percent of total billed charges,,,,,,,,,,100.7319915,49.77,percent of total billed charges,,,,182.1555,90,percent of total billed charges,,,,192.27525,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,172.03575,85,percent of total billed charges,,,,,,,,,100.7319915,202.395,
TROCAR 12MM,2709880,CDM,,,270,RC,outpatient,,,,273.465,150.40575,,246.1185,90,percent of total billed charges,,,,273.465,100,percent of total billed charges,,,,,,,,,246.1185,,,fee schedule,,,218.772,,,fee schedule,,,,,,,,,,,,,,,,232.44525,85,percent of total billed charges,,,,,,,,,,136.1035305,49.77,percent of total billed charges,,,,246.1185,90,percent of total billed charges,,,,259.79175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,232.44525,85,percent of total billed charges,,,,,,,,,136.1035305,273.465,
ARTHREX PUMP TUBING AR-6410,2709904,CDM,,,270,RC,outpatient,,,,110.416,60.7288,,99.3744,90,percent of total billed charges,,,,110.416,100,percent of total billed charges,,,,,,,,,99.3744,,,fee schedule,,,88.3328,,,fee schedule,,,,,,,,,,,,,,,,93.8536,85,percent of total billed charges,,,,,,,,,,54.9540432,49.77,percent of total billed charges,,,,99.3744,90,percent of total billed charges,,,,104.8952,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,93.8536,85,percent of total billed charges,,,,,,,,,54.9540432,110.416,
FETAL SCALP LEAD,2709915,CDM,,,270,RC,outpatient,,,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,30.9618,,,fee schedule,,,27.5216,,,fee schedule,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,,17.1218754,49.77,percent of total billed charges,,,,30.9618,90,percent of total billed charges,,,,32.6819,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,17.1218754,34.402,
JADA,2709916,CDM,,,270,RC,outpatient,,,,3459.255,1902.59025,,3113.3295,90,percent of total billed charges,,,,3459.255,100,percent of total billed charges,,,,,,,,,3113.3295,,,fee schedule,,,2767.404,,,fee schedule,,,,,,,,,,,,,,,,2940.36675,85,percent of total billed charges,,,,,,,,,,1721.671214,49.77,percent of total billed charges,,,,3113.3295,90,percent of total billed charges,,,,3286.29225,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2940.36675,85,percent of total billed charges,,,,,,,,,1721.671214,3459.255,
IUPC,2709925,CDM,,,270,RC,outpatient,,,,132.767,73.02185,,119.4903,90,percent of total billed charges,,,,132.767,100,percent of total billed charges,,,,,,,,,119.4903,,,fee schedule,,,106.2136,,,fee schedule,,,,,,,,,,,,,,,,112.85195,85,percent of total billed charges,,,,,,,,,,66.0781359,49.77,percent of total billed charges,,,,119.4903,90,percent of total billed charges,,,,126.12865,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,112.85195,85,percent of total billed charges,,,,,,,,,66.0781359,132.767,
FRED ANTI FOG,2709930,CDM,,,270,RC,outpatient,,,,8.446,4.6453,,7.6014,90,percent of total billed charges,,,,8.446,100,percent of total billed charges,,,,,,,,,7.6014,,,fee schedule,,,6.7568,,,fee schedule,,,,,,,,,,,,,,,,7.1791,85,percent of total billed charges,,,,,,,,,,4.2035742,49.77,percent of total billed charges,,,,7.6014,90,percent of total billed charges,,,,8.0237,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.1791,85,percent of total billed charges,,,,,,,,,4.2035742,8.446,
LINEAR CUTTER,2709931,CDM,,,270,RC,outpatient,,,,744.999,409.74945,,670.4991,90,percent of total billed charges,,,,744.999,100,percent of total billed charges,,,,,,,,,670.4991,,,fee schedule,,,595.9992,,,fee schedule,,,,,,,,,,,,,,,,633.24915,85,percent of total billed charges,,,,,,,,,,370.7860023,49.77,percent of total billed charges,,,,670.4991,90,percent of total billed charges,,,,707.74905,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,633.24915,85,percent of total billed charges,,,,,,,,,370.7860023,744.999,
MULTIDEX POWDER,2709935,CDM,,,270,RC,outpatient,,,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,23.2677,,,fee schedule,,,20.6824,,,fee schedule,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,,12.8670381,49.77,percent of total billed charges,,,,23.2677,90,percent of total billed charges,,,,24.56035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,12.8670381,25.853,
ENDO STITCH LOADS,2709980,CDM,,,270,RC,outpatient,,,,123.703,68.03665,,111.3327,90,percent of total billed charges,,,,123.703,100,percent of total billed charges,,,,,,,,,111.3327,,,fee schedule,,,98.9624,,,fee schedule,,,,,,,,,,,,,,,,105.14755,85,percent of total billed charges,,,,,,,,,,61.5669831,49.77,percent of total billed charges,,,,111.3327,90,percent of total billed charges,,,,117.51785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,105.14755,85,percent of total billed charges,,,,,,,,,61.5669831,123.703,
INSPACE MEDIUM,2709998,CDM,,,270,RC,outpatient,,,,14832,8157.6,,13348.8,90,percent of total billed charges,,,,14832,100,percent of total billed charges,,,,,,,,,13348.8,,,fee schedule,,,11865.6,,,fee schedule,,,,,,,,,,,,,,,,12607.2,85,percent of total billed charges,,,,,,,,,,7381.8864,49.77,percent of total billed charges,,,,13348.8,90,percent of total billed charges,,,,14090.4,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12607.2,85,percent of total billed charges,,,,,,,,,7381.8864,14832,
CRASH CART - LDRP,2790020,CDM,,,270,RC,outpatient,,,,106.914,58.8027,,96.2226,90,percent of total billed charges,,,,106.914,100,percent of total billed charges,,,,,,,,,96.2226,,,fee schedule,,,85.5312,,,fee schedule,,,,,,,,,,,,,,,,90.8769,85,percent of total billed charges,,,,,,,,,,53.2110978,49.77,percent of total billed charges,,,,96.2226,90,percent of total billed charges,,,,101.5683,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,90.8769,85,percent of total billed charges,,,,,,,,,53.2110978,106.914,
ART PRESS MONITOR/DAILY - ICU,7390000,CDM,,,270,RC,outpatient,,,,22.66,12.463,,20.394,90,percent of total billed charges,,,,22.66,100,percent of total billed charges,,,,,,,,,20.394,,,fee schedule,,,18.128,,,fee schedule,,,,,,,,,,,,,,,,19.261,85,percent of total billed charges,,,,,,,,,,11.277882,49.77,percent of total billed charges,,,,20.394,90,percent of total billed charges,,,,21.527,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.261,85,percent of total billed charges,,,,,,,,,11.277882,22.66,
ARTERIAL LINE SETUP - ICU,7390010,CDM,,,270,RC,outpatient,,,,263.371,144.85405,,237.0339,90,percent of total billed charges,,,,263.371,100,percent of total billed charges,,,,,,,,,237.0339,,,fee schedule,,,210.6968,,,fee schedule,,,,,,,,,,,,,,,,223.86535,85,percent of total billed charges,,,,,,,,,,131.0797467,49.77,percent of total billed charges,,,,237.0339,90,percent of total billed charges,,,,250.20245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,223.86535,85,percent of total billed charges,,,,,,,,,131.0797467,263.371,
LAPAROSCOPIC ELECTRODE J-HOOK,2700021,CDM,,,272,RC,outpatient,,,,85.49,47.0195,,76.941,90,percent of total billed charges,,,,85.49,100,percent of total billed charges,,,,,,,,,76.941,,,fee schedule,,,68.392,,,fee schedule,,,,,,,,,,,,,,,,72.6665,85,percent of total billed charges,,,,,,,,,,42.548373,49.77,percent of total billed charges,,,,76.941,90,percent of total billed charges,,,,81.2155,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,72.6665,85,percent of total billed charges,,,,,,,,,42.548373,85.49,
V-LOC SUTURE O GS-21,2700311,CDM,,,272,RC,outpatient,,,,66.744,36.7092,,60.0696,90,percent of total billed charges,,,,66.744,100,percent of total billed charges,,,,,,,,,60.0696,,,fee schedule,,,53.3952,,,fee schedule,,,,,,,,,,,,,,,,56.7324,85,percent of total billed charges,,,,,,,,,,33.2184888,49.77,percent of total billed charges,,,,60.0696,90,percent of total billed charges,,,,63.4068,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,56.7324,85,percent of total billed charges,,,,,,,,,33.2184888,66.744,
6.5mm X 75 Dri Lock Cannula,2701425,CDM,,,272,RC,outpatient,,,,16.2122,8.91671,,14.59098,90,percent of total billed charges,,,,16.2122,100,percent of total billed charges,,,,,,,,,14.59098,,,fee schedule,,,12.96976,,,fee schedule,,,,,,,,,,,,,,,,13.78037,85,percent of total billed charges,,,,,,,,,,8.06881194,49.77,percent of total billed charges,,,,14.59098,90,percent of total billed charges,,,,15.40159,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.78037,85,percent of total billed charges,,,,,,,,,8.06881194,16.2122,
STAPLER NTLC75,2701546,CDM,,,272,RC,outpatient,,,,141.522,77.8371,,127.3698,90,percent of total billed charges,,,,141.522,100,percent of total billed charges,,,,,,,,,127.3698,,,fee schedule,,,113.2176,,,fee schedule,,,,,,,,,,,,,,,,120.2937,85,percent of total billed charges,,,,,,,,,,70.4354994,49.77,percent of total billed charges,,,,127.3698,90,percent of total billed charges,,,,134.4459,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,120.2937,85,percent of total billed charges,,,,,,,,,70.4354994,141.522,
STAPLER SR75 RELOADS,2701547,CDM,,,272,RC,outpatient,,,,217.742,119.7581,,195.9678,90,percent of total billed charges,,,,217.742,100,percent of total billed charges,,,,,,,,,195.9678,,,fee schedule,,,174.1936,,,fee schedule,,,,,,,,,,,,,,,,185.0807,85,percent of total billed charges,,,,,,,,,,108.3701934,49.77,percent of total billed charges,,,,195.9678,90,percent of total billed charges,,,,206.8549,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,185.0807,85,percent of total billed charges,,,,,,,,,108.3701934,217.742,
STAPLER PSEE60A POWERED PLUS,2701551,CDM,,,272,RC,outpatient,,,,797.426,438.5843,,717.6834,90,percent of total billed charges,,,,797.426,100,percent of total billed charges,,,,,,,,,717.6834,,,fee schedule,,,637.9408,,,fee schedule,,,,,,,,,,,,,,,,677.8121,85,percent of total billed charges,,,,,,,,,,396.8789202,49.77,percent of total billed charges,,,,717.6834,90,percent of total billed charges,,,,757.5547,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,677.8121,85,percent of total billed charges,,,,,,,,,396.8789202,797.426,
STAPLER; HEMORRHOID,2701552,CDM,,,272,RC,outpatient,,,,911.344,501.2392,,820.2096,90,percent of total billed charges,,,,911.344,100,percent of total billed charges,,,,,,,,,820.2096,,,fee schedule,,,729.0752,,,fee schedule,,,,,,,,,,,,,,,,774.6424,85,percent of total billed charges,,,,,,,,,,453.5759088,49.77,percent of total billed charges,,,,820.2096,90,percent of total billed charges,,,,865.7768,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,774.6424,85,percent of total billed charges,,,,,,,,,453.5759088,911.344,
PICC LINE KIT,2701836,CDM,,,272,RC,outpatient,,,,378.319,208.07545,,340.4871,90,percent of total billed charges,,,,378.319,100,percent of total billed charges,,,,,,,,,340.4871,,,fee schedule,,,302.6552,,,fee schedule,,,,,,,,,,,,,,,,321.57115,85,percent of total billed charges,,,,,,,,,,188.2893663,49.77,percent of total billed charges,,,,340.4871,90,percent of total billed charges,,,,359.40305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,321.57115,85,percent of total billed charges,,,,,,,,,188.2893663,378.319,
CAPIO SUTURE (REF #833-114),2702539,CDM,,,272,RC,outpatient,,,,74.057,40.73135,,66.6513,90,percent of total billed charges,,,,74.057,100,percent of total billed charges,,,,,,,,,66.6513,,,fee schedule,,,59.2456,,,fee schedule,,,,,,,,,,,,,,,,62.94845,85,percent of total billed charges,,,,,,,,,,36.8581689,49.77,percent of total billed charges,,,,66.6513,90,percent of total billed charges,,,,70.35415,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,62.94845,85,percent of total billed charges,,,,,,,,,36.8581689,74.057,
FOGARTY EMBOL CATH,2703250,CDM,,,272,RC,outpatient,,,,155.427,85.48485,,139.8843,90,percent of total billed charges,,,,155.427,100,percent of total billed charges,,,,,,,,,139.8843,,,fee schedule,,,124.3416,,,fee schedule,,,,,,,,,,,,,,,,132.11295,85,percent of total billed charges,,,,,,,,,,77.3560179,49.77,percent of total billed charges,,,,139.8843,90,percent of total billed charges,,,,147.65565,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,132.11295,85,percent of total billed charges,,,,,,,,,77.3560179,155.427,
CHEST TUBE INSERTION KIT,2703425,CDM,,,272,RC,outpatient,,,,106.193,58.40615,,95.5737,90,percent of total billed charges,,,,106.193,100,percent of total billed charges,,,,,,,,,95.5737,,,fee schedule,,,84.9544,,,fee schedule,,,,,,,,,,,,,,,,90.26405,85,percent of total billed charges,,,,,,,,,,52.8522561,49.77,percent of total billed charges,,,,95.5737,90,percent of total billed charges,,,,100.88335,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,90.26405,85,percent of total billed charges,,,,,,,,,52.8522561,106.193,
BEDSIDE STERILE KIT,2703618,CDM,,,272,RC,outpatient,,,,199.511,109.73105,,179.5599,90,percent of total billed charges,,,,199.511,100,percent of total billed charges,,,,,,,,,179.5599,,,fee schedule,,,159.6088,,,fee schedule,,,,,,,,,,,,,,,,169.58435,85,percent of total billed charges,,,,,,,,,,99.2966247,49.77,percent of total billed charges,,,,179.5599,90,percent of total billed charges,,,,189.53545,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,169.58435,85,percent of total billed charges,,,,,,,,,99.2966247,199.511,
APPLIED SINGLE SITE TROCAR,2703671,CDM,,,272,RC,outpatient,,,,1593.204,876.2622,,1433.8836,90,percent of total billed charges,,,,1593.204,100,percent of total billed charges,,,,,,,,,1433.8836,,,fee schedule,,,1274.5632,,,fee schedule,,,,,,,,,,,,,,,,1354.2234,85,percent of total billed charges,,,,,,,,,,792.9376308,49.77,percent of total billed charges,,,,1433.8836,90,percent of total billed charges,,,,1513.5438,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1354.2234,85,percent of total billed charges,,,,,,,,,792.9376308,1593.204,
ALEXIS WOUND PROTECTOR/RETRAC,2703672,CDM,,,272,RC,outpatient,,,,124.424,68.4332,,111.9816,90,percent of total billed charges,,,,124.424,100,percent of total billed charges,,,,,,,,,111.9816,,,fee schedule,,,99.5392,,,fee schedule,,,,,,,,,,,,,,,,105.7604,85,percent of total billed charges,,,,,,,,,,61.9258248,49.77,percent of total billed charges,,,,111.9816,90,percent of total billed charges,,,,118.2028,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,105.7604,85,percent of total billed charges,,,,,,,,,61.9258248,124.424,
BOSTON SCIENCE GLIDEWIRE,2704551,CDM,,,272,RC,outpatient,,,,94.966,52.2313,,85.4694,90,percent of total billed charges,,,,94.966,100,percent of total billed charges,,,,,,,,,85.4694,,,fee schedule,,,75.9728,,,fee schedule,,,,,,,,,,,,,,,,80.7211,85,percent of total billed charges,,,,,,,,,,47.2645782,49.77,percent of total billed charges,,,,85.4694,90,percent of total billed charges,,,,90.2177,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,80.7211,85,percent of total billed charges,,,,,,,,,47.2645782,94.966,
UNIVERSAL STAPLER LOAD 30-2.5,2705346,CDM,,,272,RC,outpatient,,,,213.828,117.6054,,192.4452,90,percent of total billed charges,,,,213.828,100,percent of total billed charges,,,,,,,,,192.4452,,,fee schedule,,,171.0624,,,fee schedule,,,,,,,,,,,,,,,,181.7538,85,percent of total billed charges,,,,,,,,,,106.4221956,49.77,percent of total billed charges,,,,192.4452,90,percent of total billed charges,,,,203.1366,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,181.7538,85,percent of total billed charges,,,,,,,,,106.4221956,213.828,
LIGASURE OPEN LF4418,2705746,CDM,,,272,RC,outpatient,,,,713.172,392.2446,,641.8548,90,percent of total billed charges,,,,713.172,100,percent of total billed charges,,,,,,,,,641.8548,,,fee schedule,,,570.5376,,,fee schedule,,,,,,,,,,,,,,,,606.1962,85,percent of total billed charges,,,,,,,,,,354.9457044,49.77,percent of total billed charges,,,,641.8548,90,percent of total billed charges,,,,677.5134,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,606.1962,85,percent of total billed charges,,,,,,,,,354.9457044,713.172,
Z-THREAD TROCAR 5X100mm,2705934,CDM,,,272,RC,outpatient,,,,48.719,26.79545,,43.8471,90,percent of total billed charges,,,,48.719,100,percent of total billed charges,,,,,,,,,43.8471,,,fee schedule,,,38.9752,,,fee schedule,,,,,,,,,,,,,,,,41.41115,85,percent of total billed charges,,,,,,,,,,24.2474463,49.77,percent of total billed charges,,,,43.8471,90,percent of total billed charges,,,,46.28305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,41.41115,85,percent of total billed charges,,,,,,,,,24.2474463,48.719,
Z-THREAD TROCARS 11X100mm,2705937,CDM,,,272,RC,outpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,51.6339,,,fee schedule,,,45.8968,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,28.5535467,57.371,
SILASTIC STINT,2706570,CDM,,,272,RC,outpatient,,,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
SIMPLEX CEMENT,2706620,CDM,,,272,RC,outpatient,,,,110.416,60.7288,,99.3744,90,percent of total billed charges,,,,110.416,100,percent of total billed charges,,,,,,,,,99.3744,,,fee schedule,,,88.3328,,,fee schedule,,,,,,,,,,,,,,,,93.8536,85,percent of total billed charges,,,,,,,,,,54.9540432,49.77,percent of total billed charges,,,,99.3744,90,percent of total billed charges,,,,104.8952,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,93.8536,85,percent of total billed charges,,,,,,,,,54.9540432,110.416,
ULTRASOUND PROBE COVER,2706944,CDM,,,272,RC,outpatient,,,,31.724,17.4482,,28.5516,90,percent of total billed charges,,,,31.724,100,percent of total billed charges,,,,,,,,,28.5516,,,fee schedule,,,25.3792,,,fee schedule,,,,,,,,,,,,,,,,26.9654,85,percent of total billed charges,,,,,,,,,,15.7890348,49.77,percent of total billed charges,,,,28.5516,90,percent of total billed charges,,,,30.1378,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.9654,85,percent of total billed charges,,,,,,,,,15.7890348,31.724,
"SUTURE MO-6 18"" ETHIBOND",2707730,CDM,,,272,RC,outpatient,,,,53.148,29.2314,,47.8332,90,percent of total billed charges,,,,53.148,100,percent of total billed charges,,,,,,,,,47.8332,,,fee schedule,,,42.5184,,,fee schedule,,,,,,,,,,,,,,,,45.1758,85,percent of total billed charges,,,,,,,,,,26.4517596,49.77,percent of total billed charges,,,,47.8332,90,percent of total billed charges,,,,50.4906,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,45.1758,85,percent of total billed charges,,,,,,,,,26.4517596,53.148,
Crossflow inflow cass tubing,2707777,CDM,,,272,RC,outpatient,,,,10.506,5.7783,,9.4554,90,percent of total billed charges,,,,10.506,100,percent of total billed charges,,,,,,,,,9.4554,,,fee schedule,,,8.4048,,,fee schedule,,,,,,,,,,,,,,,,8.9301,85,percent of total billed charges,,,,,,,,,,5.2288362,49.77,percent of total billed charges,,,,9.4554,90,percent of total billed charges,,,,9.9807,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.9301,85,percent of total billed charges,,,,,,,,,5.2288362,10.506,
Arm positioning kit,2707778,CDM,,,272,RC,outpatient,,,,127.308,70.0194,,114.5772,90,percent of total billed charges,,,,127.308,100,percent of total billed charges,,,,,,,,,114.5772,,,fee schedule,,,101.8464,,,fee schedule,,,,,,,,,,,,,,,,108.2118,85,percent of total billed charges,,,,,,,,,,63.3611916,49.77,percent of total billed charges,,,,114.5772,90,percent of total billed charges,,,,120.9426,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,108.2118,85,percent of total billed charges,,,,,,,,,63.3611916,127.308,
OPTIMA STENT - ALL,2708066,CDM,,,272,RC,outpatient,,,,212.592,116.9256,,191.3328,90,percent of total billed charges,,,,212.592,100,percent of total billed charges,,,,,,,,,191.3328,,,fee schedule,,,170.0736,,,fee schedule,,,,,,,,,,,,,,,,180.7032,85,percent of total billed charges,,,,,,,,,,105.8070384,49.77,percent of total billed charges,,,,191.3328,90,percent of total billed charges,,,,201.9624,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,180.7032,85,percent of total billed charges,,,,,,,,,105.8070384,212.592,
PREVENA PEEL & PLACE DRESSING,2709622,CDM,,,272,RC,outpatient,,,,670.221,368.62155,,603.1989,90,percent of total billed charges,,,,670.221,100,percent of total billed charges,,,,,,,,,603.1989,,,fee schedule,,,536.1768,,,fee schedule,,,,,,,,,,,,,,,,569.68785,85,percent of total billed charges,,,,,,,,,,333.5689917,49.77,percent of total billed charges,,,,603.1989,90,percent of total billed charges,,,,636.70995,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,569.68785,85,percent of total billed charges,,,,,,,,,333.5689917,670.221,
X PASS Suture Braid 2,2722324,CDM,,,272,RC,outpatient,,,,105.0291,57.766005,,94.52619,90,percent of total billed charges,,,,105.0291,100,percent of total billed charges,,,,,,,,,94.52619,,,fee schedule,,,84.02328,,,fee schedule,,,,,,,,,,,,,,,,89.274735,85,percent of total billed charges,,,,,,,,,,52.27298307,49.77,percent of total billed charges,,,,94.52619,90,percent of total billed charges,,,,99.777645,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,89.274735,85,percent of total billed charges,,,,,,,,,52.27298307,105.0291,
ECHOGENIC NEEDLES,2723253,CDM,,,272,RC,outpatient,,,,38.213,21.01715,,34.3917,90,percent of total billed charges,,,,38.213,100,percent of total billed charges,,,,,,,,,34.3917,,,fee schedule,,,30.5704,,,fee schedule,,,,,,,,,,,,,,,,32.48105,85,percent of total billed charges,,,,,,,,,,19.0186101,49.77,percent of total billed charges,,,,34.3917,90,percent of total billed charges,,,,36.30235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,32.48105,85,percent of total billed charges,,,,,,,,,19.0186101,38.213,
STERILE DISP TOURNIQUET,2723362,CDM,,,272,RC,outpatient,,,,126.587,69.62285,,113.9283,90,percent of total billed charges,,,,126.587,100,percent of total billed charges,,,,,,,,,113.9283,,,fee schedule,,,101.2696,,,fee schedule,,,,,,,,,,,,,,,,107.59895,85,percent of total billed charges,,,,,,,,,,63.0023499,49.77,percent of total billed charges,,,,113.9283,90,percent of total billed charges,,,,120.25765,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,107.59895,85,percent of total billed charges,,,,,,,,,63.0023499,126.587,
PREVENA DRESSING,2723533,CDM,,,272,RC,outpatient,,,,395.726,217.6493,,356.1534,90,percent of total billed charges,,,,395.726,100,percent of total billed charges,,,,,,,,,356.1534,,,fee schedule,,,316.5808,,,fee schedule,,,,,,,,,,,,,,,,336.3671,85,percent of total billed charges,,,,,,,,,,196.9528302,49.77,percent of total billed charges,,,,356.1534,90,percent of total billed charges,,,,375.9397,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,336.3671,85,percent of total billed charges,,,,,,,,,196.9528302,395.726,
CERVICAL RIPENING BALLOON,2723706,CDM,,,272,RC,outpatient,,,,112.064,61.6352,,100.8576,90,percent of total billed charges,,,,112.064,100,percent of total billed charges,,,,,,,,,100.8576,,,fee schedule,,,89.6512,,,fee schedule,,,,,,,,,,,,,,,,95.2544,85,percent of total billed charges,,,,,,,,,,55.7742528,49.77,percent of total billed charges,,,,100.8576,90,percent of total billed charges,,,,106.4608,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,95.2544,85,percent of total billed charges,,,,,,,,,55.7742528,112.064,
PRINEO SKIN CLOSURE SYSTEM,2724159,CDM,,,272,RC,outpatient,,,,189.932,104.4626,,170.9388,90,percent of total billed charges,,,,189.932,100,percent of total billed charges,,,,,,,,,170.9388,,,fee schedule,,,151.9456,,,fee schedule,,,,,,,,,,,,,,,,161.4422,85,percent of total billed charges,,,,,,,,,,94.5291564,49.77,percent of total billed charges,,,,170.9388,90,percent of total billed charges,,,,180.4354,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,161.4422,85,percent of total billed charges,,,,,,,,,94.5291564,189.932,
SWEEP SUCTION PROBE,2724455,CDM,,,272,RC,outpatient,,,,412.412,226.8266,,371.1708,90,percent of total billed charges,,,,412.412,100,percent of total billed charges,,,,,,,,,371.1708,,,fee schedule,,,329.9296,,,fee schedule,,,,,,,,,,,,,,,,350.5502,85,percent of total billed charges,,,,,,,,,,205.2574524,49.77,percent of total billed charges,,,,371.1708,90,percent of total billed charges,,,,391.7914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,350.5502,85,percent of total billed charges,,,,,,,,,205.2574524,412.412,
UTERINE MANIP ADVINCULA 3CM,2724530,CDM,,,272,RC,outpatient,,,,141.522,77.8371,,127.3698,90,percent of total billed charges,,,,141.522,100,percent of total billed charges,,,,,,,,,127.3698,,,fee schedule,,,113.2176,,,fee schedule,,,,,,,,,,,,,,,,120.2937,85,percent of total billed charges,,,,,,,,,,70.4354994,49.77,percent of total billed charges,,,,127.3698,90,percent of total billed charges,,,,134.4459,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,120.2937,85,percent of total billed charges,,,,,,,,,70.4354994,141.522,
VIZADISC KNEE PROTRACKING KIT,2724560,CDM,,,272,RC,outpatient,,,,443.518,243.9349,,399.1662,90,percent of total billed charges,,,,443.518,100,percent of total billed charges,,,,,,,,,399.1662,,,fee schedule,,,354.8144,,,fee schedule,,,,,,,,,,,,,,,,376.9903,85,percent of total billed charges,,,,,,,,,,220.7389086,49.77,percent of total billed charges,,,,399.1662,90,percent of total billed charges,,,,421.3421,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,376.9903,85,percent of total billed charges,,,,,,,,,220.7389086,443.518,
MYOSURE LITE TISSUE DEVICE,2724596,CDM,,,272,RC,outpatient,,,,859.638,472.8009,,773.6742,90,percent of total billed charges,,,,859.638,100,percent of total billed charges,,,,,,,,,773.6742,,,fee schedule,,,687.7104,,,fee schedule,,,,,,,,,,,,,,,,730.6923,85,percent of total billed charges,,,,,,,,,,427.8418326,49.77,percent of total billed charges,,,,773.6742,90,percent of total billed charges,,,,816.6561,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,730.6923,85,percent of total billed charges,,,,,,,,,427.8418326,859.638,
SINGLE USE SEAL SET,2724597,CDM,,,272,RC,outpatient,,,,23.793,13.08615,,21.4137,90,percent of total billed charges,,,,23.793,100,percent of total billed charges,,,,,,,,,21.4137,,,fee schedule,,,19.0344,,,fee schedule,,,,,,,,,,,,,,,,20.22405,85,percent of total billed charges,,,,,,,,,,11.8417761,49.77,percent of total billed charges,,,,21.4137,90,percent of total billed charges,,,,22.60335,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.22405,85,percent of total billed charges,,,,,,,,,11.8417761,23.793,
AQUILEX INFLOW TUBESET,2724598,CDM,,,272,RC,outpatient,,,,189.52,104.236,,170.568,90,percent of total billed charges,,,,189.52,100,percent of total billed charges,,,,,,,,,170.568,,,fee schedule,,,151.616,,,fee schedule,,,,,,,,,,,,,,,,161.092,85,percent of total billed charges,,,,,,,,,,94.324104,49.77,percent of total billed charges,,,,170.568,90,percent of total billed charges,,,,180.044,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,161.092,85,percent of total billed charges,,,,,,,,,94.324104,189.52,
AQUILEX OUTFLOW TUBESET,2724599,CDM,,,272,RC,outpatient,,,,43.569,23.96295,,39.2121,90,percent of total billed charges,,,,43.569,100,percent of total billed charges,,,,,,,,,39.2121,,,fee schedule,,,34.8552,,,fee schedule,,,,,,,,,,,,,,,,37.03365,85,percent of total billed charges,,,,,,,,,,21.6842913,49.77,percent of total billed charges,,,,39.2121,90,percent of total billed charges,,,,41.39055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.03365,85,percent of total billed charges,,,,,,,,,21.6842913,43.569,
MYOSURE REACH TIS REMOVAL DEV,2724671,CDM,,,272,RC,outpatient,,,,1596.088,877.8484,,1436.4792,90,percent of total billed charges,,,,1596.088,100,percent of total billed charges,,,,,,,,,1436.4792,,,fee schedule,,,1276.8704,,,fee schedule,,,,,,,,,,,,,,,,1356.6748,85,percent of total billed charges,,,,,,,,,,794.3729976,49.77,percent of total billed charges,,,,1436.4792,90,percent of total billed charges,,,,1516.2836,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1356.6748,85,percent of total billed charges,,,,,,,,,794.3729976,1596.088,
SONICISION 7 DISSECTOR,2724701,CDM,,,272,RC,outpatient,,,,631.081,347.09455,,567.9729,90,percent of total billed charges,,,,631.081,100,percent of total billed charges,,,,,,,,,567.9729,,,fee schedule,,,504.8648,,,fee schedule,,,,,,,,,,,,,,,,536.41885,85,percent of total billed charges,,,,,,,,,,314.0890137,49.77,percent of total billed charges,,,,567.9729,90,percent of total billed charges,,,,599.52695,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,536.41885,85,percent of total billed charges,,,,,,,,,314.0890137,631.081,
MYOSURE TUBING,2724809,CDM,,,272,RC,outpatient,,,,190.241,104.63255,,171.2169,90,percent of total billed charges,,,,190.241,100,percent of total billed charges,,,,,,,,,171.2169,,,fee schedule,,,152.1928,,,fee schedule,,,,,,,,,,,,,,,,161.70485,85,percent of total billed charges,,,,,,,,,,94.6829457,49.77,percent of total billed charges,,,,171.2169,90,percent of total billed charges,,,,180.72895,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,161.70485,85,percent of total billed charges,,,,,,,,,94.6829457,190.241,
SILICONE RETRACTOR CORD,2725120,CDM,,,272,RC,outpatient,,,,12.9986,7.14923,,11.69874,90,percent of total billed charges,,,,12.9986,100,percent of total billed charges,,,,,,,,,11.69874,,,fee schedule,,,10.39888,,,fee schedule,,,,,,,,,,,,,,,,11.04881,85,percent of total billed charges,,,,,,,,,,6.46940322,49.77,percent of total billed charges,,,,11.69874,90,percent of total billed charges,,,,12.34867,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11.04881,85,percent of total billed charges,,,,,,,,,6.46940322,12.9986,
3.2 BONE PIN 110 MM,2725220,CDM,,,272,RC,outpatient,,,,262.7324,144.50282,,236.45916,90,percent of total billed charges,,,,262.7324,100,percent of total billed charges,,,,,,,,,236.45916,,,fee schedule,,,210.18592,,,fee schedule,,,,,,,,,,,,,,,,223.32254,85,percent of total billed charges,,,,,,,,,,130.7619155,49.77,percent of total billed charges,,,,236.45916,90,percent of total billed charges,,,,249.59578,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,223.32254,85,percent of total billed charges,,,,,,,,,130.7619155,262.7324,
3.2MM BONE PIN 140MM,2725255,CDM,,,272,RC,outpatient,,,,262.7324,144.50282,,236.45916,90,percent of total billed charges,,,,262.7324,100,percent of total billed charges,,,,,,,,,236.45916,,,fee schedule,,,210.18592,,,fee schedule,,,,,,,,,,,,,,,,223.32254,85,percent of total billed charges,,,,,,,,,,130.7619155,49.77,percent of total billed charges,,,,236.45916,90,percent of total billed charges,,,,249.59578,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,223.32254,85,percent of total billed charges,,,,,,,,,130.7619155,262.7324,
TIBIA CHECKPOINT STERILE,2725380,CDM,,,272,RC,outpatient,,,,104.0506,57.22783,,93.64554,90,percent of total billed charges,,,,104.0506,100,percent of total billed charges,,,,,,,,,93.64554,,,fee schedule,,,83.24048,,,fee schedule,,,,,,,,,,,,,,,,88.44301,85,percent of total billed charges,,,,,,,,,,51.78598362,49.77,percent of total billed charges,,,,93.64554,90,percent of total billed charges,,,,98.84807,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,88.44301,85,percent of total billed charges,,,,,,,,,51.78598362,104.0506,
MAKO BLADE STANDARD,2725605,CDM,,,272,RC,outpatient,,,,400.8966,220.49313,,360.80694,90,percent of total billed charges,,,,400.8966,100,percent of total billed charges,,,,,,,,,360.80694,,,fee schedule,,,320.71728,,,fee schedule,,,,,,,,,,,,,,,,340.76211,85,percent of total billed charges,,,,,,,,,,199.5262378,49.77,percent of total billed charges,,,,360.80694,90,percent of total billed charges,,,,380.85177,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,340.76211,85,percent of total billed charges,,,,,,,,,199.5262378,400.8966,
EEA STAPLER 28MM & 31MM,2725640,CDM,,,272,RC,outpatient,,,,1688.067,928.43685,,1519.2603,90,percent of total billed charges,,,,1688.067,100,percent of total billed charges,,,,,,,,,1519.2603,,,fee schedule,,,1350.4536,,,fee schedule,,,,,,,,,,,,,,,,1434.85695,85,percent of total billed charges,,,,,,,,,,840.1509459,49.77,percent of total billed charges,,,,1519.2603,90,percent of total billed charges,,,,1603.66365,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1434.85695,85,percent of total billed charges,,,,,,,,,840.1509459,1688.067,
"3DMAX LIGHT  0117321, 0117311",2726660,CDM,,,272,RC,outpatient,,,,364.414,200.4277,,327.9726,90,percent of total billed charges,,,,364.414,100,percent of total billed charges,,,,,,,,,327.9726,,,fee schedule,,,291.5312,,,fee schedule,,,,,,,,,,,,,,,,309.7519,85,percent of total billed charges,,,,,,,,,,181.3688478,49.77,percent of total billed charges,,,,327.9726,90,percent of total billed charges,,,,346.1933,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,309.7519,85,percent of total billed charges,,,,,,,,,181.3688478,364.414,
BARD SOFT MESH 6X6,2727102,CDM,,,272,RC,outpatient,,,,120.819,66.45045,,108.7371,90,percent of total billed charges,,,,120.819,100,percent of total billed charges,,,,,,,,,108.7371,,,fee schedule,,,96.6552,,,fee schedule,,,,,,,,,,,,,,,,102.69615,85,percent of total billed charges,,,,,,,,,,60.1316163,49.77,percent of total billed charges,,,,108.7371,90,percent of total billed charges,,,,114.77805,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,102.69615,85,percent of total billed charges,,,,,,,,,60.1316163,120.819,
INSORB STAPLER,2727123,CDM,,,272,RC,outpatient,,,,99.395,54.66725,,89.4555,90,percent of total billed charges,,,,99.395,100,percent of total billed charges,,,,,,,,,89.4555,,,fee schedule,,,79.516,,,fee schedule,,,,,,,,,,,,,,,,84.48575,85,percent of total billed charges,,,,,,,,,,49.4688915,49.77,percent of total billed charges,,,,89.4555,90,percent of total billed charges,,,,94.42525,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,84.48575,85,percent of total billed charges,,,,,,,,,49.4688915,99.395,
PROXIMATE CUTTER RELOAD,2727150,CDM,,,272,RC,outpatient,,,,1589.084,873.9962,,1430.1756,90,percent of total billed charges,,,,1589.084,100,percent of total billed charges,,,,,,,,,1430.1756,,,fee schedule,,,1271.2672,,,fee schedule,,,,,,,,,,,,,,,,1350.7214,85,percent of total billed charges,,,,,,,,,,790.8871068,49.77,percent of total billed charges,,,,1430.1756,90,percent of total billed charges,,,,1509.6298,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1350.7214,85,percent of total billed charges,,,,,,,,,790.8871068,1589.084,
SHORT HARMONIC HANDPIECE HAR23,2727434,CDM,,,272,RC,outpatient,,,,567.839,312.31145,,511.0551,90,percent of total billed charges,,,,567.839,100,percent of total billed charges,,,,,,,,,511.0551,,,fee schedule,,,454.2712,,,fee schedule,,,,,,,,,,,,,,,,482.66315,85,percent of total billed charges,,,,,,,,,,282.6134703,49.77,percent of total billed charges,,,,511.0551,90,percent of total billed charges,,,,539.44705,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,482.66315,85,percent of total billed charges,,,,,,,,,282.6134703,567.839,
SURGICAL APPLICATOR,2727808,CDM,,,272,RC,outpatient,,,,52.942,29.1181,,47.6478,90,percent of total billed charges,,,,52.942,100,percent of total billed charges,,,,,,,,,47.6478,,,fee schedule,,,42.3536,,,fee schedule,,,,,,,,,,,,,,,,45.0007,85,percent of total billed charges,,,,,,,,,,26.3492334,49.77,percent of total billed charges,,,,47.6478,90,percent of total billed charges,,,,50.2949,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,45.0007,85,percent of total billed charges,,,,,,,,,26.3492334,52.942,
SURGICAL POWDER,2727810,CDM,,,272,RC,outpatient,,,,431.57,237.3635,,388.413,90,percent of total billed charges,,,,431.57,100,percent of total billed charges,,,,,,,,,388.413,,,fee schedule,,,345.256,,,fee schedule,,,,,,,,,,,,,,,,366.8345,85,percent of total billed charges,,,,,,,,,,214.792389,49.77,percent of total billed charges,,,,388.413,90,percent of total billed charges,,,,409.9915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,366.8345,85,percent of total billed charges,,,,,,,,,214.792389,431.57,
BALLOON SINUPLASTY SYSTEM,2727949,CDM,,,272,RC,outpatient,,,,3352.65,1843.9575,,3017.385,90,percent of total billed charges,,,,3352.65,100,percent of total billed charges,,,,,,,,,3017.385,,,fee schedule,,,2682.12,,,fee schedule,,,,,,,,,,,,,,,,2849.7525,85,percent of total billed charges,,,,,,,,,,1668.613905,49.77,percent of total billed charges,,,,3017.385,90,percent of total billed charges,,,,3185.0175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2849.7525,85,percent of total billed charges,,,,,,,,,1668.613905,3352.65,
KII OPT ACCESS 8X100,2728245,CDM,,,272,RC,outpatient,,,,48.719,26.79545,,43.8471,90,percent of total billed charges,,,,48.719,100,percent of total billed charges,,,,,,,,,43.8471,,,fee schedule,,,38.9752,,,fee schedule,,,,,,,,,,,,,,,,41.41115,85,percent of total billed charges,,,,,,,,,,24.2474463,49.77,percent of total billed charges,,,,43.8471,90,percent of total billed charges,,,,46.28305,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,41.41115,85,percent of total billed charges,,,,,,,,,24.2474463,48.719,
BARTHOLIN CATHETER,2728386,CDM,,,272,RC,outpatient,,,,60.564,33.3102,,54.5076,90,percent of total billed charges,,,,60.564,100,percent of total billed charges,,,,,,,,,54.5076,,,fee schedule,,,48.4512,,,fee schedule,,,,,,,,,,,,,,,,51.4794,85,percent of total billed charges,,,,,,,,,,30.1427028,49.77,percent of total billed charges,,,,54.5076,90,percent of total billed charges,,,,57.5358,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,51.4794,85,percent of total billed charges,,,,,,,,,30.1427028,60.564,
STAPLER TLH90,2728393,CDM,,,272,RC,outpatient,,,,169.538,93.2459,,152.5842,90,percent of total billed charges,,,,169.538,100,percent of total billed charges,,,,,,,,,152.5842,,,fee schedule,,,135.6304,,,fee schedule,,,,,,,,,,,,,,,,144.1073,85,percent of total billed charges,,,,,,,,,,84.3790626,49.77,percent of total billed charges,,,,152.5842,90,percent of total billed charges,,,,161.0611,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,144.1073,85,percent of total billed charges,,,,,,,,,84.3790626,169.538,
STAPLER TRH90,2728394,CDM,,,272,RC,outpatient,,,,64.478,35.4629,,58.0302,90,percent of total billed charges,,,,64.478,100,percent of total billed charges,,,,,,,,,58.0302,,,fee schedule,,,51.5824,,,fee schedule,,,,,,,,,,,,,,,,54.8063,85,percent of total billed charges,,,,,,,,,,32.0907006,49.77,percent of total billed charges,,,,58.0302,90,percent of total billed charges,,,,61.2541,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,54.8063,85,percent of total billed charges,,,,,,,,,32.0907006,64.478,
PROXIMATE RELOAD THICK TISSUE,2728422,CDM,,,272,RC,outpatient,,,,1620.293,891.16115,,1458.2637,90,percent of total billed charges,,,,1620.293,100,percent of total billed charges,,,,,,,,,1458.2637,,,fee schedule,,,1296.2344,,,fee schedule,,,,,,,,,,,,,,,,1377.24905,85,percent of total billed charges,,,,,,,,,,806.4198261,49.77,percent of total billed charges,,,,1458.2637,90,percent of total billed charges,,,,1539.27835,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1377.24905,85,percent of total billed charges,,,,,,,,,806.4198261,1620.293,
J HOOK,2728442,CDM,,,272,RC,outpatient,,,,70.04,38.522,,63.036,90,percent of total billed charges,,,,70.04,100,percent of total billed charges,,,,,,,,,63.036,,,fee schedule,,,56.032,,,fee schedule,,,,,,,,,,,,,,,,59.534,85,percent of total billed charges,,,,,,,,,,34.858908,49.77,percent of total billed charges,,,,63.036,90,percent of total billed charges,,,,66.538,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,59.534,85,percent of total billed charges,,,,,,,,,34.858908,70.04,
PERFIX PLUG XLG,2728522,CDM,,,272,RC,outpatient,,,,294.065,161.73575,,264.6585,90,percent of total billed charges,,,,294.065,100,percent of total billed charges,,,,,,,,,264.6585,,,fee schedule,,,235.252,,,fee schedule,,,,,,,,,,,,,,,,249.95525,85,percent of total billed charges,,,,,,,,,,146.3561505,49.77,percent of total billed charges,,,,264.6585,90,percent of total billed charges,,,,279.36175,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,249.95525,85,percent of total billed charges,,,,,,,,,146.3561505,294.065,
VENTRALIGHT MESH,2728523,CDM,,,272,RC,outpatient,,,,729.755,401.36525,,656.7795,90,percent of total billed charges,,,,729.755,100,percent of total billed charges,,,,,,,,,656.7795,,,fee schedule,,,583.804,,,fee schedule,,,,,,,,,,,,,,,,620.29175,85,percent of total billed charges,,,,,,,,,,363.1990635,49.77,percent of total billed charges,,,,656.7795,90,percent of total billed charges,,,,693.26725,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,620.29175,85,percent of total billed charges,,,,,,,,,363.1990635,729.755,
ETS FLEX 45 ARTIC LINEAR,2728524,CDM,,,272,RC,outpatient,,,,328.467,180.65685,,295.6203,90,percent of total billed charges,,,,328.467,100,percent of total billed charges,,,,,,,,,295.6203,,,fee schedule,,,262.7736,,,fee schedule,,,,,,,,,,,,,,,,279.19695,85,percent of total billed charges,,,,,,,,,,163.4780259,49.77,percent of total billed charges,,,,295.6203,90,percent of total billed charges,,,,312.04365,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,279.19695,85,percent of total billed charges,,,,,,,,,163.4780259,328.467,
ETS 45 RELOAD VASCULAR,2728525,CDM,,,272,RC,outpatient,,,,193.022,106.1621,,173.7198,90,percent of total billed charges,,,,193.022,100,percent of total billed charges,,,,,,,,,173.7198,,,fee schedule,,,154.4176,,,fee schedule,,,,,,,,,,,,,,,,164.0687,85,percent of total billed charges,,,,,,,,,,96.0670494,49.77,percent of total billed charges,,,,173.7198,90,percent of total billed charges,,,,183.3709,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,164.0687,85,percent of total billed charges,,,,,,,,,96.0670494,193.022,
ETS 45MM BLUE RELOAD,2728526,CDM,,,272,RC,outpatient,,,,192.301,105.76555,,173.0709,90,percent of total billed charges,,,,192.301,100,percent of total billed charges,,,,,,,,,173.0709,,,fee schedule,,,153.8408,,,fee schedule,,,,,,,,,,,,,,,,163.45585,85,percent of total billed charges,,,,,,,,,,95.7082077,49.77,percent of total billed charges,,,,173.0709,90,percent of total billed charges,,,,182.68595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,163.45585,85,percent of total billed charges,,,,,,,,,95.7082077,192.301,
POWERPORT CLEAR VUL,2728529,CDM,,,272,RC,outpatient,,,,550.226,302.6243,,495.2034,90,percent of total billed charges,,,,550.226,100,percent of total billed charges,,,,,,,,,495.2034,,,fee schedule,,,440.1808,,,fee schedule,,,,,,,,,,,,,,,,467.6921,85,percent of total billed charges,,,,,,,,,,273.8474802,49.77,percent of total billed charges,,,,495.2034,90,percent of total billed charges,,,,522.7147,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,467.6921,85,percent of total billed charges,,,,,,,,,273.8474802,550.226,
PERFIX PLUG LG 1.6 X 1.9,2728560,CDM,,,272,RC,outpatient,,,,244.419,134.43045,,219.9771,90,percent of total billed charges,,,,244.419,100,percent of total billed charges,,,,,,,,,219.9771,,,fee schedule,,,195.5352,,,fee schedule,,,,,,,,,,,,,,,,207.75615,85,percent of total billed charges,,,,,,,,,,121.6473363,49.77,percent of total billed charges,,,,219.9771,90,percent of total billed charges,,,,232.19805,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,207.75615,85,percent of total billed charges,,,,,,,,,121.6473363,244.419,
SYNTHES CABLE WITH CRIMP,2728972,CDM,,,272,RC,outpatient,,,,787.126,432.9193,,708.4134,90,percent of total billed charges,,,,787.126,100,percent of total billed charges,,,,,,,,,708.4134,,,fee schedule,,,629.7008,,,fee schedule,,,,,,,,,,,,,,,,669.0571,85,percent of total billed charges,,,,,,,,,,391.7526102,49.77,percent of total billed charges,,,,708.4134,90,percent of total billed charges,,,,747.7697,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,669.0571,85,percent of total billed charges,,,,,,,,,391.7526102,787.126,
C-SECTION CLEAR DRAPE,2729025,CDM,,,272,RC,outpatient,,,,49.337,27.13535,,44.4033,90,percent of total billed charges,,,,49.337,100,percent of total billed charges,,,,,,,,,44.4033,,,fee schedule,,,39.4696,,,fee schedule,,,,,,,,,,,,,,,,41.93645,85,percent of total billed charges,,,,,,,,,,24.5550249,49.77,percent of total billed charges,,,,44.4033,90,percent of total billed charges,,,,46.87015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,41.93645,85,percent of total billed charges,,,,,,,,,24.5550249,49.337,
3DMAX LIGHT MESH XL,2729726,CDM,,,272,RC,outpatient,,,,401.906,221.0483,,361.7154,90,percent of total billed charges,,,,401.906,100,percent of total billed charges,,,,,,,,,361.7154,,,fee schedule,,,321.5248,,,fee schedule,,,,,,,,,,,,,,,,341.6201,85,percent of total billed charges,,,,,,,,,,200.0286162,49.77,percent of total billed charges,,,,361.7154,90,percent of total billed charges,,,,381.8107,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,341.6201,85,percent of total billed charges,,,,,,,,,200.0286162,401.906,
"PORT, INDWELLING (IMPLANTABLE)",2701015,CDM,C1788,HCPCS,278,RC,outpatient,,,,917.009,504.35495,,825.3081,90,percent of total billed charges,,,,917.009,100,percent of total billed charges,,,,,,,,,825.3081,,,fee schedule,,,733.6072,,,fee schedule,,,,,,,,,,,,,,,,779.45765,85,percent of total billed charges,,,,,,,,,,456.3953793,49.77,percent of total billed charges,,,,825.3081,90,percent of total billed charges,,,,871.15855,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,779.45765,85,percent of total billed charges,,,,,,,,,456.3953793,917.009,
BARD MESH 3 X 6,2701544,CDM,C1781,HCPCS,278,RC,outpatient,,,,84.46,46.453,,76.014,90,percent of total billed charges,,,,84.46,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,71.791,85,percent of total billed charges,,,,,,,,,,42.035742,49.77,percent of total billed charges,,,,76.014,90,percent of total billed charges,,,,80.237,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,71.791,85,percent of total billed charges,,,,,,,,,42.035742,84.46,
SECURESTRAP 25 FIXATION DEVICE,2703681,CDM,C1781,HCPCS,278,RC,outpatient,,,,855.312,470.4216,,769.7808,90,percent of total billed charges,,,,855.312,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,727.0152,85,percent of total billed charges,,,,,,,,,,425.6887824,49.77,percent of total billed charges,,,,769.7808,90,percent of total billed charges,,,,812.5464,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,727.0152,85,percent of total billed charges,,,,,,,,,425.6887824,855.312,
PERFIX PLUG #0112760,2705828,CDM,C1781,HCPCS,278,RC,outpatient,,,,232.677,127.97235,,209.4093,90,percent of total billed charges,,,,232.677,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,197.77545,85,percent of total billed charges,,,,,,,,,,115.8033429,49.77,percent of total billed charges,,,,209.4093,90,percent of total billed charges,,,,221.04315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,197.77545,85,percent of total billed charges,,,,,,,,,115.8033429,232.677,
VASCULAR ACCESS SYTEM DUEL,2705946,CDM,,,278,RC,outpatient,,,,368.637,202.75035,,331.7733,90,percent of total billed charges,,,,368.637,100,percent of total billed charges,,,,,,,,,331.7733,,,fee schedule,,,294.9096,,,fee schedule,,,,,,,,,,,,,,,,313.34145,85,percent of total billed charges,,,,,,,,,,183.4706349,49.77,percent of total billed charges,,,,331.7733,90,percent of total billed charges,,,,350.20515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,313.34145,85,percent of total billed charges,,,,,,,,,183.4706349,368.637,
OBTRYX HALO TM-URETHERAL SLING,2707436,CDM,C1771,HCPCS,278,RC,outpatient,,,,2088.943,1148.91865,,1880.0487,90,percent of total billed charges,,,,2088.943,100,percent of total billed charges,,,,,,,,,1880.0487,,,fee schedule,,,1671.1544,,,fee schedule,,,,,,,,,,,,,,,,1775.60155,85,percent of total billed charges,,,,,,,,,,1039.666931,49.77,percent of total billed charges,,,,1880.0487,90,percent of total billed charges,,,,1984.49585,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1775.60155,85,percent of total billed charges,,,,,,,,,1039.666931,2088.943,
VENTRALIGHT ST MESH 4x6,2707496,CDM,C1781,HCPCS,278,RC,outpatient,,,,640.66,352.363,,576.594,90,percent of total billed charges,,,,640.66,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,544.561,85,percent of total billed charges,,,,,,,,,,318.856482,49.77,percent of total billed charges,,,,576.594,90,percent of total billed charges,,,,608.627,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,544.561,85,percent of total billed charges,,,,,,,,,318.856482,640.66,
ECHO 2 VENTRALIGHT MESH 9943,2709943,CDM,C1781,HCPCS,278,RC,outpatient,,,,1874.085,1030.74675,,1686.6765,90,percent of total billed charges,,,,1874.085,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1592.97225,85,percent of total billed charges,,,,,,,,,,932.7321045,49.77,percent of total billed charges,,,,1686.6765,90,percent of total billed charges,,,,1780.38075,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1592.97225,85,percent of total billed charges,,,,,,,,,932.7321045,1874.085,
"ECHO 2 8"" CIRCLE MESH 9944",2709944,CDM,C1781,HCPCS,278,RC,outpatient,,,,2557.696,1406.7328,,2301.9264,90,percent of total billed charges,,,,2557.696,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2174.0416,85,percent of total billed charges,,,,,,,,,,1272.965299,49.77,percent of total billed charges,,,,2301.9264,90,percent of total billed charges,,,,2429.8112,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2174.0416,85,percent of total billed charges,,,,,,,,,1272.965299,2557.696,
VENTRALEX MESH PATCH 5950007,2780007,CDM,C1781,HCPCS,278,RC,outpatient,,,,644.78,354.629,,580.302,90,percent of total billed charges,,,,644.78,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,548.063,85,percent of total billed charges,,,,,,,,,,320.907006,49.77,percent of total billed charges,,,,580.302,90,percent of total billed charges,,,,612.541,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,548.063,85,percent of total billed charges,,,,,,,,,320.907006,644.78,
VENTRALEX MESH PATCH 5950008,2780008,CDM,C1781,HCPCS,278,RC,outpatient,,,,812.979,447.13845,,731.6811,90,percent of total billed charges,,,,812.979,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,691.03215,85,percent of total billed charges,,,,,,,,,,404.6196483,49.77,percent of total billed charges,,,,731.6811,90,percent of total billed charges,,,,772.33005,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,691.03215,85,percent of total billed charges,,,,,,,,,404.6196483,812.979,
VENTRALEX MESH PATCH 5950009,2780009,CDM,C1781,HCPCS,278,RC,outpatient,,,,1031.648,567.4064,,928.4832,90,percent of total billed charges,,,,1031.648,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,876.9008,85,percent of total billed charges,,,,,,,,,,513.4512096,49.77,percent of total billed charges,,,,928.4832,90,percent of total billed charges,,,,980.0656,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,876.9008,85,percent of total billed charges,,,,,,,,,513.4512096,1031.648,
BARD MESH 6x6,2780117,CDM,C1781,HCPCS,278,RC,outpatient,,,,101.146,55.6303,,91.0314,90,percent of total billed charges,,,,101.146,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.9741,85,percent of total billed charges,,,,,,,,,,50.3403642,49.77,percent of total billed charges,,,,91.0314,90,percent of total billed charges,,,,96.0887,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,85.9741,85,percent of total billed charges,,,,,,,,,50.3403642,101.146,
SYNTHES 4.0 30MM,2781619,CDM,,,278,RC,outpatient,,,,288.915,158.90325,,260.0235,90,percent of total billed charges,,,,288.915,100,percent of total billed charges,,,,,,,,,260.0235,,,fee schedule,,,231.132,,,fee schedule,,,,,,,,,,,,,,,,245.57775,85,percent of total billed charges,,,,,,,,,,143.7929955,49.77,percent of total billed charges,,,,260.0235,90,percent of total billed charges,,,,274.46925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,245.57775,85,percent of total billed charges,,,,,,,,,143.7929955,288.915,
CAPIO SLIM SUTURE CAPT DEVICE,2782631,CDM,C2631,HCPCS,278,RC,outpatient,,,,1191.813,655.49715,,1072.6317,90,percent of total billed charges,,,,1191.813,100,percent of total billed charges,,,,,,,,,1072.6317,,,fee schedule,,,953.4504,,,fee schedule,,,,,,,,,,,,,,,,1013.04105,85,percent of total billed charges,,,,,,,,,,593.1653301,49.77,percent of total billed charges,,,,1072.6317,90,percent of total billed charges,,,,1132.22235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1013.04105,85,percent of total billed charges,,,,,,,,,593.1653301,1191.813,
BARD SOFT MESH 3X6,2784062,CDM,C1781,HCPCS,278,RC,outpatient,,,,97.747,53.76085,,87.9723,90,percent of total billed charges,,,,97.747,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.08495,85,percent of total billed charges,,,,,,,,,,48.6486819,49.77,percent of total billed charges,,,,87.9723,90,percent of total billed charges,,,,92.85965,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,83.08495,85,percent of total billed charges,,,,,,,,,48.6486819,97.747,
SYNTHES CABLE W/CRIMP,2788971,CDM,,,278,RC,outpatient,,,,996.834,548.2587,,897.1506,90,percent of total billed charges,,,,996.834,100,percent of total billed charges,,,,,,,,,897.1506,,,fee schedule,,,797.4672,,,fee schedule,,,,,,,,,,,,,,,,847.3089,85,percent of total billed charges,,,,,,,,,,496.1242818,49.77,percent of total billed charges,,,,897.1506,90,percent of total billed charges,,,,946.9923,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,847.3089,85,percent of total billed charges,,,,,,,,,496.1242818,996.834,
"VENTRALIGHT ECHO CIRCLE 6""",2789960,CDM,,,278,RC,outpatient,,,,1496.487,823.06785,,1346.8383,90,percent of total billed charges,,,,1496.487,100,percent of total billed charges,,,,,,,,,1346.8383,,,fee schedule,,,1197.1896,,,fee schedule,,,,,,,,,,,,,,,,1272.01395,85,percent of total billed charges,,,,,,,,,,744.8015799,49.77,percent of total billed charges,,,,1346.8383,90,percent of total billed charges,,,,1421.66265,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1272.01395,85,percent of total billed charges,,,,,,,,,744.8015799,1496.487,
BILIRUBIN LIGHT - NURSERY,2700980,CDM,,,279,RC,outpatient,,,,34.608,19.0344,,31.1472,90,percent of total billed charges,,,,34.608,100,percent of total billed charges,,,,,,,,,31.1472,,,fee schedule,,,27.6864,,,fee schedule,,,,,,,,,,,,,,,,29.4168,85,percent of total billed charges,,,,,,,,,,17.2244016,49.77,percent of total billed charges,,,,31.1472,90,percent of total billed charges,,,,32.8776,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.4168,85,percent of total billed charges,,,,,,,,,17.2244016,34.608,
BLOOD DRAW/FINGER STICK,3000000,CDM,36416,CPT,300,RC,outpatient,,,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
BLOOD DRAWING - LABORATORY,3000002,CDM,36415,CPT,300,RC,outpatient,,,,27.81,15.2955,,25.029,90,percent of total billed charges,,,,27.81,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.6385,85,percent of total billed charges,,,,,,,,,,13.841037,49.77,percent of total billed charges,,,,25.029,90,percent of total billed charges,,,,26.4195,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,23.6385,85,percent of total billed charges,,,,,,,,,13.841037,27.81,
DRUG SCREEN COLLECT (DOT),3000010,CDM,99001,CPT,300,RC,outpatient,,,,47.792,26.2856,,43.0128,90,percent of total billed charges,,,,47.792,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.6232,85,percent of total billed charges,,,,,,,,,,23.7860784,49.77,percent of total billed charges,,,,43.0128,90,percent of total billed charges,,,,45.4024,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,40.6232,85,percent of total billed charges,,,,,,,,,23.7860784,47.792,
DRUG SCREEN MULTI PER ENCOUNT,3000012,CDM,80307,CPT,300,RC,outpatient,,,,131.222,72.1721,,118.0998,90,percent of total billed charges,,,,131.222,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.5387,85,percent of total billed charges,,,,,,,,,,65.3091894,49.77,percent of total billed charges,,,,118.0998,90,percent of total billed charges,,,,124.6609,90,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,101.3587,,,fee schedule,,,,111.5387,85,percent of total billed charges,,,,,,,,,65.3091894,131.222,
KEPPRA,3000015,CDM,80177,CPT,300,RC,outpatient,,,,180.662,99.3641,,162.5958,90,percent of total billed charges,,,,180.662,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,,,,,,,,,,,,,,153.5627,85,percent of total billed charges,,,,,,,,,,89.9154774,49.77,percent of total billed charges,,,,162.5958,90,percent of total billed charges,,,,171.6289,90,percent of total billed charges,,,,,,,,,18.09,,,fee schedule,,,22.9743,,,fee schedule,,,,153.5627,85,percent of total billed charges,,,,,,,,,15.105,180.662,
NON DOT DRUG SCREEN SPECIMEN,3000020,CDM,99001,CPT,300,RC,outpatient,,,,28.737,15.80535,,25.8633,90,percent of total billed charges,,,,28.737,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,,14.3024049,49.77,percent of total billed charges,,,,25.8633,90,percent of total billed charges,,,,27.30015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,24.42645,85,percent of total billed charges,,,,,,,,,14.3024049,28.737,
CYCLOSPORINE,3000027,CDM,80158,CPT,300,RC,outpatient,,,,216.403,119.02165,,194.7627,90,percent of total billed charges,,,,216.403,100,percent of total billed charges,,,20.577,,,fee schedule,,,20.577,,,fee schedule,,,20.577,,,fee schedule,,,,,,,,,,,,,,,,183.94255,85,percent of total billed charges,,,,,,,,,,107.7037731,49.77,percent of total billed charges,,,,194.7627,90,percent of total billed charges,,,,205.58285,90,percent of total billed charges,,,,,,,,,25.78,,,fee schedule,,,32.7406,,,fee schedule,,,,183.94255,85,percent of total billed charges,,,,,,,,,20.577,216.403,
CELL COUNT FLUID,3000050,CDM,89050,CPT,300,RC,outpatient,,,,28.325,15.57875,,25.4925,90,percent of total billed charges,,,,28.325,100,percent of total billed charges,,,5.3808,,,fee schedule,,,5.3808,,,fee schedule,,,5.3808,,,fee schedule,,,,,,,,,,,,,,,,24.07625,85,percent of total billed charges,,,,,,,,,,14.0973525,49.77,percent of total billed charges,,,,25.4925,90,percent of total billed charges,,,,26.90875,90,percent of total billed charges,,,,,,,,,6.75,,,fee schedule,,,8.5725,,,fee schedule,,,,24.07625,85,percent of total billed charges,,,,,,,,,5.3808,28.325,
COUMADIN (WARFRIN) LEVEL,3000060,CDM,80299,CPT,300,RC,outpatient,,,,180.662,99.3641,,162.5958,90,percent of total billed charges,,,,180.662,100,percent of total billed charges,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,,,,,,,,,,,,,,153.5627,85,percent of total billed charges,,,,,,,,,,89.9154774,49.77,percent of total billed charges,,,,162.5958,90,percent of total billed charges,,,,171.6289,90,percent of total billed charges,,,,,,,,,19.55,,,fee schedule,,,24.8285,,,fee schedule,,,,153.5627,85,percent of total billed charges,,,,,,,,,19.55,180.662,
LAMOTRIGINE (LAMICTAL),3000070,CDM,80175,CPT,300,RC,outpatient,,,,130.295,71.66225,,117.2655,90,percent of total billed charges,,,,130.295,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,,,,,,,,,,,,,,110.75075,85,percent of total billed charges,,,,,,,,,,64.8478215,49.77,percent of total billed charges,,,,117.2655,90,percent of total billed charges,,,,123.78025,90,percent of total billed charges,,,,,,,,,18.09,,,fee schedule,,,22.9743,,,fee schedule,,,,110.75075,85,percent of total billed charges,,,,,,,,,15.105,130.295,
TRILEPTAL (OXCARBAZEPINE),3000172,CDM,80183,CPT,300,RC,outpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,,33.6798567,49.77,percent of total billed charges,,,,60.9039,90,percent of total billed charges,,,,64.28745,90,percent of total billed charges,,,,,,,,,18.06,,,fee schedule,,,22.9362,,,fee schedule,,,,57.52035,85,percent of total billed charges,,,,,,,,,15.105,67.671,
COVID-19 ANTIGEN TEST,3000426,CDM,87426,CPT,300,RC,outpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,35.33,,,fee schedule,,,35.33,,,fee schedule,,,35.33,,,fee schedule,,,,,,,,,,,,,,,,103.39655,85,percent of total billed charges,,,,,,,,,,60.5417211,49.77,percent of total billed charges,,,,109.4787,90,percent of total billed charges,,,,115.56085,90,percent of total billed charges,,,,,,,,,45.23,,,fee schedule,,,57.4421,,,fee schedule,,,,103.39655,85,percent of total billed charges,,,,,,,,,35.33,121.643,
Advanced Lipid Panel w/Inflam,3002172,CDM,80061 83704,CPT,300,RC,outpatient,,,,667.028,366.8654,,600.3252,90,percent of total billed charges,,,,667.028,100,percent of total billed charges,,,,,,,,,600.3252,,,fee schedule,,,533.6224,,,fee schedule,,,,,,,,,,,,,,,,566.9738,85,percent of total billed charges,,,,,,,,,,331.9798356,49.77,percent of total billed charges,,,,600.3252,90,percent of total billed charges,,,,633.6766,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,566.9738,85,percent of total billed charges,,,,,,,,,331.9798356,667.028,
Collagen Type 1-C Telopeptide,3002523,CDM,82523,CPT,300,RC,outpatient,,,,399.331,219.63205,,359.3979,90,percent of total billed charges,,,,399.331,100,percent of total billed charges,,,21.2952,,,fee schedule,,,21.2952,,,fee schedule,,,21.2952,,,fee schedule,,,,,,,,,,,,,,,,339.43135,85,percent of total billed charges,,,,,,,,,,198.7470387,49.77,percent of total billed charges,,,,359.3979,90,percent of total billed charges,,,,379.36445,90,percent of total billed charges,,,,,,,,,26.69,,,fee schedule,,,33.8963,,,fee schedule,,,,339.43135,85,percent of total billed charges,,,,,,,,,21.2952,399.331,
Bile Acid Pregnancy Quest,3002542,CDM,82542,CPT,300,RC,outpatient,,,,30.179,16.59845,,27.1611,90,percent of total billed charges,,,,30.179,100,percent of total billed charges,,,27.4626,,,fee schedule,,,27.4626,,,fee schedule,,,27.4626,,,fee schedule,,,,,,,,,,,,,,,,25.65215,85,percent of total billed charges,,,,,,,,,,15.0200883,49.77,percent of total billed charges,,,,27.1611,90,percent of total billed charges,,,,28.67005,90,percent of total billed charges,,,,,,,,,25.79,,,fee schedule,,,32.7533,,,fee schedule,,,,25.65215,85,percent of total billed charges,,,,,,,,,15.0200883,32.7533,
PARANEOPLASTIC AB PROFILE,3003519,CDM,86255 83519,CPT,300,RC,outpatient,,,,1389.882,764.4351,,1250.8938,90,percent of total billed charges,,,,1389.882,100,percent of total billed charges,,,,,,,,,1250.8938,,,fee schedule,,,1111.9056,,,fee schedule,,,,,,,,,,,,,,,,1181.3997,85,percent of total billed charges,,,,,,,,,,691.7442714,49.77,percent of total billed charges,,,,1250.8938,90,percent of total billed charges,,,,1320.3879,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1181.3997,85,percent of total billed charges,,,,,,,,,691.7442714,1389.882,
Bullous Pemphigoid BP 180 ASB,3003520,CDM,83520,CPT,300,RC,outpatient,,,,101.455,55.80025,,91.3095,90,percent of total billed charges,,,,101.455,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,86.23675,85,percent of total billed charges,,,,,,,,,,50.4941535,49.77,percent of total billed charges,,,,91.3095,90,percent of total billed charges,,,,96.38225,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,86.23675,85,percent of total billed charges,,,,,,,,,18.49,101.455,
Mutated Citrullinated Vimentin,3003550,CDM,83520,CPT,300,RC,outpatient,,,,60.976,33.5368,,54.8784,90,percent of total billed charges,,,,60.976,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,51.8296,85,percent of total billed charges,,,,,,,,,,30.3477552,49.77,percent of total billed charges,,,,54.8784,90,percent of total billed charges,,,,57.9272,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,51.8296,85,percent of total billed charges,,,,,,,,,18.49,60.976,
AMNISURE ROM,3003628,CDM,84112,CPT,300,RC,outpatient,,,,115.36,63.448,,103.824,90,percent of total billed charges,,,,115.36,100,percent of total billed charges,,,111.8454,,,fee schedule,,,111.8454,,,fee schedule,,,111.8454,,,fee schedule,,,,,,,,,,,,,,,,98.056,85,percent of total billed charges,,,,,,,,,,57.414672,49.77,percent of total billed charges,,,,103.824,90,percent of total billed charges,,,,109.592,90,percent of total billed charges,,,,,,,,,90.64,,,fee schedule,,,115.1128,,,fee schedule,,,,98.056,85,percent of total billed charges,,,,,,,,,57.414672,115.36,
Organic Acids,3003918,CDM,8391882570,CPT,300,RC,outpatient,,,,315.283,173.40565,,283.7547,90,percent of total billed charges,,,,315.283,100,percent of total billed charges,,,,,,,,,283.7547,,,fee schedule,,,252.2264,,,fee schedule,,,,,,,,,,,,,,,,267.99055,85,percent of total billed charges,,,,,,,,,,156.9163491,49.77,percent of total billed charges,,,,283.7547,90,percent of total billed charges,,,,299.51885,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,267.99055,85,percent of total billed charges,,,,,,,,,156.9163491,315.283,
Phospholipase A2 Receptor,3006255,CDM,86255,CPT,300,RC,outpatient,,,,17.304,9.5172,,15.5736,90,percent of total billed charges,,,,17.304,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,,,,,,,,,,,,,,14.7084,85,percent of total billed charges,,,,,,,,,,8.6122008,49.77,percent of total billed charges,,,,15.5736,90,percent of total billed charges,,,,16.4388,90,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,21.8694,,,fee schedule,,,,14.7084,85,percent of total billed charges,,,,,,,,,8.6122008,21.8694,
Islet Cell AB,3006341,CDM,86341,CPT,300,RC,outpatient,,,,64.581,35.51955,,58.1229,90,percent of total billed charges,,,,64.581,100,percent of total billed charges,,,26.8698,,,fee schedule,,,26.8698,,,fee schedule,,,26.8698,,,fee schedule,,,,,,,,,,,,,,,,54.89385,85,percent of total billed charges,,,,,,,,,,32.1419637,49.77,percent of total billed charges,,,,58.1229,90,percent of total billed charges,,,,61.35195,90,percent of total billed charges,,,,,,,,,28.25,,,fee schedule,,,35.8775,,,fee schedule,,,,54.89385,85,percent of total billed charges,,,,,,,,,26.8698,64.581,
Strongyloides ABI66,3006682,CDM,86682,CPT,300,RC,outpatient,,,,36.565,20.11075,,32.9085,90,percent of total billed charges,,,,36.565,100,percent of total billed charges,,,14.8314,,,fee schedule,,,14.8314,,,fee schedule,,,14.8314,,,fee schedule,,,,,,,,,,,,,,,,31.08025,85,percent of total billed charges,,,,,,,,,,18.1984005,49.77,percent of total billed charges,,,,32.9085,90,percent of total billed charges,,,,34.73675,90,percent of total billed charges,,,,,,,,,18.57,,,fee schedule,,,23.5839,,,fee schedule,,,,31.08025,85,percent of total billed charges,,,,,,,,,14.8314,36.565,
CULTURE BACTERIAL BLOOD AEROB,3007040,CDM,87040,CPT,300,RC,outpatient,,,,111.24,61.182,,100.116,90,percent of total billed charges,,,,111.24,100,percent of total billed charges,,,11.7648,,,fee schedule,,,11.7648,,,fee schedule,,,11.7648,,,fee schedule,,,,,,,,,,,,,,,,94.554,85,percent of total billed charges,,,,,,,,,,55.364148,49.77,percent of total billed charges,,,,100.116,90,percent of total billed charges,,,,105.678,90,percent of total billed charges,,,,,,,,,14.75,,,fee schedule,,,18.7325,,,fee schedule,,,,94.554,85,percent of total billed charges,,,,,,,,,11.7648,111.24,
GIARDIA AG IA,3007329,CDM,87329,CPT,300,RC,outpatient,,,,67.259,36.99245,,60.5331,90,percent of total billed charges,,,,67.259,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,,,,,,,,,,,,,,57.17015,85,percent of total billed charges,,,,,,,,,,33.4748043,49.77,percent of total billed charges,,,,60.5331,90,percent of total billed charges,,,,63.89605,90,percent of total billed charges,,,,,,,,,12.92,,,fee schedule,,,16.4084,,,fee schedule,,,,57.17015,85,percent of total billed charges,,,,,,,,,12.92,67.259,
FUNGITELL 1-3 B-D-GLUCAN ASSAY,3007449,CDM,87449,CPT,300,RC,outpatient,,,,275.525,151.53875,,247.9725,90,percent of total billed charges,,,,275.525,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,,,,,,,,,,,,,,234.19625,85,percent of total billed charges,,,,,,,,,,137.1287925,49.77,percent of total billed charges,,,,247.9725,90,percent of total billed charges,,,,261.74875,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,234.19625,85,percent of total billed charges,,,,,,,,,12.87,275.525,
RESP VIRUS 12-25 TARGETS,3007633,CDM,87633,CPT,300,RC,outpatient,,,,1167.814,642.2977,,1051.0326,90,percent of total billed charges,,,,1167.814,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,992.6419,85,percent of total billed charges,,,,,,,,,,581.2210278,49.77,percent of total billed charges,,,,1051.0326,90,percent of total billed charges,,,,1109.4233,90,percent of total billed charges,,,,,,,,,242.38,,,fee schedule,,,307.8226,,,fee schedule,,,,992.6419,85,percent of total billed charges,,,,,,,,,242.38,1167.814,
COVID PCR,3007635,CDM,87635,CPT,300,RC,outpatient,,,,176.645,97.15475,,158.9805,90,percent of total billed charges,,,,176.645,100,percent of total billed charges,,,51.31,,,fee schedule,,,51.31,,,fee schedule,,,51.31,,,fee schedule,,,,,,,,,,,,,,,,150.14825,85,percent of total billed charges,,,,,,,,,,87.9162165,49.77,percent of total billed charges,,,,158.9805,90,percent of total billed charges,,,,167.81275,90,percent of total billed charges,,,,,,,,,51.31,,,fee schedule,,,65.1637,,,fee schedule,,,,150.14825,85,percent of total billed charges,,,,,,,,,51.31,176.645,
HEPATITIS PANEL,3008007,CDM,80074,CPT,300,RC,outpatient,,,,451.552,248.3536,,406.3968,90,percent of total billed charges,,,,451.552,100,percent of total billed charges,,,54.2982,,,fee schedule,,,54.2982,,,fee schedule,,,54.2982,,,fee schedule,,,,,,,,,,,,,,,,383.8192,85,percent of total billed charges,,,,,,,,,,224.7374304,49.77,percent of total billed charges,,,,406.3968,90,percent of total billed charges,,,,428.9744,90,percent of total billed charges,,,,,,,,,68.01,,,fee schedule,,,86.3727,,,fee schedule,,,,383.8192,85,percent of total billed charges,,,,,,,,,54.2982,451.552,
CLOZAPINE (CLOZARIL),3008015,CDM,80159,CPT,300,RC,outpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,22.971,,,fee schedule,,,22.971,,,fee schedule,,,22.971,,,fee schedule,,,,,,,,,,,,,,,,135.79005,85,percent of total billed charges,,,,,,,,,,79.5090681,49.77,percent of total billed charges,,,,143.7777,90,percent of total billed charges,,,,151.76535,90,percent of total billed charges,,,,,,,,,25.23,,,fee schedule,,,32.0421,,,fee schedule,,,,135.79005,85,percent of total billed charges,,,,,,,,,22.971,159.753,
EVEROLIMUS,3008016,CDM,80169,CPT,300,RC,outpatient,,,,233.707,128.53885,,210.3363,90,percent of total billed charges,,,,233.707,100,percent of total billed charges,,,15.6522,,,fee schedule,,,15.6522,,,fee schedule,,,15.6522,,,fee schedule,,,,,,,,,,,,,,,,198.65095,85,percent of total billed charges,,,,,,,,,,116.3159739,49.77,percent of total billed charges,,,,210.3363,90,percent of total billed charges,,,,222.02165,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,198.65095,85,percent of total billed charges,,,,,,,,,15.6522,233.707,
ZONEGRAN (CONISAMIDE),3008029,CDM,80203,CPT,300,RC,outpatient,,,,184.267,101.34685,,165.8403,90,percent of total billed charges,,,,184.267,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,,,,,,,,,,,,,,156.62695,85,percent of total billed charges,,,,,,,,,,91.7096859,49.77,percent of total billed charges,,,,165.8403,90,percent of total billed charges,,,,175.05365,90,percent of total billed charges,,,,,,,,,18.09,,,fee schedule,,,22.9743,,,fee schedule,,,,156.62695,85,percent of total billed charges,,,,,,,,,15.105,184.267,
DRUG SCREEN SEND-OUT,3008030,CDM,80307,CPT,300,RC,outpatient,,,,131.222,72.1721,,118.0998,90,percent of total billed charges,,,,131.222,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.5387,85,percent of total billed charges,,,,,,,,,,65.3091894,49.77,percent of total billed charges,,,,118.0998,90,percent of total billed charges,,,,124.6609,90,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,101.3587,,,fee schedule,,,,111.5387,85,percent of total billed charges,,,,,,,,,65.3091894,131.222,
SARS-COV-2RNA-QUAL-RT-PCR39448,3008076,CDM,87635,CPT,300,RC,outpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,51.31,,,fee schedule,,,51.31,,,fee schedule,,,51.31,,,fee schedule,,,,,,,,,,,,,,,,103.39655,85,percent of total billed charges,,,,,,,,,,60.5417211,49.77,percent of total billed charges,,,,109.4787,90,percent of total billed charges,,,,115.56085,90,percent of total billed charges,,,,,,,,,51.31,,,fee schedule,,,65.1637,,,fee schedule,,,,103.39655,85,percent of total billed charges,,,,,,,,,51.31,121.643,
CYCTIC FIBROSIS SCREEN,3008122,CDM,81220,CPT,300,RC,outpatient,,,,653.947,359.67085,,588.5523,90,percent of total billed charges,,,,653.947,100,percent of total billed charges,,,634.524,,,fee schedule,,,634.524,,,fee schedule,,,634.524,,,fee schedule,,,,,,,,,,,,,,,,555.85495,85,percent of total billed charges,,,,,,,,,,325.4694219,49.77,percent of total billed charges,,,,588.5523,90,percent of total billed charges,,,,621.24965,90,percent of total billed charges,,,,,,,,,372,,,fee schedule,,,472.44,,,fee schedule,,,,555.85495,85,percent of total billed charges,,,,,,,,,325.4694219,653.947,
MTHFR,3008129,CDM,81291,CPT,300,RC,outpatient,,,,567.427,312.08485,,510.6843,90,percent of total billed charges,,,,567.427,100,percent of total billed charges,,,74.4876,,,fee schedule,,,74.4876,,,fee schedule,,,74.4876,,,fee schedule,,,,,,,,,,,,,,,,482.31295,85,percent of total billed charges,,,,,,,,,,282.4084179,49.77,percent of total billed charges,,,,510.6843,90,percent of total billed charges,,,,539.05565,90,percent of total billed charges,,,,,,,,,83.52,,,fee schedule,,,106.0704,,,fee schedule,,,,482.31295,85,percent of total billed charges,,,,,,,,,74.4876,567.427,
HIV 1 AG W HIV 1&2 AG IA,3008738,CDM,87389,CPT,300,RC,outpatient,,,,124.012,68.2066,,111.6108,90,percent of total billed charges,,,,124.012,100,percent of total billed charges,,,27.4512,,,fee schedule,,,27.4512,,,fee schedule,,,27.4512,,,fee schedule,,,,,,,,,,,,,,,,105.4102,85,percent of total billed charges,,,,,,,,,,61.7207724,49.77,percent of total billed charges,,,,111.6108,90,percent of total billed charges,,,,117.8114,90,percent of total billed charges,,,,,,,,,34.12,,,fee schedule,,,43.3324,,,fee schedule,,,,105.4102,85,percent of total billed charges,,,,,,,,,27.4512,124.012,
BCR/ABL1 MAJOR BREAKPOINT,3009106,CDM,81206,CPT,300,RC,outpatient,,,,254.822,140.1521,,229.3398,90,percent of total billed charges,,,,254.822,100,percent of total billed charges,,,186.9144,,,fee schedule,,,186.9144,,,fee schedule,,,186.9144,,,fee schedule,,,,,,,,,,,,,,,,216.5987,85,percent of total billed charges,,,,,,,,,,126.8249094,49.77,percent of total billed charges,,,,229.3398,90,percent of total billed charges,,,,242.0809,90,percent of total billed charges,,,,,,,,,80.62,,,fee schedule,,,102.3874,,,fee schedule,,,,216.5987,85,percent of total billed charges,,,,,,,,,80.62,254.822,
BCR/ABL1 MINOR BREAKPOINT,3009107,CDM,81207,CPT,300,RC,outpatient,,,,254.822,140.1521,,229.3398,90,percent of total billed charges,,,,254.822,100,percent of total billed charges,,,165.1176,,,fee schedule,,,165.1176,,,fee schedule,,,165.1176,,,fee schedule,,,,,,,,,,,,,,,,216.5987,85,percent of total billed charges,,,,,,,,,,126.8249094,49.77,percent of total billed charges,,,,229.3398,90,percent of total billed charges,,,,242.0809,90,percent of total billed charges,,,,,,,,,67.19,,,fee schedule,,,85.3313,,,fee schedule,,,,216.5987,85,percent of total billed charges,,,,,,,,,67.19,254.822,
DEXAMETHASONE,3009391,CDM,80299,CPT,300,RC,outpatient,,,,46.659,25.66245,,41.9931,90,percent of total billed charges,,,,46.659,100,percent of total billed charges,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,,,,,,,,,,,,,,39.66015,85,percent of total billed charges,,,,,,,,,,23.2221843,49.77,percent of total billed charges,,,,41.9931,90,percent of total billed charges,,,,44.32605,90,percent of total billed charges,,,,,,,,,19.55,,,fee schedule,,,24.8285,,,fee schedule,,,,39.66015,85,percent of total billed charges,,,,,,,,,19.55,46.659,
SARS-COV-2 ANTI IgG,3009504,CDM,86769,CPT,300,RC,outpatient,,,,72.203,39.71165,,64.9827,90,percent of total billed charges,,,,72.203,100,percent of total billed charges,,,42.13,,,fee schedule,,,42.13,,,fee schedule,,,42.13,,,fee schedule,,,,,,,,,,,,,,,,61.37255,85,percent of total billed charges,,,,,,,,,,35.9354331,49.77,percent of total billed charges,,,,64.9827,90,percent of total billed charges,,,,68.59285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,61.37255,85,percent of total billed charges,,,,,,,,,35.9354331,72.203,
CARBAMAZEPINE,3010340,CDM,80156,CPT,300,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,16.6098,,,fee schedule,,,16.6098,,,fee schedule,,,16.6098,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,20.79,,,fee schedule,,,26.4033,,,fee schedule,,,,101.3829,85,percent of total billed charges,,,,,,,,,16.6098,119.274,
CARDIAC RISK PROFILE,3010400,CDM,80061,CPT,300,RC,outpatient,,,,224.746,123.6103,,202.2714,90,percent of total billed charges,,,,224.746,100,percent of total billed charges,,,15.2646,,,fee schedule,,,15.2646,,,fee schedule,,,15.2646,,,fee schedule,,,,,,,,,,,,,,,,191.0341,85,percent of total billed charges,,,,,,,,,,111.8560842,49.77,percent of total billed charges,,,,202.2714,90,percent of total billed charges,,,,213.5087,90,percent of total billed charges,,,,,,,,,18.16,,,fee schedule,,,23.0632,,,fee schedule,,,,191.0341,85,percent of total billed charges,,,,,,,,,15.2646,224.746,
DEPAKANE-VALPROIC ACID,3010620,CDM,80164,CPT,300,RC,outpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,15.4356,,,fee schedule,,,15.4356,,,fee schedule,,,15.4356,,,fee schedule,,,,,,,,,,,,,,,,98.31865,85,percent of total billed charges,,,,,,,,,,57.5684613,49.77,percent of total billed charges,,,,104.1021,90,percent of total billed charges,,,,109.88555,90,percent of total billed charges,,,,,,,,,19.34,,,fee schedule,,,24.5618,,,fee schedule,,,,98.31865,85,percent of total billed charges,,,,,,,,,15.4356,115.669,
DIGITOXIN,3010650,CDM,80299,CPT,300,RC,outpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,21.2496,,,fee schedule,,,,,,,,,,,,,,,,121.08165,85,percent of total billed charges,,,,,,,,,,70.8968673,49.77,percent of total billed charges,,,,128.2041,90,percent of total billed charges,,,,135.32655,90,percent of total billed charges,,,,,,,,,19.55,,,fee schedule,,,24.8285,,,fee schedule,,,,121.08165,85,percent of total billed charges,,,,,,,,,19.55,142.449,
DIGOXIN,3010660,CDM,80162,CPT,300,RC,outpatient,,,,97.232,53.4776,,87.5088,90,percent of total billed charges,,,,97.232,100,percent of total billed charges,,,15.1392,,,fee schedule,,,15.1392,,,fee schedule,,,15.1392,,,fee schedule,,,,,,,,,,,,,,,,82.6472,85,percent of total billed charges,,,,,,,,,,48.3923664,49.77,percent of total billed charges,,,,87.5088,90,percent of total billed charges,,,,92.3704,90,percent of total billed charges,,,,,,,,,18.96,,,fee schedule,,,24.0792,,,fee schedule,,,,82.6472,85,percent of total billed charges,,,,,,,,,15.1392,97.232,
DILANTIN PHENYTOIN,3010670,CDM,80185,CPT,300,RC,outpatient,,,,104.648,57.5564,,94.1832,90,percent of total billed charges,,,,104.648,100,percent of total billed charges,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,15.105,,,fee schedule,,,,,,,,,,,,,,,,88.9508,85,percent of total billed charges,,,,,,,,,,52.0833096,49.77,percent of total billed charges,,,,94.1832,90,percent of total billed charges,,,,99.4156,90,percent of total billed charges,,,,,,,,,18.93,,,fee schedule,,,24.0411,,,fee schedule,,,,88.9508,85,percent of total billed charges,,,,,,,,,15.105,104.648,
DRUG SCREEN TEST (NON DOT),3010710,CDM,80307,CPT,300,RC,outpatient,,,,81.576,44.8668,,73.4184,90,percent of total billed charges,,,,81.576,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.3396,85,percent of total billed charges,,,,,,,,,,40.6003752,49.77,percent of total billed charges,,,,73.4184,90,percent of total billed charges,,,,77.4972,90,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,101.3587,,,fee schedule,,,,69.3396,85,percent of total billed charges,,,,,,,,,40.6003752,101.3587,
DRUG SCREEN TEST (DOT),3010720,CDM,80307,CPT,300,RC,outpatient,,,,81.576,44.8668,,73.4184,90,percent of total billed charges,,,,81.576,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.3396,85,percent of total billed charges,,,,,,,,,,40.6003752,49.77,percent of total billed charges,,,,73.4184,90,percent of total billed charges,,,,77.4972,90,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,101.3587,,,fee schedule,,,,69.3396,85,percent of total billed charges,,,,,,,,,40.6003752,101.3587,
DRUG SCREEN-SERUM,3010740,CDM,80307,CPT,300,RC,outpatient,,,,201.468,110.8074,,181.3212,90,percent of total billed charges,,,,201.468,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.2478,85,percent of total billed charges,,,,,,,,,,100.2706236,49.77,percent of total billed charges,,,,181.3212,90,percent of total billed charges,,,,191.3946,90,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,101.3587,,,fee schedule,,,,171.2478,85,percent of total billed charges,,,,,,,,,79.81,201.468,
FK506 (TACROLIMUS),3010885,CDM,80197,CPT,300,RC,outpatient,,,,193.743,106.55865,,174.3687,90,percent of total billed charges,,,,193.743,100,percent of total billed charges,,,15.6522,,,fee schedule,,,15.6522,,,fee schedule,,,15.6522,,,fee schedule,,,,,,,,,,,,,,,,164.68155,85,percent of total billed charges,,,,,,,,,,96.4258911,49.77,percent of total billed charges,,,,174.3687,90,percent of total billed charges,,,,184.05585,90,percent of total billed charges,,,,,,,,,19.6,,,fee schedule,,,24.892,,,fee schedule,,,,164.68155,85,percent of total billed charges,,,,,,,,,15.6522,193.743,
GENTAMICIN LEVEL,3010950,CDM,80170,CPT,300,RC,outpatient,,,,124.321,68.37655,,111.8889,90,percent of total billed charges,,,,124.321,100,percent of total billed charges,,,18.6732,,,fee schedule,,,18.6732,,,fee schedule,,,18.6732,,,fee schedule,,,,,,,,,,,,,,,,105.67285,85,percent of total billed charges,,,,,,,,,,61.8745617,49.77,percent of total billed charges,,,,111.8889,90,percent of total billed charges,,,,118.10495,90,percent of total billed charges,,,,,,,,,23.41,,,fee schedule,,,29.7307,,,fee schedule,,,,105.67285,85,percent of total billed charges,,,,,,,,,18.6732,124.321,
LITHIUM,3011280,CDM,80178,CPT,300,RC,outpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,7.5354,,,fee schedule,,,7.5354,,,fee schedule,,,7.5354,,,fee schedule,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,,33.6798567,49.77,percent of total billed charges,,,,60.9039,90,percent of total billed charges,,,,64.28745,90,percent of total billed charges,,,,,,,,,9.43,,,fee schedule,,,11.9761,,,fee schedule,,,,57.52035,85,percent of total billed charges,,,,,,,,,7.5354,67.671,
ELECTROLYTE PANEL,3011330,CDM,80051,CPT,300,RC,outpatient,,,,138.947,76.42085,,125.0523,90,percent of total billed charges,,,,138.947,100,percent of total billed charges,,,7.9914,,,fee schedule,,,7.9914,,,fee schedule,,,7.9914,,,fee schedule,,,,,,,,,,,,,,,,118.10495,85,percent of total billed charges,,,,,,,,,,69.1539219,49.77,percent of total billed charges,,,,125.0523,90,percent of total billed charges,,,,131.99965,90,percent of total billed charges,,,,,,,,,10.01,,,fee schedule,,,12.7127,,,fee schedule,,,,118.10495,85,percent of total billed charges,,,,,,,,,7.9914,138.947,
PHENOBARBITAL,3011610,CDM,80184,CPT,300,RC,outpatient,,,,101.97,56.0835,,91.773,90,percent of total billed charges,,,,101.97,100,percent of total billed charges,,,17.442,,,fee schedule,,,17.442,,,fee schedule,,,17.442,,,fee schedule,,,,,,,,,,,,,,,,86.6745,85,percent of total billed charges,,,,,,,,,,50.750469,49.77,percent of total billed charges,,,,91.773,90,percent of total billed charges,,,,96.8715,90,percent of total billed charges,,,,,,,,,16.36,,,fee schedule,,,20.7772,,,fee schedule,,,,86.6745,85,percent of total billed charges,,,,,,,,,16.36,101.97,
SALICYLATE,3011830,CDM,80307,CPT,300,RC,outpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.61025,85,percent of total billed charges,,,,,,,,,,48.9562605,49.77,percent of total billed charges,,,,88.5285,90,percent of total billed charges,,,,93.44675,90,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,101.3587,,,fee schedule,,,,83.61025,85,percent of total billed charges,,,,,,,,,48.9562605,101.3587,
VANCOMYCIN PEAK OR TROUGH,3012380,CDM,80202,CPT,300,RC,outpatient,,,,120.407,66.22385,,108.3663,90,percent of total billed charges,,,,120.407,100,percent of total billed charges,,,15.4356,,,fee schedule,,,15.4356,,,fee schedule,,,15.4356,,,fee schedule,,,,,,,,,,,,,,,,102.34595,85,percent of total billed charges,,,,,,,,,,59.9265639,49.77,percent of total billed charges,,,,108.3663,90,percent of total billed charges,,,,114.38665,90,percent of total billed charges,,,,,,,,,19.34,,,fee schedule,,,24.5618,,,fee schedule,,,,102.34595,85,percent of total billed charges,,,,,,,,,15.4356,120.407,
CHROMOGRANIN A,3018631,CDM,86316,CPT,300,RC,outpatient,,,,166.963,91.82965,,150.2667,90,percent of total billed charges,,,,166.963,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,,,,,,,,,,,,,,141.91855,85,percent of total billed charges,,,,,,,,,,83.0974851,49.77,percent of total billed charges,,,,150.2667,90,percent of total billed charges,,,,158.61485,90,percent of total billed charges,,,,,,,,,29.72,,,fee schedule,,,37.7444,,,fee schedule,,,,141.91855,85,percent of total billed charges,,,,,,,,,23.7234,166.963,
"BK VIRUS DNA, QUANT URINE",3018779,CDM,87799,CPT,300,RC,outpatient,,,,393.46,216.403,,354.114,90,percent of total billed charges,,,,393.46,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,,,,,,,,,,,,,,334.441,85,percent of total billed charges,,,,,,,,,,195.825042,49.77,percent of total billed charges,,,,354.114,90,percent of total billed charges,,,,373.787,90,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,77.6859,,,fee schedule,,,,334.441,85,percent of total billed charges,,,,,,,,,48.8376,393.46,
CD-4 CELLS,3020230,CDM,86361,CPT,300,RC,outpatient,,,,498.623,274.24265,,448.7607,90,percent of total billed charges,,,,498.623,100,percent of total billed charges,,,30.5292,,,fee schedule,,,30.5292,,,fee schedule,,,30.5292,,,fee schedule,,,,,,,,,,,,,,,,423.82955,85,percent of total billed charges,,,,,,,,,,248.1646671,49.77,percent of total billed charges,,,,448.7607,90,percent of total billed charges,,,,473.69185,90,percent of total billed charges,,,,,,,,,28.75,,,fee schedule,,,36.5125,,,fee schedule,,,,423.82955,85,percent of total billed charges,,,,,,,,,28.75,498.623,
CLO TEST  - ENDO,3020430,CDM,87077,CPT,300,RC,outpatient,,,QW,81.576,44.8668,,73.4184,90,percent of total billed charges,,,,81.576,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,,,,,,,,,,,,,,69.3396,85,percent of total billed charges,,,,,,,,,,40.6003752,49.77,percent of total billed charges,,,,73.4184,90,percent of total billed charges,,,,77.4972,90,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,14.6431,,,fee schedule,,,,69.3396,85,percent of total billed charges,,,,,,,,,9.2112,81.576,
"HEPATITIS C RNA, QUANTITATIVE",3020515,CDM,87522,CPT,300,RC,outpatient,,,,1398.637,769.25035,,1258.7733,90,percent of total billed charges,,,,1398.637,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,,,,,,,,,,,,,,1188.84145,85,percent of total billed charges,,,,,,,,,,696.1016349,49.77,percent of total billed charges,,,,1258.7733,90,percent of total billed charges,,,,1328.70515,90,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,77.6859,,,fee schedule,,,,1188.84145,85,percent of total billed charges,,,,,,,,,48.8376,1398.637,
RPR,3020770,CDM,86592,CPT,300,RC,outpatient,,,,21.218,11.6699,,19.0962,90,percent of total billed charges,,,,21.218,100,percent of total billed charges,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,,,,,,,,,,,,,,18.0353,85,percent of total billed charges,,,,,,,,,,10.5601986,49.77,percent of total billed charges,,,,19.0962,90,percent of total billed charges,,,,20.1571,90,percent of total billed charges,,,,,,,,,5.9,,,fee schedule,,,7.493,,,fee schedule,,,,18.0353,85,percent of total billed charges,,,,,,,,,4.8678,21.218,
MYCOPHANOLATE,3028018,CDM,80180,CPT,300,RC,outpatient,,,,942.347,518.29085,,848.1123,90,percent of total billed charges,,,,942.347,100,percent of total billed charges,,,20.577,,,fee schedule,,,20.577,,,fee schedule,,,20.577,,,fee schedule,,,,,,,,,,,,,,,,800.99495,85,percent of total billed charges,,,,,,,,,,469.0061019,49.77,percent of total billed charges,,,,848.1123,90,percent of total billed charges,,,,895.22965,90,percent of total billed charges,,,,,,,,,20.06,,,fee schedule,,,25.4762,,,fee schedule,,,,800.99495,85,percent of total billed charges,,,,,,,,,20.06,942.347,
"ANTISMOOTH MUSCLE AB, QUANT",3029185,CDM,83516,CPT,300,RC,outpatient,,,,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,,,,,,,,,,,,,,257.65965,85,percent of total billed charges,,,,,,,,,,150.8673033,49.77,percent of total billed charges,,,,272.8161,90,percent of total billed charges,,,,287.97255,90,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,20.9296,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,,,,,,,13.1442,303.129,
CBC W/DIFF,3050040,CDM,89051,CPT,300,RC,outpatient,,,,30.694,16.8817,,27.6246,90,percent of total billed charges,,,,30.694,100,percent of total billed charges,,,6.384,,,fee schedule,,,6.384,,,fee schedule,,,6.384,,,fee schedule,,,,,,,,,,,,,,,,26.0899,85,percent of total billed charges,,,,,,,,,,15.2764038,49.77,percent of total billed charges,,,,27.6246,90,percent of total billed charges,,,,29.1593,90,percent of total billed charges,,,,,,,,,7.86,,,fee schedule,,,9.9822,,,fee schedule,,,,26.0899,85,percent of total billed charges,,,,,,,,,6.384,30.694,
SED RATE ESR,3050220,CDM,85652,CPT,300,RC,outpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,3.078,,,fee schedule,,,3.078,,,fee schedule,,,3.078,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,,,,,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,,,,,,,3.85,,,fee schedule,,,4.8895,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,,,,,,,3.078,49.234,
BACTERIAL AG - NEIS MEN W,3060480,CDM,86403,CPT,300,RC,outpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,,,,,,,,,,,,,,40.7983,85,percent of total billed charges,,,,,,,,,,23.8886046,49.77,percent of total billed charges,,,,43.1982,90,percent of total billed charges,,,,45.5981,90,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,18.4785,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,,,,,,,13.1556,47.998,
URINALYSIS WITH MICRO,3070100,CDM,81001,CPT,300,RC,outpatient,,,,40.582,22.3201,,36.5238,90,percent of total billed charges,,,,40.582,100,percent of total billed charges,,,3.6138,,,fee schedule,,,3.6138,,,fee schedule,,,3.6138,,,fee schedule,,,,,,,,,,,,,,,,34.4947,85,percent of total billed charges,,,,,,,,,,20.1976614,49.77,percent of total billed charges,,,,36.5238,90,percent of total billed charges,,,,38.5529,90,percent of total billed charges,,,,,,,,,4.52,,,fee schedule,,,5.7404,,,fee schedule,,,,34.4947,85,percent of total billed charges,,,,,,,,,3.6138,40.582,
FERN TEST,3090010,CDM,89060,CPT,300,RC,outpatient,,,,39.346,21.6403,,35.4114,90,percent of total billed charges,,,,39.346,100,percent of total billed charges,,,8.3562,,,fee schedule,,,8.3562,,,fee schedule,,,8.3562,,,fee schedule,,,,,,,,,,,,,,,,33.4441,85,percent of total billed charges,,,,,,,,,,19.5825042,49.77,percent of total billed charges,,,,35.4114,90,percent of total billed charges,,,,37.3787,90,percent of total billed charges,,,,,,,,,10.21,,,fee schedule,,,12.9667,,,fee schedule,,,,33.4441,85,percent of total billed charges,,,,,,,,,8.3562,39.346,
ARTERIAL BLOOD GASES,4100040,CDM,82803,CPT,300,RC,outpatient,,,,197.451,108.59805,,177.7059,90,percent of total billed charges,,,,197.451,100,percent of total billed charges,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,,,,,,,,,,,,,,167.83335,85,percent of total billed charges,,,,,,,,,,98.2713627,49.77,percent of total billed charges,,,,177.7059,90,percent of total billed charges,,,,187.57845,90,percent of total billed charges,,,,,,,,,27.63,,,fee schedule,,,35.0901,,,fee schedule,,,,167.83335,85,percent of total billed charges,,,,,,,,,27.63,197.451,
SPUTUM COLLECTION,4100235,CDM,89220,CPT,300,RC,outpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,19.30675,,,fee schedule,,,19.30675,,,fee schedule,,,,34.1445,85,percent of total billed charges,,,19.30675,,,fee schedule,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,19.8859525,,,fee schedule,,,9.66,,,fee schedule,,,12.2682,,,fee schedule,,,,34.1445,85,percent of total billed charges,,,19.30675,,,fee schedule,,,9.66,162.0624,
GASTROCCULT BLOOD,4502271,CDM,82271,CPT,300,RC,outpatient,,,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,6.0648,,,fee schedule,,,6.0648,,,fee schedule,,,6.0648,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,4.69,,,fee schedule,,,5.9563,,,fee schedule,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
HEMOCCULT STOOL,4502272,CDM,82272,CPT,300,RC,outpatient,,,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,4.8222,,,fee schedule,,,4.8222,,,fee schedule,,,4.8222,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,4.69,,,fee schedule,,,5.9563,,,fee schedule,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
BLOOD GLUCOSE W/DEVICE,4502962,CDM,82962,CPT,300,RC,outpatient,,,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,3.7392,,,fee schedule,,,3.7392,,,fee schedule,,,3.7392,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,4.37,,,fee schedule,,,5.5499,,,fee schedule,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
A-1 ANTITIRYPSIN R/L,3010000,CDM,82103,CPT,301,RC,outpatient,,,,99.601,54.78055,,89.6409,90,percent of total billed charges,,,,99.601,100,percent of total billed charges,,,15.3216,,,fee schedule,,,15.3216,,,fee schedule,,,15.3216,,,fee schedule,,,,,,,,,,,,,,,,84.66085,85,percent of total billed charges,,,,,,,,,,49.5714177,49.77,percent of total billed charges,,,,89.6409,90,percent of total billed charges,,,,94.62095,90,percent of total billed charges,,,,,,,,,19.18,,,fee schedule,,,24.3586,,,fee schedule,,,,84.66085,85,percent of total billed charges,,,,,,,,,15.3216,99.601,
ACETOMINOPHEN R/L,3010010,CDM,80307,CPT,301,RC,outpatient,,,,164.903,90.69665,,148.4127,90,percent of total billed charges,,,,164.903,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,140.16755,85,percent of total billed charges,,,,,,,,,,82.0722231,49.77,percent of total billed charges,,,,148.4127,90,percent of total billed charges,,,,156.65785,90,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,101.3587,,,fee schedule,,,,140.16755,85,percent of total billed charges,,,,,,,,,79.81,164.903,
ACID PHOSPHATASE-PR,3010020,CDM,84066,CPT,301,RC,outpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,11.0124,,,fee schedule,,,11.0124,,,fee schedule,,,11.0124,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,,,,,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,,,,,,,13.8,,,fee schedule,,,17.526,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,,,,,,,11.0124,49.234,
ALBUMIN CSF/PART OF MULSCLER,3010040,CDM,82042,CPT,301,RC,outpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,8.8692,,,fee schedule,,,8.8692,,,fee schedule,,,8.8692,,,fee schedule,,,,,,,,,,,,,,,,42.81195,85,percent of total billed charges,,,,,,,,,,25.0676559,49.77,percent of total billed charges,,,,45.3303,90,percent of total billed charges,,,,47.84865,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,42.81195,85,percent of total billed charges,,,,,,,,,7.39,50.367,
ALBUMIN - SERUM,3010045,CDM,82040,CPT,301,RC,outpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,5.643,,,fee schedule,,,5.643,,,fee schedule,,,5.643,,,fee schedule,,,,,,,,,,,,,,,,42.81195,85,percent of total billed charges,,,,,,,,,,25.0676559,49.77,percent of total billed charges,,,,45.3303,90,percent of total billed charges,,,,47.84865,90,percent of total billed charges,,,,,,,,,7.08,,,fee schedule,,,8.9916,,,fee schedule,,,,42.81195,85,percent of total billed charges,,,,,,,,,5.643,50.367,
ALCOHOL-ETHYL-ETOH,3010050,CDM,80307,CPT,301,RC,outpatient,,,,103.515,56.93325,,93.1635,90,percent of total billed charges,,,,103.515,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.98775,85,percent of total billed charges,,,,,,,,,,51.5194155,49.77,percent of total billed charges,,,,93.1635,90,percent of total billed charges,,,,98.33925,90,percent of total billed charges,,,,,,,,,79.81,,,fee schedule,,,101.3587,,,fee schedule,,,,87.98775,85,percent of total billed charges,,,,,,,,,51.5194155,103.515,
ALDOLASE R/L,3010070,CDM,82085,CPT,301,RC,outpatient,,,,95.996,52.7978,,86.3964,90,percent of total billed charges,,,,95.996,100,percent of total billed charges,,,11.0694,,,fee schedule,,,11.0694,,,fee schedule,,,11.0694,,,fee schedule,,,,,,,,,,,,,,,,81.5966,85,percent of total billed charges,,,,,,,,,,47.7772092,49.77,percent of total billed charges,,,,86.3964,90,percent of total billed charges,,,,91.1962,90,percent of total billed charges,,,,,,,,,13.87,,,fee schedule,,,17.6149,,,fee schedule,,,,81.5966,85,percent of total billed charges,,,,,,,,,11.0694,95.996,
ALK PHOSPHATASE,3010090,CDM,84075,CPT,301,RC,outpatient,,,,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,49.2031,85,percent of total billed charges,,,,,,,,,,28.8098622,49.77,percent of total billed charges,,,,52.0974,90,percent of total billed charges,,,,54.9917,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,49.2031,85,percent of total billed charges,,,,,,,,,5.9052,57.886,
ALPHA FETOPROTEIN R,3010100,CDM,82105,CPT,301,RC,outpatient,,,,149.968,82.4824,,134.9712,90,percent of total billed charges,,,,149.968,100,percent of total billed charges,,,19.1178,,,fee schedule,,,19.1178,,,fee schedule,,,19.1178,,,fee schedule,,,,,,,,,,,,,,,,127.4728,85,percent of total billed charges,,,,,,,,,,74.6390736,49.77,percent of total billed charges,,,,134.9712,90,percent of total billed charges,,,,142.4696,90,percent of total billed charges,,,,,,,,,23.95,,,fee schedule,,,30.4165,,,fee schedule,,,,127.4728,85,percent of total billed charges,,,,,,,,,19.1178,149.968,
AMMONIA,3010150,CDM,82140,CPT,301,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,16.6098,,,fee schedule,,,16.6098,,,fee schedule,,,16.6098,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,12.49,,,fee schedule,,,15.8623,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,12.49,114.536,
AMYLASE,3010160,CDM,82150,CPT,301,RC,outpatient,,,,73.954,40.6747,,66.5586,90,percent of total billed charges,,,,73.954,100,percent of total billed charges,,,7.3872,,,fee schedule,,,7.3872,,,fee schedule,,,7.3872,,,fee schedule,,,,,,,,,,,,,,,,62.8609,85,percent of total billed charges,,,,,,,,,,36.8069058,49.77,percent of total billed charges,,,,66.5586,90,percent of total billed charges,,,,70.2563,90,percent of total billed charges,,,,,,,,,9.26,,,fee schedule,,,11.7602,,,fee schedule,,,,62.8609,85,percent of total billed charges,,,,,,,,,7.3872,73.954,
LIPOPROTEIN (A),3010165,CDM,83695,CPT,301,RC,outpatient,,,,138.947,76.42085,,125.0523,90,percent of total billed charges,,,,138.947,100,percent of total billed charges,,,16.3248,,,fee schedule,,,16.3248,,,fee schedule,,,16.3248,,,fee schedule,,,,,,,,,,,,,,,,118.10495,85,percent of total billed charges,,,,,,,,,,69.1539219,49.77,percent of total billed charges,,,,125.0523,90,percent of total billed charges,,,,131.99965,90,percent of total billed charges,,,,,,,,,18.69,,,fee schedule,,,23.7363,,,fee schedule,,,,118.10495,85,percent of total billed charges,,,,,,,,,16.3248,138.947,
APOLIPOPROTEIN B,3010175,CDM,82172,CPT,301,RC,outpatient,,,,110.622,60.8421,,99.5598,90,percent of total billed charges,,,,110.622,100,percent of total billed charges,,,24.0426,,,fee schedule,,,24.0426,,,fee schedule,,,24.0426,,,fee schedule,,,,,,,,,,,,,,,,94.0287,85,percent of total billed charges,,,,,,,,,,55.0565694,49.77,percent of total billed charges,,,,99.5598,90,percent of total billed charges,,,,105.0909,90,percent of total billed charges,,,,,,,,,22.12,,,fee schedule,,,28.0924,,,fee schedule,,,,94.0287,85,percent of total billed charges,,,,,,,,,22.12,110.622,
ANGIOTENSIN CONN EN,3010180,CDM,82164,CPT,301,RC,outpatient,,,,89.713,49.34215,,80.7417,90,percent of total billed charges,,,,89.713,100,percent of total billed charges,,,16.644,,,fee schedule,,,16.644,,,fee schedule,,,16.644,,,fee schedule,,,,,,,,,,,,,,,,76.25605,85,percent of total billed charges,,,,,,,,,,44.6501601,49.77,percent of total billed charges,,,,80.7417,90,percent of total billed charges,,,,85.22735,90,percent of total billed charges,,,,,,,,,20.84,,,fee schedule,,,26.4668,,,fee schedule,,,,76.25605,85,percent of total billed charges,,,,,,,,,16.644,89.713,
B-12 R/L,3010190,CDM,82607,CPT,301,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,17.1912,,,fee schedule,,,17.1912,,,fee schedule,,,17.1912,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,21.52,,,fee schedule,,,27.3304,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,17.1912,114.536,
B-6 LABORATORY,3010200,CDM,84207,CPT,301,RC,outpatient,,,,420.24,231.132,,378.216,90,percent of total billed charges,,,,420.24,100,percent of total billed charges,,,32.034,,,fee schedule,,,32.034,,,fee schedule,,,32.034,,,fee schedule,,,,,,,,,,,,,,,,357.204,85,percent of total billed charges,,,,,,,,,,209.153448,49.77,percent of total billed charges,,,,378.216,90,percent of total billed charges,,,,399.228,90,percent of total billed charges,,,,,,,,,40.11,,,fee schedule,,,50.9397,,,fee schedule,,,,357.204,85,percent of total billed charges,,,,,,,,,32.034,420.24,
BETA SUBUNIT HCG R/L,3010210,CDM,84702,CPT,301,RC,outpatient,,,,177.057,97.38135,,159.3513,90,percent of total billed charges,,,,177.057,100,percent of total billed charges,,,17.157,,,fee schedule,,,17.157,,,fee schedule,,,17.157,,,fee schedule,,,,,,,,,,,,,,,,150.49845,85,percent of total billed charges,,,,,,,,,,88.1212689,49.77,percent of total billed charges,,,,159.3513,90,percent of total billed charges,,,,168.20415,90,percent of total billed charges,,,,,,,,,11.54,,,fee schedule,,,14.6558,,,fee schedule,,,,150.49845,85,percent of total billed charges,,,,,,,,,11.54,177.057,
B-TYPE NATRIURETIC PEPTIDE/BNP,3010214,CDM,83880,CPT,301,RC,outpatient,,,,207.751,114.26305,,186.9759,90,percent of total billed charges,,,,207.751,100,percent of total billed charges,,,44.7564,,,fee schedule,,,44.7564,,,fee schedule,,,44.7564,,,fee schedule,,,,,,,,,,,,,,,,176.58835,85,percent of total billed charges,,,,,,,,,,103.3976727,49.77,percent of total billed charges,,,,186.9759,90,percent of total billed charges,,,,197.36345,90,percent of total billed charges,,,,,,,,,47.43,,,fee schedule,,,60.2361,,,fee schedule,,,,176.58835,85,percent of total billed charges,,,,,,,,,44.7564,207.751,
BETA 2 MICROGLOBULIN,3010220,CDM,82232,CPT,301,RC,outpatient,,,,185.709,102.13995,,167.1381,90,percent of total billed charges,,,,185.709,100,percent of total billed charges,,,18.4452,,,fee schedule,,,18.4452,,,fee schedule,,,18.4452,,,fee schedule,,,,,,,,,,,,,,,,157.85265,85,percent of total billed charges,,,,,,,,,,92.4273693,49.77,percent of total billed charges,,,,167.1381,90,percent of total billed charges,,,,176.42355,90,percent of total billed charges,,,,,,,,,23.11,,,fee schedule,,,29.3497,,,fee schedule,,,,157.85265,85,percent of total billed charges,,,,,,,,,18.4452,185.709,
BILIRUBIN DIRECT,3010230,CDM,82248,CPT,301,RC,outpatient,,,,73.954,40.6747,,66.5586,90,percent of total billed charges,,,,73.954,100,percent of total billed charges,,,5.7228,,,fee schedule,,,5.7228,,,fee schedule,,,5.7228,,,fee schedule,,,,,,,,,,,,,,,,62.8609,85,percent of total billed charges,,,,,,,,,,36.8069058,49.77,percent of total billed charges,,,,66.5586,90,percent of total billed charges,,,,70.2563,90,percent of total billed charges,,,,,,,,,7.17,,,fee schedule,,,9.1059,,,fee schedule,,,,62.8609,85,percent of total billed charges,,,,,,,,,5.7228,73.954,
BILIRUBIN TOTAL,3010240,CDM,82247,CPT,301,RC,outpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,5.7228,,,fee schedule,,,5.7228,,,fee schedule,,,5.7228,,,fee schedule,,,,,,,,,,,,,,,,152.07435,85,percent of total billed charges,,,,,,,,,,89.0440047,49.77,percent of total billed charges,,,,161.0199,90,percent of total billed charges,,,,169.96545,90,percent of total billed charges,,,,,,,,,7.17,,,fee schedule,,,9.1059,,,fee schedule,,,,152.07435,85,percent of total billed charges,,,,,,,,,5.7228,178.911,
OCCULT BLOOD - FECAL,3010260,CDM,82272,CPT,301,RC,outpatient,,,,34.608,19.0344,,31.1472,90,percent of total billed charges,,,,34.608,100,percent of total billed charges,,,4.8222,,,fee schedule,,,4.8222,,,fee schedule,,,4.8222,,,fee schedule,,,,,,,,,,,,,,,,29.4168,85,percent of total billed charges,,,,,,,,,,17.2244016,49.77,percent of total billed charges,,,,31.1472,90,percent of total billed charges,,,,32.8776,90,percent of total billed charges,,,,,,,,,4.69,,,fee schedule,,,5.9563,,,fee schedule,,,,29.4168,85,percent of total billed charges,,,,,,,,,4.69,34.608,
BUN,3010270,CDM,84520,CPT,301,RC,outpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,4.503,,,fee schedule,,,4.503,,,fee schedule,,,4.503,,,fee schedule,,,,,,,,,,,,,,,,42.81195,85,percent of total billed charges,,,,,,,,,,25.0676559,49.77,percent of total billed charges,,,,45.3303,90,percent of total billed charges,,,,47.84865,90,percent of total billed charges,,,,,,,,,5.63,,,fee schedule,,,7.1501,,,fee schedule,,,,42.81195,85,percent of total billed charges,,,,,,,,,4.503,50.367,
C-PEPTIDE,3010290,CDM,84681,CPT,301,RC,outpatient,,,,216.403,119.02165,,194.7627,90,percent of total billed charges,,,,216.403,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,,,,,,,,,,,,,,183.94255,85,percent of total billed charges,,,,,,,,,,107.7037731,49.77,percent of total billed charges,,,,194.7627,90,percent of total billed charges,,,,205.58285,90,percent of total billed charges,,,,,,,,,29.71,,,fee schedule,,,37.7317,,,fee schedule,,,,183.94255,85,percent of total billed charges,,,,,,,,,23.7234,216.403,
CALCIUM,3010310,CDM,82310,CPT,301,RC,outpatient,,,,39.346,21.6403,,35.4114,90,percent of total billed charges,,,,39.346,100,percent of total billed charges,,,5.8824,,,fee schedule,,,5.8824,,,fee schedule,,,5.8824,,,fee schedule,,,,,,,,,,,,,,,,33.4441,85,percent of total billed charges,,,,,,,,,,19.5825042,49.77,percent of total billed charges,,,,35.4114,90,percent of total billed charges,,,,37.3787,90,percent of total billed charges,,,,,,,,,7.36,,,fee schedule,,,9.3472,,,fee schedule,,,,33.4441,85,percent of total billed charges,,,,,,,,,5.8824,39.346,
CALCIUM URINE,3010320,CDM,82340,CPT,301,RC,outpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,6.8742,,,fee schedule,,,6.8742,,,fee schedule,,,6.8742,,,fee schedule,,,,,,,,,,,,,,,,42.81195,85,percent of total billed charges,,,,,,,,,,25.0676559,49.77,percent of total billed charges,,,,45.3303,90,percent of total billed charges,,,,47.84865,90,percent of total billed charges,,,,,,,,,8.62,,,fee schedule,,,10.9474,,,fee schedule,,,,42.81195,85,percent of total billed charges,,,,,,,,,6.8742,50.367,
TROPONIN I,3010325,CDM,84484,CPT,301,RC,outpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,,,,,,,,,,,,,,135.79005,85,percent of total billed charges,,,,,,,,,,79.5090681,49.77,percent of total billed charges,,,,143.7777,90,percent of total billed charges,,,,151.76535,90,percent of total billed charges,,,,,,,,,14.05,,,fee schedule,,,17.8435,,,fee schedule,,,,135.79005,85,percent of total billed charges,,,,,,,,,14.05,159.753,
TROPONIN 5TH GEN 1 HOUR,3010326,CDM,84484,CPT,301,RC,outpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,,,,,,,,,,,,,,135.79005,85,percent of total billed charges,,,,,,,,,,79.5090681,49.77,percent of total billed charges,,,,143.7777,90,percent of total billed charges,,,,151.76535,90,percent of total billed charges,,,,,,,,,14.05,,,fee schedule,,,17.8435,,,fee schedule,,,,135.79005,85,percent of total billed charges,,,,,,,,,14.05,159.753,
TROPONIN 5TH GEN 3 HOUR,3010327,CDM,84484,CPT,301,RC,outpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,14.2158,,,fee schedule,,,,,,,,,,,,,,,,135.79005,85,percent of total billed charges,,,,,,,,,,79.5090681,49.77,percent of total billed charges,,,,143.7777,90,percent of total billed charges,,,,151.76535,90,percent of total billed charges,,,,,,,,,14.05,,,fee schedule,,,17.8435,,,fee schedule,,,,135.79005,85,percent of total billed charges,,,,,,,,,14.05,159.753,
ALBUMIN - BODY FLUID,3010335,CDM,82042,CPT,301,RC,outpatient,,,,56.65,31.1575,,50.985,90,percent of total billed charges,,,,56.65,100,percent of total billed charges,,,8.8692,,,fee schedule,,,8.8692,,,fee schedule,,,8.8692,,,fee schedule,,,,,,,,,,,,,,,,48.1525,85,percent of total billed charges,,,,,,,,,,28.194705,49.77,percent of total billed charges,,,,50.985,90,percent of total billed charges,,,,53.8175,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,48.1525,85,percent of total billed charges,,,,,,,,,7.39,56.65,
CARBON MONO-CARBOXY,3010350,CDM,82375,CPT,301,RC,outpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,14.0448,,,fee schedule,,,14.0448,,,fee schedule,,,14.0448,,,fee schedule,,,,,,,,,,,,,,,,111.7138,85,percent of total billed charges,,,,,,,,,,65.4117156,49.77,percent of total billed charges,,,,118.2852,90,percent of total billed charges,,,,124.8566,90,percent of total billed charges,,,,,,,,,17.6,,,fee schedule,,,22.352,,,fee schedule,,,,111.7138,85,percent of total billed charges,,,,,,,,,14.0448,131.428,
"CATECHOLAMINES, PLASMA",3010407,CDM,82384,CPT,301,RC,outpatient,,,,391.915,215.55325,,352.7235,90,percent of total billed charges,,,,391.915,100,percent of total billed charges,,,28.785,,,fee schedule,,,28.785,,,fee schedule,,,28.785,,,fee schedule,,,,,,,,,,,,,,,,333.12775,85,percent of total billed charges,,,,,,,,,,195.0560955,49.77,percent of total billed charges,,,,352.7235,90,percent of total billed charges,,,,372.31925,90,percent of total billed charges,,,,,,,,,36.06,,,fee schedule,,,45.7962,,,fee schedule,,,,333.12775,85,percent of total billed charges,,,,,,,,,28.785,391.915,
CATECHOLAMINE TOTAL,3010410,CDM,82384,CPT,301,RC,outpatient,,,,174.688,96.0784,,157.2192,90,percent of total billed charges,,,,174.688,100,percent of total billed charges,,,28.785,,,fee schedule,,,28.785,,,fee schedule,,,28.785,,,fee schedule,,,,,,,,,,,,,,,,148.4848,85,percent of total billed charges,,,,,,,,,,86.9422176,49.77,percent of total billed charges,,,,157.2192,90,percent of total billed charges,,,,165.9536,90,percent of total billed charges,,,,,,,,,36.06,,,fee schedule,,,45.7962,,,fee schedule,,,,148.4848,85,percent of total billed charges,,,,,,,,,28.785,174.688,
CBG TEST - FINGER STICK,3010420,CDM,82947,CPT,301,RC,outpatient,,,QW,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,7.112,,,fee schedule,,,,14.62085,85,percent of total billed charges,,,,,,,,,4.4802,17.201,
CEA R/L,3010430,CDM,82378,CPT,301,RC,outpatient,,,,158.62,87.241,,142.758,90,percent of total billed charges,,,,158.62,100,percent of total billed charges,,,21.6144,,,fee schedule,,,21.6144,,,fee schedule,,,21.6144,,,fee schedule,,,,,,,,,,,,,,,,134.827,85,percent of total billed charges,,,,,,,,,,78.945174,49.77,percent of total billed charges,,,,142.758,90,percent of total billed charges,,,,150.689,90,percent of total billed charges,,,,,,,,,27.09,,,fee schedule,,,34.4043,,,fee schedule,,,,134.827,85,percent of total billed charges,,,,,,,,,21.6144,158.62,
CHLORIDE,3010440,CDM,82435,CPT,301,RC,outpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,5.244,,,fee schedule,,,5.244,,,fee schedule,,,5.244,,,fee schedule,,,,,,,,,,,,,,,,51.21675,85,percent of total billed charges,,,,,,,,,,29.9889135,49.77,percent of total billed charges,,,,54.2295,90,percent of total billed charges,,,,57.24225,90,percent of total billed charges,,,,,,,,,6.56,,,fee schedule,,,8.3312,,,fee schedule,,,,51.21675,85,percent of total billed charges,,,,,,,,,5.244,60.255,
CERULOPLASMIN,3010445,CDM,82390,CPT,301,RC,outpatient,,,,81.061,44.58355,,72.9549,90,percent of total billed charges,,,,81.061,100,percent of total billed charges,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,,,,,,,,,,,,,,68.90185,85,percent of total billed charges,,,,,,,,,,40.3440597,49.77,percent of total billed charges,,,,72.9549,90,percent of total billed charges,,,,77.00795,90,percent of total billed charges,,,,,,,,,15.33,,,fee schedule,,,19.4691,,,fee schedule,,,,68.90185,85,percent of total billed charges,,,,,,,,,12.2436,81.061,
CHOLESTEROL,3010460,CDM,82465,CPT,301,RC,outpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,4.959,,,fee schedule,,,4.959,,,fee schedule,,,4.959,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,,,,,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,,,,,,,6.22,,,fee schedule,,,7.8994,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,,,,,,,4.959,49.234,
CORTISOL R/L,3010500,CDM,82533,CPT,301,RC,outpatient,,,,135.342,74.4381,,121.8078,90,percent of total billed charges,,,,135.342,100,percent of total billed charges,,,18.582,,,fee schedule,,,18.582,,,fee schedule,,,18.582,,,fee schedule,,,,,,,,,,,,,,,,115.0407,85,percent of total billed charges,,,,,,,,,,67.3597134,49.77,percent of total billed charges,,,,121.8078,90,percent of total billed charges,,,,128.5749,90,percent of total billed charges,,,,,,,,,22.53,,,fee schedule,,,28.6131,,,fee schedule,,,,115.0407,85,percent of total billed charges,,,,,,,,,18.582,135.342,
CORTISOL URINE R/L,3010510,CDM,82533,CPT,301,RC,outpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,18.582,,,fee schedule,,,18.582,,,fee schedule,,,18.582,,,fee schedule,,,,,,,,,,,,,,,,160.9169,85,percent of total billed charges,,,,,,,,,,94.2215778,49.77,percent of total billed charges,,,,170.3826,90,percent of total billed charges,,,,179.8483,90,percent of total billed charges,,,,,,,,,22.53,,,fee schedule,,,28.6131,,,fee schedule,,,,160.9169,85,percent of total billed charges,,,,,,,,,18.582,189.314,
CO2,3010520,CDM,82374,CPT,301,RC,outpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,5.5632,,,fee schedule,,,5.5632,,,fee schedule,,,5.5632,,,fee schedule,,,,,,,,,,,,,,,,42.81195,85,percent of total billed charges,,,,,,,,,,25.0676559,49.77,percent of total billed charges,,,,45.3303,90,percent of total billed charges,,,,47.84865,90,percent of total billed charges,,,,,,,,,6.99,,,fee schedule,,,8.8773,,,fee schedule,,,,42.81195,85,percent of total billed charges,,,,,,,,,5.5632,50.367,
THYROTROPIN RECEPTOR ANTIBODY,3010521,CDM,83519,CPT,301,RC,outpatient,,,,184.267,101.34685,,165.8403,90,percent of total billed charges,,,,184.267,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,,,,,,,,,,,,,,156.62695,85,percent of total billed charges,,,,,,,,,,91.7096859,49.77,percent of total billed charges,,,,165.8403,90,percent of total billed charges,,,,175.05365,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,156.62695,85,percent of total billed charges,,,,,,,,,12.87,184.267,
CPK,3010530,CDM,82550,CPT,301,RC,outpatient,,,,64.169,35.29295,,57.7521,90,percent of total billed charges,,,,64.169,100,percent of total billed charges,,,7.4214,,,fee schedule,,,7.4214,,,fee schedule,,,7.4214,,,fee schedule,,,,,,,,,,,,,,,,54.54365,85,percent of total billed charges,,,,,,,,,,31.9369113,49.77,percent of total billed charges,,,,57.7521,90,percent of total billed charges,,,,60.96055,90,percent of total billed charges,,,,,,,,,9.31,,,fee schedule,,,11.8237,,,fee schedule,,,,54.54365,85,percent of total billed charges,,,,,,,,,7.4214,64.169,
CPK-MB,3010540,CDM,82553,CPT,301,RC,outpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,13.167,,,fee schedule,,,13.167,,,fee schedule,,,13.167,,,fee schedule,,,,,,,,,,,,,,,,119.068,85,percent of total billed charges,,,,,,,,,,69.717816,49.77,percent of total billed charges,,,,126.072,90,percent of total billed charges,,,,133.076,90,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,20.9296,,,fee schedule,,,,119.068,85,percent of total billed charges,,,,,,,,,13.167,140.08,
CREATININE,3010550,CDM,82565,CPT,301,RC,outpatient,,,,50.367,27.70185,,45.3303,90,percent of total billed charges,,,,50.367,100,percent of total billed charges,,,5.8368,,,fee schedule,,,5.8368,,,fee schedule,,,5.8368,,,fee schedule,,,,,,,,,,,,,,,,42.81195,85,percent of total billed charges,,,,,,,,,,25.0676559,49.77,percent of total billed charges,,,,45.3303,90,percent of total billed charges,,,,47.84865,90,percent of total billed charges,,,,,,,,,7.31,,,fee schedule,,,9.2837,,,fee schedule,,,,42.81195,85,percent of total billed charges,,,,,,,,,5.8368,50.367,
CREATININE CLEARANCE,3010560,CDM,82575,CPT,301,RC,outpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,10.7844,,,fee schedule,,,10.7844,,,fee schedule,,,10.7844,,,fee schedule,,,,,,,,,,,,,,,,103.39655,85,percent of total billed charges,,,,,,,,,,60.5417211,49.77,percent of total billed charges,,,,109.4787,90,percent of total billed charges,,,,115.56085,90,percent of total billed charges,,,,,,,,,13.5,,,fee schedule,,,17.145,,,fee schedule,,,,103.39655,85,percent of total billed charges,,,,,,,,,10.7844,121.643,
CREATININE-URINE,3010570,CDM,82570,CPT,301,RC,outpatient,,,,65.302,35.9161,,58.7718,90,percent of total billed charges,,,,65.302,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,55.5067,85,percent of total billed charges,,,,,,,,,,32.5008054,49.77,percent of total billed charges,,,,58.7718,90,percent of total billed charges,,,,62.0369,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,55.5067,85,percent of total billed charges,,,,,,,,,5.9052,65.302,
DEHYDROEPIANDROSTERONE SULFATE,3010603,CDM,82627,CPT,301,RC,outpatient,,,,290.975,160.03625,,261.8775,90,percent of total billed charges,,,,290.975,100,percent of total billed charges,,,25.3422,,,fee schedule,,,25.3422,,,fee schedule,,,25.3422,,,fee schedule,,,,,,,,,,,,,,,,247.32875,85,percent of total billed charges,,,,,,,,,,144.8182575,49.77,percent of total billed charges,,,,261.8775,90,percent of total billed charges,,,,276.42625,90,percent of total billed charges,,,,,,,,,31.74,,,fee schedule,,,40.3098,,,fee schedule,,,,247.32875,85,percent of total billed charges,,,,,,,,,25.3422,290.975,
DHEA,3010630,CDM,82626,CPT,301,RC,outpatient,,,,321.875,177.03125,,289.6875,90,percent of total billed charges,,,,321.875,100,percent of total billed charges,,,28.8078,,,fee schedule,,,28.8078,,,fee schedule,,,28.8078,,,fee schedule,,,,,,,,,,,,,,,,273.59375,85,percent of total billed charges,,,,,,,,,,160.1971875,49.77,percent of total billed charges,,,,289.6875,90,percent of total billed charges,,,,305.78125,90,percent of total billed charges,,,,,,,,,36.09,,,fee schedule,,,45.8343,,,fee schedule,,,,273.59375,85,percent of total billed charges,,,,,,,,,28.8078,321.875,
ELECTROPHOR PROTEIN,3010770,CDM,84165,CPT,301,RC,outpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,,,,,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,,,,,,,15.33,,,fee schedule,,,19.4691,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,,,,,,,12.2436,49.234,
ERYTHROPOIETIN,3010800,CDM,82668,CPT,301,RC,outpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,21.4206,,,fee schedule,,,21.4206,,,fee schedule,,,21.4206,,,fee schedule,,,,,,,,,,,,,,,,121.08165,85,percent of total billed charges,,,,,,,,,,70.8968673,49.77,percent of total billed charges,,,,128.2041,90,percent of total billed charges,,,,135.32655,90,percent of total billed charges,,,,,,,,,26.84,,,fee schedule,,,34.0868,,,fee schedule,,,,121.08165,85,percent of total billed charges,,,,,,,,,21.4206,142.449,
ESTRADIOL,3010810,CDM,82670,CPT,301,RC,outpatient,,,,229.793,126.38615,,206.8137,90,percent of total billed charges,,,,229.793,100,percent of total billed charges,,,31.8516,,,fee schedule,,,31.8516,,,fee schedule,,,31.8516,,,fee schedule,,,,,,,,,,,,,,,,195.32405,85,percent of total billed charges,,,,,,,,,,114.3679761,49.77,percent of total billed charges,,,,206.8137,90,percent of total billed charges,,,,218.30335,90,percent of total billed charges,,,,,,,,,39.91,,,fee schedule,,,50.6857,,,fee schedule,,,,195.32405,85,percent of total billed charges,,,,,,,,,31.8516,229.793,
"ESTROGEN, TOTAL",3010830,CDM,82672,CPT,301,RC,outpatient,,,,256.985,141.34175,,231.2865,90,percent of total billed charges,,,,256.985,100,percent of total billed charges,,,24.738,,,fee schedule,,,24.738,,,fee schedule,,,24.738,,,fee schedule,,,,,,,,,,,,,,,,218.43725,85,percent of total billed charges,,,,,,,,,,127.9014345,49.77,percent of total billed charges,,,,231.2865,90,percent of total billed charges,,,,244.13575,90,percent of total billed charges,,,,,,,,,30.97,,,fee schedule,,,39.3319,,,fee schedule,,,,218.43725,85,percent of total billed charges,,,,,,,,,24.738,256.985,
FAT STOOL QUAN R/L,3010870,CDM,82710,CPT,301,RC,outpatient,,,,141.316,77.7238,,127.1844,90,percent of total billed charges,,,,141.316,100,percent of total billed charges,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,,,,,,,,,,,,,,120.1186,85,percent of total billed charges,,,,,,,,,,70.3329732,49.77,percent of total billed charges,,,,127.1844,90,percent of total billed charges,,,,134.2502,90,percent of total billed charges,,,,,,,,,16.62,,,fee schedule,,,21.1074,,,fee schedule,,,,120.1186,85,percent of total billed charges,,,,,,,,,16.62,141.316,
FERRITIN R/L,3010880,CDM,82728,CPT,301,RC,outpatient,,,,134.209,73.81495,,120.7881,90,percent of total billed charges,,,,134.209,100,percent of total billed charges,,,15.5382,,,fee schedule,,,15.5382,,,fee schedule,,,15.5382,,,fee schedule,,,,,,,,,,,,,,,,114.07765,85,percent of total billed charges,,,,,,,,,,66.7958193,49.77,percent of total billed charges,,,,120.7881,90,percent of total billed charges,,,,127.49855,90,percent of total billed charges,,,,,,,,,19.46,,,fee schedule,,,24.7142,,,fee schedule,,,,114.07765,85,percent of total billed charges,,,,,,,,,15.5382,134.209,
FOLIC ACID R/L,3010890,CDM,82746,CPT,301,RC,outpatient,,,,190.653,104.85915,,171.5877,90,percent of total billed charges,,,,190.653,100,percent of total billed charges,,,16.758,,,fee schedule,,,16.758,,,fee schedule,,,16.758,,,fee schedule,,,,,,,,,,,,,,,,162.05505,85,percent of total billed charges,,,,,,,,,,94.8879981,49.77,percent of total billed charges,,,,171.5877,90,percent of total billed charges,,,,181.12035,90,percent of total billed charges,,,,,,,,,21,,,fee schedule,,,26.67,,,fee schedule,,,,162.05505,85,percent of total billed charges,,,,,,,,,16.758,190.653,
FREE T3,3010900,CDM,84481,CPT,301,RC,outpatient,,,,385.632,212.0976,,347.0688,90,percent of total billed charges,,,,385.632,100,percent of total billed charges,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,,,,,,,,,,,,,,327.7872,85,percent of total billed charges,,,,,,,,,,191.9290464,49.77,percent of total billed charges,,,,347.0688,90,percent of total billed charges,,,,366.3504,90,percent of total billed charges,,,,,,,,,24.19,,,fee schedule,,,30.7213,,,fee schedule,,,,327.7872,85,percent of total billed charges,,,,,,,,,19.3116,385.632,
FREE T4,3010910,CDM,84439,CPT,301,RC,outpatient,,,,152.337,83.78535,,137.1033,90,percent of total billed charges,,,,152.337,100,percent of total billed charges,,,10.2828,,,fee schedule,,,10.2828,,,fee schedule,,,10.2828,,,fee schedule,,,,,,,,,,,,,,,,129.48645,85,percent of total billed charges,,,,,,,,,,75.8181249,49.77,percent of total billed charges,,,,137.1033,90,percent of total billed charges,,,,144.72015,90,percent of total billed charges,,,,,,,,,12.88,,,fee schedule,,,16.3576,,,fee schedule,,,,129.48645,85,percent of total billed charges,,,,,,,,,10.2828,152.337,
FSH (FOLIC STIM. HORMONE),3010920,CDM,83001,CPT,301,RC,outpatient,,,,234.531,128.99205,,211.0779,90,percent of total billed charges,,,,234.531,100,percent of total billed charges,,,21.1812,,,fee schedule,,,21.1812,,,fee schedule,,,21.1812,,,fee schedule,,,,,,,,,,,,,,,,199.35135,85,percent of total billed charges,,,,,,,,,,116.7260787,49.77,percent of total billed charges,,,,211.0779,90,percent of total billed charges,,,,222.80445,90,percent of total billed charges,,,,,,,,,26.55,,,fee schedule,,,33.7185,,,fee schedule,,,,199.35135,85,percent of total billed charges,,,,,,,,,21.1812,234.531,
GAMMA GLUTAMYL GTT,3010930,CDM,82977,CPT,301,RC,outpatient,,,,78.692,43.2806,,70.8228,90,percent of total billed charges,,,,78.692,100,percent of total billed charges,,,8.208,,,fee schedule,,,8.208,,,fee schedule,,,8.208,,,fee schedule,,,,,,,,,,,,,,,,66.8882,85,percent of total billed charges,,,,,,,,,,39.1650084,49.77,percent of total billed charges,,,,70.8228,90,percent of total billed charges,,,,74.7574,90,percent of total billed charges,,,,,,,,,10.28,,,fee schedule,,,13.0556,,,fee schedule,,,,66.8882,85,percent of total billed charges,,,,,,,,,8.208,78.692,
GASTRIN R/L,3010940,CDM,82941,CPT,301,RC,outpatient,,,,167.272,91.9996,,150.5448,90,percent of total billed charges,,,,167.272,100,percent of total billed charges,,,20.0982,,,fee schedule,,,20.0982,,,fee schedule,,,20.0982,,,fee schedule,,,,,,,,,,,,,,,,142.1812,85,percent of total billed charges,,,,,,,,,,83.2512744,49.77,percent of total billed charges,,,,150.5448,90,percent of total billed charges,,,,158.9084,90,percent of total billed charges,,,,,,,,,25.19,,,fee schedule,,,31.9913,,,fee schedule,,,,142.1812,85,percent of total billed charges,,,,,,,,,20.0982,167.272,
GLUCOSE  - FLUID,3010970,CDM,82945,CPT,301,RC,outpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,7.112,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,,,,,,,4.4802,55.517,
GLUCOSE POSTPRANDIAL,3010971,CDM,82947,CPT,301,RC,outpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,4.4802,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,7.112,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,,,,,,,4.4802,55.517,
G6PD GLUCOSE-6-PHOS,3011030,CDM,82955,CPT,301,RC,outpatient,,,,82.606,45.4333,,74.3454,90,percent of total billed charges,,,,82.606,100,percent of total billed charges,,,11.058,,,fee schedule,,,11.058,,,fee schedule,,,11.058,,,fee schedule,,,,,,,,,,,,,,,,70.2151,85,percent of total billed charges,,,,,,,,,,41.1130062,49.77,percent of total billed charges,,,,74.3454,90,percent of total billed charges,,,,78.4757,90,percent of total billed charges,,,,,,,,,13.85,,,fee schedule,,,17.5895,,,fee schedule,,,,70.2151,85,percent of total billed charges,,,,,,,,,11.058,82.606,
HAPTOGLOBIN,3011040,CDM,83010,CPT,301,RC,outpatient,,,,125.557,69.05635,,113.0013,90,percent of total billed charges,,,,125.557,100,percent of total billed charges,,,14.3412,,,fee schedule,,,14.3412,,,fee schedule,,,14.3412,,,fee schedule,,,,,,,,,,,,,,,,106.72345,85,percent of total billed charges,,,,,,,,,,62.4897189,49.77,percent of total billed charges,,,,113.0013,90,percent of total billed charges,,,,119.27915,90,percent of total billed charges,,,,,,,,,17.96,,,fee schedule,,,22.8092,,,fee schedule,,,,106.72345,85,percent of total billed charges,,,,,,,,,14.3412,125.557,
CYSTATIN C,3011057,CDM,82610,CPT,301,RC,outpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,21.1128,,,fee schedule,,,21.1128,,,fee schedule,,,21.1128,,,fee schedule,,,,,,,,,,,,,,,,152.07435,85,percent of total billed charges,,,,,,,,,,89.0440047,49.77,percent of total billed charges,,,,161.0199,90,percent of total billed charges,,,,169.96545,90,percent of total billed charges,,,,,,,,,19.63,,,fee schedule,,,24.9301,,,fee schedule,,,,152.07435,85,percent of total billed charges,,,,,,,,,19.63,178.911,
CHROMIUM,3011083,CDM,82495,CPT,301,RC,outpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,23.1192,,,fee schedule,,,23.1192,,,fee schedule,,,23.1192,,,fee schedule,,,,,,,,,,,,,,,,111.7138,85,percent of total billed charges,,,,,,,,,,65.4117156,49.77,percent of total billed charges,,,,118.2852,90,percent of total billed charges,,,,124.8566,90,percent of total billed charges,,,,,,,,,9.98,,,fee schedule,,,12.6746,,,fee schedule,,,,111.7138,85,percent of total billed charges,,,,,,,,,9.98,131.428,
HEAVY METAL SCREEN - ARSENIC,3011084,CDM,82175,CPT,301,RC,outpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,21.6258,,,fee schedule,,,21.6258,,,fee schedule,,,21.6258,,,fee schedule,,,,,,,,,,,,,,,,111.7138,85,percent of total billed charges,,,,,,,,,,65.4117156,49.77,percent of total billed charges,,,,118.2852,90,percent of total billed charges,,,,124.8566,90,percent of total billed charges,,,,,,,,,27.09,,,fee schedule,,,34.4043,,,fee schedule,,,,111.7138,85,percent of total billed charges,,,,,,,,,21.6258,131.428,
HEAVY METAL SCREEN - LEAD,3011087,CDM,83655,CPT,301,RC,outpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,13.8054,,,fee schedule,,,13.8054,,,fee schedule,,,13.8054,,,fee schedule,,,,,,,,,,,,,,,,135.79005,85,percent of total billed charges,,,,,,,,,,79.5090681,49.77,percent of total billed charges,,,,143.7777,90,percent of total billed charges,,,,151.76535,90,percent of total billed charges,,,,,,,,,17.28,,,fee schedule,,,21.9456,,,fee schedule,,,,135.79005,85,percent of total billed charges,,,,,,,,,13.8054,159.753,
HEAVY METAL SCREEN - MERCURY,3011088,CDM,83825,CPT,301,RC,outpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,18.5364,,,fee schedule,,,18.5364,,,fee schedule,,,18.5364,,,fee schedule,,,,,,,,,,,,,,,,111.7138,85,percent of total billed charges,,,,,,,,,,65.4117156,49.77,percent of total billed charges,,,,118.2852,90,percent of total billed charges,,,,124.8566,90,percent of total billed charges,,,,,,,,,23.22,,,fee schedule,,,29.4894,,,fee schedule,,,,111.7138,85,percent of total billed charges,,,,,,,,,18.5364,131.428,
STRONTIUM,3011089,CDM,83018,CPT,301,RC,outpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,25.0344,,,fee schedule,,,25.0344,,,fee schedule,,,25.0344,,,fee schedule,,,,,,,,,,,,,,,,111.7138,85,percent of total billed charges,,,,,,,,,,65.4117156,49.77,percent of total billed charges,,,,118.2852,90,percent of total billed charges,,,,124.8566,90,percent of total billed charges,,,,,,,,,31.28,,,fee schedule,,,39.7256,,,fee schedule,,,,111.7138,85,percent of total billed charges,,,,,,,,,25.0344,131.428,
HGB A1C,3011130,CDM,83036,CPT,301,RC,outpatient,,,,72.821,40.05155,,65.5389,90,percent of total billed charges,,,,72.821,100,percent of total billed charges,,,11.0694,,,fee schedule,,,11.0694,,,fee schedule,,,11.0694,,,fee schedule,,,,,,,,,,,,,,,,61.89785,85,percent of total billed charges,,,,,,,,,,36.2430117,49.77,percent of total billed charges,,,,65.5389,90,percent of total billed charges,,,,69.17995,90,percent of total billed charges,,,,,,,,,13.87,,,fee schedule,,,17.6149,,,fee schedule,,,,61.89785,85,percent of total billed charges,,,,,,,,,11.0694,72.821,
HGB ELECTROPHOR R/L,3011140,CDM,83020,CPT,301,RC,outpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,,,,,,,,,,,,,,73.27935,85,percent of total billed charges,,,,,,,,,,42.9072147,49.77,percent of total billed charges,,,,77.5899,90,percent of total billed charges,,,,81.90045,90,percent of total billed charges,,,,,,,,,18.39,,,fee schedule,,,23.3553,,,fee schedule,,,,73.27935,85,percent of total billed charges,,,,,,,,,14.6718,86.211,
"IMMUNOGLOBIN A,QUANTITATIVE",3011151,CDM,82784,CPT,301,RC,outpatient,,,,122.776,67.5268,,110.4984,90,percent of total billed charges,,,,122.776,100,percent of total billed charges,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,,,,,,,,,,,,,,104.3596,85,percent of total billed charges,,,,,,,,,,61.1056152,49.77,percent of total billed charges,,,,110.4984,90,percent of total billed charges,,,,116.6372,90,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,10.4648,,,fee schedule,,,,104.3596,85,percent of total billed charges,,,,,,,,,8.24,122.776,
"IMMUNOGLOBIN G, QUANTATIVE",3011156,CDM,82784,CPT,301,RC,outpatient,,,,122.776,67.5268,,110.4984,90,percent of total billed charges,,,,122.776,100,percent of total billed charges,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,,,,,,,,,,,,,,104.3596,85,percent of total billed charges,,,,,,,,,,61.1056152,49.77,percent of total billed charges,,,,110.4984,90,percent of total billed charges,,,,116.6372,90,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,10.4648,,,fee schedule,,,,104.3596,85,percent of total billed charges,,,,,,,,,8.24,122.776,
INOR PHOS PO4,3011170,CDM,84100,CPT,301,RC,outpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,5.4036,,,fee schedule,,,5.4036,,,fee schedule,,,5.4036,,,fee schedule,,,,,,,,,,,,,,,,51.21675,85,percent of total billed charges,,,,,,,,,,29.9889135,49.77,percent of total billed charges,,,,54.2295,90,percent of total billed charges,,,,57.24225,90,percent of total billed charges,,,,,,,,,6.78,,,fee schedule,,,8.6106,,,fee schedule,,,,51.21675,85,percent of total billed charges,,,,,,,,,5.4036,60.255,
INSULIN-LIKE GROWTH FACTOR 1,3011175,CDM,84305,CPT,301,RC,outpatient,,,,226.291,124.46005,,203.6619,90,percent of total billed charges,,,,226.291,100,percent of total billed charges,,,24.2364,,,fee schedule,,,24.2364,,,fee schedule,,,24.2364,,,fee schedule,,,,,,,,,,,,,,,,192.34735,85,percent of total billed charges,,,,,,,,,,112.6250307,49.77,percent of total billed charges,,,,203.6619,90,percent of total billed charges,,,,214.97645,90,percent of total billed charges,,,,,,,,,30.36,,,fee schedule,,,38.5572,,,fee schedule,,,,192.34735,85,percent of total billed charges,,,,,,,,,24.2364,226.291,
INSULIN R/L,3011180,CDM,83525,CPT,301,RC,outpatient,,,,82.606,45.4333,,74.3454,90,percent of total billed charges,,,,82.606,100,percent of total billed charges,,,13.0302,,,fee schedule,,,13.0302,,,fee schedule,,,13.0302,,,fee schedule,,,,,,,,,,,,,,,,70.2151,85,percent of total billed charges,,,,,,,,,,41.1130062,49.77,percent of total billed charges,,,,74.3454,90,percent of total billed charges,,,,78.4757,90,percent of total billed charges,,,,,,,,,16.34,,,fee schedule,,,20.7518,,,fee schedule,,,,70.2151,85,percent of total billed charges,,,,,,,,,13.0302,82.606,
IRON BINDING CAPACITY,3011190,CDM,83550,CPT,301,RC,outpatient,,,,77.559,42.65745,,69.8031,90,percent of total billed charges,,,,77.559,100,percent of total billed charges,,,9.9636,,,fee schedule,,,9.9636,,,fee schedule,,,9.9636,,,fee schedule,,,,,,,,,,,,,,,,65.92515,85,percent of total billed charges,,,,,,,,,,38.6011143,49.77,percent of total billed charges,,,,69.8031,90,percent of total billed charges,,,,73.68105,90,percent of total billed charges,,,,,,,,,12.48,,,fee schedule,,,15.8496,,,fee schedule,,,,65.92515,85,percent of total billed charges,,,,,,,,,9.9636,77.559,
IRON TOTAL,3011200,CDM,83540,CPT,301,RC,outpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,,,,,,,,,,,,,,51.21675,85,percent of total billed charges,,,,,,,,,,29.9889135,49.77,percent of total billed charges,,,,54.2295,90,percent of total billed charges,,,,57.24225,90,percent of total billed charges,,,,,,,,,9.25,,,fee schedule,,,11.7475,,,fee schedule,,,,51.21675,85,percent of total billed charges,,,,,,,,,7.3758,60.255,
ISOENZYME CPK R/L,3011210,CDM,82552,CPT,301,RC,outpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,15.2646,,,fee schedule,,,15.2646,,,fee schedule,,,15.2646,,,fee schedule,,,,,,,,,,,,,,,,60.5846,85,percent of total billed charges,,,,,,,,,,35.4740652,49.77,percent of total billed charges,,,,64.1484,90,percent of total billed charges,,,,67.7122,90,percent of total billed charges,,,,,,,,,19.13,,,fee schedule,,,24.2951,,,fee schedule,,,,60.5846,85,percent of total billed charges,,,,,,,,,15.2646,71.276,
LACTIC ACID,3011230,CDM,83605,CPT,301,RC,outpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,13.1898,,,fee schedule,,,13.1898,,,fee schedule,,,13.1898,,,fee schedule,,,,,,,,,,,,,,,,119.068,85,percent of total billed charges,,,,,,,,,,69.717816,49.77,percent of total billed charges,,,,126.072,90,percent of total billed charges,,,,133.076,90,percent of total billed charges,,,,,,,,,15.25,,,fee schedule,,,19.3675,,,fee schedule,,,,119.068,85,percent of total billed charges,,,,,,,,,13.1898,140.08,
LDH,3011240,CDM,83615,CPT,301,RC,outpatient,,,,40.582,22.3201,,36.5238,90,percent of total billed charges,,,,40.582,100,percent of total billed charges,,,6.8856,,,fee schedule,,,6.8856,,,fee schedule,,,6.8856,,,fee schedule,,,,,,,,,,,,,,,,34.4947,85,percent of total billed charges,,,,,,,,,,20.1976614,49.77,percent of total billed charges,,,,36.5238,90,percent of total billed charges,,,,38.5529,90,percent of total billed charges,,,,,,,,,8.63,,,fee schedule,,,10.9601,,,fee schedule,,,,34.4947,85,percent of total billed charges,,,,,,,,,6.8856,40.582,
LDL CHOLESTEROL - DIRECT,3011255,CDM,83721,CPT,301,RC,outpatient,,,,83.842,46.1131,,75.4578,90,percent of total billed charges,,,,83.842,100,percent of total billed charges,,,11.97,,,fee schedule,,,11.97,,,fee schedule,,,11.97,,,fee schedule,,,,,,,,,,,,,,,,71.2657,85,percent of total billed charges,,,,,,,,,,41.7281634,49.77,percent of total billed charges,,,,75.4578,90,percent of total billed charges,,,,79.6499,90,percent of total billed charges,,,,,,,,,13.62,,,fee schedule,,,17.2974,,,fee schedule,,,,71.2657,85,percent of total billed charges,,,,,,,,,11.97,83.842,
LIPASE,3011270,CDM,83690,CPT,301,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,7.8546,,,fee schedule,,,7.8546,,,fee schedule,,,7.8546,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,,,,,,,9.84,,,fee schedule,,,12.4968,,,fee schedule,,,,63.9115,85,percent of total billed charges,,,,,,,,,7.8546,75.19,
LUTEINIZING HORMONE,3011320,CDM,83002,CPT,301,RC,outpatient,,,,155.015,85.25825,,139.5135,90,percent of total billed charges,,,,155.015,100,percent of total billed charges,,,21.1128,,,fee schedule,,,21.1128,,,fee schedule,,,21.1128,,,fee schedule,,,,,,,,,,,,,,,,131.76275,85,percent of total billed charges,,,,,,,,,,77.1509655,49.77,percent of total billed charges,,,,139.5135,90,percent of total billed charges,,,,147.26425,90,percent of total billed charges,,,,,,,,,26.45,,,fee schedule,,,33.5915,,,fee schedule,,,,131.76275,85,percent of total billed charges,,,,,,,,,21.1128,155.015,
MAGNESIUM-MG,3011440,CDM,83735,CPT,301,RC,outpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,7.638,,,fee schedule,,,7.638,,,fee schedule,,,7.638,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,,,,,,,9.57,,,fee schedule,,,12.1539,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,,,,,,,7.638,55.517,
METANEPHRINES TOTAL,3011460,CDM,83835,CPT,301,RC,outpatient,,,,244.419,134.43045,,219.9771,90,percent of total billed charges,,,,244.419,100,percent of total billed charges,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,,,,,,,,,,,,,,207.75615,85,percent of total billed charges,,,,,,,,,,121.6473363,49.77,percent of total billed charges,,,,219.9771,90,percent of total billed charges,,,,232.19805,90,percent of total billed charges,,,,,,,,,21.51,,,fee schedule,,,27.3177,,,fee schedule,,,,207.75615,85,percent of total billed charges,,,,,,,,,19.3116,244.419,
METHYLMALONIC ACID,3011475,CDM,83921,CPT,301,RC,outpatient,,,,330.527,181.78985,,297.4743,90,percent of total billed charges,,,,330.527,100,percent of total billed charges,,,24.1794,,,fee schedule,,,24.1794,,,fee schedule,,,24.1794,,,fee schedule,,,,,,,,,,,,,,,,280.94795,85,percent of total billed charges,,,,,,,,,,164.5032879,49.77,percent of total billed charges,,,,297.4743,90,percent of total billed charges,,,,314.00065,90,percent of total billed charges,,,,,,,,,23.51,,,fee schedule,,,29.8577,,,fee schedule,,,,280.94795,85,percent of total billed charges,,,,,,,,,23.51,330.527,
OSMOLALITY SERUM,3011550,CDM,83930,CPT,301,RC,outpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,7.5354,,,fee schedule,,,7.5354,,,fee schedule,,,7.5354,,,fee schedule,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,,33.6798567,49.77,percent of total billed charges,,,,60.9039,90,percent of total billed charges,,,,64.28745,90,percent of total billed charges,,,,,,,,,9.43,,,fee schedule,,,11.9761,,,fee schedule,,,,57.52035,85,percent of total billed charges,,,,,,,,,7.5354,67.671,
OSMOLALITY; URINE,3011551,CDM,83935,CPT,301,RC,outpatient,,,,70.04,38.522,,63.036,90,percent of total billed charges,,,,70.04,100,percent of total billed charges,,,7.7748,,,fee schedule,,,7.7748,,,fee schedule,,,7.7748,,,fee schedule,,,,,,,,,,,,,,,,59.534,85,percent of total billed charges,,,,,,,,,,34.858908,49.77,percent of total billed charges,,,,63.036,90,percent of total billed charges,,,,66.538,90,percent of total billed charges,,,,,,,,,9.73,,,fee schedule,,,12.3571,,,fee schedule,,,,59.534,85,percent of total billed charges,,,,,,,,,7.7748,70.04,
PARATHYROID PTH R/L,3011590,CDM,83970,CPT,301,RC,outpatient,,,,287.679,158.22345,,258.9111,90,percent of total billed charges,,,,287.679,100,percent of total billed charges,,,47.0592,,,fee schedule,,,47.0592,,,fee schedule,,,47.0592,,,fee schedule,,,,,,,,,,,,,,,,244.52715,85,percent of total billed charges,,,,,,,,,,143.1778383,49.77,percent of total billed charges,,,,258.9111,90,percent of total billed charges,,,,273.29505,90,percent of total billed charges,,,,,,,,,58.94,,,fee schedule,,,74.8538,,,fee schedule,,,,244.52715,85,percent of total billed charges,,,,,,,,,47.0592,287.679,
PH BLOOD,3011600,CDM,82800,CPT,301,RC,outpatient,,,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,12.54,,,fee schedule,,,12.54,,,fee schedule,,,12.54,,,fee schedule,,,,,,,,,,,,,,,,44.1252,85,percent of total billed charges,,,,,,,,,,25.8366024,49.77,percent of total billed charges,,,,46.7208,90,percent of total billed charges,,,,49.3164,90,percent of total billed charges,,,,,,,,,12.1,,,fee schedule,,,15.367,,,fee schedule,,,,44.1252,85,percent of total billed charges,,,,,,,,,12.1,51.912,
PORPHYRINS QUANT.,3011640,CDM,84120,CPT,301,RC,outpatient,,,,122.776,67.5268,,110.4984,90,percent of total billed charges,,,,122.776,100,percent of total billed charges,,,16.7694,,,fee schedule,,,16.7694,,,fee schedule,,,16.7694,,,fee schedule,,,,,,,,,,,,,,,,104.3596,85,percent of total billed charges,,,,,,,,,,61.1056152,49.77,percent of total billed charges,,,,110.4984,90,percent of total billed charges,,,,116.6372,90,percent of total billed charges,,,,,,,,,19.11,,,fee schedule,,,24.2697,,,fee schedule,,,,104.3596,85,percent of total billed charges,,,,,,,,,16.7694,122.776,
POTASSIUM,3011650,CDM,84132,CPT,301,RC,outpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,5.4264,,,fee schedule,,,5.4264,,,fee schedule,,,5.4264,,,fee schedule,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,,33.6798567,49.77,percent of total billed charges,,,,60.9039,90,percent of total billed charges,,,,64.28745,90,percent of total billed charges,,,,,,,,,6.56,,,fee schedule,,,8.3312,,,fee schedule,,,,57.52035,85,percent of total billed charges,,,,,,,,,5.4264,67.671,
POTASSIUM URINE,3011660,CDM,84133,CPT,301,RC,outpatient,,,,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,5.3922,,,fee schedule,,,5.3922,,,fee schedule,,,5.3922,,,fee schedule,,,,,,,,,,,,,,,,46.13885,85,percent of total billed charges,,,,,,,,,,27.0156537,49.77,percent of total billed charges,,,,48.8529,90,percent of total billed charges,,,,51.56695,90,percent of total billed charges,,,,,,,,,6.14,,,fee schedule,,,7.7978,,,fee schedule,,,,46.13885,85,percent of total billed charges,,,,,,,,,5.3922,54.281,
PREALBUMIN,3011665,CDM,84134,CPT,301,RC,outpatient,,,,134.209,73.81495,,120.7881,90,percent of total billed charges,,,,134.209,100,percent of total billed charges,,,16.6326,,,fee schedule,,,16.6326,,,fee schedule,,,16.6326,,,fee schedule,,,,,,,,,,,,,,,,114.07765,85,percent of total billed charges,,,,,,,,,,66.7958193,49.77,percent of total billed charges,,,,120.7881,90,percent of total billed charges,,,,127.49855,90,percent of total billed charges,,,,,,,,,20.83,,,fee schedule,,,26.4541,,,fee schedule,,,,114.07765,85,percent of total billed charges,,,,,,,,,16.6326,134.209,
PREGNANCY TEST SERUM,3011670,CDM,84703,CPT,301,RC,outpatient,,,,103.515,56.93325,,93.1635,90,percent of total billed charges,,,,103.515,100,percent of total billed charges,,,8.5728,,,fee schedule,,,8.5728,,,fee schedule,,,8.5728,,,fee schedule,,,,,,,,,,,,,,,,87.98775,85,percent of total billed charges,,,,,,,,,,51.5194155,49.77,percent of total billed charges,,,,93.1635,90,percent of total billed charges,,,,98.33925,90,percent of total billed charges,,,,,,,,,10.73,,,fee schedule,,,13.6271,,,fee schedule,,,,87.98775,85,percent of total billed charges,,,,,,,,,8.5728,103.515,
PROGESTERONE,3011700,CDM,84144,CPT,301,RC,outpatient,,,,197.966,108.8813,,178.1694,90,percent of total billed charges,,,,197.966,100,percent of total billed charges,,,23.7804,,,fee schedule,,,23.7804,,,fee schedule,,,23.7804,,,fee schedule,,,,,,,,,,,,,,,,168.2711,85,percent of total billed charges,,,,,,,,,,98.5276782,49.77,percent of total billed charges,,,,178.1694,90,percent of total billed charges,,,,188.0677,90,percent of total billed charges,,,,,,,,,29.79,,,fee schedule,,,37.8333,,,fee schedule,,,,168.2711,85,percent of total billed charges,,,,,,,,,23.7804,197.966,
PROLACTIN,3011720,CDM,84146,CPT,301,RC,outpatient,,,,167.272,91.9996,,150.5448,90,percent of total billed charges,,,,167.272,100,percent of total billed charges,,,22.0932,,,fee schedule,,,22.0932,,,fee schedule,,,22.0932,,,fee schedule,,,,,,,,,,,,,,,,142.1812,85,percent of total billed charges,,,,,,,,,,83.2512744,49.77,percent of total billed charges,,,,150.5448,90,percent of total billed charges,,,,158.9084,90,percent of total billed charges,,,,,,,,,27.67,,,fee schedule,,,35.1409,,,fee schedule,,,,142.1812,85,percent of total billed charges,,,,,,,,,22.0932,167.272,
PSA -,3011730,CDM,84153,CPT,301,RC,outpatient,,,,135.342,74.4381,,121.8078,90,percent of total billed charges,,,,135.342,100,percent of total billed charges,,,20.9646,,,fee schedule,,,20.9646,,,fee schedule,,,20.9646,,,fee schedule,,,,,,,,,,,,,,,,115.0407,85,percent of total billed charges,,,,,,,,,,67.3597134,49.77,percent of total billed charges,,,,121.8078,90,percent of total billed charges,,,,128.5749,90,percent of total billed charges,,,,,,,,,26.27,,,fee schedule,,,33.3629,,,fee schedule,,,,115.0407,85,percent of total billed charges,,,,,,,,,20.9646,135.342,
PTH - RELATED PEPTIDE,3011738,CDM,83519,CPT,301,RC,outpatient,,,,218.772,120.3246,,196.8948,90,percent of total billed charges,,,,218.772,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,,,,,,,,,,,,,,185.9562,85,percent of total billed charges,,,,,,,,,,108.8828244,49.77,percent of total billed charges,,,,196.8948,90,percent of total billed charges,,,,207.8334,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,185.9562,85,percent of total billed charges,,,,,,,,,12.87,218.772,
PROTEIN TOTAL,3011750,CDM,84155,CPT,301,RC,outpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,4.1838,,,fee schedule,,,4.1838,,,fee schedule,,,4.1838,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,,,,,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,,,,,,,5.23,,,fee schedule,,,6.6421,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,,,,,,,4.1838,49.234,
PROTEIN TOTAL FLUID,3011760,CDM,84157,CPT,301,RC,outpatient,,,,169.95,93.4725,,152.955,90,percent of total billed charges,,,,169.95,100,percent of total billed charges,,,4.56,,,fee schedule,,,4.56,,,fee schedule,,,4.56,,,fee schedule,,,,,,,,,,,,,,,,144.4575,85,percent of total billed charges,,,,,,,,,,84.584115,49.77,percent of total billed charges,,,,152.955,90,percent of total billed charges,,,,161.4525,90,percent of total billed charges,,,,,,,,,5.25,,,fee schedule,,,6.6675,,,fee schedule,,,,144.4575,85,percent of total billed charges,,,,,,,,,4.56,169.95,
RENIN,3011790,CDM,84244,CPT,301,RC,outpatient,,,,163.358,89.8469,,147.0222,90,percent of total billed charges,,,,163.358,100,percent of total billed charges,,,25.0686,,,fee schedule,,,25.0686,,,fee schedule,,,25.0686,,,fee schedule,,,,,,,,,,,,,,,,138.8543,85,percent of total billed charges,,,,,,,,,,81.3032766,49.77,percent of total billed charges,,,,147.0222,90,percent of total billed charges,,,,155.1901,90,percent of total billed charges,,,,,,,,,31.41,,,fee schedule,,,39.8907,,,fee schedule,,,,138.8543,85,percent of total billed charges,,,,,,,,,25.0686,163.358,
REVERSE T3,3011800,CDM,84482,CPT,301,RC,outpatient,,,,345.153,189.83415,,310.6377,90,percent of total billed charges,,,,345.153,100,percent of total billed charges,,,17.9664,,,fee schedule,,,17.9664,,,fee schedule,,,17.9664,,,fee schedule,,,,,,,,,,,,,,,,293.38005,85,percent of total billed charges,,,,,,,,,,171.7826481,49.77,percent of total billed charges,,,,310.6377,90,percent of total billed charges,,,,327.89535,90,percent of total billed charges,,,,,,,,,22.51,,,fee schedule,,,28.5877,,,fee schedule,,,,293.38005,85,percent of total billed charges,,,,,,,,,17.9664,345.153,
RED CELL FOLATE,3011815,CDM,82747,CPT,301,RC,outpatient,,,,153.573,84.46515,,138.2157,90,percent of total billed charges,,,,153.573,100,percent of total billed charges,,,20.121,,,fee schedule,,,20.121,,,fee schedule,,,20.121,,,fee schedule,,,,,,,,,,,,,,,,130.53705,85,percent of total billed charges,,,,,,,,,,76.4332821,49.77,percent of total billed charges,,,,138.2157,90,percent of total billed charges,,,,145.89435,90,percent of total billed charges,,,,,,,,,24.73,,,fee schedule,,,31.4071,,,fee schedule,,,,130.53705,85,percent of total billed charges,,,,,,,,,20.121,153.573,
SERUM ACETONE,3011840,CDM,82009,CPT,301,RC,outpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,5.1528,,,fee schedule,,,5.1528,,,fee schedule,,,5.1528,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,,,,,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,,,,,,,6.46,,,fee schedule,,,8.2042,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,,,,,,,5.1528,49.234,
SGOT,3011850,CDM,84450,CPT,301,RC,outpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,,,,,,,7.38,,,fee schedule,,,9.3726,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,,,,,,,5.9052,55.517,
SGPT,3011860,CDM,84460,CPT,301,RC,outpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,6.042,,,fee schedule,,,6.042,,,fee schedule,,,6.042,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,,,,,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,,,,,,,7.56,,,fee schedule,,,9.6012,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,,,,,,,6.042,49.234,
ACETYLCHOLINE RECEPTOR BLOC AB,3011983,CDM,83519,CPT,301,RC,outpatient,,,,364.826,200.6543,,328.3434,90,percent of total billed charges,,,,364.826,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,,,,,,,,,,,,,,310.1021,85,percent of total billed charges,,,,,,,,,,181.5739002,49.77,percent of total billed charges,,,,328.3434,90,percent of total billed charges,,,,346.5847,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,310.1021,85,percent of total billed charges,,,,,,,,,12.87,364.826,
SODIUM,3012080,CDM,84295,CPT,301,RC,outpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,5.4834,,,fee schedule,,,5.4834,,,fee schedule,,,5.4834,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,,,,,,,6.87,,,fee schedule,,,8.7249,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,,,,,,,5.4834,55.517,
SODIUM URINE,3012090,CDM,84300,CPT,301,RC,outpatient,,,,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,5.7684,,,fee schedule,,,5.7684,,,fee schedule,,,5.7684,,,fee schedule,,,,,,,,,,,,,,,,53.49305,85,percent of total billed charges,,,,,,,,,,31.3217541,49.77,percent of total billed charges,,,,56.6397,90,percent of total billed charges,,,,59.78635,90,percent of total billed charges,,,,,,,,,6.94,,,fee schedule,,,8.8138,,,fee schedule,,,,53.49305,85,percent of total billed charges,,,,,,,,,5.7684,62.933,
AFP & AFP - L3,3012107,CDM,82107,CPT,301,RC,outpatient,,,,238.754,131.3147,,214.8786,90,percent of total billed charges,,,,238.754,100,percent of total billed charges,,,73.4274,,,fee schedule,,,73.4274,,,fee schedule,,,73.4274,,,fee schedule,,,,,,,,,,,,,,,,202.9409,85,percent of total billed charges,,,,,,,,,,118.8278658,49.77,percent of total billed charges,,,,214.8786,90,percent of total billed charges,,,,226.8163,90,percent of total billed charges,,,,,,,,,92.99,,,fee schedule,,,118.0973,,,fee schedule,,,,202.9409,85,percent of total billed charges,,,,,,,,,73.4274,238.754,
STONE ASSAY R/L,3012110,CDM,82365,CPT,301,RC,outpatient,,,,111.755,61.46525,,100.5795,90,percent of total billed charges,,,,111.755,100,percent of total billed charges,,,14.706,,,fee schedule,,,14.706,,,fee schedule,,,14.706,,,fee schedule,,,,,,,,,,,,,,,,94.99175,85,percent of total billed charges,,,,,,,,,,55.6204635,49.77,percent of total billed charges,,,,100.5795,90,percent of total billed charges,,,,106.16725,90,percent of total billed charges,,,,,,,,,18.41,,,fee schedule,,,23.3807,,,fee schedule,,,,94.99175,85,percent of total billed charges,,,,,,,,,14.706,111.755,
T PROTEIN URINE,3012130,CDM,84156,CPT,301,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,4.1838,,,fee schedule,,,4.1838,,,fee schedule,,,4.1838,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,,,,,,,5.25,,,fee schedule,,,6.6675,,,fee schedule,,,,63.9115,85,percent of total billed charges,,,,,,,,,4.1838,75.19,
TESTOSTERONE R/L,3012140,CDM,84403,CPT,301,RC,outpatient,,,,181.795,99.98725,,163.6155,90,percent of total billed charges,,,,181.795,100,percent of total billed charges,,,29.4234,,,fee schedule,,,29.4234,,,fee schedule,,,29.4234,,,fee schedule,,,,,,,,,,,,,,,,154.52575,85,percent of total billed charges,,,,,,,,,,90.4793715,49.77,percent of total billed charges,,,,163.6155,90,percent of total billed charges,,,,172.70525,90,percent of total billed charges,,,,,,,,,36.87,,,fee schedule,,,46.8249,,,fee schedule,,,,154.52575,85,percent of total billed charges,,,,,,,,,29.4234,181.795,
THIAMINE,3012160,CDM,84425,CPT,301,RC,outpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,24.2022,,,fee schedule,,,24.2022,,,fee schedule,,,24.2022,,,fee schedule,,,,,,,,,,,,,,,,181.66625,85,percent of total billed charges,,,,,,,,,,106.3709325,49.77,percent of total billed charges,,,,192.3525,90,percent of total billed charges,,,,203.03875,90,percent of total billed charges,,,,,,,,,30.33,,,fee schedule,,,38.5191,,,fee schedule,,,,181.66625,85,percent of total billed charges,,,,,,,,,24.2022,213.725,
THYROXINE BINDING GLOBULIN,3012183,CDM,84442,CPT,301,RC,outpatient,,,,177.057,97.38135,,159.3513,90,percent of total billed charges,,,,177.057,100,percent of total billed charges,,,16.8492,,,fee schedule,,,16.8492,,,fee schedule,,,16.8492,,,fee schedule,,,,,,,,,,,,,,,,150.49845,85,percent of total billed charges,,,,,,,,,,88.1212689,49.77,percent of total billed charges,,,,159.3513,90,percent of total billed charges,,,,168.20415,90,percent of total billed charges,,,,,,,,,21.12,,,fee schedule,,,26.8224,,,fee schedule,,,,150.49845,85,percent of total billed charges,,,,,,,,,16.8492,177.057,
THYROGLOBULIN LEVEL,3012185,CDM,84432,CPT,301,RC,outpatient,,,,99.601,54.78055,,89.6409,90,percent of total billed charges,,,,99.601,100,percent of total billed charges,,,18.3084,,,fee schedule,,,18.3084,,,fee schedule,,,18.3084,,,fee schedule,,,,,,,,,,,,,,,,84.66085,85,percent of total billed charges,,,,,,,,,,49.5714177,49.77,percent of total billed charges,,,,89.6409,90,percent of total billed charges,,,,94.62095,90,percent of total billed charges,,,,,,,,,22.94,,,fee schedule,,,29.1338,,,fee schedule,,,,84.66085,85,percent of total billed charges,,,,,,,,,18.3084,99.601,
THYROID STIMLATING (TSH),3012220,CDM,84443,CPT,301,RC,outpatient,,,,107.017,58.85935,,96.3153,90,percent of total billed charges,,,,107.017,100,percent of total billed charges,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,,,,,,,,,,,,,,90.96445,85,percent of total billed charges,,,,,,,,,,53.2623609,49.77,percent of total billed charges,,,,96.3153,90,percent of total billed charges,,,,101.66615,90,percent of total billed charges,,,,,,,,,23.98,,,fee schedule,,,30.4546,,,fee schedule,,,,90.96445,85,percent of total billed charges,,,,,,,,,19.152,107.017,
TISSUE TRANSGLUTAMINASE IGA A,3012223,CDM,83516,CPT,301,RC,outpatient,,,,191.683,105.42565,,172.5147,90,percent of total billed charges,,,,191.683,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,,,,,,,,,,,,,,162.93055,85,percent of total billed charges,,,,,,,,,,95.4006291,49.77,percent of total billed charges,,,,172.5147,90,percent of total billed charges,,,,182.09885,90,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,20.9296,,,fee schedule,,,,162.93055,85,percent of total billed charges,,,,,,,,,13.1442,191.683,
TOPAMAX,3012245,CDM,80201,CPT,301,RC,outpatient,,,,138.947,76.42085,,125.0523,90,percent of total billed charges,,,,138.947,100,percent of total billed charges,,,13.5888,,,fee schedule,,,13.5888,,,fee schedule,,,13.5888,,,fee schedule,,,,,,,,,,,,,,,,118.10495,85,percent of total billed charges,,,,,,,,,,69.1539219,49.77,percent of total billed charges,,,,125.0523,90,percent of total billed charges,,,,131.99965,90,percent of total billed charges,,,,,,,,,17.03,,,fee schedule,,,21.6281,,,fee schedule,,,,118.10495,85,percent of total billed charges,,,,,,,,,13.5888,138.947,
TRANSFERRIN,3012250,CDM,84466,CPT,301,RC,outpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,14.5464,,,fee schedule,,,14.5464,,,fee schedule,,,14.5464,,,fee schedule,,,,,,,,,,,,,,,,83.61025,85,percent of total billed charges,,,,,,,,,,48.9562605,49.77,percent of total billed charges,,,,88.5285,90,percent of total billed charges,,,,93.44675,90,percent of total billed charges,,,,,,,,,18.24,,,fee schedule,,,23.1648,,,fee schedule,,,,83.61025,85,percent of total billed charges,,,,,,,,,14.5464,98.365,
TRIGLYCERIDES,3012270,CDM,84478,CPT,301,RC,outpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,6.5436,,,fee schedule,,,6.5436,,,fee schedule,,,6.5436,,,fee schedule,,,,,,,,,,,,,,,,56.5573,85,percent of total billed charges,,,,,,,,,,33.1159626,49.77,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,63.2111,90,percent of total billed charges,,,,,,,,,8.22,,,fee schedule,,,10.4394,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,,,,,,,6.5436,66.538,
T3 RIA,3012310,CDM,84480,CPT,301,RC,outpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,16.1652,,,fee schedule,,,16.1652,,,fee schedule,,,16.1652,,,fee schedule,,,,,,,,,,,,,,,,103.39655,85,percent of total billed charges,,,,,,,,,,60.5417211,49.77,percent of total billed charges,,,,109.4787,90,percent of total billed charges,,,,115.56085,90,percent of total billed charges,,,,,,,,,20.25,,,fee schedule,,,25.7175,,,fee schedule,,,,103.39655,85,percent of total billed charges,,,,,,,,,16.1652,121.643,
T4,3012320,CDM,84436,CPT,301,RC,outpatient,,,,70.04,38.522,,63.036,90,percent of total billed charges,,,,70.04,100,percent of total billed charges,,,7.8318,,,fee schedule,,,7.8318,,,fee schedule,,,7.8318,,,fee schedule,,,,,,,,,,,,,,,,59.534,85,percent of total billed charges,,,,,,,,,,34.858908,49.77,percent of total billed charges,,,,63.036,90,percent of total billed charges,,,,66.538,90,percent of total billed charges,,,,,,,,,8.9,,,fee schedule,,,11.303,,,fee schedule,,,,59.534,85,percent of total billed charges,,,,,,,,,7.8318,70.04,
UREA NITROGEN URINE,3012340,CDM,84540,CPT,301,RC,outpatient,,,,64.169,35.29295,,57.7521,90,percent of total billed charges,,,,64.169,100,percent of total billed charges,,,6.3384,,,fee schedule,,,6.3384,,,fee schedule,,,6.3384,,,fee schedule,,,,,,,,,,,,,,,,54.54365,85,percent of total billed charges,,,,,,,,,,31.9369113,49.77,percent of total billed charges,,,,57.7521,90,percent of total billed charges,,,,60.96055,90,percent of total billed charges,,,,,,,,,6.78,,,fee schedule,,,8.6106,,,fee schedule,,,,54.54365,85,percent of total billed charges,,,,,,,,,6.3384,64.169,
URIC ACID,3012350,CDM,84550,CPT,301,RC,outpatient,,,,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,5.1528,,,fee schedule,,,5.1528,,,fee schedule,,,5.1528,,,fee schedule,,,,,,,,,,,,,,,,49.2031,85,percent of total billed charges,,,,,,,,,,28.8098622,49.77,percent of total billed charges,,,,52.0974,90,percent of total billed charges,,,,54.9917,90,percent of total billed charges,,,,,,,,,6.46,,,fee schedule,,,8.2042,,,fee schedule,,,,49.2031,85,percent of total billed charges,,,,,,,,,5.1528,57.886,
VITAMIN D 25-HYDROXY,3012385,CDM,82306,CPT,301,RC,outpatient,,,,220.008,121.0044,,198.0072,90,percent of total billed charges,,,,220.008,100,percent of total billed charges,,,33.744,,,fee schedule,,,33.744,,,fee schedule,,,33.744,,,fee schedule,,,,,,,,,,,,,,,,187.0068,85,percent of total billed charges,,,,,,,,,,109.4979816,49.77,percent of total billed charges,,,,198.0072,90,percent of total billed charges,,,,209.0076,90,percent of total billed charges,,,,,,,,,42.27,,,fee schedule,,,53.6829,,,fee schedule,,,,187.0068,85,percent of total billed charges,,,,,,,,,33.744,220.008,
"VITAMIN D 1,25 DIHYDROXY",3012389,CDM,82652,CPT,301,RC,outpatient,,,,405.305,222.91775,,364.7745,90,percent of total billed charges,,,,405.305,100,percent of total billed charges,,,43.89,,,fee schedule,,,43.89,,,fee schedule,,,43.89,,,fee schedule,,,,,,,,,,,,,,,,344.50925,85,percent of total billed charges,,,,,,,,,,201.7202985,49.77,percent of total billed charges,,,,364.7745,90,percent of total billed charges,,,,385.03975,90,percent of total billed charges,,,,,,,,,54.96,,,fee schedule,,,69.7992,,,fee schedule,,,,344.50925,85,percent of total billed charges,,,,,,,,,43.89,405.305,
CHLORIDE RANDOM URINE,3012436,CDM,82436,CPT,301,RC,outpatient,,,,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,6.555,,,fee schedule,,,6.555,,,fee schedule,,,6.555,,,fee schedule,,,,,,,,,,,,,,,,53.49305,85,percent of total billed charges,,,,,,,,,,31.3217541,49.77,percent of total billed charges,,,,56.6397,90,percent of total billed charges,,,,59.78635,90,percent of total billed charges,,,,,,,,,7.18,,,fee schedule,,,9.1186,,,fee schedule,,,,53.49305,85,percent of total billed charges,,,,,,,,,6.555,62.933,
THIOPURINE METHYL TRANSFERASE,3012542,CDM,83789,CPT,301,RC,outpatient,,,,402.936,221.6148,,362.6424,90,percent of total billed charges,,,,402.936,100,percent of total billed charges,,,27.4854,,,fee schedule,,,27.4854,,,fee schedule,,,27.4854,,,fee schedule,,,,,,,,,,,,,,,,342.4956,85,percent of total billed charges,,,,,,,,,,200.5412472,49.77,percent of total billed charges,,,,362.6424,90,percent of total billed charges,,,,382.7892,90,percent of total billed charges,,,,,,,,,25.79,,,fee schedule,,,32.7533,,,fee schedule,,,,342.4956,85,percent of total billed charges,,,,,,,,,25.79,402.936,
ESTROGENS FRACTION,3012650,CDM,82671,CPT,301,RC,outpatient,,,,515.927,283.75985,,464.3343,90,percent of total billed charges,,,,515.927,100,percent of total billed charges,,,36.822,,,fee schedule,,,36.822,,,fee schedule,,,36.822,,,fee schedule,,,,,,,,,,,,,,,,438.53795,85,percent of total billed charges,,,,,,,,,,256.7768679,49.77,percent of total billed charges,,,,464.3343,90,percent of total billed charges,,,,490.13065,90,percent of total billed charges,,,,,,,,,34.28,,,fee schedule,,,43.5356,,,fee schedule,,,,438.53795,85,percent of total billed charges,,,,,,,,,34.28,515.927,
PH BODY FLUID,3012670,CDM,83986,CPT,301,RC,outpatient,,,,37.904,20.8472,,34.1136,90,percent of total billed charges,,,,37.904,100,percent of total billed charges,,,4.0812,,,fee schedule,,,4.0812,,,fee schedule,,,4.0812,,,fee schedule,,,,,,,,,,,,,,,,32.2184,85,percent of total billed charges,,,,,,,,,,18.8648208,49.77,percent of total billed charges,,,,34.1136,90,percent of total billed charges,,,,36.0088,90,percent of total billed charges,,,,,,,,,5.12,,,fee schedule,,,6.5024,,,fee schedule,,,,32.2184,85,percent of total billed charges,,,,,,,,,4.0812,37.904,
BASIC METABOLIC PANEL,3012700,CDM,80048,CPT,301,RC,outpatient,,,,391.709,215.43995,,352.5381,90,percent of total billed charges,,,,391.709,100,percent of total billed charges,,,9.6444,,,fee schedule,,,9.6444,,,fee schedule,,,9.6444,,,fee schedule,,,,,,,,,,,,,,,,332.95265,85,percent of total billed charges,,,,,,,,,,194.9535693,49.77,percent of total billed charges,,,,352.5381,90,percent of total billed charges,,,,372.12355,90,percent of total billed charges,,,,,,,,,12.09,,,fee schedule,,,15.3543,,,fee schedule,,,,332.95265,85,percent of total billed charges,,,,,,,,,9.6444,391.709,
COMPREHENSIVE METABOLIC PANEL,3012710,CDM,80053,CPT,301,RC,outpatient,,,,745.926,410.2593,,671.3334,90,percent of total billed charges,,,,745.926,100,percent of total billed charges,,,12.0384,,,fee schedule,,,12.0384,,,fee schedule,,,12.0384,,,fee schedule,,,,,,,,,,,,,,,,634.0371,85,percent of total billed charges,,,,,,,,,,371.2473702,49.77,percent of total billed charges,,,,671.3334,90,percent of total billed charges,,,,708.6297,90,percent of total billed charges,,,,,,,,,15.1,,,fee schedule,,,19.177,,,fee schedule,,,,634.0371,85,percent of total billed charges,,,,,,,,,12.0384,745.926,
ACTH,3012720,CDM,82024,CPT,301,RC,outpatient,,,,323.111,177.71105,,290.7999,90,percent of total billed charges,,,,323.111,100,percent of total billed charges,,,44.0268,,,fee schedule,,,44.0268,,,fee schedule,,,44.0268,,,fee schedule,,,,,,,,,,,,,,,,274.64435,85,percent of total billed charges,,,,,,,,,,160.8123447,49.77,percent of total billed charges,,,,290.7999,90,percent of total billed charges,,,,306.95545,90,percent of total billed charges,,,,,,,,,23.66,,,fee schedule,,,30.0482,,,fee schedule,,,,274.64435,85,percent of total billed charges,,,,,,,,,23.66,323.111,
ALDOSTERONE,3012790,CDM,82088,CPT,301,RC,outpatient,,,,372.242,204.7331,,335.0178,90,percent of total billed charges,,,,372.242,100,percent of total billed charges,,,46.455,,,fee schedule,,,46.455,,,fee schedule,,,46.455,,,fee schedule,,,,,,,,,,,,,,,,316.4057,85,percent of total billed charges,,,,,,,,,,185.2648434,49.77,percent of total billed charges,,,,335.0178,90,percent of total billed charges,,,,353.6299,90,percent of total billed charges,,,,,,,,,58.2,,,fee schedule,,,73.914,,,fee schedule,,,,316.4057,85,percent of total billed charges,,,,,,,,,46.455,372.242,
NICOTINE ALKALOIDS NOS URINE,3012800,CDM,80323,CPT,301,RC,outpatient,,,,155.015,85.25825,,139.5135,90,percent of total billed charges,,,,155.015,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,131.76275,85,percent of total billed charges,,,,,,,,,,77.1509655,49.77,percent of total billed charges,,,,139.5135,90,percent of total billed charges,,,,147.26425,90,percent of total billed charges,,,,,,,,,45.59,,,fee schedule,,,57.8993,,,fee schedule,,,,131.76275,85,percent of total billed charges,,,,,,,,,45.59,155.015,
TESTOSTERONE-FREE,3012870,CDM,84402,CPT,301,RC,outpatient,,,,273.877,150.63235,,246.4893,90,percent of total billed charges,,,,273.877,100,percent of total billed charges,,,29.0358,,,fee schedule,,,29.0358,,,fee schedule,,,29.0358,,,fee schedule,,,,,,,,,,,,,,,,232.79545,85,percent of total billed charges,,,,,,,,,,136.3085829,49.77,percent of total billed charges,,,,246.4893,90,percent of total billed charges,,,,260.18315,90,percent of total billed charges,,,,,,,,,36.36,,,fee schedule,,,46.1772,,,fee schedule,,,,232.79545,85,percent of total billed charges,,,,,,,,,29.0358,273.877,
ZINC LEVEL,3012880,CDM,84630,CPT,301,RC,outpatient,,,,87.344,48.0392,,78.6096,90,percent of total billed charges,,,,87.344,100,percent of total billed charges,,,12.9846,,,fee schedule,,,12.9846,,,fee schedule,,,12.9846,,,fee schedule,,,,,,,,,,,,,,,,74.2424,85,percent of total billed charges,,,,,,,,,,43.4711088,49.77,percent of total billed charges,,,,78.6096,90,percent of total billed charges,,,,82.9768,90,percent of total billed charges,,,,,,,,,16.26,,,fee schedule,,,20.6502,,,fee schedule,,,,74.2424,85,percent of total billed charges,,,,,,,,,12.9846,87.344,
ELECTROPHORESIS/URINE PROTEIN,3012900,CDM,84166,CPT,301,RC,outpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,20.3262,,,fee schedule,,,20.3262,,,fee schedule,,,20.3262,,,fee schedule,,,,,,,,,,,,,,,,60.5846,85,percent of total billed charges,,,,,,,,,,35.4740652,49.77,percent of total billed charges,,,,64.1484,90,percent of total billed charges,,,,67.7122,90,percent of total billed charges,,,,,,,,,27.75,,,fee schedule,,,35.2425,,,fee schedule,,,,60.5846,85,percent of total billed charges,,,,,,,,,20.3262,71.276,
"OCCULT BLOOD, GASTRIC",3012915,CDM,82271,CPT,301,RC,outpatient,,,,73.336,40.3348,,66.0024,90,percent of total billed charges,,,,73.336,100,percent of total billed charges,,,6.0648,,,fee schedule,,,6.0648,,,fee schedule,,,6.0648,,,fee schedule,,,,,,,,,,,,,,,,62.3356,85,percent of total billed charges,,,,,,,,,,36.4993272,49.77,percent of total billed charges,,,,66.0024,90,percent of total billed charges,,,,69.6692,90,percent of total billed charges,,,,,,,,,4.69,,,fee schedule,,,5.9563,,,fee schedule,,,,62.3356,85,percent of total billed charges,,,,,,,,,4.69,73.336,
MICROALBUMIN,3012920,CDM,82043,CPT,301,RC,outpatient,,,,76.323,41.97765,,68.6907,90,percent of total billed charges,,,,76.323,100,percent of total billed charges,,,6.5892,,,fee schedule,,,6.5892,,,fee schedule,,,6.5892,,,fee schedule,,,,,,,,,,,,,,,,64.87455,85,percent of total billed charges,,,,,,,,,,37.9859571,49.77,percent of total billed charges,,,,68.6907,90,percent of total billed charges,,,,72.50685,90,percent of total billed charges,,,,,,,,,8.27,,,fee schedule,,,10.5029,,,fee schedule,,,,64.87455,85,percent of total billed charges,,,,,,,,,6.5892,76.323,
LEAD BLOOD LEVEL,3012940,CDM,83655,CPT,301,RC,outpatient,,,,68.598,37.7289,,61.7382,90,percent of total billed charges,,,,68.598,100,percent of total billed charges,,,13.8054,,,fee schedule,,,13.8054,,,fee schedule,,,13.8054,,,fee schedule,,,,,,,,,,,,,,,,58.3083,85,percent of total billed charges,,,,,,,,,,34.1412246,49.77,percent of total billed charges,,,,61.7382,90,percent of total billed charges,,,,65.1681,90,percent of total billed charges,,,,,,,,,17.28,,,fee schedule,,,21.9456,,,fee schedule,,,,58.3083,85,percent of total billed charges,,,,,,,,,13.8054,68.598,
"CRYOGLOBULINS, QUALITATIVE",3012950,CDM,82595,CPT,301,RC,outpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,,,,,,,,,,,,,,51.21675,85,percent of total billed charges,,,,,,,,,,29.9889135,49.77,percent of total billed charges,,,,54.2295,90,percent of total billed charges,,,,57.24225,90,percent of total billed charges,,,,,,,,,9.25,,,fee schedule,,,11.7475,,,fee schedule,,,,51.21675,85,percent of total billed charges,,,,,,,,,7.3758,60.255,
PSA - FREE,3012970,CDM,84154,CPT,301,RC,outpatient,,,,190.447,104.74585,,171.4023,90,percent of total billed charges,,,,190.447,100,percent of total billed charges,,,20.9646,,,fee schedule,,,20.9646,,,fee schedule,,,20.9646,,,fee schedule,,,,,,,,,,,,,,,,161.87995,85,percent of total billed charges,,,,,,,,,,94.7854719,49.77,percent of total billed charges,,,,171.4023,90,percent of total billed charges,,,,180.92465,90,percent of total billed charges,,,,,,,,,26.27,,,fee schedule,,,33.3629,,,fee schedule,,,,161.87995,85,percent of total billed charges,,,,,,,,,20.9646,190.447,
TRYPTASE,3012995,CDM,83520,CPT,301,RC,outpatient,,,,178.293,98.06115,,160.4637,90,percent of total billed charges,,,,178.293,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,151.54905,85,percent of total billed charges,,,,,,,,,,88.7364261,49.77,percent of total billed charges,,,,160.4637,90,percent of total billed charges,,,,169.37835,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,151.54905,85,percent of total billed charges,,,,,,,,,18.49,178.293,
HOMOCYSTEINE,3013010,CDM,83090,CPT,301,RC,outpatient,,,,331.763,182.46965,,298.5867,90,percent of total billed charges,,,,331.763,100,percent of total billed charges,,,20.4288,,,fee schedule,,,20.4288,,,fee schedule,,,20.4288,,,fee schedule,,,,,,,,,,,,,,,,281.99855,85,percent of total billed charges,,,,,,,,,,165.1184451,49.77,percent of total billed charges,,,,298.5867,90,percent of total billed charges,,,,315.17485,90,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,30.5943,,,fee schedule,,,,281.99855,85,percent of total billed charges,,,,,,,,,20.4288,331.763,
HEMOGLOBIN FRACTIONATION,3013021,CDM,83021,CPT,301,RC,outpatient,,,,25.338,13.9359,,22.8042,90,percent of total billed charges,,,,25.338,100,percent of total billed charges,,,20.5884,,,fee schedule,,,20.5884,,,fee schedule,,,20.5884,,,fee schedule,,,,,,,,,,,,,,,,21.5373,85,percent of total billed charges,,,,,,,,,,12.6107226,49.77,percent of total billed charges,,,,22.8042,90,percent of total billed charges,,,,24.0711,90,percent of total billed charges,,,,,,,,,25.79,,,fee schedule,,,32.7533,,,fee schedule,,,,21.5373,85,percent of total billed charges,,,,,,,,,12.6107226,32.7533,
IRT FOR CF,3013022,CDM,83520,CPT,301,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,23.4823,
AMINO ACIDS (6 OR MORE) QUANT,3013023,CDM,82139,CPT,301,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,30.5943,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,30.5943,
CARNITINE (TOTAL & FREE) QUANT,3013024,CDM,82379,CPT,301,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,30.5943,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,30.5943,
"ACYLCARNITINES, QUANTATIVE",3013025,CDM,82017,CPT,301,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,30.5943,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,30.5943,
TSH - NEONATAL SCREEN,3013026,CDM,84443,CPT,301,RC,outpatient,,,,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,19.152,,,fee schedule,,,,,,,,,,,,,,,,10.6811,85,percent of total billed charges,,,,,,,,,,6.2540982,49.77,percent of total billed charges,,,,11.3094,90,percent of total billed charges,,,,11.9377,90,percent of total billed charges,,,,,,,,,23.98,,,fee schedule,,,30.4546,,,fee schedule,,,,10.6811,85,percent of total billed charges,,,,,,,,,6.2540982,30.4546,
TOTAL THYROXINE (ELUTION),3013027,CDM,84437,CPT,301,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,9.25,,,fee schedule,,,11.7475,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.3758,14.935,
GALACTOSE 1 PHOSPHATE URIDYL,3013028,CDM,82775,CPT,301,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,24.0198,,,fee schedule,,,24.0198,,,fee schedule,,,24.0198,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,30.08,,,fee schedule,,,38.2016,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,38.2016,
17 ALPHA HYDROXYPROGESTERONE,3013029,CDM,83498,CPT,301,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,30.9738,,,fee schedule,,,30.9738,,,fee schedule,,,30.9738,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,38.79,,,fee schedule,,,49.2633,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,49.2633,
BIOTINIDASE,3013030,CDM,82261,CPT,301,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,30.5943,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,30.5943,
GLUTAMIC ACID DECARBOXYLASE,3013519,CDM,83519,CPT,301,RC,outpatient,,,,264.092,145.2506,,237.6828,90,percent of total billed charges,,,,264.092,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,,,,,,,,,,,,,,224.4782,85,percent of total billed charges,,,,,,,,,,131.4385884,49.77,percent of total billed charges,,,,237.6828,90,percent of total billed charges,,,,250.8874,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,224.4782,85,percent of total billed charges,,,,,,,,,12.87,264.092,
RA - IGA,3013523,CDM,83520,CPT,301,RC,outpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,,17.8395588,49.77,percent of total billed charges,,,,32.2596,90,percent of total billed charges,,,,34.0518,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,30.4674,85,percent of total billed charges,,,,,,,,,17.8395588,35.844,
RA - IGG,3013524,CDM,83520,CPT,301,RC,outpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,,17.8395588,49.77,percent of total billed charges,,,,32.2596,90,percent of total billed charges,,,,34.0518,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,30.4674,85,percent of total billed charges,,,,,,,,,17.8395588,35.844,
RA - IGM,3013525,CDM,83520,CPT,301,RC,outpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,,17.8395588,49.77,percent of total billed charges,,,,32.2596,90,percent of total billed charges,,,,34.0518,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,30.4674,85,percent of total billed charges,,,,,,,,,17.8395588,35.844,
"METANEPHRINES, PLASMA FREE",3013835,CDM,83835,CPT,301,RC,outpatient,,,,427.347,235.04085,,384.6123,90,percent of total billed charges,,,,427.347,100,percent of total billed charges,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,19.3116,,,fee schedule,,,,,,,,,,,,,,,,363.24495,85,percent of total billed charges,,,,,,,,,,212.6906019,49.77,percent of total billed charges,,,,384.6123,90,percent of total billed charges,,,,405.97965,90,percent of total billed charges,,,,,,,,,21.51,,,fee schedule,,,27.3177,,,fee schedule,,,,363.24495,85,percent of total billed charges,,,,,,,,,19.3116,427.347,
AMH - FEMALE,3013856,CDM,83520,CPT,301,RC,outpatient,,,,181.074,99.5907,,162.9666,90,percent of total billed charges,,,,181.074,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,153.9129,85,percent of total billed charges,,,,,,,,,,90.1205298,49.77,percent of total billed charges,,,,162.9666,90,percent of total billed charges,,,,172.0203,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,153.9129,85,percent of total billed charges,,,,,,,,,18.49,181.074,
ALPHA 1 ANTITRYPSIN PHENOTYPE,3013952,CDM,82104,CPT,301,RC,outpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,16.4844,,,fee schedule,,,16.4844,,,fee schedule,,,16.4844,,,fee schedule,,,,,,,,,,,,,,,,152.07435,85,percent of total billed charges,,,,,,,,,,89.0440047,49.77,percent of total billed charges,,,,161.0199,90,percent of total billed charges,,,,169.96545,90,percent of total billed charges,,,,,,,,,20.65,,,fee schedule,,,26.2255,,,fee schedule,,,,152.07435,85,percent of total billed charges,,,,,,,,,16.4844,178.911,
"MYELIN BASIC PROTEIN, CSF",3014030,CDM,83873,CPT,301,RC,outpatient,,,,205.382,112.9601,,184.8438,90,percent of total billed charges,,,,205.382,100,percent of total billed charges,,,19.608,,,fee schedule,,,19.608,,,fee schedule,,,19.608,,,fee schedule,,,,,,,,,,,,,,,,174.5747,85,percent of total billed charges,,,,,,,,,,102.2186214,49.77,percent of total billed charges,,,,184.8438,90,percent of total billed charges,,,,195.1129,90,percent of total billed charges,,,,,,,,,24.57,,,fee schedule,,,31.2039,,,fee schedule,,,,174.5747,85,percent of total billed charges,,,,,,,,,19.608,205.382,
OLIGOCLONAL IMMUNOGLOBIN,3014040,CDM,83916,CPT,301,RC,outpatient,,,,200.335,110.18425,,180.3015,90,percent of total billed charges,,,,200.335,100,percent of total billed charges,,,31.2246,,,fee schedule,,,31.2246,,,fee schedule,,,31.2246,,,fee schedule,,,,,,,,,,,,,,,,170.28475,85,percent of total billed charges,,,,,,,,,,99.7067295,49.77,percent of total billed charges,,,,180.3015,90,percent of total billed charges,,,,190.31825,90,percent of total billed charges,,,,,,,,,28.72,,,fee schedule,,,36.4744,,,fee schedule,,,,170.28475,85,percent of total billed charges,,,,,,,,,28.72,200.335,
IGG SYNTHESIS RATE,3014050,CDM,82784,CPT,301,RC,outpatient,,,,229.793,126.38615,,206.8137,90,percent of total billed charges,,,,229.793,100,percent of total billed charges,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,,,,,,,,,,,,,,195.32405,85,percent of total billed charges,,,,,,,,,,114.3679761,49.77,percent of total billed charges,,,,206.8137,90,percent of total billed charges,,,,218.30335,90,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,10.4648,,,fee schedule,,,,195.32405,85,percent of total billed charges,,,,,,,,,8.24,229.793,
"IMMUNOGLOBIN E, TOTAL",3014060,CDM,82785,CPT,301,RC,outpatient,,,,178.293,98.06115,,160.4637,90,percent of total billed charges,,,,178.293,100,percent of total billed charges,,,18.7644,,,fee schedule,,,18.7644,,,fee schedule,,,18.7644,,,fee schedule,,,,,,,,,,,,,,,,151.54905,85,percent of total billed charges,,,,,,,,,,88.7364261,49.77,percent of total billed charges,,,,160.4637,90,percent of total billed charges,,,,169.37835,90,percent of total billed charges,,,,,,,,,23.13,,,fee schedule,,,29.3751,,,fee schedule,,,,151.54905,85,percent of total billed charges,,,,,,,,,18.7644,178.293,
MYOGLOBIN-SERUM,3014070,CDM,83874,CPT,301,RC,outpatient,,,,79.928,43.9604,,71.9352,90,percent of total billed charges,,,,79.928,100,percent of total billed charges,,,14.7288,,,fee schedule,,,14.7288,,,fee schedule,,,14.7288,,,fee schedule,,,,,,,,,,,,,,,,67.9388,85,percent of total billed charges,,,,,,,,,,39.7801656,49.77,percent of total billed charges,,,,71.9352,90,percent of total billed charges,,,,75.9316,90,percent of total billed charges,,,,,,,,,18.43,,,fee schedule,,,23.4061,,,fee schedule,,,,67.9388,85,percent of total billed charges,,,,,,,,,14.7288,79.928,
GTT - EACH ADDL SPECIMEN,3014100,CDM,82952,CPT,301,RC,outpatient,,,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,4.4688,,,fee schedule,,,4.4688,,,fee schedule,,,4.4688,,,fee schedule,,,,,,,,,,,,,,,,27.40315,85,percent of total billed charges,,,,,,,,,,16.0453503,49.77,percent of total billed charges,,,,29.0151,90,percent of total billed charges,,,,30.62705,90,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,7.112,,,fee schedule,,,,27.40315,85,percent of total billed charges,,,,,,,,,4.4688,32.239,
GTT - 1ST 3 SPECIMENS,3014110,CDM,82951,CPT,301,RC,outpatient,,,,137.711,75.74105,,123.9399,90,percent of total billed charges,,,,137.711,100,percent of total billed charges,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,,,,,,,,,,,,,,117.05435,85,percent of total billed charges,,,,,,,,,,68.5387647,49.77,percent of total billed charges,,,,123.9399,90,percent of total billed charges,,,,130.82545,90,percent of total billed charges,,,,,,,,,18.39,,,fee schedule,,,23.3553,,,fee schedule,,,,117.05435,85,percent of total billed charges,,,,,,,,,14.6718,137.711,
GTT - 5TH SPECIMEN,3014130,CDM,82952,CPT,301,RC,outpatient,,,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,4.4688,,,fee schedule,,,4.4688,,,fee schedule,,,4.4688,,,fee schedule,,,,,,,,,,,,,,,,27.40315,85,percent of total billed charges,,,,,,,,,,16.0453503,49.77,percent of total billed charges,,,,29.0151,90,percent of total billed charges,,,,30.62705,90,percent of total billed charges,,,,,,,,,5.6,,,fee schedule,,,7.112,,,fee schedule,,,,27.40315,85,percent of total billed charges,,,,,,,,,4.4688,32.239,
PROCALCITONIN (PCT),3014310,CDM,84145,CPT,301,RC,outpatient,,,,409.013,224.95715,,368.1117,90,percent of total billed charges,,,,409.013,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,347.66105,85,percent of total billed charges,,,,,,,,,,203.5657701,49.77,percent of total billed charges,,,,368.1117,90,percent of total billed charges,,,,388.56235,90,percent of total billed charges,,,,,,,,,28.69,,,fee schedule,,,36.4363,,,fee schedule,,,,347.66105,85,percent of total billed charges,,,,,,,,,28.69,409.013,
VITAMIN E (TOCOPHEROL),3014446,CDM,84446,CPT,301,RC,outpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,16.1652,,,fee schedule,,,16.1652,,,fee schedule,,,16.1652,,,fee schedule,,,,,,,,,,,,,,,,56.5573,85,percent of total billed charges,,,,,,,,,,33.1159626,49.77,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,63.2111,90,percent of total billed charges,,,,,,,,,20.25,,,fee schedule,,,25.7175,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,,,,,,,16.1652,66.538,
ACETYLCHOLINE RECEPTOR MOD AB,3015198,CDM,83519,CPT,301,RC,outpatient,,,,364.826,200.6543,,328.3434,90,percent of total billed charges,,,,364.826,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,,,,,,,,,,,,,,310.1021,85,percent of total billed charges,,,,,,,,,,181.5739002,49.77,percent of total billed charges,,,,328.3434,90,percent of total billed charges,,,,346.5847,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,310.1021,85,percent of total billed charges,,,,,,,,,12.87,364.826,
"PANCREATIC ELASTASE, FECAL",3015208,CDM,83789,CPT,301,RC,outpatient,,,,361.221,198.67155,,325.0989,90,percent of total billed charges,,,,361.221,100,percent of total billed charges,,,27.4854,,,fee schedule,,,27.4854,,,fee schedule,,,27.4854,,,fee schedule,,,,,,,,,,,,,,,,307.03785,85,percent of total billed charges,,,,,,,,,,179.7796917,49.77,percent of total billed charges,,,,325.0989,90,percent of total billed charges,,,,343.15995,90,percent of total billed charges,,,,,,,,,25.79,,,fee schedule,,,32.7533,,,fee schedule,,,,307.03785,85,percent of total billed charges,,,,,,,,,25.79,361.221,
HEPATIC PANEL,3015500,CDM,80076,CPT,301,RC,outpatient,,,,211.665,116.41575,,190.4985,90,percent of total billed charges,,,,211.665,100,percent of total billed charges,,,9.3138,,,fee schedule,,,9.3138,,,fee schedule,,,9.3138,,,fee schedule,,,,,,,,,,,,,,,,179.91525,85,percent of total billed charges,,,,,,,,,,105.3456705,49.77,percent of total billed charges,,,,190.4985,90,percent of total billed charges,,,,201.08175,90,percent of total billed charges,,,,,,,,,11.67,,,fee schedule,,,14.8209,,,fee schedule,,,,179.91525,85,percent of total billed charges,,,,,,,,,9.3138,211.665,
CENTROMERE B ANTIBODY,3016153,CDM,83516,CPT,301,RC,outpatient,,,,41.818,22.9999,,37.6362,90,percent of total billed charges,,,,41.818,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,,,,,,,,,,,,,,35.5453,85,percent of total billed charges,,,,,,,,,,20.8128186,49.77,percent of total billed charges,,,,37.6362,90,percent of total billed charges,,,,39.7271,90,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,20.9296,,,fee schedule,,,,35.5453,85,percent of total billed charges,,,,,,,,,13.1442,41.818,
RIBOSOMAL P ANTIBODY,3016154,CDM,83516,CPT,301,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,20.9296,,,fee schedule,,,,101.3829,85,percent of total billed charges,,,,,,,,,13.1442,119.274,
RENAL FUNCTION PANEL,3016550,CDM,80069,CPT,301,RC,outpatient,,,,164.285,90.35675,,147.8565,90,percent of total billed charges,,,,164.285,100,percent of total billed charges,,,9.8952,,,fee schedule,,,9.8952,,,fee schedule,,,9.8952,,,fee schedule,,,,,,,,,,,,,,,,139.64225,85,percent of total billed charges,,,,,,,,,,81.7646445,49.77,percent of total billed charges,,,,147.8565,90,percent of total billed charges,,,,156.07075,90,percent of total billed charges,,,,,,,,,12.4,,,fee schedule,,,15.748,,,fee schedule,,,,139.64225,85,percent of total billed charges,,,,,,,,,9.8952,164.285,
ACYLCARNITINE,3018201,CDM,82017,CPT,301,RC,outpatient,,,,238.445,131.14475,,214.6005,90,percent of total billed charges,,,,238.445,100,percent of total billed charges,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,19.2318,,,fee schedule,,,,,,,,,,,,,,,,202.67825,85,percent of total billed charges,,,,,,,,,,118.6740765,49.77,percent of total billed charges,,,,214.6005,90,percent of total billed charges,,,,226.52275,90,percent of total billed charges,,,,,,,,,24.09,,,fee schedule,,,30.5943,,,fee schedule,,,,202.67825,85,percent of total billed charges,,,,,,,,,19.2318,238.445,
"ARSENIC, BLOOD",3018217,CDM,82175,CPT,301,RC,outpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,21.6258,,,fee schedule,,,21.6258,,,fee schedule,,,21.6258,,,fee schedule,,,,,,,,,,,,,,,,181.66625,85,percent of total billed charges,,,,,,,,,,106.3709325,49.77,percent of total billed charges,,,,192.3525,90,percent of total billed charges,,,,203.03875,90,percent of total billed charges,,,,,,,,,27.09,,,fee schedule,,,34.4043,,,fee schedule,,,,181.66625,85,percent of total billed charges,,,,,,,,,21.6258,213.725,
VITAMIN C (ASCORBIC ACID),3018218,CDM,82180,CPT,301,RC,outpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,11.2746,,,fee schedule,,,11.2746,,,fee schedule,,,11.2746,,,fee schedule,,,,,,,,,,,,,,,,80.63355,85,percent of total billed charges,,,,,,,,,,47.2133151,49.77,percent of total billed charges,,,,85.3767,90,percent of total billed charges,,,,90.11985,90,percent of total billed charges,,,,,,,,,14.12,,,fee schedule,,,17.9324,,,fee schedule,,,,80.63355,85,percent of total billed charges,,,,,,,,,11.2746,94.863,
ADH NEWBORN SCREENING,3018226,CDM,,,301,RC,outpatient,,,,144.303,79.36665,,129.8727,90,percent of total billed charges,,,,144.303,100,percent of total billed charges,,,,,,,,,129.8727,,,fee schedule,,,115.4424,,,fee schedule,,,,,,,,,,,,,,,,122.65755,85,percent of total billed charges,,,,,,,,,,71.8196031,49.77,percent of total billed charges,,,,129.8727,90,percent of total billed charges,,,,137.08785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,122.65755,85,percent of total billed charges,,,,,,,,,71.8196031,144.303,
CHLORIDE - 24 Hr URINE,3018243,CDM,82436,CPT,301,RC,outpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,6.555,,,fee schedule,,,6.555,,,fee schedule,,,6.555,,,fee schedule,,,,,,,,,,,,,,,,60.5846,85,percent of total billed charges,,,,,,,,,,35.4740652,49.77,percent of total billed charges,,,,64.1484,90,percent of total billed charges,,,,67.7122,90,percent of total billed charges,,,,,,,,,7.18,,,fee schedule,,,9.1186,,,fee schedule,,,,60.5846,85,percent of total billed charges,,,,,,,,,6.555,71.276,
COPPER - SERUM,3018252,CDM,82525,CPT,301,RC,outpatient,,,,130.295,71.66225,,117.2655,90,percent of total billed charges,,,,130.295,100,percent of total billed charges,,,14.1474,,,fee schedule,,,14.1474,,,fee schedule,,,14.1474,,,fee schedule,,,,,,,,,,,,,,,,110.75075,85,percent of total billed charges,,,,,,,,,,64.8478215,49.77,percent of total billed charges,,,,117.2655,90,percent of total billed charges,,,,123.78025,90,percent of total billed charges,,,,,,,,,17.72,,,fee schedule,,,22.5044,,,fee schedule,,,,110.75075,85,percent of total billed charges,,,,,,,,,14.1474,130.295,
COPPER - URINE 24 HR,3018253,CDM,82525,CPT,301,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,14.1474,,,fee schedule,,,14.1474,,,fee schedule,,,14.1474,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,17.72,,,fee schedule,,,22.5044,,,fee schedule,,,,101.3829,85,percent of total billed charges,,,,,,,,,14.1474,119.274,
FETAL FIBRONECTIN,3018273,CDM,82731,CPT,301,RC,outpatient,,,,335.265,184.39575,,301.7385,90,percent of total billed charges,,,,335.265,100,percent of total billed charges,,,73.4274,,,fee schedule,,,73.4274,,,fee schedule,,,73.4274,,,fee schedule,,,,,,,,,,,,,,,,284.97525,85,percent of total billed charges,,,,,,,,,,166.8613905,49.77,percent of total billed charges,,,,301.7385,90,percent of total billed charges,,,,318.50175,90,percent of total billed charges,,,,,,,,,91.98,,,fee schedule,,,116.8146,,,fee schedule,,,,284.97525,85,percent of total billed charges,,,,,,,,,73.4274,335.265,
VITAMIN K MEPHYTON,3018275,CDM,84597,CPT,301,RC,outpatient,,,,424.978,233.7379,,382.4802,90,percent of total billed charges,,,,424.978,100,percent of total billed charges,,,15.6408,,,fee schedule,,,15.6408,,,fee schedule,,,15.6408,,,fee schedule,,,,,,,,,,,,,,,,361.2313,85,percent of total billed charges,,,,,,,,,,211.5115506,49.77,percent of total billed charges,,,,382.4802,90,percent of total billed charges,,,,403.7291,90,percent of total billed charges,,,,,,,,,19.57,,,fee schedule,,,24.8539,,,fee schedule,,,,361.2313,85,percent of total billed charges,,,,,,,,,15.6408,424.978,
"IMMUNOGLOBULIN M,QUANTITATIVE",3018278,CDM,82784,CPT,301,RC,outpatient,,,,116.905,64.29775,,105.2145,90,percent of total billed charges,,,,116.905,100,percent of total billed charges,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,10.602,,,fee schedule,,,,,,,,,,,,,,,,99.36925,85,percent of total billed charges,,,,,,,,,,58.1836185,49.77,percent of total billed charges,,,,105.2145,90,percent of total billed charges,,,,111.05975,90,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,10.4648,,,fee schedule,,,,99.36925,85,percent of total billed charges,,,,,,,,,8.24,116.905,
GESTATIONAL GLUCOSE 1 HR 50G,3018295,CDM,82950,CPT,301,RC,outpatient,,,,71.585,39.37175,,64.4265,90,percent of total billed charges,,,,71.585,100,percent of total billed charges,,,5.415,,,fee schedule,,,5.415,,,fee schedule,,,5.415,,,fee schedule,,,,,,,,,,,,,,,,60.84725,85,percent of total billed charges,,,,,,,,,,35.6278545,49.77,percent of total billed charges,,,,64.4265,90,percent of total billed charges,,,,68.00575,90,percent of total billed charges,,,,,,,,,6.78,,,fee schedule,,,8.6106,,,fee schedule,,,,60.84725,85,percent of total billed charges,,,,,,,,,5.415,71.585,
"HISTAMINE, PLASMA",3018308,CDM,83088,CPT,301,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,33.6642,,,fee schedule,,,33.6642,,,fee schedule,,,33.6642,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,39.86,,,fee schedule,,,50.6222,,,fee schedule,,,,101.3829,85,percent of total billed charges,,,,,,,,,33.6642,119.274,
TISSUE TRANSGLUTAMINASE AB IGG,3018351,CDM,83516,CPT,301,RC,outpatient,,,,191.683,105.42565,,172.5147,90,percent of total billed charges,,,,191.683,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,,,,,,,,,,,,,,162.93055,85,percent of total billed charges,,,,,,,,,,95.4006291,49.77,percent of total billed charges,,,,172.5147,90,percent of total billed charges,,,,182.09885,90,percent of total billed charges,,,,,,,,,16.48,,,fee schedule,,,20.9296,,,fee schedule,,,,162.93055,85,percent of total billed charges,,,,,,,,,13.1442,191.683,
INHIBIN B,3018352,CDM,83520,CPT,301,RC,outpatient,,,,313.223,172.27265,,281.9007,90,percent of total billed charges,,,,313.223,100,percent of total billed charges,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,19.6878,,,fee schedule,,,,,,,,,,,,,,,,266.23955,85,percent of total billed charges,,,,,,,,,,155.8910871,49.77,percent of total billed charges,,,,281.9007,90,percent of total billed charges,,,,297.56185,90,percent of total billed charges,,,,,,,,,18.49,,,fee schedule,,,23.4823,,,fee schedule,,,,266.23955,85,percent of total billed charges,,,,,,,,,18.49,313.223,
MAGNESIUM 24 HR URINE,3018373,CDM,83735,CPT,301,RC,outpatient,,,,62.624,34.4432,,56.3616,90,percent of total billed charges,,,,62.624,100,percent of total billed charges,,,7.638,,,fee schedule,,,7.638,,,fee schedule,,,7.638,,,fee schedule,,,,,,,,,,,,,,,,53.2304,85,percent of total billed charges,,,,,,,,,,31.1679648,49.77,percent of total billed charges,,,,56.3616,90,percent of total billed charges,,,,59.4928,90,percent of total billed charges,,,,,,,,,9.57,,,fee schedule,,,12.1539,,,fee schedule,,,,53.2304,85,percent of total billed charges,,,,,,,,,7.638,62.624,
"MERCURY, BLOOD",3018382,CDM,83825,CPT,301,RC,outpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,18.5364,,,fee schedule,,,18.5364,,,fee schedule,,,18.5364,,,fee schedule,,,,,,,,,,,,,,,,181.66625,85,percent of total billed charges,,,,,,,,,,106.3709325,49.77,percent of total billed charges,,,,192.3525,90,percent of total billed charges,,,,203.03875,90,percent of total billed charges,,,,,,,,,23.22,,,fee schedule,,,29.4894,,,fee schedule,,,,181.66625,85,percent of total billed charges,,,,,,,,,18.5364,213.725,
FREE LAMBDA LIGHT CHAIN,3018387,CDM,83883,CPT,301,RC,outpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,,,,,,,,,,,,,,152.07435,85,percent of total billed charges,,,,,,,,,,89.0440047,49.77,percent of total billed charges,,,,161.0199,90,percent of total billed charges,,,,169.96545,90,percent of total billed charges,,,,,,,,,19.42,,,fee schedule,,,24.6634,,,fee schedule,,,,152.07435,85,percent of total billed charges,,,,,,,,,15.504,178.911,
FREE KAPPA LIGHT CHAIN,3018388,CDM,83883,CPT,301,RC,outpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,,,,,,,,,,,,,,152.07435,85,percent of total billed charges,,,,,,,,,,89.0440047,49.77,percent of total billed charges,,,,161.0199,90,percent of total billed charges,,,,169.96545,90,percent of total billed charges,,,,,,,,,19.42,,,fee schedule,,,24.6634,,,fee schedule,,,,152.07435,85,percent of total billed charges,,,,,,,,,15.504,178.911,
"CALPROTECTIN, STOOL",3018399,CDM,83993,CPT,301,RC,outpatient,,,,214.652,118.0586,,193.1868,90,percent of total billed charges,,,,214.652,100,percent of total billed charges,,,22.3782,,,fee schedule,,,22.3782,,,fee schedule,,,22.3782,,,fee schedule,,,,,,,,,,,,,,,,182.4542,85,percent of total billed charges,,,,,,,,,,106.8323004,49.77,percent of total billed charges,,,,193.1868,90,percent of total billed charges,,,,203.9194,90,percent of total billed charges,,,,,,,,,28.33,,,fee schedule,,,35.9791,,,fee schedule,,,,182.4542,85,percent of total billed charges,,,,,,,,,22.3782,214.652,
PREGNENOLONE,3018414,CDM,84140,CPT,301,RC,outpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,23.5638,,,fee schedule,,,23.5638,,,fee schedule,,,23.5638,,,fee schedule,,,,,,,,,,,,,,,,152.07435,85,percent of total billed charges,,,,,,,,,,89.0440047,49.77,percent of total billed charges,,,,161.0199,90,percent of total billed charges,,,,169.96545,90,percent of total billed charges,,,,,,,,,29.53,,,fee schedule,,,37.5031,,,fee schedule,,,,152.07435,85,percent of total billed charges,,,,,,,,,23.5638,178.911,
PROTEIN / CSF ELECTROPHORESIS,3018415,CDM,84157,CPT,301,RC,outpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,4.56,,,fee schedule,,,4.56,,,fee schedule,,,4.56,,,fee schedule,,,,,,,,,,,,,,,,60.5846,85,percent of total billed charges,,,,,,,,,,35.4740652,49.77,percent of total billed charges,,,,64.1484,90,percent of total billed charges,,,,67.7122,90,percent of total billed charges,,,,,,,,,5.25,,,fee schedule,,,6.6675,,,fee schedule,,,,60.5846,85,percent of total billed charges,,,,,,,,,4.56,71.276,
ELECTROPHORESIS - PROTEIN CSF,3018416,CDM,84166,CPT,301,RC,outpatient,,,,282.529,155.39095,,254.2761,90,percent of total billed charges,,,,282.529,100,percent of total billed charges,,,20.3262,,,fee schedule,,,20.3262,,,fee schedule,,,20.3262,,,fee schedule,,,,,,,,,,,,,,,,240.14965,85,percent of total billed charges,,,,,,,,,,140.6146833,49.77,percent of total billed charges,,,,254.2761,90,percent of total billed charges,,,,268.40255,90,percent of total billed charges,,,,,,,,,27.75,,,fee schedule,,,35.2425,,,fee schedule,,,,240.14965,85,percent of total billed charges,,,,,,,,,20.3262,282.529,
SEROTONIN,3018426,CDM,84260,CPT,301,RC,outpatient,,,,238.445,131.14475,,214.6005,90,percent of total billed charges,,,,238.445,100,percent of total billed charges,,,35.3172,,,fee schedule,,,35.3172,,,fee schedule,,,35.3172,,,fee schedule,,,,,,,,,,,,,,,,202.67825,85,percent of total billed charges,,,,,,,,,,118.6740765,49.77,percent of total billed charges,,,,214.6005,90,percent of total billed charges,,,,226.52275,90,percent of total billed charges,,,,,,,,,44.24,,,fee schedule,,,56.1848,,,fee schedule,,,,202.67825,85,percent of total billed charges,,,,,,,,,35.3172,238.445,
SEX HORMONE BINDING GLOBULIN,3018427,CDM,84270,CPT,301,RC,outpatient,,,,145.23,79.8765,,130.707,90,percent of total billed charges,,,,145.23,100,percent of total billed charges,,,24.7722,,,fee schedule,,,24.7722,,,fee schedule,,,24.7722,,,fee schedule,,,,,,,,,,,,,,,,123.4455,85,percent of total billed charges,,,,,,,,,,72.280971,49.77,percent of total billed charges,,,,130.707,90,percent of total billed charges,,,,137.9685,90,percent of total billed charges,,,,,,,,,31.03,,,fee schedule,,,39.4081,,,fee schedule,,,,123.4455,85,percent of total billed charges,,,,,,,,,24.7722,145.23,
TSI THYROID STIMULATING IMMUNO,3018444,CDM,84445,CPT,301,RC,outpatient,,,,364.826,200.6543,,328.3434,90,percent of total billed charges,,,,364.826,100,percent of total billed charges,,,57.9804,,,fee schedule,,,57.9804,,,fee schedule,,,57.9804,,,fee schedule,,,,,,,,,,,,,,,,310.1021,85,percent of total billed charges,,,,,,,,,,181.5739002,49.77,percent of total billed charges,,,,328.3434,90,percent of total billed charges,,,,346.5847,90,percent of total billed charges,,,,,,,,,72.62,,,fee schedule,,,92.2274,,,fee schedule,,,,310.1021,85,percent of total billed charges,,,,,,,,,57.9804,364.826,
ARGININE VASOPRESSIN ADH/AVP,3018458,CDM,84588,CPT,301,RC,outpatient,,,,143.067,78.68685,,128.7603,90,percent of total billed charges,,,,143.067,100,percent of total billed charges,,,38.6916,,,fee schedule,,,38.6916,,,fee schedule,,,38.6916,,,fee schedule,,,,,,,,,,,,,,,,121.60695,85,percent of total billed charges,,,,,,,,,,71.2044459,49.77,percent of total billed charges,,,,128.7603,90,percent of total billed charges,,,,135.91365,90,percent of total billed charges,,,,,,,,,48.47,,,fee schedule,,,61.5569,,,fee schedule,,,,121.60695,85,percent of total billed charges,,,,,,,,,38.6916,143.067,
VITAMIN A (RETINOL),3018459,CDM,84590,CPT,301,RC,outpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,13.2354,,,fee schedule,,,13.2354,,,fee schedule,,,13.2354,,,fee schedule,,,,,,,,,,,,,,,,73.27935,85,percent of total billed charges,,,,,,,,,,42.9072147,49.77,percent of total billed charges,,,,77.5899,90,percent of total billed charges,,,,81.90045,90,percent of total billed charges,,,,,,,,,15.26,,,fee schedule,,,19.3802,,,fee schedule,,,,73.27935,85,percent of total billed charges,,,,,,,,,13.2354,86.211,
ACETYLCHOLINE RECEPTOR BIND AB,3019835,CDM,83519,CPT,301,RC,outpatient,,,,364.826,200.6543,,328.3434,90,percent of total billed charges,,,,364.826,100,percent of total billed charges,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,20.976,,,fee schedule,,,,,,,,,,,,,,,,310.1021,85,percent of total billed charges,,,,,,,,,,181.5739002,49.77,percent of total billed charges,,,,328.3434,90,percent of total billed charges,,,,346.5847,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,310.1021,85,percent of total billed charges,,,,,,,,,12.87,364.826,
ALPHA-2-MACROGLOBULIN,3020020,CDM,83883,CPT,301,RC,outpatient,,,,221.141,121.62755,,199.0269,90,percent of total billed charges,,,,221.141,100,percent of total billed charges,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,15.504,,,fee schedule,,,,,,,,,,,,,,,,187.96985,85,percent of total billed charges,,,,,,,,,,110.0618757,49.77,percent of total billed charges,,,,199.0269,90,percent of total billed charges,,,,210.08395,90,percent of total billed charges,,,,,,,,,19.42,,,fee schedule,,,24.6634,,,fee schedule,,,,187.96985,85,percent of total billed charges,,,,,,,,,15.504,221.141,
CALCIUM IONIZED,3020200,CDM,82330,CPT,301,RC,outpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,15.5952,,,fee schedule,,,15.5952,,,fee schedule,,,15.5952,,,fee schedule,,,,,,,,,,,,,,,,83.61025,85,percent of total billed charges,,,,,,,,,,48.9562605,49.77,percent of total billed charges,,,,88.5285,90,percent of total billed charges,,,,93.44675,90,percent of total billed charges,,,,,,,,,18.87,,,fee schedule,,,23.9649,,,fee schedule,,,,83.61025,85,percent of total billed charges,,,,,,,,,15.5952,98.365,
CITRIC ACID-URINE,3070040,CDM,82507,CPT,301,RC,outpatient,,,,530.553,291.80415,,477.4977,90,percent of total billed charges,,,,530.553,100,percent of total billed charges,,,31.692,,,fee schedule,,,31.692,,,fee schedule,,,31.692,,,fee schedule,,,,,,,,,,,,,,,,450.97005,85,percent of total billed charges,,,,,,,,,,264.0562281,49.77,percent of total billed charges,,,,477.4977,90,percent of total billed charges,,,,504.02535,90,percent of total billed charges,,,,,,,,,39.71,,,fee schedule,,,50.4317,,,fee schedule,,,,450.97005,85,percent of total billed charges,,,,,,,,,31.692,530.553,
THYROID PEROXIDASE,3012210,CDM,86376,CPT,302,RC,outpatient,,,,99.601,54.78055,,89.6409,90,percent of total billed charges,,,,99.601,100,percent of total billed charges,,,16.587,,,fee schedule,,,16.587,,,fee schedule,,,16.587,,,fee schedule,,,,,,,,,,,,,,,,84.66085,85,percent of total billed charges,,,,,,,,,,49.5714177,49.77,percent of total billed charges,,,,89.6409,90,percent of total billed charges,,,,94.62095,90,percent of total billed charges,,,,,,,,,20.78,,,fee schedule,,,26.3906,,,fee schedule,,,,84.66085,85,percent of total billed charges,,,,,,,,,16.587,99.601,
RAST - PORK (f26) IgE,3012318,CDM,86003,CPT,302,RC,outpatient,,,,38.934,21.4137,,35.0406,90,percent of total billed charges,,,,38.934,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,33.0939,85,percent of total billed charges,,,,,,,,,,19.3774518,49.77,percent of total billed charges,,,,35.0406,90,percent of total billed charges,,,,36.9873,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,33.0939,85,percent of total billed charges,,,,,,,,,5.9508,38.934,
BLOOD TYPING SEROLOGIC ABO,3020000,CDM,86900,CPT,302,RC,outpatient,,,,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,119.6658,,,fee schedule,,,119.6658,,,fee schedule,,,119.6658,,,fee schedule,,,,,,,,,,,,,,,,46.13885,85,percent of total billed charges,,,,,,,,,,27.0156537,49.77,percent of total billed charges,,,,48.8529,90,percent of total billed charges,,,,51.56695,90,percent of total billed charges,,,,,,,,,4.26,,,fee schedule,,,5.4102,,,fee schedule,,,,46.13885,85,percent of total billed charges,,,,,,,,,4.26,119.6658,
RAST - ALMOND,3020012,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
ANTI SS-A/Ro ANTIBODY,3020015,CDM,86235,CPT,302,RC,outpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,,,,,,,,,,,,,,80.63355,85,percent of total billed charges,,,,,,,,,,47.2133151,49.77,percent of total billed charges,,,,85.3767,90,percent of total billed charges,,,,90.11985,90,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,32.5247,,,fee schedule,,,,80.63355,85,percent of total billed charges,,,,,,,,,20.4402,94.863,
HAZELNUT ALLERGEN,3020027,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
SALMON ALLERGEN,3020028,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
TUNA ALLERGEN,3020029,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
MOUSE URINE PROTEIN ALLERGEN,3020031,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
ANTI-SS-B/La ANTIBODY,3020035,CDM,86235,CPT,302,RC,outpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,,,,,,,,,,,,,,80.63355,85,percent of total billed charges,,,,,,,,,,47.2133151,49.77,percent of total billed charges,,,,85.3767,90,percent of total billed charges,,,,90.11985,90,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,32.5247,,,fee schedule,,,,80.63355,85,percent of total billed charges,,,,,,,,,20.4402,94.863,
ANA R/L,3020040,CDM,86038,CPT,302,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,13.7826,,,fee schedule,,,13.7826,,,fee schedule,,,13.7826,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,17.26,,,fee schedule,,,21.9202,,,fee schedule,,,,101.3829,85,percent of total billed charges,,,,,,,,,13.7826,119.274,
ANTI DNA ANTIBODY,3020050,CDM,86225,CPT,302,RC,outpatient,,,,97.232,53.4776,,87.5088,90,percent of total billed charges,,,,97.232,100,percent of total billed charges,,,15.6636,,,fee schedule,,,15.6636,,,fee schedule,,,15.6636,,,fee schedule,,,,,,,,,,,,,,,,82.6472,85,percent of total billed charges,,,,,,,,,,48.3923664,49.77,percent of total billed charges,,,,87.5088,90,percent of total billed charges,,,,92.3704,90,percent of total billed charges,,,,,,,,,19.62,,,fee schedule,,,24.9174,,,fee schedule,,,,82.6472,85,percent of total billed charges,,,,,,,,,15.6636,97.232,
ANTI SC1-70,3020055,CDM,86235,CPT,302,RC,outpatient,,,,195.597,107.57835,,176.0373,90,percent of total billed charges,,,,195.597,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,,,,,,,,,,,,,,166.25745,85,percent of total billed charges,,,,,,,,,,97.3486269,49.77,percent of total billed charges,,,,176.0373,90,percent of total billed charges,,,,185.81715,90,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,32.5247,,,fee schedule,,,,166.25745,85,percent of total billed charges,,,,,,,,,20.4402,195.597,
ANTI-CARDIOLIP IGA,3020060,CDM,86147,CPT,302,RC,outpatient,,,,203.837,112.11035,,183.4533,90,percent of total billed charges,,,,203.837,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,,,,,,,,,,,,,,173.26145,85,percent of total billed charges,,,,,,,,,,101.4496749,49.77,percent of total billed charges,,,,183.4533,90,percent of total billed charges,,,,193.64515,90,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,46.1391,,,fee schedule,,,,173.26145,85,percent of total billed charges,,,,,,,,,29.013,203.837,
ANTI JO-1,3020065,CDM,86235,CPT,302,RC,outpatient,,,,232.162,127.6891,,208.9458,90,percent of total billed charges,,,,232.162,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,,,,,,,,,,,,,,197.3377,85,percent of total billed charges,,,,,,,,,,115.5470274,49.77,percent of total billed charges,,,,208.9458,90,percent of total billed charges,,,,220.5539,90,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,32.5247,,,fee schedule,,,,197.3377,85,percent of total billed charges,,,,,,,,,20.4402,232.162,
ANTI-CARDIOLIP IGG,3020070,CDM,86147,CPT,302,RC,outpatient,,,,239.681,131.82455,,215.7129,90,percent of total billed charges,,,,239.681,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,,,,,,,,,,,,,,203.72885,85,percent of total billed charges,,,,,,,,,,119.2892337,49.77,percent of total billed charges,,,,215.7129,90,percent of total billed charges,,,,227.69695,90,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,46.1391,,,fee schedule,,,,203.72885,85,percent of total billed charges,,,,,,,,,29.013,239.681,
ANTI-CARDIOLIP IGM,3020080,CDM,86147,CPT,302,RC,outpatient,,,,239.681,131.82455,,215.7129,90,percent of total billed charges,,,,239.681,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,,,,,,,,,,,,,,203.72885,85,percent of total billed charges,,,,,,,,,,119.2892337,49.77,percent of total billed charges,,,,215.7129,90,percent of total billed charges,,,,227.69695,90,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,46.1391,,,fee schedule,,,,203.72885,85,percent of total billed charges,,,,,,,,,29.013,239.681,
ANTI-NEUTROPHIL CYTOPLAS/ANTI,3020100,CDM,86256,CPT,302,RC,outpatient,,,,234.531,128.99205,,211.0779,90,percent of total billed charges,,,,234.531,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,,,,,,,,,,,,,,199.35135,85,percent of total billed charges,,,,,,,,,,116.7260787,49.77,percent of total billed charges,,,,211.0779,90,percent of total billed charges,,,,222.80445,90,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,21.8694,,,fee schedule,,,,199.35135,85,percent of total billed charges,,,,,,,,,13.737,234.531,
ANTIBODY PANEL EACH,3020120,CDM,86870,CPT,302,RC,outpatient,,,,295.198,162.3589,,265.6782,90,percent of total billed charges,,,,295.198,100,percent of total billed charges,,,334.0314,,,fee schedule,,,334.0314,,,fee schedule,,,334.0314,,,fee schedule,,,,,,,,,,,,,,,,250.9183,85,percent of total billed charges,,,,,,,,,,146.9200446,49.77,percent of total billed charges,,,,265.6782,90,percent of total billed charges,,,,280.4381,90,percent of total billed charges,,,,,,,,,11,,,fee schedule,,,13.97,,,fee schedule,,,,250.9183,85,percent of total billed charges,,,,,,,,,11,334.0314,
ANTIBODY TITER,3020130,CDM,86886,CPT,302,RC,outpatient,,,,87.344,48.0392,,78.6096,90,percent of total billed charges,,,,87.344,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,,,,,,,,,,,,,,74.2424,85,percent of total billed charges,,,,,,,,,,43.4711088,49.77,percent of total billed charges,,,,78.6096,90,percent of total billed charges,,,,82.9768,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,74.2424,85,percent of total billed charges,,,,,,,,,7.39,162.0624,
ANTISTREPTOLYSIN O,3020140,CDM,86060,CPT,302,RC,outpatient,,,,92.082,50.6451,,82.8738,90,percent of total billed charges,,,,92.082,100,percent of total billed charges,,,8.322,,,fee schedule,,,8.322,,,fee schedule,,,8.322,,,fee schedule,,,,,,,,,,,,,,,,78.2697,85,percent of total billed charges,,,,,,,,,,45.8292114,49.77,percent of total billed charges,,,,82.8738,90,percent of total billed charges,,,,87.4779,90,percent of total billed charges,,,,,,,,,10.43,,,fee schedule,,,13.2461,,,fee schedule,,,,78.2697,85,percent of total billed charges,,,,,,,,,8.322,92.082,
BRUCELLA IgG,3020165,CDM,86622,CPT,302,RC,outpatient,,,,121.643,66.90365,,109.4787,90,percent of total billed charges,,,,121.643,100,percent of total billed charges,,,10.1802,,,fee schedule,,,10.1802,,,fee schedule,,,10.1802,,,fee schedule,,,,,,,,,,,,,,,,103.39655,85,percent of total billed charges,,,,,,,,,,60.5417211,49.77,percent of total billed charges,,,,109.4787,90,percent of total billed charges,,,,115.56085,90,percent of total billed charges,,,,,,,,,12.76,,,fee schedule,,,16.2052,,,fee schedule,,,,103.39655,85,percent of total billed charges,,,,,,,,,10.1802,121.643,
BRUCELLA IgM,3020166,CDM,86622,CPT,302,RC,outpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,10.1802,,,fee schedule,,,10.1802,,,fee schedule,,,10.1802,,,fee schedule,,,,,,,,,,,,,,,,98.31865,85,percent of total billed charges,,,,,,,,,,57.5684613,49.77,percent of total billed charges,,,,104.1021,90,percent of total billed charges,,,,109.88555,90,percent of total billed charges,,,,,,,,,12.76,,,fee schedule,,,16.2052,,,fee schedule,,,,98.31865,85,percent of total billed charges,,,,,,,,,10.1802,115.669,
C REACTIVE PROTEIN,3020170,CDM,86140,CPT,302,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,63.9115,85,percent of total billed charges,,,,,,,,,5.9052,75.19,
CRP CARDIAC ULTRASENS,3020175,CDM,86141,CPT,302,RC,outpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,14.763,,,fee schedule,,,14.763,,,fee schedule,,,14.763,,,fee schedule,,,,,,,,,,,,,,,,80.63355,85,percent of total billed charges,,,,,,,,,,47.2133151,49.77,percent of total billed charges,,,,85.3767,90,percent of total billed charges,,,,90.11985,90,percent of total billed charges,,,,,,,,,17.89,,,fee schedule,,,22.7203,,,fee schedule,,,,80.63355,85,percent of total billed charges,,,,,,,,,14.763,94.863,
CA 19-9,3020190,CDM,86301,CPT,302,RC,outpatient,,,,266.77,146.7235,,240.093,90,percent of total billed charges,,,,266.77,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,,,,,,,,,,,,,,226.7545,85,percent of total billed charges,,,,,,,,,,132.771429,49.77,percent of total billed charges,,,,240.093,90,percent of total billed charges,,,,253.4315,90,percent of total billed charges,,,,,,,,,29.72,,,fee schedule,,,37.7444,,,fee schedule,,,,226.7545,85,percent of total billed charges,,,,,,,,,23.7234,266.77,
CANCER ANTIGEN 125,3020210,CDM,86304,CPT,302,RC,outpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,,,,,,,,,,,,,,160.9169,85,percent of total billed charges,,,,,,,,,,94.2215778,49.77,percent of total billed charges,,,,170.3826,90,percent of total billed charges,,,,179.8483,90,percent of total billed charges,,,,,,,,,29.72,,,fee schedule,,,37.7444,,,fee schedule,,,,160.9169,85,percent of total billed charges,,,,,,,,,23.7234,189.314,
CANCER ANTIGEN 15-3,3020215,CDM,86300,CPT,302,RC,outpatient,,,,194.052,106.7286,,174.6468,90,percent of total billed charges,,,,194.052,100,percent of total billed charges,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,23.7234,,,fee schedule,,,,,,,,,,,,,,,,164.9442,85,percent of total billed charges,,,,,,,,,,96.5796804,49.77,percent of total billed charges,,,,174.6468,90,percent of total billed charges,,,,184.3494,90,percent of total billed charges,,,,,,,,,29.72,,,fee schedule,,,37.7444,,,fee schedule,,,,164.9442,85,percent of total billed charges,,,,,,,,,23.7234,194.052,
COLD AGGLUTININS,3020260,CDM,86157,CPT,302,RC,outpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,9.1884,,,fee schedule,,,9.1884,,,fee schedule,,,9.1884,,,fee schedule,,,,,,,,,,,,,,,,73.27935,85,percent of total billed charges,,,,,,,,,,42.9072147,49.77,percent of total billed charges,,,,77.5899,90,percent of total billed charges,,,,81.90045,90,percent of total billed charges,,,,,,,,,11.51,,,fee schedule,,,14.6177,,,fee schedule,,,,73.27935,85,percent of total billed charges,,,,,,,,,9.1884,86.211,
COMPLEMENT TOTAL,3020270,CDM,86162,CPT,302,RC,outpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,23.1648,,,fee schedule,,,23.1648,,,fee schedule,,,23.1648,,,fee schedule,,,,,,,,,,,,,,,,181.66625,85,percent of total billed charges,,,,,,,,,,106.3709325,49.77,percent of total billed charges,,,,192.3525,90,percent of total billed charges,,,,203.03875,90,percent of total billed charges,,,,,,,,,29.02,,,fee schedule,,,36.8554,,,fee schedule,,,,181.66625,85,percent of total billed charges,,,,,,,,,23.1648,213.725,
COOMBS DIRECT,3020280,CDM,86880,CPT,302,RC,outpatient,,,,59.019,32.46045,,53.1171,90,percent of total billed charges,,,,59.019,100,percent of total billed charges,,,59.2344,,,fee schedule,,,59.2344,,,fee schedule,,,59.2344,,,fee schedule,,,,,,,,,,,,,,,,50.16615,85,percent of total billed charges,,,,,,,,,,29.3737563,49.77,percent of total billed charges,,,,53.1171,90,percent of total billed charges,,,,56.06805,90,percent of total billed charges,,,,,,,,,7.67,,,fee schedule,,,9.7409,,,fee schedule,,,,50.16615,85,percent of total billed charges,,,,,,,,,7.67,59.2344,
COOMBS INDIRECT,3020290,CDM,86885,CPT,302,RC,outpatient,,,,72.821,40.05155,,65.5389,90,percent of total billed charges,,,,72.821,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,,,,,,,,,,,,,,61.89785,85,percent of total billed charges,,,,,,,,,,36.2430117,49.77,percent of total billed charges,,,,65.5389,90,percent of total billed charges,,,,69.17995,90,percent of total billed charges,,,,,,,,,8.16,,,fee schedule,,,10.3632,,,fee schedule,,,,61.89785,85,percent of total billed charges,,,,,,,,,8.16,162.0624,
ECHOVIRUS #11,3020296,CDM,86658,CPT,302,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,23.6347,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,14.8542,95.481,
COXSACKIE B VIRUS ANTIBODY,3020297,CDM,86658,CPT,302,RC,outpatient,,,,65.302,35.9161,,58.7718,90,percent of total billed charges,,,,65.302,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,,,,,,,,,,,,,,55.5067,85,percent of total billed charges,,,,,,,,,,32.5008054,49.77,percent of total billed charges,,,,58.7718,90,percent of total billed charges,,,,62.0369,90,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,23.6347,,,fee schedule,,,,55.5067,85,percent of total billed charges,,,,,,,,,14.8542,65.302,
ECHOVIRUS #4,3020298,CDM,86658,CPT,302,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,23.6347,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,14.8542,95.481,
ECHOVIRUS #7,3020299,CDM,86658,CPT,302,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,23.6347,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,14.8542,95.481,
CROSSMATCH EACH UNIT,3020300,CDM,86920,CPT,302,RC,outpatient,,,,39.346,21.6403,,35.4114,90,percent of total billed charges,,,,39.346,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,,,,,,,,,,,,,,33.4441,85,percent of total billed charges,,,,,,,,,,19.5825042,49.77,percent of total billed charges,,,,35.4114,90,percent of total billed charges,,,,37.3787,90,percent of total billed charges,,,,,,,,,34,,,fee schedule,,,43.18,,,fee schedule,,,,33.4441,85,percent of total billed charges,,,,,,,,,19.5825042,162.0624,
ECHOVIRUS #9,3020301,CDM,86658,CPT,302,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,23.6347,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,14.8542,95.481,
ECHOVIRUS #30,3020302,CDM,86658,CPT,302,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,14.8542,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,18.61,,,fee schedule,,,23.6347,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,14.8542,95.481,
CRYPTOCOCCAL ANTIGEN,3020320,CDM,86403,CPT,302,RC,outpatient,,,,113.3,62.315,,101.97,90,percent of total billed charges,,,,113.3,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,,,,,,,,,,,,,,96.305,85,percent of total billed charges,,,,,,,,,,56.38941,49.77,percent of total billed charges,,,,101.97,90,percent of total billed charges,,,,107.635,90,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,18.4785,,,fee schedule,,,,96.305,85,percent of total billed charges,,,,,,,,,13.1556,113.3,
CYTOMEGALOVIRUS AB IGM,3020330,CDM,86645,CPT,302,RC,outpatient,,,,146.363,80.49965,,131.7267,90,percent of total billed charges,,,,146.363,100,percent of total billed charges,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,,,,,,,,,,,,,,124.40855,85,percent of total billed charges,,,,,,,,,,72.8448651,49.77,percent of total billed charges,,,,131.7267,90,percent of total billed charges,,,,139.04485,90,percent of total billed charges,,,,,,,,,24.06,,,fee schedule,,,30.5562,,,fee schedule,,,,124.40855,85,percent of total billed charges,,,,,,,,,19.209,146.363,
CYTOMEGALOVIRUS AB IGG,3020333,CDM,86644,CPT,302,RC,outpatient,,,,218.772,120.3246,,196.8948,90,percent of total billed charges,,,,218.772,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,,,,,,,,,,,,,,185.9562,85,percent of total billed charges,,,,,,,,,,108.8828244,49.77,percent of total billed charges,,,,196.8948,90,percent of total billed charges,,,,207.8334,90,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,26.0985,,,fee schedule,,,,185.9562,85,percent of total billed charges,,,,,,,,,16.4046,218.772,
EHRLICHIA CHAFFENSIS AB IGG,3020340,CDM,86666,CPT,302,RC,outpatient,,,,167.272,91.9996,,150.5448,90,percent of total billed charges,,,,167.272,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,,,,,,,,,,,,,,142.1812,85,percent of total billed charges,,,,,,,,,,83.2512744,49.77,percent of total billed charges,,,,150.5448,90,percent of total billed charges,,,,158.9084,90,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,18.4531,,,fee schedule,,,,142.1812,85,percent of total billed charges,,,,,,,,,11.6052,167.272,
EHRLICHIA CHAFFENIS AB IGM,3020341,CDM,86666,CPT,302,RC,outpatient,,,,167.272,91.9996,,150.5448,90,percent of total billed charges,,,,167.272,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,,,,,,,,,,,,,,142.1812,85,percent of total billed charges,,,,,,,,,,83.2512744,49.77,percent of total billed charges,,,,150.5448,90,percent of total billed charges,,,,158.9084,90,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,18.4531,,,fee schedule,,,,142.1812,85,percent of total billed charges,,,,,,,,,11.6052,167.272,
EPSTEIN BARR AB IGM (VIRAL CAP,3020360,CDM,86665,CPT,302,RC,outpatient,,,,163.358,89.8469,,147.0222,90,percent of total billed charges,,,,163.358,100,percent of total billed charges,,,20.6796,,,fee schedule,,,20.6796,,,fee schedule,,,20.6796,,,fee schedule,,,,,,,,,,,,,,,,138.8543,85,percent of total billed charges,,,,,,,,,,81.3032766,49.77,percent of total billed charges,,,,147.0222,90,percent of total billed charges,,,,155.1901,90,percent of total billed charges,,,,,,,,,25.91,,,fee schedule,,,32.9057,,,fee schedule,,,,138.8543,85,percent of total billed charges,,,,,,,,,20.6796,163.358,
TULAREMIA ANTIBODY IGG,3020371,CDM,86000,CPT,302,RC,outpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,7.9572,,,fee schedule,,,7.9572,,,fee schedule,,,7.9572,,,fee schedule,,,,,,,,,,,,,,,,119.068,85,percent of total billed charges,,,,,,,,,,69.717816,49.77,percent of total billed charges,,,,126.072,90,percent of total billed charges,,,,133.076,90,percent of total billed charges,,,,,,,,,2.26,,,fee schedule,,,2.8702,,,fee schedule,,,,119.068,85,percent of total billed charges,,,,,,,,,2.26,140.08,
FETAL BLEED SCREEN,3020390,CDM,86850,CPT,302,RC,outpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,,,,,,,,,,,,,,51.21675,85,percent of total billed charges,,,,,,,,,,29.9889135,49.77,percent of total billed charges,,,,54.2295,90,percent of total billed charges,,,,57.24225,90,percent of total billed charges,,,,,,,,,5,,,fee schedule,,,6.35,,,fee schedule,,,,51.21675,85,percent of total billed charges,,,,,,,,,5,60.255,
FTA,3020400,CDM,86780,CPT,302,RC,outpatient,,,,124.321,68.37655,,111.8889,90,percent of total billed charges,,,,124.321,100,percent of total billed charges,,,15.0936,,,fee schedule,,,15.0936,,,fee schedule,,,15.0936,,,fee schedule,,,,,,,,,,,,,,,,105.67285,85,percent of total billed charges,,,,,,,,,,61.8745617,49.77,percent of total billed charges,,,,111.8889,90,percent of total billed charges,,,,118.10495,90,percent of total billed charges,,,,,,,,,19.55,,,fee schedule,,,24.8285,,,fee schedule,,,,105.67285,85,percent of total billed charges,,,,,,,,,15.0936,124.321,
GIARDIASIS ANTIBODY,3020420,CDM,86674,CPT,302,RC,outpatient,,,,224.746,123.6103,,202.2714,90,percent of total billed charges,,,,224.746,100,percent of total billed charges,,,16.7808,,,fee schedule,,,16.7808,,,fee schedule,,,16.7808,,,fee schedule,,,,,,,,,,,,,,,,191.0341,85,percent of total billed charges,,,,,,,,,,111.8560842,49.77,percent of total billed charges,,,,202.2714,90,percent of total billed charges,,,,213.5087,90,percent of total billed charges,,,,,,,,,21.02,,,fee schedule,,,26.6954,,,fee schedule,,,,191.0341,85,percent of total billed charges,,,,,,,,,16.7808,224.746,
HEPATITIS B SURFACE ANTIBODY,3020470,CDM,86706,CPT,302,RC,outpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,12.2436,,,fee schedule,,,,,,,,,,,,,,,,98.31865,85,percent of total billed charges,,,,,,,,,,57.5684613,49.77,percent of total billed charges,,,,104.1021,90,percent of total billed charges,,,,109.88555,90,percent of total billed charges,,,,,,,,,15.33,,,fee schedule,,,19.4691,,,fee schedule,,,,98.31865,85,percent of total billed charges,,,,,,,,,12.2436,115.669,
HEPATITIS C ANTIBODY,3020490,CDM,86803,CPT,302,RC,outpatient,,,,195.597,107.57835,,176.0373,90,percent of total billed charges,,,,195.597,100,percent of total billed charges,,,16.2678,,,fee schedule,,,16.2678,,,fee schedule,,,16.2678,,,fee schedule,,,,,,,,,,,,,,,,166.25745,85,percent of total billed charges,,,,,,,,,,97.3486269,49.77,percent of total billed charges,,,,176.0373,90,percent of total billed charges,,,,185.81715,90,percent of total billed charges,,,,,,,,,20.39,,,fee schedule,,,25.8953,,,fee schedule,,,,166.25745,85,percent of total billed charges,,,,,,,,,16.2678,195.597,
IMMUNOFIXATION - SERUM,3020512,CDM,86334,CPT,302,RC,outpatient,,,,87.344,48.0392,,78.6096,90,percent of total billed charges,,,,87.344,100,percent of total billed charges,,,25.4676,,,fee schedule,,,25.4676,,,fee schedule,,,25.4676,,,fee schedule,,,,,,,,,,,,,,,,74.2424,85,percent of total billed charges,,,,,,,,,,43.4711088,49.77,percent of total billed charges,,,,78.6096,90,percent of total billed charges,,,,82.9768,90,percent of total billed charges,,,,,,,,,31.9,,,fee schedule,,,40.513,,,fee schedule,,,,74.2424,85,percent of total billed charges,,,,,,,,,25.4676,87.344,
"VARICELLA ZOSTER AB, IGG",3020520,CDM,86787,CPT,302,RC,outpatient,,,,157.384,86.5612,,141.6456,90,percent of total billed charges,,,,157.384,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,,,,,,,,,,,,,,133.7764,85,percent of total billed charges,,,,,,,,,,78.3300168,49.77,percent of total billed charges,,,,141.6456,90,percent of total billed charges,,,,149.5148,90,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,23.368,,,fee schedule,,,,133.7764,85,percent of total billed charges,,,,,,,,,14.6832,157.384,
"VARICELLA ZOSTER AB, IGM",3020530,CDM,86787,CPT,302,RC,outpatient,,,,138.947,76.42085,,125.0523,90,percent of total billed charges,,,,138.947,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,,,,,,,,,,,,,,118.10495,85,percent of total billed charges,,,,,,,,,,69.1539219,49.77,percent of total billed charges,,,,125.0523,90,percent of total billed charges,,,,131.99965,90,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,23.368,,,fee schedule,,,,118.10495,85,percent of total billed charges,,,,,,,,,14.6832,138.947,
HLA-B27,3020550,CDM,86812,CPT,302,RC,outpatient,,,,180.662,99.3641,,162.5958,90,percent of total billed charges,,,,180.662,100,percent of total billed charges,,,29.4234,,,fee schedule,,,29.4234,,,fee schedule,,,29.4234,,,fee schedule,,,,,,,,,,,,,,,,153.5627,85,percent of total billed charges,,,,,,,,,,89.9154774,49.77,percent of total billed charges,,,,162.5958,90,percent of total billed charges,,,,171.6289,90,percent of total billed charges,,,,,,,,,36.85,,,fee schedule,,,46.7995,,,fee schedule,,,,153.5627,85,percent of total billed charges,,,,,,,,,29.4234,180.662,
LEGIONELLA SCREEN,3020600,CDM,86713,CPT,302,RC,outpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,17.442,,,fee schedule,,,17.442,,,fee schedule,,,17.442,,,fee schedule,,,,,,,,,,,,,,,,121.08165,85,percent of total billed charges,,,,,,,,,,70.8968673,49.77,percent of total billed charges,,,,128.2041,90,percent of total billed charges,,,,135.32655,90,percent of total billed charges,,,,,,,,,21.86,,,fee schedule,,,27.7622,,,fee schedule,,,,121.08165,85,percent of total billed charges,,,,,,,,,17.442,142.449,
LYME DISEASE ANTIBODY TOTAL,3020610,CDM,86618,CPT,302,RC,outpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,19.4142,,,fee schedule,,,19.4142,,,fee schedule,,,19.4142,,,fee schedule,,,,,,,,,,,,,,,,60.5846,85,percent of total billed charges,,,,,,,,,,35.4740652,49.77,percent of total billed charges,,,,64.1484,90,percent of total billed charges,,,,67.7122,90,percent of total billed charges,,,,,,,,,24.32,,,fee schedule,,,30.8864,,,fee schedule,,,,60.5846,85,percent of total billed charges,,,,,,,,,19.4142,71.276,
MONO SLIDE TEST,3020620,CDM,86308,CPT,302,RC,outpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,56.5573,85,percent of total billed charges,,,,,,,,,,33.1159626,49.77,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,63.2111,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,,,,,,,5.9052,66.538,
MUMPS ANTIBODIES IGG,3020634,CDM,86735,CPT,302,RC,outpatient,,,,205.382,112.9601,,184.8438,90,percent of total billed charges,,,,205.382,100,percent of total billed charges,,,14.877,,,fee schedule,,,14.877,,,fee schedule,,,14.877,,,fee schedule,,,,,,,,,,,,,,,,174.5747,85,percent of total billed charges,,,,,,,,,,102.2186214,49.77,percent of total billed charges,,,,184.8438,90,percent of total billed charges,,,,195.1129,90,percent of total billed charges,,,,,,,,,18.63,,,fee schedule,,,23.6601,,,fee schedule,,,,174.5747,85,percent of total billed charges,,,,,,,,,14.877,205.382,
"MUMPS ANTIBODIES,IgM",3020635,CDM,86735,CPT,302,RC,outpatient,,,,104.648,57.5564,,94.1832,90,percent of total billed charges,,,,104.648,100,percent of total billed charges,,,14.877,,,fee schedule,,,14.877,,,fee schedule,,,14.877,,,fee schedule,,,,,,,,,,,,,,,,88.9508,85,percent of total billed charges,,,,,,,,,,52.0833096,49.77,percent of total billed charges,,,,94.1832,90,percent of total billed charges,,,,99.4156,90,percent of total billed charges,,,,,,,,,18.63,,,fee schedule,,,23.6601,,,fee schedule,,,,88.9508,85,percent of total billed charges,,,,,,,,,14.877,104.648,
PARVOVIRUS B19 IgG,3020655,CDM,86747,CPT,302,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,17.1342,,,fee schedule,,,17.1342,,,fee schedule,,,17.1342,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,21.46,,,fee schedule,,,27.2542,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,17.1342,148.732,
PARVOVIRUS B19 AB 1gM,3020666,CDM,86747,CPT,302,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,17.1342,,,fee schedule,,,17.1342,,,fee schedule,,,17.1342,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,21.46,,,fee schedule,,,27.2542,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,17.1342,148.732,
PLATELET ANTIBODIES IGA,3020667,CDM,86022,CPT,302,RC,outpatient,,,,341.651,187.90805,,307.4859,90,percent of total billed charges,,,,341.651,100,percent of total billed charges,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,,,,,,,,,,,,,,290.40335,85,percent of total billed charges,,,,,,,,,,170.0397027,49.77,percent of total billed charges,,,,307.4859,90,percent of total billed charges,,,,324.56845,90,percent of total billed charges,,,,,,,,,26.23,,,fee schedule,,,33.3121,,,fee schedule,,,,290.40335,85,percent of total billed charges,,,,,,,,,20.9418,341.651,
PLATELET ANTIBODY IGG,3020668,CDM,86022,CPT,302,RC,outpatient,,,,341.651,187.90805,,307.4859,90,percent of total billed charges,,,,341.651,100,percent of total billed charges,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,,,,,,,,,,,,,,290.40335,85,percent of total billed charges,,,,,,,,,,170.0397027,49.77,percent of total billed charges,,,,307.4859,90,percent of total billed charges,,,,324.56845,90,percent of total billed charges,,,,,,,,,26.23,,,fee schedule,,,33.3121,,,fee schedule,,,,290.40335,85,percent of total billed charges,,,,,,,,,20.9418,341.651,
PLATELET ANTIBODIES IGM,3020669,CDM,86022,CPT,302,RC,outpatient,,,,341.651,187.90805,,307.4859,90,percent of total billed charges,,,,341.651,100,percent of total billed charges,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,20.9418,,,fee schedule,,,,,,,,,,,,,,,,290.40335,85,percent of total billed charges,,,,,,,,,,170.0397027,49.77,percent of total billed charges,,,,307.4859,90,percent of total billed charges,,,,324.56845,90,percent of total billed charges,,,,,,,,,26.23,,,fee schedule,,,33.3121,,,fee schedule,,,,290.40335,85,percent of total billed charges,,,,,,,,,20.9418,341.651,
RA QUANTITATIVE,3020690,CDM,86430,CPT,302,RC,outpatient,,,,72.821,40.05155,,65.5389,90,percent of total billed charges,,,,72.821,100,percent of total billed charges,,,6.9996,,,fee schedule,,,6.9996,,,fee schedule,,,6.9996,,,fee schedule,,,,,,,,,,,,,,,,61.89785,85,percent of total billed charges,,,,,,,,,,36.2430117,49.77,percent of total billed charges,,,,65.5389,90,percent of total billed charges,,,,69.17995,90,percent of total billed charges,,,,,,,,,8.11,,,fee schedule,,,10.2997,,,fee schedule,,,,61.89785,85,percent of total billed charges,,,,,,,,,6.9996,72.821,
BLOD TYPING SEROLOGIC RH,3020720,CDM,86901,CPT,302,RC,outpatient,,,,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,,,,,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,,,,,,,35,,,fee schedule,,,44.45,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,,,,,,,24.5037618,49.234,
TYPHUS FEVER GROUP IGG,3020730,CDM,86757,CPT,302,RC,outpatient,,,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,,,,,,,,,,,,,,44.1252,85,percent of total billed charges,,,,,,,,,,25.8366024,49.77,percent of total billed charges,,,,46.7208,90,percent of total billed charges,,,,49.3164,90,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,35.1028,,,fee schedule,,,,44.1252,85,percent of total billed charges,,,,,,,,,22.059,51.912,
TYPHUS FEVER GROUP IGM,3020740,CDM,86757,CPT,302,RC,outpatient,,,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,,,,,,,,,,,,,,44.1252,85,percent of total billed charges,,,,,,,,,,25.8366024,49.77,percent of total billed charges,,,,46.7208,90,percent of total billed charges,,,,49.3164,90,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,35.1028,,,fee schedule,,,,44.1252,85,percent of total billed charges,,,,,,,,,22.059,51.912,
RAST CORN,3020741,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
ALTERNARIA ALTERNATA (m6),3020742,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST WHEAT lgG,3020743,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST-SOYBEAN,3020744,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST-TOMATO,3020745,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RMSF GROUP IGG,3020750,CDM,86757,CPT,302,RC,outpatient,,,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,,,,,,,,,,,,,,44.1252,85,percent of total billed charges,,,,,,,,,,25.8366024,49.77,percent of total billed charges,,,,46.7208,90,percent of total billed charges,,,,49.3164,90,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,35.1028,,,fee schedule,,,,44.1252,85,percent of total billed charges,,,,,,,,,22.059,51.912,
RMSF GROUP IGM,3020760,CDM,86757,CPT,302,RC,outpatient,,,,78.692,43.2806,,70.8228,90,percent of total billed charges,,,,78.692,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,,,,,,,,,,,,,,66.8882,85,percent of total billed charges,,,,,,,,,,39.1650084,49.77,percent of total billed charges,,,,70.8228,90,percent of total billed charges,,,,74.7574,90,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,35.1028,,,fee schedule,,,,66.8882,85,percent of total billed charges,,,,,,,,,22.059,78.692,
RUBELLA IGM,3020783,CDM,86762,CPT,302,RC,outpatient,,,,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,,,,,,,,,,,,,,80.63355,85,percent of total billed charges,,,,,,,,,,47.2133151,49.77,percent of total billed charges,,,,85.3767,90,percent of total billed charges,,,,90.11985,90,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,26.0985,,,fee schedule,,,,80.63355,85,percent of total billed charges,,,,,,,,,16.4046,94.863,
RUBELLA TITER IGG,3020790,CDM,86762,CPT,302,RC,outpatient,,,,64.169,35.29295,,57.7521,90,percent of total billed charges,,,,64.169,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,,,,,,,,,,,,,,54.54365,85,percent of total billed charges,,,,,,,,,,31.9369113,49.77,percent of total billed charges,,,,57.7521,90,percent of total billed charges,,,,60.96055,90,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,26.0985,,,fee schedule,,,,54.54365,85,percent of total billed charges,,,,,,,,,16.4046,64.169,
HEPATITIS B CORE IGM,3020815,CDM,86705,CPT,302,RC,outpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,13.4178,,,fee schedule,,,13.4178,,,fee schedule,,,13.4178,,,fee schedule,,,,,,,,,,,,,,,,83.61025,85,percent of total billed charges,,,,,,,,,,48.9562605,49.77,percent of total billed charges,,,,88.5285,90,percent of total billed charges,,,,93.44675,90,percent of total billed charges,,,,,,,,,16.81,,,fee schedule,,,21.3487,,,fee schedule,,,,83.61025,85,percent of total billed charges,,,,,,,,,13.4178,98.365,
THYROGLOBULIN ANTIBODY,3020830,CDM,86800,CPT,302,RC,outpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,18.1374,,,fee schedule,,,18.1374,,,fee schedule,,,18.1374,,,fee schedule,,,,,,,,,,,,,,,,83.61025,85,percent of total billed charges,,,,,,,,,,48.9562605,49.77,percent of total billed charges,,,,88.5285,90,percent of total billed charges,,,,93.44675,90,percent of total billed charges,,,,,,,,,22.71,,,fee schedule,,,28.8417,,,fee schedule,,,,83.61025,85,percent of total billed charges,,,,,,,,,18.1374,98.365,
TOXOPLASMOSIS ANTIBODY IGM,3020840,CDM,86778,CPT,302,RC,outpatient,,,,152.337,83.78535,,137.1033,90,percent of total billed charges,,,,152.337,100,percent of total billed charges,,,16.4274,,,fee schedule,,,16.4274,,,fee schedule,,,16.4274,,,fee schedule,,,,,,,,,,,,,,,,129.48645,85,percent of total billed charges,,,,,,,,,,75.8181249,49.77,percent of total billed charges,,,,137.1033,90,percent of total billed charges,,,,144.72015,90,percent of total billed charges,,,,,,,,,20.56,,,fee schedule,,,26.1112,,,fee schedule,,,,129.48645,85,percent of total billed charges,,,,,,,,,16.4274,152.337,
TOXOPLASMOSIS AB IGG,3020841,CDM,86777,CPT,302,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,26.0985,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,16.4046,148.732,
TB SKIN TEST,3020890,CDM,86580,CPT,302,RC,outpatient,,,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,10.319125,,,fee schedule,,,10.319125,,,fee schedule,,,,19.0859,85,percent of total billed charges,,,10.319125,,,fee schedule,,,,11.1753558,49.77,percent of total billed charges,,,,20.2086,90,percent of total billed charges,,,,21.3313,90,percent of total billed charges,,,10.62869875,,,fee schedule,,,8,,,fee schedule,,,10.16,,,fee schedule,,,,19.0859,85,percent of total billed charges,,,10.319125,,,fee schedule,,,8,25.7184,
C-1 ESTERASE INHIBITORS,3020910,CDM,86160,CPT,302,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,17.14,,,fee schedule,,,21.7678,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,13.68,114.536,
ANTI MITOCHONDRIAL ANTIBODY,3021035,CDM,86255,CPT,302,RC,outpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,,,,,,,,,,,,,,119.068,85,percent of total billed charges,,,,,,,,,,69.717816,49.77,percent of total billed charges,,,,126.072,90,percent of total billed charges,,,,133.076,90,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,21.8694,,,fee schedule,,,,119.068,85,percent of total billed charges,,,,,,,,,13.737,140.08,
BETA - 2 GLYCOPROTEIN IgM,3021090,CDM,86146,CPT,302,RC,outpatient,,,,107.017,58.85935,,96.3153,90,percent of total billed charges,,,,107.017,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,,,,,,,,,,,,,,90.96445,85,percent of total billed charges,,,,,,,,,,53.2623609,49.77,percent of total billed charges,,,,96.3153,90,percent of total billed charges,,,,101.66615,90,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,46.1391,,,fee schedule,,,,90.96445,85,percent of total billed charges,,,,,,,,,29.013,107.017,
BETA - 2 GLYCOPROTEIN IgG,3021091,CDM,86146,CPT,302,RC,outpatient,,,,107.017,58.85935,,96.3153,90,percent of total billed charges,,,,107.017,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,,,,,,,,,,,,,,90.96445,85,percent of total billed charges,,,,,,,,,,53.2623609,49.77,percent of total billed charges,,,,96.3153,90,percent of total billed charges,,,,101.66615,90,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,46.1391,,,fee schedule,,,,90.96445,85,percent of total billed charges,,,,,,,,,29.013,107.017,
BETA - 2 GLYCOPROTEIN IgA,3021092,CDM,86146,CPT,302,RC,outpatient,,,,107.017,58.85935,,96.3153,90,percent of total billed charges,,,,107.017,100,percent of total billed charges,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,29.013,,,fee schedule,,,,,,,,,,,,,,,,90.96445,85,percent of total billed charges,,,,,,,,,,53.2623609,49.77,percent of total billed charges,,,,96.3153,90,percent of total billed charges,,,,101.66615,90,percent of total billed charges,,,,,,,,,36.33,,,fee schedule,,,46.1391,,,fee schedule,,,,90.96445,85,percent of total billed charges,,,,,,,,,29.013,107.017,
INSULIN AUTOANTIBODIES,3021162,CDM,86337,CPT,302,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,24.4074,,,fee schedule,,,24.4074,,,fee schedule,,,24.4074,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,30.58,,,fee schedule,,,38.8366,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,24.4074,148.732,
WESTNILE VIRUS CSF IgG,3021516,CDM,86789,CPT,302,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,20.78,,,fee schedule,,,26.3906,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,16.4046,148.732,
WESTNILE VIRUS CSF IgM,3021517,CDM,86788,CPT,302,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,24.32,,,fee schedule,,,30.8864,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,19.209,148.732,
WEST NILE VIRUS IgG,3021518,CDM,86789,CPT,302,RC,outpatient,,,,195.597,107.57835,,176.0373,90,percent of total billed charges,,,,195.597,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,,,,,,,,,,,,,,166.25745,85,percent of total billed charges,,,,,,,,,,97.3486269,49.77,percent of total billed charges,,,,176.0373,90,percent of total billed charges,,,,185.81715,90,percent of total billed charges,,,,,,,,,20.78,,,fee schedule,,,26.3906,,,fee schedule,,,,166.25745,85,percent of total billed charges,,,,,,,,,16.4046,195.597,
WEST NILE VIRUS IgM,3021519,CDM,86788,CPT,302,RC,outpatient,,,,195.597,107.57835,,176.0373,90,percent of total billed charges,,,,195.597,100,percent of total billed charges,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,19.209,,,fee schedule,,,,,,,,,,,,,,,,166.25745,85,percent of total billed charges,,,,,,,,,,97.3486269,49.77,percent of total billed charges,,,,176.0373,90,percent of total billed charges,,,,185.81715,90,percent of total billed charges,,,,,,,,,24.32,,,fee schedule,,,30.8864,,,fee schedule,,,,166.25745,85,percent of total billed charges,,,,,,,,,19.209,195.597,
"ALPHA GAL - GALACTOSE 1,3 IgE",3022930,CDM,86003,CPT,302,RC,outpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,28.7164,85,percent of total billed charges,,,,,,,,,,16.8142968,49.77,percent of total billed charges,,,,30.4056,90,percent of total billed charges,,,,32.0948,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,28.7164,85,percent of total billed charges,,,,,,,,,5.9508,33.784,
ALPHA GAL - BEEF IgE,3022931,CDM,86003,CPT,302,RC,outpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,28.7164,85,percent of total billed charges,,,,,,,,,,16.8142968,49.77,percent of total billed charges,,,,30.4056,90,percent of total billed charges,,,,32.0948,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,28.7164,85,percent of total billed charges,,,,,,,,,5.9508,33.784,
ALPHA GAL - PORK IgE,3022932,CDM,86003,CPT,302,RC,outpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,28.7164,85,percent of total billed charges,,,,,,,,,,16.8142968,49.77,percent of total billed charges,,,,30.4056,90,percent of total billed charges,,,,32.0948,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,28.7164,85,percent of total billed charges,,,,,,,,,5.9508,33.784,
ALPHA GAL - LAMB/MUTTON IgE,3022933,CDM,86003,CPT,302,RC,outpatient,,,,33.784,18.5812,,30.4056,90,percent of total billed charges,,,,33.784,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,28.7164,85,percent of total billed charges,,,,,,,,,,16.8142968,49.77,percent of total billed charges,,,,30.4056,90,percent of total billed charges,,,,32.0948,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,28.7164,85,percent of total billed charges,,,,,,,,,5.9508,33.784,
BARTONELLA QUINTANA Ab IGM,3023425,CDM,86611,CPT,302,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,18.4531,,,fee schedule,,,,63.9115,85,percent of total billed charges,,,,,,,,,11.6052,75.19,
BARTONELLA QUINTANA Ab IGG,3023426,CDM,86611,CPT,302,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,18.4531,,,fee schedule,,,,63.9115,85,percent of total billed charges,,,,,,,,,11.6052,75.19,
BARTONELLA HENSELAE Ab IGG,3023427,CDM,86611,CPT,302,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,18.4531,,,fee schedule,,,,63.9115,85,percent of total billed charges,,,,,,,,,11.6052,75.19,
BARTONELLA HENSELAE Ab IGM,3023428,CDM,86611,CPT,302,RC,outpatient,,,,75.19,41.3545,,67.671,90,percent of total billed charges,,,,75.19,100,percent of total billed charges,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,11.6052,,,fee schedule,,,,,,,,,,,,,,,,63.9115,85,percent of total billed charges,,,,,,,,,,37.422063,49.77,percent of total billed charges,,,,67.671,90,percent of total billed charges,,,,71.4305,90,percent of total billed charges,,,,,,,,,14.53,,,fee schedule,,,18.4531,,,fee schedule,,,,63.9115,85,percent of total billed charges,,,,,,,,,11.6052,75.19,
1A-2 ANTIBODY,3023617,CDM,86341,CPT,302,RC,outpatient,,,,257.294,141.5117,,231.5646,90,percent of total billed charges,,,,257.294,100,percent of total billed charges,,,26.8698,,,fee schedule,,,26.8698,,,fee schedule,,,26.8698,,,fee schedule,,,,,,,,,,,,,,,,218.6999,85,percent of total billed charges,,,,,,,,,,128.0552238,49.77,percent of total billed charges,,,,231.5646,90,percent of total billed charges,,,,244.4293,90,percent of total billed charges,,,,,,,,,28.25,,,fee schedule,,,35.8775,,,fee schedule,,,,218.6999,85,percent of total billed charges,,,,,,,,,26.8698,257.294,
S PNEUMONIAE ANTIGEN,3024460,CDM,86403,CPT,302,RC,outpatient,,,,183.34,100.837,,165.006,90,percent of total billed charges,,,,183.34,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,,,,,,,,,,,,,,155.839,85,percent of total billed charges,,,,,,,,,,91.248318,49.77,percent of total billed charges,,,,165.006,90,percent of total billed charges,,,,174.173,90,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,18.4785,,,fee schedule,,,,155.839,85,percent of total billed charges,,,,,,,,,13.1556,183.34,
RAST - CASHEW,3026001,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST - WALNUT,3026003,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST - PEANUT,3026004,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST - COCONUT,3026016,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST - EGG WHITE,3026017,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
"RAST - FISH, COD",3026018,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST - GREEN PEA,3026020,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST - MILK,3026021,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST - OAT,3026022,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
T-SPOT TB TEST,3026481,CDM,86481,CPT,302,RC,outpatient,,,,133.591,73.47505,,120.2319,90,percent of total billed charges,,,,133.591,100,percent of total billed charges,,,114,,,fee schedule,,,114,,,fee schedule,,,114,,,fee schedule,,,,,,,,,,,,,,,,113.55235,85,percent of total billed charges,,,,,,,,,,66.4882407,49.77,percent of total billed charges,,,,120.2319,90,percent of total billed charges,,,,126.91145,90,percent of total billed charges,,,,,,,,,87.22,,,fee schedule,,,110.7694,,,fee schedule,,,,113.55235,85,percent of total billed charges,,,,,,,,,66.4882407,133.591,
RPR TITER,3026593,CDM,86593,CPT,302,RC,outpatient,,,,35.844,19.7142,,32.2596,90,percent of total billed charges,,,,35.844,100,percent of total billed charges,,,5.016,,,fee schedule,,,5.016,,,fee schedule,,,5.016,,,fee schedule,,,,,,,,,,,,,,,,30.4674,85,percent of total billed charges,,,,,,,,,,17.8395588,49.77,percent of total billed charges,,,,32.2596,90,percent of total billed charges,,,,34.0518,90,percent of total billed charges,,,,,,,,,6.29,,,fee schedule,,,7.9883,,,fee schedule,,,,30.4674,85,percent of total billed charges,,,,,,,,,5.016,35.844,
"HSV 2 - IGM, IFA (CSF)",3026696,CDM,86696,CPT,302,RC,outpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,,,,,,,,,,,,,,121.08165,85,percent of total billed charges,,,,,,,,,,70.8968673,49.77,percent of total billed charges,,,,128.2041,90,percent of total billed charges,,,,135.32655,90,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,35.1028,,,fee schedule,,,,121.08165,85,percent of total billed charges,,,,,,,,,22.059,142.449,
LISTERIA ANTIBODY CF,3026723,CDM,86723,CPT,302,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,18.84,,,fee schedule,,,23.9268,,,fee schedule,,,,101.3829,85,percent of total billed charges,,,,,,,,,15.0366,119.274,
ASPERGILLUS FUMIGATUS (m3),3027010,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
BERMUDA GRASS (g2),3027011,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
BIRCH (BETUAL VERRUCOSA (t3),3027012,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
CAT DANDER (e1),3027013,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
CLADOSPORIUM HERBARUM (m2),3027014,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
COCKROACH (i6),3027015,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
COMMON RAGWEED (short w1),3027016,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
DERMATOPHAGOIDES FARINAE (d2),3027017,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
DERMATOPHAGOIDES PTERONYSSINUS,3027018,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
DOG DANDER (e5),3027019,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
ELM (ULMUS AMERICANA)(t8),3027020,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
"MAPLE (BOX ELDER,ACER NEGINDO)",3027021,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
MOUNTAIN CEDAR (JUNIPERUS SAB),3027022,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
MULBERRY (t70),3027023,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
OAK (QUERCUS ALBA)(t70),3027024,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
PECAN/HICKORY (t22),3027025,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
PENICILLUM NOTATUM (m1),3027026,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
ROUGH MARSH ELDER (Iva)(w16),3027027,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
ROUGH PIGWEED (w14),3027028,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
TIMOTHY GRASS (g6),3027029,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
WALNUT (t10),3027030,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
FFP THAWING EACH UNIT,3027296,CDM,86927,CPT,302,RC,outpatient,,,,321.257,176.69135,,289.1313,90,percent of total billed charges,,,,321.257,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,,,,,,,,,,,,,,273.06845,85,percent of total billed charges,,,,,,,,,,159.8896089,49.77,percent of total billed charges,,,,289.1313,90,percent of total billed charges,,,,305.19415,90,percent of total billed charges,,,,,,,,,5,,,fee schedule,,,6.35,,,fee schedule,,,,273.06845,85,percent of total billed charges,,,,,,,,,5,321.257,
RAST - CLAM,3028601,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST - SCALLOP,3028602,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST SHRIMP,3028603,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
RAST = SESAME SEED,3028604,CDM,86003,CPT,302,RC,outpatient,,,,29.87,16.4285,,26.883,90,percent of total billed charges,,,,29.87,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,25.3895,85,percent of total billed charges,,,,,,,,,,14.866299,49.77,percent of total billed charges,,,,26.883,90,percent of total billed charges,,,,28.3765,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,25.3895,85,percent of total billed charges,,,,,,,,,5.9508,29.87,
MYELOPEROXIDASE ANTIBODY,3028606,CDM,86021,CPT,302,RC,outpatient,,,,157.384,86.5612,,141.6456,90,percent of total billed charges,,,,157.384,100,percent of total billed charges,,,17.157,,,fee schedule,,,17.157,,,fee schedule,,,17.157,,,fee schedule,,,,,,,,,,,,,,,,133.7764,85,percent of total billed charges,,,,,,,,,,78.3300168,49.77,percent of total billed charges,,,,141.6456,90,percent of total billed charges,,,,149.5148,90,percent of total billed charges,,,,,,,,,21.49,,,fee schedule,,,27.2923,,,fee schedule,,,,133.7764,85,percent of total billed charges,,,,,,,,,17.157,157.384,
CYCLIC CITRULLINATED PEPTIDE,3028620,CDM,86200,CPT,302,RC,outpatient,,,,166.963,91.82965,,150.2667,90,percent of total billed charges,,,,166.963,100,percent of total billed charges,,,14.763,,,fee schedule,,,14.763,,,fee schedule,,,14.763,,,fee schedule,,,,,,,,,,,,,,,,141.91855,85,percent of total billed charges,,,,,,,,,,83.0974851,49.77,percent of total billed charges,,,,150.2667,90,percent of total billed charges,,,,158.61485,90,percent of total billed charges,,,,,,,,,18.69,,,fee schedule,,,23.7363,,,fee schedule,,,,141.91855,85,percent of total billed charges,,,,,,,,,14.763,166.963,
ENDOMYSIAL ANTIBODY IGA,3028625,CDM,86255,CPT,302,RC,outpatient,,,,191.683,105.42565,,172.5147,90,percent of total billed charges,,,,191.683,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,,,,,,,,,,,,,,162.93055,85,percent of total billed charges,,,,,,,,,,95.4006291,49.77,percent of total billed charges,,,,172.5147,90,percent of total billed charges,,,,182.09885,90,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,21.8694,,,fee schedule,,,,162.93055,85,percent of total billed charges,,,,,,,,,13.737,191.683,
LCM VIRUS - IGG,3028627,CDM,86727,CPT,302,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,18.38,,,fee schedule,,,23.3426,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,14.6718,114.536,
"HEPATITIS B SURFACE Ab, QUANT",3028631,CDM,86317,CPT,302,RC,outpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,17.0886,,,fee schedule,,,17.0886,,,fee schedule,,,17.0886,,,fee schedule,,,,,,,,,,,,,,,,98.31865,85,percent of total billed charges,,,,,,,,,,57.5684613,49.77,percent of total billed charges,,,,104.1021,90,percent of total billed charges,,,,109.88555,90,percent of total billed charges,,,,,,,,,21.41,,,fee schedule,,,27.1907,,,fee schedule,,,,98.31865,85,percent of total billed charges,,,,,,,,,17.0886,115.669,
"INHIBIN A, ULTRASENSITIVE",3028633,CDM,86336,CPT,302,RC,outpatient,,,,313.223,172.27265,,281.9007,90,percent of total billed charges,,,,313.223,100,percent of total billed charges,,,17.7726,,,fee schedule,,,17.7726,,,fee schedule,,,17.7726,,,fee schedule,,,,,,,,,,,,,,,,266.23955,85,percent of total billed charges,,,,,,,,,,155.8910871,49.77,percent of total billed charges,,,,281.9007,90,percent of total billed charges,,,,297.56185,90,percent of total billed charges,,,,,,,,,21.77,,,fee schedule,,,27.6479,,,fee schedule,,,,266.23955,85,percent of total billed charges,,,,,,,,,17.7726,313.223,
INTRINSIC FACTOR BLOCKING ANTI,3028634,CDM,86340,CPT,302,RC,outpatient,,,,119.274,65.6007,,107.3466,90,percent of total billed charges,,,,119.274,100,percent of total billed charges,,,17.1912,,,fee schedule,,,17.1912,,,fee schedule,,,17.1912,,,fee schedule,,,,,,,,,,,,,,,,101.3829,85,percent of total billed charges,,,,,,,,,,59.3626698,49.77,percent of total billed charges,,,,107.3466,90,percent of total billed charges,,,,113.3103,90,percent of total billed charges,,,,,,,,,21.52,,,fee schedule,,,27.3304,,,fee schedule,,,,101.3829,85,percent of total billed charges,,,,,,,,,17.1912,119.274,
LIVER KIDNEY MICROSOMAL LKM1AB,3028637,CDM,86376,CPT,302,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,16.587,,,fee schedule,,,16.587,,,fee schedule,,,16.587,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,20.78,,,fee schedule,,,26.3906,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,16.587,95.481,
QUANIFERON TB GOLD,3028648,CDM,86480,CPT,302,RC,outpatient,,,,228.969,125.93295,,206.0721,90,percent of total billed charges,,,,228.969,100,percent of total billed charges,,,70.6572,,,fee schedule,,,70.6572,,,fee schedule,,,70.6572,,,fee schedule,,,,,,,,,,,,,,,,194.62365,85,percent of total billed charges,,,,,,,,,,113.9578713,49.77,percent of total billed charges,,,,206.0721,90,percent of total billed charges,,,,217.52055,90,percent of total billed charges,,,,,,,,,89.48,,,fee schedule,,,113.6396,,,fee schedule,,,,194.62365,85,percent of total billed charges,,,,,,,,,70.6572,228.969,
CALIFORNIA ENCEPHALITIS-SERUM,3028651,CDM,86651,CPT,302,RC,outpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,,,,,,,,,,,,,,73.27935,85,percent of total billed charges,,,,,,,,,,42.9072147,49.77,percent of total billed charges,,,,77.5899,90,percent of total billed charges,,,,81.90045,90,percent of total billed charges,,,,,,,,,18.84,,,fee schedule,,,23.9268,,,fee schedule,,,,73.27935,85,percent of total billed charges,,,,,,,,,15.0366,86.211,
EAST EQUINE ENCEPHALITIS,3028652,CDM,86652,CPT,302,RC,outpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,,,,,,,,,,,,,,73.27935,85,percent of total billed charges,,,,,,,,,,42.9072147,49.77,percent of total billed charges,,,,77.5899,90,percent of total billed charges,,,,81.90045,90,percent of total billed charges,,,,,,,,,18.84,,,fee schedule,,,23.9268,,,fee schedule,,,,73.27935,85,percent of total billed charges,,,,,,,,,15.0366,86.211,
WESTERN EQUINE ENCEPHALITIS,3028654,CDM,86654,CPT,302,RC,outpatient,,,,86.211,47.41605,,77.5899,90,percent of total billed charges,,,,86.211,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,,,,,,,,,,,,,,73.27935,85,percent of total billed charges,,,,,,,,,,42.9072147,49.77,percent of total billed charges,,,,77.5899,90,percent of total billed charges,,,,81.90045,90,percent of total billed charges,,,,,,,,,18.84,,,fee schedule,,,23.9268,,,fee schedule,,,,73.27935,85,percent of total billed charges,,,,,,,,,15.0366,86.211,
"VDRL, SERUM",3028659,CDM,86592,CPT,302,RC,outpatient,,,,53.766,29.5713,,48.3894,90,percent of total billed charges,,,,53.766,100,percent of total billed charges,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,,,,,,,,,,,,,,45.7011,85,percent of total billed charges,,,,,,,,,,26.7593382,49.77,percent of total billed charges,,,,48.3894,90,percent of total billed charges,,,,51.0777,90,percent of total billed charges,,,,,,,,,5.9,,,fee schedule,,,7.493,,,fee schedule,,,,45.7011,85,percent of total billed charges,,,,,,,,,4.8678,53.766,
"HSV 1 - IGM, IFA (CSF)",3028669,CDM,86695,CPT,302,RC,outpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,,,,,,,,,,,,,,121.08165,85,percent of total billed charges,,,,,,,,,,70.8968673,49.77,percent of total billed charges,,,,128.2041,90,percent of total billed charges,,,,135.32655,90,percent of total billed charges,,,,,,,,,13.55,,,fee schedule,,,17.2085,,,fee schedule,,,,121.08165,85,percent of total billed charges,,,,,,,,,13.55,142.449,
LCM VIRUS - IGM,3028672,CDM,86727,CPT,302,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,14.6718,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,18.38,,,fee schedule,,,23.3426,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,14.6718,114.536,
VARICELL-ZOSTER - IGG,3028687,CDM,86787,CPT,302,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,23.368,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,14.6832,114.536,
HERPES SIMPLES 1/2 - IGM,3028694,CDM,86694,CPT,302,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,16.4046,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,20.55,,,fee schedule,,,26.0985,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,16.4046,114.536,
HERPES SIMPLEX I - IGG,3028695,CDM,86695,CPT,302,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,15.0366,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,13.55,,,fee schedule,,,17.2085,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,13.55,114.536,
HEPATITIS A VIRUS ANTIBODY IGM,3029030,CDM,86709,CPT,302,RC,outpatient,,,,64.169,35.29295,,57.7521,90,percent of total billed charges,,,,64.169,100,percent of total billed charges,,,12.8364,,,fee schedule,,,12.8364,,,fee schedule,,,12.8364,,,fee schedule,,,,,,,,,,,,,,,,54.54365,85,percent of total billed charges,,,,,,,,,,31.9369113,49.77,percent of total billed charges,,,,57.7521,90,percent of total billed charges,,,,60.96055,90,percent of total billed charges,,,,,,,,,16.07,,,fee schedule,,,20.4089,,,fee schedule,,,,54.54365,85,percent of total billed charges,,,,,,,,,12.8364,64.169,
C3 COMPLEMENT,3029040,CDM,86160,CPT,302,RC,outpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,,,,,,,17.14,,,fee schedule,,,21.7678,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,,,,,,,13.68,55.517,
C4 COMPLEMENT,3029050,CDM,86160,CPT,302,RC,outpatient,,,,44.496,24.4728,,40.0464,90,percent of total billed charges,,,,44.496,100,percent of total billed charges,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,13.68,,,fee schedule,,,,,,,,,,,,,,,,37.8216,85,percent of total billed charges,,,,,,,,,,22.1456592,49.77,percent of total billed charges,,,,40.0464,90,percent of total billed charges,,,,42.2712,90,percent of total billed charges,,,,,,,,,17.14,,,fee schedule,,,21.7678,,,fee schedule,,,,37.8216,85,percent of total billed charges,,,,,,,,,13.68,44.496,
MEASLES (RUBEOLA) IGM,3029070,CDM,86765,CPT,302,RC,outpatient,,,,149.968,82.4824,,134.9712,90,percent of total billed charges,,,,149.968,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,,,,,,,,,,,,,,127.4728,85,percent of total billed charges,,,,,,,,,,74.6390736,49.77,percent of total billed charges,,,,134.9712,90,percent of total billed charges,,,,142.4696,90,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,23.368,,,fee schedule,,,,127.4728,85,percent of total billed charges,,,,,,,,,14.6832,149.968,
MEASLES (RUBEOLA) IGG,3029080,CDM,86765,CPT,302,RC,outpatient,,,,173.143,95.22865,,155.8287,90,percent of total billed charges,,,,173.143,100,percent of total billed charges,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,14.6832,,,fee schedule,,,,,,,,,,,,,,,,147.17155,85,percent of total billed charges,,,,,,,,,,86.1732711,49.77,percent of total billed charges,,,,155.8287,90,percent of total billed charges,,,,164.48585,90,percent of total billed charges,,,,,,,,,18.4,,,fee schedule,,,23.368,,,fee schedule,,,,147.17155,85,percent of total billed charges,,,,,,,,,14.6832,173.143,
"HERPES SIMPLEX VIRUS II, IgG",3029112,CDM,86696,CPT,302,RC,outpatient,,,,185.709,102.13995,,167.1381,90,percent of total billed charges,,,,185.709,100,percent of total billed charges,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,22.059,,,fee schedule,,,,,,,,,,,,,,,,157.85265,85,percent of total billed charges,,,,,,,,,,92.4273693,49.77,percent of total billed charges,,,,167.1381,90,percent of total billed charges,,,,176.42355,90,percent of total billed charges,,,,,,,,,27.64,,,fee schedule,,,35.1028,,,fee schedule,,,,157.85265,85,percent of total billed charges,,,,,,,,,22.059,185.709,
EPSTEIN BARR NUCLEAR ANTIGEN,3029120,CDM,86664,CPT,302,RC,outpatient,,,,163.358,89.8469,,147.0222,90,percent of total billed charges,,,,163.358,100,percent of total billed charges,,,17.4306,,,fee schedule,,,17.4306,,,fee schedule,,,17.4306,,,fee schedule,,,,,,,,,,,,,,,,138.8543,85,percent of total billed charges,,,,,,,,,,81.3032766,49.77,percent of total billed charges,,,,147.0222,90,percent of total billed charges,,,,155.1901,90,percent of total billed charges,,,,,,,,,21.84,,,fee schedule,,,27.7368,,,fee schedule,,,,138.8543,85,percent of total billed charges,,,,,,,,,17.4306,163.358,
EPSTEIN BARR IGG VIRAL CAP,3029140,CDM,86665,CPT,302,RC,outpatient,,,,155.015,85.25825,,139.5135,90,percent of total billed charges,,,,155.015,100,percent of total billed charges,,,20.6796,,,fee schedule,,,20.6796,,,fee schedule,,,20.6796,,,fee schedule,,,,,,,,,,,,,,,,131.76275,85,percent of total billed charges,,,,,,,,,,77.1509655,49.77,percent of total billed charges,,,,139.5135,90,percent of total billed charges,,,,147.26425,90,percent of total billed charges,,,,,,,,,25.91,,,fee schedule,,,32.9057,,,fee schedule,,,,131.76275,85,percent of total billed charges,,,,,,,,,20.6796,155.015,
"HEPATITIS A ANTIBODY,TOTAL",3029150,CDM,86708,CPT,302,RC,outpatient,,,,113.3,62.315,,101.97,90,percent of total billed charges,,,,113.3,100,percent of total billed charges,,,14.1246,,,fee schedule,,,14.1246,,,fee schedule,,,14.1246,,,fee schedule,,,,,,,,,,,,,,,,96.305,85,percent of total billed charges,,,,,,,,,,56.38941,49.77,percent of total billed charges,,,,101.97,90,percent of total billed charges,,,,107.635,90,percent of total billed charges,,,,,,,,,17.69,,,fee schedule,,,22.4663,,,fee schedule,,,,96.305,85,percent of total billed charges,,,,,,,,,14.1246,113.3,
HEPATITIS B CORE ANTI IGG/IGM,3029160,CDM,86704,CPT,302,RC,outpatient,,,,115.669,63.61795,,104.1021,90,percent of total billed charges,,,,115.669,100,percent of total billed charges,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,13.737,,,fee schedule,,,,,,,,,,,,,,,,98.31865,85,percent of total billed charges,,,,,,,,,,57.5684613,49.77,percent of total billed charges,,,,104.1021,90,percent of total billed charges,,,,109.88555,90,percent of total billed charges,,,,,,,,,17.22,,,fee schedule,,,21.8694,,,fee schedule,,,,98.31865,85,percent of total billed charges,,,,,,,,,13.737,115.669,
"GALACTOSE-ALPHA 1,3IGE 092524",3029524,CDM,86003,CPT,302,RC,outpatient,,,,92.7,50.985,,83.43,90,percent of total billed charges,,,,92.7,100,percent of total billed charges,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,5.9508,,,fee schedule,,,,,,,,,,,,,,,,78.795,85,percent of total billed charges,,,,,,,,,,46.13679,49.77,percent of total billed charges,,,,83.43,90,percent of total billed charges,,,,88.065,90,percent of total billed charges,,,,,,,,,7.46,,,fee schedule,,,9.4742,,,fee schedule,,,,78.795,85,percent of total billed charges,,,,,,,,,5.9508,92.7,
BACTERIAL AG - NEIS MEN A,3060460,CDM,86403,CPT,302,RC,outpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,,,,,,,,,,,,,,40.7983,85,percent of total billed charges,,,,,,,,,,23.8886046,49.77,percent of total billed charges,,,,43.1982,90,percent of total billed charges,,,,45.5981,90,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,18.4785,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,,,,,,,13.1556,47.998,
BACTERIAL AG - H INFLUE B,3060470,CDM,86403,CPT,302,RC,outpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,,,,,,,,,,,,,,60.5846,85,percent of total billed charges,,,,,,,,,,35.4740652,49.77,percent of total billed charges,,,,64.1484,90,percent of total billed charges,,,,67.7122,90,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,18.4785,,,fee schedule,,,,60.5846,85,percent of total billed charges,,,,,,,,,13.1556,71.276,
BACTERIAL AG - STREP PNEUMONIA,3060490,CDM,86403,CPT,302,RC,outpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,,,,,,,,,,,,,,60.5846,85,percent of total billed charges,,,,,,,,,,35.4740652,49.77,percent of total billed charges,,,,64.1484,90,percent of total billed charges,,,,67.7122,90,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,18.4785,,,fee schedule,,,,60.5846,85,percent of total billed charges,,,,,,,,,13.1556,71.276,
BACTERIAL AG - STREP B,3060500,CDM,86403,CPT,302,RC,outpatient,,,,71.276,39.2018,,64.1484,90,percent of total billed charges,,,,71.276,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,,,,,,,,,,,,,,60.5846,85,percent of total billed charges,,,,,,,,,,35.4740652,49.77,percent of total billed charges,,,,64.1484,90,percent of total billed charges,,,,67.7122,90,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,18.4785,,,fee schedule,,,,60.5846,85,percent of total billed charges,,,,,,,,,13.1556,71.276,
BACTERIAL AG - NEIS MEN B,3060520,CDM,86403,CPT,302,RC,outpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,13.1556,,,fee schedule,,,,,,,,,,,,,,,,40.7983,85,percent of total billed charges,,,,,,,,,,23.8886046,49.77,percent of total billed charges,,,,43.1982,90,percent of total billed charges,,,,45.5981,90,percent of total billed charges,,,,,,,,,14.55,,,fee schedule,,,18.4785,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,,,,,,,13.1556,47.998,
SM/RNP ANTIBODY,3066235,CDM,86235,CPT,302,RC,outpatient,,,,304.262,167.3441,,273.8358,90,percent of total billed charges,,,,304.262,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,,,,,,,,,,,,,,258.6227,85,percent of total billed charges,,,,,,,,,,151.4311974,49.77,percent of total billed charges,,,,273.8358,90,percent of total billed charges,,,,289.0489,90,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,32.5247,,,fee schedule,,,,258.6227,85,percent of total billed charges,,,,,,,,,20.4402,304.262,
RNP ANTIBODY,3068623,CDM,86235,CPT,302,RC,outpatient,,,,266.77,146.7235,,240.093,90,percent of total billed charges,,,,266.77,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,,,,,,,,,,,,,,226.7545,85,percent of total billed charges,,,,,,,,,,132.771429,49.77,percent of total billed charges,,,,240.093,90,percent of total billed charges,,,,253.4315,90,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,32.5247,,,fee schedule,,,,226.7545,85,percent of total billed charges,,,,,,,,,20.4402,266.77,
SMITH ANTIBODY,3068626,CDM,86235,CPT,302,RC,outpatient,,,,297.567,163.66185,,267.8103,90,percent of total billed charges,,,,297.567,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,,,,,,,,,,,,,,252.93195,85,percent of total billed charges,,,,,,,,,,148.0990959,49.77,percent of total billed charges,,,,267.8103,90,percent of total billed charges,,,,282.68865,90,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,32.5247,,,fee schedule,,,,252.93195,85,percent of total billed charges,,,,,,,,,20.4402,297.567,
CHROMATIN (NUCLEOSONSAL) ANTI,3068627,CDM,86235,CPT,302,RC,outpatient,,,,297.567,163.66185,,267.8103,90,percent of total billed charges,,,,297.567,100,percent of total billed charges,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,20.4402,,,fee schedule,,,,,,,,,,,,,,,,252.93195,85,percent of total billed charges,,,,,,,,,,148.0990959,49.77,percent of total billed charges,,,,267.8103,90,percent of total billed charges,,,,282.68865,90,percent of total billed charges,,,,,,,,,25.61,,,fee schedule,,,32.5247,,,fee schedule,,,,252.93195,85,percent of total billed charges,,,,,,,,,20.4402,297.567,
ANTITHROMBIN III,3050000,CDM,85300,CPT,305,RC,outpatient,,,,205.382,112.9601,,184.8438,90,percent of total billed charges,,,,205.382,100,percent of total billed charges,,,13.509,,,fee schedule,,,13.509,,,fee schedule,,,13.509,,,fee schedule,,,,,,,,,,,,,,,,174.5747,85,percent of total billed charges,,,,,,,,,,102.2186214,49.77,percent of total billed charges,,,,184.8438,90,percent of total billed charges,,,,195.1129,90,percent of total billed charges,,,,,,,,,16.93,,,fee schedule,,,21.5011,,,fee schedule,,,,174.5747,85,percent of total billed charges,,,,,,,,,13.509,205.382,
CBC/PLT/DIFF/AUTO,3050020,CDM,85025,CPT,305,RC,outpatient,,,,88.992,48.9456,,80.0928,90,percent of total billed charges,,,,88.992,100,percent of total billed charges,,,8.8578,,,fee schedule,,,8.8578,,,fee schedule,,,8.8578,,,fee schedule,,,,,,,,,,,,,,,,75.6432,85,percent of total billed charges,,,,,,,,,,44.2913184,49.77,percent of total billed charges,,,,80.0928,90,percent of total billed charges,,,,84.5424,90,percent of total billed charges,,,,,,,,,11.1,,,fee schedule,,,14.097,,,fee schedule,,,,75.6432,85,percent of total billed charges,,,,,,,,,8.8578,88.992,
CBC W/O DIFF,3050030,CDM,85027,CPT,305,RC,outpatient,,,,59.019,32.46045,,53.1171,90,percent of total billed charges,,,,59.019,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,,,,,,,,,,,,,,50.16615,85,percent of total billed charges,,,,,,,,,,29.3737563,49.77,percent of total billed charges,,,,53.1171,90,percent of total billed charges,,,,56.06805,90,percent of total billed charges,,,,,,,,,9.25,,,fee schedule,,,11.7475,,,fee schedule,,,,50.16615,85,percent of total billed charges,,,,,,,,,7.3758,59.019,
D-DIMER,3050050,CDM,85378,CPT,305,RC,outpatient,,,,98.365,54.10075,,88.5285,90,percent of total billed charges,,,,98.365,100,percent of total billed charges,,,11.0808,,,fee schedule,,,11.0808,,,fee schedule,,,11.0808,,,fee schedule,,,,,,,,,,,,,,,,83.61025,85,percent of total billed charges,,,,,,,,,,48.9562605,49.77,percent of total billed charges,,,,88.5285,90,percent of total billed charges,,,,93.44675,90,percent of total billed charges,,,,,,,,,10.19,,,fee schedule,,,12.9413,,,fee schedule,,,,83.61025,85,percent of total billed charges,,,,,,,,,10.19,98.365,
DIFFERENTIAL - AUTO,3050060,CDM,85004,CPT,305,RC,outpatient,,,,17.304,9.5172,,15.5736,90,percent of total billed charges,,,,17.304,100,percent of total billed charges,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,7.3758,,,fee schedule,,,,,,,,,,,,,,,,14.7084,85,percent of total billed charges,,,,,,,,,,8.6122008,49.77,percent of total billed charges,,,,15.5736,90,percent of total billed charges,,,,16.4388,90,percent of total billed charges,,,,,,,,,9.04,,,fee schedule,,,11.4808,,,fee schedule,,,,14.7084,85,percent of total billed charges,,,,,,,,,7.3758,17.304,
DIFFERENTIAL - MANUAL,3050065,CDM,85007,CPT,305,RC,outpatient,,,,36.977,20.33735,,33.2793,90,percent of total billed charges,,,,36.977,100,percent of total billed charges,,,4.332,,,fee schedule,,,4.332,,,fee schedule,,,4.332,,,fee schedule,,,,,,,,,,,,,,,,31.43045,85,percent of total billed charges,,,,,,,,,,18.4034529,49.77,percent of total billed charges,,,,33.2793,90,percent of total billed charges,,,,35.12815,90,percent of total billed charges,,,,,,,,,4.92,,,fee schedule,,,6.2484,,,fee schedule,,,,31.43045,85,percent of total billed charges,,,,,,,,,4.332,36.977,
FACTOR VIII ASSAY,3050070,CDM,85240,CPT,305,RC,outpatient,,,,290.048,159.5264,,261.0432,90,percent of total billed charges,,,,290.048,100,percent of total billed charges,,,20.406,,,fee schedule,,,20.406,,,fee schedule,,,20.406,,,fee schedule,,,,,,,,,,,,,,,,246.5408,85,percent of total billed charges,,,,,,,,,,144.3568896,49.77,percent of total billed charges,,,,261.0432,90,percent of total billed charges,,,,275.5456,90,percent of total billed charges,,,,,,,,,25.58,,,fee schedule,,,32.4866,,,fee schedule,,,,246.5408,85,percent of total billed charges,,,,,,,,,20.406,290.048,
von WILLEBRAND FACTOR,3050078,CDM,85246,CPT,305,RC,outpatient,,,,158.62,87.241,,142.758,90,percent of total billed charges,,,,158.62,100,percent of total billed charges,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,,,,,,,,,,,,,,134.827,85,percent of total billed charges,,,,,,,,,,78.945174,49.77,percent of total billed charges,,,,142.758,90,percent of total billed charges,,,,150.689,90,percent of total billed charges,,,,,,,,,32.78,,,fee schedule,,,41.6306,,,fee schedule,,,,134.827,85,percent of total billed charges,,,,,,,,,26.1516,158.62,
von WILLEBRAND MULTIMERIC,3050081,CDM,85247,CPT,305,RC,outpatient,,,,265.328,145.9304,,238.7952,90,percent of total billed charges,,,,265.328,100,percent of total billed charges,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,,,,,,,,,,,,,,225.5288,85,percent of total billed charges,,,,,,,,,,132.0537456,49.77,percent of total billed charges,,,,238.7952,90,percent of total billed charges,,,,252.0616,90,percent of total billed charges,,,,,,,,,32.78,,,fee schedule,,,41.6306,,,fee schedule,,,,225.5288,85,percent of total billed charges,,,,,,,,,26.1516,265.328,
FIBRINOGEN,3050090,CDM,85384,CPT,305,RC,outpatient,,,,67.671,37.21905,,60.9039,90,percent of total billed charges,,,,67.671,100,percent of total billed charges,,,11.0808,,,fee schedule,,,11.0808,,,fee schedule,,,11.0808,,,fee schedule,,,,,,,,,,,,,,,,57.52035,85,percent of total billed charges,,,,,,,,,,33.6798567,49.77,percent of total billed charges,,,,60.9039,90,percent of total billed charges,,,,64.28745,90,percent of total billed charges,,,,,,,,,12.13,,,fee schedule,,,15.4051,,,fee schedule,,,,57.52035,85,percent of total billed charges,,,,,,,,,11.0808,67.671,
HEMATOCRIT (HCT),3050100,CDM,85014,CPT,305,RC,outpatient,,,,33.475,18.41125,,30.1275,90,percent of total billed charges,,,,33.475,100,percent of total billed charges,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,,,,,,,,,,,,,,28.45375,85,percent of total billed charges,,,,,,,,,,16.6605075,49.77,percent of total billed charges,,,,30.1275,90,percent of total billed charges,,,,31.80125,90,percent of total billed charges,,,,,,,,,3.38,,,fee schedule,,,4.2926,,,fee schedule,,,,28.45375,85,percent of total billed charges,,,,,,,,,2.7018,33.475,
HEMOGLOBIN (HGB),3050110,CDM,85018,CPT,305,RC,outpatient,,,,33.475,18.41125,,30.1275,90,percent of total billed charges,,,,33.475,100,percent of total billed charges,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,,,,,,,,,,,,,,28.45375,85,percent of total billed charges,,,,,,,,,,16.6605075,49.77,percent of total billed charges,,,,30.1275,90,percent of total billed charges,,,,31.80125,90,percent of total billed charges,,,,,,,,,3.38,,,fee schedule,,,4.2926,,,fee schedule,,,,28.45375,85,percent of total billed charges,,,,,,,,,2.7018,33.475,
KLEINHAUER BETKE STAIN,3050130,CDM,85460,CPT,305,RC,outpatient,,,,134.209,73.81495,,120.7881,90,percent of total billed charges,,,,134.209,100,percent of total billed charges,,,8.8122,,,fee schedule,,,8.8122,,,fee schedule,,,8.8122,,,fee schedule,,,,,,,,,,,,,,,,114.07765,85,percent of total billed charges,,,,,,,,,,66.7958193,49.77,percent of total billed charges,,,,120.7881,90,percent of total billed charges,,,,127.49855,90,percent of total billed charges,,,,,,,,,11.05,,,fee schedule,,,14.0335,,,fee schedule,,,,114.07765,85,percent of total billed charges,,,,,,,,,8.8122,134.209,
LUPUS ANTICOAGULANT,3050140,CDM,85730,CPT,305,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,6.8514,,,fee schedule,,,6.8514,,,fee schedule,,,6.8514,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,8.58,,,fee schedule,,,10.8966,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,6.8514,148.732,
LYSOZYME (SERUM),3050145,CDM,85549,CPT,305,RC,outpatient,,,,164.903,90.69665,,148.4127,90,percent of total billed charges,,,,164.903,100,percent of total billed charges,,,21.375,,,fee schedule,,,21.375,,,fee schedule,,,21.375,,,fee schedule,,,,,,,,,,,,,,,,140.16755,85,percent of total billed charges,,,,,,,,,,82.0722231,49.77,percent of total billed charges,,,,148.4127,90,percent of total billed charges,,,,156.65785,90,percent of total billed charges,,,,,,,,,26.78,,,fee schedule,,,34.0106,,,fee schedule,,,,140.16755,85,percent of total billed charges,,,,,,,,,21.375,164.903,
PART THROMB TIME PTT,3050150,CDM,85730,CPT,305,RC,outpatient,,,,76.323,41.97765,,68.6907,90,percent of total billed charges,,,,76.323,100,percent of total billed charges,,,6.8514,,,fee schedule,,,6.8514,,,fee schedule,,,6.8514,,,fee schedule,,,,,,,,,,,,,,,,64.87455,85,percent of total billed charges,,,,,,,,,,37.9859571,49.77,percent of total billed charges,,,,68.6907,90,percent of total billed charges,,,,72.50685,90,percent of total billed charges,,,,,,,,,8.58,,,fee schedule,,,10.8966,,,fee schedule,,,,64.87455,85,percent of total billed charges,,,,,,,,,6.8514,76.323,
PLATELET COUNT - AUTO,3050160,CDM,85049,CPT,305,RC,outpatient,,,,39.346,21.6403,,35.4114,90,percent of total billed charges,,,,39.346,100,percent of total billed charges,,,5.1072,,,fee schedule,,,5.1072,,,fee schedule,,,5.1072,,,fee schedule,,,,,,,,,,,,,,,,33.4441,85,percent of total billed charges,,,,,,,,,,19.5825042,49.77,percent of total billed charges,,,,35.4114,90,percent of total billed charges,,,,37.3787,90,percent of total billed charges,,,,,,,,,6.25,,,fee schedule,,,7.9375,,,fee schedule,,,,33.4441,85,percent of total billed charges,,,,,,,,,5.1072,39.346,
PROTEIN C,3050170,CDM,85302,CPT,305,RC,outpatient,,,,463.191,254.75505,,416.8719,90,percent of total billed charges,,,,463.191,100,percent of total billed charges,,,13.6914,,,fee schedule,,,13.6914,,,fee schedule,,,13.6914,,,fee schedule,,,,,,,,,,,,,,,,393.71235,85,percent of total billed charges,,,,,,,,,,230.5301607,49.77,percent of total billed charges,,,,416.8719,90,percent of total billed charges,,,,440.03145,90,percent of total billed charges,,,,,,,,,17.16,,,fee schedule,,,21.7932,,,fee schedule,,,,393.71235,85,percent of total billed charges,,,,,,,,,13.6914,463.191,
PROTEIN - S TOTAL,3050180,CDM,85305,CPT,305,RC,outpatient,,,,203.837,112.11035,,183.4533,90,percent of total billed charges,,,,203.837,100,percent of total billed charges,,,13.2354,,,fee schedule,,,13.2354,,,fee schedule,,,13.2354,,,fee schedule,,,,,,,,,,,,,,,,173.26145,85,percent of total billed charges,,,,,,,,,,101.4496749,49.77,percent of total billed charges,,,,183.4533,90,percent of total billed charges,,,,193.64515,90,percent of total billed charges,,,,,,,,,16.55,,,fee schedule,,,21.0185,,,fee schedule,,,,173.26145,85,percent of total billed charges,,,,,,,,,13.2354,203.837,
PROTHROMBIN TIME PT,3050190,CDM,85610,CPT,305,RC,outpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,4.8906,,,fee schedule,,,4.8906,,,fee schedule,,,4.8906,,,fee schedule,,,,,,,,,,,,,,,,40.7983,85,percent of total billed charges,,,,,,,,,,23.8886046,49.77,percent of total billed charges,,,,43.1982,90,percent of total billed charges,,,,45.5981,90,percent of total billed charges,,,,,,,,,5.61,,,fee schedule,,,7.1247,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,,,,,,,4.8906,47.998,
RED BLOOD CELL COUNT - AUTO,3050200,CDM,85041,CPT,305,RC,outpatient,,,,25.956,14.2758,,23.3604,90,percent of total billed charges,,,,25.956,100,percent of total billed charges,,,3.4428,,,fee schedule,,,3.4428,,,fee schedule,,,3.4428,,,fee schedule,,,,,,,,,,,,,,,,22.0626,85,percent of total billed charges,,,,,,,,,,12.9183012,49.77,percent of total billed charges,,,,23.3604,90,percent of total billed charges,,,,24.6582,90,percent of total billed charges,,,,,,,,,4.3,,,fee schedule,,,5.461,,,fee schedule,,,,22.0626,85,percent of total billed charges,,,,,,,,,3.4428,25.956,
RETIC COUNT - AUTO,3050210,CDM,85045,CPT,305,RC,outpatient,,,,36.977,20.33735,,33.2793,90,percent of total billed charges,,,,36.977,100,percent of total billed charges,,,4.5486,,,fee schedule,,,4.5486,,,fee schedule,,,4.5486,,,fee schedule,,,,,,,,,,,,,,,,31.43045,85,percent of total billed charges,,,,,,,,,,18.4034529,49.77,percent of total billed charges,,,,33.2793,90,percent of total billed charges,,,,35.12815,90,percent of total billed charges,,,,,,,,,5.72,,,fee schedule,,,7.2644,,,fee schedule,,,,31.43045,85,percent of total billed charges,,,,,,,,,4.5486,36.977,
WHITE CELL COUNT WBC - AUTO,3050250,CDM,85048,CPT,305,RC,outpatient,,,,28.325,15.57875,,25.4925,90,percent of total billed charges,,,,28.325,100,percent of total billed charges,,,2.8956,,,fee schedule,,,2.8956,,,fee schedule,,,2.8956,,,fee schedule,,,,,,,,,,,,,,,,24.07625,85,percent of total billed charges,,,,,,,,,,14.0973525,49.77,percent of total billed charges,,,,25.4925,90,percent of total billed charges,,,,26.90875,90,percent of total billed charges,,,,,,,,,3.64,,,fee schedule,,,4.6228,,,fee schedule,,,,24.07625,85,percent of total billed charges,,,,,,,,,2.8956,28.325,
HEMOGLOBINOPATHY SCREEN,3050260,CDM,85660,CPT,305,RC,outpatient,,,,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,6.2814,,,fee schedule,,,6.2814,,,fee schedule,,,6.2814,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,,,,,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,,,,,,,7.88,,,fee schedule,,,10.0076,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,,,,,,,6.2814,55.517,
HEMACUE HEMOGLOBIN,3050270,CDM,85018,CPT,305,RC,outpatient,,,QW,33.475,18.41125,,30.1275,90,percent of total billed charges,,,,33.475,100,percent of total billed charges,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,2.7018,,,fee schedule,,,,,,,,,,,,,,,,28.45375,85,percent of total billed charges,,,,,,,,,,16.6605075,49.77,percent of total billed charges,,,,30.1275,90,percent of total billed charges,,,,31.80125,90,percent of total billed charges,,,,,,,,,3.38,,,fee schedule,,,4.2926,,,fee schedule,,,,28.45375,85,percent of total billed charges,,,,,,,,,2.7018,33.475,
FACTOR IX ASSAY,3050290,CDM,85250,CPT,305,RC,outpatient,,,,223.51,122.9305,,201.159,90,percent of total billed charges,,,,223.51,100,percent of total billed charges,,,21.7056,,,fee schedule,,,21.7056,,,fee schedule,,,21.7056,,,fee schedule,,,,,,,,,,,,,,,,189.9835,85,percent of total billed charges,,,,,,,,,,111.240927,49.77,percent of total billed charges,,,,201.159,90,percent of total billed charges,,,,212.3345,90,percent of total billed charges,,,,,,,,,27.19,,,fee schedule,,,34.5313,,,fee schedule,,,,189.9835,85,percent of total billed charges,,,,,,,,,21.7056,223.51,
FACTOR 5 ASSAY,3050310,CDM,85220,CPT,305,RC,outpatient,,,,312.09,171.6495,,280.881,90,percent of total billed charges,,,,312.09,100,percent of total billed charges,,,20.121,,,fee schedule,,,20.121,,,fee schedule,,,20.121,,,fee schedule,,,,,,,,,,,,,,,,265.2765,85,percent of total billed charges,,,,,,,,,,155.327193,49.77,percent of total billed charges,,,,280.881,90,percent of total billed charges,,,,296.4855,90,percent of total billed charges,,,,,,,,,25.2,,,fee schedule,,,32.004,,,fee schedule,,,,265.2765,85,percent of total billed charges,,,,,,,,,20.121,312.09,
FACTOR 7 ASSAY,3050320,CDM,85230,CPT,305,RC,outpatient,,,,259.354,142.6447,,233.4186,90,percent of total billed charges,,,,259.354,100,percent of total billed charges,,,20.406,,,fee schedule,,,20.406,,,fee schedule,,,20.406,,,fee schedule,,,,,,,,,,,,,,,,220.4509,85,percent of total billed charges,,,,,,,,,,129.0804858,49.77,percent of total billed charges,,,,233.4186,90,percent of total billed charges,,,,246.3863,90,percent of total billed charges,,,,,,,,,25.58,,,fee schedule,,,32.4866,,,fee schedule,,,,220.4509,85,percent of total billed charges,,,,,,,,,20.406,259.354,
"PORTEIN - S, FREE",3050340,CDM,85306,CPT,305,RC,outpatient,,,,203.837,112.11035,,183.4533,90,percent of total billed charges,,,,203.837,100,percent of total billed charges,,,17.4648,,,fee schedule,,,17.4648,,,fee schedule,,,17.4648,,,fee schedule,,,,,,,,,,,,,,,,173.26145,85,percent of total billed charges,,,,,,,,,,101.4496749,49.77,percent of total billed charges,,,,183.4533,90,percent of total billed charges,,,,193.64515,90,percent of total billed charges,,,,,,,,,21.89,,,fee schedule,,,27.8003,,,fee schedule,,,,173.26145,85,percent of total billed charges,,,,,,,,,17.4648,203.837,
d RUSSELL VIPER VENOM TIME,3050400,CDM,85613,CPT,305,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,10.9212,,,fee schedule,,,10.9212,,,fee schedule,,,10.9212,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,10.4648,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,8.24,148.732,
HEXAGONAL PHASE PHOSPHOLIPID,3050410,CDM,85598,CPT,305,RC,outpatient,,,,213.725,117.54875,,192.3525,90,percent of total billed charges,,,,213.725,100,percent of total billed charges,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,,,,,,,,,,,,,,181.66625,85,percent of total billed charges,,,,,,,,,,106.3709325,49.77,percent of total billed charges,,,,192.3525,90,percent of total billed charges,,,,203.03875,90,percent of total billed charges,,,,,,,,,25.3,,,fee schedule,,,32.131,,,fee schedule,,,,181.66625,85,percent of total billed charges,,,,,,,,,20.4972,213.725,
ANTI THROMBIN III ANTIGEN,3055158,CDM,85301,CPT,305,RC,outpatient,,,,214.652,118.0586,,193.1868,90,percent of total billed charges,,,,214.652,100,percent of total billed charges,,,12.3234,,,fee schedule,,,12.3234,,,fee schedule,,,12.3234,,,fee schedule,,,,,,,,,,,,,,,,182.4542,85,percent of total billed charges,,,,,,,,,,106.8323004,49.77,percent of total billed charges,,,,193.1868,90,percent of total billed charges,,,,203.9194,90,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,19.6215,,,fee schedule,,,,182.4542,85,percent of total billed charges,,,,,,,,,12.3234,214.652,
PROTEIN S ACTIVITY,3055306,CDM,85306,CPT,305,RC,outpatient,,,,202.704,111.4872,,182.4336,90,percent of total billed charges,,,,202.704,100,percent of total billed charges,,,17.4648,,,fee schedule,,,17.4648,,,fee schedule,,,17.4648,,,fee schedule,,,,,,,,,,,,,,,,172.2984,85,percent of total billed charges,,,,,,,,,,100.8857808,49.77,percent of total billed charges,,,,182.4336,90,percent of total billed charges,,,,192.5688,90,percent of total billed charges,,,,,,,,,21.89,,,fee schedule,,,27.8003,,,fee schedule,,,,172.2984,85,percent of total billed charges,,,,,,,,,17.4648,202.704,
MORPHOLOGY,3057200,CDM,85008,CPT,305,RC,outpatient,,,,46.762,25.7191,,42.0858,90,percent of total billed charges,,,,46.762,100,percent of total billed charges,,,3.9102,,,fee schedule,,,3.9102,,,fee schedule,,,3.9102,,,fee schedule,,,,,,,,,,,,,,,,39.7477,85,percent of total billed charges,,,,,,,,,,23.2734474,49.77,percent of total billed charges,,,,42.0858,90,percent of total billed charges,,,,44.4239,90,percent of total billed charges,,,,,,,,,4.92,,,fee schedule,,,6.2484,,,fee schedule,,,,39.7477,85,percent of total billed charges,,,,,,,,,3.9102,46.762,
VON WILLEBRAND RISTOCETIN COF,3058524,CDM,85245,CPT,305,RC,outpatient,,,,245.655,135.11025,,221.0895,90,percent of total billed charges,,,,245.655,100,percent of total billed charges,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,26.1516,,,fee schedule,,,,,,,,,,,,,,,,208.80675,85,percent of total billed charges,,,,,,,,,,122.2624935,49.77,percent of total billed charges,,,,221.0895,90,percent of total billed charges,,,,233.37225,90,percent of total billed charges,,,,,,,,,32.78,,,fee schedule,,,41.6306,,,fee schedule,,,,208.80675,85,percent of total billed charges,,,,,,,,,26.1516,245.655,
PROTEIN C ACTIVITY,3058530,CDM,85303,CPT,305,RC,outpatient,,,,202.704,111.4872,,182.4336,90,percent of total billed charges,,,,202.704,100,percent of total billed charges,,,15.7776,,,fee schedule,,,15.7776,,,fee schedule,,,15.7776,,,fee schedule,,,,,,,,,,,,,,,,172.2984,85,percent of total billed charges,,,,,,,,,,100.8857808,49.77,percent of total billed charges,,,,182.4336,90,percent of total billed charges,,,,192.5688,90,percent of total billed charges,,,,,,,,,19.75,,,fee schedule,,,25.0825,,,fee schedule,,,,172.2984,85,percent of total billed charges,,,,,,,,,15.7776,202.704,
DRVVT CONFIRMATION,3058559,CDM,85597,CPT,305,RC,outpatient,,,,148.732,81.8026,,133.8588,90,percent of total billed charges,,,,148.732,100,percent of total billed charges,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,,,,,,,,,,,,,,126.4222,85,percent of total billed charges,,,,,,,,,,74.0239164,49.77,percent of total billed charges,,,,133.8588,90,percent of total billed charges,,,,141.2954,90,percent of total billed charges,,,,,,,,,25.67,,,fee schedule,,,32.6009,,,fee schedule,,,,126.4222,85,percent of total billed charges,,,,,,,,,20.4972,148.732,
GIARDIA ANTIGEN IMMUNO ASSAY,3010960,CDM,87329,CPT,306,RC,outpatient,,,,131.428,72.2854,,118.2852,90,percent of total billed charges,,,,131.428,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,,,,,,,,,,,,,,111.7138,85,percent of total billed charges,,,,,,,,,,65.4117156,49.77,percent of total billed charges,,,,118.2852,90,percent of total billed charges,,,,124.8566,90,percent of total billed charges,,,,,,,,,12.92,,,fee schedule,,,16.4084,,,fee schedule,,,,111.7138,85,percent of total billed charges,,,,,,,,,12.92,131.428,
ROTAVIRUS ANTIGEN,3011820,CDM,87425,CPT,306,RC,outpatient,,,,140.08,77.044,,126.072,90,percent of total billed charges,,,,140.08,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,,,,,,,,,,,,,,119.068,85,percent of total billed charges,,,,,,,,,,69.717816,49.77,percent of total billed charges,,,,126.072,90,percent of total billed charges,,,,133.076,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,119.068,85,percent of total billed charges,,,,,,,,,12.87,140.08,
HEPATITIS B SURFACE ANTIGEN,3020480,CDM,87340,CPT,306,RC,outpatient,,,,93.627,51.49485,,84.2643,90,percent of total billed charges,,,,93.627,100,percent of total billed charges,,,11.7762,,,fee schedule,,,11.7762,,,fee schedule,,,11.7762,,,fee schedule,,,,,,,,,,,,,,,,79.58295,85,percent of total billed charges,,,,,,,,,,46.5981579,49.77,percent of total billed charges,,,,84.2643,90,percent of total billed charges,,,,88.94565,90,percent of total billed charges,,,,,,,,,14.75,,,fee schedule,,,18.7325,,,fee schedule,,,,79.58295,85,percent of total billed charges,,,,,,,,,11.7762,93.627,
RSV ANTIGEN PREP,3020780,CDM,87634,CPT,306,RC,outpatient,,,,114.536,62.9948,,103.0824,90,percent of total billed charges,,,,114.536,100,percent of total billed charges,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,,,,,,,,,,,,,,97.3556,85,percent of total billed charges,,,,,,,,,,57.0045672,49.77,percent of total billed charges,,,,103.0824,90,percent of total billed charges,,,,108.8092,90,percent of total billed charges,,,,,,,,,86.66,,,fee schedule,,,110.0582,,,fee schedule,,,,97.3556,85,percent of total billed charges,,,,,,,,,57.0045672,114.536,
STOOL FOR WBC,3020800,CDM,89055,CPT,306,RC,outpatient,,,,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,,,,,,,,,,,,,,40.7983,85,percent of total billed charges,,,,,,,,,,23.8886046,49.77,percent of total billed charges,,,,43.1982,90,percent of total billed charges,,,,45.5981,90,percent of total billed charges,,,,,,,,,5.96,,,fee schedule,,,7.5692,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,,,,,,,4.8678,47.998,
"STREP SCREEN, GROUP A",3020810,CDM,87651,CPT,306,RC,outpatient,,,,250.805,137.94275,,225.7245,90,percent of total billed charges,,,,250.805,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,213.18425,85,percent of total billed charges,,,,,,,,,,124.8256485,49.77,percent of total billed charges,,,,225.7245,90,percent of total billed charges,,,,238.26475,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,213.18425,85,percent of total billed charges,,,,,,,,,40.0026,250.805,
BACITRACIN TEST,3060020,CDM,87163,CPT,306,RC,outpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,,,,,,,44.5887,,,fee schedule,,,39.6344,,,fee schedule,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,,24.6575511,49.77,percent of total billed charges,,,,44.5887,90,percent of total billed charges,,,,47.06585,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,24.6575511,49.543,
BACTERIA IDENTIFICATION #1,3060030,CDM,87077,CPT,306,RC,outpatient,,,,145.539,80.04645,,130.9851,90,percent of total billed charges,,,,145.539,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,,,,,,,,,,,,,,123.70815,85,percent of total billed charges,,,,,,,,,,72.4347603,49.77,percent of total billed charges,,,,130.9851,90,percent of total billed charges,,,,138.26205,90,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,14.6431,,,fee schedule,,,,123.70815,85,percent of total billed charges,,,,,,,,,9.2112,145.539,
BACTERIAL IDENTIFICATION 2,3060031,CDM,87077,CPT,306,RC,outpatient,,,,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,,,,,,,,,,,,,,53.49305,85,percent of total billed charges,,,,,,,,,,31.3217541,49.77,percent of total billed charges,,,,56.6397,90,percent of total billed charges,,,,59.78635,90,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,14.6431,,,fee schedule,,,,53.49305,85,percent of total billed charges,,,,,,,,,9.2112,62.933,
BACTERIAL IDENTIFICATION 3,3060032,CDM,87077,CPT,306,RC,outpatient,,,,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,,,,,,,,,,,,,,53.49305,85,percent of total billed charges,,,,,,,,,,31.3217541,49.77,percent of total billed charges,,,,56.6397,90,percent of total billed charges,,,,59.78635,90,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,14.6431,,,fee schedule,,,,53.49305,85,percent of total billed charges,,,,,,,,,9.2112,62.933,
CATALASE,3060070,CDM,87163,CPT,306,RC,outpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,,,,,,,44.5887,,,fee schedule,,,39.6344,,,fee schedule,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,,24.6575511,49.77,percent of total billed charges,,,,44.5887,90,percent of total billed charges,,,,47.06585,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,24.6575511,49.543,
CLOSTRIDIUM DIFFICILE,3060080,CDM,87324,CPT,306,RC,outpatient,,,,124.321,68.37655,,111.8889,90,percent of total billed charges,,,,124.321,100,percent of total billed charges,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,13.6572,,,fee schedule,,,,,,,,,,,,,,,,105.67285,85,percent of total billed charges,,,,,,,,,,61.8745617,49.77,percent of total billed charges,,,,111.8889,90,percent of total billed charges,,,,118.10495,90,percent of total billed charges,,,,,,,,,12.87,,,fee schedule,,,16.3449,,,fee schedule,,,,105.67285,85,percent of total billed charges,,,,,,,,,12.87,124.321,
CRYTOSPORIDIUM,3060100,CDM,87206,CPT,306,RC,outpatient,,,,25.956,14.2758,,23.3604,90,percent of total billed charges,,,,25.956,100,percent of total billed charges,,,6.1446,,,fee schedule,,,6.1446,,,fee schedule,,,6.1446,,,fee schedule,,,,,,,,,,,,,,,,22.0626,85,percent of total billed charges,,,,,,,,,,12.9183012,49.77,percent of total billed charges,,,,23.3604,90,percent of total billed charges,,,,24.6582,90,percent of total billed charges,,,,,,,,,7.67,,,fee schedule,,,9.7409,,,fee schedule,,,,22.0626,85,percent of total billed charges,,,,,,,,,6.1446,25.956,
CULTURE BACTERIA-ANY SOURCE,3060110,CDM,87070,CPT,306,RC,outpatient,,,,193.228,106.2754,,173.9052,90,percent of total billed charges,,,,193.228,100,percent of total billed charges,,,9.8268,,,fee schedule,,,9.8268,,,fee schedule,,,9.8268,,,fee schedule,,,,,,,,,,,,,,,,164.2438,85,percent of total billed charges,,,,,,,,,,96.1695756,49.77,percent of total billed charges,,,,173.9052,90,percent of total billed charges,,,,183.5666,90,percent of total billed charges,,,,,,,,,12.3,,,fee schedule,,,15.621,,,fee schedule,,,,164.2438,85,percent of total billed charges,,,,,,,,,9.8268,193.228,
CULTURE - FUNGUS - TO LABCORP,3060122,CDM,87102,CPT,306,RC,outpatient,,,,81.061,44.58355,,72.9549,90,percent of total billed charges,,,,81.061,100,percent of total billed charges,,,9.5874,,,fee schedule,,,9.5874,,,fee schedule,,,9.5874,,,fee schedule,,,,,,,,,,,,,,,,68.90185,85,percent of total billed charges,,,,,,,,,,40.3440597,49.77,percent of total billed charges,,,,72.9549,90,percent of total billed charges,,,,77.00795,90,percent of total billed charges,,,,,,,,,12,,,fee schedule,,,15.24,,,fee schedule,,,,68.90185,85,percent of total billed charges,,,,,,,,,9.5874,81.061,
CULTURE - AFB - TO LABCORP,3060132,CDM,87116,CPT,306,RC,outpatient,,,,81.061,44.58355,,72.9549,90,percent of total billed charges,,,,81.061,100,percent of total billed charges,,,12.312,,,fee schedule,,,12.312,,,fee schedule,,,12.312,,,fee schedule,,,,,,,,,,,,,,,,68.90185,85,percent of total billed charges,,,,,,,,,,40.3440597,49.77,percent of total billed charges,,,,72.9549,90,percent of total billed charges,,,,77.00795,90,percent of total billed charges,,,,,,,,,15.43,,,fee schedule,,,19.5961,,,fee schedule,,,,68.90185,85,percent of total billed charges,,,,,,,,,12.312,81.061,
CULTURE ANAEROBIC R,3060140,CDM,87075,CPT,306,RC,outpatient,,,,149.968,82.4824,,134.9712,90,percent of total billed charges,,,,149.968,100,percent of total billed charges,,,10.7958,,,fee schedule,,,10.7958,,,fee schedule,,,10.7958,,,fee schedule,,,,,,,,,,,,,,,,127.4728,85,percent of total billed charges,,,,,,,,,,74.6390736,49.77,percent of total billed charges,,,,134.9712,90,percent of total billed charges,,,,142.4696,90,percent of total billed charges,,,,,,,,,12.49,,,fee schedule,,,15.8623,,,fee schedule,,,,127.4728,85,percent of total billed charges,,,,,,,,,10.7958,149.968,
CULTURE BLOOD,3060150,CDM,87040,CPT,306,RC,outpatient,,,,88.58,48.719,,79.722,90,percent of total billed charges,,,,88.58,100,percent of total billed charges,,,11.7648,,,fee schedule,,,11.7648,,,fee schedule,,,11.7648,,,fee schedule,,,,,,,,,,,,,,,,75.293,85,percent of total billed charges,,,,,,,,,,44.086266,49.77,percent of total billed charges,,,,79.722,90,percent of total billed charges,,,,84.151,90,percent of total billed charges,,,,,,,,,14.75,,,fee schedule,,,18.7325,,,fee schedule,,,,75.293,85,percent of total billed charges,,,,,,,,,11.7648,88.58,
CULTURE; STOOL,3060170,CDM,87045,CPT,306,RC,outpatient,,,,147.599,81.17945,,132.8391,90,percent of total billed charges,,,,147.599,100,percent of total billed charges,,,10.7616,,,fee schedule,,,10.7616,,,fee schedule,,,10.7616,,,fee schedule,,,,,,,,,,,,,,,,125.45915,85,percent of total billed charges,,,,,,,,,,73.4600223,49.77,percent of total billed charges,,,,132.8391,90,percent of total billed charges,,,,140.21905,90,percent of total billed charges,,,,,,,,,13.47,,,fee schedule,,,17.1069,,,fee schedule,,,,125.45915,85,percent of total billed charges,,,,,,,,,10.7616,147.599,
CULTURE; STOOL - E COLI O157,3060173,CDM,87046,CPT,306,RC,outpatient,,,,36.977,20.33735,,33.2793,90,percent of total billed charges,,,,36.977,100,percent of total billed charges,,,10.7616,,,fee schedule,,,10.7616,,,fee schedule,,,10.7616,,,fee schedule,,,,,,,,,,,,,,,,31.43045,85,percent of total billed charges,,,,,,,,,,18.4034529,49.77,percent of total billed charges,,,,33.2793,90,percent of total billed charges,,,,35.12815,90,percent of total billed charges,,,,,,,,,3.37,,,fee schedule,,,4.2799,,,fee schedule,,,,31.43045,85,percent of total billed charges,,,,,,,,,3.37,36.977,
CULTURE-URINE,3060200,CDM,87086,CPT,306,RC,outpatient,,,,81.061,44.58355,,72.9549,90,percent of total billed charges,,,,81.061,100,percent of total billed charges,,,9.1998,,,fee schedule,,,9.1998,,,fee schedule,,,9.1998,,,fee schedule,,,,,,,,,,,,,,,,68.90185,85,percent of total billed charges,,,,,,,,,,40.3440597,49.77,percent of total billed charges,,,,72.9549,90,percent of total billed charges,,,,77.00795,90,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,14.6431,,,fee schedule,,,,68.90185,85,percent of total billed charges,,,,,,,,,9.1998,81.061,
EHLICHIA CHAFFEENSIS DNA PCR,3060205,CDM,87798,CPT,306,RC,outpatient,,,,504.906,277.6983,,454.4154,90,percent of total billed charges,,,,504.906,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,429.1701,85,percent of total billed charges,,,,,,,,,,251.2917162,49.77,percent of total billed charges,,,,454.4154,90,percent of total billed charges,,,,479.6607,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,429.1701,85,percent of total billed charges,,,,,,,,,40.0026,504.906,
HSV DNA AMP PROBE,3060230,CDM,87529,CPT,306,RC,outpatient,,,,177.057,97.38135,,159.3513,90,percent of total billed charges,,,,177.057,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,150.49845,85,percent of total billed charges,,,,,,,,,,88.1212689,49.77,percent of total billed charges,,,,159.3513,90,percent of total billed charges,,,,168.20415,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,150.49845,85,percent of total billed charges,,,,,,,,,40.0026,177.057,
HELICOBACTER PYLORI ANTIGEN,3060236,CDM,87338,CPT,306,RC,outpatient,,,,222.377,122.30735,,200.1393,90,percent of total billed charges,,,,222.377,100,percent of total billed charges,,,16.3932,,,fee schedule,,,16.3932,,,fee schedule,,,16.3932,,,fee schedule,,,,,,,,,,,,,,,,189.02045,85,percent of total billed charges,,,,,,,,,,110.6770329,49.77,percent of total billed charges,,,,200.1393,90,percent of total billed charges,,,,211.25815,90,percent of total billed charges,,,,,,,,,6.12,,,fee schedule,,,7.7724,,,fee schedule,,,,189.02045,85,percent of total billed charges,,,,,,,,,6.12,222.377,
HERPES CULTURE - TYPE 1,3060240,CDM,87255,CPT,306,RC,outpatient,,,,99.601,54.78055,,89.6409,90,percent of total billed charges,,,,99.601,100,percent of total billed charges,,,38.6004,,,fee schedule,,,38.6004,,,fee schedule,,,38.6004,,,fee schedule,,,,,,,,,,,,,,,,84.66085,85,percent of total billed charges,,,,,,,,,,49.5714177,49.77,percent of total billed charges,,,,89.6409,90,percent of total billed charges,,,,94.62095,90,percent of total billed charges,,,,,,,,,47.31,,,fee schedule,,,60.0837,,,fee schedule,,,,84.66085,85,percent of total billed charges,,,,,,,,,38.6004,99.601,
INFLUENZA A&B,3060257,CDM,87502,CPT,306,RC,outpatient,,,,158.62,87.241,,142.758,90,percent of total billed charges,,,,158.62,100,percent of total billed charges,,,109.212,,,fee schedule,,,109.212,,,fee schedule,,,109.212,,,fee schedule,,,,,,,,,,,,,,,,134.827,85,percent of total billed charges,,,,,,,,,,78.945174,49.77,percent of total billed charges,,,,142.758,90,percent of total billed charges,,,,150.689,90,percent of total billed charges,,,,,,,,,119.75,,,fee schedule,,,152.0825,,,fee schedule,,,,134.827,85,percent of total billed charges,,,,,,,,,78.945174,158.62,
MALARIA SMEAR,3060260,CDM,87207,CPT,306,RC,outpatient,,,,55.4346,30.48903,,49.89114,90,percent of total billed charges,,,,55.4346,100,percent of total billed charges,,,6.8286,,,fee schedule,,,6.8286,,,fee schedule,,,6.8286,,,fee schedule,,,,,,,,,,,,,,,,47.11941,85,percent of total billed charges,,,,,,,,,,27.58980042,49.77,percent of total billed charges,,,,49.89114,90,percent of total billed charges,,,,52.66287,90,percent of total billed charges,,,,,,,,,8.56,,,fee schedule,,,10.8712,,,fee schedule,,,,47.11941,85,percent of total billed charges,,,,,,,,,6.8286,55.4346,
OPTHOCHIN TEST,3060270,CDM,87163,CPT,306,RC,outpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,,,,,,,44.5887,,,fee schedule,,,39.6344,,,fee schedule,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,,24.6575511,49.77,percent of total billed charges,,,,44.5887,90,percent of total billed charges,,,,47.06585,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,24.6575511,49.543,
ENTEROVIRUS GROUP PCR,3060273,CDM,87798,CPT,306,RC,outpatient,,,,415.193,228.35615,,373.6737,90,percent of total billed charges,,,,415.193,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,352.91405,85,percent of total billed charges,,,,,,,,,,206.6415561,49.77,percent of total billed charges,,,,373.6737,90,percent of total billed charges,,,,394.43335,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,352.91405,85,percent of total billed charges,,,,,,,,,40.0026,415.193,
OVA CYSTS PARA FECES,3060280,CDM,87177,CPT,306,RC,outpatient,,,,72.821,40.05155,,65.5389,90,percent of total billed charges,,,,72.821,100,percent of total billed charges,,,10.146,,,fee schedule,,,10.146,,,fee schedule,,,10.146,,,fee schedule,,,,,,,,,,,,,,,,61.89785,85,percent of total billed charges,,,,,,,,,,36.2430117,49.77,percent of total billed charges,,,,65.5389,90,percent of total billed charges,,,,69.17995,90,percent of total billed charges,,,,,,,,,12.71,,,fee schedule,,,16.1417,,,fee schedule,,,,61.89785,85,percent of total billed charges,,,,,,,,,10.146,72.821,
POTASSIUM OH,3060320,CDM,87210,CPT,306,RC,outpatient,,,,32.239,17.73145,,29.0151,90,percent of total billed charges,,,,32.239,100,percent of total billed charges,,,6.6348,,,fee schedule,,,6.6348,,,fee schedule,,,6.6348,,,fee schedule,,,,,,,,,,,,,,,,27.40315,85,percent of total billed charges,,,,,,,,,,16.0453503,49.77,percent of total billed charges,,,,29.0151,90,percent of total billed charges,,,,30.62705,90,percent of total billed charges,,,,,,,,,6.1,,,fee schedule,,,7.747,,,fee schedule,,,,27.40315,85,percent of total billed charges,,,,,,,,,6.1,32.239,
GRAM STAIN,3060350,CDM,87205,CPT,306,RC,outpatient,,,,40.582,22.3201,,36.5238,90,percent of total billed charges,,,,40.582,100,percent of total billed charges,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,4.8678,,,fee schedule,,,,,,,,,,,,,,,,34.4947,85,percent of total billed charges,,,,,,,,,,20.1976614,49.77,percent of total billed charges,,,,36.5238,90,percent of total billed charges,,,,38.5529,90,percent of total billed charges,,,,,,,,,6.1,,,fee schedule,,,7.747,,,fee schedule,,,,34.4947,85,percent of total billed charges,,,,,,,,,4.8678,40.582,
STAPH LATEX,3060360,CDM,87163,CPT,306,RC,outpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,,,,,,,44.5887,,,fee schedule,,,39.6344,,,fee schedule,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,,24.6575511,49.77,percent of total billed charges,,,,44.5887,90,percent of total billed charges,,,,47.06585,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,24.6575511,49.543,
VIRAL CULTURE R/L,3060370,CDM,87252,CPT,306,RC,outpatient,,,,323.111,177.71105,,290.7999,90,percent of total billed charges,,,,323.111,100,percent of total billed charges,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,,,,,,,,,,,,,,274.64435,85,percent of total billed charges,,,,,,,,,,160.8123447,49.77,percent of total billed charges,,,,290.7999,90,percent of total billed charges,,,,306.95545,90,percent of total billed charges,,,,,,,,,37.22,,,fee schedule,,,47.2694,,,fee schedule,,,,274.64435,85,percent of total billed charges,,,,,,,,,29.7198,323.111,
WET PREP,3060390,CDM,87210,CPT,306,RC,outpatient,,,,40.582,22.3201,,36.5238,90,percent of total billed charges,,,,40.582,100,percent of total billed charges,,,6.6348,,,fee schedule,,,6.6348,,,fee schedule,,,6.6348,,,fee schedule,,,,,,,,,,,,,,,,34.4947,85,percent of total billed charges,,,,,,,,,,20.1976614,49.77,percent of total billed charges,,,,36.5238,90,percent of total billed charges,,,,38.5529,90,percent of total billed charges,,,,,,,,,6.1,,,fee schedule,,,7.747,,,fee schedule,,,,34.4947,85,percent of total billed charges,,,,,,,,,6.1,40.582,
SPECIAL MICROBIOLOGY CULTURE,3060410,CDM,87076,CPT,306,RC,outpatient,,,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,9.2112,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,11.53,,,fee schedule,,,14.6431,,,fee schedule,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,14.935,
STREP ID - GROUP A,3060420,CDM,87147,CPT,306,RC,outpatient,,,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,19.0859,85,percent of total billed charges,,,,,,,,,,11.1753558,49.77,percent of total billed charges,,,,20.2086,90,percent of total billed charges,,,,21.3313,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,19.0859,85,percent of total billed charges,,,,,,,,,5.9052,22.454,
STREP ID - GROUP B,3060421,CDM,87147,CPT,306,RC,outpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,,24.6575511,49.77,percent of total billed charges,,,,44.5887,90,percent of total billed charges,,,,47.06585,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,42.11155,85,percent of total billed charges,,,,,,,,,5.9052,49.543,
STREP ID - GROUP C,3060422,CDM,87147,CPT,306,RC,outpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,,24.6575511,49.77,percent of total billed charges,,,,44.5887,90,percent of total billed charges,,,,47.06585,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,42.11155,85,percent of total billed charges,,,,,,,,,5.9052,49.543,
STREP ID - GROUP F,3060423,CDM,87147,CPT,306,RC,outpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,,24.6575511,49.77,percent of total billed charges,,,,44.5887,90,percent of total billed charges,,,,47.06585,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,42.11155,85,percent of total billed charges,,,,,,,,,5.9052,49.543,
STREP ID - GROUP G,3060424,CDM,87147,CPT,306,RC,outpatient,,,,49.543,27.24865,,44.5887,90,percent of total billed charges,,,,49.543,100,percent of total billed charges,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,5.9052,,,fee schedule,,,,,,,,,,,,,,,,42.11155,85,percent of total billed charges,,,,,,,,,,24.6575511,49.77,percent of total billed charges,,,,44.5887,90,percent of total billed charges,,,,47.06585,90,percent of total billed charges,,,,,,,,,7.39,,,fee schedule,,,9.3853,,,fee schedule,,,,42.11155,85,percent of total billed charges,,,,,,,,,5.9052,49.543,
HERPES CULTURE - TYPE 2,3060430,CDM,87252,CPT,306,RC,outpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,29.7198,,,fee schedule,,,,,,,,,,,,,,,,56.5573,85,percent of total billed charges,,,,,,,,,,33.1159626,49.77,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,63.2111,90,percent of total billed charges,,,,,,,,,37.22,,,fee schedule,,,47.2694,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,,,,,,,29.7198,66.538,
HIV RNA/PCR QUANT (VIRAL LOAD),3060530,CDM,87536,CPT,306,RC,outpatient,,,,487.602,268.1811,,438.8418,90,percent of total billed charges,,,,487.602,100,percent of total billed charges,,,97.014,,,fee schedule,,,97.014,,,fee schedule,,,97.014,,,fee schedule,,,,,,,,,,,,,,,,414.4617,85,percent of total billed charges,,,,,,,,,,242.6795154,49.77,percent of total billed charges,,,,438.8418,90,percent of total billed charges,,,,463.2219,90,percent of total billed charges,,,,,,,,,121.51,,,fee schedule,,,154.3177,,,fee schedule,,,,414.4617,85,percent of total billed charges,,,,,,,,,97.014,487.602,
"VARICELLA (VZV) DNA, QL RT PCR",3060973,CDM,87798,CPT,306,RC,outpatient,,,,376.877,207.28235,,339.1893,90,percent of total billed charges,,,,376.877,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,320.34545,85,percent of total billed charges,,,,,,,,,,187.5716829,49.77,percent of total billed charges,,,,339.1893,90,percent of total billed charges,,,,358.03315,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,320.34545,85,percent of total billed charges,,,,,,,,,40.0026,376.877,
EPSTEIN-BARR VIRUS PCR QUANT,3061018,CDM,87799,CPT,306,RC,outpatient,,,,273.465,150.40575,,246.1185,90,percent of total billed charges,,,,273.465,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,,,,,,,,,,,,,,232.44525,85,percent of total billed charges,,,,,,,,,,136.1035305,49.77,percent of total billed charges,,,,246.1185,90,percent of total billed charges,,,,259.79175,90,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,77.6859,,,fee schedule,,,,232.44525,85,percent of total billed charges,,,,,,,,,48.8376,273.465,
LACTOBACILLUS SPECIES,3061550,CDM,87799,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,77.6859,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,47.5208937,95.481,
C DIFF AMPLIFIED PROBE,3061637,CDM,87493,CPT,306,RC,outpatient,,,,178.911,98.40105,,161.0199,90,percent of total billed charges,,,,178.911,100,percent of total billed charges,,,42.4878,,,fee schedule,,,42.4878,,,fee schedule,,,42.4878,,,fee schedule,,,,,,,,,,,,,,,,152.07435,85,percent of total billed charges,,,,,,,,,,89.0440047,49.77,percent of total billed charges,,,,161.0199,90,percent of total billed charges,,,,169.96545,90,percent of total billed charges,,,,,,,,,51.95,,,fee schedule,,,65.9765,,,fee schedule,,,,152.07435,85,percent of total billed charges,,,,,,,,,42.4878,178.911,
CANDIDA ALBICAUS,3064818,CDM,87481,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,40.0026,95.481,
MEGASPHAERA SPECIES,3065091,CDM,87799,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,77.6859,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,47.5208937,95.481,
ATOPOBIUM VAGINAL,3065509,CDM,87799,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,77.6859,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,47.5208937,95.481,
OVA & PARASITE COLON WASHING,3067209,CDM,87209,CPT,306,RC,outpatient,,,,73.954,40.6747,,66.5586,90,percent of total billed charges,,,,73.954,100,percent of total billed charges,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,20.4972,,,fee schedule,,,,,,,,,,,,,,,,62.8609,85,percent of total billed charges,,,,,,,,,,36.8069058,49.77,percent of total billed charges,,,,66.5586,90,percent of total billed charges,,,,70.2563,90,percent of total billed charges,,,,,,,,,25.95,,,fee schedule,,,32.9565,,,fee schedule,,,,62.8609,85,percent of total billed charges,,,,,,,,,20.4972,73.954,
LYME TEST BY PCR,3067476,CDM,87801,CPT,306,RC,outpatient,,,,357.719,196.74545,,321.9471,90,percent of total billed charges,,,,357.719,100,percent of total billed charges,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,,,,,,,,,,,,,,304.06115,85,percent of total billed charges,,,,,,,,,,178.0367463,49.77,percent of total billed charges,,,,321.9471,90,percent of total billed charges,,,,339.83305,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,304.06115,85,percent of total billed charges,,,,,,,,,50.12,357.719,
CANDIDA TROPICALIS,3067481,CDM,87481,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,40.0026,95.481,
CHLYMD TRACH DNA AMP PROBE,3067491,CDM,87491,CPT,306,RC,outpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,121.08165,85,percent of total billed charges,,,,,,,,,,70.8968673,49.77,percent of total billed charges,,,,128.2041,90,percent of total billed charges,,,,135.32655,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,121.08165,85,percent of total billed charges,,,,,,,,,40.0026,142.449,
CYTOMEGALOVIRUS - PCR - QUANT,3067497,CDM,87497,CPT,306,RC,outpatient,,,,491.207,270.16385,,442.0863,90,percent of total billed charges,,,,491.207,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,,,,,,,,,,,,,,417.52595,85,percent of total billed charges,,,,,,,,,,244.4737239,49.77,percent of total billed charges,,,,442.0863,90,percent of total billed charges,,,,466.64665,90,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,77.6859,,,fee schedule,,,,417.52595,85,percent of total billed charges,,,,,,,,,48.8376,491.207,
GC NUCLEIC ACID AMPLIFICATION,3067591,CDM,87591,CPT,306,RC,outpatient,,,,142.449,78.34695,,128.2041,90,percent of total billed charges,,,,142.449,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,121.08165,85,percent of total billed charges,,,,,,,,,,70.8968673,49.77,percent of total billed charges,,,,128.2041,90,percent of total billed charges,,,,135.32655,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,121.08165,85,percent of total billed charges,,,,,,,,,40.0026,142.449,
CANDIDA GLABRATA,3068187,CDM,87481,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,40.0026,95.481,
SUSCEPTIBILITY STUDY - MIC,3068718,CDM,87186,CPT,306,RC,outpatient,,,,116.39,64.0145,,104.751,90,percent of total billed charges,,,,116.39,100,percent of total billed charges,,,9.861,,,fee schedule,,,9.861,,,fee schedule,,,9.861,,,fee schedule,,,,,,,,,,,,,,,,98.9315,85,percent of total billed charges,,,,,,,,,,57.927303,49.77,percent of total billed charges,,,,104.751,90,percent of total billed charges,,,,110.5705,90,percent of total billed charges,,,,,,,,,8.24,,,fee schedule,,,10.4648,,,fee schedule,,,,98.9315,85,percent of total billed charges,,,,,,,,,8.24,116.39,
AFB SMEAR,3068720,CDM,87206,CPT,306,RC,outpatient,,,,30.694,16.8817,,27.6246,90,percent of total billed charges,,,,30.694,100,percent of total billed charges,,,6.1446,,,fee schedule,,,6.1446,,,fee schedule,,,6.1446,,,fee schedule,,,,,,,,,,,,,,,,26.0899,85,percent of total billed charges,,,,,,,,,,15.2764038,49.77,percent of total billed charges,,,,27.6246,90,percent of total billed charges,,,,29.1593,90,percent of total billed charges,,,,,,,,,7.67,,,fee schedule,,,9.7409,,,fee schedule,,,,26.0899,85,percent of total billed charges,,,,,,,,,6.1446,30.694,
CANDIDA PARAPSILOSIS,3068748,CDM,87481,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,40.0026,95.481,
GARDNERELLA VAGINALIS,3068751,CDM,87512,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,47.6064,,,fee schedule,,,47.6064,,,fee schedule,,,47.6064,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,23.52,,,fee schedule,,,29.8704,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,23.52,95.481,
HIV-1 PROBE & REVERSE TRNSCRP,3068753,CDM,87535,CPT,306,RC,outpatient,,,,368.431,202.63705,,331.5879,90,percent of total billed charges,,,,368.431,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,313.16635,85,percent of total billed charges,,,,,,,,,,183.3681087,49.77,percent of total billed charges,,,,331.5879,90,percent of total billed charges,,,,350.00945,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,313.16635,85,percent of total billed charges,,,,,,,,,40.0026,368.431,
TRICHOMONAS VAGINALIS,3068766,CDM,87661,CPT,306,RC,outpatient,,,,95.481,52.51455,,85.9329,90,percent of total billed charges,,,,95.481,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,81.15885,85,percent of total billed charges,,,,,,,,,,47.5208937,49.77,percent of total billed charges,,,,85.9329,90,percent of total billed charges,,,,90.70695,90,percent of total billed charges,,,,,,,,,47.87,,,fee schedule,,,60.7949,,,fee schedule,,,,81.15885,85,percent of total billed charges,,,,,,,,,40.0026,95.481,
HERPES SIM VIRUS I PCR CSF,3068780,CDM,87801,CPT,306,RC,outpatient,,,,177.057,97.38135,,159.3513,90,percent of total billed charges,,,,177.057,100,percent of total billed charges,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,80.028,,,fee schedule,,,,,,,,,,,,,,,,150.49845,85,percent of total billed charges,,,,,,,,,,88.1212689,49.77,percent of total billed charges,,,,159.3513,90,percent of total billed charges,,,,168.20415,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,150.49845,85,percent of total billed charges,,,,,,,,,50.12,177.057,
HEPATITIS C VIRUS GENOTYPING,3068790,CDM,87902,CPT,306,RC,outpatient,,,,739.437,406.69035,,665.4933,90,percent of total billed charges,,,,739.437,100,percent of total billed charges,,,293.493,,,fee schedule,,,293.493,,,fee schedule,,,293.493,,,fee schedule,,,,,,,,,,,,,,,,628.52145,85,percent of total billed charges,,,,,,,,,,368.0177949,49.77,percent of total billed charges,,,,665.4933,90,percent of total billed charges,,,,702.46515,90,percent of total billed charges,,,,,,,,,364.64,,,fee schedule,,,463.0928,,,fee schedule,,,,628.52145,85,percent of total billed charges,,,,,,,,,293.493,739.437,
SURESWAB CAND NUCLEIC ACID PRO,3068791,CDM,87481,CPT,306,RC,outpatient,,,,290.666,159.8663,,261.5994,90,percent of total billed charges,,,,290.666,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,247.0661,85,percent of total billed charges,,,,,,,,,,144.6644682,49.77,percent of total billed charges,,,,261.5994,90,percent of total billed charges,,,,276.1327,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,247.0661,85,percent of total billed charges,,,,,,,,,40.0026,290.666,
SURESWAB - GLABRATA,3068792,CDM,87481,CPT,306,RC,outpatient,,,,290.666,159.8663,,261.5994,90,percent of total billed charges,,,,290.666,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,247.0661,85,percent of total billed charges,,,,,,,,,,144.6644682,49.77,percent of total billed charges,,,,261.5994,90,percent of total billed charges,,,,276.1327,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,247.0661,85,percent of total billed charges,,,,,,,,,40.0026,290.666,
SURESWAB - TRICHOMONAS,3068793,CDM,87661,CPT,306,RC,outpatient,,,,290.666,159.8663,,261.5994,90,percent of total billed charges,,,,290.666,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,247.0661,85,percent of total billed charges,,,,,,,,,,144.6644682,49.77,percent of total billed charges,,,,261.5994,90,percent of total billed charges,,,,276.1327,90,percent of total billed charges,,,,,,,,,47.87,,,fee schedule,,,60.7949,,,fee schedule,,,,247.0661,85,percent of total billed charges,,,,,,,,,40.0026,290.666,
SURESWAB - LACTOBACILLUS,3068794,CDM,87798,CPT,306,RC,outpatient,,,,290.666,159.8663,,261.5994,90,percent of total billed charges,,,,290.666,100,percent of total billed charges,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,40.0026,,,fee schedule,,,,,,,,,,,,,,,,247.0661,85,percent of total billed charges,,,,,,,,,,144.6644682,49.77,percent of total billed charges,,,,261.5994,90,percent of total billed charges,,,,276.1327,90,percent of total billed charges,,,,,,,,,50.12,,,fee schedule,,,63.6524,,,fee schedule,,,,247.0661,85,percent of total billed charges,,,,,,,,,40.0026,290.666,
HEPATITIS BE AG IA,3090025,CDM,87350,CPT,306,RC,outpatient,,,,132.664,72.9652,,119.3976,90,percent of total billed charges,,,,132.664,100,percent of total billed charges,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,13.1442,,,fee schedule,,,,,,,,,,,,,,,,112.7644,85,percent of total billed charges,,,,,,,,,,66.0268728,49.77,percent of total billed charges,,,,119.3976,90,percent of total billed charges,,,,126.0308,90,percent of total billed charges,,,,,,,,,16.45,,,fee schedule,,,20.8915,,,fee schedule,,,,112.7644,85,percent of total billed charges,,,,,,,,,13.1442,132.664,
"HEPATITIS B VIRUS DNA, QUANT",3090027,CDM,87517,CPT,306,RC,outpatient,,,,305.807,168.19385,,275.2263,90,percent of total billed charges,,,,305.807,100,percent of total billed charges,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,48.8376,,,fee schedule,,,,,,,,,,,,,,,,259.93595,85,percent of total billed charges,,,,,,,,,,152.2001439,49.77,percent of total billed charges,,,,275.2263,90,percent of total billed charges,,,,290.51665,90,percent of total billed charges,,,,,,,,,61.17,,,fee schedule,,,77.6859,,,fee schedule,,,,259.93595,85,percent of total billed charges,,,,,,,,,48.8376,305.807,
URINE COLLECT - 24 HOUR,3012460,CDM,81050,CPT,307,RC,outpatient,,,,19.673,10.82015,,17.7057,90,percent of total billed charges,,,,19.673,100,percent of total billed charges,,,4.1496,,,fee schedule,,,4.1496,,,fee schedule,,,4.1496,,,fee schedule,,,,,,,,,,,,,,,,16.72205,85,percent of total billed charges,,,,,,,,,,9.7912521,49.77,percent of total billed charges,,,,17.7057,90,percent of total billed charges,,,,18.68935,90,percent of total billed charges,,,,,,,,,4.28,,,fee schedule,,,5.4356,,,fee schedule,,,,16.72205,85,percent of total billed charges,,,,,,,,,4.1496,19.673,
PREG TEST- URINE,3070050,CDM,81025,CPT,307,RC,outpatient,,,,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,9.8154,,,fee schedule,,,9.8154,,,fee schedule,,,9.8154,,,fee schedule,,,,,,,,,,,,,,,,49.2031,85,percent of total billed charges,,,,,,,,,,28.8098622,49.77,percent of total billed charges,,,,52.0974,90,percent of total billed charges,,,,54.9917,90,percent of total billed charges,,,,,,,,,8.74,,,fee schedule,,,11.0998,,,fee schedule,,,,49.2031,85,percent of total billed charges,,,,,,,,,8.74,57.886,
REDUCING SUB URINE,3070060,CDM,81002,CPT,307,RC,outpatient,,,,25.956,14.2758,,23.3604,90,percent of total billed charges,,,,25.956,100,percent of total billed charges,,,3.9672,,,fee schedule,,,3.9672,,,fee schedule,,,3.9672,,,fee schedule,,,,,,,,,,,,,,,,22.0626,85,percent of total billed charges,,,,,,,,,,12.9183012,49.77,percent of total billed charges,,,,23.3604,90,percent of total billed charges,,,,24.6582,90,percent of total billed charges,,,,,,,,,3.66,,,fee schedule,,,4.6482,,,fee schedule,,,,22.0626,85,percent of total billed charges,,,,,,,,,3.66,25.956,
URINALYSIS DIPSTICK,3070080,CDM,81002,CPT,307,RC,outpatient,,,,21.218,11.6699,,19.0962,90,percent of total billed charges,,,,21.218,100,percent of total billed charges,,,3.9672,,,fee schedule,,,3.9672,,,fee schedule,,,3.9672,,,fee schedule,,,,,,,,,,,,,,,,18.0353,85,percent of total billed charges,,,,,,,,,,10.5601986,49.77,percent of total billed charges,,,,19.0962,90,percent of total billed charges,,,,20.1571,90,percent of total billed charges,,,,,,,,,3.66,,,fee schedule,,,4.6482,,,fee schedule,,,,18.0353,85,percent of total billed charges,,,,,,,,,3.66,21.218,
URINALYSIS MICRO ONLY,3070090,CDM,81015,CPT,307,RC,outpatient,,,,28.325,15.57875,,25.4925,90,percent of total billed charges,,,,28.325,100,percent of total billed charges,,,3.477,,,fee schedule,,,3.477,,,fee schedule,,,3.477,,,fee schedule,,,,,,,,,,,,,,,,24.07625,85,percent of total billed charges,,,,,,,,,,14.0973525,49.77,percent of total billed charges,,,,25.4925,90,percent of total billed charges,,,,26.90875,90,percent of total billed charges,,,,,,,,,4.34,,,fee schedule,,,5.5118,,,fee schedule,,,,24.07625,85,percent of total billed charges,,,,,,,,,3.477,28.325,
CRYSTAL ID,3090000,CDM,89060,CPT,309,RC,outpatient,,,,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,8.3562,,,fee schedule,,,8.3562,,,fee schedule,,,8.3562,,,fee schedule,,,,,,,,,,,,,,,,46.13885,85,percent of total billed charges,,,,,,,,,,27.0156537,49.77,percent of total billed charges,,,,48.8529,90,percent of total billed charges,,,,51.56695,90,percent of total billed charges,,,,,,,,,10.21,,,fee schedule,,,12.9667,,,fee schedule,,,,46.13885,85,percent of total billed charges,,,,,,,,,8.3562,54.281,
FACTOR 5 LEIDEN,3001241,CDM,81241,CPT,310,RC,outpatient,,,,458.968,252.4324,,413.0712,90,percent of total billed charges,,,,458.968,100,percent of total billed charges,,,83.6418,,,fee schedule,,,83.6418,,,fee schedule,,,83.6418,,,fee schedule,,,,,,,,,,,,,,,,390.1228,85,percent of total billed charges,,,,,,,,,,228.4283736,49.77,percent of total billed charges,,,,413.0712,90,percent of total billed charges,,,,436.0196,90,percent of total billed charges,,,,,,,,,58.32,,,fee schedule,,,74.0664,,,fee schedule,,,,390.1228,85,percent of total billed charges,,,,,,,,,58.32,458.968,
FACTOR 2 DNA ANALYSIS,3008124,CDM,81240,CPT,310,RC,outpatient,,,,454.539,249.99645,,409.0851,90,percent of total billed charges,,,,454.539,100,percent of total billed charges,,,74.8866,,,fee schedule,,,74.8866,,,fee schedule,,,74.8866,,,fee schedule,,,,,,,,,,,,,,,,386.35815,85,percent of total billed charges,,,,,,,,,,226.2240603,49.77,percent of total billed charges,,,,409.0851,90,percent of total billed charges,,,,431.81205,90,percent of total billed charges,,,,,,,,,30.81,,,fee schedule,,,39.1287,,,fee schedule,,,,386.35815,85,percent of total billed charges,,,,,,,,,30.81,454.539,
QNATAL,3008142,CDM,81420,CPT,310,RC,outpatient,,,,3337.715,1835.74325,,3003.9435,90,percent of total billed charges,,,,3337.715,100,percent of total billed charges,,,865.317,,,fee schedule,,,865.317,,,fee schedule,,,865.317,,,fee schedule,,,,,,,,,,,,,,,,2837.05775,85,percent of total billed charges,,,,,,,,,,1661.180756,49.77,percent of total billed charges,,,,3003.9435,90,percent of total billed charges,,,,3170.82925,90,percent of total billed charges,,,,,,,,,985.8,,,fee schedule,,,1251.966,,,fee schedule,,,,2837.05775,85,percent of total billed charges,,,,,,,,,865.317,3337.715,
FRAGILE X PCR,3018124,CDM,81243,CPT,310,RC,outpatient,,,,357.719,196.74545,,321.9471,90,percent of total billed charges,,,,357.719,100,percent of total billed charges,,,65.0256,,,fee schedule,,,65.0256,,,fee schedule,,,65.0256,,,fee schedule,,,,,,,,,,,,,,,,304.06115,85,percent of total billed charges,,,,,,,,,,178.0367463,49.77,percent of total billed charges,,,,321.9471,90,percent of total billed charges,,,,339.83305,90,percent of total billed charges,,,,,,,,,64.66,,,fee schedule,,,82.1182,,,fee schedule,,,,304.06115,85,percent of total billed charges,,,,,,,,,64.66,357.719,
TISSUE CULTURE,3098823,CDM,88230,CPT,310,RC,outpatient,,,,357.719,196.74545,,321.9471,90,percent of total billed charges,,,,357.719,100,percent of total billed charges,,,132.7986,,,fee schedule,,,132.7986,,,fee schedule,,,132.7986,,,fee schedule,,,,,,,,,,,,,,,,304.06115,85,percent of total billed charges,,,,,,,,,,178.0367463,49.77,percent of total billed charges,,,,321.9471,90,percent of total billed charges,,,,339.83305,90,percent of total billed charges,,,,,,,,,91.26,,,fee schedule,,,115.9002,,,fee schedule,,,,304.06115,85,percent of total billed charges,,,,,,,,,91.26,357.719,
CHROMOSOME ANALYSIS,3098826,CDM,88262,CPT,310,RC,outpatient,,,,476.89,262.2895,,429.201,90,percent of total billed charges,,,,476.89,100,percent of total billed charges,,,143.0586,,,fee schedule,,,143.0586,,,fee schedule,,,143.0586,,,fee schedule,,,,,,,,,,,,,,,,405.3565,85,percent of total billed charges,,,,,,,,,,237.348153,49.77,percent of total billed charges,,,,429.201,90,percent of total billed charges,,,,453.0455,90,percent of total billed charges,,,,,,,,,177.99,,,fee schedule,,,226.0473,,,fee schedule,,,,405.3565,85,percent of total billed charges,,,,,,,,,143.0586,476.89,
"Cytopathology,selective cellul",3108112,CDM,88112,CPT,310,RC,outpatient,,,,54.899,30.19445,,49.4091,90,percent of total billed charges,,,,54.899,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,67.9065,,,fee schedule,,,67.9065,,,fee schedule,,,,46.66415,85,percent of total billed charges,,,67.9065,,,fee schedule,,,,27.3232323,49.77,percent of total billed charges,,,,49.4091,90,percent of total billed charges,,,,52.15405,90,percent of total billed charges,,,69.943695,,,fee schedule,,,55.88,,,fee schedule,,,70.9676,,,fee schedule,,,,46.66415,85,percent of total billed charges,,,67.9065,,,fee schedule,,,27.3232323,70.9676,
HEREDITARY HEMACHROMATOSIS,3108125,CDM,81256,CPT,310,RC,outpatient,,,,243.08,133.694,,218.772,90,percent of total billed charges,,,,243.08,100,percent of total billed charges,,,74.5104,,,fee schedule,,,74.5104,,,fee schedule,,,74.5104,,,fee schedule,,,,,,,,,,,,,,,,206.618,85,percent of total billed charges,,,,,,,,,,120.980916,49.77,percent of total billed charges,,,,218.772,90,percent of total billed charges,,,,230.926,90,percent of total billed charges,,,,,,,,,77.28,,,fee schedule,,,98.1456,,,fee schedule,,,,206.618,85,percent of total billed charges,,,,,,,,,74.5104,243.08,
HLA CLASS - B51,3108138,CDM,81381,CPT,310,RC,outpatient,,,,1040.712,572.3916,,936.6408,90,percent of total billed charges,,,,1040.712,100,percent of total billed charges,,,193.686,,,fee schedule,,,193.686,,,fee schedule,,,193.686,,,fee schedule,,,,,,,,,,,,,,,,884.6052,85,percent of total billed charges,,,,,,,,,,517.9623624,49.77,percent of total billed charges,,,,936.6408,90,percent of total billed charges,,,,988.6764,90,percent of total billed charges,,,,,,,,,96.72,,,fee schedule,,,122.8344,,,fee schedule,,,,884.6052,85,percent of total billed charges,,,,,,,,,96.72,1040.712,
CYTP FNA INTERPRET & REPORT,3108173,CDM,88173,CPT,310,RC,outpatient,,,,116.184,63.9012,,104.5656,90,percent of total billed charges,,,,116.184,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,167.10325,,,fee schedule,,,167.10325,,,fee schedule,,,,98.7564,85,percent of total billed charges,,,167.10325,,,fee schedule,,,,57.8247768,49.77,percent of total billed charges,,,,104.5656,90,percent of total billed charges,,,,110.3748,90,percent of total billed charges,,,172.1163475,,,fee schedule,,,,,,,,,,,,,,,,98.7564,85,percent of total billed charges,,,167.10325,,,fee schedule,,,51.6648,172.1163475,
Level I - Surgical pathology,3108300,CDM,88300,CPT,310,RC,outpatient,,,,18.54,10.197,,16.686,90,percent of total billed charges,,,,18.54,100,percent of total billed charges,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,16.310875,,,fee schedule,,,16.310875,,,fee schedule,,,,15.759,85,percent of total billed charges,,,16.310875,,,fee schedule,,,,9.227358,49.77,percent of total billed charges,,,,16.686,90,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,16.80020125,,,fee schedule,,,9,,,fee schedule,,,11.43,,,fee schedule,,,,15.759,85,percent of total billed charges,,,16.310875,,,fee schedule,,,9,25.7184,
Level II - Surgical pathology,3108302,CDM,88302,CPT,310,RC,outpatient,,,,34.608,19.0344,,31.1472,90,percent of total billed charges,,,,34.608,100,percent of total billed charges,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,25.7184,,,fee schedule,,,33.2875,,,fee schedule,,,33.2875,,,fee schedule,,,,29.4168,85,percent of total billed charges,,,33.2875,,,fee schedule,,,,17.2244016,49.77,percent of total billed charges,,,,31.1472,90,percent of total billed charges,,,,32.8776,90,percent of total billed charges,,,34.286125,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,29.4168,85,percent of total billed charges,,,33.2875,,,fee schedule,,,17.2244016,34.608,
Level III - Surgical pathology,3108304,CDM,88304,CPT,310,RC,outpatient,,,,54.899,30.19445,,49.4091,90,percent of total billed charges,,,,54.899,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,42.940875,,,fee schedule,,,42.940875,,,fee schedule,,,,46.66415,85,percent of total billed charges,,,42.940875,,,fee schedule,,,,27.3232323,49.77,percent of total billed charges,,,,49.4091,90,percent of total billed charges,,,,52.15405,90,percent of total billed charges,,,44.22910125,,,fee schedule,,,22,,,fee schedule,,,27.94,,,fee schedule,,,,46.66415,85,percent of total billed charges,,,42.940875,,,fee schedule,,,22,54.899,
Level IV - Surgical pathology,3108305,CDM,88305,CPT,310,RC,outpatient,,,,51.191,28.15505,,46.0719,90,percent of total billed charges,,,,51.191,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,71.568125,,,fee schedule,,,71.568125,,,fee schedule,,,,43.51235,85,percent of total billed charges,,,71.568125,,,fee schedule,,,,25.4777607,49.77,percent of total billed charges,,,,46.0719,90,percent of total billed charges,,,,48.63145,90,percent of total billed charges,,,73.71516875,,,fee schedule,,,28,,,fee schedule,,,35.56,,,fee schedule,,,,43.51235,85,percent of total billed charges,,,71.568125,,,fee schedule,,,25.4777607,73.71516875,
Level V - Surgical pathology,3108307,CDM,88307,CPT,310,RC,outpatient,,,,295.198,162.3589,,265.6782,90,percent of total billed charges,,,,295.198,100,percent of total billed charges,,,334.0314,,,fee schedule,,,334.0314,,,fee schedule,,,334.0314,,,fee schedule,,,287.604,,,fee schedule,,,287.604,,,fee schedule,,,,250.9183,85,percent of total billed charges,,,287.604,,,fee schedule,,,,146.9200446,49.77,percent of total billed charges,,,,265.6782,90,percent of total billed charges,,,,280.4381,90,percent of total billed charges,,,296.23212,,,fee schedule,,,53,,,fee schedule,,,67.31,,,fee schedule,,,,250.9183,85,percent of total billed charges,,,287.604,,,fee schedule,,,53,334.0314,
Level VI - Surgical pathology,3108309,CDM,88309,CPT,310,RC,outpatient,,,,600.696,330.3828,,540.6264,90,percent of total billed charges,,,,600.696,100,percent of total billed charges,,,800.2686,,,fee schedule,,,800.2686,,,fee schedule,,,800.2686,,,fee schedule,,,432.07175,,,fee schedule,,,432.07175,,,fee schedule,,,,510.5916,85,percent of total billed charges,,,432.07175,,,fee schedule,,,,298.9663992,49.77,percent of total billed charges,,,,540.6264,90,percent of total billed charges,,,,570.6612,90,percent of total billed charges,,,445.0339025,,,fee schedule,,,46,,,fee schedule,,,58.42,,,fee schedule,,,,510.5916,85,percent of total billed charges,,,432.07175,,,fee schedule,,,46,800.2686,
Decalcification procedure,3108311,CDM,88311,CPT,310,RC,outpatient,,,,14.523,7.98765,,13.0707,90,percent of total billed charges,,,,14.523,100,percent of total billed charges,,,7.82,,,fee schedule,,,7.82,,,fee schedule,,,7.82,,,fee schedule,,,20.305375,,,fee schedule,,,20.305375,,,fee schedule,,,,12.34455,85,percent of total billed charges,,,20.305375,,,fee schedule,,,,7.2280971,49.77,percent of total billed charges,,,,13.0707,90,percent of total billed charges,,,,13.79685,90,percent of total billed charges,,,20.91453625,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,12.34455,85,percent of total billed charges,,,20.305375,,,fee schedule,,,7.2280971,20.91453625,
SPECIAL STAIN GROUP I,3108312,CDM,88312,CPT,310,RC,outpatient,,,,94.245,51.83475,,84.8205,90,percent of total billed charges,,,,94.245,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,112.51175,,,fee schedule,,,112.51175,,,fee schedule,,,,80.10825,85,percent of total billed charges,,,112.51175,,,fee schedule,,,,46.9057365,49.77,percent of total billed charges,,,,84.8205,90,percent of total billed charges,,,,89.53275,90,percent of total billed charges,,,115.8871025,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,80.10825,85,percent of total billed charges,,,112.51175,,,fee schedule,,,13,115.8871025,
SPECIAL STAIN GROUP II,3108313,CDM,88313,CPT,310,RC,outpatient,,,,76.735,42.20425,,69.0615,90,percent of total billed charges,,,,76.735,100,percent of total billed charges,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,82.885875,,,fee schedule,,,82.885875,,,fee schedule,,,,65.22475,85,percent of total billed charges,,,82.885875,,,fee schedule,,,,38.1910095,49.77,percent of total billed charges,,,,69.0615,90,percent of total billed charges,,,,72.89825,90,percent of total billed charges,,,85.37245125,,,fee schedule,,,7,,,fee schedule,,,8.89,,,fee schedule,,,,65.22475,85,percent of total billed charges,,,82.885875,,,fee schedule,,,7,85.37245125,
Immunohistochemistry ea add'l,3108341,CDM,88341,CPT,310,RC,outpatient,,,,82.606,45.4333,,74.3454,90,percent of total billed charges,,,,82.606,100,percent of total billed charges,,,56.88,,,fee schedule,,,56.88,,,fee schedule,,,56.88,,,fee schedule,,,90.542,,,fee schedule,,,90.542,,,fee schedule,,,,70.2151,85,percent of total billed charges,,,90.542,,,fee schedule,,,,41.1130062,49.77,percent of total billed charges,,,,74.3454,90,percent of total billed charges,,,,78.4757,90,percent of total billed charges,,,93.25826,,,fee schedule,,,40.26,,,fee schedule,,,51.1302,,,fee schedule,,,,70.2151,85,percent of total billed charges,,,90.542,,,fee schedule,,,40.26,93.25826,
Immunohistochemistry per spec,3108342,CDM,88342,CPT,310,RC,outpatient,,,,93.73,51.5515,,84.357,90,percent of total billed charges,,,,93.73,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,105.85425,,,fee schedule,,,105.85425,,,fee schedule,,,,79.6705,85,percent of total billed charges,,,105.85425,,,fee schedule,,,,46.649421,49.77,percent of total billed charges,,,,84.357,90,percent of total billed charges,,,,89.0435,90,percent of total billed charges,,,109.0298775,,,fee schedule,,,39.6,,,fee schedule,,,50.292,,,fee schedule,,,,79.6705,85,percent of total billed charges,,,105.85425,,,fee schedule,,,39.6,162.0624,
FLOW CYTOTOGY,3110000,CDM,88182,CPT,311,RC,outpatient,,,,362.972,199.6346,,326.6748,90,percent of total billed charges,,,,362.972,100,percent of total billed charges,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,51.6648,,,fee schedule,,,166.770375,,,fee schedule,,,166.770375,,,fee schedule,,,,308.5262,85,percent of total billed charges,,,166.770375,,,fee schedule,,,,180.6511644,49.77,percent of total billed charges,,,,326.6748,90,percent of total billed charges,,,,344.8234,90,percent of total billed charges,,,171.7734863,,,fee schedule,,,34,,,fee schedule,,,43.18,,,fee schedule,,,,308.5262,85,percent of total billed charges,,,166.770375,,,fee schedule,,,34,362.972,
CYTOPATHOLOGY EVAL FNA,3118172,CDM,88172,CPT,311,RC,outpatient,,,,336.707,185.18885,,303.0363,90,percent of total billed charges,,,,336.707,100,percent of total billed charges,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,162.0624,,,fee schedule,,,55.590125,,,fee schedule,,,55.590125,,,fee schedule,,,,286.20095,85,percent of total billed charges,,,55.590125,,,fee schedule,,,,167.5790739,49.77,percent of total billed charges,,,,303.0363,90,percent of total billed charges,,,,319.87165,90,percent of total billed charges,,,57.25782875,,,fee schedule,,,52.89,,,fee schedule,,,67.1703,,,fee schedule,,,,286.20095,85,percent of total billed charges,,,55.590125,,,fee schedule,,,52.89,336.707,
FNA BX W/FLURO 1ST LESION,3200007,CDM,10007,CPT,320,RC,outpatient,,,,826.266,454.4463,,743.6394,90,percent of total billed charges,,,,826.266,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,88.211875,,,fee schedule,,,88.211875,,,fee schedule,,,,702.3261,85,percent of total billed charges,,,88.211875,,,fee schedule,,,,411.2325882,49.77,percent of total billed charges,,,,743.6394,90,percent of total billed charges,,,,784.9527,90,percent of total billed charges,,,90.85823125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,702.3261,85,percent of total billed charges,,,88.211875,,,fee schedule,,,88.211875,826.266,
ABDOMEN ACUTE SERIES,3200010,CDM,74022,CPT,320,RC,outpatient,,,,375.229,206.37595,,337.7061,90,percent of total billed charges,,,,375.229,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,49.93125,,,fee schedule,,,49.93125,,,fee schedule,,,,318.94465,85,percent of total billed charges,,,49.93125,,,fee schedule,,,,186.7514733,49.77,percent of total billed charges,,,,337.7061,90,percent of total billed charges,,,,356.46755,90,percent of total billed charges,,,51.4291875,,,fee schedule,,,32,,,fee schedule,,,40.64,,,fee schedule,,,,318.94465,85,percent of total billed charges,,,49.93125,,,fee schedule,,,32,375.229,
X-RAY ABDOMEN 1 VIEW,3200020,CDM,74018,CPT,320,RC,outpatient,,,,206.618,113.6399,,185.9562,90,percent of total billed charges,,,,206.618,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,30.291625,,,fee schedule,,,30.291625,,,fee schedule,,,,175.6253,85,percent of total billed charges,,,30.291625,,,fee schedule,,,,102.8337786,49.77,percent of total billed charges,,,,185.9562,90,percent of total billed charges,,,,196.2871,90,percent of total billed charges,,,31.20037375,,,fee schedule,,,20.26,,,fee schedule,,,25.7302,,,fee schedule,,,,175.6253,85,percent of total billed charges,,,30.291625,,,fee schedule,,,20.26,206.618,
X-RAY ANKLE 3 VIEWS BILATERAL,3200045,CDM,73610,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,18,87.55,
X-RAY BONE SURVEY COMPLETE,3200150,CDM,77075,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,99.529625,,,fee schedule,,,99.529625,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,99.529625,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,102.5155138,,,fee schedule,,,72.09,,,fee schedule,,,91.5543,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,99.529625,,,fee schedule,,,72.09,167.375,
"X-RAY,SPINE CERVICAL 3 OR LESS",3200210,CDM,72040,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,39.612125,,,fee schedule,,,39.612125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,39.612125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,40.80048875,,,fee schedule,,,28,,,fee schedule,,,35.56,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,39.612125,,,fee schedule,,,28,87.55,
SWALLOW STUDY/W/VIDEO,3200220,CDM,74230,CPT,320,RC,outpatient,,,,194.979,107.23845,,175.4811,90,percent of total billed charges,,,,194.979,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,124.49525,,,fee schedule,,,124.49525,,,fee schedule,,,,165.73215,85,percent of total billed charges,,,124.49525,,,fee schedule,,,,97.0410483,49.77,percent of total billed charges,,,,175.4811,90,percent of total billed charges,,,,185.23005,90,percent of total billed charges,,,128.2301075,,,fee schedule,,,29,,,fee schedule,,,36.83,,,fee schedule,,,,165.73215,85,percent of total billed charges,,,124.49525,,,fee schedule,,,29,194.979,
"X-RAY,SPINE CERVICAL;4 OR 5 V",3200230,CDM,72050,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,53.592875,,,fee schedule,,,53.592875,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,53.592875,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,55.20066125,,,fee schedule,,,32,,,fee schedule,,,40.64,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,53.592875,,,fee schedule,,,32,167.375,
"X-RAY,SPINE CERVICAL 6 OR MORE",3200240,CDM,72052,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,62.5805,,,fee schedule,,,62.5805,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,62.5805,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,64.457915,,,fee schedule,,,55,,,fee schedule,,,69.85,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,62.5805,,,fee schedule,,,55,167.375,
X-RAY CHEST 2 VIEWS,3200250,CDM,71046,CPT,320,RC,outpatient,,,,217.227,119.47485,,195.5043,90,percent of total billed charges,,,,217.227,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,33.620375,,,fee schedule,,,33.620375,,,fee schedule,,,,184.64295,85,percent of total billed charges,,,33.620375,,,fee schedule,,,,108.1138779,49.77,percent of total billed charges,,,,195.5043,90,percent of total billed charges,,,,206.36565,90,percent of total billed charges,,,34.62898625,,,fee schedule,,,21.87,,,fee schedule,,,27.7749,,,fee schedule,,,,184.64295,85,percent of total billed charges,,,33.620375,,,fee schedule,,,21.87,217.227,
CHOLANGIOGRAPHY INTRAOPERATIVE,3200280,CDM,74300,CPT,320,RC,outpatient,,,FY,369.77,203.3735,,332.793,90,percent of total billed charges,,,,369.77,100,percent of total billed charges,,,,,,,,,332.793,,,fee schedule,,,295.816,,,fee schedule,,,,,,,,,,,,,,,,314.3045,85,percent of total billed charges,,,,,,,,,,184.034529,49.77,percent of total billed charges,,,,332.793,90,percent of total billed charges,,,,351.2815,90,percent of total billed charges,,,,,,,,,24,,,fee schedule,,,30.48,,,fee schedule,,,,314.3045,85,percent of total billed charges,,,,,,,,,24,369.77,
X-RAY SACRUM & COCCYX > 2,3200310,CDM,72220,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.62175,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.6004025,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.62175,,,fee schedule,,,17,87.55,
X-RAY COLON W/AIR W/HD BARIUM,3200320,CDM,74280,CPT,320,RC,outpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,219.364625,,,fee schedule,,,219.364625,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,219.364625,,,fee schedule,,,,177.2165367,49.77,percent of total billed charges,,,,320.4639,90,percent of total billed charges,,,,338.26745,90,percent of total billed charges,,,225.9455638,,,fee schedule,,,45,,,fee schedule,,,57.15,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,219.364625,,,fee schedule,,,45,356.071,
X-RAY COLON BARIUM ENEMA,3200330,CDM,74270,CPT,320,RC,outpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,153.1225,,,fee schedule,,,153.1225,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,153.1225,,,fee schedule,,,,177.2165367,49.77,percent of total billed charges,,,,320.4639,90,percent of total billed charges,,,,338.26745,90,percent of total billed charges,,,157.716175,,,fee schedule,,,49,,,fee schedule,,,62.23,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,153.1225,,,fee schedule,,,49,356.071,
CYSTOGRAPHY MINIMUM 3 VIEWS,3200340,CDM,74430,CPT,320,RC,outpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,41.2765,,,fee schedule,,,,177.2165367,49.77,percent of total billed charges,,,,320.4639,90,percent of total billed charges,,,,338.26745,90,percent of total billed charges,,,42.514795,,,fee schedule,,,,,,,,,,,,,,,,302.66035,85,percent of total billed charges,,,41.2765,,,fee schedule,,,41.2765,366.59,
VOIDING URETHROCYSTOGRAPHY,3200345,CDM,74455,CPT,320,RC,outpatient,,,,345.462,190.0041,,310.9158,90,percent of total billed charges,,,,345.462,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,103.857,,,fee schedule,,,103.857,,,fee schedule,,,,293.6427,85,percent of total billed charges,,,103.857,,,fee schedule,,,,171.9364374,49.77,percent of total billed charges,,,,310.9158,90,percent of total billed charges,,,,328.1889,90,percent of total billed charges,,,106.97271,,,fee schedule,,,,,,,,,,,,,,,,293.6427,85,percent of total billed charges,,,103.857,,,fee schedule,,,103.857,345.462,
X-RAY ELBOW (BILAT) AP & LAT,3200415,CDM,73070,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,18,87.55,
ESOPHAGRAM,3200430,CDM,74220,CPT,320,RC,outpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,97.1995,,,fee schedule,,,97.1995,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,97.1995,,,fee schedule,,,,177.2165367,49.77,percent of total billed charges,,,,320.4639,90,percent of total billed charges,,,,338.26745,90,percent of total billed charges,,,100.115485,,,fee schedule,,,36,,,fee schedule,,,45.72,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,97.1995,,,fee schedule,,,36,356.071,
X-RAY FACIAL BONES MIN 3 VWS,3200450,CDM,70150,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.26825,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,48.6862975,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.26825,,,fee schedule,,,18,167.375,
X-RAY CHEST 1 VIEW,3200500,CDM,71045,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,25.631375,,,fee schedule,,,25.631375,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,25.631375,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,26.40031625,,,fee schedule,,,11.86,,,fee schedule,,,15.0622,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,25.631375,,,fee schedule,,,11.86,87.55,
FLUOROSCOPY UP TO 1 HR,3200510,CDM,76000,CPT,320,RC,outpatient,,,,450.316,247.6738,,405.2844,90,percent of total billed charges,,,,450.316,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,42.608,,,fee schedule,,,42.608,,,fee schedule,,,,382.7686,85,percent of total billed charges,,,42.608,,,fee schedule,,,,224.1222732,49.77,percent of total billed charges,,,,405.2844,90,percent of total billed charges,,,,427.8002,90,percent of total billed charges,,,43.88624,,,fee schedule,,,,,,,,,,,,,,,,382.7686,85,percent of total billed charges,,,42.608,,,fee schedule,,,42.608,450.316,
X-RAY FOOT COMPLETE BILATERAL,3200535,CDM,73630,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,35.31470875,,,fee schedule,,,28,,,fee schedule,,,35.56,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,28,87.55,
FOREIGN BODY SINGLE FILM CHILD,3200570,CDM,76010,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,7.2,,,fee schedule,,,9.144,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,7.2,87.55,
FLUORO NEEDLE PLACEMENT,3200600,CDM,77002,CPT,320,RC,outpatient,,,,89.61,49.2855,,80.649,90,percent of total billed charges,,,,89.61,100,percent of total billed charges,,,75.65,,,fee schedule,,,75.65,,,fee schedule,,,75.65,,,fee schedule,,,115.8405,,,fee schedule,,,115.8405,,,fee schedule,,,,76.1685,85,percent of total billed charges,,,115.8405,,,fee schedule,,,,44.598897,49.77,percent of total billed charges,,,,80.649,90,percent of total billed charges,,,,85.1295,90,percent of total billed charges,,,119.315715,,,fee schedule,,,65.45,,,fee schedule,,,83.1215,,,fee schedule,,,,76.1685,85,percent of total billed charges,,,115.8405,,,fee schedule,,,44.598897,119.315715,
X-RAY HAND 3 VW MINIMUM/BIL,3200611,CDM,73130,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,37.282,,,fee schedule,,,37.282,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.282,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,38.40046,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.282,,,fee schedule,,,25,87.55,
HYSTEROSALPINGOGRAPHY S&I,3200710,CDM,74740,CPT,320,RC,outpatient,,,,345.462,190.0041,,310.9158,90,percent of total billed charges,,,,345.462,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,93.537875,,,fee schedule,,,93.537875,,,fee schedule,,,,293.6427,85,percent of total billed charges,,,93.537875,,,fee schedule,,,,171.9364374,49.77,percent of total billed charges,,,,310.9158,90,percent of total billed charges,,,,328.1889,90,percent of total billed charges,,,96.34401125,,,fee schedule,,,,,,,,,,,,,,,,293.6427,85,percent of total billed charges,,,93.537875,,,fee schedule,,,93.537875,345.462,
UROGRAPHY IV/W/WO KUB (IVP),3200720,CDM,74400,CPT,320,RC,outpatient,,,,356.071,195.83905,,320.4639,90,percent of total billed charges,,,,356.071,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,134.814375,,,fee schedule,,,134.814375,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,134.814375,,,fee schedule,,,,177.2165367,49.77,percent of total billed charges,,,,320.4639,90,percent of total billed charges,,,,338.26745,90,percent of total billed charges,,,138.8588063,,,fee schedule,,,55,,,fee schedule,,,69.85,,,fee schedule,,,,302.66035,85,percent of total billed charges,,,134.814375,,,fee schedule,,,55,356.071,
X-RAY SPINE/LUMBOSACRAL AP/LAT,3200800,CDM,72100,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,39.945,,,fee schedule,,,39.945,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,39.945,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,41.14335,,,fee schedule,,,28,,,fee schedule,,,35.56,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,39.945,,,fee schedule,,,28,167.375,
X-RAY SPINE LUMBAR COMPL/W/OBL,3200820,CDM,72110,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,51.9285,,,fee schedule,,,51.9285,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,51.9285,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,53.486355,,,fee schedule,,,40,,,fee schedule,,,50.8,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,51.9285,,,fee schedule,,,40,167.375,
X-RAY LUMBOSCRAL COMPLETE W/BE,3200825,CDM,72114,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,61.249,,,fee schedule,,,61.249,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,61.249,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,63.08647,,,fee schedule,,,45,,,fee schedule,,,57.15,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,61.249,,,fee schedule,,,45,167.375,
X-RAY BOTH KNEES STANDING A&P,3200840,CDM,73565,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,39.945,,,fee schedule,,,39.945,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,39.945,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,41.14335,,,fee schedule,,,22,,,fee schedule,,,27.94,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,39.945,,,fee schedule,,,22,87.55,
X-RAY MANDIBLE;COMPL MIN 4 VIE,3200850,CDM,70110,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,43.606625,,,fee schedule,,,43.606625,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,43.606625,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,44.91482375,,,fee schedule,,,26,,,fee schedule,,,33.02,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,43.606625,,,fee schedule,,,26,167.375,
"MYELOGRAPHY,CERVICAL, S&I",3200870,CDM,72240,CPT,320,RC,outpatient,,,,960.578,528.3179,,864.5202,90,percent of total billed charges,,,,960.578,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,111.846,,,fee schedule,,,111.846,,,fee schedule,,,,816.4913,85,percent of total billed charges,,,111.846,,,fee schedule,,,,478.0796706,49.77,percent of total billed charges,,,,864.5202,90,percent of total billed charges,,,,912.5491,90,percent of total billed charges,,,115.20138,,,fee schedule,,,,,,,,,,,,,,,,816.4913,85,percent of total billed charges,,,111.846,,,fee schedule,,,111.846,960.578,
"MYELOGRAPHY,LUMBOSACRAL, S&I",3200880,CDM,62304,CPT,320,RC,outpatient,,,,978.809,538.34495,,880.9281,90,percent of total billed charges,,,,978.809,100,percent of total billed charges,,,753.3675,,,fee schedule,,,753.3675,,,fee schedule,,,753.3675,,,fee schedule,,,115.507625,,,fee schedule,,,115.507625,,,fee schedule,,,,831.98765,85,percent of total billed charges,,,115.507625,,,fee schedule,,,,487.1532393,49.77,percent of total billed charges,,,,880.9281,90,percent of total billed charges,,,,929.86855,90,percent of total billed charges,,,118.9728538,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,831.98765,85,percent of total billed charges,,,115.507625,,,fee schedule,,,115.507625,978.809,
X-RAY NASASL BONES COMPL MIN 3,3200900,CDM,70160,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,37.614875,,,fee schedule,,,37.614875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.614875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,38.74332125,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.614875,,,fee schedule,,,23,87.55,
X-RAY NECK SOFT TISSUE,3200910,CDM,70360,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,31.29025,,,fee schedule,,,31.29025,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.29025,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,32.2289575,,,fee schedule,,,10,,,fee schedule,,,12.7,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.29025,,,fee schedule,,,10,87.55,
FLUORO GUIDE SPINAL INJECTIONS,3200920,CDM,77003,CPT,320,RC,outpatient,,,,88.683,48.77565,,79.8147,90,percent of total billed charges,,,,88.683,100,percent of total billed charges,,,66.93,,,fee schedule,,,66.93,,,fee schedule,,,66.93,,,fee schedule,,,105.1885,,,fee schedule,,,105.1885,,,fee schedule,,,,75.38055,85,percent of total billed charges,,,105.1885,,,fee schedule,,,,44.1375291,49.77,percent of total billed charges,,,,79.8147,90,percent of total billed charges,,,,84.24885,90,percent of total billed charges,,,108.344155,,,fee schedule,,,65.45,,,fee schedule,,,83.1215,,,fee schedule,,,,75.38055,85,percent of total billed charges,,,105.1885,,,fee schedule,,,44.1375291,108.344155,
MAMMO GUIDE NEEDLE PLCMNT RT,3200930,CDM,19281,CPT,320,RC,outpatient,,,RT,721.824,397.0032,,649.6416,90,percent of total billed charges,,,,721.824,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,96.200875,,,fee schedule,,,96.200875,,,fee schedule,,,,613.5504,85,percent of total billed charges,,,96.200875,,,fee schedule,,,,359.2518048,49.77,percent of total billed charges,,,,649.6416,90,percent of total billed charges,,,,685.7328,90,percent of total billed charges,,,99.08690125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,613.5504,85,percent of total billed charges,,,96.200875,,,fee schedule,,,96.200875,1525.095,
MAMMO GUIDE NEEDLE PLCMT LT,3200935,CDM,19281,CPT,320,RC,outpatient,,,LT,721.824,397.0032,,649.6416,90,percent of total billed charges,,,,721.824,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,96.200875,,,fee schedule,,,96.200875,,,fee schedule,,,,613.5504,85,percent of total billed charges,,,96.200875,,,fee schedule,,,,359.2518048,49.77,percent of total billed charges,,,,649.6416,90,percent of total billed charges,,,,685.7328,90,percent of total billed charges,,,99.08690125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,613.5504,85,percent of total billed charges,,,96.200875,,,fee schedule,,,96.200875,1525.095,
BREAST TISSUE SPEC SURG RT,3200950,CDM,76098,CPT,320,RC,outpatient,,,,685.671,377.11905,,617.1039,90,percent of total billed charges,,,,685.671,100,percent of total billed charges,,,462.34,,,fee schedule,,,462.34,,,fee schedule,,,462.34,,,fee schedule,,,42.608,,,fee schedule,,,42.608,,,fee schedule,,,,582.82035,85,percent of total billed charges,,,42.608,,,fee schedule,,,,341.2584567,49.77,percent of total billed charges,,,,617.1039,90,percent of total billed charges,,,,651.38745,90,percent of total billed charges,,,43.88624,,,fee schedule,,,14,,,fee schedule,,,17.78,,,fee schedule,,,,582.82035,85,percent of total billed charges,,,42.608,,,fee schedule,,,14,685.671,
BREAST TISSUE SPEC SURG LT,3200951,CDM,76098,CPT,320,RC,outpatient,,,,685.671,377.11905,,617.1039,90,percent of total billed charges,,,,685.671,100,percent of total billed charges,,,462.34,,,fee schedule,,,462.34,,,fee schedule,,,462.34,,,fee schedule,,,42.608,,,fee schedule,,,42.608,,,fee schedule,,,,582.82035,85,percent of total billed charges,,,42.608,,,fee schedule,,,,341.2584567,49.77,percent of total billed charges,,,,617.1039,90,percent of total billed charges,,,,651.38745,90,percent of total billed charges,,,43.88624,,,fee schedule,,,14,,,fee schedule,,,17.78,,,fee schedule,,,,582.82035,85,percent of total billed charges,,,42.608,,,fee schedule,,,14,685.671,
X-RAY ORBITS COMPL MIN 4 VIEWS,3200960,CDM,70200,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,47.934,,,fee schedule,,,47.934,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.934,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,49.37202,,,fee schedule,,,14,,,fee schedule,,,17.78,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.934,,,fee schedule,,,14,167.375,
X-RAY PELVIS 1 OR 2 VIEWS,3201020,CDM,72170,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,27.9615,,,fee schedule,,,27.9615,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,27.9615,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,28.800345,,,fee schedule,,,21,,,fee schedule,,,26.67,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,27.9615,,,fee schedule,,,21,167.375,
"X-RAY,RIBS BILAT/W/CHEST MIN 4",3201050,CDM,71111,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,52.59425,,,fee schedule,,,52.59425,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,52.59425,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,54.1720775,,,fee schedule,,,32,,,fee schedule,,,40.64,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,52.59425,,,fee schedule,,,32,167.375,
X-RAY RIBS BILATERAL 3 VIEWS,3201051,CDM,71110,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,43.9395,,,fee schedule,,,43.9395,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,43.9395,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,45.257685,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,43.9395,,,fee schedule,,,25,167.375,
X-RAY SACROILIAC JNT > 3 VIEW,3201070,CDM,72202,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,39.27925,,,fee schedule,,,39.27925,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,39.27925,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,40.4576275,,,fee schedule,,,21,,,fee schedule,,,26.67,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,39.27925,,,fee schedule,,,21,167.375,
X-RAY SINUSES LESS THAN 3 VWS,3201180,CDM,70210,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,14,,,fee schedule,,,17.78,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.288875,,,fee schedule,,,14,87.55,
X-RAY SINUSES COMPL MIN 3 VWS,3201190,CDM,70220,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,37.614875,,,fee schedule,,,37.614875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.614875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,38.74332125,,,fee schedule,,,30,,,fee schedule,,,38.1,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.614875,,,fee schedule,,,30,87.55,
X-RAY ANKLE 3VW RT,3201201,CDM,73610,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,18,87.55,
X-RAY ANKLE 3VW LT,3201202,CDM,73610,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,18,87.55,
X-RAY ANKLE 2VW RT,3201203,CDM,73600,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,30,,,fee schedule,,,38.1,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.288875,,,fee schedule,,,30,87.55,
X-RAY ANKLE 2VW LT,3201204,CDM,73600,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,30,,,fee schedule,,,38.1,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.288875,,,fee schedule,,,30,87.55,
X-RAY ANKLE 2VW BILATERAL,3201205,CDM,73600,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,30,,,fee schedule,,,38.1,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.288875,,,fee schedule,,,30,87.55,
X-RAY CLAVICLE 2VW RT,3201206,CDM,73000,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.62175,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.6004025,,,fee schedule,,,15,,,fee schedule,,,19.05,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.62175,,,fee schedule,,,15,87.55,
X-RAY CLAVICLE 2VW LT,3201207,CDM,73000,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.62175,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.6004025,,,fee schedule,,,15,,,fee schedule,,,19.05,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.62175,,,fee schedule,,,15,87.55,
X-RAY CLAVICLE 2VW BILATERAL,3201208,CDM,73000,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.62175,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.6004025,,,fee schedule,,,15,,,fee schedule,,,19.05,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.62175,,,fee schedule,,,15,87.55,
X-RAY ELBOW 2VW RT,3201209,CDM,73070,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,18,87.55,
X-RAY SKULL LESS THAN 4 VIEWS,3201220,CDM,70250,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,35.9505,,,fee schedule,,,35.9505,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,35.9505,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,37.029015,,,fee schedule,,,22,,,fee schedule,,,27.94,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,35.9505,,,fee schedule,,,22,167.375,
X-RAY SKULL COMPLETE MIN 4 VWS,3201230,CDM,70260,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,44.60525,,,fee schedule,,,44.60525,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,44.60525,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,45.9434075,,,fee schedule,,,30,,,fee schedule,,,38.1,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,44.60525,,,fee schedule,,,30,167.375,
X-RAY SM BOWEL C/ MULTI SERIAL,3201240,CDM,74250,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,121.499375,,,fee schedule,,,121.499375,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,121.499375,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,125.1443563,,,fee schedule,,,35,,,fee schedule,,,44.45,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,121.499375,,,fee schedule,,,35,174.94,
"X-RAY,STERNUM MIN 2 VIEWS",3201270,CDM,71120,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,33.620375,,,fee schedule,,,33.620375,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,33.620375,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,34.62898625,,,fee schedule,,,14,,,fee schedule,,,17.78,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,33.620375,,,fee schedule,,,14,87.55,
"XRAY,SPINE,THORACIC,ANTEROPOST",3201290,CDM,72070,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,32.954625,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,33.94326375,,,fee schedule,,,24,,,fee schedule,,,30.48,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,32.954625,,,fee schedule,,,24,167.375,
X-RAY ELBOW 2VW LT,3201301,CDM,73070,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,18,87.55,
X-RAY ELBOW 3VW RT,3201303,CDM,73080,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.94326375,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,19,87.55,
X-RAY ELBOW 3VW LT,3201304,CDM,73080,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.94326375,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,19,87.55,
X-RAY ELBOW 3VW BILATERAL,3201305,CDM,73080,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.94326375,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,19,87.55,
X-RAY FEMUR MIN 2 VIEWS (RT),3201306,CDM,73552,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,35.617625,,,fee schedule,,,35.617625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,35.617625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,36.68615375,,,fee schedule,,,21.18,,,fee schedule,,,26.8986,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,35.617625,,,fee schedule,,,21.18,87.55,
X-RAY FEMUR MIN 2 VIEWS (LT),3201307,CDM,73552,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,35.617625,,,fee schedule,,,35.617625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,35.617625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,36.68615375,,,fee schedule,,,21.18,,,fee schedule,,,26.8986,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,35.617625,,,fee schedule,,,21.18,87.55,
X-RAY FEMUR MIN 2 VIEWS (BIL),3201308,CDM,73552,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,35.617625,,,fee schedule,,,35.617625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,35.617625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,36.68615375,,,fee schedule,,,21.18,,,fee schedule,,,26.8986,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,35.617625,,,fee schedule,,,21.18,87.55,
X-RAY FINGER RT HAND,3201309,CDM,73140,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,38.280625,,,fee schedule,,,38.280625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,38.280625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,39.42904375,,,fee schedule,,,16,,,fee schedule,,,20.32,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,38.280625,,,fee schedule,,,16,87.55,
XRAY UGI W/AIR W/O KUB,3201350,CDM,74246,CPT,320,RC,outpatient,,,,177.572,97.6646,,159.8148,90,percent of total billed charges,,,,177.572,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,150.9362,85,percent of total billed charges,,,138.808875,,,fee schedule,,,,88.3775844,49.77,percent of total billed charges,,,,159.8148,90,percent of total billed charges,,,,168.6934,90,percent of total billed charges,,,142.9731413,,,fee schedule,,,41,,,fee schedule,,,52.07,,,fee schedule,,,,150.9362,85,percent of total billed charges,,,138.808875,,,fee schedule,,,41,177.572,
X-RAY UGI W/SMALL BOWELL,3201370,CDM,74248,CPT,320,RC,outpatient,,,,105.678,58.1229,,95.1102,90,percent of total billed charges,,,,105.678,100,percent of total billed charges,,,44.6,,,fee schedule,,,44.6,,,fee schedule,,,44.6,,,fee schedule,,,82.220125,,,fee schedule,,,82.220125,,,fee schedule,,,,89.8263,85,percent of total billed charges,,,82.220125,,,fee schedule,,,,52.5959406,49.77,percent of total billed charges,,,,95.1102,90,percent of total billed charges,,,,100.3941,90,percent of total billed charges,,,84.68672875,,,fee schedule,,,,,,,,,,,,,,,,89.8263,85,percent of total billed charges,,,82.220125,,,fee schedule,,,44.6,105.678,
X-RAY UPPER GI WITH KUB,3201391,CDM,74240,CPT,320,RC,outpatient,,,,154.294,84.8617,,138.8646,90,percent of total billed charges,,,,154.294,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,122.498,,,fee schedule,,,122.498,,,fee schedule,,,,131.1499,85,percent of total billed charges,,,122.498,,,fee schedule,,,,76.7921238,49.77,percent of total billed charges,,,,138.8646,90,percent of total billed charges,,,,146.5793,90,percent of total billed charges,,,126.17294,,,fee schedule,,,30,,,fee schedule,,,38.1,,,fee schedule,,,,131.1499,85,percent of total billed charges,,,122.498,,,fee schedule,,,30,174.94,
X-RAY FINGER LT HAND,3201401,CDM,73140,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,38.280625,,,fee schedule,,,38.280625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,38.280625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,39.42904375,,,fee schedule,,,16,,,fee schedule,,,20.32,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,38.280625,,,fee schedule,,,16,87.55,
X-RAY FOREARM 2VW RT,3201402,CDM,73090,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,19,87.55,
X-RAY FOREARM 2VW LT,3201403,CDM,73090,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,19,87.55,
X-RAY FOREARM 2VW BILATERAL,3201404,CDM,73090,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,19,87.55,
X-RAY FOOT 3VW RT,3201405,CDM,73630,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,35.31470875,,,fee schedule,,,28,,,fee schedule,,,35.56,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,28,87.55,
X-RAY FOOT 3VW LT,3201406,CDM,73630,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,35.31470875,,,fee schedule,,,28,,,fee schedule,,,35.56,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,28,87.55,
X-RAY FOOT 2VW RT,3201407,CDM,73620,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,29.4860675,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,23,87.55,
X-RAY FOOT 2VW LT,3201408,CDM,73620,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,29.4860675,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,23,87.55,
X-RAY FOOT 2VW BILATERAL,3201409,CDM,73620,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,29.4860675,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,23,87.55,
X-RAY HAND 3VW RT,3201501,CDM,73130,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,37.282,,,fee schedule,,,37.282,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.282,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,38.40046,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.282,,,fee schedule,,,25,87.55,
X-RAY HAND 3VW LT,3201502,CDM,73130,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,37.282,,,fee schedule,,,37.282,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.282,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,38.40046,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,37.282,,,fee schedule,,,25,87.55,
X-RAY HAND 2VW RT,3201503,CDM,73120,CPT,320,RC,outpatient,,,RT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,31.623125,,,fee schedule,,,17,167.375,
X-RAY HAND 2VW LT,3201504,CDM,73120,CPT,320,RC,outpatient,,,LT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,31.623125,,,fee schedule,,,17,167.375,
X-RAY HAND 2VW BILATERAL,3201505,CDM,73120,CPT,320,RC,outpatient,,,50,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,31.623125,,,fee schedule,,,17,167.375,
HIP ARTHROGRAM RT,3201603,CDM,73525,CPT,320,RC,outpatient,,,RT,642.926,353.6093,,578.6334,90,percent of total billed charges,,,,642.926,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,128.822625,,,fee schedule,,,128.822625,,,fee schedule,,,,546.4871,85,percent of total billed charges,,,128.822625,,,fee schedule,,,,319.9842702,49.77,percent of total billed charges,,,,578.6334,90,percent of total billed charges,,,,610.7797,90,percent of total billed charges,,,132.6873038,,,fee schedule,,,,,,,,,,,,,,,,546.4871,85,percent of total billed charges,,,128.822625,,,fee schedule,,,128.822625,642.926,
INJECTION HIP ARTHROGRAM LT,3201603.1,CDM,27093,CPT,320,RC,outpatient,,,LT,283.147,155.73085,,254.8323,90,percent of total billed charges,,,,283.147,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,66.907875,,,fee schedule,,,66.907875,,,fee schedule,,,,240.67495,85,percent of total billed charges,,,66.907875,,,fee schedule,,,,140.9222619,49.77,percent of total billed charges,,,,254.8323,90,percent of total billed charges,,,,268.98965,90,percent of total billed charges,,,68.91511125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,240.67495,85,percent of total billed charges,,,66.907875,,,fee schedule,,,66.907875,317.5,
HIP ARTHROGRAM LT,3201604,CDM,73525,CPT,320,RC,outpatient,,,LT,642.926,353.6093,,578.6334,90,percent of total billed charges,,,,642.926,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,128.822625,,,fee schedule,,,128.822625,,,fee schedule,,,,546.4871,85,percent of total billed charges,,,128.822625,,,fee schedule,,,,319.9842702,49.77,percent of total billed charges,,,,578.6334,90,percent of total billed charges,,,,610.7797,90,percent of total billed charges,,,132.6873038,,,fee schedule,,,,,,,,,,,,,,,,546.4871,85,percent of total billed charges,,,128.822625,,,fee schedule,,,128.822625,642.926,
X-RAY HUMERUS RT,3201606,CDM,73060,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,31.956,,,fee schedule,,,31.956,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.956,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,32.91468,,,fee schedule,,,22,,,fee schedule,,,27.94,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.956,,,fee schedule,,,22,87.55,
X-RAY HUMERUS LT,3201607,CDM,73060,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,31.956,,,fee schedule,,,31.956,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.956,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,32.91468,,,fee schedule,,,22,,,fee schedule,,,27.94,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.956,,,fee schedule,,,22,87.55,
X-RAY HUMERUS 2 VIEWS,3201608,CDM,73060,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,31.956,,,fee schedule,,,31.956,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.956,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,32.91468,,,fee schedule,,,22,,,fee schedule,,,27.94,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.956,,,fee schedule,,,22,87.55,
XR ARTHROGRAM INJ HIP RT,3201610,CDM,27093,CPT,320,RC,outpatient,,,RT,283.147,155.73085,,254.8323,90,percent of total billed charges,,,,283.147,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,66.907875,,,fee schedule,,,66.907875,,,fee schedule,,,,240.67495,85,percent of total billed charges,,,66.907875,,,fee schedule,,,,140.9222619,49.77,percent of total billed charges,,,,254.8323,90,percent of total billed charges,,,,268.98965,90,percent of total billed charges,,,68.91511125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,240.67495,85,percent of total billed charges,,,66.907875,,,fee schedule,,,66.907875,317.5,
X-RAY KNEE 1 OR 2 VW RT,3201701,CDM,73560,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,35.31470875,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,25,87.55,
X-RAY KNEE 1 OR 2 VW LT,3201702,CDM,73560,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,35.31470875,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,25,87.55,
X-RAY KNEE 3VW RT,3201703,CDM,73562,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,40.943625,,,fee schedule,,,40.943625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,40.943625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,42.17193375,,,fee schedule,,,35,,,fee schedule,,,44.45,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,40.943625,,,fee schedule,,,35,87.55,
X-RAY KNEE 3VW LT,3201704,CDM,73562,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,40.943625,,,fee schedule,,,40.943625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,40.943625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,42.17193375,,,fee schedule,,,35,,,fee schedule,,,44.45,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,40.943625,,,fee schedule,,,35,87.55,
 X-RAY KNEE 3VW BILATERAL,3201705,CDM,73562,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,40.943625,,,fee schedule,,,40.943625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,40.943625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,42.17193375,,,fee schedule,,,35,,,fee schedule,,,44.45,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,40.943625,,,fee schedule,,,35,87.55,
X-RAY KNEE 4 VW RT,3201706,CDM,73564,CPT,320,RC,outpatient,,,RT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.26825,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,48.6862975,,,fee schedule,,,37,,,fee schedule,,,46.99,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.26825,,,fee schedule,,,37,167.375,
X-RAY KNEE 4 VW LT,3201707,CDM,73564,CPT,320,RC,outpatient,,,LT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.26825,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,48.6862975,,,fee schedule,,,37,,,fee schedule,,,46.99,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.26825,,,fee schedule,,,37,167.375,
X-RAY KNEE 4 VW BILATERAL,3201708,CDM,73564,CPT,320,RC,outpatient,,,50,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.26825,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,48.6862975,,,fee schedule,,,37,,,fee schedule,,,46.99,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,47.26825,,,fee schedule,,,37,167.375,
X-RAY LOWER LEG RT,3201801,CDM,73590,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.623125,,,fee schedule,,,25,87.55,
X-RAY LOWER LEG LT,3201802,CDM,73590,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.623125,,,fee schedule,,,25,87.55,
X-RAY LOWER LEG BILATERAL,3201803,CDM,73590,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.623125,,,fee schedule,,,25,87.55,
X-RAY OS CALCANEUS RT,3201804,CDM,73650,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,29.4860675,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,13,87.55,
X-RAY OS CALCANEUS LT,3201805,CDM,73650,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,29.4860675,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,13,87.55,
X-RAY OS CALCANEUS BILATERAL,3201806,CDM,73650,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,29.4860675,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,28.62725,,,fee schedule,,,13,87.55,
X-RAY RIBS 2VW RT,3201807,CDM,71100,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,17,87.55,
X-RAY RIBS 2VW LT,3201808,CDM,71100,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,36.61625,,,fee schedule,,,17,87.55,
X-RAY RIBS 3VW E/CHEST RT,3201809,CDM,71101,CPT,320,RC,outpatient,,,RT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,42.275125,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,43.54337875,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,42.275125,,,fee schedule,,,17,167.375,
X-RAY RIBS 3VW W/CHEST LT,3201901,CDM,71101,CPT,320,RC,outpatient,,,LT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,42.275125,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,43.54337875,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,42.275125,,,fee schedule,,,17,167.375,
X-RAY SCAPULA RT,3201902,CDM,73010,CPT,320,RC,outpatient,,,RT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,23.967,,,fee schedule,,,23.967,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,23.967,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,24.68601,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,23.967,,,fee schedule,,,18,167.375,
 X-RAY SCAPULA LT,3201903,CDM,73010,CPT,320,RC,outpatient,,,LT,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,23.967,,,fee schedule,,,23.967,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,23.967,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,24.68601,,,fee schedule,,,18,,,fee schedule,,,22.86,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,23.967,,,fee schedule,,,18,167.375,
X-RAY SHOULDER 1VW RT,3201904,CDM,73020,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,21.636875,,,fee schedule,,,21.636875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,21.636875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,22.28598125,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,21.636875,,,fee schedule,,,13,87.55,
X-RAY SHOULDER 1VW LT,3201905,CDM,73020,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,21.636875,,,fee schedule,,,21.636875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,21.636875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,22.28598125,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,21.636875,,,fee schedule,,,13,87.55,
X-RAY SHOULDER 2VW RT,3201907,CDM,73030,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.951875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,36.00043125,,,fee schedule,,,20,,,fee schedule,,,25.4,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.951875,,,fee schedule,,,20,87.55,
X-RAY SHOULDER 2VW LT,3201908,CDM,73030,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.951875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,36.00043125,,,fee schedule,,,20,,,fee schedule,,,25.4,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.951875,,,fee schedule,,,20,87.55,
X-RAY SHOULDER 2VW BILATERAL,3201909,CDM,73030,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.951875,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,36.00043125,,,fee schedule,,,20,,,fee schedule,,,25.4,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.951875,,,fee schedule,,,20,87.55,
X-RAY TOES RT,3202000,CDM,73660,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,13,87.55,
X-RAY SHOULDER ARTH RT,3202001,CDM,73040,CPT,320,RC,outpatient,,,RT,156.045,85.82475,,140.4405,90,percent of total billed charges,,,,156.045,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,131.485625,,,fee schedule,,,131.485625,,,fee schedule,,,,132.63825,85,percent of total billed charges,,,131.485625,,,fee schedule,,,,77.6635965,49.77,percent of total billed charges,,,,140.4405,90,percent of total billed charges,,,,148.24275,90,percent of total billed charges,,,135.4301938,,,fee schedule,,,,,,,,,,,,,,,,132.63825,85,percent of total billed charges,,,131.485625,,,fee schedule,,,77.6635965,366.59,
X-RAY SHOULDER ARTH LT,3202002,CDM,73040,CPT,320,RC,outpatient,,,LT,642.926,353.6093,,578.6334,90,percent of total billed charges,,,,642.926,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,131.485625,,,fee schedule,,,131.485625,,,fee schedule,,,,546.4871,85,percent of total billed charges,,,131.485625,,,fee schedule,,,,319.9842702,49.77,percent of total billed charges,,,,578.6334,90,percent of total billed charges,,,,610.7797,90,percent of total billed charges,,,135.4301938,,,fee schedule,,,,,,,,,,,,,,,,546.4871,85,percent of total billed charges,,,131.485625,,,fee schedule,,,131.485625,642.926,
X-RAY TOES LT,3202004,CDM,73660,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,13,87.55,
X-RAY TOES BILATERAL,3202005,CDM,73660,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,30.17179,,,fee schedule,,,13,,,fee schedule,,,16.51,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,29.293,,,fee schedule,,,13,87.55,
X-RAY WRIST 2VW RT,3202006,CDM,73100,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,33.95325,,,fee schedule,,,33.95325,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,33.95325,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,34.9718475,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,33.95325,,,fee schedule,,,19,87.55,
X-RAY WRIST 2VW LT,3202007,CDM,73100,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,33.95325,,,fee schedule,,,33.95325,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,33.95325,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,34.9718475,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,33.95325,,,fee schedule,,,19,87.55,
X-RAY WRIST 2VW BILATERAL,3202008,CDM,73100,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,33.95325,,,fee schedule,,,33.95325,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,33.95325,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,34.9718475,,,fee schedule,,,19,,,fee schedule,,,24.13,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,33.95325,,,fee schedule,,,19,87.55,
X-RAY WRIST 3VW RT,3202009,CDM,73110,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,41.2765,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,42.514795,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,41.2765,,,fee schedule,,,23,87.55,
ARTHOCENTESIS ASPIRATION LT,3202061,CDM,20610,CPT,320,RC,outpatient,,,LT,453.921,249.65655,,408.5289,90,percent of total billed charges,,,,453.921,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,45.271,,,fee schedule,,,45.271,,,fee schedule,,,,385.83285,85,percent of total billed charges,,,45.271,,,fee schedule,,,,225.9164817,49.77,percent of total billed charges,,,,408.5289,90,percent of total billed charges,,,,431.22495,90,percent of total billed charges,,,46.62913,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,385.83285,85,percent of total billed charges,,,45.271,,,fee schedule,,,45.271,453.921,
ARTHOCENTESIS ASPIRATION RT,3202065,CDM,20610,CPT,320,RC,outpatient,,,RT,453.921,249.65655,,408.5289,90,percent of total billed charges,,,,453.921,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,45.271,,,fee schedule,,,45.271,,,fee schedule,,,,385.83285,85,percent of total billed charges,,,45.271,,,fee schedule,,,,225.9164817,49.77,percent of total billed charges,,,,408.5289,90,percent of total billed charges,,,,431.22495,90,percent of total billed charges,,,46.62913,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,385.83285,85,percent of total billed charges,,,45.271,,,fee schedule,,,45.271,453.921,
X-RAY SPINE ENTIRE 1 VIEW,3202081,CDM,72081,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,42.608,,,fee schedule,,,42.608,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,42.608,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,43.88624,,,fee schedule,,,23.51,,,fee schedule,,,29.8577,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,42.608,,,fee schedule,,,23.51,87.55,
X-RAY SPINE ENTIRE 2 OR 3 VIEW,3202082,CDM,72082,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,70.236625,,,fee schedule,,,70.236625,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,70.236625,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,72.34372375,,,fee schedule,,,42.84,,,fee schedule,,,54.4068,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,70.236625,,,fee schedule,,,42.84,167.375,
X-RAY SPINE ENTIRE 4 OR 5 VIEW,3202083,CDM,72083,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,79.22425,,,fee schedule,,,79.22425,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,79.22425,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,81.6009775,,,fee schedule,,,46.48,,,fee schedule,,,59.0296,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,79.22425,,,fee schedule,,,46.48,167.375,
X-RAY WRIST 3VW LT,3202109,CDM,73110,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,41.2765,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,42.514795,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,41.2765,,,fee schedule,,,23,87.55,
MYLEOGRAM LMBR INJ;LUMBOSACRAL,3202304,CDM,62304,CPT,320,RC,outpatient,,,,978.809,538.34495,,880.9281,90,percent of total billed charges,,,,978.809,100,percent of total billed charges,,,753.3675,,,fee schedule,,,753.3675,,,fee schedule,,,753.3675,,,fee schedule,,,115.507625,,,fee schedule,,,115.507625,,,fee schedule,,,,831.98765,85,percent of total billed charges,,,115.507625,,,fee schedule,,,,487.1532393,49.77,percent of total billed charges,,,,880.9281,90,percent of total billed charges,,,,929.86855,90,percent of total billed charges,,,118.9728538,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,831.98765,85,percent of total billed charges,,,115.507625,,,fee schedule,,,115.507625,978.809,
thoracentesis without image gu,3202554,CDM,32554,CPT,320,RC,outpatient,,,,346.801,190.74055,,312.1209,90,percent of total billed charges,,,,346.801,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,86.880375,,,fee schedule,,,86.880375,,,fee schedule,,,,294.78085,85,percent of total billed charges,,,86.880375,,,fee schedule,,,,172.6028577,49.77,percent of total billed charges,,,,312.1209,90,percent of total billed charges,,,,329.46095,90,percent of total billed charges,,,89.48678625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,294.78085,85,percent of total billed charges,,,86.880375,,,fee schedule,,,86.880375,588.3525,
INJ SI JNT ARTHRGRPHY ANES LT,3202709,CDM,G0260,HCPCS,320,RC,outpatient,,,LT,749.634,412.2987,,674.6706,90,percent of total billed charges,,,,749.634,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,637.1889,85,percent of total billed charges,,,,,,,,,,373.0928418,49.77,percent of total billed charges,,,,674.6706,90,percent of total billed charges,,,,712.1523,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,637.1889,85,percent of total billed charges,,,,,,,,,373.0928418,749.634,
INJ SI JNT ARTHRGRPHY RT,3202710,CDM,G0260,HCPCS,320,RC,outpatient,,,RT,749.634,412.2987,,674.6706,90,percent of total billed charges,,,,749.634,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,637.1889,85,percent of total billed charges,,,,,,,,,,373.0928418,49.77,percent of total billed charges,,,,674.6706,90,percent of total billed charges,,,,712.1523,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,637.1889,85,percent of total billed charges,,,,,,,,,373.0928418,749.634,
THORACENTESIS/W/IMAGING GUIDE,3203255,CDM,32555,CPT,320,RC,outpatient,,,,821.116,451.6138,,739.0044,90,percent of total billed charges,,,,821.116,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,106.52,,,fee schedule,,,106.52,,,fee schedule,,,,697.9486,85,percent of total billed charges,,,106.52,,,fee schedule,,,,408.6694332,49.77,percent of total billed charges,,,,739.0044,90,percent of total billed charges,,,,780.0602,90,percent of total billed charges,,,109.7156,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,697.9486,85,percent of total billed charges,,,106.52,,,fee schedule,,,106.52,821.116,
X-RAY HIP/W/PELVIS 1 VW,3203501,CDM,73501,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.94326375,,,fee schedule,,,18.85,,,fee schedule,,,23.9395,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,18.85,87.55,
X-RAY HIP/W/PELVIS 1 VIEW (LT),3203501.1,CDM,73501,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.94326375,,,fee schedule,,,18.85,,,fee schedule,,,23.9395,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,18.85,87.55,
X-RAY HIP/W/PELVIS 1 VIEW (RT),3203501.2,CDM,73501,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,32.954625,,,fee schedule,,,32.954625,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,33.94326375,,,fee schedule,,,18.85,,,fee schedule,,,23.9395,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,32.954625,,,fee schedule,,,18.85,87.55,
X-RAY HIP/W/PELVIS 2-3 VW (RT),3203502.1,CDM,73502,CPT,320,RC,outpatient,,,RT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,47.601125,,,fee schedule,,,47.601125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,47.601125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,49.02915875,,,fee schedule,,,27.84,,,fee schedule,,,35.3568,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,47.601125,,,fee schedule,,,27.84,87.55,
X-RAY HIP/W/PELVIS 2-3 VW (LT),3203502.2,CDM,73502,CPT,320,RC,outpatient,,,LT,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,47.601125,,,fee schedule,,,47.601125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,47.601125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,49.02915875,,,fee schedule,,,27.84,,,fee schedule,,,35.3568,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,47.601125,,,fee schedule,,,27.84,87.55,
X-RAY HIP/W/PELVIS BIL 2 VIEWS,3203521,CDM,73521,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,41.2765,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,42.514795,,,fee schedule,,,26.17,,,fee schedule,,,33.2359,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,41.2765,,,fee schedule,,,26.17,167.375,
X-RAY HIP/W/PELVIS BIL 3-4 VW,3203522,CDM,73522,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,53.92575,,,fee schedule,,,53.92575,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,53.92575,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,55.5435225,,,fee schedule,,,31.17,,,fee schedule,,,39.5859,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,53.92575,,,fee schedule,,,31.17,167.375,
X-RAY ABDOMEN 2 VIEWS,3204019,CDM,74019,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,24.26,,,fee schedule,,,30.8102,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,36.61625,,,fee schedule,,,24.26,167.375,
X-RAY ABDOMEN 3 OR MORE VIEWS,3204021,CDM,74021,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,42.940875,,,fee schedule,,,42.940875,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,42.940875,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,44.22910125,,,fee schedule,,,28.27,,,fee schedule,,,35.9029,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,42.940875,,,fee schedule,,,28.27,167.375,
ABD PARACENTESIS W/IMAGE GUIDE,3204908,CDM,49083,CPT,320,RC,outpatient,,,,978.809,538.34495,,880.9281,90,percent of total billed charges,,,,978.809,100,percent of total billed charges,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,103.857,,,fee schedule,,,103.857,,,fee schedule,,,,831.98765,85,percent of total billed charges,,,103.857,,,fee schedule,,,,487.1532393,49.77,percent of total billed charges,,,,880.9281,90,percent of total billed charges,,,,929.86855,90,percent of total billed charges,,,106.97271,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,831.98765,85,percent of total billed charges,,,103.857,,,fee schedule,,,103.857,978.809,
FLOROSCOPY GUIDED LUMBAR PUNC,3206231,CDM,62328,CPT,320,RC,outpatient,,,,117.935,64.86425,,106.1415,90,percent of total billed charges,,,,117.935,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,83.8845,,,fee schedule,,,83.8845,,,fee schedule,,,,100.24475,85,percent of total billed charges,,,83.8845,,,fee schedule,,,,58.6962495,49.77,percent of total billed charges,,,,106.1415,90,percent of total billed charges,,,,112.03825,90,percent of total billed charges,,,86.401035,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,100.24475,85,percent of total billed charges,,,83.8845,,,fee schedule,,,58.6962495,655.3125,
PICC INSERT W/US GUIDANCE,3206573,CDM,36573,CPT,320,RC,outpatient,,,,982.105,540.15775,,883.8945,90,percent of total billed charges,,,,982.105,100,percent of total billed charges,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,81.2215,,,fee schedule,,,81.2215,,,fee schedule,,,,834.78925,85,percent of total billed charges,,,81.2215,,,fee schedule,,,,488.7936585,49.77,percent of total billed charges,,,,883.8945,90,percent of total billed charges,,,,932.99975,90,percent of total billed charges,,,83.658145,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,834.78925,85,percent of total billed charges,,,81.2215,,,fee schedule,,,81.2215,1513.1925,
X-RAY MANDIBLE;PART < 4 VIEWS,3207010,CDM,70100,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,38.946375,,,fee schedule,,,38.946375,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,38.946375,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,40.11476625,,,fee schedule,,,16,,,fee schedule,,,20.32,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,38.946375,,,fee schedule,,,16,87.55,
X-RAY FACIAL BONES < 3 VIEWS,3207014,CDM,70140,CPT,320,RC,outpatient,,,,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,31.956,,,fee schedule,,,31.956,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.956,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,32.91468,,,fee schedule,,,20,,,fee schedule,,,25.4,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,31.956,,,fee schedule,,,20,87.55,
PELVIS COMPLETE MIN 3 VIEWS,3207219,CDM,72190,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,42.275125,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,43.54337875,,,fee schedule,,,30,,,fee schedule,,,38.1,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,42.275125,,,fee schedule,,,30,167.375,
X-RAY WRIST BILATERAL,3207311,CDM,73110,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,41.2765,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,42.514795,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,41.2765,,,fee schedule,,,23,87.55,
X-RAY KNEE 1/2 VIEWS BILATERAL,3207356,CDM,73560,CPT,320,RC,outpatient,,,50,87.55,48.1525,,78.795,90,percent of total billed charges,,,,87.55,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,34.286125,,,fee schedule,,,34.286125,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,,43.573635,49.77,percent of total billed charges,,,,78.795,90,percent of total billed charges,,,,83.1725,90,percent of total billed charges,,,35.31470875,,,fee schedule,,,25,,,fee schedule,,,31.75,,,fee schedule,,,,74.4175,85,percent of total billed charges,,,34.286125,,,fee schedule,,,25,87.55,
FLOUROSCOPY FOR VEIN DEVICE,3207700,CDM,77001,CPT,320,RC,outpatient,,,,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,72.96,,,fee schedule,,,72.96,,,fee schedule,,,72.96,,,fee schedule,,,98.531,,,fee schedule,,,98.531,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,98.531,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,101.48693,,,fee schedule,,,66.86,,,fee schedule,,,84.9122,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,98.531,,,fee schedule,,,66.86,167.375,
PARACENTESIS W/O IMAGE GUIDANC,3209082,CDM,49082,CPT,320,RC,outpatient,,,,710.7,390.885,,639.63,90,percent of total billed charges,,,,710.7,100,percent of total billed charges,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,72.56675,,,fee schedule,,,72.56675,,,fee schedule,,,,604.095,85,percent of total billed charges,,,72.56675,,,fee schedule,,,,353.71539,49.77,percent of total billed charges,,,,639.63,90,percent of total billed charges,,,,675.165,90,percent of total billed charges,,,74.7437525,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,604.095,85,percent of total billed charges,,,72.56675,,,fee schedule,,,72.56675,839.57625,
"DXA AXIAL/HIPS,PELVIS,SPINE",3290010,CDM,77080,CPT,320,RC,outpatient,,,FY,167.375,92.05625,,150.6375,90,percent of total billed charges,,,,167.375,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,38.946375,,,fee schedule,,,38.946375,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,38.946375,,,fee schedule,,,,83.3025375,49.77,percent of total billed charges,,,,150.6375,90,percent of total billed charges,,,,159.00625,90,percent of total billed charges,,,40.11476625,,,fee schedule,,,155.08,,,fee schedule,,,196.9516,,,fee schedule,,,,142.26875,85,percent of total billed charges,,,38.946375,,,fee schedule,,,38.946375,196.9516,
ST - SWALLOW EVAL/W/RADIO-OPAQ,4400471,CDM,92611,CPT,320,RC,outpatient,,,,228.66,125.763,,205.794,90,percent of total billed charges,,,,228.66,100,percent of total billed charges,,,88.8405,,,fee schedule,,,88.8405,,,fee schedule,,,88.8405,,,fee schedule,,,91.8735,,,fee schedule,,,91.8735,,,fee schedule,,,,194.361,85,percent of total billed charges,,,91.8735,,,fee schedule,,,,113.804082,49.77,percent of total billed charges,,,,205.794,90,percent of total billed charges,,,,217.227,90,percent of total billed charges,,,94.629705,,,fee schedule,,,46.87,,,fee schedule,,,59.5249,,,fee schedule,,,,194.361,85,percent of total billed charges,,,91.8735,,,fee schedule,,,46.87,228.66,
BONE AN/OR JNT SCAN;WHOL BODY,3400020,CDM,78306,CPT,340,RC,outpatient,,,,862.625,474.44375,,776.3625,90,percent of total billed charges,,,,862.625,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,268.963,,,fee schedule,,,268.963,,,fee schedule,,,,733.23125,85,percent of total billed charges,,,268.963,,,fee schedule,,,,429.3284625,49.77,percent of total billed charges,,,,776.3625,90,percent of total billed charges,,,,819.49375,90,percent of total billed charges,,,277.03189,,,fee schedule,,,59,,,fee schedule,,,74.93,,,fee schedule,,,,733.23125,85,percent of total billed charges,,,268.963,,,fee schedule,,,59,862.625,
BONE AND/OR JOINT SCAN;LIMITED,3400030,CDM,78300,CPT,340,RC,outpatient,,,,412.824,227.0532,,371.5416,90,percent of total billed charges,,,,412.824,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,206.3825,,,fee schedule,,,206.3825,,,fee schedule,,,,350.9004,85,percent of total billed charges,,,206.3825,,,fee schedule,,,,205.4625048,49.77,percent of total billed charges,,,,371.5416,90,percent of total billed charges,,,,392.1828,90,percent of total billed charges,,,212.573975,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,350.9004,85,percent of total billed charges,,,206.3825,,,fee schedule,,,23,412.824,
GASTRIC EMPTYING STUDY,3400060,CDM,78264,CPT,340,RC,outpatient,,,,647.664,356.2152,,582.8976,90,percent of total billed charges,,,,647.664,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,301.58475,,,fee schedule,,,301.58475,,,fee schedule,,,,550.5144,85,percent of total billed charges,,,301.58475,,,fee schedule,,,,322.3423728,49.77,percent of total billed charges,,,,582.8976,90,percent of total billed charges,,,,615.2808,90,percent of total billed charges,,,310.6322925,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,550.5144,85,percent of total billed charges,,,301.58475,,,fee schedule,,,23,647.664,
HEPATOBILIARY SYSTEM IMAGING,3400080,CDM,78226,CPT,340,RC,outpatient,,,,1154.012,634.7066,,1038.6108,90,percent of total billed charges,,,,1154.012,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,296.25875,,,fee schedule,,,296.25875,,,fee schedule,,,,980.9102,85,percent of total billed charges,,,296.25875,,,fee schedule,,,,574.3517724,49.77,percent of total billed charges,,,,1038.6108,90,percent of total billed charges,,,,1096.3114,90,percent of total billed charges,,,305.1465125,,,fee schedule,,,312.39,,,fee schedule,,,396.7353,,,fee schedule,,,,980.9102,85,percent of total billed charges,,,296.25875,,,fee schedule,,,296.25875,1154.012,
HEPATOBILIARY W/PHARM/QUANT,3400081,CDM,78227,CPT,340,RC,outpatient,,,,1154.012,634.7066,,1038.6108,90,percent of total billed charges,,,,1154.012,100,percent of total billed charges,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,397.45275,,,fee schedule,,,397.45275,,,fee schedule,,,,980.9102,85,percent of total billed charges,,,397.45275,,,fee schedule,,,,574.3517724,49.77,percent of total billed charges,,,,1038.6108,90,percent of total billed charges,,,,1096.3114,90,percent of total billed charges,,,409.3763325,,,fee schedule,,,433.79,,,fee schedule,,,550.9133,,,fee schedule,,,,980.9102,85,percent of total billed charges,,,397.45275,,,fee schedule,,,397.45275,1154.012,
PULMONARY PERFUSION IMAGING,3400120,CDM,78580,CPT,340,RC,outpatient,,,,574.122,315.7671,,516.7098,90,percent of total billed charges,,,,574.122,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,216.36875,,,fee schedule,,,216.36875,,,fee schedule,,,,488.0037,85,percent of total billed charges,,,216.36875,,,fee schedule,,,,285.7405194,49.77,percent of total billed charges,,,,516.7098,90,percent of total billed charges,,,,545.4159,90,percent of total billed charges,,,222.8598125,,,fee schedule,,,63,,,fee schedule,,,80.01,,,fee schedule,,,,488.0037,85,percent of total billed charges,,,216.36875,,,fee schedule,,,63,574.122,
KIDNEY IMAGE/W/FLOW & FUNCTION,3400160,CDM,78707,CPT,340,RC,outpatient,,,,794.336,436.8848,,714.9024,90,percent of total billed charges,,,,794.336,100,percent of total billed charges,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,214.704375,,,fee schedule,,,214.704375,,,fee schedule,,,,675.1856,85,percent of total billed charges,,,214.704375,,,fee schedule,,,,395.3410272,49.77,percent of total billed charges,,,,714.9024,90,percent of total billed charges,,,,754.6192,90,percent of total billed charges,,,221.1455063,,,fee schedule,,,69,,,fee schedule,,,87.63,,,fee schedule,,,,675.1856,85,percent of total billed charges,,,214.704375,,,fee schedule,,,69,794.336,
BONE AND/OR JOINT SCAN;3 PHASE,3400195,CDM,78315,CPT,340,RC,outpatient,,,,836.875,460.28125,,753.1875,90,percent of total billed charges,,,,836.875,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,316.23125,,,fee schedule,,,316.23125,,,fee schedule,,,,711.34375,85,percent of total billed charges,,,316.23125,,,fee schedule,,,,416.5126875,49.77,percent of total billed charges,,,,753.1875,90,percent of total billed charges,,,,795.03125,90,percent of total billed charges,,,325.7181875,,,fee schedule,,,125,,,fee schedule,,,158.75,,,fee schedule,,,,711.34375,85,percent of total billed charges,,,316.23125,,,fee schedule,,,125,836.875,
MYOCARDIAL PERF SPECT; SINGLE,3400220,CDM,78451,CPT,340,RC,outpatient,,,,1096.023,602.81265,,986.4207,90,percent of total billed charges,,,,1096.023,100,percent of total billed charges,,,1221.35,,,fee schedule,,,1221.35,,,fee schedule,,,1221.35,,,fee schedule,,,312.569625,,,fee schedule,,,312.569625,,,fee schedule,,,,931.61955,85,percent of total billed charges,,,312.569625,,,fee schedule,,,,545.4906471,49.77,percent of total billed charges,,,,986.4207,90,percent of total billed charges,,,,1041.22185,90,percent of total billed charges,,,321.9467138,,,fee schedule,,,138.07,,,fee schedule,,,175.3489,,,fee schedule,,,,931.61955,85,percent of total billed charges,,,312.569625,,,fee schedule,,,138.07,1221.35,
MYOCARDIAL W/EJECTION FRACTION,3408468,CDM,78468,CPT,340,RC,outpatient,,,,581.95,320.0725,,523.755,90,percent of total billed charges,,,,581.95,100,percent of total billed charges,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,183.08125,,,fee schedule,,,183.08125,,,fee schedule,,,,494.6575,85,percent of total billed charges,,,183.08125,,,fee schedule,,,,289.636515,49.77,percent of total billed charges,,,,523.755,90,percent of total billed charges,,,,552.8525,90,percent of total billed charges,,,188.5736875,,,fee schedule,,,38,,,fee schedule,,,48.26,,,fee schedule,,,,494.6575,85,percent of total billed charges,,,183.08125,,,fee schedule,,,38,581.95,
PULMONARY VENT & PERFUSION,3408582,CDM,78582,CPT,340,RC,outpatient,,,,615.116,338.3138,,553.6044,90,percent of total billed charges,,,,615.116,100,percent of total billed charges,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,453.12,,,fee schedule,,,302.91625,,,fee schedule,,,302.91625,,,fee schedule,,,,522.8486,85,percent of total billed charges,,,302.91625,,,fee schedule,,,,306.1432332,49.77,percent of total billed charges,,,,553.6044,90,percent of total billed charges,,,,584.3602,90,percent of total billed charges,,,312.0037375,,,fee schedule,,,289.19,,,fee schedule,,,367.2713,,,fee schedule,,,,522.8486,85,percent of total billed charges,,,302.91625,,,fee schedule,,,289.19,615.116,
THYROID IMAG/W/UPTAKE;SINGLE,3400180,CDM,78014,CPT,341,RC,outpatient,,,,683.508,375.9294,,615.1572,90,percent of total billed charges,,,,683.508,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,217.367375,,,fee schedule,,,217.367375,,,fee schedule,,,,580.9818,85,percent of total billed charges,,,217.367375,,,fee schedule,,,,340.1819316,49.77,percent of total billed charges,,,,615.1572,90,percent of total billed charges,,,,649.3326,90,percent of total billed charges,,,223.8883963,,,fee schedule,,,195.81,,,fee schedule,,,248.6787,,,fee schedule,,,,580.9818,85,percent of total billed charges,,,217.367375,,,fee schedule,,,195.81,683.508,
MYOCARADIAL PERF SPECT; MULTI,3400230,CDM,78452,CPT,341,RC,outpatient,,,,2200.286,1210.1573,,1980.2574,90,percent of total billed charges,,,,2200.286,100,percent of total billed charges,,,1221.35,,,fee schedule,,,1221.35,,,fee schedule,,,1221.35,,,fee schedule,,,432.404625,,,fee schedule,,,432.404625,,,fee schedule,,,,1870.2431,85,percent of total billed charges,,,432.404625,,,fee schedule,,,,1095.082342,49.77,percent of total billed charges,,,,1980.2574,90,percent of total billed charges,,,,2090.2717,90,percent of total billed charges,,,445.3767638,,,fee schedule,,,266.71,,,fee schedule,,,338.7217,,,fee schedule,,,,1870.2431,85,percent of total billed charges,,,432.404625,,,fee schedule,,,266.71,2200.286,
PARATHYROID NUCLEAR IMAGING,3410000,CDM,78070,CPT,341,RC,outpatient,,,,395.829,217.70595,,356.2461,90,percent of total billed charges,,,,395.829,100,percent of total billed charges,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,353.41,,,fee schedule,,,268.963,,,fee schedule,,,268.963,,,fee schedule,,,,336.45465,85,percent of total billed charges,,,268.963,,,fee schedule,,,,197.0040933,49.77,percent of total billed charges,,,,356.2461,90,percent of total billed charges,,,,376.03755,90,percent of total billed charges,,,277.03189,,,fee schedule,,,24,,,fee schedule,,,30.48,,,fee schedule,,,,336.45465,85,percent of total billed charges,,,268.963,,,fee schedule,,,24,395.829,
"XENON XE 133, PER 10 mCi",3403004,CDM,A9558,HCPCS,343,RC,outpatient,,,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,35.2,,,fee schedule,,,35.2,,,fee schedule,,,35.2,,,fee schedule,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,,,,,,,25.6,,,fee schedule,,,32.512,,,fee schedule,,,,34.1445,85,percent of total billed charges,,,,,,,,,19.992609,40.17,
TECHNETIUM TC 99m OXIDRONATE,3403009,CDM,A9561,HCPCS,343,RC,outpatient,,,,28.634,15.7487,,25.7706,90,percent of total billed charges,,,,28.634,100,percent of total billed charges,,,31.68,,,fee schedule,,,31.68,,,fee schedule,,,31.68,,,fee schedule,,,,,,,,,,,,,,,,24.3389,85,percent of total billed charges,,,,,,,,,,14.2511418,49.77,percent of total billed charges,,,,25.7706,90,percent of total billed charges,,,,27.2023,90,percent of total billed charges,,,,,,,,,23.04,,,fee schedule,,,29.2608,,,fee schedule,,,,24.3389,85,percent of total billed charges,,,,,,,,,14.2511418,31.68,
TC 99m PERTECHNETATE PER mCi,3409512,CDM,,,343,RC,outpatient,,,,5.562,3.0591,,5.0058,90,percent of total billed charges,,,,5.562,100,percent of total billed charges,,,,,,,,,5.0058,,,fee schedule,,,4.4496,,,fee schedule,,,,,,,,,,,,,,,,4.7277,85,percent of total billed charges,,,,,,,,,,2.7682074,49.77,percent of total billed charges,,,,5.0058,90,percent of total billed charges,,,,5.2839,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.7277,85,percent of total billed charges,,,,,,,,,2.7682074,5.562,
TC 99m MEBROFENIN UP TO 15mCi,3409513,CDM,,,343,RC,outpatient,,,,51.706,28.4383,,46.5354,90,percent of total billed charges,,,,51.706,100,percent of total billed charges,,,,,,,,,46.5354,,,fee schedule,,,41.3648,,,fee schedule,,,,,,,,,,,,,,,,43.9501,85,percent of total billed charges,,,,,,,,,,25.7340762,49.77,percent of total billed charges,,,,46.5354,90,percent of total billed charges,,,,49.1207,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,43.9501,85,percent of total billed charges,,,,,,,,,25.7340762,51.706,
IODINE I-123 PER 100 MICROCURI,3409516,CDM,A9516,HCPCS,343,RC,outpatient,,,,121.54,66.847,,109.386,90,percent of total billed charges,,,,121.54,100,percent of total billed charges,,,28.12,,,fee schedule,,,28.12,,,fee schedule,,,28.12,,,fee schedule,,,,,,,,,,,,,,,,103.309,85,percent of total billed charges,,,,,,,,,,60.490458,49.77,percent of total billed charges,,,,109.386,90,percent of total billed charges,,,,115.463,90,percent of total billed charges,,,,,,,,,20.45,,,fee schedule,,,25.9715,,,fee schedule,,,,103.309,85,percent of total billed charges,,,,,,,,,20.45,121.54,
TC 99m ALBUMIN AGGR UP TO 10,3409519,CDM,,,343,RC,outpatient,,,,6.798,3.7389,,6.1182,90,percent of total billed charges,,,,6.798,100,percent of total billed charges,,,,,,,,,6.1182,,,fee schedule,,,5.4384,,,fee schedule,,,,,,,,,,,,,,,,5.7783,85,percent of total billed charges,,,,,,,,,,3.3833646,49.77,percent of total billed charges,,,,6.1182,90,percent of total billed charges,,,,6.4581,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.7783,85,percent of total billed charges,,,,,,,,,3.3833646,6.798,
TC 99m SULFUR COLLOID UP TO 20,3409520,CDM,A9541,HCPCS,343,RC,outpatient,,,,34.093,18.75115,,30.6837,90,percent of total billed charges,,,,34.093,100,percent of total billed charges,,,134.56,,,fee schedule,,,134.56,,,fee schedule,,,134.56,,,fee schedule,,,,,,,,,,,,,,,,28.97905,85,percent of total billed charges,,,,,,,,,,16.9680861,49.77,percent of total billed charges,,,,30.6837,90,percent of total billed charges,,,,32.38835,90,percent of total billed charges,,,,,,,,,52.88,,,fee schedule,,,67.1576,,,fee schedule,,,,28.97905,85,percent of total billed charges,,,,,,,,,16.9680861,134.56,
TECHNETIUM Tc 99m SESTAMIBI,6360070,CDM,,,343,RC,outpatient,,,,209.605,115.28275,,188.6445,90,percent of total billed charges,,,,209.605,100,percent of total billed charges,,,,,,,,,188.6445,,,fee schedule,,,167.684,,,fee schedule,,,,,,,,,,,,,,,,178.16425,85,percent of total billed charges,,,,,,,,,,104.3204085,49.77,percent of total billed charges,,,,188.6445,90,percent of total billed charges,,,,199.12475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,178.16425,85,percent of total billed charges,,,,,,,,,104.3204085,209.605,
CT ABDOMEN W/CONTRAST,3500000,CDM,74160,CPT,350,RC,outpatient,,,,1683.741,926.05755,,1515.3669,90,percent of total billed charges,,,,1683.741,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,239.00425,,,fee schedule,,,239.00425,,,fee schedule,,,630,,,case rate,,,239.00425,,,fee schedule,,,,837.9978957,49.77,percent of total billed charges,,,,1515.3669,90,percent of total billed charges,,,,1599.55395,90,percent of total billed charges,,,246.1743775,,,fee schedule,,,261,,,fee schedule,,,331.47,,,fee schedule,,,600,,,case rate,,,239.00425,,,fee schedule,,,174.94,1683.741,
FNA BIOPSY W/CT 1ST LESION,3500009,CDM,10009,CPT,350,RC,outpatient,,,,826.266,454.4463,,743.6394,90,percent of total billed charges,,,,826.266,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,106.52,,,fee schedule,,,106.52,,,fee schedule,,,630,,,case rate,,,106.52,,,fee schedule,,,,411.2325882,49.77,percent of total billed charges,,,,743.6394,90,percent of total billed charges,,,,784.9527,90,percent of total billed charges,,,109.7156,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,600,,,case rate,,,106.52,,,fee schedule,,,106.52,826.266,
CT ABDOMEN WO/CONTRAST,3500010,CDM,74150,CPT,350,RC,outpatient,,,,1327.979,730.38845,,1195.1811,90,percent of total billed charges,,,,1327.979,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,139.8075,,,fee schedule,,,139.8075,,,fee schedule,,,630,,,case rate,,,139.8075,,,fee schedule,,,,660.9351483,49.77,percent of total billed charges,,,,1195.1811,90,percent of total billed charges,,,,1261.58005,90,percent of total billed charges,,,144.001725,,,fee schedule,,,218,,,fee schedule,,,276.86,,,fee schedule,,,600,,,case rate,,,139.8075,,,fee schedule,,,107.6,1327.979,
CT ABD W/O FOLLOWED W CONTRAST,3500020,CDM,74170,CPT,350,RC,outpatient,,,,2036.928,1120.3104,,1833.2352,90,percent of total billed charges,,,,2036.928,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,268.630125,,,fee schedule,,,268.630125,,,fee schedule,,,630,,,case rate,,,268.630125,,,fee schedule,,,,1013.779066,49.77,percent of total billed charges,,,,1833.2352,90,percent of total billed charges,,,,1935.0816,90,percent of total billed charges,,,276.6890288,,,fee schedule,,,317,,,fee schedule,,,402.59,,,fee schedule,,,600,,,case rate,,,268.630125,,,fee schedule,,,174.94,2036.928,
CT SCAN GUIDE NEEDLE PLACEMENT,3500030,CDM,77012,CPT,350,RC,outpatient,,,,578.242,318.0331,,520.4178,90,percent of total billed charges,,,,578.242,100,percent of total billed charges,,,72.29,,,fee schedule,,,72.29,,,fee schedule,,,72.29,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,630,,,case rate,,,138.808875,,,fee schedule,,,,287.7910434,49.77,percent of total billed charges,,,,520.4178,90,percent of total billed charges,,,,549.3299,90,percent of total billed charges,,,142.9731413,,,fee schedule,,,,,,,,,,,,,,,600,,,case rate,,,138.808875,,,fee schedule,,,72.29,630,
CT GUIDED ABSCESS DRAINAGE,3500031,CDM,10030,CPT,350,RC,outpatient,,,,768.689,422.77895,,691.8201,90,percent of total billed charges,,,,768.689,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,132.151375,,,fee schedule,,,132.151375,,,fee schedule,,,630,,,case rate,,,132.151375,,,fee schedule,,,,382.5765153,49.77,percent of total billed charges,,,,691.8201,90,percent of total billed charges,,,,730.25455,90,percent of total billed charges,,,136.1159163,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,600,,,case rate,,,132.151375,,,fee schedule,,,132.151375,768.689,
CT CERVICAL SPINE W/O CONT,3500080,CDM,72125,CPT,350,RC,outpatient,,,,1445.193,794.85615,,1300.6737,90,percent of total billed charges,,,,1445.193,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,133.15,,,fee schedule,,,133.15,,,fee schedule,,,630,,,case rate,,,133.15,,,fee schedule,,,,719.2725561,49.77,percent of total billed charges,,,,1300.6737,90,percent of total billed charges,,,,1372.93335,90,percent of total billed charges,,,137.1445,,,fee schedule,,,215,,,fee schedule,,,273.05,,,fee schedule,,,600,,,case rate,,,133.15,,,fee schedule,,,107.6,1445.193,
CT THORAX W/CONTRAST,3500090,CDM,71260,CPT,350,RC,outpatient,,,,1860.489,1023.26895,,1674.4401,90,percent of total billed charges,,,,1860.489,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,171.09775,,,fee schedule,,,171.09775,,,fee schedule,,,630,,,case rate,,,171.09775,,,fee schedule,,,,925.9653753,49.77,percent of total billed charges,,,,1674.4401,90,percent of total billed charges,,,,1767.46455,90,percent of total billed charges,,,176.2306825,,,fee schedule,,,264,,,fee schedule,,,335.28,,,fee schedule,,,600,,,case rate,,,171.09775,,,fee schedule,,,171.09775,1860.489,
CT THORAX W/& W/O CONTRAST,3500100,CDM,71270,CPT,350,RC,outpatient,,,,1949.172,1072.0446,,1754.2548,90,percent of total billed charges,,,,1949.172,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,201.0565,,,fee schedule,,,201.0565,,,fee schedule,,,630,,,case rate,,,201.0565,,,fee schedule,,,,970.1029044,49.77,percent of total billed charges,,,,1754.2548,90,percent of total billed charges,,,,1851.7134,90,percent of total billed charges,,,207.088195,,,fee schedule,,,330,,,fee schedule,,,419.1,,,fee schedule,,,600,,,case rate,,,201.0565,,,fee schedule,,,174.94,1949.172,
CT THORAX W/O CONTRAST,3500110,CDM,71250,CPT,350,RC,outpatient,,,,1097.465,603.60575,,987.7185,90,percent of total billed charges,,,,1097.465,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,136.145875,,,fee schedule,,,136.145875,,,fee schedule,,,630,,,case rate,,,136.145875,,,fee schedule,,,,546.2083305,49.77,percent of total billed charges,,,,987.7185,90,percent of total billed charges,,,,1042.59175,90,percent of total billed charges,,,140.2302513,,,fee schedule,,,215,,,fee schedule,,,273.05,,,fee schedule,,,600,,,case rate,,,136.145875,,,fee schedule,,,107.6,1097.465,
CT THORAX LDCT,3500115,CDM,71271,CPT,350,RC,outpatient,,,,569.487,313.21785,,512.5383,90,percent of total billed charges,,,,569.487,100,percent of total billed charges,,,78.83,,,fee schedule,,,78.83,,,fee schedule,,,78.83,,,fee schedule,,,140.806125,,,fee schedule,,,140.806125,,,fee schedule,,,630,,,case rate,,,140.806125,,,fee schedule,,,,283.4336799,49.77,percent of total billed charges,,,,512.5383,90,percent of total billed charges,,,,541.01265,90,percent of total billed charges,,,145.0303088,,,fee schedule,,,94.39,,,fee schedule,,,119.8753,,,fee schedule,,,600,,,case rate,,,140.806125,,,fee schedule,,,78.83,630,
CT NECK SOFT TISSUE W/ CONT,3500130,CDM,70491,CPT,350,RC,outpatient,,,,1194.079,656.74345,,1074.6711,90,percent of total billed charges,,,,1194.079,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,188.740125,,,fee schedule,,,188.740125,,,fee schedule,,,630,,,case rate,,,188.740125,,,fee schedule,,,,594.2931183,49.77,percent of total billed charges,,,,1074.6711,90,percent of total billed charges,,,,1134.37505,90,percent of total billed charges,,,194.4023288,,,fee schedule,,,228,,,fee schedule,,,289.56,,,fee schedule,,,600,,,case rate,,,188.740125,,,fee schedule,,,174.94,1194.079,
CT NECK SOFT TISSUE W/&/WO CON,3500140,CDM,70492,CPT,350,RC,outpatient,,,,1562.51,859.3805,,1406.259,90,percent of total billed charges,,,,1562.51,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,226.355,,,fee schedule,,,226.355,,,fee schedule,,,630,,,case rate,,,226.355,,,fee schedule,,,,777.661227,49.77,percent of total billed charges,,,,1406.259,90,percent of total billed charges,,,,1484.3845,90,percent of total billed charges,,,233.14565,,,fee schedule,,,142,,,fee schedule,,,180.34,,,fee schedule,,,600,,,case rate,,,226.355,,,fee schedule,,,142,1562.51,
CT INTRACRANIAL W & W/O CONT,3500190,CDM,70482,CPT,350,RC,outpatient,,,,1165.548,641.0514,,1048.9932,90,percent of total billed charges,,,,1165.548,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,216.035875,,,fee schedule,,,216.035875,,,fee schedule,,,630,,,case rate,,,216.035875,,,fee schedule,,,,580.0932396,49.77,percent of total billed charges,,,,1048.9932,90,percent of total billed charges,,,,1107.2706,90,percent of total billed charges,,,222.5169513,,,fee schedule,,,257,,,fee schedule,,,326.39,,,fee schedule,,,600,,,case rate,,,216.035875,,,fee schedule,,,174.94,1165.548,
CT NECK SOFT TISSUE W/O CONT,3500200,CDM,70490,CPT,350,RC,outpatient,,,,1196.448,658.0464,,1076.8032,90,percent of total billed charges,,,,1196.448,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,153.455375,,,fee schedule,,,153.455375,,,fee schedule,,,630,,,case rate,,,153.455375,,,fee schedule,,,,595.4721696,49.77,percent of total billed charges,,,,1076.8032,90,percent of total billed charges,,,,1136.6256,90,percent of total billed charges,,,158.0590363,,,fee schedule,,,188,,,fee schedule,,,238.76,,,fee schedule,,,600,,,case rate,,,153.455375,,,fee schedule,,,107.6,1196.448,
CT LUMBAR SPINE W/O CONTRAST,3500250,CDM,72131,CPT,350,RC,outpatient,,,,1256.909,691.29995,,1131.2181,90,percent of total billed charges,,,,1256.909,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,132.151375,,,fee schedule,,,132.151375,,,fee schedule,,,630,,,case rate,,,132.151375,,,fee schedule,,,,625.5636093,49.77,percent of total billed charges,,,,1131.2181,90,percent of total billed charges,,,,1194.06355,90,percent of total billed charges,,,136.1159163,,,fee schedule,,,215,,,fee schedule,,,273.05,,,fee schedule,,,600,,,case rate,,,132.151375,,,fee schedule,,,107.6,1256.909,
CT PELVIS W/CONTRAST,3500260,CDM,72193,CPT,350,RC,outpatient,,,,1683.741,926.05755,,1515.3669,90,percent of total billed charges,,,,1683.741,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,234.676875,,,fee schedule,,,234.676875,,,fee schedule,,,630,,,case rate,,,234.676875,,,fee schedule,,,,837.9978957,49.77,percent of total billed charges,,,,1515.3669,90,percent of total billed charges,,,,1599.55395,90,percent of total billed charges,,,241.7171813,,,fee schedule,,,254,,,fee schedule,,,322.58,,,fee schedule,,,600,,,case rate,,,234.676875,,,fee schedule,,,174.94,1683.741,
CT PELVIS W/O CONTRAST,3500270,CDM,72192,CPT,350,RC,outpatient,,,,1327.979,730.38845,,1195.1811,90,percent of total billed charges,,,,1327.979,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,136.145875,,,fee schedule,,,136.145875,,,fee schedule,,,630,,,case rate,,,136.145875,,,fee schedule,,,,660.9351483,49.77,percent of total billed charges,,,,1195.1811,90,percent of total billed charges,,,,1261.58005,90,percent of total billed charges,,,140.2302513,,,fee schedule,,,228,,,fee schedule,,,289.56,,,fee schedule,,,600,,,case rate,,,136.145875,,,fee schedule,,,107.6,1327.979,
"CT, PELVIS WO/W CONTRAST",3500280,CDM,72194,CPT,350,RC,outpatient,,,,1463.424,804.8832,,1317.0816,90,percent of total billed charges,,,,1463.424,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,258.97675,,,fee schedule,,,258.97675,,,fee schedule,,,630,,,case rate,,,258.97675,,,fee schedule,,,,728.3461248,49.77,percent of total billed charges,,,,1317.0816,90,percent of total billed charges,,,,1390.2528,90,percent of total billed charges,,,266.7460525,,,fee schedule,,,310,,,fee schedule,,,393.7,,,fee schedule,,,600,,,case rate,,,258.97675,,,fee schedule,,,174.94,1463.424,
CT MAXILLOFACIAL W/O CONTRAST,3500340,CDM,70486,CPT,350,RC,outpatient,,,,1369.282,753.1051,,1232.3538,90,percent of total billed charges,,,,1369.282,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,131.15275,,,fee schedule,,,131.15275,,,fee schedule,,,630,,,case rate,,,131.15275,,,fee schedule,,,,681.4916514,49.77,percent of total billed charges,,,,1232.3538,90,percent of total billed charges,,,,1300.8179,90,percent of total billed charges,,,135.0873325,,,fee schedule,,,178,,,fee schedule,,,226.06,,,fee schedule,,,600,,,case rate,,,131.15275,,,fee schedule,,,107.6,1369.282,
CT MAXILLOFACIAL W/WO CONTRAST,3500350,CDM,70488,CPT,350,RC,outpatient,,,,1433.76,788.568,,1290.384,90,percent of total billed charges,,,,1433.76,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,188.740125,,,fee schedule,,,188.740125,,,fee schedule,,,630,,,case rate,,,188.740125,,,fee schedule,,,,713.582352,49.77,percent of total billed charges,,,,1290.384,90,percent of total billed charges,,,,1362.072,90,percent of total billed charges,,,194.4023288,,,fee schedule,,,278,,,fee schedule,,,353.06,,,fee schedule,,,600,,,case rate,,,188.740125,,,fee schedule,,,174.94,1433.76,
CTA CHEST W/WO,3500600,CDM,71275,CPT,350,RC,outpatient,,,,936.167,514.89185,,842.5503,90,percent of total billed charges,,,,936.167,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,288.26975,,,fee schedule,,,288.26975,,,fee schedule,,,630,,,case rate,,,288.26975,,,fee schedule,,,,465.9303159,49.77,percent of total billed charges,,,,842.5503,90,percent of total billed charges,,,,889.35865,90,percent of total billed charges,,,296.9178425,,,fee schedule,,,341.28,,,fee schedule,,,433.4256,,,fee schedule,,,600,,,case rate,,,288.26975,,,fee schedule,,,174.94,936.167,
CTA ABDOMEN W/WO CONTRAST,3500612,CDM,74175,CPT,350,RC,outpatient,,,,1327.979,730.38845,,1195.1811,90,percent of total billed charges,,,,1327.979,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,313.235375,,,fee schedule,,,313.235375,,,fee schedule,,,630,,,case rate,,,313.235375,,,fee schedule,,,,660.9351483,49.77,percent of total billed charges,,,,1195.1811,90,percent of total billed charges,,,,1261.58005,90,percent of total billed charges,,,322.6324363,,,fee schedule,,,328.15,,,fee schedule,,,416.7505,,,fee schedule,,,600,,,case rate,,,313.235375,,,fee schedule,,,174.94,1327.979,
CTA ABD W/BI-ILIOFEMORAL W/WO,3500614,CDM,75635,CPT,350,RC,outpatient,,,,1244.24,684.332,,1119.816,90,percent of total billed charges,,,,1244.24,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,420.754,,,fee schedule,,,420.754,,,fee schedule,,,630,,,case rate,,,420.754,,,fee schedule,,,,619.258248,49.77,percent of total billed charges,,,,1119.816,90,percent of total billed charges,,,,1182.028,90,percent of total billed charges,,,433.37662,,,fee schedule,,,328.15,,,fee schedule,,,416.7505,,,fee schedule,,,600,,,case rate,,,420.754,,,fee schedule,,,174.94,1244.24,
CT ANGIO ABD&PELV W/O&W/CONTR,3500615,CDM,74174,CPT,350,RC,outpatient,,,,1244.24,684.332,,1119.816,90,percent of total billed charges,,,,1244.24,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,389.796625,,,fee schedule,,,389.796625,,,fee schedule,,,630,,,case rate,,,389.796625,,,fee schedule,,,,619.258248,49.77,percent of total billed charges,,,,1119.816,90,percent of total billed charges,,,,1182.028,90,percent of total billed charges,,,401.4905238,,,fee schedule,,,429.16,,,fee schedule,,,545.0332,,,fee schedule,,,600,,,case rate,,,389.796625,,,fee schedule,,,366.59,1244.24,
CT C-SPINE W/O & W CONTRAST,3502127,CDM,72127,CPT,350,RC,outpatient,,,,1339.515,736.73325,,1205.5635,90,percent of total billed charges,,,,1339.515,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,202.388,,,fee schedule,,,202.388,,,fee schedule,,,630,,,case rate,,,202.388,,,fee schedule,,,,666.6766155,49.77,percent of total billed charges,,,,1205.5635,90,percent of total billed charges,,,,1272.53925,90,percent of total billed charges,,,208.45964,,,fee schedule,,,323,,,fee schedule,,,410.21,,,fee schedule,,,600,,,case rate,,,202.388,,,fee schedule,,,174.94,1339.515,
CT LOW EXT W/CONTRAST RT,3502501,CDM,73701,CPT,350,RC,outpatient,,,RT,793.718,436.5449,,714.3462,90,percent of total billed charges,,,,793.718,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,170.764875,,,fee schedule,,,170.764875,,,fee schedule,,,630,,,case rate,,,170.764875,,,fee schedule,,,,395.0334486,49.77,percent of total billed charges,,,,714.3462,90,percent of total billed charges,,,,754.0321,90,percent of total billed charges,,,175.8878213,,,fee schedule,,,136,,,fee schedule,,,172.72,,,fee schedule,,,600,,,case rate,,,170.764875,,,fee schedule,,,136,793.718,
CT LOW EXT W/CONTRAST LT,3502502,CDM,73701,CPT,350,RC,outpatient,,,LT,793.718,436.5449,,714.3462,90,percent of total billed charges,,,,793.718,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,170.764875,,,fee schedule,,,170.764875,,,fee schedule,,,630,,,case rate,,,170.764875,,,fee schedule,,,,395.0334486,49.77,percent of total billed charges,,,,714.3462,90,percent of total billed charges,,,,754.0321,90,percent of total billed charges,,,175.8878213,,,fee schedule,,,136,,,fee schedule,,,172.72,,,fee schedule,,,600,,,case rate,,,170.764875,,,fee schedule,,,136,793.718,
CT LOW EXT W/CONTRAST BIL,3502503,CDM,73701,CPT,350,RC,outpatient,,,50,1587.127,872.91985,,1428.4143,90,percent of total billed charges,,,,1587.127,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,170.764875,,,fee schedule,,,170.764875,,,fee schedule,,,630,,,case rate,,,170.764875,,,fee schedule,,,,789.9131079,49.77,percent of total billed charges,,,,1428.4143,90,percent of total billed charges,,,,1507.77065,90,percent of total billed charges,,,175.8878213,,,fee schedule,,,136,,,fee schedule,,,172.72,,,fee schedule,,,600,,,case rate,,,170.764875,,,fee schedule,,,136,1587.127,
CT LOW EXT W/O & W/CONTRAST RT,3502601,CDM,73702,CPT,350,RC,outpatient,,,RT,1275.449,701.49695,,1147.9041,90,percent of total billed charges,,,,1275.449,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,200.057875,,,fee schedule,,,200.057875,,,fee schedule,,,630,,,case rate,,,200.057875,,,fee schedule,,,,634.7909673,49.77,percent of total billed charges,,,,1147.9041,90,percent of total billed charges,,,,1211.67655,90,percent of total billed charges,,,206.0596113,,,fee schedule,,,162,,,fee schedule,,,205.74,,,fee schedule,,,600,,,case rate,,,200.057875,,,fee schedule,,,162,1275.449,
CT LOW EXT W/O& W/CONTRAST LT,3502602,CDM,73702,CPT,350,RC,outpatient,,,LT,1275.449,701.49695,,1147.9041,90,percent of total billed charges,,,,1275.449,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,200.057875,,,fee schedule,,,200.057875,,,fee schedule,,,630,,,case rate,,,200.057875,,,fee schedule,,,,634.7909673,49.77,percent of total billed charges,,,,1147.9041,90,percent of total billed charges,,,,1211.67655,90,percent of total billed charges,,,206.0596113,,,fee schedule,,,162,,,fee schedule,,,205.74,,,fee schedule,,,600,,,case rate,,,200.057875,,,fee schedule,,,162,1275.449,
CT UP EXT W/O CONTRAST RT,3502701,CDM,73200,CPT,350,RC,outpatient,,,RT,637.364,350.5502,,573.6276,90,percent of total billed charges,,,,637.364,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,165.106,,,fee schedule,,,165.106,,,fee schedule,,,630,,,case rate,,,165.106,,,fee schedule,,,,317.2160628,49.77,percent of total billed charges,,,,573.6276,90,percent of total billed charges,,,,605.4958,90,percent of total billed charges,,,170.05918,,,fee schedule,,,185,,,fee schedule,,,234.95,,,fee schedule,,,600,,,case rate,,,165.106,,,fee schedule,,,107.6,637.364,
CT UP EXT W/O CONTRAST LT,3502702,CDM,73200,CPT,350,RC,outpatient,,,LT,637.364,350.5502,,573.6276,90,percent of total billed charges,,,,637.364,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,165.106,,,fee schedule,,,165.106,,,fee schedule,,,630,,,case rate,,,165.106,,,fee schedule,,,,317.2160628,49.77,percent of total billed charges,,,,573.6276,90,percent of total billed charges,,,,605.4958,90,percent of total billed charges,,,170.05918,,,fee schedule,,,185,,,fee schedule,,,234.95,,,fee schedule,,,600,,,case rate,,,165.106,,,fee schedule,,,107.6,637.364,
CT UP EXT W/O CONTRAST BIL,3502703,CDM,73200,CPT,350,RC,outpatient,,,50,1274.213,700.81715,,1146.7917,90,percent of total billed charges,,,,1274.213,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,165.106,,,fee schedule,,,165.106,,,fee schedule,,,630,,,case rate,,,165.106,,,fee schedule,,,,634.1758101,49.77,percent of total billed charges,,,,1146.7917,90,percent of total billed charges,,,,1210.50235,90,percent of total billed charges,,,170.05918,,,fee schedule,,,185,,,fee schedule,,,234.95,,,fee schedule,,,600,,,case rate,,,165.106,,,fee schedule,,,107.6,1274.213,
CT UP EXT W/CONTRAST RT,3502801,CDM,73201,CPT,350,RC,outpatient,,,RT,793.718,436.5449,,714.3462,90,percent of total billed charges,,,,793.718,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,205.71675,,,fee schedule,,,205.71675,,,fee schedule,,,630,,,case rate,,,205.71675,,,fee schedule,,,,395.0334486,49.77,percent of total billed charges,,,,714.3462,90,percent of total billed charges,,,,754.0321,90,percent of total billed charges,,,211.8882525,,,fee schedule,,,136,,,fee schedule,,,172.72,,,fee schedule,,,600,,,case rate,,,205.71675,,,fee schedule,,,136,793.718,
CT UP EXT W/CONTRAST LT,3502802,CDM,73201,CPT,350,RC,outpatient,,,LT,793.718,436.5449,,714.3462,90,percent of total billed charges,,,,793.718,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,205.71675,,,fee schedule,,,205.71675,,,fee schedule,,,630,,,case rate,,,205.71675,,,fee schedule,,,,395.0334486,49.77,percent of total billed charges,,,,714.3462,90,percent of total billed charges,,,,754.0321,90,percent of total billed charges,,,211.8882525,,,fee schedule,,,136,,,fee schedule,,,172.72,,,fee schedule,,,600,,,case rate,,,205.71675,,,fee schedule,,,136,793.718,
CT UP EXT WOW/CONTRAST RT,3502901,CDM,73202,CPT,350,RC,outpatient,,,RT,1275.449,701.49695,,1147.9041,90,percent of total billed charges,,,,1275.449,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,254.98225,,,fee schedule,,,254.98225,,,fee schedule,,,630,,,case rate,,,254.98225,,,fee schedule,,,,634.7909673,49.77,percent of total billed charges,,,,1147.9041,90,percent of total billed charges,,,,1211.67655,90,percent of total billed charges,,,262.6317175,,,fee schedule,,,162,,,fee schedule,,,205.74,,,fee schedule,,,600,,,case rate,,,254.98225,,,fee schedule,,,162,1275.449,
CT UP EXT W/O & W/CONTRAST LT,3502902,CDM,73202,CPT,350,RC,outpatient,,,LT,1275.449,701.49695,,1147.9041,90,percent of total billed charges,,,,1275.449,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,254.98225,,,fee schedule,,,254.98225,,,fee schedule,,,630,,,case rate,,,254.98225,,,fee schedule,,,,634.7909673,49.77,percent of total billed charges,,,,1147.9041,90,percent of total billed charges,,,,1211.67655,90,percent of total billed charges,,,262.6317175,,,fee schedule,,,162,,,fee schedule,,,205.74,,,fee schedule,,,600,,,case rate,,,254.98225,,,fee schedule,,,162,1275.449,
CT ANGIO UPR EXTRM W/O&W/ DYE,3503210,CDM,73206,CPT,350,RC,outpatient,,,RT,1911.474,1051.3107,,1720.3266,90,percent of total billed charges,,,,1911.474,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,304.24775,,,fee schedule,,,304.24775,,,fee schedule,,,630,,,case rate,,,304.24775,,,fee schedule,,,,951.3406098,49.77,percent of total billed charges,,,,1720.3266,90,percent of total billed charges,,,,1815.9003,90,percent of total billed charges,,,313.3751825,,,fee schedule,,,288.4,,,fee schedule,,,366.268,,,fee schedule,,,600,,,case rate,,,304.24775,,,fee schedule,,,174.94,1911.474,
CT ANGIO UPPER EXTREMITY LEFT,3503220,CDM,73206,CPT,350,RC,outpatient,,,LT,1911.474,1051.3107,,1720.3266,90,percent of total billed charges,,,,1911.474,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,304.24775,,,fee schedule,,,304.24775,,,fee schedule,,,630,,,case rate,,,304.24775,,,fee schedule,,,,951.3406098,49.77,percent of total billed charges,,,,1720.3266,90,percent of total billed charges,,,,1815.9003,90,percent of total billed charges,,,313.3751825,,,fee schedule,,,288.4,,,fee schedule,,,366.268,,,fee schedule,,,600,,,case rate,,,304.24775,,,fee schedule,,,174.94,1911.474,
CT LOW EXT W/O CONTRAST LT,3503700,CDM,73700,CPT,350,RC,outpatient,,,LT,637.364,350.5502,,573.6276,90,percent of total billed charges,,,,637.364,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,132.48425,,,fee schedule,,,132.48425,,,fee schedule,,,630,,,case rate,,,132.48425,,,fee schedule,,,,317.2160628,49.77,percent of total billed charges,,,,573.6276,90,percent of total billed charges,,,,605.4958,90,percent of total billed charges,,,136.4587775,,,fee schedule,,,182,,,fee schedule,,,231.14,,,fee schedule,,,600,,,case rate,,,132.48425,,,fee schedule,,,107.6,637.364,
CT ABD & PELVIS WITH CONTRAST,3504177,CDM,74177,CPT,350,RC,outpatient,,,,2524.427,1388.43485,,2271.9843,90,percent of total billed charges,,,,2524.427,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,310.90525,,,fee schedule,,,310.90525,,,fee schedule,,,630,,,case rate,,,310.90525,,,fee schedule,,,,1256.407318,49.77,percent of total billed charges,,,,2271.9843,90,percent of total billed charges,,,,2398.20565,90,percent of total billed charges,,,320.2324075,,,fee schedule,,,206.27,,,fee schedule,,,261.9629,,,fee schedule,,,600,,,case rate,,,310.90525,,,fee schedule,,,206.27,2524.427,
CT ABD & PELVIS WO/W CONTRAST,3504178,CDM,74178,CPT,350,RC,outpatient,,,,2767.095,1521.90225,,2490.3855,90,percent of total billed charges,,,,2767.095,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,348.853,,,fee schedule,,,348.853,,,fee schedule,,,630,,,case rate,,,348.853,,,fee schedule,,,,1377.183182,49.77,percent of total billed charges,,,,2490.3855,90,percent of total billed charges,,,,2628.74025,90,percent of total billed charges,,,359.31859,,,fee schedule,,,272.95,,,fee schedule,,,346.6465,,,fee schedule,,,600,,,case rate,,,348.853,,,fee schedule,,,272.95,2767.095,
CT LOW EXT W/O CONTRAST BIL,3507003,CDM,73200,CPT,350,RC,outpatient,,,50,1274.213,700.81715,,1146.7917,90,percent of total billed charges,,,,1274.213,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,165.106,,,fee schedule,,,165.106,,,fee schedule,,,630,,,case rate,,,165.106,,,fee schedule,,,,634.1758101,49.77,percent of total billed charges,,,,1146.7917,90,percent of total billed charges,,,,1210.50235,90,percent of total billed charges,,,170.05918,,,fee schedule,,,185,,,fee schedule,,,234.95,,,fee schedule,,,600,,,case rate,,,165.106,,,fee schedule,,,107.6,1274.213,
CTA NECK W/O & W CONTRAST,3507049,CDM,70498,CPT,350,RC,outpatient,,,,1562.51,859.3805,,1406.259,90,percent of total billed charges,,,,1562.51,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,282.278,,,fee schedule,,,282.278,,,fee schedule,,,630,,,case rate,,,282.278,,,fee schedule,,,,777.661227,49.77,percent of total billed charges,,,,1406.259,90,percent of total billed charges,,,,1484.3845,90,percent of total billed charges,,,290.74634,,,fee schedule,,,280.9,,,fee schedule,,,356.743,,,fee schedule,,,600,,,case rate,,,282.278,,,fee schedule,,,174.94,1562.51,
CT CERVICAL SPINE W/CONTRAST,3507212,CDM,72126,CPT,350,RC,outpatient,,,,1172.14,644.677,,1054.926,90,percent of total billed charges,,,,1172.14,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,172.762125,,,fee schedule,,,172.762125,,,fee schedule,,,630,,,case rate,,,172.762125,,,fee schedule,,,,583.374078,49.77,percent of total billed charges,,,,1054.926,90,percent of total billed charges,,,,1113.533,90,percent of total billed charges,,,177.9449888,,,fee schedule,,,261,,,fee schedule,,,331.47,,,fee schedule,,,600,,,case rate,,,172.762125,,,fee schedule,,,172.762125,1172.14,
CT LOW EXT W/O CONTRAST RT,3507370,CDM,73700,CPT,350,RC,outpatient,,,RT,637.364,350.5502,,573.6276,90,percent of total billed charges,,,,637.364,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,132.48425,,,fee schedule,,,132.48425,,,fee schedule,,,630,,,case rate,,,132.48425,,,fee schedule,,,,317.2160628,49.77,percent of total billed charges,,,,573.6276,90,percent of total billed charges,,,,605.4958,90,percent of total billed charges,,,136.4587775,,,fee schedule,,,182,,,fee schedule,,,231.14,,,fee schedule,,,600,,,case rate,,,132.48425,,,fee schedule,,,107.6,637.364,
CT ABD & PELVIS W/O CONTRAST,3507417,CDM,74176,CPT,350,RC,outpatient,,,,2002.32,1101.276,,1802.088,90,percent of total billed charges,,,,2002.32,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,187.408625,,,fee schedule,,,187.408625,,,fee schedule,,,630,,,case rate,,,187.408625,,,fee schedule,,,,996.554664,49.77,percent of total billed charges,,,,1802.088,90,percent of total billed charges,,,,1902.204,90,percent of total billed charges,,,193.0308838,,,fee schedule,,,108.3,,,fee schedule,,,137.541,,,fee schedule,,,600,,,case rate,,,187.408625,,,fee schedule,,,108.3,2002.32,
CT GUIDANCE NEEDLE PLCMNT RAD,3507701,CDM,77012,CPT,350,RC,outpatient,,,,578.242,318.0331,,520.4178,90,percent of total billed charges,,,,578.242,100,percent of total billed charges,,,72.29,,,fee schedule,,,72.29,,,fee schedule,,,72.29,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,630,,,case rate,,,138.808875,,,fee schedule,,,,287.7910434,49.77,percent of total billed charges,,,,520.4178,90,percent of total billed charges,,,,549.3299,90,percent of total billed charges,,,142.9731413,,,fee schedule,,,,,,,,,,,,,,,600,,,case rate,,,138.808875,,,fee schedule,,,72.29,630,
CT HEAD OR BRAIN W/O CONTRAST,3500050,CDM,70450,CPT,351,RC,outpatient,,,,1368.046,752.4253,,1231.2414,90,percent of total billed charges,,,,1368.046,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,108.51725,,,fee schedule,,,108.51725,,,fee schedule,,,630,,,case rate,,,108.51725,,,fee schedule,,,,680.8764942,49.77,percent of total billed charges,,,,1231.2414,90,percent of total billed charges,,,,1299.6437,90,percent of total billed charges,,,111.7727675,,,fee schedule,,,165,,,fee schedule,,,209.55,,,fee schedule,,,600,,,case rate,,,108.51725,,,fee schedule,,,107.6,1368.046,
CT HEAD OR BRAIN W/CONTRAST,3500060,CDM,70460,CPT,351,RC,outpatient,,,,1500.607,825.33385,,1350.5463,90,percent of total billed charges,,,,1500.607,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,151.791,,,fee schedule,,,151.791,,,fee schedule,,,630,,,case rate,,,151.791,,,fee schedule,,,,746.8521039,49.77,percent of total billed charges,,,,1350.5463,90,percent of total billed charges,,,,1425.57665,90,percent of total billed charges,,,156.34473,,,fee schedule,,,208,,,fee schedule,,,264.16,,,fee schedule,,,600,,,case rate,,,151.791,,,fee schedule,,,151.791,1500.607,
CT HEAD OR BRIAN W & W/O CONT,3500070,CDM,70470,CPT,351,RC,outpatient,,,,1580.741,869.40755,,1422.6669,90,percent of total billed charges,,,,1580.741,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,177.75525,,,fee schedule,,,177.75525,,,fee schedule,,,630,,,case rate,,,177.75525,,,fee schedule,,,,786.7347957,49.77,percent of total billed charges,,,,1422.6669,90,percent of total billed charges,,,,1501.70395,90,percent of total billed charges,,,183.0879075,,,fee schedule,,,251,,,fee schedule,,,318.77,,,fee schedule,,,600,,,case rate,,,177.75525,,,fee schedule,,,174.94,1580.741,
CT INTRACRANIAL W/CONTRAST,3500170,CDM,70481,CPT,351,RC,outpatient,,,,946.57,520.6135,,851.913,90,percent of total billed charges,,,,946.57,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,185.0785,,,fee schedule,,,185.0785,,,fee schedule,,,630,,,case rate,,,185.0785,,,fee schedule,,,,471.107889,49.77,percent of total billed charges,,,,851.913,90,percent of total billed charges,,,,899.2415,90,percent of total billed charges,,,190.630855,,,fee schedule,,,221,,,fee schedule,,,280.67,,,fee schedule,,,600,,,case rate,,,185.0785,,,fee schedule,,,174.94,946.57,
CT INTRACRANIAL W/O CONTRAST,3500180,CDM,70480,CPT,351,RC,outpatient,,,,962.02,529.111,,865.818,90,percent of total billed charges,,,,962.02,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,162.775875,,,fee schedule,,,162.775875,,,fee schedule,,,630,,,case rate,,,162.775875,,,fee schedule,,,,478.797354,49.77,percent of total billed charges,,,,865.818,90,percent of total billed charges,,,,913.919,90,percent of total billed charges,,,167.6591513,,,fee schedule,,,182,,,fee schedule,,,231.14,,,fee schedule,,,600,,,case rate,,,162.775875,,,fee schedule,,,107.6,962.02,
CT MAXILLOFACIAL W/CONTRAST,3500310,CDM,70487,CPT,351,RC,outpatient,,,,1311.293,721.21115,,1180.1637,90,percent of total billed charges,,,,1311.293,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,155.7855,,,fee schedule,,,155.7855,,,fee schedule,,,630,,,case rate,,,155.7855,,,fee schedule,,,,652.6305261,49.77,percent of total billed charges,,,,1180.1637,90,percent of total billed charges,,,,1245.72835,90,percent of total billed charges,,,160.459065,,,fee schedule,,,191,,,fee schedule,,,242.57,,,fee schedule,,,600,,,case rate,,,155.7855,,,fee schedule,,,155.7855,1311.293,
CTA HEAD W/O CONTRAST FB CONT,3500580,CDM,70496,CPT,351,RC,outpatient,,,,912.786,502.0323,,821.5074,90,percent of total billed charges,,,,912.786,100,percent of total billed charges,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,174.94,,,fee schedule,,,282.610875,,,fee schedule,,,282.610875,,,fee schedule,,,630,,,case rate,,,282.610875,,,fee schedule,,,,454.2935922,49.77,percent of total billed charges,,,,821.5074,90,percent of total billed charges,,,,867.1467,90,percent of total billed charges,,,291.0892013,,,fee schedule,,,280.9,,,fee schedule,,,356.743,,,fee schedule,,,600,,,case rate,,,282.610875,,,fee schedule,,,174.94,912.786,
CT THORACIC SPINE W/O CONTRAST,3500290,CDM,72128,CPT,352,RC,outpatient,,,,1256.909,691.29995,,1131.2181,90,percent of total billed charges,,,,1256.909,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,132.817125,,,fee schedule,,,132.817125,,,fee schedule,,,630,,,case rate,,,132.817125,,,fee schedule,,,,625.5636093,49.77,percent of total billed charges,,,,1131.2181,90,percent of total billed charges,,,,1194.06355,90,percent of total billed charges,,,136.8016388,,,fee schedule,,,215,,,fee schedule,,,273.05,,,fee schedule,,,600,,,case rate,,,132.817125,,,fee schedule,,,107.6,1256.909,
CT LUMBAR SPINE W/CONTRAST,3527213,CDM,72132,CPT,352,RC,outpatient,,,,1577.96,867.878,,1420.164,90,percent of total billed charges,,,,1577.96,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,173.095,,,fee schedule,,,173.095,,,fee schedule,,,630,,,case rate,,,173.095,,,fee schedule,,,,785.350692,49.77,percent of total billed charges,,,,1420.164,90,percent of total billed charges,,,,1499.062,90,percent of total billed charges,,,178.28785,,,fee schedule,,,261,,,fee schedule,,,331.47,,,fee schedule,,,600,,,case rate,,,173.095,,,fee schedule,,,173.095,1577.96,
BRONCHOSCOPY,3600030,CDM,,,360,RC,outpatient,,,,1501.74,825.957,,1351.566,90,percent of total billed charges,,,,1501.74,100,percent of total billed charges,,,,,,,,,1351.566,,,fee schedule,,,1201.392,,,fee schedule,,,,,,,,,,,,,,,,1276.479,85,percent of total billed charges,,,,,,,,,,747.415998,49.77,percent of total billed charges,,,,1351.566,90,percent of total billed charges,,,,1426.653,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1276.479,85,percent of total billed charges,,,,,,,,,747.415998,1501.74,
COLONSCOPY - DIAGNOSTIC,3600060,CDM,,,360,RC,outpatient,,,,1864.712,1025.5916,,1678.2408,90,percent of total billed charges,,,,1864.712,100,percent of total billed charges,,,,,,,,,1678.2408,,,fee schedule,,,1491.7696,,,fee schedule,,,,,,,,,,,,,,,,1585.0052,85,percent of total billed charges,,,,,,,,,,928.0671624,49.77,percent of total billed charges,,,,1678.2408,90,percent of total billed charges,,,,1771.4764,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1585.0052,85,percent of total billed charges,,,,,,,,,928.0671624,1864.712,
COLONOSCOPY HIGHRISK SCREENING,3600061,CDM,G0105,HCPCS,360,RC,outpatient,,,,1864.712,1025.5916,,1678.2408,90,percent of total billed charges,,,,1864.712,100,percent of total billed charges,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,181.416875,,,fee schedule,,,181.416875,,,fee schedule,,,,1585.0052,85,percent of total billed charges,,,181.416875,,,fee schedule,,,,928.0671624,49.77,percent of total billed charges,,,,1678.2408,90,percent of total billed charges,,,,1771.4764,90,percent of total billed charges,,,186.8593813,,,fee schedule,,,,,,,,,,,,,,,,1585.0052,85,percent of total billed charges,,,181.416875,,,fee schedule,,,181.416875,1864.712,
COLONOSCOPY - SCREENING,3600062,CDM,G0121,HCPCS,360,RC,outpatient,,,,1864.712,1025.5916,,1678.2408,90,percent of total billed charges,,,,1864.712,100,percent of total billed charges,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,181.74975,,,fee schedule,,,181.74975,,,fee schedule,,,,1585.0052,85,percent of total billed charges,,,181.74975,,,fee schedule,,,,928.0671624,49.77,percent of total billed charges,,,,1678.2408,90,percent of total billed charges,,,,1771.4764,90,percent of total billed charges,,,187.2022425,,,fee schedule,,,,,,,,,,,,,,,,1585.0052,85,percent of total billed charges,,,181.74975,,,fee schedule,,,181.74975,1864.712,
EGD,3600140,CDM,,,360,RC,outpatient,,,,1501.74,825.957,,1351.566,90,percent of total billed charges,,,,1501.74,100,percent of total billed charges,,,,,,,,,1351.566,,,fee schedule,,,1201.392,,,fee schedule,,,,,,,,,,,,,,,,1276.479,85,percent of total billed charges,,,,,,,,,,747.415998,49.77,percent of total billed charges,,,,1351.566,90,percent of total billed charges,,,,1426.653,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1276.479,85,percent of total billed charges,,,,,,,,,747.415998,1501.74,
FLEX SIGMOIDOSCOPY/SCREENING,3600170,CDM,G0104,HCPCS,360,RC,outpatient,,,,941.317,517.72435,,847.1853,90,percent of total billed charges,,,,941.317,100,percent of total billed charges,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,56.255875,,,fee schedule,,,56.255875,,,fee schedule,,,,800.11945,85,percent of total billed charges,,,56.255875,,,fee schedule,,,,468.4934709,49.77,percent of total billed charges,,,,847.1853,90,percent of total billed charges,,,,894.25115,90,percent of total billed charges,,,57.94355125,,,fee schedule,,,,,,,,,,,,,,,,800.11945,85,percent of total billed charges,,,56.255875,,,fee schedule,,,56.255875,941.317,
SIGMOIDOSCOPY - DIAGNOSTIC,3600175,CDM,,,360,RC,outpatient,,,,941.317,517.72435,,847.1853,90,percent of total billed charges,,,,941.317,100,percent of total billed charges,,,,,,,,,847.1853,,,fee schedule,,,753.0536,,,fee schedule,,,,,,,,,,,,,,,,800.11945,85,percent of total billed charges,,,,,,,,,,468.4934709,49.77,percent of total billed charges,,,,847.1853,90,percent of total billed charges,,,,894.25115,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,800.11945,85,percent of total billed charges,,,,,,,,,468.4934709,941.317,
SURGERY TIME - 1-15 MINUTES,3600300,CDM,,,360,RC,outpatient,,,,1327.773,730.27515,,1194.9957,90,percent of total billed charges,,,,1327.773,100,percent of total billed charges,,,,,,,,,1194.9957,,,fee schedule,,,1062.2184,,,fee schedule,,,,,,,,,,,,,,,,1128.60705,85,percent of total billed charges,,,,,,,,,,660.8326221,49.77,percent of total billed charges,,,,1194.9957,90,percent of total billed charges,,,,1261.38435,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1128.60705,85,percent of total billed charges,,,,,,,,,660.8326221,1327.773,
SURGERY TIME - 16-30 MINUTES,3600310,CDM,,,360,RC,outpatient,,,,2655.958,1460.7769,,2390.3622,90,percent of total billed charges,,,,2655.958,100,percent of total billed charges,,,,,,,,,2390.3622,,,fee schedule,,,2124.7664,,,fee schedule,,,,,,,,,,,,,,,,2257.5643,85,percent of total billed charges,,,,,,,,,,1321.870297,49.77,percent of total billed charges,,,,2390.3622,90,percent of total billed charges,,,,2523.1601,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2257.5643,85,percent of total billed charges,,,,,,,,,1321.870297,2655.958,
SURGERY TIME - 31-60 MINUTES,3600320,CDM,,,360,RC,outpatient,,,,3983.937,2191.16535,,3585.5433,90,percent of total billed charges,,,,3983.937,100,percent of total billed charges,,,,,,,,,3585.5433,,,fee schedule,,,3187.1496,,,fee schedule,,,,,,,,,,,,,,,,3386.34645,85,percent of total billed charges,,,,,,,,,,1982.805445,49.77,percent of total billed charges,,,,3585.5433,90,percent of total billed charges,,,,3784.74015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3386.34645,85,percent of total billed charges,,,,,,,,,1982.805445,3983.937,
SURGERY TIME - 61-90 MINUTES,3600330,CDM,,,360,RC,outpatient,,,,5311.813,2921.49715,,4780.6317,90,percent of total billed charges,,,,5311.813,100,percent of total billed charges,,,,,,,,,4780.6317,,,fee schedule,,,4249.4504,,,fee schedule,,,,,,,,,,,,,,,,4515.04105,85,percent of total billed charges,,,,,,,,,,2643.68933,49.77,percent of total billed charges,,,,4780.6317,90,percent of total billed charges,,,,5046.22235,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4515.04105,85,percent of total billed charges,,,,,,,,,2643.68933,5311.813,
SURGERY TIME - 91-120 MINUTES,3600340,CDM,,,360,RC,outpatient,,,,6591.176,3625.1468,,5932.0584,90,percent of total billed charges,,,,6591.176,100,percent of total billed charges,,,,,,,,,5932.0584,,,fee schedule,,,5272.9408,,,fee schedule,,,,,,,,,,,,,,,,5602.4996,85,percent of total billed charges,,,,,,,,,,3280.428295,49.77,percent of total billed charges,,,,5932.0584,90,percent of total billed charges,,,,6261.6172,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5602.4996,85,percent of total billed charges,,,,,,,,,3280.428295,6591.176,
SURGERY TIME 121-150 MINUTES,3600350,CDM,,,360,RC,outpatient,,,,7967.771,4382.27405,,7170.9939,90,percent of total billed charges,,,,7967.771,100,percent of total billed charges,,,,,,,,,7170.9939,,,fee schedule,,,6374.2168,,,fee schedule,,,,,,,,,,,,,,,,6772.60535,85,percent of total billed charges,,,,,,,,,,3965.559627,49.77,percent of total billed charges,,,,7170.9939,90,percent of total billed charges,,,,7569.38245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6772.60535,85,percent of total billed charges,,,,,,,,,3965.559627,7967.771,
SURGERY TIME 151-180 MINUTES,3600360,CDM,,,360,RC,outpatient,,,,9295.75,5112.6625,,8366.175,90,percent of total billed charges,,,,9295.75,100,percent of total billed charges,,,,,,,,,8366.175,,,fee schedule,,,7436.6,,,fee schedule,,,,,,,,,,,,,,,,7901.3875,85,percent of total billed charges,,,,,,,,,,4626.494775,49.77,percent of total billed charges,,,,8366.175,90,percent of total billed charges,,,,8830.9625,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7901.3875,85,percent of total billed charges,,,,,,,,,4626.494775,9295.75,
SURGERY TIME 181-210 MINUTES,3600370,CDM,,,360,RC,outpatient,,,,10623.626,5842.9943,,9561.2634,90,percent of total billed charges,,,,10623.626,100,percent of total billed charges,,,,,,,,,9561.2634,,,fee schedule,,,8498.9008,,,fee schedule,,,,,,,,,,,,,,,,9030.0821,85,percent of total billed charges,,,,,,,,,,5287.37866,49.77,percent of total billed charges,,,,9561.2634,90,percent of total billed charges,,,,10092.4447,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9030.0821,85,percent of total billed charges,,,,,,,,,5287.37866,10623.626,
SURGERY TIME 211-240 MINUTES,3600380,CDM,,,360,RC,outpatient,,,,11951.605,6573.38275,,10756.4445,90,percent of total billed charges,,,,11951.605,100,percent of total billed charges,,,,,,,,,10756.4445,,,fee schedule,,,9561.284,,,fee schedule,,,,,,,,,,,,,,,,10158.86425,85,percent of total billed charges,,,,,,,,,,5948.313809,49.77,percent of total billed charges,,,,10756.4445,90,percent of total billed charges,,,,11354.02475,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10158.86425,85,percent of total billed charges,,,,,,,,,5948.313809,11951.605,
SURGERY TIME 241-270 MINUTES,3600390,CDM,,,360,RC,outpatient,,,,13279.481,7303.71455,,11951.5329,90,percent of total billed charges,,,,13279.481,100,percent of total billed charges,,,,,,,,,11951.5329,,,fee schedule,,,10623.5848,,,fee schedule,,,,,,,,,,,,,,,,11287.55885,85,percent of total billed charges,,,,,,,,,,6609.197694,49.77,percent of total billed charges,,,,11951.5329,90,percent of total billed charges,,,,12615.50695,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,11287.55885,85,percent of total billed charges,,,,,,,,,6609.197694,13279.481,
SURGERY TIME 271-300 MINUTES,3600400,CDM,,,360,RC,outpatient,,,,14607.46,8034.103,,13146.714,90,percent of total billed charges,,,,14607.46,100,percent of total billed charges,,,,,,,,,13146.714,,,fee schedule,,,11685.968,,,fee schedule,,,,,,,,,,,,,,,,12416.341,85,percent of total billed charges,,,,,,,,,,7270.132842,49.77,percent of total billed charges,,,,13146.714,90,percent of total billed charges,,,,13877.087,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12416.341,85,percent of total billed charges,,,,,,,,,7270.132842,14607.46,
SURGERY TIME 301-330 MINUTES,3600410,CDM,,,360,RC,outpatient,,,,15935.439,8764.49145,,14341.8951,90,percent of total billed charges,,,,15935.439,100,percent of total billed charges,,,,,,,,,14341.8951,,,fee schedule,,,12748.3512,,,fee schedule,,,,,,,,,,,,,,,,13545.12315,85,percent of total billed charges,,,,,,,,,,7931.06799,49.77,percent of total billed charges,,,,14341.8951,90,percent of total billed charges,,,,15138.66705,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13545.12315,85,percent of total billed charges,,,,,,,,,7931.06799,15935.439,
SURGERY TIME 331-360 MINUTES,3600420,CDM,,,360,RC,outpatient,,,,17263.315,9494.82325,,15536.9835,90,percent of total billed charges,,,,17263.315,100,percent of total billed charges,,,,,,,,,15536.9835,,,fee schedule,,,13810.652,,,fee schedule,,,,,,,,,,,,,,,,14673.81775,85,percent of total billed charges,,,,,,,,,,8591.951876,49.77,percent of total billed charges,,,,15536.9835,90,percent of total billed charges,,,,16400.14925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14673.81775,85,percent of total billed charges,,,,,,,,,8591.951876,17263.315,
SURGERY TIME - 1ST HOUR,3601000,CDM,,,360,RC,outpatient,,,,3306.3,1818.465,,2975.67,90,percent of total billed charges,,,,3306.3,100,percent of total billed charges,,,,,,,,,2975.67,,,fee schedule,,,2645.04,,,fee schedule,,,,,,,,,,,,,,,,2810.355,85,percent of total billed charges,,,,,,,,,,1645.54551,49.77,percent of total billed charges,,,,2975.67,90,percent of total billed charges,,,,3140.985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2810.355,85,percent of total billed charges,,,,,,,,,1645.54551,3306.3,
PREOP PLACE/NEEDLE LOCAL WIRE,3601929,CDM,,,360,RC,outpatient,,,,220.626,121.3443,,198.5634,90,percent of total billed charges,,,,220.626,100,percent of total billed charges,,,,,,,,,198.5634,,,fee schedule,,,176.5008,,,fee schedule,,,,,,,,,,,,,,,,187.5321,85,percent of total billed charges,,,,,,,,,,109.8055602,49.77,percent of total billed charges,,,,198.5634,90,percent of total billed charges,,,,209.5947,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,187.5321,85,percent of total billed charges,,,,,,,,,109.8055602,220.626,
SURGERY TIME - EA ADDL 30 MINS,3602000,CDM,,,360,RC,outpatient,,,,1653.15,909.2325,,1487.835,90,percent of total billed charges,,,,1653.15,100,percent of total billed charges,,,,,,,,,1487.835,,,fee schedule,,,1322.52,,,fee schedule,,,,,,,,,,,,,,,,1405.1775,85,percent of total billed charges,,,,,,,,,,822.772755,49.77,percent of total billed charges,,,,1487.835,90,percent of total billed charges,,,,1570.4925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1405.1775,85,percent of total billed charges,,,,,,,,,822.772755,1653.15,
PROCTOSIGMOIDOSCOPY,3604530,CDM,,,360,RC,outpatient,,,,880.856,484.4708,,792.7704,90,percent of total billed charges,,,,880.856,100,percent of total billed charges,,,,,,,,,792.7704,,,fee schedule,,,704.6848,,,fee schedule,,,,,,,,,,,,,,,,748.7276,85,percent of total billed charges,,,,,,,,,,438.4020312,49.77,percent of total billed charges,,,,792.7704,90,percent of total billed charges,,,,836.8132,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,748.7276,85,percent of total billed charges,,,,,,,,,438.4020312,880.856,
UMBILICAL CATH TRAY,7200000,CDM,,,361,RC,outpatient,,,,39.861,21.92355,,35.8749,90,percent of total billed charges,,,,39.861,100,percent of total billed charges,,,,,,,,,35.8749,,,fee schedule,,,31.8888,,,fee schedule,,,,,,,,,,,,,,,,33.88185,85,percent of total billed charges,,,,,,,,,,19.8388197,49.77,percent of total billed charges,,,,35.8749,90,percent of total billed charges,,,,37.86795,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.88185,85,percent of total billed charges,,,,,,,,,19.8388197,39.861,
ANESTHESIA TIME (1 MINUTE),3700000,CDM,,,370,RC,outpatient,,,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,,,,,,,8.8065,,,fee schedule,,,7.828,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,4.8699945,9.785,
"EYE, BLEPHAROPLASTY-5 UNITS",3700020,CDM,00103,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
EAR; NOS - 5 UNITS,3700030,CDM,00120,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
TYMPANOTOMY - 4 UNITS,3700035,CDM,00126,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
EYE; NOS - 5 UNITS,3700040,CDM,00140,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
IRIDECTOMY - 4 UNITS,3700080,CDM,00147,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
NOSE/SINUSES;NOS - 5 UNITS,3700090,CDM,00160,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
INTRAORAL PROC;NOS - 5 UNITS,3700100,CDM,00170,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
INTEGUMENTARY NECK - 5 UNITS,3700110,CDM,00300,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
NECK/ALL PROCEDURES;NOS-6 UNIT,3700120,CDM,00320,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
THORAX/ANTERIOR - 3 UNITS,3700130,CDM,00400,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
RADICAL/MODIFIED BREAST-5 UNIT,3700140,CDM,00404,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
RAD/MOD BREAST W/NODE-13 UNITS,3700150,CDM,00406,CPT,370,RC,outpatient,,,QZ,1708.255,939.54025,,1537.4295,90,percent of total billed charges,,,,1708.255,100,percent of total billed charges,,,,,,,,,1537.4295,,,fee schedule,,,1366.604,,,fee schedule,,,,,,,,,,,,,,,,1452.01675,85,percent of total billed charges,,,,,,,,,,850.1985135,49.77,percent of total billed charges,,,,1537.4295,90,percent of total billed charges,,,,1622.84225,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1452.01675,85,percent of total billed charges,,,,,,,,,850.1985135,1708.255,
CLOSED CHEST PROCEDURE-6 UNITS,3700170,CDM,00520,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
ACCESS CVC - 4 UNITS,3700190,CDM,00532,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
LUMBAR PUNCTURE - 4 UNITS,3700210,CDM,00635,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
UPPER ANT ABD WALL - 4 UNITS,3700220,CDM,00700,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
UPPER GASTRIC ENDO; NOS 5 UNIT,3700253,CDM,00731,CPT,370,RC,outpatient,,,QZ,660.745,363.40975,,594.6705,90,percent of total billed charges,,,,660.745,100,percent of total billed charges,,,,,,,,,594.6705,,,fee schedule,,,528.596,,,fee schedule,,,,,,,,,,,,,,,,561.63325,85,percent of total billed charges,,,,,,,,,,328.8527865,49.77,percent of total billed charges,,,,594.6705,90,percent of total billed charges,,,,627.70775,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,561.63325,85,percent of total billed charges,,,,,,,,,328.8527865,660.745,
UPPER ABD/HERNIA REPAIR-4 UNIT,3700260,CDM,00750,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
LUMBAR/VENTRAL HERNIAS-6 UNITS,3700270,CDM,00752,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
INTRAPERITONEAL UP/ABD -7 UNIT,3700290,CDM,00790,CPT,370,RC,outpatient,,,QZ,920.099,506.05445,,828.0891,90,percent of total billed charges,,,,920.099,100,percent of total billed charges,,,,,,,,,828.0891,,,fee schedule,,,736.0792,,,fee schedule,,,,,,,,,,,,,,,,782.08415,85,percent of total billed charges,,,,,,,,,,457.9332723,49.77,percent of total billed charges,,,,828.0891,90,percent of total billed charges,,,,874.09405,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,782.08415,85,percent of total billed charges,,,,,,,,,457.9332723,920.099,
LOWER ANT ABD WALL - 4 UNITS,3700310,CDM,00800,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
ANESTHESIA SCREEN COLONOSCOPY,3700321,CDM,00812,CPT,370,RC,outpatient,,,QZ,396.447,218.04585,,356.8023,90,percent of total billed charges,,,,396.447,100,percent of total billed charges,,,,,,,,,356.8023,,,fee schedule,,,317.1576,,,fee schedule,,,,,,,,,,,,,,,,336.97995,85,percent of total billed charges,,,,,,,,,,197.3116719,49.77,percent of total billed charges,,,,356.8023,90,percent of total billed charges,,,,376.62465,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,336.97995,85,percent of total billed charges,,,,,,,,,197.3116719,396.447,
UPPER & LOWER INTESTINAL ENDO,3700322,CDM,00813,CPT,370,RC,outpatient,,,QZ,660.745,363.40975,,594.6705,90,percent of total billed charges,,,,660.745,100,percent of total billed charges,,,,,,,,,594.6705,,,fee schedule,,,528.596,,,fee schedule,,,,,,,,,,,,,,,,561.63325,85,percent of total billed charges,,,,,,,,,,328.8527865,49.77,percent of total billed charges,,,,594.6705,90,percent of total billed charges,,,,627.70775,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,561.63325,85,percent of total billed charges,,,,,,,,,328.8527865,660.745,
LOWER INTESTINAL ENDO; NOS,3700323,CDM,00811,CPT,370,RC,outpatient,,,QZ,528.596,290.7278,,475.7364,90,percent of total billed charges,,,,528.596,100,percent of total billed charges,,,,,,,,,475.7364,,,fee schedule,,,422.8768,,,fee schedule,,,,,,,,,,,,,,,,449.3066,85,percent of total billed charges,,,,,,,,,,263.0822292,49.77,percent of total billed charges,,,,475.7364,90,percent of total billed charges,,,,502.1662,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,449.3066,85,percent of total billed charges,,,,,,,,,263.0822292,528.596,
LOWER POST ABD WALL - 5 UNITS,3700330,CDM,00820,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
HERNIA REPAIR LOWER ABD-4 UNIT,3700340,CDM,00830,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
VENTRAL/INCIS HERNIAS - 6 UNIT,3700350,CDM,00832,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
INTRAPERITONEAL LOW ABD-6 UNIT,3700360,CDM,00840,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
CESAREAN SECTION ANESTHESIA,3700370,CDM,01961,CPT,370,RC,outpatient,,,QZ,920.099,506.05445,,828.0891,90,percent of total billed charges,,,,920.099,100,percent of total billed charges,,,,,,,,,828.0891,,,fee schedule,,,736.0792,,,fee schedule,,,,,,,,,,,,,,,,782.08415,85,percent of total billed charges,,,,,,,,,,457.9332723,49.77,percent of total billed charges,,,,828.0891,90,percent of total billed charges,,,,874.09405,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,782.08415,85,percent of total billed charges,,,,,,,,,457.9332723,920.099,
RADICAL HYSTERECTOMY - 8 UNITS,3700380,CDM,00846,CPT,370,RC,outpatient,,,QZ,1051.321,578.22655,,946.1889,90,percent of total billed charges,,,,1051.321,100,percent of total billed charges,,,,,,,,,946.1889,,,fee schedule,,,841.0568,,,fee schedule,,,,,,,,,,,,,,,,893.62285,85,percent of total billed charges,,,,,,,,,,523.2424617,49.77,percent of total billed charges,,,,946.1889,90,percent of total billed charges,,,,998.75495,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,893.62285,85,percent of total billed charges,,,,,,,,,523.2424617,1051.321,
ABDOMINOPERINEAL RESECT-7 UNIT,3700390,CDM,00844,CPT,370,RC,outpatient,,,QZ,920.099,506.05445,,828.0891,90,percent of total billed charges,,,,920.099,100,percent of total billed charges,,,,,,,,,828.0891,,,fee schedule,,,736.0792,,,fee schedule,,,,,,,,,,,,,,,,782.08415,85,percent of total billed charges,,,,,,,,,,457.9332723,49.77,percent of total billed charges,,,,828.0891,90,percent of total billed charges,,,,874.09405,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,782.08415,85,percent of total billed charges,,,,,,,,,457.9332723,920.099,
EXTRAPERITONEAL LOW ABD-6 UNIT,3700410,CDM,00860,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
ANORECTAL PROCEDURE - 5 UNITS,3700480,CDM,00902,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
VAGINAL PROCEDURES - 3 UNITS,3700630,CDM,00940,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
"COLPOTOMY,COLPECTOMY - 4 UNITS",3700640,CDM,00942,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
VAGINAL HYSTERECTOMY - 6 UNITS,3700660,CDM,00944,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
CERVICAL CERCLAGE - 4 UNITS,3700680,CDM,00948,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
HYSTEROSCOPY - 4 UNITS,3700700,CDM,00952,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
CLOSED PROC/HIP JOINT - 4 UNIT,3700750,CDM,01200,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
OPEN PROCEDURE/HIP JOINT- 6,3700770,CDM,01210,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
TOTAL HIP REPLACEMENT - 8 UNIT,3700780,CDM,01214,CPT,370,RC,outpatient,,,QZ,1051.321,578.22655,,946.1889,90,percent of total billed charges,,,,1051.321,100,percent of total billed charges,,,,,,,,,946.1889,,,fee schedule,,,841.0568,,,fee schedule,,,,,,,,,,,,,,,,893.62285,85,percent of total billed charges,,,,,,,,,,523.2424617,49.77,percent of total billed charges,,,,946.1889,90,percent of total billed charges,,,,998.75495,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,893.62285,85,percent of total billed charges,,,,,,,,,523.2424617,1051.321,
TOTAL HIP ARTH/REVISIO - 10,3700790,CDM,01215,CPT,370,RC,outpatient,,,QZ,1314.074,722.7407,,1182.6666,90,percent of total billed charges,,,,1314.074,100,percent of total billed charges,,,,,,,,,1182.6666,,,fee schedule,,,1051.2592,,,fee schedule,,,,,,,,,,,,,,,,1116.9629,85,percent of total billed charges,,,,,,,,,,654.0146298,49.77,percent of total billed charges,,,,1182.6666,90,percent of total billed charges,,,,1248.3703,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1116.9629,85,percent of total billed charges,,,,,,,,,654.0146298,1314.074,
OPEN PROC/UPPER FEMUR - 6 UNIT,3700810,CDM,01230,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
AMPUTATION/UPPER LEG - 5 UNITS,3700820,CDM,01232,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
"NERVES,MUSCLE/UPPER LEG - 4",3700830,CDM,01250,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
VEIN PROCEDURES/UPPER LEG - 3,3700840,CDM,01260,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
ARTERIES UPPER LEG - 8 UNITS,3700850,CDM,01270,CPT,370,RC,outpatient,,,QZ,1051.321,578.22655,,946.1889,90,percent of total billed charges,,,,1051.321,100,percent of total billed charges,,,,,,,,,946.1889,,,fee schedule,,,841.0568,,,fee schedule,,,,,,,,,,,,,,,,893.62285,85,percent of total billed charges,,,,,,,,,,523.2424617,49.77,percent of total billed charges,,,,946.1889,90,percent of total billed charges,,,,998.75495,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,893.62285,85,percent of total billed charges,,,,,,,,,523.2424617,1051.321,
TUBAL LIGATION/TRANSECTION - 6,3700851,CDM,00851,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
"NERVES,MUSC,KNEE/POPLITEAL- 4",3700880,CDM,01320,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
OPEN PROC/LOWER FEMUR - 5 UNIT,3700900,CDM,01360,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
ARTHROSCOPIC/KNEE JOINT- 3,3700920,CDM,01382,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
"OPEN/UPPER TIBIA,FIBULA - 4",3700940,CDM,01392,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
OPEN PROC/KNEE JOINT- 4 UNITS,3700950,CDM,01400,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
TOTAL KNEE REPLACEMENT - 7,3700960,CDM,01402,CPT,370,RC,outpatient,,,QZ,920.099,506.05445,,828.0891,90,percent of total billed charges,,,,920.099,100,percent of total billed charges,,,,,,,,,828.0891,,,fee schedule,,,736.0792,,,fee schedule,,,,,,,,,,,,,,,,782.08415,85,percent of total billed charges,,,,,,,,,,457.9332723,49.77,percent of total billed charges,,,,828.0891,90,percent of total billed charges,,,,874.09405,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,782.08415,85,percent of total billed charges,,,,,,,,,457.9332723,920.099,
CLOSED PROC/LOWER LEG - 3 UNIT,3700990,CDM,01462,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
"NERVES,MUSCLE/LOWER LEG-3 UNIT",3701000,CDM,01470,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
RUPTURED ACHILLES TEN - 5 UNIT,3701010,CDM,01472,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
OPEN/BONES LOWER LEG - 3 UNITS,3701020,CDM,01480,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
"NERVES,MUSCLES SHOULDER - 5",3701080,CDM,01610,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
CLOSED SHOULDER/AXILLA - 4,3701090,CDM,01620,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
OPEN SHOULDER/AXILLA - 5 UNITS,3701100,CDM,01630,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
"NERVES,MUSCLES/UP-ARM - 3 UNIT",3701120,CDM,01710,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
UPPER ARM/ELBOW TENOTOMY-5 UNI,3701130,CDM,01712,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
CLOSED PR HUMERUS/ELBOW - 3,3701140,CDM,01730,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
OPEN PROC HUMERUS/ELBOW-4 UNIT,3701150,CDM,01740,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
HUMERUS NON/MALUNI0N RPR-5 UNI,3701160,CDM,01744,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
"NERVES,MUSCLE FOREARM - 3 UNIT",3701180,CDM,01810,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
CLOSED F-ARM/WRIST/HAND-3 UNIT,3701190,CDM,01820,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
OPEN F-ARM/WRIST/HAND-3 UNITS,3701200,CDM,01830,CPT,370,RC,outpatient,,,QZ,394.284,216.8562,,354.8556,90,percent of total billed charges,,,,394.284,100,percent of total billed charges,,,,,,,,,354.8556,,,fee schedule,,,315.4272,,,fee schedule,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,,196.2351468,49.77,percent of total billed charges,,,,354.8556,90,percent of total billed charges,,,,374.5698,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,335.1414,85,percent of total billed charges,,,,,,,,,196.2351468,394.284,
ARTERIES UP-ARM/ELBOW-6 UNITS,3701290,CDM,01770,CPT,370,RC,outpatient,,,QZ,788.568,433.7124,,709.7112,90,percent of total billed charges,,,,788.568,100,percent of total billed charges,,,,,,,,,709.7112,,,fee schedule,,,630.8544,,,fee schedule,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,,392.4702936,49.77,percent of total billed charges,,,,709.7112,90,percent of total billed charges,,,,749.1396,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,670.2828,85,percent of total billed charges,,,,,,,,,392.4702936,788.568,
PNEUMOCENTESIS - 4 UNITS,3701300,CDM,00524,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
SPINAL PUNCT LUMBAR DX- 5 UNIT,3701310,CDM,62270,CPT,370,RC,outpatient,,,,381.821,210.00155,,343.6389,90,percent of total billed charges,,,,381.821,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,324.54785,85,percent of total billed charges,,,63.24625,,,fee schedule,,,,190.0323117,49.77,percent of total billed charges,,,,343.6389,90,percent of total billed charges,,,,362.72995,90,percent of total billed charges,,,65.1436375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,324.54785,85,percent of total billed charges,,,63.24625,,,fee schedule,,,63.24625,655.3125,
EPIDURAL PATCH INJECTION,3701320,CDM,62273,CPT,370,RC,outpatient,,,,381.821,210.00155,,343.6389,90,percent of total billed charges,,,,381.821,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,112.178875,,,fee schedule,,,112.178875,,,fee schedule,,,,324.54785,85,percent of total billed charges,,,112.178875,,,fee schedule,,,,190.0323117,49.77,percent of total billed charges,,,,343.6389,90,percent of total billed charges,,,,362.72995,90,percent of total billed charges,,,115.5442413,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,324.54785,85,percent of total billed charges,,,112.178875,,,fee schedule,,,112.178875,655.3125,
"LUMBAR,SACRAL INJECTION",3701330,CDM,0216T,CPT,370,RC,outpatient,,,,608.421,334.63155,,547.5789,90,percent of total billed charges,,,,608.421,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,517.15785,85,percent of total billed charges,,,,,,,,,,302.8111317,49.77,percent of total billed charges,,,,547.5789,90,percent of total billed charges,,,,577.99995,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,517.15785,85,percent of total billed charges,,,,,,,,,302.8111317,608.421,
INTRATHECAL; VAG DEL - 5 UNITS,3701340,CDM,01967,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
C-SECTION; AFTER INTRATHECAL,3701345,CDM,01968,CPT,370,RC,outpatient,,,QZ,263.165,144.74075,,236.8485,90,percent of total billed charges,,,,263.165,100,percent of total billed charges,,,,,,,,,236.8485,,,fee schedule,,,210.532,,,fee schedule,,,,,,,,,,,,,,,,223.69025,85,percent of total billed charges,,,,,,,,,,130.9772205,49.77,percent of total billed charges,,,,236.8485,90,percent of total billed charges,,,,250.00675,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,223.69025,85,percent of total billed charges,,,,,,,,,130.9772205,263.165,
INTUBAT ENDOTRACHEAL/ER-6 UNIT,3701430,CDM,31500,CPT,370,RC,outpatient,,,QZ,664.659,365.56245,,598.1931,90,percent of total billed charges,,,,664.659,100,percent of total billed charges,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,564.96015,85,percent of total billed charges,,,138.808875,,,fee schedule,,,,330.8007843,49.77,percent of total billed charges,,,,598.1931,90,percent of total billed charges,,,,631.42605,90,percent of total billed charges,,,142.9731413,,,fee schedule,,,363,,,fee schedule,,,461.01,,,fee schedule,,,,564.96015,85,percent of total billed charges,,,138.808875,,,fee schedule,,,138.808875,664.659,
PROCEDURE LOWER LEG - 4 UNITS,3701482,CDM,01482,CPT,370,RC,outpatient,,,QZ,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
MONITORED ANESTHESIA CARE,3701510,CDM,G9654,HCPCS,370,RC,outpatient,,,,8.858,4.8719,,7.9722,90,percent of total billed charges,,,,8.858,100,percent of total billed charges,,,,,,,,,7.9722,,,fee schedule,,,7.0864,,,fee schedule,,,,,,,,,,,,,,,,7.5293,85,percent of total billed charges,,,,,,,,,,4.4086266,49.77,percent of total billed charges,,,,7.9722,90,percent of total billed charges,,,,8.4151,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.5293,85,percent of total billed charges,,,,,,,,,4.4086266,8.858,
INCOMPLETE OR MISSED ABORTION,3701965,CDM,01965,CPT,370,RC,outpatient,,,,525.815,289.19825,,473.2335,90,percent of total billed charges,,,,525.815,100,percent of total billed charges,,,,,,,,,473.2335,,,fee schedule,,,420.652,,,fee schedule,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,,261.6981255,49.77,percent of total billed charges,,,,473.2335,90,percent of total billed charges,,,,499.52425,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,446.94275,85,percent of total billed charges,,,,,,,,,261.6981255,525.815,
EPIDURAL - VAG DELIVERY - 5,3701967,CDM,01967,CPT,370,RC,outpatient,,,QZ,657.037,361.37035,,591.3333,90,percent of total billed charges,,,,657.037,100,percent of total billed charges,,,,,,,,,591.3333,,,fee schedule,,,525.6296,,,fee schedule,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,,327.0073149,49.77,percent of total billed charges,,,,591.3333,90,percent of total billed charges,,,,624.18515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,558.48145,85,percent of total billed charges,,,,,,,,,327.0073149,657.037,
EPIDURAL C-SECTION/ADD ON - 2,3701968,CDM,01968,CPT,370,RC,outpatient,,,QZ,263.165,144.74075,,236.8485,90,percent of total billed charges,,,,263.165,100,percent of total billed charges,,,,,,,,,236.8485,,,fee schedule,,,210.532,,,fee schedule,,,,,,,,,,,,,,,,223.69025,85,percent of total billed charges,,,,,,,,,,130.9772205,49.77,percent of total billed charges,,,,236.8485,90,percent of total billed charges,,,,250.00675,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,223.69025,85,percent of total billed charges,,,,,,,,,130.9772205,263.165,
RBC LEUKOCYTES REDUCED,3910010,CDM,P9016,HCPCS,381,RC,outpatient,,,BL,428.274,235.5507,,385.4466,90,percent of total billed charges,,,,428.274,100,percent of total billed charges,,,194.997,,,fee schedule,,,194.997,,,fee schedule,,,194.997,,,fee schedule,,,,,,,,,,,,,,,,364.0329,85,percent of total billed charges,,,,,,,,,,213.1519698,49.77,percent of total billed charges,,,,385.4466,90,percent of total billed charges,,,,406.8603,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,364.0329,85,percent of total billed charges,,,,,,,,,194.997,428.274,
BLOOD/PLASMA 1 DONOR FRZ,3910030,CDM,P9017,HCPCS,383,RC,outpatient,,,,262.032,144.1176,,235.8288,90,percent of total billed charges,,,,262.032,100,percent of total billed charges,,,88.0764,,,fee schedule,,,88.0764,,,fee schedule,,,88.0764,,,fee schedule,,,,,,,,,,,,,,,,222.7272,85,percent of total billed charges,,,,,,,,,,130.4133264,49.77,percent of total billed charges,,,,235.8288,90,percent of total billed charges,,,,248.9304,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,222.7272,85,percent of total billed charges,,,,,,,,,88.0764,262.032,
BLOOD STORAGE AND PROCESSING,3901100,CDM,P9016,HCPCS,390,RC,outpatient,,,BL,365.959,201.27745,,329.3631,90,percent of total billed charges,,,,365.959,100,percent of total billed charges,,,194.997,,,fee schedule,,,194.997,,,fee schedule,,,194.997,,,fee schedule,,,,,,,,,,,,,,,,311.06515,85,percent of total billed charges,,,,,,,,,,182.1377943,49.77,percent of total billed charges,,,,329.3631,90,percent of total billed charges,,,,347.66105,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,311.06515,85,percent of total billed charges,,,,,,,,,182.1377943,365.959,
PLATELETS EACH UNIT,3910040,CDM,P9019,HCPCS,390,RC,outpatient,,,,1186.457,652.55135,,1067.8113,90,percent of total billed charges,,,,1186.457,100,percent of total billed charges,,,79.5948,,,fee schedule,,,79.5948,,,fee schedule,,,79.5948,,,fee schedule,,,,,,,,,,,,,,,,1008.48845,85,percent of total billed charges,,,,,,,,,,590.4996489,49.77,percent of total billed charges,,,,1067.8113,90,percent of total billed charges,,,,1127.13415,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1008.48845,85,percent of total billed charges,,,,,,,,,79.5948,1186.457,
PLATELETS PHERESIS LEUKO REDUC,3910060,CDM,P9035,HCPCS,390,RC,outpatient,,,BL,1186.457,652.55135,,1067.8113,90,percent of total billed charges,,,,1186.457,100,percent of total billed charges,,,500.517,,,fee schedule,,,500.517,,,fee schedule,,,500.517,,,fee schedule,,,,,,,,,,,,,,,,1008.48845,85,percent of total billed charges,,,,,,,,,,590.4996489,49.77,percent of total billed charges,,,,1067.8113,90,percent of total billed charges,,,,1127.13415,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1008.48845,85,percent of total billed charges,,,,,,,,,500.517,1186.457,
CRYOPRECIPITATE EACH UNIT,3910070,CDM,P9012,HCPCS,390,RC,outpatient,,,,75.396,41.4678,,67.8564,90,percent of total billed charges,,,,75.396,100,percent of total billed charges,,,76.665,,,fee schedule,,,76.665,,,fee schedule,,,76.665,,,fee schedule,,,,,,,,,,,,,,,,64.0866,85,percent of total billed charges,,,,,,,,,,37.5245892,49.77,percent of total billed charges,,,,67.8564,90,percent of total billed charges,,,,71.6262,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,64.0866,85,percent of total billed charges,,,,,,,,,37.5245892,76.665,
TRANSFUSION BLO0D COMPONETS,3610000,CDM,36430,CPT,391,RC,outpatient,,,,752.518,413.8849,,677.2662,90,percent of total billed charges,,,,752.518,100,percent of total billed charges,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,639.6403,85,percent of total billed charges,,,42.275125,,,fee schedule,,,,374.5282086,49.77,percent of total billed charges,,,,677.2662,90,percent of total billed charges,,,,714.8921,90,percent of total billed charges,,,43.54337875,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,639.6403,85,percent of total billed charges,,,42.275125,,,fee schedule,,,42.275125,752.518,
BLOOD TRANSFUSION,3610001,CDM,36430,CPT,391,RC,outpatient,,,,364.517,200.48435,,328.0653,90,percent of total billed charges,,,,364.517,100,percent of total billed charges,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,309.83945,85,percent of total billed charges,,,42.275125,,,fee schedule,,,,181.4201109,49.77,percent of total billed charges,,,,328.0653,90,percent of total billed charges,,,,346.29115,90,percent of total billed charges,,,43.54337875,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,309.83945,85,percent of total billed charges,,,42.275125,,,fee schedule,,,42.275125,414.6975,
BLOOD TRANSFUSION - ADMIN ICU,3910025,CDM,36430,CPT,391,RC,outpatient,,,,752.518,413.8849,,677.2662,90,percent of total billed charges,,,,752.518,100,percent of total billed charges,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,639.6403,85,percent of total billed charges,,,42.275125,,,fee schedule,,,,374.5282086,49.77,percent of total billed charges,,,,677.2662,90,percent of total billed charges,,,,714.8921,90,percent of total billed charges,,,43.54337875,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,639.6403,85,percent of total billed charges,,,42.275125,,,fee schedule,,,42.275125,752.518,
BLOOD TRANSFUSION - ADMIN LDRP,3910027,CDM,36430,CPT,391,RC,outpatient,,,,752.518,413.8849,,677.2662,90,percent of total billed charges,,,,752.518,100,percent of total billed charges,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,414.6975,,,fee schedule,,,42.275125,,,fee schedule,,,42.275125,,,fee schedule,,,,639.6403,85,percent of total billed charges,,,42.275125,,,fee schedule,,,,374.5282086,49.77,percent of total billed charges,,,,677.2662,90,percent of total billed charges,,,,714.8921,90,percent of total billed charges,,,43.54337875,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,639.6403,85,percent of total billed charges,,,42.275125,,,fee schedule,,,42.275125,752.518,
IRRADIATION-BLOOD,3990000,CDM,86945,CPT,399,RC,outpatient,,,,119.5315,65.742325,,107.57835,90,percent of total billed charges,,,,119.5315,100,percent of total billed charges,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,34.998,,,fee schedule,,,,,,,,,,,,,,,,101.601775,85,percent of total billed charges,,,,,,,,,,59.49082755,49.77,percent of total billed charges,,,,107.57835,90,percent of total billed charges,,,,113.554925,90,percent of total billed charges,,,,,,,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,101.601775,85,percent of total billed charges,,,,,,,,,17,119.5315,
MAMMOGRAPHY DIAG BILATERAL,4010040,CDM,77066,CPT,401,RC,outpatient,,,,301.172,165.6446,,271.0548,90,percent of total billed charges,,,,301.172,100,percent of total billed charges,,,111.86,,,fee schedule,,,111.86,,,fee schedule,,,111.86,,,fee schedule,,,158.4485,,,fee schedule,,,158.4485,,,fee schedule,,,,255.9962,85,percent of total billed charges,,,158.4485,,,fee schedule,,,,149.8933044,49.77,percent of total billed charges,,,,271.0548,90,percent of total billed charges,,,,286.1134,90,percent of total billed charges,,,163.201955,,,fee schedule,,,126.48,,,fee schedule,,,160.6296,,,fee schedule,,,,255.9962,85,percent of total billed charges,,,158.4485,,,fee schedule,,,111.86,301.172,
MAMMOGRAM DX UNILATERAL RT,4011001,CDM,77065,CPT,401,RC,outpatient,,,RT,278.1,152.955,,250.29,90,percent of total billed charges,,,,278.1,100,percent of total billed charges,,,87.72,,,fee schedule,,,87.72,,,fee schedule,,,87.72,,,fee schedule,,,125.161,,,fee schedule,,,125.161,,,fee schedule,,,,236.385,85,percent of total billed charges,,,125.161,,,fee schedule,,,,138.41037,49.77,percent of total billed charges,,,,250.29,90,percent of total billed charges,,,,264.195,90,percent of total billed charges,,,128.91583,,,fee schedule,,,104.44,,,fee schedule,,,132.6388,,,fee schedule,,,,236.385,85,percent of total billed charges,,,125.161,,,fee schedule,,,87.72,278.1,
MAMMOGRAM DX UNILATERAL LT,4011002,CDM,77065,CPT,401,RC,outpatient,,,LT,278.1,152.955,,250.29,90,percent of total billed charges,,,,278.1,100,percent of total billed charges,,,87.72,,,fee schedule,,,87.72,,,fee schedule,,,87.72,,,fee schedule,,,125.161,,,fee schedule,,,125.161,,,fee schedule,,,,236.385,85,percent of total billed charges,,,125.161,,,fee schedule,,,,138.41037,49.77,percent of total billed charges,,,,250.29,90,percent of total billed charges,,,,264.195,90,percent of total billed charges,,,128.91583,,,fee schedule,,,104.44,,,fee schedule,,,132.6388,,,fee schedule,,,,236.385,85,percent of total billed charges,,,125.161,,,fee schedule,,,87.72,278.1,
"ULTRASOUND,ABD SINGLE ORGAN",3200000,CDM,76705,CPT,402,RC,outpatient,,,,400.155,220.08525,,360.1395,90,percent of total billed charges,,,,400.155,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,86.880375,,,fee schedule,,,86.880375,,,fee schedule,,,,340.13175,85,percent of total billed charges,,,86.880375,,,fee schedule,,,,199.1571435,49.77,percent of total billed charges,,,,360.1395,90,percent of total billed charges,,,,380.14725,90,percent of total billed charges,,,89.48678625,,,fee schedule,,,20,,,fee schedule,,,25.4,,,fee schedule,,,,340.13175,85,percent of total billed charges,,,86.880375,,,fee schedule,,,20,400.155,
ULTRASOUND ABDOMINAL;COMPLETE,3200050,CDM,76700,CPT,402,RC,outpatient,,,,835.021,459.26155,,751.5189,90,percent of total billed charges,,,,835.021,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,116.173375,,,fee schedule,,,116.173375,,,fee schedule,,,,709.76785,85,percent of total billed charges,,,116.173375,,,fee schedule,,,,415.5899517,49.77,percent of total billed charges,,,,751.5189,90,percent of total billed charges,,,,793.26995,90,percent of total billed charges,,,119.6585763,,,fee schedule,,,56,,,fee schedule,,,71.12,,,fee schedule,,,,709.76785,85,percent of total billed charges,,,116.173375,,,fee schedule,,,56,835.021,
BPP WITH NON-STRESS,3200360,CDM,76818,CPT,402,RC,outpatient,,,,455.26,250.393,,409.734,90,percent of total billed charges,,,,455.26,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,118.5035,,,fee schedule,,,118.5035,,,fee schedule,,,,386.971,85,percent of total billed charges,,,118.5035,,,fee schedule,,,,226.582902,49.77,percent of total billed charges,,,,409.734,90,percent of total billed charges,,,,432.497,90,percent of total billed charges,,,122.058605,,,fee schedule,,,34.68,,,fee schedule,,,44.0436,,,fee schedule,,,,386.971,85,percent of total billed charges,,,118.5035,,,fee schedule,,,34.68,455.26,
"ULTRASOUND,PREGNANCY;LIMITED",3200940,CDM,76815,CPT,402,RC,outpatient,,,,285.31,156.9205,,256.779,90,percent of total billed charges,,,,285.31,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,80.888625,,,fee schedule,,,80.888625,,,fee schedule,,,,242.5135,85,percent of total billed charges,,,80.888625,,,fee schedule,,,,141.998787,49.77,percent of total billed charges,,,,256.779,90,percent of total billed charges,,,,271.0445,90,percent of total billed charges,,,83.31528375,,,fee schedule,,,26,,,fee schedule,,,33.02,,,fee schedule,,,,242.5135,85,percent of total billed charges,,,80.888625,,,fee schedule,,,26,285.31,
"US, OB >/= 14 WKS;SINGLE GEST",3200990,CDM,76805,CPT,402,RC,outpatient,,,,511.292,281.2106,,460.1628,90,percent of total billed charges,,,,511.292,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,135.480125,,,fee schedule,,,135.480125,,,fee schedule,,,,434.5982,85,percent of total billed charges,,,135.480125,,,fee schedule,,,,254.4700284,49.77,percent of total billed charges,,,,460.1628,90,percent of total billed charges,,,,485.7274,90,percent of total billed charges,,,139.5445288,,,fee schedule,,,56,,,fee schedule,,,71.12,,,fee schedule,,,,434.5982,85,percent of total billed charges,,,135.480125,,,fee schedule,,,56,511.292,
"ULTRASOUND,PELVIC; COMPLETE",3201000,CDM,76856,CPT,402,RC,outpatient,,,,769.513,423.23215,,692.5617,90,percent of total billed charges,,,,769.513,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,105.1885,,,fee schedule,,,105.1885,,,fee schedule,,,,654.08605,85,percent of total billed charges,,,105.1885,,,fee schedule,,,,382.9866201,49.77,percent of total billed charges,,,,692.5617,90,percent of total billed charges,,,,731.03735,90,percent of total billed charges,,,108.344155,,,fee schedule,,,40,,,fee schedule,,,50.8,,,fee schedule,,,,654.08605,85,percent of total billed charges,,,105.1885,,,fee schedule,,,40,769.513,
"ULTRASOUND, TRANSVAGINAL",3201001,CDM,76830,CPT,402,RC,outpatient,,,,726.974,399.8357,,654.2766,90,percent of total billed charges,,,,726.974,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,119.16925,,,fee schedule,,,119.16925,,,fee schedule,,,,617.9279,85,percent of total billed charges,,,119.16925,,,fee schedule,,,,361.8149598,49.77,percent of total billed charges,,,,654.2766,90,percent of total billed charges,,,,690.6253,90,percent of total billed charges,,,122.7443275,,,fee schedule,,,68,,,fee schedule,,,86.36,,,fee schedule,,,,617.9279,85,percent of total billed charges,,,119.16925,,,fee schedule,,,68,726.974,
"ULTRASOUND,SCROTUM & CONTENTS",3201280,CDM,76870,CPT,402,RC,outpatient,,,,491.516,270.3338,,442.3644,90,percent of total billed charges,,,,491.516,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,99.8625,,,fee schedule,,,99.8625,,,fee schedule,,,,417.7886,85,percent of total billed charges,,,99.8625,,,fee schedule,,,,244.6275132,49.77,percent of total billed charges,,,,442.3644,90,percent of total billed charges,,,,466.9402,90,percent of total billed charges,,,102.858375,,,fee schedule,,,31,,,fee schedule,,,39.37,,,fee schedule,,,,417.7886,85,percent of total billed charges,,,99.8625,,,fee schedule,,,31,491.516,
"ULTRASOUND,NECK,HEAD,THYROID",3201300,CDM,76536,CPT,402,RC,outpatient,,,,415.193,228.35615,,373.6737,90,percent of total billed charges,,,,415.193,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,110.181625,,,fee schedule,,,110.181625,,,fee schedule,,,,352.91405,85,percent of total billed charges,,,110.181625,,,fee schedule,,,,206.6415561,49.77,percent of total billed charges,,,,373.6737,90,percent of total billed charges,,,,394.43335,90,percent of total billed charges,,,113.4870738,,,fee schedule,,,54,,,fee schedule,,,68.58,,,fee schedule,,,,352.91405,85,percent of total billed charges,,,110.181625,,,fee schedule,,,54,415.193,
US OB DETAILED SINGLE GEST,3206811,CDM,76811,CPT,402,RC,outpatient,,,,489.868,269.4274,,440.8812,90,percent of total billed charges,,,,489.868,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,177.0895,,,fee schedule,,,177.0895,,,fee schedule,,,,416.3878,85,percent of total billed charges,,,177.0895,,,fee schedule,,,,243.8073036,49.77,percent of total billed charges,,,,440.8812,90,percent of total billed charges,,,,465.3746,90,percent of total billed charges,,,182.402185,,,fee schedule,,,145.14,,,fee schedule,,,184.3278,,,fee schedule,,,,416.3878,85,percent of total billed charges,,,177.0895,,,fee schedule,,,145.14,489.868,
US EA ADD'L GESTATION,3206812,CDM,76812,CPT,402,RC,outpatient,,,,243.698,134.0339,,219.3282,90,percent of total billed charges,,,,243.698,100,percent of total billed charges,,,103.68,,,fee schedule,,,103.68,,,fee schedule,,,103.68,,,fee schedule,,,191.403125,,,fee schedule,,,191.403125,,,fee schedule,,,,207.1433,85,percent of total billed charges,,,191.403125,,,fee schedule,,,,121.2884946,49.77,percent of total billed charges,,,,219.3282,90,percent of total billed charges,,,,231.5131,90,percent of total billed charges,,,197.1452188,,,fee schedule,,,51.75,,,fee schedule,,,65.7225,,,fee schedule,,,,207.1433,85,percent of total billed charges,,,191.403125,,,fee schedule,,,51.75,243.698,
FNA BIOPSY W/US GUIDE 1ST LES,4020005,CDM,10005,CPT,402,RC,outpatient,,,,826.266,454.4463,,743.6394,90,percent of total billed charges,,,,826.266,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,71.901,,,fee schedule,,,71.901,,,fee schedule,,,,702.3261,85,percent of total billed charges,,,71.901,,,fee schedule,,,,411.2325882,49.77,percent of total billed charges,,,,743.6394,90,percent of total billed charges,,,,784.9527,90,percent of total billed charges,,,74.05803,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,702.3261,85,percent of total billed charges,,,71.901,,,fee schedule,,,71.901,826.266,
"ULTRASOUND,INFANT HIPS;DYNAMIC",4020010,CDM,76885,CPT,402,RC,outpatient,,,,331.454,182.2997,,298.3086,90,percent of total billed charges,,,,331.454,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,135.480125,,,fee schedule,,,135.480125,,,fee schedule,,,,281.7359,85,percent of total billed charges,,,135.480125,,,fee schedule,,,,164.9646558,49.77,percent of total billed charges,,,,298.3086,90,percent of total billed charges,,,,314.8813,90,percent of total billed charges,,,139.5445288,,,fee schedule,,,58.13,,,fee schedule,,,73.8251,,,fee schedule,,,,281.7359,85,percent of total billed charges,,,135.480125,,,fee schedule,,,58.13,331.454,
US GUIDE FOR NEEDLE PLACEMENT,4020030,CDM,76942,CPT,402,RC,outpatient,,,,322.39,177.3145,,290.151,90,percent of total billed charges,,,,322.39,100,percent of total billed charges,,,24.01,,,fee schedule,,,24.01,,,fee schedule,,,24.01,,,fee schedule,,,57.92025,,,fee schedule,,,57.92025,,,fee schedule,,,,274.0315,85,percent of total billed charges,,,57.92025,,,fee schedule,,,,160.453503,49.77,percent of total billed charges,,,,290.151,90,percent of total billed charges,,,,306.2705,90,percent of total billed charges,,,59.6578575,,,fee schedule,,,,,,,,,,,,,,,,274.0315,85,percent of total billed charges,,,57.92025,,,fee schedule,,,24.01,322.39,
"ULTRASOUND, RENAL OR AORTA",4020040,CDM,76770,CPT,402,RC,outpatient,,,,429.51,236.2305,,386.559,90,percent of total billed charges,,,,429.51,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,108.184375,,,fee schedule,,,108.184375,,,fee schedule,,,,365.0835,85,percent of total billed charges,,,108.184375,,,fee schedule,,,,213.767127,49.77,percent of total billed charges,,,,386.559,90,percent of total billed charges,,,,408.0345,90,percent of total billed charges,,,111.4299063,,,fee schedule,,,44,,,fee schedule,,,55.88,,,fee schedule,,,,365.0835,85,percent of total billed charges,,,108.184375,,,fee schedule,,,44,429.51,
"US, OB < 14 WKS; SINGLE GEST",4020060,CDM,76801,CPT,402,RC,outpatient,,,,478.435,263.13925,,430.5915,90,percent of total billed charges,,,,478.435,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,117.172,,,fee schedule,,,117.172,,,fee schedule,,,,406.66975,85,percent of total billed charges,,,117.172,,,fee schedule,,,,238.1170995,49.77,percent of total billed charges,,,,430.5915,90,percent of total billed charges,,,,454.51325,90,percent of total billed charges,,,120.68716,,,fee schedule,,,42.75,,,fee schedule,,,54.2925,,,fee schedule,,,,406.66975,85,percent of total billed charges,,,117.172,,,fee schedule,,,42.75,478.435,
"US, OB >/= 14 WKS;EA ADD'L GES",4020075,CDM,76810,CPT,402,RC,outpatient,,,,356.38,196.009,,320.742,90,percent of total billed charges,,,,356.38,100,percent of total billed charges,,,39.77,,,fee schedule,,,39.77,,,fee schedule,,,39.77,,,fee schedule,,,87.21325,,,fee schedule,,,87.21325,,,fee schedule,,,,302.923,85,percent of total billed charges,,,87.21325,,,fee schedule,,,,177.370326,49.77,percent of total billed charges,,,,320.742,90,percent of total billed charges,,,,338.561,90,percent of total billed charges,,,89.8296475,,,fee schedule,,,64,,,fee schedule,,,81.28,,,fee schedule,,,,302.923,85,percent of total billed charges,,,87.21325,,,fee schedule,,,39.77,356.38,
"US, OB TRANSVAGINAL",4020080,CDM,76817,CPT,402,RC,outpatient,,,,478.435,263.13925,,430.5915,90,percent of total billed charges,,,,478.435,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,92.53925,,,fee schedule,,,92.53925,,,fee schedule,,,,406.66975,85,percent of total billed charges,,,92.53925,,,fee schedule,,,,238.1170995,49.77,percent of total billed charges,,,,430.5915,90,percent of total billed charges,,,,454.51325,90,percent of total billed charges,,,95.3154275,,,fee schedule,,,58.5,,,fee schedule,,,74.295,,,fee schedule,,,,406.66975,85,percent of total billed charges,,,92.53925,,,fee schedule,,,58.5,478.435,
BPP WITHOUT NON-STRESS TEST,4020090,CDM,76819,CPT,402,RC,outpatient,,,,254.307,139.86885,,228.8763,90,percent of total billed charges,,,,254.307,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,85.548875,,,fee schedule,,,85.548875,,,fee schedule,,,,216.16095,85,percent of total billed charges,,,85.548875,,,fee schedule,,,,126.5685939,49.77,percent of total billed charges,,,,228.8763,90,percent of total billed charges,,,,241.59165,90,percent of total billed charges,,,88.11534125,,,fee schedule,,,63.01,,,fee schedule,,,80.0227,,,fee schedule,,,,216.16095,85,percent of total billed charges,,,85.548875,,,fee schedule,,,63.01,254.307,
US - BREAST RT; 4 QUADS,4021501,CDM,76641,CPT,402,RC,outpatient,,,RT,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,102.5255,,,fee schedule,,,102.5255,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,102.5255,,,fee schedule,,,,150.8673033,49.77,percent of total billed charges,,,,272.8161,90,percent of total billed charges,,,,287.97255,90,percent of total billed charges,,,105.601265,,,fee schedule,,,63.4,,,fee schedule,,,80.518,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,102.5255,,,fee schedule,,,63.4,303.129,
US - BREAST LT; 4 QUADS,4021502,CDM,76641,CPT,402,RC,outpatient,,,LT,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,102.5255,,,fee schedule,,,102.5255,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,102.5255,,,fee schedule,,,,150.8673033,49.77,percent of total billed charges,,,,272.8161,90,percent of total billed charges,,,,287.97255,90,percent of total billed charges,,,105.601265,,,fee schedule,,,63.4,,,fee schedule,,,80.518,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,102.5255,,,fee schedule,,,63.4,303.129,
US BREAST BILATERAL; 8 QUADS,4021503,CDM,76641,CPT,402,RC,outpatient,,,50,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,102.5255,,,fee schedule,,,102.5255,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,102.5255,,,fee schedule,,,,150.8673033,49.77,percent of total billed charges,,,,272.8161,90,percent of total billed charges,,,,287.97255,90,percent of total billed charges,,,105.601265,,,fee schedule,,,63.4,,,fee schedule,,,80.518,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,102.5255,,,fee schedule,,,63.4,303.129,
US EXAM CHEST,4021701,CDM,76604,CPT,402,RC,outpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,56.921625,,,fee schedule,,,56.921625,,,fee schedule,,,,160.9169,85,percent of total billed charges,,,56.921625,,,fee schedule,,,,94.2215778,49.77,percent of total billed charges,,,,170.3826,90,percent of total billed charges,,,,179.8483,90,percent of total billed charges,,,58.62927375,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,160.9169,85,percent of total billed charges,,,56.921625,,,fee schedule,,,23,189.314,
US EXAM CHEST,4021702,CDM,76604,CPT,402,RC,outpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,56.921625,,,fee schedule,,,56.921625,,,fee schedule,,,,160.9169,85,percent of total billed charges,,,56.921625,,,fee schedule,,,,94.2215778,49.77,percent of total billed charges,,,,170.3826,90,percent of total billed charges,,,,179.8483,90,percent of total billed charges,,,58.62927375,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,160.9169,85,percent of total billed charges,,,56.921625,,,fee schedule,,,23,189.314,
US - CHEST B-SCAN BILATERAL,4021703,CDM,76604,CPT,402,RC,outpatient,,,,189.314,104.1227,,170.3826,90,percent of total billed charges,,,,189.314,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,56.921625,,,fee schedule,,,56.921625,,,fee schedule,,,,160.9169,85,percent of total billed charges,,,56.921625,,,fee schedule,,,,94.2215778,49.77,percent of total billed charges,,,,170.3826,90,percent of total billed charges,,,,179.8483,90,percent of total billed charges,,,58.62927375,,,fee schedule,,,23,,,fee schedule,,,29.21,,,fee schedule,,,,160.9169,85,percent of total billed charges,,,56.921625,,,fee schedule,,,23,189.314,
UMBILICAL ARTERY ECHO US,4025500,CDM,76820,CPT,402,RC,outpatient,,,,154.5,84.975,,139.05,90,percent of total billed charges,,,,154.5,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,44.60525,,,fee schedule,,,44.60525,,,fee schedule,,,,131.325,85,percent of total billed charges,,,44.60525,,,fee schedule,,,,76.89465,49.77,percent of total billed charges,,,,139.05,90,percent of total billed charges,,,,146.775,90,percent of total billed charges,,,45.9434075,,,fee schedule,,,57.11,,,fee schedule,,,72.5297,,,fee schedule,,,,131.325,85,percent of total billed charges,,,44.60525,,,fee schedule,,,44.60525,154.5,
US BREAST RT LIMITED;< 4 QUADS,4027662,CDM,76642,CPT,402,RC,outpatient,,,RT,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,84.883125,,,fee schedule,,,84.883125,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,84.883125,,,fee schedule,,,,150.8673033,49.77,percent of total billed charges,,,,272.8161,90,percent of total billed charges,,,,287.97255,90,percent of total billed charges,,,87.42961875,,,fee schedule,,,48.5,,,fee schedule,,,61.595,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,84.883125,,,fee schedule,,,48.5,303.129,
US BREAST LT LIMITED;< 4 QUADS,4027664,CDM,76642,CPT,402,RC,outpatient,,,LT,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,84.883125,,,fee schedule,,,84.883125,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,84.883125,,,fee schedule,,,,150.8673033,49.77,percent of total billed charges,,,,272.8161,90,percent of total billed charges,,,,287.97255,90,percent of total billed charges,,,87.42961875,,,fee schedule,,,48.5,,,fee schedule,,,61.595,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,84.883125,,,fee schedule,,,48.5,303.129,
US BREAST LIMITED; BILATERAL,4027665,CDM,76642,CPT,402,RC,outpatient,,,50,303.129,166.72095,,272.8161,90,percent of total billed charges,,,,303.129,100,percent of total billed charges,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,76.62,,,fee schedule,,,84.883125,,,fee schedule,,,84.883125,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,84.883125,,,fee schedule,,,,150.8673033,49.77,percent of total billed charges,,,,272.8161,90,percent of total billed charges,,,,287.97255,90,percent of total billed charges,,,87.42961875,,,fee schedule,,,48.5,,,fee schedule,,,61.595,,,fee schedule,,,,257.65965,85,percent of total billed charges,,,84.883125,,,fee schedule,,,48.5,303.129,
SCREENING US FOR AAA,4027670,CDM,76706,CPT,402,RC,outpatient,,,,429.51,236.2305,,386.559,90,percent of total billed charges,,,,429.51,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,106.52,,,fee schedule,,,106.52,,,fee schedule,,,,365.0835,85,percent of total billed charges,,,106.52,,,fee schedule,,,,213.767127,49.77,percent of total billed charges,,,,386.559,90,percent of total billed charges,,,,408.0345,90,percent of total billed charges,,,109.7156,,,fee schedule,,,72.03,,,fee schedule,,,91.4781,,,fee schedule,,,,365.0835,85,percent of total billed charges,,,106.52,,,fee schedule,,,72.03,429.51,
US EXTR N/VASCULAR LIMITED,4027688,CDM,76882,CPT,402,RC,outpatient,,,,544.973,299.73515,,490.4757,90,percent of total billed charges,,,,544.973,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,463.22705,85,percent of total billed charges,,,63.24625,,,fee schedule,,,,271.2330621,49.77,percent of total billed charges,,,,490.4757,90,percent of total billed charges,,,,517.72435,90,percent of total billed charges,,,65.1436375,,,fee schedule,,,11.99,,,fee schedule,,,15.2273,,,fee schedule,,,,463.22705,85,percent of total billed charges,,,63.24625,,,fee schedule,,,11.99,544.973,
US EXTR N/VASCULAR LIMITED RT,4027688.1,CDM,76882,CPT,402,RC,outpatient,,,RT,272.538,149.8959,,245.2842,90,percent of total billed charges,,,,272.538,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,231.6573,85,percent of total billed charges,,,63.24625,,,fee schedule,,,,135.6421626,49.77,percent of total billed charges,,,,245.2842,90,percent of total billed charges,,,,258.9111,90,percent of total billed charges,,,65.1436375,,,fee schedule,,,11.99,,,fee schedule,,,15.2273,,,fee schedule,,,,231.6573,85,percent of total billed charges,,,63.24625,,,fee schedule,,,11.99,272.538,
US EXTR N/VASCULAR LIMITED LT,4027688.2,CDM,76882,CPT,402,RC,outpatient,,,LT,272.538,149.8959,,245.2842,90,percent of total billed charges,,,,272.538,100,percent of total billed charges,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,107.6,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,231.6573,85,percent of total billed charges,,,63.24625,,,fee schedule,,,,135.6421626,49.77,percent of total billed charges,,,,245.2842,90,percent of total billed charges,,,,258.9111,90,percent of total billed charges,,,65.1436375,,,fee schedule,,,11.99,,,fee schedule,,,15.2273,,,fee schedule,,,,231.6573,85,percent of total billed charges,,,63.24625,,,fee schedule,,,11.99,272.538,
"MAMMOGRAPHY SCREEN, BILATERAL",4030010,CDM,77067,CPT,403,RC,outpatient,,,,239.372,131.6546,,215.4348,90,percent of total billed charges,,,,239.372,100,percent of total billed charges,,,92.75,,,fee schedule,,,92.75,,,fee schedule,,,92.75,,,fee schedule,,,127.824,,,fee schedule,,,127.824,,,fee schedule,,,,203.4662,85,percent of total billed charges,,,127.824,,,fee schedule,,,,119.1354444,49.77,percent of total billed charges,,,,215.4348,90,percent of total billed charges,,,,227.4034,90,percent of total billed charges,,,131.65872,,,fee schedule,,,98.84,,,fee schedule,,,125.5268,,,fee schedule,,,,203.4662,85,percent of total billed charges,,,127.824,,,fee schedule,,,92.75,239.372,
MDI UPDRAFT INHALATION AIRWAY,4100005,CDM,94640,CPT,410,RC,outpatient,,,,207.751,114.26305,,186.9759,90,percent of total billed charges,,,,207.751,100,percent of total billed charges,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,7.989,,,fee schedule,,,7.989,,,fee schedule,,,,176.58835,85,percent of total billed charges,,,7.989,,,fee schedule,,,,103.3976727,49.77,percent of total billed charges,,,,186.9759,90,percent of total billed charges,,,,197.36345,90,percent of total billed charges,,,8.22867,,,fee schedule,,,6,,,fee schedule,,,7.62,,,fee schedule,,,,176.58835,85,percent of total billed charges,,,7.989,,,fee schedule,,,6,207.751,
MDI/UPDRAFT TRMT;ADD'L PER DAY,4100025,CDM,94640,CPT,410,RC,outpatient,,,,77.765,42.77075,,69.9885,90,percent of total billed charges,,,,77.765,100,percent of total billed charges,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,7.989,,,fee schedule,,,7.989,,,fee schedule,,,,66.10025,85,percent of total billed charges,,,7.989,,,fee schedule,,,,38.7036405,49.77,percent of total billed charges,,,,69.9885,90,percent of total billed charges,,,,73.87675,90,percent of total billed charges,,,8.22867,,,fee schedule,,,6,,,fee schedule,,,7.62,,,fee schedule,,,,66.10025,85,percent of total billed charges,,,7.989,,,fee schedule,,,6,181.776,
CPAP/BiPAP INITIATION & MGMT,4100080,CDM,94660,CPT,410,RC,outpatient,,,,514.691,283.08005,,463.2219,90,percent of total billed charges,,,,514.691,100,percent of total billed charges,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,437.48735,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,256.1617107,49.77,percent of total billed charges,,,,463.2219,90,percent of total billed charges,,,,488.95645,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,437.48735,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,514.691,
NT SUCTION,4100095,CDM,31720,CPT,410,RC,outpatient,,,,82.606,45.4333,,74.3454,90,percent of total billed charges,,,,82.606,100,percent of total billed charges,,,194.76,,,fee schedule,,,194.76,,,fee schedule,,,194.76,,,fee schedule,,,47.601125,,,fee schedule,,,47.601125,,,fee schedule,,,,70.2151,85,percent of total billed charges,,,47.601125,,,fee schedule,,,,41.1130062,49.77,percent of total billed charges,,,,74.3454,90,percent of total billed charges,,,,78.4757,90,percent of total billed charges,,,49.02915875,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,70.2151,85,percent of total billed charges,,,47.601125,,,fee schedule,,,41.1130062,317.5,
MANIPULATE CHEST WALL;INITIAL,4100130,CDM,94667,CPT,410,RC,outpatient,,,,114.433,62.93815,,102.9897,90,percent of total billed charges,,,,114.433,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,24.965625,,,fee schedule,,,24.965625,,,fee schedule,,,,97.26805,85,percent of total billed charges,,,24.965625,,,fee schedule,,,,56.9533041,49.77,percent of total billed charges,,,,102.9897,90,percent of total billed charges,,,,108.71135,90,percent of total billed charges,,,25.71459375,,,fee schedule,,,,,,,,,,,,,,,,97.26805,85,percent of total billed charges,,,24.965625,,,fee schedule,,,24.965625,114.433,
MANIPULATE CHEST WALL; SUBSEQ,4100135,CDM,94668,CPT,410,RC,outpatient,,,,89.198,49.0589,,80.2782,90,percent of total billed charges,,,,89.198,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,39.27925,,,fee schedule,,,39.27925,,,fee schedule,,,,75.8183,85,percent of total billed charges,,,39.27925,,,fee schedule,,,,44.3938446,49.77,percent of total billed charges,,,,80.2782,90,percent of total billed charges,,,,84.7381,90,percent of total billed charges,,,40.4576275,,,fee schedule,,,,,,,,,,,,,,,,75.8183,85,percent of total billed charges,,,39.27925,,,fee schedule,,,39.27925,110.2185,
VENTILATOR MGMT;SUBSEQUENT DAY,4100260,CDM,94003,CPT,410,RC,outpatient,,,,491.207,270.16385,,442.0863,90,percent of total billed charges,,,,491.207,100,percent of total billed charges,,,528.4545,,,fee schedule,,,528.4545,,,fee schedule,,,528.4545,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,417.52595,85,percent of total billed charges,,,63.24625,,,fee schedule,,,,244.4737239,49.77,percent of total billed charges,,,,442.0863,90,percent of total billed charges,,,,466.64665,90,percent of total billed charges,,,65.1436375,,,fee schedule,,,,,,,,,,,,,,,,417.52595,85,percent of total billed charges,,,63.24625,,,fee schedule,,,63.24625,528.4545,
VENTILATOR MGMT; INITIAL DAY,4100270,CDM,94002,CPT,410,RC,outpatient,,,,1106.426,608.5343,,995.7834,90,percent of total billed charges,,,,1106.426,100,percent of total billed charges,,,528.4545,,,fee schedule,,,528.4545,,,fee schedule,,,528.4545,,,fee schedule,,,89.87625,,,fee schedule,,,89.87625,,,fee schedule,,,,940.4621,85,percent of total billed charges,,,89.87625,,,fee schedule,,,,550.6682202,49.77,percent of total billed charges,,,,995.7834,90,percent of total billed charges,,,,1051.1047,90,percent of total billed charges,,,92.5725375,,,fee schedule,,,,,,,,,,,,,,,,940.4621,85,percent of total billed charges,,,89.87625,,,fee schedule,,,89.87625,1106.426,
ARTERIAL PUNCTURE,9200000,CDM,36600,CPT,410,RC,outpatient,,,,53.766,29.5713,,48.3894,90,percent of total billed charges,,,,53.766,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,45.7011,85,percent of total billed charges,,,14.6465,,,fee schedule,,,,26.7593382,49.77,percent of total billed charges,,,,48.3894,90,percent of total billed charges,,,,51.0777,90,percent of total billed charges,,,15.085895,,,fee schedule,,,,,,,,,,,,,,,,45.7011,85,percent of total billed charges,,,14.6465,,,fee schedule,,,14.6465,118.09125,
PT CONSULT,4000020,CDM,,,420,RC,outpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,51.6339,,,fee schedule,,,45.8968,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,28.5535467,57.371,
PT - SELF/HOME ADL'S EA 15 MIN,4200000,CDM,97535,CPT,420,RC,outpatient,,,GP,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,33.495,,,fee schedule,,,33.495,,,fee schedule,,,33.495,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,32.62175,,,fee schedule,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,33.6004025,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,32.62175,,,fee schedule,,,27.6308109,55.517,
PT - AQUATIC THERAPY/W/EXER,4200010,CDM,97113,CPT,420,RC,outpatient,,,GP,89.713,49.34215,,80.7417,90,percent of total billed charges,,,,89.713,100,percent of total billed charges,,,40.884,,,fee schedule,,,40.884,,,fee schedule,,,40.884,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,76.25605,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,44.6501601,49.77,percent of total billed charges,,,,80.7417,90,percent of total billed charges,,,,85.22735,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,76.25605,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,89.713,
PT - CONTINOUS PASSIVE MOTION,4200130,CDM,97039,CPT,420,RC,outpatient,,,,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.21675,85,percent of total billed charges,,,,,,,,,,29.9889135,49.77,percent of total billed charges,,,,54.2295,90,percent of total billed charges,,,,57.24225,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,51.21675,85,percent of total billed charges,,,,,,,,,29.9889135,60.255,
DBRDMT OPEN WOUND 1ST 20CM<,4200135,CDM,97597,CPT,420,RC,outpatient,,,GP,143.582,78.9701,,129.2238,90,percent of total billed charges,,,,143.582,100,percent of total billed charges,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,122.0447,85,percent of total billed charges,,,34.951875,,,fee schedule,,,,71.4607614,49.77,percent of total billed charges,,,,129.2238,90,percent of total billed charges,,,,136.4029,90,percent of total billed charges,,,36.00043125,,,fee schedule,,,24.06,,,fee schedule,,,30.5562,,,fee schedule,,,,122.0447,85,percent of total billed charges,,,34.951875,,,fee schedule,,,24.06,179.575,
WOUND CARE DBRDB NON-SELECT,4200136,CDM,97602,CPT,420,RC,outpatient,,,,137.711,75.74105,,123.9399,90,percent of total billed charges,,,,137.711,100,percent of total billed charges,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,,,,,,,,,,,,,,117.05435,85,percent of total billed charges,,,,,,,,,,68.5387647,49.77,percent of total billed charges,,,,123.9399,90,percent of total billed charges,,,,130.82545,90,percent of total billed charges,,,,,,,,,67.65,,,fee schedule,,,85.9155,,,fee schedule,,,,117.05435,85,percent of total billed charges,,,,,,,,,67.65,179.575,
PT-ELECT STIMULATION MANUAL/15,4200220,CDM,97032,CPT,420,RC,outpatient,,,GP,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,44.1252,85,percent of total billed charges,,,14.313625,,,fee schedule,,,,25.8366024,49.77,percent of total billed charges,,,,46.7208,90,percent of total billed charges,,,,49.3164,90,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,44.1252,85,percent of total billed charges,,,14.313625,,,fee schedule,,,14.313625,51.912,
"ELECT STIM,OTHER THAN WOUND",4200230,CDM,97014,CPT,420,RC,outpatient,,,GP,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,15.27,,,fee schedule,,,15.27,,,fee schedule,,,15.27,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,12.316375,,,fee schedule,,,,23.8886046,49.77,percent of total billed charges,,,,43.1982,90,percent of total billed charges,,,,45.5981,90,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,40.7983,85,percent of total billed charges,,,12.316375,,,fee schedule,,,12.316375,47.998,
PT - MANUAL THERAPY EA 15 MIN,4200310,CDM,97140,CPT,420,RC,outpatient,,,GP,77.559,42.65745,,69.8031,90,percent of total billed charges,,,,77.559,100,percent of total billed charges,,,27.973,,,fee schedule,,,27.973,,,fee schedule,,,27.973,,,fee schedule,,,26.962875,,,fee schedule,,,26.962875,,,fee schedule,,,,65.92515,85,percent of total billed charges,,,26.962875,,,fee schedule,,,,38.6011143,49.77,percent of total billed charges,,,,69.8031,90,percent of total billed charges,,,,73.68105,90,percent of total billed charges,,,27.77176125,,,fee schedule,,,,,,,,,,,,,,,,65.92515,85,percent of total billed charges,,,26.962875,,,fee schedule,,,26.962875,77.559,
PT-NEUROMUSCULAR RE-ED 15 MIN,4200330,CDM,97112,CPT,420,RC,outpatient,,,GP,78.692,43.2806,,70.8228,90,percent of total billed charges,,,,78.692,100,percent of total billed charges,,,34.716,,,fee schedule,,,34.716,,,fee schedule,,,34.716,,,fee schedule,,,33.620375,,,fee schedule,,,33.620375,,,fee schedule,,,,66.8882,85,percent of total billed charges,,,33.620375,,,fee schedule,,,,39.1650084,49.77,percent of total billed charges,,,,70.8228,90,percent of total billed charges,,,,74.7574,90,percent of total billed charges,,,34.62898625,,,fee schedule,,,,,,,,,,,,,,,,66.8882,85,percent of total billed charges,,,33.620375,,,fee schedule,,,33.620375,78.692,
PT - RE-EVAL EST PLAN 20 MINS,4200430,CDM,97164,CPT,420,RC,outpatient,,,,83.842,46.1131,,75.4578,90,percent of total billed charges,,,,83.842,100,percent of total billed charges,,,70.862,,,fee schedule,,,70.862,,,fee schedule,,,70.862,,,fee schedule,,,69.570875,,,fee schedule,,,69.570875,,,fee schedule,,,,71.2657,85,percent of total billed charges,,,69.570875,,,fee schedule,,,,41.7281634,49.77,percent of total billed charges,,,,75.4578,90,percent of total billed charges,,,,79.6499,90,percent of total billed charges,,,71.65800125,,,fee schedule,,,98.88,,,fee schedule,,,125.5776,,,fee schedule,,,,71.2657,85,percent of total billed charges,,,69.570875,,,fee schedule,,,41.7281634,125.5776,
PT - THERAPUTIC ACTIVITY/15 M,4200460,CDM,97530,CPT,420,RC,outpatient,,,GP,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,37.565,,,fee schedule,,,37.565,,,fee schedule,,,37.565,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,21.76,,,fee schedule,,,27.6352,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,36.61625,,,fee schedule,,,21.76,55.517,
PT - GAIT TRAINING EA 15 MIN,4200470,CDM,97116,CPT,420,RC,outpatient,,,GP,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,53.49305,85,percent of total billed charges,,,29.293,,,fee schedule,,,,31.3217541,49.77,percent of total billed charges,,,,56.6397,90,percent of total billed charges,,,,59.78635,90,percent of total billed charges,,,30.17179,,,fee schedule,,,,,,,,,,,,,,,,53.49305,85,percent of total billed charges,,,29.293,,,fee schedule,,,29.293,62.933,
DRY NEEDLING 1-2 MUSCLES,4200560,CDM,20560,CPT,420,RC,outpatient,,,,49.646,27.3053,,44.6814,90,percent of total billed charges,,,,49.646,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,42.1991,85,percent of total billed charges,,,14.6465,,,fee schedule,,,,24.7088142,49.77,percent of total billed charges,,,,44.6814,90,percent of total billed charges,,,,47.1637,90,percent of total billed charges,,,15.085895,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,42.1991,85,percent of total billed charges,,,14.6465,,,fee schedule,,,14.6465,317.5,
DRY NEEDLING 3 OR MORE MUSCLES,4200561,CDM,20561,CPT,420,RC,outpatient,,,,39.758,21.8669,,35.7822,90,percent of total billed charges,,,,39.758,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,21.96975,,,fee schedule,,,21.96975,,,fee schedule,,,,33.7943,85,percent of total billed charges,,,21.96975,,,fee schedule,,,,19.7875566,49.77,percent of total billed charges,,,,35.7822,90,percent of total billed charges,,,,37.7701,90,percent of total billed charges,,,22.6288425,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,33.7943,85,percent of total billed charges,,,21.96975,,,fee schedule,,,19.7875566,317.5,
PT-THERAPEUTIC EXERCISE/15 MIN,4200760,CDM,97110,CPT,420,RC,outpatient,,,GP,84.975,46.73625,,76.4775,90,percent of total billed charges,,,,84.975,100,percent of total billed charges,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,72.22875,85,percent of total billed charges,,,29.293,,,fee schedule,,,,42.2920575,49.77,percent of total billed charges,,,,76.4775,90,percent of total billed charges,,,,80.72625,90,percent of total billed charges,,,30.17179,,,fee schedule,,,21.76,,,fee schedule,,,27.6352,,,fee schedule,,,,72.22875,85,percent of total billed charges,,,29.293,,,fee schedule,,,21.76,84.975,
PT - TRACTION MECHANICAL,4200810,CDM,97012,CPT,420,RC,outpatient,,,GP,49.234,27.0787,,44.3106,90,percent of total billed charges,,,,49.234,100,percent of total billed charges,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,13.98075,,,fee schedule,,,13.98075,,,fee schedule,,,,41.8489,85,percent of total billed charges,,,13.98075,,,fee schedule,,,,24.5037618,49.77,percent of total billed charges,,,,44.3106,90,percent of total billed charges,,,,46.7723,90,percent of total billed charges,,,14.4001725,,,fee schedule,,,,,,,,,,,,,,,,41.8489,85,percent of total billed charges,,,13.98075,,,fee schedule,,,13.98075,49.234,
PT - ULTRASOUND EACH 15 MIN,4200820,CDM,97035,CPT,420,RC,outpatient,,,GP,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,14.685,,,fee schedule,,,14.685,,,fee schedule,,,14.685,,,fee schedule,,,13.98075,,,fee schedule,,,13.98075,,,fee schedule,,,,46.13885,85,percent of total billed charges,,,13.98075,,,fee schedule,,,,27.0156537,49.77,percent of total billed charges,,,,48.8529,90,percent of total billed charges,,,,51.56695,90,percent of total billed charges,,,14.4001725,,,fee schedule,,,,,,,,,,,,,,,,46.13885,85,percent of total billed charges,,,13.98075,,,fee schedule,,,13.98075,54.281,
PT - WHIRLPOOL,4200840,CDM,97022,CPT,420,RC,outpatient,,,GP,59.019,32.46045,,53.1171,90,percent of total billed charges,,,,59.019,100,percent of total billed charges,,,17.017,,,fee schedule,,,17.017,,,fee schedule,,,17.017,,,fee schedule,,,16.976625,,,fee schedule,,,16.976625,,,fee schedule,,,,50.16615,85,percent of total billed charges,,,16.976625,,,fee schedule,,,,29.3737563,49.77,percent of total billed charges,,,,53.1171,90,percent of total billed charges,,,,56.06805,90,percent of total billed charges,,,17.48592375,,,fee schedule,,,,,,,,,,,,,,,,50.16615,85,percent of total billed charges,,,16.976625,,,fee schedule,,,16.976625,59.019,
PT - WHEELCHAIR MGMT EA 15 MIN,4200850,CDM,97542,CPT,420,RC,outpatient,,,,46.865,25.77575,,42.1785,90,percent of total billed charges,,,,46.865,100,percent of total billed charges,,,32.703,,,fee schedule,,,32.703,,,fee schedule,,,32.703,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,39.83525,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,23.3247105,49.77,percent of total billed charges,,,,42.1785,90,percent of total billed charges,,,,44.52175,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,,,,,,,,,,,,,,39.83525,85,percent of total billed charges,,,31.623125,,,fee schedule,,,23.3247105,46.865,
APPLICATION FS STATIC,4202913,CDM,29130,CPT,420,RC,outpatient,,,,100.734,55.4037,,90.6606,90,percent of total billed charges,,,,100.734,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,28.960125,,,fee schedule,,,28.960125,,,fee schedule,,,,85.6239,85,percent of total billed charges,,,28.960125,,,fee schedule,,,,50.1353118,49.77,percent of total billed charges,,,,90.6606,90,percent of total billed charges,,,,95.6973,90,percent of total billed charges,,,29.82892875,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,85.6239,85,percent of total billed charges,,,28.960125,,,fee schedule,,,28.960125,317.5,
PT - UNNA BOOT,4202958,CDM,29580,CPT,420,RC,outpatient,,,GP,142.037,78.12035,,127.8333,90,percent of total billed charges,,,,142.037,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,25.96425,,,fee schedule,,,25.96425,,,fee schedule,,,,120.73145,85,percent of total billed charges,,,25.96425,,,fee schedule,,,,70.6918149,49.77,percent of total billed charges,,,,127.8333,90,percent of total billed charges,,,,134.93515,90,percent of total billed charges,,,26.7431775,,,fee schedule,,,,,,,,,,,,,,,,120.73145,85,percent of total billed charges,,,25.96425,,,fee schedule,,,25.96425,148.24125,
PT - UNNA BOOT/BILATERAL,4202959,CDM,29580,CPT,420,RC,outpatient,,,GP,284.074,156.2407,,255.6666,90,percent of total billed charges,,,,284.074,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,25.96425,,,fee schedule,,,25.96425,,,fee schedule,,,,241.4629,85,percent of total billed charges,,,25.96425,,,fee schedule,,,,141.3836298,49.77,percent of total billed charges,,,,255.6666,90,percent of total billed charges,,,,269.8703,90,percent of total billed charges,,,26.7431775,,,fee schedule,,,,,,,,,,,,,,,,241.4629,85,percent of total billed charges,,,25.96425,,,fee schedule,,,25.96425,284.074,
PT EVALUATION; LOW COMPLEXITY,4207161,CDM,97161,CPT,420,RC,outpatient,,,GP,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,100.195375,,,fee schedule,,,100.195375,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,100.195375,,,fee schedule,,,,84.9942198,49.77,percent of total billed charges,,,,153.6966,90,percent of total billed charges,,,,162.2353,90,percent of total billed charges,,,103.2012363,,,fee schedule,,,98.88,,,fee schedule,,,125.5776,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,100.195375,,,fee schedule,,,84.9942198,170.774,
PT EVALUATION; MOD COMPLEXITY,4207162,CDM,97162,CPT,420,RC,outpatient,,,GP,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,100.195375,,,fee schedule,,,100.195375,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,100.195375,,,fee schedule,,,,84.9942198,49.77,percent of total billed charges,,,,153.6966,90,percent of total billed charges,,,,162.2353,90,percent of total billed charges,,,103.2012363,,,fee schedule,,,148.32,,,fee schedule,,,188.3664,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,100.195375,,,fee schedule,,,84.9942198,188.3664,
PT EVAL HIGH COMP 45 MIN,4207163,CDM,97163,CPT,420,RC,outpatient,,,GP,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,100.195375,,,fee schedule,,,100.195375,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,100.195375,,,fee schedule,,,,84.9942198,49.77,percent of total billed charges,,,,153.6966,90,percent of total billed charges,,,,162.2353,90,percent of total billed charges,,,103.2012363,,,fee schedule,,,197.76,,,fee schedule,,,251.1552,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,100.195375,,,fee schedule,,,84.9942198,251.1552,
PT ESTAB RE-EVAL 20 MINS,4207164,CDM,97164,CPT,420,RC,outpatient,,,GP,83.842,46.1131,,75.4578,90,percent of total billed charges,,,,83.842,100,percent of total billed charges,,,70.862,,,fee schedule,,,70.862,,,fee schedule,,,70.862,,,fee schedule,,,69.570875,,,fee schedule,,,69.570875,,,fee schedule,,,,71.2657,85,percent of total billed charges,,,69.570875,,,fee schedule,,,,41.7281634,49.77,percent of total billed charges,,,,75.4578,90,percent of total billed charges,,,,79.6499,90,percent of total billed charges,,,71.65800125,,,fee schedule,,,98.88,,,fee schedule,,,125.5776,,,fee schedule,,,,71.2657,85,percent of total billed charges,,,69.570875,,,fee schedule,,,41.7281634,125.5776,
CANALITH REPOSITIONING,4209599,CDM,95992,CPT,420,RC,outpatient,,,GP,84.254,46.3397,,75.8286,90,percent of total billed charges,,,,84.254,100,percent of total billed charges,,,37.598,,,fee schedule,,,37.598,,,fee schedule,,,37.598,,,fee schedule,,,35.28475,,,fee schedule,,,35.28475,,,fee schedule,,,,71.6159,85,percent of total billed charges,,,35.28475,,,fee schedule,,,,41.9332158,49.77,percent of total billed charges,,,,75.8286,90,percent of total billed charges,,,,80.0413,90,percent of total billed charges,,,36.3432925,,,fee schedule,,,,,,,,,,,,,,,,71.6159,85,percent of total billed charges,,,35.28475,,,fee schedule,,,35.28475,84.254,
PT - INFRARED MODALITY,4209702,CDM,97026,CPT,420,RC,outpatient,,,GP,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,6.556,,,fee schedule,,,6.556,,,fee schedule,,,6.556,,,fee schedule,,,6.6575,,,fee schedule,,,6.6575,,,fee schedule,,,,10.6811,85,percent of total billed charges,,,6.6575,,,fee schedule,,,,6.2540982,49.77,percent of total billed charges,,,,11.3094,90,percent of total billed charges,,,,11.9377,90,percent of total billed charges,,,6.857225,,,fee schedule,,,,,,,,,,,,,,,,10.6811,85,percent of total billed charges,,,6.6575,,,fee schedule,,,6.2540982,12.566,
PHYSICAL PERFORMANCE TEST 15/M,4209775,CDM,97750,CPT,420,RC,outpatient,,,GP,94.863,52.17465,,85.3767,90,percent of total billed charges,,,,94.863,100,percent of total billed charges,,,34.441,,,fee schedule,,,34.441,,,fee schedule,,,34.441,,,fee schedule,,,33.95325,,,fee schedule,,,33.95325,,,fee schedule,,,,80.63355,85,percent of total billed charges,,,33.95325,,,fee schedule,,,,47.2133151,49.77,percent of total billed charges,,,,85.3767,90,percent of total billed charges,,,,90.11985,90,percent of total billed charges,,,34.9718475,,,fee schedule,,,27.35,,,fee schedule,,,34.7345,,,fee schedule,,,,80.63355,85,percent of total billed charges,,,33.95325,,,fee schedule,,,27.35,94.863,
OT - SELF/HOME ADL'S EA 15 MIN,4300000,CDM,97535,CPT,430,RC,outpatient,,,GO,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,33.495,,,fee schedule,,,33.495,,,fee schedule,,,33.495,,,fee schedule,,,32.62175,,,fee schedule,,,32.62175,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,32.62175,,,fee schedule,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,33.6004025,,,fee schedule,,,,,,,,,,,,,,,,47.18945,85,percent of total billed charges,,,32.62175,,,fee schedule,,,27.6308109,55.517,
OT - AQUATIC THERAPY EA 15 MIN,4300010,CDM,97113,CPT,430,RC,outpatient,,,GO,89.713,49.34215,,80.7417,90,percent of total billed charges,,,,89.713,100,percent of total billed charges,,,40.884,,,fee schedule,,,40.884,,,fee schedule,,,40.884,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,76.25605,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,44.6501601,49.77,percent of total billed charges,,,,80.7417,90,percent of total billed charges,,,,85.22735,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,76.25605,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,89.713,
SELECT DEBRIDE 1ST 20 SQ CM,4300135,CDM,97597,CPT,430,RC,outpatient,,,GO,117.832,64.8076,,106.0488,90,percent of total billed charges,,,,117.832,100,percent of total billed charges,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,100.1572,85,percent of total billed charges,,,34.951875,,,fee schedule,,,,58.6449864,49.77,percent of total billed charges,,,,106.0488,90,percent of total billed charges,,,,111.9404,90,percent of total billed charges,,,36.00043125,,,fee schedule,,,24.06,,,fee schedule,,,30.5562,,,fee schedule,,,,100.1572,85,percent of total billed charges,,,34.951875,,,fee schedule,,,24.06,179.575,
OT - COMMUNITY REINT EA 15 MIN,4300187,CDM,97537,CPT,430,RC,outpatient,,,GO,60.255,33.14025,,54.2295,90,percent of total billed charges,,,,60.255,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,51.21675,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,29.9889135,49.77,percent of total billed charges,,,,54.2295,90,percent of total billed charges,,,,57.24225,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,,,,,,,,,,,,,,51.21675,85,percent of total billed charges,,,31.623125,,,fee schedule,,,29.9889135,60.255,
OT-ELECT STIMULATION MANUAL/15,4300220,CDM,97032,CPT,430,RC,outpatient,,,GO,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,14.905,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,44.1252,85,percent of total billed charges,,,14.313625,,,fee schedule,,,,25.8366024,49.77,percent of total billed charges,,,,46.7208,90,percent of total billed charges,,,,49.3164,90,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,44.1252,85,percent of total billed charges,,,14.313625,,,fee schedule,,,14.313625,51.912,
"ELECT STIM, OTHER THAN WOUND",4300230,CDM,97014,CPT,430,RC,outpatient,,,GO,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,15.27,,,fee schedule,,,15.27,,,fee schedule,,,15.27,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,12.316375,,,fee schedule,,,,23.8886046,49.77,percent of total billed charges,,,,43.1982,90,percent of total billed charges,,,,45.5981,90,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,40.7983,85,percent of total billed charges,,,12.316375,,,fee schedule,,,12.316375,47.998,
OT - GROUP THERAPY,4300250,CDM,97150,CPT,430,RC,outpatient,,,G0,47.998,26.3989,,43.1982,90,percent of total billed charges,,,,47.998,100,percent of total billed charges,,,18.304,,,fee schedule,,,18.304,,,fee schedule,,,18.304,,,fee schedule,,,17.97525,,,fee schedule,,,17.97525,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,17.97525,,,fee schedule,,,,23.8886046,49.77,percent of total billed charges,,,,43.1982,90,percent of total billed charges,,,,45.5981,90,percent of total billed charges,,,18.5145075,,,fee schedule,,,5.94,,,fee schedule,,,7.5438,,,fee schedule,,,,40.7983,85,percent of total billed charges,,,17.97525,,,fee schedule,,,5.94,47.998,
OT - MANUAL THERAPY EA 15 MIN,4300310,CDM,97140,CPT,430,RC,outpatient,,,GO,77.559,42.65745,,69.8031,90,percent of total billed charges,,,,77.559,100,percent of total billed charges,,,27.973,,,fee schedule,,,27.973,,,fee schedule,,,27.973,,,fee schedule,,,26.962875,,,fee schedule,,,26.962875,,,fee schedule,,,,65.92515,85,percent of total billed charges,,,26.962875,,,fee schedule,,,,38.6011143,49.77,percent of total billed charges,,,,69.8031,90,percent of total billed charges,,,,73.68105,90,percent of total billed charges,,,27.77176125,,,fee schedule,,,,,,,,,,,,,,,,65.92515,85,percent of total billed charges,,,26.962875,,,fee schedule,,,26.962875,77.559,
OT-NEUROMUSCULAR RE-ED 15 MIN,4300330,CDM,97112,CPT,430,RC,outpatient,,,GO,78.692,43.2806,,70.8228,90,percent of total billed charges,,,,78.692,100,percent of total billed charges,,,34.716,,,fee schedule,,,34.716,,,fee schedule,,,34.716,,,fee schedule,,,33.620375,,,fee schedule,,,33.620375,,,fee schedule,,,,66.8882,85,percent of total billed charges,,,33.620375,,,fee schedule,,,,39.1650084,49.77,percent of total billed charges,,,,70.8228,90,percent of total billed charges,,,,74.7574,90,percent of total billed charges,,,34.62898625,,,fee schedule,,,,,,,,,,,,,,,,66.8882,85,percent of total billed charges,,,33.620375,,,fee schedule,,,33.620375,78.692,
OT - ORTHOTIC FIT/TRAIN 15 MIN,4300390,CDM,97760,CPT,430,RC,outpatient,,,GO,61.388,33.7634,,55.2492,90,percent of total billed charges,,,,61.388,100,percent of total billed charges,,,48.708,,,fee schedule,,,48.708,,,fee schedule,,,48.708,,,fee schedule,,,47.601125,,,fee schedule,,,47.601125,,,fee schedule,,,,52.1798,85,percent of total billed charges,,,47.601125,,,fee schedule,,,,30.5528076,49.77,percent of total billed charges,,,,55.2492,90,percent of total billed charges,,,,58.3186,90,percent of total billed charges,,,49.02915875,,,fee schedule,,,,,,,,,,,,,,,,52.1798,85,percent of total billed charges,,,47.601125,,,fee schedule,,,30.5528076,61.388,
OT - THERAPUTIC ACTIVITY/ 15 M,4300460,CDM,97530,CPT,430,RC,outpatient,,,GO,55.517,30.53435,,49.9653,90,percent of total billed charges,,,,55.517,100,percent of total billed charges,,,37.565,,,fee schedule,,,37.565,,,fee schedule,,,37.565,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,27.6308109,49.77,percent of total billed charges,,,,49.9653,90,percent of total billed charges,,,,52.74115,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,21.76,,,fee schedule,,,27.6352,,,fee schedule,,,,47.18945,85,percent of total billed charges,,,36.61625,,,fee schedule,,,21.76,55.517,
OT - GAIT TRAINING EA 15 MIN,4300470,CDM,97116,CPT,430,RC,outpatient,,,GO,62.933,34.61315,,56.6397,90,percent of total billed charges,,,,62.933,100,percent of total billed charges,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,53.49305,85,percent of total billed charges,,,29.293,,,fee schedule,,,,31.3217541,49.77,percent of total billed charges,,,,56.6397,90,percent of total billed charges,,,,59.78635,90,percent of total billed charges,,,30.17179,,,fee schedule,,,,,,,,,,,,,,,,53.49305,85,percent of total billed charges,,,29.293,,,fee schedule,,,29.293,62.933,
OT - PROSTHETIC TRAIN 15 MIN,4300660,CDM,97761,CPT,430,RC,outpatient,,,,61.388,33.7634,,55.2492,90,percent of total billed charges,,,,61.388,100,percent of total billed charges,,,42.35,,,fee schedule,,,42.35,,,fee schedule,,,42.35,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,52.1798,85,percent of total billed charges,,,41.609375,,,fee schedule,,,,30.5528076,49.77,percent of total billed charges,,,,55.2492,90,percent of total billed charges,,,,58.3186,90,percent of total billed charges,,,42.85765625,,,fee schedule,,,,,,,,,,,,,,,,52.1798,85,percent of total billed charges,,,41.609375,,,fee schedule,,,30.5528076,61.388,
OT - SENSORY INTEGRATION TECH,4300700,CDM,97533,CPT,430,RC,outpatient,,,GO,77.559,42.65745,,69.8031,90,percent of total billed charges,,,,77.559,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,62.247625,,,fee schedule,,,62.247625,,,fee schedule,,,,65.92515,85,percent of total billed charges,,,62.247625,,,fee schedule,,,,38.6011143,49.77,percent of total billed charges,,,,69.8031,90,percent of total billed charges,,,,73.68105,90,percent of total billed charges,,,64.11505375,,,fee schedule,,,,,,,,,,,,,,,,65.92515,85,percent of total billed charges,,,62.247625,,,fee schedule,,,38.6011143,77.559,
OT-THERAPUTIC EXER EACH 15 MIN,4300760,CDM,97110,CPT,430,RC,outpatient,,,GO,84.975,46.73625,,76.4775,90,percent of total billed charges,,,,84.975,100,percent of total billed charges,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,30.316,,,fee schedule,,,29.293,,,fee schedule,,,29.293,,,fee schedule,,,,72.22875,85,percent of total billed charges,,,29.293,,,fee schedule,,,,42.2920575,49.77,percent of total billed charges,,,,76.4775,90,percent of total billed charges,,,,80.72625,90,percent of total billed charges,,,30.17179,,,fee schedule,,,21.76,,,fee schedule,,,27.6352,,,fee schedule,,,,72.22875,85,percent of total billed charges,,,29.293,,,fee schedule,,,21.76,84.975,
OT - ULTRASOUND EACH 15 MIN,4300820,CDM,97035,CPT,430,RC,outpatient,,,GO,54.281,29.85455,,48.8529,90,percent of total billed charges,,,,54.281,100,percent of total billed charges,,,14.685,,,fee schedule,,,14.685,,,fee schedule,,,14.685,,,fee schedule,,,13.98075,,,fee schedule,,,13.98075,,,fee schedule,,,,46.13885,85,percent of total billed charges,,,13.98075,,,fee schedule,,,,27.0156537,49.77,percent of total billed charges,,,,48.8529,90,percent of total billed charges,,,,51.56695,90,percent of total billed charges,,,14.4001725,,,fee schedule,,,,,,,,,,,,,,,,46.13885,85,percent of total billed charges,,,13.98075,,,fee schedule,,,13.98075,54.281,
OT - WHEELCHAIR MGMT EA 15 MIN,4300850,CDM,97542,CPT,430,RC,outpatient,,,GO,46.865,25.77575,,42.1785,90,percent of total billed charges,,,,46.865,100,percent of total billed charges,,,32.703,,,fee schedule,,,32.703,,,fee schedule,,,32.703,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,39.83525,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,23.3247105,49.77,percent of total billed charges,,,,42.1785,90,percent of total billed charges,,,,44.52175,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,,,,,,,,,,,,,,39.83525,85,percent of total billed charges,,,31.623125,,,fee schedule,,,23.3247105,46.865,
APPLICATION LAS SHOULDER-HAND,4302910,CDM,29105,CPT,430,RC,outpatient,,,,142.037,78.12035,,127.8333,90,percent of total billed charges,,,,142.037,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,120.73145,85,percent of total billed charges,,,41.609375,,,fee schedule,,,,70.6918149,49.77,percent of total billed charges,,,,127.8333,90,percent of total billed charges,,,,134.93515,90,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,120.73145,85,percent of total billed charges,,,41.609375,,,fee schedule,,,41.609375,317.5,
APPLICATION SAS FOREARM-HAND,4302912,CDM,29125,CPT,430,RC,outpatient,,,,142.037,78.12035,,127.8333,90,percent of total billed charges,,,,142.037,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,40.61075,,,fee schedule,,,40.61075,,,fee schedule,,,,120.73145,85,percent of total billed charges,,,40.61075,,,fee schedule,,,,70.6918149,49.77,percent of total billed charges,,,,127.8333,90,percent of total billed charges,,,,134.93515,90,percent of total billed charges,,,41.8290725,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,120.73145,85,percent of total billed charges,,,40.61075,,,fee schedule,,,40.61075,317.5,
STRAPPING SHOULDER - SS,4302924,CDM,29240,CPT,430,RC,outpatient,,,,100.734,55.4037,,90.6606,90,percent of total billed charges,,,,100.734,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,17.642375,,,fee schedule,,,17.642375,,,fee schedule,,,,85.6239,85,percent of total billed charges,,,17.642375,,,fee schedule,,,,50.1353118,49.77,percent of total billed charges,,,,90.6606,90,percent of total billed charges,,,,95.6973,90,percent of total billed charges,,,18.17164625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,85.6239,85,percent of total billed charges,,,17.642375,,,fee schedule,,,17.642375,317.5,
STRAPPING ELBOW OR WRIST - EWS,4302926,CDM,29260,CPT,430,RC,outpatient,,,,100.734,55.4037,,90.6606,90,percent of total billed charges,,,,100.734,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,18.641,,,fee schedule,,,18.641,,,fee schedule,,,,85.6239,85,percent of total billed charges,,,18.641,,,fee schedule,,,,50.1353118,49.77,percent of total billed charges,,,,90.6606,90,percent of total billed charges,,,,95.6973,90,percent of total billed charges,,,19.20023,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,85.6239,85,percent of total billed charges,,,18.641,,,fee schedule,,,18.641,317.5,
OT EVALUATION; LOW COMPLEXITY,4307165,CDM,97165,CPT,430,RC,outpatient,,,GO,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,101.194,,,fee schedule,,,101.194,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,101.194,,,fee schedule,,,,84.9942198,49.77,percent of total billed charges,,,,153.6966,90,percent of total billed charges,,,,162.2353,90,percent of total billed charges,,,104.22982,,,fee schedule,,,98.88,,,fee schedule,,,125.5776,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,101.194,,,fee schedule,,,84.9942198,170.774,
OT EVALUATION; MOD COMPLEXITY,4307166,CDM,97166,CPT,430,RC,outpatient,,,GO,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,101.194,,,fee schedule,,,101.194,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,101.194,,,fee schedule,,,,84.9942198,49.77,percent of total billed charges,,,,153.6966,90,percent of total billed charges,,,,162.2353,90,percent of total billed charges,,,104.22982,,,fee schedule,,,148.32,,,fee schedule,,,188.3664,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,101.194,,,fee schedule,,,84.9942198,188.3664,
OT EVAL HIGH COMPLEX 60 MIN,4307167,CDM,97167,CPT,430,RC,outpatient,,,GO,170.774,93.9257,,153.6966,90,percent of total billed charges,,,,170.774,100,percent of total billed charges,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,103.29,,,fee schedule,,,101.194,,,fee schedule,,,101.194,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,101.194,,,fee schedule,,,,84.9942198,49.77,percent of total billed charges,,,,153.6966,90,percent of total billed charges,,,,162.2353,90,percent of total billed charges,,,104.22982,,,fee schedule,,,197.76,,,fee schedule,,,251.1552,,,fee schedule,,,,145.1579,85,percent of total billed charges,,,101.194,,,fee schedule,,,84.9942198,251.1552,
OT RE-EVALUATION,4307168,CDM,97168,CPT,430,RC,outpatient,,,GO,83.842,46.1131,,75.4578,90,percent of total billed charges,,,,83.842,100,percent of total billed charges,,,70.543,,,fee schedule,,,70.543,,,fee schedule,,,70.543,,,fee schedule,,,69.90375,,,fee schedule,,,69.90375,,,fee schedule,,,,71.2657,85,percent of total billed charges,,,69.90375,,,fee schedule,,,,41.7281634,49.77,percent of total billed charges,,,,75.4578,90,percent of total billed charges,,,,79.6499,90,percent of total billed charges,,,72.0008625,,,fee schedule,,,98.88,,,fee schedule,,,125.5776,,,fee schedule,,,,71.2657,85,percent of total billed charges,,,69.90375,,,fee schedule,,,41.7281634,125.5776,
OT - INFRARED MODALITY,4309702,CDM,97026,CPT,430,RC,outpatient,,,GO,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,6.556,,,fee schedule,,,6.556,,,fee schedule,,,6.556,,,fee schedule,,,6.6575,,,fee schedule,,,6.6575,,,fee schedule,,,,10.6811,85,percent of total billed charges,,,6.6575,,,fee schedule,,,,6.2540982,49.77,percent of total billed charges,,,,11.3094,90,percent of total billed charges,,,,11.9377,90,percent of total billed charges,,,6.857225,,,fee schedule,,,,,,,,,,,,,,,,10.6811,85,percent of total billed charges,,,6.6575,,,fee schedule,,,6.2540982,12.566,
ST - SPEECH THERAPY TREATMENT,4400460,CDM,92507,CPT,440,RC,outpatient,,,GN,156.251,85.93805,,140.6259,90,percent of total billed charges,,,,156.251,100,percent of total billed charges,,,79.079,,,fee schedule,,,79.079,,,fee schedule,,,79.079,,,fee schedule,,,76.228375,,,fee schedule,,,76.228375,,,fee schedule,,,,132.81335,85,percent of total billed charges,,,76.228375,,,fee schedule,,,,77.7661227,49.77,percent of total billed charges,,,,140.6259,90,percent of total billed charges,,,,148.43845,90,percent of total billed charges,,,78.51522625,,,fee schedule,,,21.76,,,fee schedule,,,27.6352,,,fee schedule,,,,132.81335,85,percent of total billed charges,,,76.228375,,,fee schedule,,,21.76,156.251,
ST - SWALLOWING EVALUTATION,4400470,CDM,92610,CPT,440,RC,outpatient,,,GN,194.052,106.7286,,174.6468,90,percent of total billed charges,,,,194.052,100,percent of total billed charges,,,,,,,,,174.6468,,,fee schedule,,,155.2416,,,fee schedule,,,69.90375,,,fee schedule,,,69.90375,,,fee schedule,,,,164.9442,85,percent of total billed charges,,,69.90375,,,fee schedule,,,,96.5796804,49.77,percent of total billed charges,,,,174.6468,90,percent of total billed charges,,,,184.3494,90,percent of total billed charges,,,72.0008625,,,fee schedule,,,,,,,,,,,,,,,,164.9442,85,percent of total billed charges,,,69.90375,,,fee schedule,,,69.90375,194.052,
ST - TRMT OF SWALLOWING DYSFUN,4400480,CDM,92526,CPT,440,RC,outpatient,,,GN,89.713,49.34215,,80.7417,90,percent of total billed charges,,,,89.713,100,percent of total billed charges,,,87.252,,,fee schedule,,,87.252,,,fee schedule,,,87.252,,,fee schedule,,,84.55025,,,fee schedule,,,84.55025,,,fee schedule,,,,76.25605,85,percent of total billed charges,,,84.55025,,,fee schedule,,,,44.6501601,49.77,percent of total billed charges,,,,80.7417,90,percent of total billed charges,,,,85.22735,90,percent of total billed charges,,,87.0867575,,,fee schedule,,,,,,,,,,,,,,,,76.25605,85,percent of total billed charges,,,84.55025,,,fee schedule,,,44.6501601,89.713,
ST - LARYNGEAL FUNCTION STUDY,4400500,CDM,92520,CPT,440,RC,outpatient,,,GN,132.664,72.9652,,119.3976,90,percent of total billed charges,,,,132.664,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,39.27925,,,fee schedule,,,39.27925,,,fee schedule,,,,112.7644,85,percent of total billed charges,,,39.27925,,,fee schedule,,,,66.0268728,49.77,percent of total billed charges,,,,119.3976,90,percent of total billed charges,,,,126.0308,90,percent of total billed charges,,,40.4576275,,,fee schedule,,,7.2,,,fee schedule,,,9.144,,,fee schedule,,,,112.7644,85,percent of total billed charges,,,39.27925,,,fee schedule,,,7.2,132.664,
"ST - SCREENING,PURE TONE,AIR",4400510,CDM,92551,CPT,440,RC,outpatient,,,GN,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,,,,,,,52.0974,,,fee schedule,,,46.3088,,,fee schedule,,,12.64925,,,fee schedule,,,12.64925,,,fee schedule,,,,49.2031,85,percent of total billed charges,,,12.64925,,,fee schedule,,,,28.8098622,49.77,percent of total billed charges,,,,52.0974,90,percent of total billed charges,,,,54.9917,90,percent of total billed charges,,,13.0287275,,,fee schedule,,,4,,,fee schedule,,,5.08,,,fee schedule,,,,49.2031,85,percent of total billed charges,,,12.64925,,,fee schedule,,,4,57.886,
ST - EVAL USE/FITTING VOICE DE,4400520,CDM,92597,CPT,440,RC,outpatient,,,GN,266.77,146.7235,,240.093,90,percent of total billed charges,,,,266.77,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,72.233875,,,fee schedule,,,72.233875,,,fee schedule,,,,226.7545,85,percent of total billed charges,,,72.233875,,,fee schedule,,,,132.771429,49.77,percent of total billed charges,,,,240.093,90,percent of total billed charges,,,,253.4315,90,percent of total billed charges,,,74.40089125,,,fee schedule,,,,,,,,,,,,,,,,226.7545,85,percent of total billed charges,,,72.233875,,,fee schedule,,,72.233875,266.77,
ST - ASSESSMENT APHASIA PER HR,4400540,CDM,96105,CPT,440,RC,outpatient,,,GN,211.356,116.2458,,190.2204,90,percent of total billed charges,,,,211.356,100,percent of total billed charges,,,,,,,,,190.2204,,,fee schedule,,,169.0848,,,fee schedule,,,95.868,,,fee schedule,,,95.868,,,fee schedule,,,,179.6526,85,percent of total billed charges,,,95.868,,,fee schedule,,,,105.1918812,49.77,percent of total billed charges,,,,190.2204,90,percent of total billed charges,,,,200.7882,90,percent of total billed charges,,,98.74404,,,fee schedule,,,,,,,,,,,,,,,,179.6526,85,percent of total billed charges,,,95.868,,,fee schedule,,,95.868,211.356,
ST - EVAL FLUENCY (STUTTER,4402521,CDM,92521,CPT,440,RC,outpatient,,,GN,118.553,65.20415,,106.6977,90,percent of total billed charges,,,,118.553,100,percent of total billed charges,,,137.379,,,fee schedule,,,137.379,,,fee schedule,,,137.379,,,fee schedule,,,132.817125,,,fee schedule,,,132.817125,,,fee schedule,,,,100.77005,85,percent of total billed charges,,,132.817125,,,fee schedule,,,,59.0038281,49.77,percent of total billed charges,,,,106.6977,90,percent of total billed charges,,,,112.62535,90,percent of total billed charges,,,136.8016388,,,fee schedule,,,49.44,,,fee schedule,,,62.7888,,,fee schedule,,,,100.77005,85,percent of total billed charges,,,132.817125,,,fee schedule,,,49.44,137.379,
ST - EVAL SOUND PRODUCTION,4402522,CDM,92522,CPT,440,RC,outpatient,,,GN,180.662,99.3641,,162.5958,90,percent of total billed charges,,,,180.662,100,percent of total billed charges,,,114.829,,,fee schedule,,,114.829,,,fee schedule,,,114.829,,,fee schedule,,,111.18025,,,fee schedule,,,111.18025,,,fee schedule,,,,153.5627,85,percent of total billed charges,,,111.18025,,,fee schedule,,,,89.9154774,49.77,percent of total billed charges,,,,162.5958,90,percent of total billed charges,,,,171.6289,90,percent of total billed charges,,,114.5156575,,,fee schedule,,,49.44,,,fee schedule,,,62.7888,,,fee schedule,,,,153.5627,85,percent of total billed charges,,,111.18025,,,fee schedule,,,49.44,180.662,
ST - EVAL SOUND W/LANG COMP/EX,4402523,CDM,92523,CPT,440,RC,outpatient,,,GN,222.171,122.19405,,199.9539,90,percent of total billed charges,,,,222.171,100,percent of total billed charges,,,235.598,,,fee schedule,,,235.598,,,fee schedule,,,235.598,,,fee schedule,,,227.6865,,,fee schedule,,,227.6865,,,fee schedule,,,,188.84535,85,percent of total billed charges,,,227.6865,,,fee schedule,,,,110.5745067,49.77,percent of total billed charges,,,,199.9539,90,percent of total billed charges,,,,211.06245,90,percent of total billed charges,,,234.517095,,,fee schedule,,,49.44,,,fee schedule,,,62.7888,,,fee schedule,,,,188.84535,85,percent of total billed charges,,,227.6865,,,fee schedule,,,49.44,235.598,
BEHAVORIAL QUALITY ANALYSIS,4402524,CDM,92524,CPT,440,RC,outpatient,,,GN,122.673,67.47015,,110.4057,90,percent of total billed charges,,,,122.673,100,percent of total billed charges,,,113.553,,,fee schedule,,,113.553,,,fee schedule,,,113.553,,,fee schedule,,,109.515875,,,fee schedule,,,109.515875,,,fee schedule,,,,104.27205,85,percent of total billed charges,,,109.515875,,,fee schedule,,,,61.0543521,49.77,percent of total billed charges,,,,110.4057,90,percent of total billed charges,,,,116.53935,90,percent of total billed charges,,,112.8013513,,,fee schedule,,,49.44,,,fee schedule,,,62.7888,,,fee schedule,,,,104.27205,85,percent of total billed charges,,,109.515875,,,fee schedule,,,49.44,122.673,
EA ADD'L 30 MIN/SP COMM DEVICE,4402608,CDM,92608,CPT,440,RC,outpatient,,,,57.886,31.8373,,52.0974,90,percent of total billed charges,,,,57.886,100,percent of total billed charges,,,,,,,,,52.0974,,,fee schedule,,,46.3088,,,fee schedule,,,48.59975,,,fee schedule,,,48.59975,,,fee schedule,,,,49.2031,85,percent of total billed charges,,,48.59975,,,fee schedule,,,,28.8098622,49.77,percent of total billed charges,,,,52.0974,90,percent of total billed charges,,,,54.9917,90,percent of total billed charges,,,50.0577425,,,fee schedule,,,22.13,,,fee schedule,,,28.1051,,,fee schedule,,,,49.2031,85,percent of total billed charges,,,48.59975,,,fee schedule,,,22.13,57.886,
THERAPEUTIC SERV/AAC DEVICE,4402609,CDM,92609,CPT,440,RC,outpatient,,,,173.143,95.22865,,155.8287,90,percent of total billed charges,,,,173.143,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,103.19125,,,fee schedule,,,103.19125,,,fee schedule,,,,147.17155,85,percent of total billed charges,,,103.19125,,,fee schedule,,,,86.1732711,49.77,percent of total billed charges,,,,155.8287,90,percent of total billed charges,,,,164.48585,90,percent of total billed charges,,,106.2869875,,,fee schedule,,,,,,,,,,,,,,,,147.17155,85,percent of total billed charges,,,103.19125,,,fee schedule,,,86.1732711,173.143,
EVAL RX/SPEECH COMM DEVICE 1HR,4409260,CDM,92607,CPT,440,RC,outpatient,,,,331.763,182.46965,,298.5867,90,percent of total billed charges,,,,331.763,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,123.8295,,,fee schedule,,,123.8295,,,fee schedule,,,,281.99855,85,percent of total billed charges,,,123.8295,,,fee schedule,,,,165.1184451,49.77,percent of total billed charges,,,,298.5867,90,percent of total billed charges,,,,315.17485,90,percent of total billed charges,,,127.544385,,,fee schedule,,,111.38,,,fee schedule,,,141.4526,,,fee schedule,,,,281.99855,85,percent of total billed charges,,,123.8295,,,fee schedule,,,111.38,331.763,
OB - LEVEL IV EMERGENT CARE,3100080,CDM,99284,CPT,450,RC,outpatient,,,,407.571,224.16405,,366.8139,90,percent of total billed charges,,,,407.571,100,percent of total billed charges,,,248.05,,,fee schedule,,,248.05,,,fee schedule,,,248.05,,,fee schedule,,,119.502125,,,fee schedule,,,119.502125,,,fee schedule,,,625,,,case rate,,,119.502125,,,fee schedule,,,,202.8480867,49.77,percent of total billed charges,,,,366.8139,90,percent of total billed charges,,,,387.19245,90,percent of total billed charges,,,123.0871888,,,fee schedule,,,,,,,,,,,,,,,650,,,case rate,,,119.502125,,,fee schedule,,,119.502125,650,
OB - LEVEL III EMERGENT CARE,3100090,CDM,99283,CPT,450,RC,outpatient,,,,212.695,116.98225,,191.4255,90,percent of total billed charges,,,,212.695,100,percent of total billed charges,,,203.66,,,fee schedule,,,203.66,,,fee schedule,,,203.66,,,fee schedule,,,70.236625,,,fee schedule,,,70.236625,,,fee schedule,,,525,,,case rate,,,70.236625,,,fee schedule,,,,105.8583015,49.77,percent of total billed charges,,,,191.4255,90,percent of total billed charges,,,,202.06025,90,percent of total billed charges,,,72.34372375,,,fee schedule,,,,,,,,,,,,,,,500,,,case rate,,,70.236625,,,fee schedule,,,70.236625,525,
OB - LEVEL II EMERGENT CARE,3100100,CDM,99282,CPT,450,RC,outpatient,,,,152.543,83.89865,,137.2887,90,percent of total billed charges,,,,152.543,100,percent of total billed charges,,,169.42,,,fee schedule,,,169.42,,,fee schedule,,,169.42,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,368,,,case rate,,,41.2765,,,fee schedule,,,,75.9206511,49.77,percent of total billed charges,,,,137.2887,90,percent of total billed charges,,,,144.91585,90,percent of total billed charges,,,42.514795,,,fee schedule,,,,,,,,,,,,,,,350,,,case rate,,,41.2765,,,fee schedule,,,41.2765,368,
OB - LEVEL I EMERGENT CARE,3100110,CDM,99281,CPT,450,RC,outpatient,,,,107.532,59.1426,,96.7788,90,percent of total billed charges,,,,107.532,100,percent of total billed charges,,,148.43,,,fee schedule,,,148.43,,,fee schedule,,,148.43,,,fee schedule,,,11.31775,,,fee schedule,,,11.31775,,,fee schedule,,,263,,,case rate,,,11.31775,,,fee schedule,,,,53.5186764,49.77,percent of total billed charges,,,,96.7788,90,percent of total billed charges,,,,102.1554,90,percent of total billed charges,,,11.6572825,,,fee schedule,,,,,,,,,,,,,,,200,,,case rate,,,11.31775,,,fee schedule,,,11.31775,263,
AVULSION NAIL PLATE; SINGLE,4500021,CDM,11730,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,53.26,,,fee schedule,,,53.26,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,53.26,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,54.8578,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,53.26,,,fee schedule,,,53.26,317.5,
ER FACILITY - LEVEL 5,4500070,CDM,99285,CPT,450,RC,outpatient,,,,1257.321,691.52655,,1131.5889,90,percent of total billed charges,,,,1257.321,100,percent of total billed charges,,,320.24,,,fee schedule,,,320.24,,,fee schedule,,,320.24,,,fee schedule,,,173.095,,,fee schedule,,,173.095,,,fee schedule,,,700,,,case rate,,,173.095,,,fee schedule,,,,625.7686617,49.77,percent of total billed charges,,,,1131.5889,90,percent of total billed charges,,,,1194.45495,90,percent of total billed charges,,,178.28785,,,fee schedule,,,,,,,,,,,,,,,,1068.72285,85,percent of total billed charges,,,173.095,,,fee schedule,,,173.095,1257.321,
ER FACILITY - LEVEL 4,4500080,CDM,99284,CPT,450,RC,outpatient,,,,967.17,531.9435,,870.453,90,percent of total billed charges,,,,967.17,100,percent of total billed charges,,,248.05,,,fee schedule,,,248.05,,,fee schedule,,,248.05,,,fee schedule,,,119.502125,,,fee schedule,,,119.502125,,,fee schedule,,,625,,,case rate,,,119.502125,,,fee schedule,,,,481.360509,49.77,percent of total billed charges,,,,870.453,90,percent of total billed charges,,,,918.8115,90,percent of total billed charges,,,123.0871888,,,fee schedule,,,,,,,,,,,,,,,650,,,case rate,,,119.502125,,,fee schedule,,,119.502125,967.17,
ER FACILTIY - LEVEL 3,4500090,CDM,99283,CPT,450,RC,outpatient,,,,677.431,372.58705,,609.6879,90,percent of total billed charges,,,,677.431,100,percent of total billed charges,,,203.66,,,fee schedule,,,203.66,,,fee schedule,,,203.66,,,fee schedule,,,70.236625,,,fee schedule,,,70.236625,,,fee schedule,,,525,,,case rate,,,70.236625,,,fee schedule,,,,337.1574087,49.77,percent of total billed charges,,,,609.6879,90,percent of total billed charges,,,,643.55945,90,percent of total billed charges,,,72.34372375,,,fee schedule,,,,,,,,,,,,,,,500,,,case rate,,,70.236625,,,fee schedule,,,70.236625,677.431,
ER FACILITY - LEVEL 2,4500100,CDM,99282,CPT,450,RC,outpatient,,,,290.254,159.6397,,261.2286,90,percent of total billed charges,,,,290.254,100,percent of total billed charges,,,169.42,,,fee schedule,,,169.42,,,fee schedule,,,169.42,,,fee schedule,,,41.2765,,,fee schedule,,,41.2765,,,fee schedule,,,368,,,case rate,,,41.2765,,,fee schedule,,,,144.4594158,49.77,percent of total billed charges,,,,261.2286,90,percent of total billed charges,,,,275.7413,90,percent of total billed charges,,,42.514795,,,fee schedule,,,,,,,,,,,,,,,350,,,case rate,,,41.2765,,,fee schedule,,,41.2765,368,
WOUND EXPLORATION EXTREMITY,4500103,CDM,20103,CPT,450,RC,outpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,345.52425,,,fee schedule,,,345.52425,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,345.52425,,,fee schedule,,,,326.5972101,49.77,percent of total billed charges,,,,590.5917,90,percent of total billed charges,,,,623.40235,90,percent of total billed charges,,,355.8899775,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,345.52425,,,fee schedule,,,250,1525.095,
ER FACILITY - LEVEL I,4500110,CDM,99281,CPT,450,RC,outpatient,,,,180.559,99.30745,,162.5031,90,percent of total billed charges,,,,180.559,100,percent of total billed charges,,,148.43,,,fee schedule,,,148.43,,,fee schedule,,,148.43,,,fee schedule,,,11.31775,,,fee schedule,,,11.31775,,,fee schedule,,,263,,,case rate,,,11.31775,,,fee schedule,,,,89.8642143,49.77,percent of total billed charges,,,,162.5031,90,percent of total billed charges,,,,171.53105,90,percent of total billed charges,,,11.6572825,,,fee schedule,,,,,,,,,,,,,,,200,,,case rate,,,11.31775,,,fee schedule,,,11.31775,263,
FB REMOVAL TISSUE SIMPLE,4500120,CDM,10120,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,106.187125,,,fee schedule,,,106.187125,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,106.187125,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,109.3727388,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,106.187125,,,fee schedule,,,106.187125,412.721,
ER FACIL CRITICAL CARE ADD'L,4500180,CDM,99292,CPT,450,RC,outpatient,,,,275.113,151.31215,,247.6017,90,percent of total billed charges,,,,275.113,100,percent of total billed charges,,,,,,,,,247.6017,,,fee schedule,,,220.0904,,,fee schedule,,,105.85425,,,fee schedule,,,105.85425,,,fee schedule,,,,233.84605,85,percent of total billed charges,,,105.85425,,,fee schedule,,,,136.9237401,49.77,percent of total billed charges,,,,247.6017,90,percent of total billed charges,,,,261.35735,90,percent of total billed charges,,,109.0298775,,,fee schedule,,,,,,,,,,,,,,,,233.84605,85,percent of total billed charges,,,105.85425,,,fee schedule,,,105.85425,275.113,
ER FACILITY CRITICAL CARE,4500190,CDM,99291,CPT,450,RC,outpatient,,,,1654.489,909.96895,,1489.0401,90,percent of total billed charges,,,,1654.489,100,percent of total billed charges,,,373.53,,,fee schedule,,,373.53,,,fee schedule,,,373.53,,,fee schedule,,,210.044125,,,fee schedule,,,210.044125,,,fee schedule,,,,1406.31565,85,percent of total billed charges,,,210.044125,,,fee schedule,,,,823.4391753,49.77,percent of total billed charges,,,,1489.0401,90,percent of total billed charges,,,,1571.76455,90,percent of total billed charges,,,216.3454488,,,fee schedule,,,,,,,,,,,,,,,,1406.31565,85,percent of total billed charges,,,210.044125,,,fee schedule,,,210.044125,1654.489,
CERUMEN REMOVAL,4500205,CDM,69210,CPT,450,RC,outpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,33.1159626,49.77,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,63.2111,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,32.288875,,,fee schedule,,,32.288875,317.5,
FB REMOVAL EAR,4500207,CDM,69200,CPT,450,RC,outpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,47.26825,,,fee schedule,,,47.26825,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,47.26825,,,fee schedule,,,,33.1159626,49.77,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,63.2111,90,percent of total billed charges,,,48.6862975,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,47.26825,,,fee schedule,,,33.1159626,317.5,
SUBQ/IM INJECTION - ER,4500220,CDM,96372,CPT,450,RC,outpatient,,,,59.122,32.5171,,53.2098,90,percent of total billed charges,,,,59.122,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,14.313625,,,fee schedule,,,14.313625,,,fee schedule,,,,50.2537,85,percent of total billed charges,,,14.313625,,,fee schedule,,,,29.4250194,49.77,percent of total billed charges,,,,53.2098,90,percent of total billed charges,,,,56.1659,90,percent of total billed charges,,,14.74303375,,,fee schedule,,,,,,,,,,,,,,,,50.2537,85,percent of total billed charges,,,14.313625,,,fee schedule,,,14.313625,64.0395,
THER PROPH DIAG INJ IV PUSH SI,4500222,CDM,96374,CPT,450,RC,outpatient,,,,128.853,70.86915,,115.9677,90,percent of total billed charges,,,,128.853,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,109.52505,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,64.1301381,49.77,percent of total billed charges,,,,115.9677,90,percent of total billed charges,,,,122.41035,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,,,,,,,,,,,,,,109.52505,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,196.077,
FB REMOVAL NOSE,4500303,CDM,30300,CPT,450,RC,outpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,123.8295,,,fee schedule,,,123.8295,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,123.8295,,,fee schedule,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,127.544385,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,123.8295,,,fee schedule,,,57.0558303,317.5,
SIMPLE REPAIR FACE <2.5cm,4500380,CDM,12011,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,55.25725,,,fee schedule,,,55.25725,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,55.25725,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,56.9149675,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,55.25725,,,fee schedule,,,55.25725,317.5,
JAW REDUCTION,4500480,CDM,21480,CPT,450,RC,outpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,30.957375,,,fee schedule,,,30.957375,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,30.957375,,,fee schedule,,,,153.3279321,49.77,percent of total billed charges,,,,277.2657,90,percent of total billed charges,,,,292.66935,90,percent of total billed charges,,,31.88609625,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,30.957375,,,fee schedule,,,30.957375,377.19,
"TRIGGER PT(S) INJ,1 OR 2 MUSCL",4500552,CDM,20552,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,412.721,
ARTHROCENTESIS INTERM JOINT,4500605,CDM,20605,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,36.61625,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,412.721,
ARTHROCENTESIS MAJOR JOINT,4500610,CDM,20610,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,45.271,,,fee schedule,,,45.271,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,45.271,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,46.62913,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,45.271,,,fee schedule,,,45.271,412.721,
HYDRATION IV INFUSION 31m-1hr,4500760,CDM,96360,CPT,450,RC,outpatient,,,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,196.077,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,88.68815,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,51.9295203,49.77,percent of total billed charges,,,,93.9051,90,percent of total billed charges,,,,99.12205,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,,,,,,,,,,,,,,88.68815,85,percent of total billed charges,,,32.288875,,,fee schedule,,,32.288875,196.077,
IV INFUS HYDRA +HRS S/IV ACCES,4500761,CDM,96361,CPT,450,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,12.316375,,,fee schedule,,,12.316375,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,12.316375,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,12.68586625,,,fee schedule,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,12.316375,,,fee schedule,,,12.316375,51.603,
IV INFUS MED/SEQUENT 1 HR - ER,4500767,CDM,96367,CPT,450,RC,outpatient,,,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,28.294375,,,fee schedule,,,28.294375,,,fee schedule,,,,42.98705,85,percent of total billed charges,,,28.294375,,,fee schedule,,,,25.1701821,49.77,percent of total billed charges,,,,45.5157,90,percent of total billed charges,,,,48.04435,90,percent of total billed charges,,,29.14320625,,,fee schedule,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,28.294375,,,fee schedule,,,25.1701821,64.0395,
IV CONCURRENT INFUSION MED/ER,4500768,CDM,96368,CPT,450,RC,outpatient,,,,39.037,21.47035,,35.1333,90,percent of total billed charges,,,,39.037,100,percent of total billed charges,,,19.64,,,fee schedule,,,19.64,,,fee schedule,,,19.64,,,fee schedule,,,19.639625,,,fee schedule,,,19.639625,,,fee schedule,,,,33.18145,85,percent of total billed charges,,,19.639625,,,fee schedule,,,,19.4287149,49.77,percent of total billed charges,,,,35.1333,90,percent of total billed charges,,,,37.08515,90,percent of total billed charges,,,20.22881375,,,fee schedule,,,,,,,,,,,,,,,,33.18145,85,percent of total billed charges,,,19.639625,,,fee schedule,,,19.4287149,39.037,
ANTERIOR NASAL PACKING SIMPLE,4500901,CDM,30901,CPT,450,RC,outpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,56.255875,,,fee schedule,,,56.255875,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,56.255875,,,fee schedule,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,57.94355125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,56.255875,,,fee schedule,,,56.255875,317.5,
POSTERIOR NASAL PACK INITIAL,4500905,CDM,30905,CPT,450,RC,outpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,105.1885,,,fee schedule,,,105.1885,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,105.1885,,,fee schedule,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,108.344155,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,105.1885,,,fee schedule,,,57.0558303,317.5,
"REPAIR SIMPLE SCALP,ETC <2.5cm",4501000,CDM,12001,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,44.60525,,,fee schedule,,,44.60525,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,44.60525,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,45.9434075,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,44.60525,,,fee schedule,,,44.60525,317.5,
I&D SIMPLE SKIN ABSCESS,4501006,CDM,10060,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,107.18575,,,fee schedule,,,107.18575,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,107.18575,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,110.4013225,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,107.18575,,,fee schedule,,,92.7349479,317.5,
I&D PILONIDAL CYST SIMPLE,4501008,CDM,10080,CPT,450,RC,outpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,105.85425,,,fee schedule,,,105.85425,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,105.85425,,,fee schedule,,,,326.5972101,49.77,percent of total billed charges,,,,590.5917,90,percent of total billed charges,,,,623.40235,90,percent of total billed charges,,,109.0298775,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,105.85425,,,fee schedule,,,105.85425,660.02625,
DEBRIDE ECZE/INFECTED SKIN 10%,4501009,CDM,11000,CPT,450,RC,outpatient,,,,626.137,344.37535,,563.5233,90,percent of total billed charges,,,,626.137,100,percent of total billed charges,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,27.29575,,,fee schedule,,,27.29575,,,fee schedule,,,,532.21645,85,percent of total billed charges,,,27.29575,,,fee schedule,,,,311.6283849,49.77,percent of total billed charges,,,,563.5233,90,percent of total billed charges,,,,594.83015,90,percent of total billed charges,,,28.1146225,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,532.21645,85,percent of total billed charges,,,27.29575,,,fee schedule,,,27.29575,626.137,
"RPR SIMPLE SCALP,ETC 2.6-7.5cm",4501010,CDM,12002,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,58.586,,,fee schedule,,,58.586,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,58.586,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,60.34358,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,58.586,,,fee schedule,,,58.586,317.5,
"RPR SIMPLE SCALP,ETC 7.6-12.5",4501020,CDM,12004,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,73.2325,,,fee schedule,,,73.2325,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,73.2325,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,75.429475,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,73.2325,,,fee schedule,,,73.2325,317.5,
"RPR SIMPLE SCALP,ETC 12.6-2.0",4501030,CDM,12005,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,94.203625,,,fee schedule,,,94.203625,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,94.203625,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,97.02973375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,94.203625,,,fee schedule,,,94.203625,412.721,
"RPR SIMPLE SCALP,ETC 20.1-30cm",4501040,CDM,12006,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,115.17475,,,fee schedule,,,115.17475,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,115.17475,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,118.6299925,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,115.17475,,,fee schedule,,,115.17475,412.721,
I&D COMPLICATED SKIN ABSCESS,4501061,CDM,10061,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,185.0785,,,fee schedule,,,185.0785,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,185.0785,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,190.630855,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,185.0785,,,fee schedule,,,185.0785,412.721,
SIMPLE REPAIR FACE 2.6 - 5cm,4501070,CDM,12013,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,57.587375,,,fee schedule,,,57.587375,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,57.587375,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,59.31499625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,57.587375,,,fee schedule,,,57.587375,317.5,
SIMPLE REPAIR 5.1cm TO 7.5cm,4501080,CDM,12014,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,74.564,,,fee schedule,,,74.564,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,74.564,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,76.80092,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,74.564,,,fee schedule,,,74.564,317.5,
SIMPLE REPAIR FACE 7.6-12.5cm,4501090,CDM,12015,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,93.537875,,,fee schedule,,,93.537875,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,93.537875,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,96.34401125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,93.537875,,,fee schedule,,,92.7349479,317.5,
DEBRIDEMENT SQ TISSUE,4501104,CDM,11042,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,60.250375,,,fee schedule,,,60.250375,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,60.250375,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,62.05788625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,60.250375,,,fee schedule,,,60.250375,412.721,
DEBRIDEMENT OF NAIL(S) 1-5,4501720,CDM,11720,CPT,450,RC,outpatient,,,,89.507,49.22885,,80.5563,90,percent of total billed charges,,,,89.507,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,13.98075,,,fee schedule,,,13.98075,,,fee schedule,,,,76.08095,85,percent of total billed charges,,,13.98075,,,fee schedule,,,,44.5476339,49.77,percent of total billed charges,,,,80.5563,90,percent of total billed charges,,,,85.03165,90,percent of total billed charges,,,14.4001725,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,76.08095,85,percent of total billed charges,,,13.98075,,,fee schedule,,,13.98075,317.5,
EVACUATION SUBUNGAL HEMATOMA,4501740,CDM,11740,CPT,450,RC,outpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,32.288875,,,fee schedule,,,32.288875,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,32.288875,,,fee schedule,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,33.25754125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,32.288875,,,fee schedule,,,32.288875,317.5,
REMOVAL NAILBED AND MATRIX,4501750,CDM,11750,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,101.85975,,,fee schedule,,,101.85975,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,101.85975,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,104.9155425,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,101.85975,,,fee schedule,,,101.85975,412.721,
REPAIR NAILBED,4501760,CDM,11760,CPT,450,RC,outpatient,,,,626.137,344.37535,,563.5233,90,percent of total billed charges,,,,626.137,100,percent of total billed charges,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,109.515875,,,fee schedule,,,109.515875,,,fee schedule,,,,532.21645,85,percent of total billed charges,,,109.515875,,,fee schedule,,,,311.6283849,49.77,percent of total billed charges,,,,563.5233,90,percent of total billed charges,,,,594.83015,90,percent of total billed charges,,,112.8013513,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,532.21645,85,percent of total billed charges,,,109.515875,,,fee schedule,,,109.515875,626.137,
INTERMEDIATE RPR S/T/E <2.5cm,4502000,CDM,12031,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,151.12525,,,fee schedule,,,151.12525,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,151.12525,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,155.6590075,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,151.12525,,,fee schedule,,,151.12525,412.721,
INTERMEDIATE RPR S/T/E 2.6-7.5,4502010,CDM,12032,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,189.73875,,,fee schedule,,,189.73875,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,189.73875,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,195.4309125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,189.73875,,,fee schedule,,,189.73875,412.721,
INTERMEDIATE RPR S/T/E7.6-12.5,4502020,CDM,12034,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,204.718125,,,fee schedule,,,204.718125,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,204.718125,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,210.8596688,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,204.718125,,,fee schedule,,,204.718125,412.721,
INTERMEDIATE RPR HFNG 2.6-7.5,4502070,CDM,12042,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,195.06475,,,fee schedule,,,195.06475,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,195.06475,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,200.9166925,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,195.06475,,,fee schedule,,,195.06475,412.721,
INTERMEDIATE RPR HFNG 7.6-12.5,4502080,CDM,12044,CPT,450,RC,outpatient,,,,626.137,344.37535,,563.5233,90,percent of total billed charges,,,,626.137,100,percent of total billed charges,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,213.70575,,,fee schedule,,,213.70575,,,fee schedule,,,,532.21645,85,percent of total billed charges,,,213.70575,,,fee schedule,,,,311.6283849,49.77,percent of total billed charges,,,,563.5233,90,percent of total billed charges,,,,594.83015,90,percent of total billed charges,,,220.1169225,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,532.21645,85,percent of total billed charges,,,213.70575,,,fee schedule,,,213.70575,626.137,
INTERMEDIATE REPAIR FACE <2.5,4502120,CDM,12051,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,169.1005,,,fee schedule,,,169.1005,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,169.1005,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,174.173515,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,169.1005,,,fee schedule,,,169.1005,412.721,
INTERMEDIATE RPR FACE 2.6-5cm,4502130,CDM,12052,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,198.726375,,,fee schedule,,,198.726375,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,198.726375,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,204.6881663,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,198.726375,,,fee schedule,,,198.726375,412.721,
INTERMEDIATE RPR FACE 5.1-7.5,4502140,CDM,12053,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,214.3715,,,fee schedule,,,214.3715,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,214.3715,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,220.802645,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,214.3715,,,fee schedule,,,205.4112417,412.721,
INTERMEDIATE RPR FACE 7.6-12.5,4502150,CDM,12054,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,219.364625,,,fee schedule,,,219.364625,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,219.364625,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,225.9455638,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,219.364625,,,fee schedule,,,205.4112417,412.721,
INTERMEDIATE RPR FACE 12.6-20,4502160,CDM,12055,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,301.251875,,,fee schedule,,,301.251875,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,301.251875,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,310.2894313,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,301.251875,,,fee schedule,,,205.4112417,412.721,
LUMBAR PUNCTURE DIAGNOSTIC,4502270,CDM,62270,CPT,450,RC,outpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,63.24625,,,fee schedule,,,63.24625,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,63.24625,,,fee schedule,,,,326.5972101,49.77,percent of total billed charges,,,,590.5917,90,percent of total billed charges,,,,623.40235,90,percent of total billed charges,,,65.1436375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,63.24625,,,fee schedule,,,63.24625,656.213,
SHOULDER REDCUTION/W/MAN/W/ANE,4502365,CDM,23655,CPT,450,RC,outpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,419.4225,,,fee schedule,,,419.4225,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,419.4225,,,fee schedule,,,,796.5260478,49.77,percent of total billed charges,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,90,percent of total billed charges,,,432.005175,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,419.4225,,,fee schedule,,,250,1600.414,
TRMT DISL HIP PROSTHES W/ANES,4502726,CDM,27266,CPT,450,RC,outpatient,,,,1600.723,880.39765,,1440.6507,90,percent of total billed charges,,,,1600.723,100,percent of total billed charges,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,592.184625,,,fee schedule,,,592.184625,,,fee schedule,,,,1360.61455,85,percent of total billed charges,,,592.184625,,,fee schedule,,,,796.6798371,49.77,percent of total billed charges,,,,1440.6507,90,percent of total billed charges,,,,1520.68685,90,percent of total billed charges,,,609.9501638,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1360.61455,85,percent of total billed charges,,,592.184625,,,fee schedule,,,250,1600.723,
FB REMOVAL PHARYNX,4502809,CDM,42809,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,127.824,,,fee schedule,,,127.824,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,127.824,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,131.65872,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,127.824,,,fee schedule,,,127.824,412.721,
SHORT ARM SPLINT,4502912,CDM,29125,CPT,450,RC,outpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,40.61075,,,fee schedule,,,40.61075,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,40.61075,,,fee schedule,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,41.8290725,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,40.61075,,,fee schedule,,,40.61075,317.5,
APPLICATION LONG LEG SPLINT,4502950,CDM,29505,CPT,450,RC,outpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,52.59425,,,fee schedule,,,52.59425,,,fee schedule,,,,121.78205,85,percent of total billed charges,,,52.59425,,,fee schedule,,,,71.3069721,49.77,percent of total billed charges,,,,128.9457,90,percent of total billed charges,,,,136.10935,90,percent of total billed charges,,,54.1720775,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,121.78205,85,percent of total billed charges,,,52.59425,,,fee schedule,,,52.59425,317.5,
APPLICATION SHORT LEG SPLINT,4502951,CDM,29515,CPT,450,RC,outpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,49.93125,,,fee schedule,,,49.93125,,,fee schedule,,,,121.78205,85,percent of total billed charges,,,49.93125,,,fee schedule,,,,71.3069721,49.77,percent of total billed charges,,,,128.9457,90,percent of total billed charges,,,,136.10935,90,percent of total billed charges,,,51.4291875,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,121.78205,85,percent of total billed charges,,,49.93125,,,fee schedule,,,49.93125,317.5,
TRANSUCTANEOUS PACING,4502953,CDM,92953,CPT,450,RC,outpatient,,,,224.746,123.6103,,202.2714,90,percent of total billed charges,,,,224.746,100,percent of total billed charges,,,598.1625,,,fee schedule,,,598.1625,,,fee schedule,,,598.1625,,,fee schedule,,,0.998625,,,fee schedule,,,0.998625,,,fee schedule,,,,191.0341,85,percent of total billed charges,,,0.998625,,,fee schedule,,,,111.8560842,49.77,percent of total billed charges,,,,202.2714,90,percent of total billed charges,,,,213.5087,90,percent of total billed charges,,,1.02858375,,,fee schedule,,,45,,,fee schedule,,,57.15,,,fee schedule,,,,191.0341,85,percent of total billed charges,,,0.998625,,,fee schedule,,,0.998625,598.1625,
COMPLEX REPAIR FACE 2.6-7.5,4503060,CDM,13132,CPT,450,RC,outpatient,,,,626.137,344.37535,,563.5233,90,percent of total billed charges,,,,626.137,100,percent of total billed charges,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,590.85,,,fee schedule,,,299.5875,,,fee schedule,,,299.5875,,,fee schedule,,,,532.21645,85,percent of total billed charges,,,299.5875,,,fee schedule,,,,311.6283849,49.77,percent of total billed charges,,,,563.5233,90,percent of total billed charges,,,,594.83015,90,percent of total billed charges,,,308.575125,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,532.21645,85,percent of total billed charges,,,299.5875,,,fee schedule,,,297,626.137,
COMPLEX REPAIR FACE >7.5 + 5,4503133,CDM,13133,CPT,450,RC,outpatient,,,,326.716,179.6938,,294.0444,90,percent of total billed charges,,,,326.716,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,123.8295,,,fee schedule,,,123.8295,,,fee schedule,,,,277.7086,85,percent of total billed charges,,,123.8295,,,fee schedule,,,,162.6065532,49.77,percent of total billed charges,,,,294.0444,90,percent of total billed charges,,,,310.3802,90,percent of total billed charges,,,127.544385,,,fee schedule,,,,,,,,,,,,,,,,277.7086,85,percent of total billed charges,,,123.8295,,,fee schedule,,,123.8295,326.716,
EMERGENT INTUBATION,4503150,CDM,31500,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,138.808875,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,142.9731413,,,fee schedule,,,363,,,fee schedule,,,461.01,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,138.808875,,,fee schedule,,,92.7349479,461.01,
THORACENTESIS/NEEDLE CHEST W/O,4503242,CDM,32554,CPT,450,RC,outpatient,,,,746.544,410.5992,,671.8896,90,percent of total billed charges,,,,746.544,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,86.880375,,,fee schedule,,,86.880375,,,fee schedule,,,,634.5624,85,percent of total billed charges,,,86.880375,,,fee schedule,,,,371.5549488,49.77,percent of total billed charges,,,,671.8896,90,percent of total billed charges,,,,709.2168,90,percent of total billed charges,,,89.48678625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,634.5624,85,percent of total billed charges,,,86.880375,,,fee schedule,,,86.880375,746.544,
INSERT CHEST TUBE PNEUMOTHORAX,4503244,CDM,32554,CPT,450,RC,outpatient,,,,746.544,410.5992,,671.8896,90,percent of total billed charges,,,,746.544,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,86.880375,,,fee schedule,,,86.880375,,,fee schedule,,,,634.5624,85,percent of total billed charges,,,86.880375,,,fee schedule,,,,371.5549488,49.77,percent of total billed charges,,,,671.8896,90,percent of total billed charges,,,,709.2168,90,percent of total billed charges,,,89.48678625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,634.5624,85,percent of total billed charges,,,86.880375,,,fee schedule,,,86.880375,746.544,
TUBE THORACOSTOMY,4503255,CDM,32551,CPT,450,RC,outpatient,,,,1196.345,657.98975,,1076.7105,90,percent of total billed charges,,,,1196.345,100,percent of total billed charges,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,152.789625,,,fee schedule,,,152.789625,,,fee schedule,,,,1016.89325,85,percent of total billed charges,,,152.789625,,,fee schedule,,,,595.4209065,49.77,percent of total billed charges,,,,1076.7105,90,percent of total billed charges,,,,1136.52775,90,percent of total billed charges,,,157.3733138,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1016.89325,85,percent of total billed charges,,,152.789625,,,fee schedule,,,152.789625,1513.1925,
SHOULDER REDCUTION/W/MAN/WO/A,4503650,CDM,23650,CPT,450,RC,outpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,312.9025,,,fee schedule,,,312.9025,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,312.9025,,,fee schedule,,,,153.3279321,49.77,percent of total billed charges,,,,277.2657,90,percent of total billed charges,,,,292.66935,90,percent of total billed charges,,,322.289575,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,312.9025,,,fee schedule,,,153.3279321,322.289575,
REPLACE G-TUBE W/O REVISION,4503762,CDM,43762,CPT,450,RC,outpatient,,,,331.866,182.5263,,298.6794,90,percent of total billed charges,,,,331.866,100,percent of total billed charges,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,36.949125,,,fee schedule,,,36.949125,,,fee schedule,,,,282.0861,85,percent of total billed charges,,,36.949125,,,fee schedule,,,,165.1697082,49.77,percent of total billed charges,,,,298.6794,90,percent of total billed charges,,,,315.2727,90,percent of total billed charges,,,38.05759875,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,282.0861,85,percent of total billed charges,,,36.949125,,,fee schedule,,,36.949125,377.19,
I&D UP ARM OR ELBOW ABSC/HEMAT,4503930,CDM,23930,CPT,450,RC,outpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,217.367375,,,fee schedule,,,217.367375,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,217.367375,,,fee schedule,,,,796.5260478,49.77,percent of total billed charges,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,90,percent of total billed charges,,,223.8883963,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,217.367375,,,fee schedule,,,217.367375,2627.2575,
FB REMOVAL ARM/ELBOW SQ,4504200,CDM,24200,CPT,450,RC,outpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,143.13625,,,fee schedule,,,143.13625,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,143.13625,,,fee schedule,,,,796.5260478,49.77,percent of total billed charges,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,90,percent of total billed charges,,,147.4303375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,143.13625,,,fee schedule,,,143.13625,1600.414,
FB REMOVAL ARM/ELBOW DEEP,4504201,CDM,24201,CPT,450,RC,outpatient,,,,3053.229,1679.27595,,2747.9061,90,percent of total billed charges,,,,3053.229,100,percent of total billed charges,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,408.437625,,,fee schedule,,,408.437625,,,fee schedule,,,,2595.24465,85,percent of total billed charges,,,408.437625,,,fee schedule,,,,1519.592073,49.77,percent of total billed charges,,,,2747.9061,90,percent of total billed charges,,,,2900.56755,90,percent of total billed charges,,,420.6907538,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,2595.24465,85,percent of total billed charges,,,408.437625,,,fee schedule,,,250,3053.229,
IRRIG CORPORA CAVERNOSA PRIAPI,4504220,CDM,54220,CPT,450,RC,outpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,133.81575,,,fee schedule,,,133.81575,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,133.81575,,,fee schedule,,,,135.4883733,49.77,percent of total billed charges,,,,245.0061,90,percent of total billed charges,,,,258.61755,90,percent of total billed charges,,,137.8302225,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,133.81575,,,fee schedule,,,133.81575,317.5,
DENTAL BLOCK,4504400,CDM,64400,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,51.595625,,,fee schedule,,,51.595625,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,51.595625,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,53.14349375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,51.595625,,,fee schedule,,,51.595625,412.721,
DIGITAL BLOCK,4504450,CDM,64450,CPT,450,RC,outpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,41.609375,,,fee schedule,,,,326.5972101,49.77,percent of total billed charges,,,,590.5917,90,percent of total billed charges,,,,623.40235,90,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,41.609375,,,fee schedule,,,41.609375,656.213,
PARAPHIMOSIS REDUCTION,4504451,CDM,,,450,RC,outpatient,,,,315.283,173.40565,,283.7547,90,percent of total billed charges,,,,315.283,100,percent of total billed charges,,,,,,,,,283.7547,,,fee schedule,,,252.2264,,,fee schedule,,,,,,,,,,,,,,,,267.99055,85,percent of total billed charges,,,,,,,,,,156.9163491,49.77,percent of total billed charges,,,,283.7547,90,percent of total billed charges,,,,299.51885,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,267.99055,85,percent of total billed charges,,,,,,,,,156.9163491,315.283,
CLSD TX HUMERAL SHAFT W/O MANI,4504500,CDM,24500,CPT,450,RC,outpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,348.853,,,fee schedule,,,348.853,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,348.853,,,fee schedule,,,,153.3279321,49.77,percent of total billed charges,,,,277.2657,90,percent of total billed charges,,,,292.66935,90,percent of total billed charges,,,359.31859,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,348.853,,,fee schedule,,,153.3279321,359.31859,
POSTERIOR ELBOW REDUCTION,4504600,CDM,24600,CPT,450,RC,outpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,354.84475,,,fee schedule,,,354.84475,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,354.84475,,,fee schedule,,,,153.3279321,49.77,percent of total billed charges,,,,277.2657,90,percent of total billed charges,,,,292.66935,90,percent of total billed charges,,,365.4900925,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,354.84475,,,fee schedule,,,153.3279321,365.4900925,
REDUCTION NURSEMAIDS ELBOW,4504640,CDM,24640,CPT,450,RC,outpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,80.55575,,,fee schedule,,,80.55575,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,80.55575,,,fee schedule,,,,153.3279321,49.77,percent of total billed charges,,,,277.2657,90,percent of total billed charges,,,,292.66935,90,percent of total billed charges,,,82.9724225,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,80.55575,,,fee schedule,,,80.55575,317.5,
INSERTION SUPRAPUBIC CATHETER,4505112,CDM,51102,CPT,450,RC,outpatient,,,,1924.246,1058.3353,,1731.8214,90,percent of total billed charges,,,,1924.246,100,percent of total billed charges,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,140.47325,,,fee schedule,,,140.47325,,,fee schedule,,,,1635.6091,85,percent of total billed charges,,,140.47325,,,fee schedule,,,,957.6972342,49.77,percent of total billed charges,,,,1731.8214,90,percent of total billed charges,,,,1828.0337,90,percent of total billed charges,,,144.6874475,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1635.6091,85,percent of total billed charges,,,140.47325,,,fee schedule,,,140.47325,1924.246,
BLADDER IRRIGATION,4505117,CDM,51700,CPT,450,RC,outpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,218.53125,,,fee schedule,,,29.625875,,,fee schedule,,,29.625875,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,29.625875,,,fee schedule,,,,135.4883733,49.77,percent of total billed charges,,,,245.0061,90,percent of total billed charges,,,,258.61755,90,percent of total billed charges,,,30.51465125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,29.625875,,,fee schedule,,,29.625875,317.5,
ANCHOR FOLEY CATH SIMPLE,4505170,CDM,51702,CPT,450,RC,outpatient,,,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,24.965625,,,fee schedule,,,24.965625,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,24.965625,,,fee schedule,,,,33.1159626,49.77,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,63.2111,90,percent of total billed charges,,,25.71459375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,56.5573,85,percent of total billed charges,,,24.965625,,,fee schedule,,,24.965625,317.5,
ANCHOR FOLEY CATH COMPLICATED,4505173,CDM,51703,CPT,450,RC,outpatient,,,,804.533,442.49315,,724.0797,90,percent of total billed charges,,,,804.533,100,percent of total billed charges,,,147.90375,,,fee schedule,,,147.90375,,,fee schedule,,,147.90375,,,fee schedule,,,75.22975,,,fee schedule,,,75.22975,,,fee schedule,,,,683.85305,85,percent of total billed charges,,,75.22975,,,fee schedule,,,,400.4160741,49.77,percent of total billed charges,,,,724.0797,90,percent of total billed charges,,,,764.30635,90,percent of total billed charges,,,77.4866425,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,683.85305,85,percent of total billed charges,,,75.22975,,,fee schedule,,,75.22975,804.533,
REMV SUPERFICIAL SUBCONJUNC FB,4505205,CDM,65205,CPT,450,RC,outpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,28.62725,,,fee schedule,,,28.62725,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,28.62725,,,fee schedule,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,29.4860675,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,28.62725,,,fee schedule,,,28.62725,317.5,
REMOVAL EMBEDDED SUBCONJUNCTIV,4505210,CDM,65210,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,35.28475,,,fee schedule,,,35.28475,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,35.28475,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,36.3432925,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,35.28475,,,fee schedule,,,35.28475,412.721,
REMOVAL COREAL FB W/O SLIT LAM,4505220,CDM,65220,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,383.99625,,,fee schedule,,,40.943625,,,fee schedule,,,40.943625,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,40.943625,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,42.17193375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,40.943625,,,fee schedule,,,40.943625,412.721,
REMOVAL COREAL FB W/SLIT LAM,4505222,CDM,65222,CPT,450,RC,outpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,49.598375,,,fee schedule,,,49.598375,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,49.598375,,,fee schedule,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,51.08632625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,49.598375,,,fee schedule,,,49.598375,317.5,
CLSD TX COLLES FX W/ MANIP,4505605,CDM,25605,CPT,450,RC,outpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,526.60825,,,fee schedule,,,526.60825,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,526.60825,,,fee schedule,,,,796.5260478,49.77,percent of total billed charges,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,90,percent of total billed charges,,,542.4064975,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,526.60825,,,fee schedule,,,250,1600.414,
CLSD TX NAVICULAR FX W/O MANIP,4505622,CDM,25622,CPT,450,RC,outpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,296.9245,,,fee schedule,,,296.9245,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,296.9245,,,fee schedule,,,,153.3279321,49.77,percent of total billed charges,,,,277.2657,90,percent of total billed charges,,,,292.66935,90,percent of total billed charges,,,305.832235,,,fee schedule,,,,,,,,,,,,,,,,261.86205,85,percent of total billed charges,,,296.9245,,,fee schedule,,,153.3279321,308.073,
I&D VULVA/PERINEUM,4505640,CDM,56405,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,296.9325,,,fee schedule,,,296.9325,,,fee schedule,,,296.9325,,,fee schedule,,,128.156875,,,fee schedule,,,128.156875,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,128.156875,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,132.0015813,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,128.156875,,,fee schedule,,,128.156875,412.721,
I&D BARTHOLIN'S GLAND,4505642,CDM,56420,CPT,450,RC,outpatient,,,,159.032,87.4676,,143.1288,90,percent of total billed charges,,,,159.032,100,percent of total billed charges,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,111.513125,,,fee schedule,,,111.513125,,,fee schedule,,,,135.1772,85,percent of total billed charges,,,111.513125,,,fee schedule,,,,79.1502264,49.77,percent of total billed charges,,,,143.1288,90,percent of total billed charges,,,,151.0804,90,percent of total billed charges,,,114.8585188,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,135.1772,85,percent of total billed charges,,,111.513125,,,fee schedule,,,79.1502264,317.5,
WRIST REDUCTION,4505660,CDM,25660,CPT,450,RC,outpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,463.694875,,,fee schedule,,,463.694875,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,463.694875,,,fee schedule,,,,153.3279321,49.77,percent of total billed charges,,,,277.2657,90,percent of total billed charges,,,,292.66935,90,percent of total billed charges,,,477.6057213,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,463.694875,,,fee schedule,,,153.3279321,477.6057213,
MINOR LOCAL BURN TX,4506000,CDM,16000,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,45.271,,,fee schedule,,,45.271,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,45.271,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,46.62913,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,45.271,,,fee schedule,,,45.271,317.5,
I&D SIMPLE FINGER ABSCESS,4506010,CDM,26010,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,143.13625,,,fee schedule,,,143.13625,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,143.13625,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,147.4303375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,143.13625,,,fee schedule,,,92.7349479,317.5,
DRESS/DEBRID P-THICK BURN SM,4506020,CDM,16020,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,55.923,,,fee schedule,,,55.923,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,55.923,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,57.60069,,,fee schedule,,,102,,,fee schedule,,,129.54,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,55.923,,,fee schedule,,,55.923,186.327,
DRESS/DEBRID P-THICK BURN MED,4506025,CDM,16025,CPT,450,RC,outpatient,,,,186.327,102.47985,,167.6943,90,percent of total billed charges,,,,186.327,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,111.18025,,,fee schedule,,,111.18025,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,111.18025,,,fee schedule,,,,92.7349479,49.77,percent of total billed charges,,,,167.6943,90,percent of total billed charges,,,,177.01065,90,percent of total billed charges,,,114.5156575,,,fee schedule,,,205,,,fee schedule,,,260.35,,,fee schedule,,,,158.37795,85,percent of total billed charges,,,111.18025,,,fee schedule,,,92.7349479,260.35,
DRESS/DEBRID P-THICK BURN LGE,4506030,CDM,16030,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,379.4175,,,fee schedule,,,131.485625,,,fee schedule,,,131.485625,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,131.485625,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,135.4301938,,,fee schedule,,,308,,,fee schedule,,,391.16,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,131.485625,,,fee schedule,,,131.485625,412.721,
I&D PERIANAL ABCESS,4506050,CDM,46050,CPT,450,RC,outpatient,,,,3053.229,1679.27595,,2747.9061,90,percent of total billed charges,,,,3053.229,100,percent of total billed charges,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,845.19,,,fee schedule,,,102.192625,,,fee schedule,,,102.192625,,,fee schedule,,,,2595.24465,85,percent of total billed charges,,,102.192625,,,fee schedule,,,,1519.592073,49.77,percent of total billed charges,,,,2747.9061,90,percent of total billed charges,,,,2900.56755,90,percent of total billed charges,,,105.2584038,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,2595.24465,85,percent of total billed charges,,,102.192625,,,fee schedule,,,102.192625,3053.229,
EPIDURAL INJ OF BLOOD PATCH,4506227,CDM,62273,CPT,450,RC,outpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,112.178875,,,fee schedule,,,112.178875,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,112.178875,,,fee schedule,,,,326.5972101,49.77,percent of total billed charges,,,,590.5917,90,percent of total billed charges,,,,623.40235,90,percent of total billed charges,,,115.5442413,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,112.178875,,,fee schedule,,,112.178875,656.213,
FINGER EXTENSOR TENDON REPAIR,4506418,CDM,26418,CPT,450,RC,outpatient,,,,1600.414,880.2277,,1440.3726,90,percent of total billed charges,,,,1600.414,100,percent of total billed charges,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,1458.95625,,,fee schedule,,,633.794,,,fee schedule,,,633.794,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,633.794,,,fee schedule,,,,796.5260478,49.77,percent of total billed charges,,,,1440.3726,90,percent of total billed charges,,,,1520.3933,90,percent of total billed charges,,,652.80782,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1360.3519,85,percent of total billed charges,,,633.794,,,fee schedule,,,250,1600.414,
CENTRAL LINE INSERTION >5YRS,4506556,CDM,36556,CPT,450,RC,outpatient,,,,1196.345,657.98975,,1076.7105,90,percent of total billed charges,,,,1196.345,100,percent of total billed charges,,,3029.715,,,fee schedule,,,3029.715,,,fee schedule,,,3029.715,,,fee schedule,,,82.885875,,,fee schedule,,,82.885875,,,fee schedule,,,,1016.89325,85,percent of total billed charges,,,82.885875,,,fee schedule,,,,595.4209065,49.77,percent of total billed charges,,,,1076.7105,90,percent of total billed charges,,,,1136.52775,90,percent of total billed charges,,,85.37245125,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1016.89325,85,percent of total billed charges,,,82.885875,,,fee schedule,,,82.885875,3029.715,
COLLECTION BLOOD VAD,4506591,CDM,36591,CPT,450,RC,outpatient,,,,1111.885,611.53675,,1000.6965,90,percent of total billed charges,,,,1111.885,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,27.628625,,,fee schedule,,,27.628625,,,fee schedule,,,,945.10225,85,percent of total billed charges,,,27.628625,,,fee schedule,,,,553.3851645,49.77,percent of total billed charges,,,,1000.6965,90,percent of total billed charges,,,,1056.29075,90,percent of total billed charges,,,28.45748375,,,fee schedule,,,,,,,,,,,,,,,,945.10225,85,percent of total billed charges,,,27.628625,,,fee schedule,,,27.628625,1111.885,
CLCT BLOOD CENT OR PERIPH CATH,4506592,CDM,36592,CPT,450,RC,outpatient,,,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,118.09125,,,fee schedule,,,29.95875,,,fee schedule,,,29.95875,,,fee schedule,,,,97.44315,85,percent of total billed charges,,,29.95875,,,fee schedule,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,30.8575125,,,fee schedule,,,,,,,,,,,,,,,,97.44315,85,percent of total billed charges,,,29.95875,,,fee schedule,,,29.95875,118.09125,
THUMB REDUCTION,4506641,CDM,26641,CPT,450,RC,outpatient,,,,308.073,169.44015,,277.2657,90,percent of total billed charges,,,,308.073,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,396.787,,,fee schedule,,,396.787,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,396.787,,,fee schedule,,,,153.3279321,49.77,percent of total billed charges,,,,277.2657,90,percent of total billed charges,,,,292.66935,90,percent of total billed charges,,,408.69061,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,261.86205,85,percent of total billed charges,,,396.787,,,fee schedule,,,153.3279321,408.69061,
REDUCTION FINGER IP,4506770,CDM,26770,CPT,450,RC,outpatient,,,,747.059,410.88245,,672.3531,90,percent of total billed charges,,,,747.059,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,274.621875,,,fee schedule,,,274.621875,,,fee schedule,,,,635.00015,85,percent of total billed charges,,,274.621875,,,fee schedule,,,,371.8112643,49.77,percent of total billed charges,,,,672.3531,90,percent of total billed charges,,,,709.70605,90,percent of total billed charges,,,282.8605313,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,635.00015,85,percent of total billed charges,,,274.621875,,,fee schedule,,,210.54375,747.059,
CERUMEN IMPACTION W/IRRIGATION,4506920,CDM,69209,CPT,450,RC,outpatient,,,,30.076,16.5418,,27.0684,90,percent of total billed charges,,,,30.076,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,15.978,,,fee schedule,,,15.978,,,fee schedule,,,,25.5646,85,percent of total billed charges,,,15.978,,,fee schedule,,,,14.9688252,49.77,percent of total billed charges,,,,27.0684,90,percent of total billed charges,,,,28.5722,90,percent of total billed charges,,,16.45734,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,25.5646,85,percent of total billed charges,,,15.978,,,fee schedule,,,14.9688252,317.5,
REDUCTION HIP TRAUMA,4507250,CDM,27250,CPT,450,RC,outpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,178.753875,,,fee schedule,,,178.753875,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,178.753875,,,fee schedule,,,,135.4883733,49.77,percent of total billed charges,,,,245.0061,90,percent of total billed charges,,,,258.61755,90,percent of total billed charges,,,184.1164913,,,fee schedule,,,,,,,,,,,,,,,,231.39465,85,percent of total billed charges,,,178.753875,,,fee schedule,,,135.4883733,272.229,
I&D THIGH OR KNEE,4507301,CDM,27301,CPT,450,RC,outpatient,,,,3053.229,1679.27595,,2747.9061,90,percent of total billed charges,,,,3053.229,100,percent of total billed charges,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,515.623375,,,fee schedule,,,515.623375,,,fee schedule,,,,2595.24465,85,percent of total billed charges,,,515.623375,,,fee schedule,,,,1519.592073,49.77,percent of total billed charges,,,,2747.9061,90,percent of total billed charges,,,,2900.56755,90,percent of total billed charges,,,531.0920763,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,2595.24465,85,percent of total billed charges,,,515.623375,,,fee schedule,,,250,3053.229,
REDUCTION KNEE,4507550,CDM,27550,CPT,450,RC,outpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,483.001625,,,fee schedule,,,483.001625,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,483.001625,,,fee schedule,,,,135.4883733,49.77,percent of total billed charges,,,,245.0061,90,percent of total billed charges,,,,258.61755,90,percent of total billed charges,,,497.4916738,,,fee schedule,,,,,,,,,,,,,,,,231.39465,85,percent of total billed charges,,,483.001625,,,fee schedule,,,135.4883733,497.4916738,
REDUCTION KNEE PATELLA,4507560,CDM,27560,CPT,450,RC,outpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,354.179,,,fee schedule,,,354.179,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,354.179,,,fee schedule,,,,135.4883733,49.77,percent of total billed charges,,,,245.0061,90,percent of total billed charges,,,,258.61755,90,percent of total billed charges,,,364.80437,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,354.179,,,fee schedule,,,135.4883733,364.80437,
REDUCTION ANKLE,4507840,CDM,27840,CPT,450,RC,outpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,399.45,,,fee schedule,,,399.45,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,399.45,,,fee schedule,,,,135.4883733,49.77,percent of total billed charges,,,,245.0061,90,percent of total billed charges,,,,258.61755,90,percent of total billed charges,,,411.4335,,,fee schedule,,,,,,,,,,,,,,,,231.39465,85,percent of total billed charges,,,399.45,,,fee schedule,,,135.4883733,411.4335,
REMOVAL FB EYELID,4507938,CDM,67938,CPT,450,RC,outpatient,,,,412.721,226.99655,,371.4489,90,percent of total billed charges,,,,412.721,100,percent of total billed charges,,,269.22375,,,fee schedule,,,269.22375,,,fee schedule,,,269.22375,,,fee schedule,,,116.839125,,,fee schedule,,,116.839125,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,116.839125,,,fee schedule,,,,205.4112417,49.77,percent of total billed charges,,,,371.4489,90,percent of total billed charges,,,,392.08495,90,percent of total billed charges,,,120.3442988,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,350.81285,85,percent of total billed charges,,,116.839125,,,fee schedule,,,116.839125,412.721,
FOREIGN BODY REM SQ FOOT,4508190,CDM,28190,CPT,450,RC,outpatient,,,,656.213,360.91715,,590.5917,90,percent of total billed charges,,,,656.213,100,percent of total billed charges,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,660.02625,,,fee schedule,,,133.15,,,fee schedule,,,133.15,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,133.15,,,fee schedule,,,,326.5972101,49.77,percent of total billed charges,,,,590.5917,90,percent of total billed charges,,,,623.40235,90,percent of total billed charges,,,137.1445,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,557.78105,85,percent of total billed charges,,,133.15,,,fee schedule,,,133.15,660.02625,
FOREIGN BODY REM FOOT DEEP,4508192,CDM,28192,CPT,450,RC,outpatient,,,,1600.723,880.39765,,1440.6507,90,percent of total billed charges,,,,1600.723,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,312.23675,,,fee schedule,,,312.23675,,,fee schedule,,,,1360.61455,85,percent of total billed charges,,,312.23675,,,fee schedule,,,,796.6798371,49.77,percent of total billed charges,,,,1440.6507,90,percent of total billed charges,,,,1520.68685,90,percent of total billed charges,,,321.6038525,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1360.61455,85,percent of total billed charges,,,312.23675,,,fee schedule,,,250,1600.723,
REDUCTION TOE MP,4508630,CDM,28630,CPT,450,RC,outpatient,,,,272.229,149.72595,,245.0061,90,percent of total billed charges,,,,272.229,100,percent of total billed charges,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,210.54375,,,fee schedule,,,112.178875,,,fee schedule,,,112.178875,,,fee schedule,,,,231.39465,85,percent of total billed charges,,,112.178875,,,fee schedule,,,,135.4883733,49.77,percent of total billed charges,,,,245.0061,90,percent of total billed charges,,,,258.61755,90,percent of total billed charges,,,115.5442413,,,fee schedule,,,,,,,,,,,,,,,,231.39465,85,percent of total billed charges,,,112.178875,,,fee schedule,,,112.178875,272.229,
IV PUSH SEQUENT SAME MED - ER,4509077,CDM,96376,CPT,450,RC,outpatient,,,,22.454,12.3497,,20.2086,90,percent of total billed charges,,,,22.454,100,percent of total billed charges,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,32.55,,,fee schedule,,,,,,,,,,,,,,,,19.0859,85,percent of total billed charges,,,,,,,,,,11.1753558,49.77,percent of total billed charges,,,,20.2086,90,percent of total billed charges,,,,21.3313,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,19.0859,85,percent of total billed charges,,,,,,,,,11.1753558,32.55,
ABD PARACENTESIS W/O IMA GUIDE,4509082,CDM,49082,CPT,450,RC,outpatient,,,,889.817,489.39935,,800.8353,90,percent of total billed charges,,,,889.817,100,percent of total billed charges,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,839.57625,,,fee schedule,,,72.56675,,,fee schedule,,,72.56675,,,fee schedule,,,,756.34445,85,percent of total billed charges,,,72.56675,,,fee schedule,,,,442.8619209,49.77,percent of total billed charges,,,,800.8353,90,percent of total billed charges,,,,845.32615,90,percent of total billed charges,,,74.7437525,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,756.34445,85,percent of total billed charges,,,72.56675,,,fee schedule,,,72.56675,889.817,
LONG ARM SPLINT,4509105,CDM,29105,CPT,450,RC,outpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,121.78205,85,percent of total billed charges,,,41.609375,,,fee schedule,,,,71.3069721,49.77,percent of total billed charges,,,,128.9457,90,percent of total billed charges,,,,136.10935,90,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,121.78205,85,percent of total billed charges,,,41.609375,,,fee schedule,,,41.609375,317.5,
MOD SED INITIAL 15 MIN UNDER 5,4509151,CDM,99151,CPT,450,RC,outpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,23.634125,,,fee schedule,,,23.634125,,,fee schedule,,,,48.76535,85,percent of total billed charges,,,23.634125,,,fee schedule,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,24.34314875,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,23.634125,,,fee schedule,,,23.634125,57.371,
MOD SED INITIAL 15 MIN OVER 5,4509152,CDM,99152,CPT,450,RC,outpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,11.9835,,,fee schedule,,,11.9835,,,fee schedule,,,,48.76535,85,percent of total billed charges,,,11.9835,,,fee schedule,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,12.343005,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,11.9835,,,fee schedule,,,11.9835,57.371,
MOD SED EA ADD'L 15 MINUTES,4509153,CDM,99153,CPT,450,RC,outpatient,,,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,11.650625,,,fee schedule,,,11.650625,,,fee schedule,,,,48.76535,85,percent of total billed charges,,,11.650625,,,fee schedule,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,12.00014375,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,11.650625,,,fee schedule,,,11.650625,57.371,
CARDIOPULMONARY RESUSCITATION,4509295,CDM,92950,CPT,450,RC,outpatient,,,,233.707,128.53885,,210.3363,90,percent of total billed charges,,,,233.707,100,percent of total billed charges,,,284.8275,,,fee schedule,,,284.8275,,,fee schedule,,,284.8275,,,fee schedule,,,180.085375,,,fee schedule,,,180.085375,,,fee schedule,,,,198.65095,85,percent of total billed charges,,,180.085375,,,fee schedule,,,,116.3159739,49.77,percent of total billed charges,,,,210.3363,90,percent of total billed charges,,,,222.02165,90,percent of total billed charges,,,185.4879363,,,fee schedule,,,,,,,,,,,,,,,,198.65095,85,percent of total billed charges,,,180.085375,,,fee schedule,,,116.3159739,284.8275,
CARDIOVERSION; EXTERNAL,4509296,CDM,92960,CPT,450,RC,outpatient,,,,705.035,387.76925,,634.5315,90,percent of total billed charges,,,,705.035,100,percent of total billed charges,,,598.1625,,,fee schedule,,,598.1625,,,fee schedule,,,598.1625,,,fee schedule,,,105.85425,,,fee schedule,,,105.85425,,,fee schedule,,,,599.27975,85,percent of total billed charges,,,105.85425,,,fee schedule,,,,350.8959195,49.77,percent of total billed charges,,,,634.5315,90,percent of total billed charges,,,,669.78325,90,percent of total billed charges,,,109.0298775,,,fee schedule,,,76,,,fee schedule,,,96.52,,,fee schedule,,,,599.27975,85,percent of total billed charges,,,105.85425,,,fee schedule,,,76,705.035,
AIRWAY INHALATION TXT ER,4509464,CDM,94640,CPT,450,RC,outpatient,,,,196.009,107.80495,,176.4081,90,percent of total billed charges,,,,196.009,100,percent of total billed charges,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,181.776,,,fee schedule,,,7.989,,,fee schedule,,,7.989,,,fee schedule,,,,166.60765,85,percent of total billed charges,,,7.989,,,fee schedule,,,,97.5536793,49.77,percent of total billed charges,,,,176.4081,90,percent of total billed charges,,,,186.20855,90,percent of total billed charges,,,8.22867,,,fee schedule,,,6,,,fee schedule,,,7.62,,,fee schedule,,,,166.60765,85,percent of total billed charges,,,7.989,,,fee schedule,,,6,196.009,
ANKLE/FOOT STRAPPING,4509540,CDM,29540,CPT,450,RC,outpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,16.976625,,,fee schedule,,,16.976625,,,fee schedule,,,,121.78205,85,percent of total billed charges,,,16.976625,,,fee schedule,,,,71.3069721,49.77,percent of total billed charges,,,,128.9457,90,percent of total billed charges,,,,136.10935,90,percent of total billed charges,,,17.48592375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,121.78205,85,percent of total billed charges,,,16.976625,,,fee schedule,,,16.976625,317.5,
IRRIGATION IMPLANTED VAD,4509652,CDM,96523,CPT,450,RC,outpatient,,,,73.748,40.5614,,66.3732,90,percent of total billed charges,,,,73.748,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,24.965625,,,fee schedule,,,24.965625,,,fee schedule,,,,62.6858,85,percent of total billed charges,,,24.965625,,,fee schedule,,,,36.7043796,49.77,percent of total billed charges,,,,66.3732,90,percent of total billed charges,,,,70.0606,90,percent of total billed charges,,,25.71459375,,,fee schedule,,,,,,,,,,,,,,,,62.6858,85,percent of total billed charges,,,24.965625,,,fee schedule,,,24.965625,73.748,
DBRDMT OPEN WND 1ST 20CM<SELEC,4509795,CDM,97597,CPT,450,RC,outpatient,,,,150.38,82.709,,135.342,90,percent of total billed charges,,,,150.38,100,percent of total billed charges,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,179.575,,,fee schedule,,,34.951875,,,fee schedule,,,34.951875,,,fee schedule,,,,127.823,85,percent of total billed charges,,,34.951875,,,fee schedule,,,,74.844126,49.77,percent of total billed charges,,,,135.342,90,percent of total billed charges,,,,142.861,90,percent of total billed charges,,,36.00043125,,,fee schedule,,,24.06,,,fee schedule,,,30.5562,,,fee schedule,,,,127.823,85,percent of total billed charges,,,34.951875,,,fee schedule,,,24.06,179.575,
UNLISTD CASTING/STRAPPING PROC,4509799,CDM,29799,CPT,450,RC,outpatient,,,,143.273,78.80015,,128.9457,90,percent of total billed charges,,,,143.273,100,percent of total billed charges,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,148.24125,,,fee schedule,,,,,,,,,,,,,,,,121.78205,85,percent of total billed charges,,,,,,,,,,71.3069721,49.77,percent of total billed charges,,,,128.9457,90,percent of total billed charges,,,,136.10935,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,121.78205,85,percent of total billed charges,,,,,,,,,71.3069721,148.24125,
ER MINOR PROCEDURE,4509999,CDM,,,450,RC,outpatient,,,,151.101,83.10555,,135.9909,90,percent of total billed charges,,,,151.101,100,percent of total billed charges,,,,,,,,,135.9909,,,fee schedule,,,120.8808,,,fee schedule,,,,,,,,,,,,,,,,128.43585,85,percent of total billed charges,,,,,,,,,,75.2029677,49.77,percent of total billed charges,,,,135.9909,90,percent of total billed charges,,,,143.54595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,128.43585,85,percent of total billed charges,,,,,,,,,75.2029677,151.101,
OB - EMERGENT CARE ASSESSMENT,3100015,CDM,,,451,RC,outpatient,,,,23.896,13.1428,,21.5064,90,percent of total billed charges,,,,23.896,100,percent of total billed charges,,,,,,,,,21.5064,,,fee schedule,,,19.1168,,,fee schedule,,,,,,,,,,,,,,,,20.3116,85,percent of total billed charges,,,,,,,,,,11.8930392,49.77,percent of total billed charges,,,,21.5064,90,percent of total billed charges,,,,22.7012,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.3116,85,percent of total billed charges,,,,,,,,,11.8930392,23.896,
ER FACILITY -  ASSESS/SCREEN,4500015,CDM,,,451,RC,outpatient,,,,139.359,76.64745,,125.4231,90,percent of total billed charges,,,,139.359,100,percent of total billed charges,,,,,,,,,125.4231,,,fee schedule,,,111.4872,,,fee schedule,,,,,,,,,,,,,,,,118.45515,85,percent of total billed charges,,,,,,,,,,69.3589743,49.77,percent of total billed charges,,,,125.4231,90,percent of total billed charges,,,,132.39105,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,118.45515,85,percent of total billed charges,,,,,,,,,69.3589743,139.359,
OB - NON EMERGENT CARE,3100459,CDM,,,459,RC,outpatient,,,,107.532,59.1426,,96.7788,90,percent of total billed charges,,,,107.532,100,percent of total billed charges,,,,,,,,,96.7788,,,fee schedule,,,86.0256,,,fee schedule,,,,,,,,,,,,,,,,91.4022,85,percent of total billed charges,,,,,,,,,,53.5186764,49.77,percent of total billed charges,,,,96.7788,90,percent of total billed charges,,,,102.1554,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,91.4022,85,percent of total billed charges,,,,,,,,,53.5186764,107.532,
PFT SPIROMETRY PRE/POST,4600010,CDM,94060,CPT,460,RC,outpatient,,,,293.447,161.39585,,264.1023,90,percent of total billed charges,,,,293.447,100,percent of total billed charges,,,265.839,,,fee schedule,,,265.839,,,fee schedule,,,265.839,,,fee schedule,,,38.946375,,,fee schedule,,,38.946375,,,fee schedule,,,,249.42995,85,percent of total billed charges,,,38.946375,,,fee schedule,,,,146.0485719,49.77,percent of total billed charges,,,,264.1023,90,percent of total billed charges,,,,278.77465,90,percent of total billed charges,,,40.11476625,,,fee schedule,,,39,,,fee schedule,,,49.53,,,fee schedule,,,,249.42995,85,percent of total billed charges,,,38.946375,,,fee schedule,,,38.946375,293.447,
PFT SIMPLE SPIROMETRY,4600020,CDM,94010,CPT,460,RC,outpatient,,,,154.809,85.14495,,139.3281,90,percent of total billed charges,,,,154.809,100,percent of total billed charges,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,27.29575,,,fee schedule,,,27.29575,,,fee schedule,,,,131.58765,85,percent of total billed charges,,,27.29575,,,fee schedule,,,,77.0484393,49.77,percent of total billed charges,,,,139.3281,90,percent of total billed charges,,,,147.06855,90,percent of total billed charges,,,28.1146225,,,fee schedule,,,24,,,fee schedule,,,30.48,,,fee schedule,,,,131.58765,85,percent of total billed charges,,,27.29575,,,fee schedule,,,24,154.809,
INCENTIVE SPIROMETRY,4609420,CDM,94200,CPT,460,RC,outpatient,,,,57.989,31.89395,,52.1901,90,percent of total billed charges,,,,57.989,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,14.979375,,,fee schedule,,,14.979375,,,fee schedule,,,,49.29065,85,percent of total billed charges,,,14.979375,,,fee schedule,,,,28.8611253,49.77,percent of total billed charges,,,,52.1901,90,percent of total billed charges,,,,55.08955,90,percent of total billed charges,,,15.42875625,,,fee schedule,,,16,,,fee schedule,,,20.32,,,fee schedule,,,,49.29065,85,percent of total billed charges,,,14.979375,,,fee schedule,,,14.979375,57.989,
"PULSE OXIMETRY, SINGLE",4690000,CDM,94760,CPT,460,RC,outpatient,,,,46.865,25.77575,,42.1785,90,percent of total billed charges,,,,46.865,100,percent of total billed charges,,,2.13,,,fee schedule,,,2.13,,,fee schedule,,,2.13,,,fee schedule,,,2.663,,,fee schedule,,,2.663,,,fee schedule,,,,39.83525,85,percent of total billed charges,,,2.663,,,fee schedule,,,,23.3247105,49.77,percent of total billed charges,,,,42.1785,90,percent of total billed charges,,,,44.52175,90,percent of total billed charges,,,2.74289,,,fee schedule,,,28,,,fee schedule,,,35.56,,,fee schedule,,,,39.83525,85,percent of total billed charges,,,2.663,,,fee schedule,,,2.13,46.865,
"PULSE OX, CONTINOUS OVERNIGHT",4690040,CDM,94762,CPT,460,RC,outpatient,,,,320.948,176.5214,,288.8532,90,percent of total billed charges,,,,320.948,100,percent of total billed charges,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,25.2985,,,fee schedule,,,25.2985,,,fee schedule,,,,272.8058,85,percent of total billed charges,,,25.2985,,,fee schedule,,,,159.7358196,49.77,percent of total billed charges,,,,288.8532,90,percent of total billed charges,,,,304.9006,90,percent of total billed charges,,,26.057455,,,fee schedule,,,,,,,,,,,,,,,,272.8058,85,percent of total billed charges,,,25.2985,,,fee schedule,,,25.2985,320.948,
AEP SCR AUDITORY POTENTIAL,4710000,CDM,92650,CPT,471,RC,outpatient,,,,129.677,71.32235,,116.7093,90,percent of total billed charges,,,,129.677,100,percent of total billed charges,,,144.0246178,,,fee schedule,,,144.0246178,,,fee schedule,,,144.0246178,,,fee schedule,,,26.962875,,,fee schedule,,,26.962875,,,fee schedule,,,,110.22545,85,percent of total billed charges,,,26.962875,,,fee schedule,,,,64.5402429,49.77,percent of total billed charges,,,,116.7093,90,percent of total billed charges,,,,123.19315,90,percent of total billed charges,,,27.77176125,,,fee schedule,,,28.74,,,fee schedule,,,36.4998,,,fee schedule,,,,110.22545,85,percent of total billed charges,,,26.962875,,,fee schedule,,,26.962875,144.0246178,
CARDIAC OUTPUT/DAILY - ICU,7390020,CDM,93598,CPT,480,RC,outpatient,,,,48.513,26.68215,,43.6617,90,percent of total billed charges,,,,48.513,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.23605,85,percent of total billed charges,,,,,,,,,,24.1449201,49.77,percent of total billed charges,,,,43.6617,90,percent of total billed charges,,,,46.08735,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,41.23605,85,percent of total billed charges,,,,,,,,,24.1449201,48.513,
CARDIAC STRESS TEST(TREADMILL),4820000,CDM,93017,CPT,482,RC,outpatient,,,,322.699,177.48445,,290.4291,90,percent of total billed charges,,,,322.699,100,percent of total billed charges,,,265.839,,,fee schedule,,,265.839,,,fee schedule,,,265.839,,,fee schedule,,,37.614875,,,fee schedule,,,37.614875,,,fee schedule,,,,274.29415,85,percent of total billed charges,,,37.614875,,,fee schedule,,,,160.6072923,49.77,percent of total billed charges,,,,290.4291,90,percent of total billed charges,,,,306.56405,90,percent of total billed charges,,,38.74332125,,,fee schedule,,,61,,,fee schedule,,,77.47,,,fee schedule,,,,274.29415,85,percent of total billed charges,,,37.614875,,,fee schedule,,,37.614875,322.699,
TTE W DOPPLER COMPLETE,4803306,CDM,93306,CPT,483,RC,outpatient,,,,1450.755,797.91525,,1305.6795,90,percent of total billed charges,,,,1450.755,100,percent of total billed charges,,,477.582,,,fee schedule,,,477.582,,,fee schedule,,,477.582,,,fee schedule,,,196.063375,,,fee schedule,,,196.063375,,,fee schedule,,,,1233.14175,85,percent of total billed charges,,,196.063375,,,fee schedule,,,,722.0407635,49.77,percent of total billed charges,,,,1305.6795,90,percent of total billed charges,,,,1378.21725,90,percent of total billed charges,,,201.9452763,,,fee schedule,,,257.51,,,fee schedule,,,327.0377,,,fee schedule,,,,1233.14175,85,percent of total billed charges,,,196.063375,,,fee schedule,,,196.063375,1450.755,
OUTPT ESTABLILSHED LOW MDM 20,5100020,CDM,99213,CPT,510,RC,outpatient,,,,102.691,56.48005,,92.4219,90,percent of total billed charges,,,,102.691,100,percent of total billed charges,,,74.12,,,fee schedule,,,74.12,,,fee schedule,,,74.12,,,fee schedule,,,65.2435,,,fee schedule,,,65.2435,,,fee schedule,,,,,,,,,65.2435,,,fee schedule,,,,51.1093107,49.77,percent of total billed charges,,,,92.4219,90,percent of total billed charges,,,,97.55645,90,percent of total billed charges,,,67.200805,,,fee schedule,,,,,,,,,,,,,,,,87.28735,85,percent of total billed charges,,,65.2435,,,fee schedule,,,51.1093107,102.691,
TRIGGER POINT 1-2,5100552,CDM,20552,CPT,510,RC,outpatient,,,,657.346,361.5403,,591.6114,90,percent of total billed charges,,,,657.346,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,327.1611042,49.77,percent of total billed charges,,,,591.6114,90,percent of total billed charges,,,,624.4787,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,558.7441,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,657.346,
TRIGGER POINT 3+ FACILITY,5100553,CDM,20553,CPT,510,RC,outpatient,,,,657.2842,361.50631,,591.55578,90,percent of total billed charges,,,,657.2842,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,,327.1303463,49.77,percent of total billed charges,,,,591.55578,90,percent of total billed charges,,,,624.41999,90,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,558.69157,85,percent of total billed charges,,,41.609375,,,fee schedule,,,41.609375,657.2842,
SMALL JOINT /BURSA TECH COMP,5100600,CDM,20600,CPT,510,RC,outpatient,,,,632.008,347.6044,,568.8072,90,percent of total billed charges,,,,632.008,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,35.617625,,,fee schedule,,,35.617625,,,fee schedule,,,,,,,,,35.617625,,,fee schedule,,,,314.5503816,49.77,percent of total billed charges,,,,568.8072,90,percent of total billed charges,,,,600.4076,90,percent of total billed charges,,,36.68615375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,537.2068,85,percent of total billed charges,,,35.617625,,,fee schedule,,,35.617625,632.008,
Inter Joint/ Bursa Facility,5100605,CDM,20605,CPT,510,RC,outpatient,,,,551.05,303.0775,,495.945,90,percent of total billed charges,,,,551.05,100,percent of total billed charges,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,276.525,,,fee schedule,,,36.61625,,,fee schedule,,,36.61625,,,fee schedule,,,,,,,,,36.61625,,,fee schedule,,,,274.257585,49.77,percent of total billed charges,,,,495.945,90,percent of total billed charges,,,,523.4975,90,percent of total billed charges,,,37.7147375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,468.3925,85,percent of total billed charges,,,36.61625,,,fee schedule,,,36.61625,551.05,
Inj Interlaminar Lum/Spine,5102323,CDM,62323,CPT,510,RC,outpatient,,,,1762.021,969.11155,,1585.8189,90,percent of total billed charges,,,,1762.021,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,98.531,,,fee schedule,,,98.531,,,fee schedule,,,,,,,,,98.531,,,fee schedule,,,,876.9578517,49.77,percent of total billed charges,,,,1585.8189,90,percent of total billed charges,,,,1673.91995,90,percent of total billed charges,,,101.48693,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1497.71785,85,percent of total billed charges,,,98.531,,,fee schedule,,,98.531,1762.021,
INJ ANEST AGENT/ STEROID EPI,5104483,CDM,64483,CPT,510,RC,outpatient,,,,1361.66,748.913,,1225.494,90,percent of total billed charges,,,,1361.66,100,percent of total billed charges,,,866.68875,,,fee schedule,,,866.68875,,,fee schedule,,,866.68875,,,fee schedule,,,110.5145,,,fee schedule,,,110.5145,,,fee schedule,,,,,,,,,110.5145,,,fee schedule,,,,677.698182,49.77,percent of total billed charges,,,,1225.494,90,percent of total billed charges,,,,1293.577,90,percent of total billed charges,,,113.829935,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1157.411,85,percent of total billed charges,,,110.5145,,,fee schedule,,,110.5145,1361.66,
INJ ANESTHETIC ADDL LEVEL FAC,5104484,CDM,64484,CPT,510,RC,outpatient,,,,429.819,236.40045,,386.8371,90,percent of total billed charges,,,,429.819,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,50.929875,,,fee schedule,,,50.929875,,,fee schedule,,,,,,,,,50.929875,,,fee schedule,,,,213.9209163,49.77,percent of total billed charges,,,,386.8371,90,percent of total billed charges,,,,408.32805,90,percent of total billed charges,,,52.45777125,,,fee schedule,,,,,,,,,,,,,,,,365.34615,85,percent of total billed charges,,,50.929875,,,fee schedule,,,50.929875,429.819,
INJ FIRST FACET 1 LEVEL,5104493,CDM,64493,CPT,510,RC,outpatient,,,,1221.683,671.92565,,1099.5147,90,percent of total billed charges,,,,1221.683,100,percent of total billed charges,,,866.68875,,,fee schedule,,,866.68875,,,fee schedule,,,866.68875,,,fee schedule,,,89.87625,,,fee schedule,,,89.87625,,,fee schedule,,,,,,,,,89.87625,,,fee schedule,,,,608.0316291,49.77,percent of total billed charges,,,,1099.5147,90,percent of total billed charges,,,,1160.59885,90,percent of total billed charges,,,92.5725375,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1038.43055,85,percent of total billed charges,,,89.87625,,,fee schedule,,,89.87625,1221.683,
INJ PARAVERT F JNT L/S 2 LEVEL,5104494,CDM,64494,CPT,510,RC,outpatient,,,,1221.683,671.92565,,1099.5147,90,percent of total billed charges,,,,1221.683,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,50.264125,,,fee schedule,,,50.264125,,,fee schedule,,,,,,,,,50.264125,,,fee schedule,,,,608.0316291,49.77,percent of total billed charges,,,,1099.5147,90,percent of total billed charges,,,,1160.59885,90,percent of total billed charges,,,51.77204875,,,fee schedule,,,,,,,,,,,,,,,,1038.43055,85,percent of total billed charges,,,50.264125,,,fee schedule,,,50.264125,1221.683,
INJ PARAVERT F JNT L/S 3 LEVEL,5104495,CDM,64495,CPT,510,RC,outpatient,,,,275.525,151.53875,,247.9725,90,percent of total billed charges,,,,275.525,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,51.26275,,,fee schedule,,,51.26275,,,fee schedule,,,,,,,,,51.26275,,,fee schedule,,,,137.1287925,49.77,percent of total billed charges,,,,247.9725,90,percent of total billed charges,,,,261.74875,90,percent of total billed charges,,,52.8006325,,,fee schedule,,,,,,,,,,,,,,,,234.19625,85,percent of total billed charges,,,51.26275,,,fee schedule,,,51.26275,275.525,
DESTROY LUMB/SAC FACET JOINT,5104635,CDM,64635,CPT,510,RC,outpatient,,,,4308.284,2369.5562,,3877.4556,90,percent of total billed charges,,,,4308.284,100,percent of total billed charges,,,1828.1475,,,fee schedule,,,1828.1475,,,fee schedule,,,1828.1475,,,fee schedule,,,191.403125,,,fee schedule,,,191.403125,,,fee schedule,,,,,,,,,191.403125,,,fee schedule,,,,2144.232947,49.77,percent of total billed charges,,,,3877.4556,90,percent of total billed charges,,,,4092.8698,90,percent of total billed charges,,,197.1452188,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,3662.0414,85,percent of total billed charges,,,191.403125,,,fee schedule,,,191.403125,4308.284,
DSTR NROLYTC AGNT PARVERT ADDL,5104636,CDM,64636,CPT,510,RC,outpatient,,,,1503.285,826.80675,,1352.9565,90,percent of total billed charges,,,,1503.285,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,57.92025,,,fee schedule,,,57.92025,,,fee schedule,,,,,,,,,57.92025,,,fee schedule,,,,748.1849445,49.77,percent of total billed charges,,,,1352.9565,90,percent of total billed charges,,,,1428.12075,90,percent of total billed charges,,,59.6578575,,,fee schedule,,,,,,,,,,,,,,,,1277.79225,85,percent of total billed charges,,,57.92025,,,fee schedule,,,57.92025,1503.285,
CIRCUMCISION - OUTPATIENT,5105416,CDM,54150,CPT,510,RC,outpatient,,,,2219.65,1220.8075,,1997.685,90,percent of total billed charges,,,,2219.65,100,percent of total billed charges,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,94.869375,,,fee schedule,,,94.869375,,,fee schedule,,,,,,,,,94.869375,,,fee schedule,,,,1104.719805,49.77,percent of total billed charges,,,,1997.685,90,percent of total billed charges,,,,2108.6675,90,percent of total billed charges,,,97.71545625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1886.7025,85,percent of total billed charges,,,94.869375,,,fee schedule,,,94.869375,2219.65,
INJ SACROILIAC JOINT ANES STER,5107096,CDM,G0260,HCPCS,510,RC,outpatient,,,,749.634,412.2987,,674.6706,90,percent of total billed charges,,,,749.634,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,373.0928418,49.77,percent of total billed charges,,,,674.6706,90,percent of total billed charges,,,,712.1523,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,637.1889,85,percent of total billed charges,,,,,,,,,373.0928418,749.634,
OFFICE VISIT EXP PROBLEM 15-29,5109202,CDM,99202,CPT,510,RC,outpatient,,,,515,283.25,,463.5,90,percent of total billed charges,,,,515,100,percent of total billed charges,,,49.05,,,fee schedule,,,49.05,,,fee schedule,,,49.05,,,fee schedule,,,46.935375,,,fee schedule,,,46.935375,,,fee schedule,,,,,,,,,46.935375,,,fee schedule,,,,256.3155,49.77,percent of total billed charges,,,,463.5,90,percent of total billed charges,,,,489.25,90,percent of total billed charges,,,48.34343625,,,fee schedule,,,,,,,,,,,,,,,,437.75,85,percent of total billed charges,,,46.935375,,,fee schedule,,,46.935375,515,
INJ AA& STRD OTHER PERIPH NERV,7614450,CDM,64450,CPT,510,RC,outpatient,,,,1566.218,861.4199,,1409.5962,90,percent of total billed charges,,,,1566.218,100,percent of total billed charges,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,655.3125,,,fee schedule,,,41.609375,,,fee schedule,,,41.609375,,,fee schedule,,,,,,,,,41.609375,,,fee schedule,,,,779.5066986,49.77,percent of total billed charges,,,,1409.5962,90,percent of total billed charges,,,,1487.9071,90,percent of total billed charges,,,42.85765625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1331.2853,85,percent of total billed charges,,,41.609375,,,fee schedule,,,41.609375,1566.218,
ALS 2 EMERGENCY - RUN #1,5400000,CDM,A0433,HCPCS,540,RC,outpatient,,,,2126.847,1169.76585,,1914.1623,90,percent of total billed charges,,,,2126.847,100,percent of total billed charges,,,,,,,,,1914.1623,,,fee schedule,,,1701.4776,,,fee schedule,,,,,,,,,,,,,,,,1807.81995,85,percent of total billed charges,,,,,,,,,,1058.531752,49.77,percent of total billed charges,,,,1914.1623,90,percent of total billed charges,,,,2020.50465,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1807.81995,85,percent of total billed charges,,,,,,,,,1058.531752,2126.847,
ALS 2 EMERGENCY - RUN #2,5400001,CDM,A0433,HCPCS,540,RC,outpatient,,,,706.889,388.78895,,636.2001,90,percent of total billed charges,,,,706.889,100,percent of total billed charges,,,,,,,,,636.2001,,,fee schedule,,,565.5112,,,fee schedule,,,,,,,,,,,,,,,,600.85565,85,percent of total billed charges,,,,,,,,,,351.8186553,49.77,percent of total billed charges,,,,636.2001,90,percent of total billed charges,,,,671.54455,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,600.85565,85,percent of total billed charges,,,,,,,,,351.8186553,706.889,
ALS 1 EMERGENCY - RUN #1,5400010,CDM,A0427,HCPCS,540,RC,outpatient,,,,1469.089,807.99895,,1322.1801,90,percent of total billed charges,,,,1469.089,100,percent of total billed charges,,,,,,,,,1322.1801,,,fee schedule,,,1175.2712,,,fee schedule,,,,,,,,,,,,,,,,1248.72565,85,percent of total billed charges,,,,,,,,,,731.1655953,49.77,percent of total billed charges,,,,1322.1801,90,percent of total billed charges,,,,1395.63455,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1248.72565,85,percent of total billed charges,,,,,,,,,731.1655953,1469.089,
ALS 1 EMERGENCY - RUN #2,5400011,CDM,A0427,HCPCS,540,RC,outpatient,,,,1805.281,992.90455,,1624.7529,90,percent of total billed charges,,,,1805.281,100,percent of total billed charges,,,,,,,,,1624.7529,,,fee schedule,,,1444.2248,,,fee schedule,,,,,,,,,,,,,,,,1534.48885,85,percent of total billed charges,,,,,,,,,,898.4883537,49.77,percent of total billed charges,,,,1624.7529,90,percent of total billed charges,,,,1715.01695,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1534.48885,85,percent of total billed charges,,,,,,,,,898.4883537,1805.281,
ALS MILEAGE - RUN #1,5400050,CDM,A0425,HCPCS,540,RC,outpatient,,,QN,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,,,,,,,23.2677,,,fee schedule,,,20.6824,,,fee schedule,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,,12.8670381,49.77,percent of total billed charges,,,,23.2677,90,percent of total billed charges,,,,24.56035,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,12.8670381,25.853,
ALS MILEAGE - RUN #2,5400050.1,CDM,A0425,HCPCS,540,RC,outpatient,,,,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,22.7115,,,fee schedule,,,20.188,,,fee schedule,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,,12.5594595,49.77,percent of total billed charges,,,,22.7115,90,percent of total billed charges,,,,23.97325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,12.5594595,25.235,
ALS1 NON-EMERGENCY - RUN #1,5400070,CDM,A0426,HCPCS,540,RC,outpatient,,,,853.973,469.68515,,768.5757,90,percent of total billed charges,,,,853.973,100,percent of total billed charges,,,,,,,,,768.5757,,,fee schedule,,,683.1784,,,fee schedule,,,,,,,,,,,,,,,,725.87705,85,percent of total billed charges,,,,,,,,,,425.0223621,49.77,percent of total billed charges,,,,768.5757,90,percent of total billed charges,,,,811.27435,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,725.87705,85,percent of total billed charges,,,,,,,,,425.0223621,853.973,
ALS1 NON-EMERGENCY - RUN #2,5400071,CDM,A0426,HCPCS,540,RC,outpatient,,,,853.973,469.68515,,768.5757,90,percent of total billed charges,,,,853.973,100,percent of total billed charges,,,,,,,,,768.5757,,,fee schedule,,,683.1784,,,fee schedule,,,,,,,,,,,,,,,,725.87705,85,percent of total billed charges,,,,,,,,,,425.0223621,49.77,percent of total billed charges,,,,768.5757,90,percent of total billed charges,,,,811.27435,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,725.87705,85,percent of total billed charges,,,,,,,,,425.0223621,853.973,
BLS NON-EMERGENCY - RUN #1,5400090,CDM,A0428,HCPCS,540,RC,outpatient,,,,773.427,425.38485,,696.0843,90,percent of total billed charges,,,,773.427,100,percent of total billed charges,,,,,,,,,696.0843,,,fee schedule,,,618.7416,,,fee schedule,,,,,,,,,,,,,,,,657.41295,85,percent of total billed charges,,,,,,,,,,384.9346179,49.77,percent of total billed charges,,,,696.0843,90,percent of total billed charges,,,,734.75565,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,657.41295,85,percent of total billed charges,,,,,,,,,384.9346179,773.427,
BLS MILEAGE - RUN #1,5400091,CDM,A0425,HCPCS,540,RC,outpatient,,,QN,25.235,13.87925,,22.7115,90,percent of total billed charges,,,,25.235,100,percent of total billed charges,,,,,,,,,22.7115,,,fee schedule,,,20.188,,,fee schedule,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,,12.5594595,49.77,percent of total billed charges,,,,22.7115,90,percent of total billed charges,,,,23.97325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,21.44975,85,percent of total billed charges,,,,,,,,,12.5594595,25.235,
BLS NON-EMERGENCY - RUN #2,5400092,CDM,A0428,HCPCS,540,RC,outpatient,,,,773.427,425.38485,,696.0843,90,percent of total billed charges,,,,773.427,100,percent of total billed charges,,,,,,,,,696.0843,,,fee schedule,,,618.7416,,,fee schedule,,,,,,,,,,,,,,,,657.41295,85,percent of total billed charges,,,,,,,,,,384.9346179,49.77,percent of total billed charges,,,,696.0843,90,percent of total billed charges,,,,734.75565,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,657.41295,85,percent of total billed charges,,,,,,,,,384.9346179,773.427,
BLS MILEAGE - RUN #2,5400093,CDM,A0425,HCPCS,540,RC,outpatient,,,,14.42,7.931,,12.978,90,percent of total billed charges,,,,14.42,100,percent of total billed charges,,,,,,,,,12.978,,,fee schedule,,,11.536,,,fee schedule,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,,7.176834,49.77,percent of total billed charges,,,,12.978,90,percent of total billed charges,,,,13.699,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.257,85,percent of total billed charges,,,,,,,,,7.176834,14.42,
HH - PRIVATE DUTY RN - HOURLY,5500070,CDM,S9123,HCPCS,551,RC,outpatient,,,,65.096,35.8028,,58.5864,90,percent of total billed charges,,,,65.096,100,percent of total billed charges,,,,,,,,,58.5864,,,fee schedule,,,52.0768,,,fee schedule,,,,,,,,,,,,,,,,55.3316,85,percent of total billed charges,,,,,,,,,,32.3982792,49.77,percent of total billed charges,,,,58.5864,90,percent of total billed charges,,,,61.8412,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.3982792,65.096,
HH - RN SUPERVISORY VISIT,5500071,CDM,S9123,HCPCS,551,RC,outpatient,,,U1,64.272,35.3496,,57.8448,90,percent of total billed charges,,,,64.272,100,percent of total billed charges,,,,,,,,,57.8448,,,fee schedule,,,51.4176,,,fee schedule,,,,,,,,,,,,,,,,54.6312,85,percent of total billed charges,,,,,,,,,,31.9881744,49.77,percent of total billed charges,,,,57.8448,90,percent of total billed charges,,,,61.0584,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.9881744,64.272,
HH - PRIVATE DUTY LPN - HOURLY,5500080,CDM,S9124,HCPCS,551,RC,outpatient,,,,45.835,25.20925,,41.2515,90,percent of total billed charges,,,,45.835,100,percent of total billed charges,,,,,,,,,41.2515,,,fee schedule,,,36.668,,,fee schedule,,,,,,,,,,,,,,,,38.95975,85,percent of total billed charges,,,,,,,,,,22.8120795,49.77,percent of total billed charges,,,,41.2515,90,percent of total billed charges,,,,43.54325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.8120795,45.835,
"MRI,ABDOMEN",6100000,CDM,74181,CPT,610,RC,outpatient,,,,2344.898,1289.6939,,2110.4082,90,percent of total billed charges,,,,2344.898,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.0565,,,fee schedule,,,201.0565,,,fee schedule,,,945,,,case rate,,,201.0565,,,fee schedule,,,,1167.055735,49.77,percent of total billed charges,,,,2110.4082,90,percent of total billed charges,,,,2227.6531,90,percent of total billed charges,,,207.088195,,,fee schedule,,,409,,,fee schedule,,,519.43,,,fee schedule,,,900,,,case rate,,,201.0565,,,fee schedule,,,201.0565,2344.898,
MRA HEAD W/O CONTRAST,6100025,CDM,70544,CPT,610,RC,outpatient,,,,1585.891,872.24005,,1427.3019,90,percent of total billed charges,,,,1585.891,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,221.361875,,,fee schedule,,,221.361875,,,fee schedule,,,945,,,case rate,,,221.361875,,,fee schedule,,,,789.2979507,49.77,percent of total billed charges,,,,1427.3019,90,percent of total billed charges,,,,1506.59645,90,percent of total billed charges,,,228.0027313,,,fee schedule,,,435.78,,,fee schedule,,,553.4406,,,fee schedule,,,900,,,case rate,,,221.361875,,,fee schedule,,,221.361875,1585.891,
"MRI,ABDOMEN WO/W GAD",6100122,CDM,74183,CPT,610,RC,outpatient,,,,2297.312,1263.5216,,2067.5808,90,percent of total billed charges,,,,2297.312,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,347.188625,,,fee schedule,,,347.188625,,,fee schedule,,,945,,,case rate,,,347.188625,,,fee schedule,,,,1143.372182,49.77,percent of total billed charges,,,,2067.5808,90,percent of total billed charges,,,,2182.4464,90,percent of total billed charges,,,357.6042838,,,fee schedule,,,955.2,,,fee schedule,,,1213.104,,,fee schedule,,,900,,,case rate,,,347.188625,,,fee schedule,,,347.188625,2297.312,
"MRI,PELVIS; W/O CONTRAST",6100245,CDM,72195,CPT,610,RC,outpatient,,,,1327.979,730.38845,,1195.1811,90,percent of total billed charges,,,,1327.979,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,235.342625,,,fee schedule,,,235.342625,,,fee schedule,,,945,,,case rate,,,235.342625,,,fee schedule,,,,660.9351483,49.77,percent of total billed charges,,,,1195.1811,90,percent of total billed charges,,,,1261.58005,90,percent of total billed charges,,,242.4029038,,,fee schedule,,,431.29,,,fee schedule,,,547.7383,,,fee schedule,,,900,,,case rate,,,235.342625,,,fee schedule,,,223.73,1327.979,
"MRI,PELVIS; WO/W GAD",6100246,CDM,72197,CPT,610,RC,outpatient,,,,2297.312,1263.5216,,2067.5808,90,percent of total billed charges,,,,2297.312,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,345.857125,,,fee schedule,,,345.857125,,,fee schedule,,,945,,,case rate,,,345.857125,,,fee schedule,,,,1143.372182,49.77,percent of total billed charges,,,,2067.5808,90,percent of total billed charges,,,,2182.4464,90,percent of total billed charges,,,356.2328388,,,fee schedule,,,955.2,,,fee schedule,,,1213.104,,,fee schedule,,,900,,,case rate,,,345.857125,,,fee schedule,,,345.857125,2297.312,
MRA NECK W/O CONTRAST,6100312,CDM,70547,CPT,610,RC,outpatient,,,,1012.387,556.81285,,911.1483,90,percent of total billed charges,,,,1012.387,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,221.69475,,,fee schedule,,,221.69475,,,fee schedule,,,945,,,case rate,,,221.69475,,,fee schedule,,,,503.8650099,49.77,percent of total billed charges,,,,911.1483,90,percent of total billed charges,,,,961.76765,90,percent of total billed charges,,,228.3455925,,,fee schedule,,,435.78,,,fee schedule,,,553.4406,,,fee schedule,,,900,,,case rate,,,221.69475,,,fee schedule,,,221.69475,1012.387,
MRA NECK W & W/O CONTRAST,6100313,CDM,70549,CPT,610,RC,outpatient,,,,1683.741,926.05755,,1515.3669,90,percent of total billed charges,,,,1683.741,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,354.84475,,,fee schedule,,,354.84475,,,fee schedule,,,945,,,case rate,,,354.84475,,,fee schedule,,,,837.9978957,49.77,percent of total billed charges,,,,1515.3669,90,percent of total billed charges,,,,1599.55395,90,percent of total billed charges,,,365.4900925,,,fee schedule,,,852.82,,,fee schedule,,,1083.0814,,,fee schedule,,,900,,,case rate,,,354.84475,,,fee schedule,,,354.84475,1683.741,
MRA NECK WITH CONTRAST,6100314,CDM,70548,CPT,610,RC,outpatient,,,,1307.379,719.05845,,1176.6411,90,percent of total billed charges,,,,1307.379,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,252.652125,,,fee schedule,,,252.652125,,,fee schedule,,,945,,,case rate,,,252.652125,,,fee schedule,,,,650.6825283,49.77,percent of total billed charges,,,,1176.6411,90,percent of total billed charges,,,,1242.01005,90,percent of total billed charges,,,260.2316888,,,fee schedule,,,435.78,,,fee schedule,,,553.4406,,,fee schedule,,,900,,,case rate,,,252.652125,,,fee schedule,,,252.652125,1307.379,
MRI - UP EXT NONJT WOW/GAD RT,6101001,CDM,73220,CPT,610,RC,outpatient,,,RT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,421.086875,,,fee schedule,,,421.086875,,,fee schedule,,,945,,,case rate,,,421.086875,,,fee schedule,,,,990.3518289,49.77,percent of total billed charges,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,90,percent of total billed charges,,,433.7194813,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,421.086875,,,fee schedule,,,366.59,1989.857,
MRI - UP EXT NONJT WOW/GAD LT,6101002,CDM,73220,CPT,610,RC,outpatient,,,LT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,421.086875,,,fee schedule,,,421.086875,,,fee schedule,,,945,,,case rate,,,421.086875,,,fee schedule,,,,990.3518289,49.77,percent of total billed charges,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,90,percent of total billed charges,,,433.7194813,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,421.086875,,,fee schedule,,,366.59,1989.857,
MRI - UP EXT JOINT WO/GAD RT,6101101,CDM,73221,CPT,610,RC,outpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,208.37975,,,fee schedule,,,208.37975,,,fee schedule,,,945,,,case rate,,,208.37975,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,214.6311425,,,fee schedule,,,380,,,fee schedule,,,482.6,,,fee schedule,,,900,,,case rate,,,208.37975,,,fee schedule,,,208.37975,1376.595,
MRI - UP EXT JOINT WO/GAD LT,6101102,CDM,73221,CPT,610,RC,outpatient,,,LT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,208.37975,,,fee schedule,,,208.37975,,,fee schedule,,,945,,,case rate,,,208.37975,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,214.6311425,,,fee schedule,,,380,,,fee schedule,,,482.6,,,fee schedule,,,900,,,case rate,,,208.37975,,,fee schedule,,,208.37975,1376.595,
MRI - UP EXT JOINT WO/GAD BIL,6101103,CDM,73221,CPT,610,RC,outpatient,,,50,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,208.37975,,,fee schedule,,,208.37975,,,fee schedule,,,945,,,case rate,,,208.37975,,,fee schedule,,,,1370.262663,49.77,percent of total billed charges,,,,2477.871,90,percent of total billed charges,,,,2615.5305,90,percent of total billed charges,,,214.6311425,,,fee schedule,,,380,,,fee schedule,,,482.6,,,fee schedule,,,900,,,case rate,,,208.37975,,,fee schedule,,,208.37975,2753.19,
MRI - LOW EXT NONJT WO/GAD RT,6101201,CDM,73718,CPT,610,RC,outpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,229.350875,,,fee schedule,,,229.350875,,,fee schedule,,,945,,,case rate,,,229.350875,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,236.2314013,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,229.350875,,,fee schedule,,,223.73,1376.595,
MRI - LOW EXT NONJT WO/GAD LT,6101202,CDM,73718,CPT,610,RC,outpatient,,,LT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,229.350875,,,fee schedule,,,229.350875,,,fee schedule,,,945,,,case rate,,,229.350875,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,236.2314013,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,229.350875,,,fee schedule,,,223.73,1376.595,
MRI - LOW EXT NONJT WO/GAD BIL,6101203,CDM,73718,CPT,610,RC,outpatient,,,50,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,229.350875,,,fee schedule,,,229.350875,,,fee schedule,,,945,,,case rate,,,229.350875,,,fee schedule,,,,1370.262663,49.77,percent of total billed charges,,,,2477.871,90,percent of total billed charges,,,,2615.5305,90,percent of total billed charges,,,236.2314013,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,229.350875,,,fee schedule,,,223.73,2753.19,
MRI - LOW EXT NONJT WOW/GAD RT,6101401,CDM,73720,CPT,610,RC,outpatient,,,RT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,346.19,,,fee schedule,,,346.19,,,fee schedule,,,945,,,case rate,,,346.19,,,fee schedule,,,,990.3518289,49.77,percent of total billed charges,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,90,percent of total billed charges,,,356.5757,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,346.19,,,fee schedule,,,346.19,1989.857,
MRI - LOW EXT NONJT WOW/GAD LT,6101402,CDM,73720,CPT,610,RC,outpatient,,,LT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,346.19,,,fee schedule,,,346.19,,,fee schedule,,,945,,,case rate,,,346.19,,,fee schedule,,,,990.3518289,49.77,percent of total billed charges,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,90,percent of total billed charges,,,356.5757,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,346.19,,,fee schedule,,,346.19,1989.857,
MRI - LOW EXT NONJT WOW/GAD BI,6101403,CDM,73720,CPT,610,RC,outpatient,,,50,3979.714,2188.8427,,3581.7426,90,percent of total billed charges,,,,3979.714,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,346.19,,,fee schedule,,,346.19,,,fee schedule,,,945,,,case rate,,,346.19,,,fee schedule,,,,1980.703658,49.77,percent of total billed charges,,,,3581.7426,90,percent of total billed charges,,,,3780.7283,90,percent of total billed charges,,,356.5757,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,346.19,,,fee schedule,,,346.19,3979.714,
MRI - LOW EXT JOINT WO/GAD RT,6101501,CDM,73721,CPT,610,RC,outpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,208.046875,,,fee schedule,,,208.046875,,,fee schedule,,,945,,,case rate,,,208.046875,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,214.2882813,,,fee schedule,,,380,,,fee schedule,,,482.6,,,fee schedule,,,900,,,case rate,,,208.046875,,,fee schedule,,,208.046875,1376.595,
MRI - LOW EXT JOINT WO/GAD LT,6101502,CDM,73721,CPT,610,RC,outpatient,,,LT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,208.046875,,,fee schedule,,,208.046875,,,fee schedule,,,945,,,case rate,,,208.046875,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,214.2882813,,,fee schedule,,,380,,,fee schedule,,,482.6,,,fee schedule,,,900,,,case rate,,,208.046875,,,fee schedule,,,208.046875,1376.595,
MRI - LOW EXT JOINT WO/GAD BIL,6101503,CDM,73721,CPT,610,RC,outpatient,,,50,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,208.046875,,,fee schedule,,,208.046875,,,fee schedule,,,945,,,case rate,,,208.046875,,,fee schedule,,,,1370.262663,49.77,percent of total billed charges,,,,2477.871,90,percent of total billed charges,,,,2615.5305,90,percent of total billed charges,,,214.2882813,,,fee schedule,,,380,,,fee schedule,,,482.6,,,fee schedule,,,900,,,case rate,,,208.046875,,,fee schedule,,,208.046875,2753.19,
MRI - LOW EXT JOINT W/GAD RT,6101601,CDM,73722,CPT,610,RC,outpatient,,,RT,1558.287,857.05785,,1402.4583,90,percent of total billed charges,,,,1558.287,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,322.223,,,fee schedule,,,322.223,,,fee schedule,,,945,,,case rate,,,322.223,,,fee schedule,,,,775.5594399,49.77,percent of total billed charges,,,,1402.4583,90,percent of total billed charges,,,,1480.37265,90,percent of total billed charges,,,331.88969,,,fee schedule,,,514.92,,,fee schedule,,,653.9484,,,fee schedule,,,900,,,case rate,,,322.223,,,fee schedule,,,322.223,1558.287,
MRI - LOW EXT JOINT W/GAD LT,6101602,CDM,73722,CPT,610,RC,outpatient,,,LT,1558.287,857.05785,,1402.4583,90,percent of total billed charges,,,,1558.287,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,322.223,,,fee schedule,,,322.223,,,fee schedule,,,945,,,case rate,,,322.223,,,fee schedule,,,,775.5594399,49.77,percent of total billed charges,,,,1402.4583,90,percent of total billed charges,,,,1480.37265,90,percent of total billed charges,,,331.88969,,,fee schedule,,,514.92,,,fee schedule,,,653.9484,,,fee schedule,,,900,,,case rate,,,322.223,,,fee schedule,,,322.223,1558.287,
MRI - LOW EXT JOINT WOW/GAD RT,6101701,CDM,73723,CPT,610,RC,outpatient,,,RT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,396.12125,,,fee schedule,,,396.12125,,,fee schedule,,,945,,,case rate,,,396.12125,,,fee schedule,,,,990.3518289,49.77,percent of total billed charges,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,90,percent of total billed charges,,,408.0048875,,,fee schedule,,,952.95,,,fee schedule,,,1210.2465,,,fee schedule,,,900,,,case rate,,,396.12125,,,fee schedule,,,366.59,1989.857,
MRI - LOW EXT JOINT WOW/GAD LT,6101702,CDM,73723,CPT,610,RC,outpatient,,,LT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,396.12125,,,fee schedule,,,396.12125,,,fee schedule,,,945,,,case rate,,,396.12125,,,fee schedule,,,,990.3518289,49.77,percent of total billed charges,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,90,percent of total billed charges,,,408.0048875,,,fee schedule,,,952.95,,,fee schedule,,,1210.2465,,,fee schedule,,,900,,,case rate,,,396.12125,,,fee schedule,,,366.59,1989.857,
MRI - UP EXT NONJT WO/GAD RT,6101801,CDM,73218,CPT,610,RC,outpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,311.903875,,,fee schedule,,,311.903875,,,fee schedule,,,945,,,case rate,,,311.903875,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,321.2609913,,,fee schedule,,,429.41,,,fee schedule,,,545.3507,,,fee schedule,,,900,,,case rate,,,311.903875,,,fee schedule,,,223.73,1376.595,
MRI - UP EXT NONJT WO/GAD LT,6101802,CDM,73218,CPT,610,RC,outpatient,,,LT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,311.903875,,,fee schedule,,,311.903875,,,fee schedule,,,945,,,case rate,,,311.903875,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,321.2609913,,,fee schedule,,,429.41,,,fee schedule,,,545.3507,,,fee schedule,,,900,,,case rate,,,311.903875,,,fee schedule,,,223.73,1376.595,
MRI - UP EXT NONJT WO/GAD BIL,6101803,CDM,73218,CPT,610,RC,outpatient,,,50,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,311.903875,,,fee schedule,,,311.903875,,,fee schedule,,,945,,,case rate,,,311.903875,,,fee schedule,,,,1370.262663,49.77,percent of total billed charges,,,,2477.871,90,percent of total billed charges,,,,2615.5305,90,percent of total billed charges,,,321.2609913,,,fee schedule,,,429.41,,,fee schedule,,,545.3507,,,fee schedule,,,900,,,case rate,,,311.903875,,,fee schedule,,,223.73,2753.19,
MRI - UP EXT JOINT W/GAD RT,6102001,CDM,73222,CPT,610,RC,outpatient,,,RT,1558.287,857.05785,,1402.4583,90,percent of total billed charges,,,,1558.287,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,321.890125,,,fee schedule,,,321.890125,,,fee schedule,,,945,,,case rate,,,321.890125,,,fee schedule,,,,775.5594399,49.77,percent of total billed charges,,,,1402.4583,90,percent of total billed charges,,,,1480.37265,90,percent of total billed charges,,,331.5468288,,,fee schedule,,,514.92,,,fee schedule,,,653.9484,,,fee schedule,,,900,,,case rate,,,321.890125,,,fee schedule,,,321.890125,1558.287,
MRI - UP EXT JOINT W/GAD LT,6102002,CDM,73222,CPT,610,RC,outpatient,,,LT,1558.287,857.05785,,1402.4583,90,percent of total billed charges,,,,1558.287,100,percent of total billed charges,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,653.61,,,fee schedule,,,321.890125,,,fee schedule,,,321.890125,,,fee schedule,,,945,,,case rate,,,321.890125,,,fee schedule,,,,775.5594399,49.77,percent of total billed charges,,,,1402.4583,90,percent of total billed charges,,,,1480.37265,90,percent of total billed charges,,,331.5468288,,,fee schedule,,,514.92,,,fee schedule,,,653.9484,,,fee schedule,,,900,,,case rate,,,321.890125,,,fee schedule,,,321.890125,1558.287,
MRI - UP EXT JOINT WOW/GAD RT,6102101,CDM,73223,CPT,610,RC,outpatient,,,RT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,397.785625,,,fee schedule,,,397.785625,,,fee schedule,,,945,,,case rate,,,397.785625,,,fee schedule,,,,990.3518289,49.77,percent of total billed charges,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,90,percent of total billed charges,,,409.7191938,,,fee schedule,,,952.95,,,fee schedule,,,1210.2465,,,fee schedule,,,900,,,case rate,,,397.785625,,,fee schedule,,,366.59,1989.857,
MRI - UP EXT JOINT WOW/GAD LT,6102102,CDM,73223,CPT,610,RC,outpatient,,,LT,1989.857,1094.42135,,1790.8713,90,percent of total billed charges,,,,1989.857,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,397.785625,,,fee schedule,,,397.785625,,,fee schedule,,,945,,,case rate,,,397.785625,,,fee schedule,,,,990.3518289,49.77,percent of total billed charges,,,,1790.8713,90,percent of total billed charges,,,,1890.36415,90,percent of total billed charges,,,409.7191938,,,fee schedule,,,952.95,,,fee schedule,,,1210.2465,,,fee schedule,,,900,,,case rate,,,397.785625,,,fee schedule,,,366.59,1989.857,
MRI - TMJ WO/GAD RT,6102201,CDM,70336,CPT,610,RC,outpatient,,,RT,1376.595,757.12725,,1238.9355,90,percent of total billed charges,,,,1376.595,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,271.293125,,,fee schedule,,,271.293125,,,fee schedule,,,945,,,case rate,,,271.293125,,,fee schedule,,,,685.1313315,49.77,percent of total billed charges,,,,1238.9355,90,percent of total billed charges,,,,1307.76525,90,percent of total billed charges,,,279.4319188,,,fee schedule,,,343,,,fee schedule,,,435.61,,,fee schedule,,,900,,,case rate,,,271.293125,,,fee schedule,,,223.73,1376.595,
 MRI - TMJ WO/GAD,6102203,CDM,70336,CPT,610,RC,outpatient,,,,2753.19,1514.2545,,2477.871,90,percent of total billed charges,,,,2753.19,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,271.293125,,,fee schedule,,,271.293125,,,fee schedule,,,945,,,case rate,,,271.293125,,,fee schedule,,,,1370.262663,49.77,percent of total billed charges,,,,2477.871,90,percent of total billed charges,,,,2615.5305,90,percent of total billed charges,,,279.4319188,,,fee schedule,,,343,,,fee schedule,,,435.61,,,fee schedule,,,900,,,case rate,,,271.293125,,,fee schedule,,,223.73,2753.19,
"MRI,ORBIT,FACE,NECK WO/W CONT",6107054,CDM,70543,CPT,610,RC,outpatient,,,,1827.014,1004.8577,,1644.3126,90,percent of total billed charges,,,,1827.014,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,347.854375,,,fee schedule,,,347.854375,,,fee schedule,,,945,,,case rate,,,347.854375,,,fee schedule,,,,909.3048678,49.77,percent of total billed charges,,,,1644.3126,90,percent of total billed charges,,,,1735.6633,90,percent of total billed charges,,,358.2900063,,,fee schedule,,,952.95,,,fee schedule,,,1210.2465,,,fee schedule,,,900,,,case rate,,,347.854375,,,fee schedule,,,347.854375,1827.014,
MRA ABDOMEN W OR W/O CONTRAST,6107418,CDM,74185,CPT,610,RC,outpatient,,,,1294.607,712.03385,,1165.1463,90,percent of total billed charges,,,,1294.607,100,percent of total billed charges,,,280.59,,,fee schedule,,,280.59,,,fee schedule,,,280.59,,,fee schedule,,,345.857125,,,fee schedule,,,345.857125,,,fee schedule,,,945,,,case rate,,,345.857125,,,fee schedule,,,,644.3259039,49.77,percent of total billed charges,,,,1165.1463,90,percent of total billed charges,,,,1229.87665,90,percent of total billed charges,,,356.2328388,,,fee schedule,,,447.41,,,fee schedule,,,568.2107,,,fee schedule,,,900,,,case rate,,,345.857125,,,fee schedule,,,280.59,1294.607,
"MRI,BRAIN & STEM W/O & W CONT",6100030,CDM,70553,CPT,611,RC,outpatient,,,,2970.005,1633.50275,,2673.0045,90,percent of total billed charges,,,,2970.005,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,326.88325,,,fee schedule,,,326.88325,,,fee schedule,,,945,,,case rate,,,326.88325,,,fee schedule,,,,1478.171489,49.77,percent of total billed charges,,,,2673.0045,90,percent of total billed charges,,,,2821.50475,90,percent of total billed charges,,,336.6897475,,,fee schedule,,,578,,,fee schedule,,,734.06,,,fee schedule,,,900,,,case rate,,,326.88325,,,fee schedule,,,326.88325,2970.005,
"MRI,BRAIN & STEM W/O CONTRAST",6100040,CDM,70551,CPT,611,RC,outpatient,,,,2157.85,1186.8175,,1942.065,90,percent of total billed charges,,,,2157.85,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,201.389375,,,fee schedule,,,201.389375,,,fee schedule,,,945,,,case rate,,,201.389375,,,fee schedule,,,,1073.961945,49.77,percent of total billed charges,,,,1942.065,90,percent of total billed charges,,,,2049.9575,90,percent of total billed charges,,,207.4310563,,,fee schedule,,,403,,,fee schedule,,,511.81,,,fee schedule,,,900,,,case rate,,,201.389375,,,fee schedule,,,201.389375,2157.85,
"MRI,SPINAL CANAL CERV WO/W GAD",6100050,CDM,72156,CPT,612,RC,outpatient,,,,3099.064,1704.4852,,2789.1576,90,percent of total billed charges,,,,3099.064,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,328.547625,,,fee schedule,,,328.547625,,,fee schedule,,,945,,,case rate,,,328.547625,,,fee schedule,,,,1542.404153,49.77,percent of total billed charges,,,,2789.1576,90,percent of total billed charges,,,,2944.1108,90,percent of total billed charges,,,338.4040538,,,fee schedule,,,578,,,fee schedule,,,734.06,,,fee schedule,,,900,,,case rate,,,328.547625,,,fee schedule,,,328.547625,3099.064,
"MRI,SPINAL CANAL CERVICAL; WO",6100060,CDM,72141,CPT,612,RC,outpatient,,,,3013.78,1657.579,,2712.402,90,percent of total billed charges,,,,3013.78,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,195.7305,,,fee schedule,,,195.7305,,,fee schedule,,,945,,,case rate,,,195.7305,,,fee schedule,,,,1499.958306,49.77,percent of total billed charges,,,,2712.402,90,percent of total billed charges,,,,2863.091,90,percent of total billed charges,,,201.602415,,,fee schedule,,,406,,,fee schedule,,,515.62,,,fee schedule,,,900,,,case rate,,,195.7305,,,fee schedule,,,195.7305,3013.78,
"MRI,SPINAL CANAL LUMBAR WO/W G",6100130,CDM,72158,CPT,612,RC,outpatient,,,,2709.724,1490.3482,,2438.7516,90,percent of total billed charges,,,,2709.724,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,327.881875,,,fee schedule,,,327.881875,,,fee schedule,,,945,,,case rate,,,327.881875,,,fee schedule,,,,1348.629635,49.77,percent of total billed charges,,,,2438.7516,90,percent of total billed charges,,,,2574.2378,90,percent of total billed charges,,,337.7183313,,,fee schedule,,,578,,,fee schedule,,,734.06,,,fee schedule,,,900,,,case rate,,,327.881875,,,fee schedule,,,327.881875,2709.724,
"MRI, LUMBAR SPINE W/O CONTRAST",6100140,CDM,72148,CPT,612,RC,outpatient,,,,2646.585,1455.62175,,2381.9265,90,percent of total billed charges,,,,2646.585,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,196.39625,,,fee schedule,,,196.39625,,,fee schedule,,,945,,,case rate,,,196.39625,,,fee schedule,,,,1317.205355,49.77,percent of total billed charges,,,,2381.9265,90,percent of total billed charges,,,,2514.25575,90,percent of total billed charges,,,202.2881375,,,fee schedule,,,432,,,fee schedule,,,548.64,,,fee schedule,,,900,,,case rate,,,196.39625,,,fee schedule,,,196.39625,2646.585,
"MRI,SPINAL THORACIC W/WO GAD",6100250,CDM,72157,CPT,612,RC,outpatient,,,,2892.858,1591.0719,,2603.5722,90,percent of total billed charges,,,,2892.858,100,percent of total billed charges,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,366.59,,,fee schedule,,,329.213375,,,fee schedule,,,329.213375,,,fee schedule,,,945,,,case rate,,,329.213375,,,fee schedule,,,,1439.775427,49.77,percent of total billed charges,,,,2603.5722,90,percent of total billed charges,,,,2748.2151,90,percent of total billed charges,,,339.0897763,,,fee schedule,,,578,,,fee schedule,,,734.06,,,fee schedule,,,900,,,case rate,,,329.213375,,,fee schedule,,,329.213375,2892.858,
"MRI,SPINAL CANAL THORACIC; WO",6100260,CDM,72146,CPT,612,RC,outpatient,,,,2754.941,1515.21755,,2479.4469,90,percent of total billed charges,,,,2754.941,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,195.397625,,,fee schedule,,,195.397625,,,fee schedule,,,945,,,case rate,,,195.397625,,,fee schedule,,,,1371.134136,49.77,percent of total billed charges,,,,2479.4469,90,percent of total billed charges,,,,2617.19395,90,percent of total billed charges,,,201.2595538,,,fee schedule,,,446,,,fee schedule,,,566.42,,,fee schedule,,,900,,,case rate,,,195.397625,,,fee schedule,,,195.397625,2754.941,
MRI BREAST W/O CONTRAST BILAT,6147047,CDM,77047,CPT,614,RC,outpatient,,,,291.387,160.26285,,262.2483,90,percent of total billed charges,,,,291.387,100,percent of total billed charges,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,223.73,,,fee schedule,,,224.690625,,,fee schedule,,,224.690625,,,fee schedule,,,945,,,case rate,,,224.690625,,,fee schedule,,,,145.0233099,49.77,percent of total billed charges,,,,262.2483,90,percent of total billed charges,,,,276.81765,90,percent of total billed charges,,,231.4313438,,,fee schedule,,,185.79,,,fee schedule,,,235.9533,,,fee schedule,,,900,,,case rate,,,224.690625,,,fee schedule,,,145.0233099,945,
NEO-SYNEPHRINE 1% 10MG/ML INJ,2500055,CDM,J2371,HCPCS,636,RC,outpatient,10,ME,,16.48,9.064,,14.832,90,percent of total billed charges,,,,16.48,100,percent of total billed charges,,,,,,,,,14.832,,,fee schedule,,,13.184,,,fee schedule,,,,,,,,,,,,,,,,14.008,85,percent of total billed charges,,,,,,,,,,8.202096,49.77,percent of total billed charges,,,,14.832,90,percent of total billed charges,,,,15.656,90,percent of total billed charges,,,,,,,,,0.01,,,fee schedule,,,0.0127,,,fee schedule,,,,12.36,75,percent of total billed charges,,,,,,,,,0.01,16.48,
ACTIVASE 100mg VIAL,2500070,CDM,J2997,HCPCS,636,RC,outpatient,100,ME,,9575.292,5266.4106,,8617.7628,90,percent of total billed charges,,,,9575.292,100,percent of total billed charges,,,100.09,,,fee schedule,,,100.09,,,fee schedule,,,100.09,,,fee schedule,,,,,,,,,,,,,,,,8138.9982,85,percent of total billed charges,,,,,,,,,,4765.622828,49.77,percent of total billed charges,,,,8617.7628,90,percent of total billed charges,,,,9096.5274,90,percent of total billed charges,,,,,,,,,35.63,,,fee schedule,,,45.2501,,,fee schedule,,,,4500,75,percent of total billed charges,,,,,,,,,35.63,9575.292,
ADENOCARD 6mg  - OP,2500100,CDM,J0153,HCPCS,636,RC,outpatient,65,ME,,87.138,47.9259,,78.4242,90,percent of total billed charges,,,,87.138,100,percent of total billed charges,,,0.72,,,fee schedule,,,0.72,,,fee schedule,,,0.72,,,fee schedule,,,,,,,,,,,,,,,,74.0673,85,percent of total billed charges,,,,,,,,,,43.3685826,49.77,percent of total billed charges,,,,78.4242,90,percent of total billed charges,,,,82.7811,90,percent of total billed charges,,,,,,,,,0.85,,,fee schedule,,,1.0795,,,fee schedule,,,,65.3535,75,percent of total billed charges,,,,,,,,,0.72,87.138,
EPINEPHRINE 1:1000 1 MG INJ,2500110,CDM,J0171,HCPCS,636,RC,outpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,1.64,,,fee schedule,,,2.0828,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.98,10.403,
AMINOPHYLLIN UP TO 250mg,2500490,CDM,J0280,HCPCS,636,RC,outpatient,250,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,8.37,,,fee schedule,,,8.37,,,fee schedule,,,8.37,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,14.64,,,fee schedule,,,18.5928,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,4.8699945,18.5928,
NORFLEX 30mg/1ml 2ml INJ,2500515,CDM,J2360,HCPCS,636,RC,outpatient,2,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,7.33,,,fee schedule,,,7.33,,,fee schedule,,,7.33,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,6.48,,,fee schedule,,,8.2296,,,fee schedule,,,,12.12825,75,percent of total billed charges,,,,,,,,,6.48,16.171,
ANCEF/CEFAZOLIN 1 gr,2500760,CDM,J0690,HCPCS,636,RC,outpatient,1,GR,,15.965,8.78075,,14.3685,90,percent of total billed charges,,,,15.965,100,percent of total billed charges,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,,,,,,,,,,,,,,13.57025,85,percent of total billed charges,,,,,,,,,,7.9457805,49.77,percent of total billed charges,,,,14.3685,90,percent of total billed charges,,,,15.16675,90,percent of total billed charges,,,,,,,,,4.55,,,fee schedule,,,5.7785,,,fee schedule,,,,11.97375,75,percent of total billed charges,,,,,,,,,0.86,15.965,
SUCCINYLCHOLINE UP TO 20mg,2500800,CDM,J0330,HCPCS,636,RC,outpatient,20,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.18,,,fee schedule,,,0.18,,,fee schedule,,,0.18,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,2.39,,,fee schedule,,,3.0353,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.18,9.785,
APRESOLINE 20MG/ML INJ,2500970,CDM,J0360,HCPCS,636,RC,outpatient,20,ME,,50.573,27.81515,,45.5157,90,percent of total billed charges,,,,50.573,100,percent of total billed charges,,,4.64,,,fee schedule,,,4.64,,,fee schedule,,,4.64,,,fee schedule,,,,,,,,,,,,,,,,42.98705,85,percent of total billed charges,,,,,,,,,,25.1701821,49.77,percent of total billed charges,,,,45.5157,90,percent of total billed charges,,,,48.04435,90,percent of total billed charges,,,,,,,,,7.01,,,fee schedule,,,8.9027,,,fee schedule,,,,37.92975,75,percent of total billed charges,,,,,,,,,4.64,50.573,
VITAMIN K PER 1 MG,2501000,CDM,J3430,HCPCS,636,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,4.18,,,fee schedule,,,5.3086,,,fee schedule,,,,3.47625,75,percent of total billed charges,,,,,,,,,2.3068395,5.3086,
AREDIA 30mg,2501020,CDM,J2430,HCPCS,636,RC,outpatient,30,ME,,114.639,63.05145,,103.1751,90,percent of total billed charges,,,,114.639,100,percent of total billed charges,,,14.23,,,fee schedule,,,14.23,,,fee schedule,,,14.23,,,fee schedule,,,,,,,,,,,,,,,,97.44315,85,percent of total billed charges,,,,,,,,,,57.0558303,49.77,percent of total billed charges,,,,103.1751,90,percent of total billed charges,,,,108.90705,90,percent of total billed charges,,,,,,,,,254.81,,,fee schedule,,,323.6087,,,fee schedule,,,,85.97925,75,percent of total billed charges,,,,,,,,,14.23,323.6087,
ATIVAN PER 2mg,2501170,CDM,J2060,HCPCS,636,RC,outpatient,2,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.84,,,fee schedule,,,0.84,,,fee schedule,,,0.84,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,4.64,,,fee schedule,,,5.8928,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.84,9.785,
ATROPINE 1mg INJ,2501190,CDM,J0461,HCPCS,636,RC,outpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.08,,,fee schedule,,,0.08,,,fee schedule,,,0.08,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,0.03,,,fee schedule,,,0.0381,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.03,10.403,
ATROPINE SULFATE 1mg INJ,2501210,CDM,J0461,HCPCS,636,RC,outpatient,1,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.08,,,fee schedule,,,0.08,,,fee schedule,,,0.08,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,0.03,,,fee schedule,,,0.0381,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.03,9.785,
PHENERGAN 25mg,2501355,CDM,J2550,HCPCS,636,RC,outpatient,25,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,2.77,,,fee schedule,,,2.77,,,fee schedule,,,2.77,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,5.44,,,fee schedule,,,6.9088,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,2.77,9.785,
BENADRYL UP TO 50mg - OP,2501540,CDM,J1200,HCPCS,636,RC,outpatient,50,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,3.12,,,fee schedule,,,3.9624,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.98,10.403,
PITOCIN 10u/ml 1ml,2501585,CDM,J2590,HCPCS,636,RC,outpatient,10,ML,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.61,,,fee schedule,,,0.61,,,fee schedule,,,0.61,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,2.55,,,fee schedule,,,3.2385,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.61,10.403,
PNU-IMUNE 23 25U INJ,2501655,CDM,90732,CPT,636,RC,outpatient,1,EA,,236.385,130.01175,,212.7465,90,percent of total billed charges,,,,236.385,100,percent of total billed charges,,,130.37,,,fee schedule,,,130.37,,,fee schedule,,,130.37,,,fee schedule,,,,,,,,,,,,,,,,200.92725,85,percent of total billed charges,,,,,,,,,,117.6488145,49.77,percent of total billed charges,,,,212.7465,90,percent of total billed charges,,,,224.56575,90,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,177.28875,75,percent of total billed charges,,,,,,,,,13.14,236.385,
PENICILLIN G BENZ 600000u/ml 2,2501720,CDM,J0561,HCPCS,636,RC,outpatient,2,ML,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,15.81,,,fee schedule,,,15.81,,,fee schedule,,,15.81,,,fee schedule,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,,,,,,,5.66,,,fee schedule,,,7.1882,,,fee schedule,,,,30.1275,75,percent of total billed charges,,,,,,,,,5.66,40.17,
BRETHINE UP TO 1MG INJ,2501790,CDM,J3105,HCPCS,636,RC,outpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.93,,,fee schedule,,,2.93,,,fee schedule,,,2.93,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,3.6,,,fee schedule,,,4.572,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,2.93,10.403,
LOVENOX 40mg INJ,2501912,CDM,J1650,HCPCS,636,RC,outpatient,40,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,,9.739989,49.77,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,18.5915,90,percent of total billed charges,,,,,,,,,17.66,,,fee schedule,,,22.4282,,,fee schedule,,,,14.6775,75,percent of total billed charges,,,,,,,,,0.96,22.4282,
PROLIXIN DECANOATE UP TO 25mg,2501939,CDM,J2680,HCPCS,636,RC,outpatient,25,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,13.08,,,fee schedule,,,13.08,,,fee schedule,,,13.08,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,20.51,,,fee schedule,,,26.0477,,,fee schedule,,,,9.50175,75,percent of total billed charges,,,,,,,,,6.3053613,26.0477,
PRIMAXIN 500mg VIAL,2501955,CDM,J0743,HCPCS,636,RC,outpatient,500,ME,,93.627,51.49485,,84.2643,90,percent of total billed charges,,,,93.627,100,percent of total billed charges,,,6.68,,,fee schedule,,,6.68,,,fee schedule,,,6.68,,,fee schedule,,,,,,,,,,,,,,,,79.58295,85,percent of total billed charges,,,,,,,,,,46.5981579,49.77,percent of total billed charges,,,,84.2643,90,percent of total billed charges,,,,88.94565,90,percent of total billed charges,,,,,,,,,15.22,,,fee schedule,,,19.3294,,,fee schedule,,,,70.22025,75,percent of total billed charges,,,,,,,,,6.68,93.627,
LEVAQUIN 500mg DUPLEX IV,2501974,CDM,J1956,HCPCS,636,RC,outpatient,500,ME,,104.751,57.61305,,94.2759,90,percent of total billed charges,,,,104.751,100,percent of total billed charges,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,,,,,,,,,,,,,,89.03835,85,percent of total billed charges,,,,,,,,,,52.1345727,49.77,percent of total billed charges,,,,94.2759,90,percent of total billed charges,,,,99.51345,90,percent of total billed charges,,,,,,,,,18.62,,,fee schedule,,,23.6474,,,fee schedule,,,,78.56325,75,percent of total billed charges,,,,,,,,,1.23,104.751,
LEVAQUIN 250mg IV DUPLEX,2501976,CDM,J1956,HCPCS,636,RC,outpatient,250,ME,,52.427,28.83485,,47.1843,90,percent of total billed charges,,,,52.427,100,percent of total billed charges,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,,,,,,,,,,,,,,44.56295,85,percent of total billed charges,,,,,,,,,,26.0929179,49.77,percent of total billed charges,,,,47.1843,90,percent of total billed charges,,,,49.80565,90,percent of total billed charges,,,,,,,,,18.62,,,fee schedule,,,23.6474,,,fee schedule,,,,39.32025,75,percent of total billed charges,,,,,,,,,1.23,52.427,
TENECTEPLASE PER 50mg,2501998,CDM,J3101,HCPCS,636,RC,outpatient,50,ME,,6687.996,3678.3978,,6019.1964,90,percent of total billed charges,,,,6687.996,100,percent of total billed charges,,,139.02,,,fee schedule,,,139.02,,,fee schedule,,,139.02,,,fee schedule,,,,,,,,,,,,,,,,5684.7966,85,percent of total billed charges,,,,,,,,,,3328.615609,49.77,percent of total billed charges,,,,6019.1964,90,percent of total billed charges,,,,6353.5962,90,percent of total billed charges,,,,,,,,,41.06,,,fee schedule,,,52.1462,,,fee schedule,,,,4500,75,percent of total billed charges,,,,,,,,,41.06,6687.996,
LEVAQUIN 750mg DUPLEX,2502127,CDM,J1956,HCPCS,636,RC,outpatient,750,ME,,157.075,86.39125,,141.3675,90,percent of total billed charges,,,,157.075,100,percent of total billed charges,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,1.23,,,fee schedule,,,,,,,,,,,,,,,,133.51375,85,percent of total billed charges,,,,,,,,,,78.1762275,49.77,percent of total billed charges,,,,141.3675,90,percent of total billed charges,,,,149.22125,90,percent of total billed charges,,,,,,,,,18.62,,,fee schedule,,,23.6474,,,fee schedule,,,,117.80625,75,percent of total billed charges,,,,,,,,,1.23,157.075,
CALCIUM GLUCONATE 10ML INJ,2502130,CDM,J0610,HCPCS,636,RC,outpatient,10,ML,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,3.67,,,fee schedule,,,3.67,,,fee schedule,,,3.67,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.33875,75,percent of total billed charges,,,,,,,,,3.67,9.785,
HUMALOG 75/25,2502141,CDM,J1817,HCPCS,636,RC,outpatient,1,EA,,128.029,70.41595,,115.2261,90,percent of total billed charges,,,,128.029,100,percent of total billed charges,,,12.54,,,fee schedule,,,12.54,,,fee schedule,,,12.54,,,fee schedule,,,,,,,,,,,,,,,,108.82465,85,percent of total billed charges,,,,,,,,,,63.7200333,49.77,percent of total billed charges,,,,115.2261,90,percent of total billed charges,,,,121.62755,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,96.02175,75,percent of total billed charges,,,,,,,,,12.54,128.029,
RABAVERT RABIES VACCINE,2502148,CDM,90675,CPT,636,RC,outpatient,1,EA,,443.415,243.87825,,399.0735,90,percent of total billed charges,,,,443.415,100,percent of total billed charges,,,336.2,,,fee schedule,,,336.2,,,fee schedule,,,336.2,,,fee schedule,,,,,,,,,,,,,,,,376.90275,85,percent of total billed charges,,,,,,,,,,220.6876455,49.77,percent of total billed charges,,,,399.0735,90,percent of total billed charges,,,,421.24425,90,percent of total billed charges,,,,,,,,,262.98,,,fee schedule,,,333.9846,,,fee schedule,,,,332.56125,75,percent of total billed charges,,,,,,,,,220.6876455,443.415,
CROFAB UP TO Igr IV,2502163,CDM,J0840,HCPCS,636,RC,outpatient,1,GR,,3367.07,1851.8885,,3030.363,90,percent of total billed charges,,,,3367.07,100,percent of total billed charges,,,3695.08,,,fee schedule,,,3695.08,,,fee schedule,,,3695.08,,,fee schedule,,,,,,,,,,,,,,,,2862.0095,85,percent of total billed charges,,,,,,,,,,1675.790739,49.77,percent of total billed charges,,,,3030.363,90,percent of total billed charges,,,,3198.7165,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2525.3025,75,percent of total billed charges,,,,,,,,,1675.790739,3695.08,
METHOTREXATE ORAL 2.5mg,2502191,CDM,J8610,HCPCS,636,RC,outpatient,2.5,ME,,13.802,7.5911,,12.4218,90,percent of total billed charges,,,,13.802,100,percent of total billed charges,,,0.18,,,fee schedule,,,0.18,,,fee schedule,,,0.18,,,fee schedule,,,,,,,,,,,,,,,,11.7317,85,percent of total billed charges,,,,,,,,,,6.8692554,49.77,percent of total billed charges,,,,12.4218,90,percent of total billed charges,,,,13.1119,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.3515,75,percent of total billed charges,,,,,,,,,0.18,13.802,
LOVENOX 150mg INJ,2502193,CDM,J1650,HCPCS,636,RC,outpatient,150,ME,,403.863,222.12465,,363.4767,90,percent of total billed charges,,,,403.863,100,percent of total billed charges,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,,,,,,,,,,,,,,343.28355,85,percent of total billed charges,,,,,,,,,,201.0026151,49.77,percent of total billed charges,,,,363.4767,90,percent of total billed charges,,,,383.66985,90,percent of total billed charges,,,,,,,,,17.66,,,fee schedule,,,22.4282,,,fee schedule,,,,302.89725,75,percent of total billed charges,,,,,,,,,0.96,403.863,
ZYVOX IV PER 200mg - OP,2502213,CDM,J2020,HCPCS,636,RC,outpatient,200,ME,,62.727,34.49985,,56.4543,90,percent of total billed charges,,,,62.727,100,percent of total billed charges,,,7.89,,,fee schedule,,,7.89,,,fee schedule,,,7.89,,,fee schedule,,,,,,,,,,,,,,,,53.31795,85,percent of total billed charges,,,,,,,,,,31.2192279,49.77,percent of total billed charges,,,,56.4543,90,percent of total billed charges,,,,59.59065,90,percent of total billed charges,,,,,,,,,32.93,,,fee schedule,,,41.8211,,,fee schedule,,,,47.04525,75,percent of total billed charges,,,,,,,,,7.89,62.727,
PROSTIGMINE 1mg INJECTION,2502295,CDM,J2710,HCPCS,636,RC,outpatient,1,ME,,22.969,12.63295,,20.6721,90,percent of total billed charges,,,,22.969,100,percent of total billed charges,,,0.1,,,fee schedule,,,0.1,,,fee schedule,,,0.1,,,fee schedule,,,,,,,,,,,,,,,,19.52365,85,percent of total billed charges,,,,,,,,,,11.4316713,49.77,percent of total billed charges,,,,20.6721,90,percent of total billed charges,,,,21.82055,90,percent of total billed charges,,,,,,,,,3.22,,,fee schedule,,,4.0894,,,fee schedule,,,,17.22675,75,percent of total billed charges,,,,,,,,,0.1,22.969,
DEXAMETHASONE SOD PHOS 4mg/ml,2502298,CDM,J1100,HCPCS,636,RC,outpatient,4,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,7.4,,,fee schedule,,,9.398,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.14,9.785,
ANCEF 1gr DUPLEX,2502307,CDM,J0690,HCPCS,636,RC,outpatient,1,GR,,51.912,28.5516,,46.7208,90,percent of total billed charges,,,,51.912,100,percent of total billed charges,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,,,,,,,,,,,,,,44.1252,85,percent of total billed charges,,,,,,,,,,25.8366024,49.77,percent of total billed charges,,,,46.7208,90,percent of total billed charges,,,,49.3164,90,percent of total billed charges,,,,,,,,,4.55,,,fee schedule,,,5.7785,,,fee schedule,,,,38.934,75,percent of total billed charges,,,,,,,,,0.86,51.912,
XYLOCAINE MPF 2% 10mg,2502314,CDM,J2001,HCPCS,636,RC,outpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,1.1176,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.04,9.785,
VERSED 5mg/ml VIAL,2502336,CDM,J2250,HCPCS,636,RC,outpatient,5,ME,,57.371,31.55405,,51.6339,90,percent of total billed charges,,,,57.371,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,,,,,,,,,,,,,,48.76535,85,percent of total billed charges,,,,,,,,,,28.5535467,49.77,percent of total billed charges,,,,51.6339,90,percent of total billed charges,,,,54.50245,90,percent of total billed charges,,,,,,,,,3.89,,,fee schedule,,,4.9403,,,fee schedule,,,,43.02825,75,percent of total billed charges,,,,,,,,,0.14,57.371,
ZOFRAN SOLUTION 4mg/5ml UNIT,2502367,CDM,J2405,HCPCS,636,RC,outpatient,4,ME,,55.002,30.2511,,49.5018,90,percent of total billed charges,,,,55.002,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,,,,,,,,,,,,,,46.7517,85,percent of total billed charges,,,,,,,,,,27.3744954,49.77,percent of total billed charges,,,,49.5018,90,percent of total billed charges,,,,52.2519,90,percent of total billed charges,,,,,,,,,6.79,,,fee schedule,,,8.6233,,,fee schedule,,,,41.2515,75,percent of total billed charges,,,,,,,,,0.14,55.002,
LIDOCAINE 10mg/ml 10ml VIAL,2502368,CDM,J2001,HCPCS,636,RC,outpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,1.1176,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.04,9.785,
ZOSYN 4.5gr VIAL,2502374,CDM,,,636,RC,outpatient,4.5,GR,,66.538,36.5959,,59.8842,90,percent of total billed charges,,,,66.538,100,percent of total billed charges,,,,,,,,,59.8842,,,fee schedule,,,53.2304,,,fee schedule,,,,,,,,,,,,,,,,56.5573,85,percent of total billed charges,,,,,,,,,,33.1159626,49.77,percent of total billed charges,,,,59.8842,90,percent of total billed charges,,,,63.2111,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,49.9035,75,percent of total billed charges,,,,,,,,,33.1159626,66.538,
HEPARIN SODIUM 100u/ml 5ml,2502388,CDM,J1642,HCPCS,636,RC,outpatient,5,ML,,12.566,6.9113,,11.3094,90,percent of total billed charges,,,,12.566,100,percent of total billed charges,,,0.19,,,fee schedule,,,0.19,,,fee schedule,,,0.19,,,fee schedule,,,,,,,,,,,,,,,,10.6811,85,percent of total billed charges,,,,,,,,,,6.2540982,49.77,percent of total billed charges,,,,11.3094,90,percent of total billed charges,,,,11.9377,90,percent of total billed charges,,,,,,,,,1.01,,,fee schedule,,,1.2827,,,fee schedule,,,,9.4245,75,percent of total billed charges,,,,,,,,,0.19,12.566,
ROCEPHIN 1gr DUPLEX,2502391,CDM,J0696,HCPCS,636,RC,outpatient,1,GR,,34.196,18.8078,,30.7764,90,percent of total billed charges,,,,34.196,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,,,,,,,,,,,,,,29.0666,85,percent of total billed charges,,,,,,,,,,17.0193492,49.77,percent of total billed charges,,,,30.7764,90,percent of total billed charges,,,,32.4862,90,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,15.0368,,,fee schedule,,,,25.647,75,percent of total billed charges,,,,,,,,,0.56,34.196,
MAGNESIUM SULFATE 1gr/2ml VIAL,2502422,CDM,J3475,HCPCS,636,RC,outpatient,2,GR,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.78,,,fee schedule,,,0.78,,,fee schedule,,,0.78,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,1.91,,,fee schedule,,,2.4257,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.78,9.785,
HEP B PF VACCINE ADULT 20mcg,2502548,CDM,90739,CPT,636,RC,outpatient,1,EA,,118.656,65.2608,,106.7904,90,percent of total billed charges,,,,118.656,100,percent of total billed charges,,,149.66,,,fee schedule,,,149.66,,,fee schedule,,,149.66,,,fee schedule,,,,,,,,,,,,,,,,100.8576,85,percent of total billed charges,,,,,,,,,,59.0550912,49.77,percent of total billed charges,,,,106.7904,90,percent of total billed charges,,,,112.7232,90,percent of total billed charges,,,,,,,,,160.28,,,fee schedule,,,203.5556,,,fee schedule,,,,88.992,75,percent of total billed charges,,,,,,,,,59.0550912,203.5556,
CELESTONE PHOS PER 4 MG INJ,2502550,CDM,,,636,RC,outpatient,4,ME,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,,,,,,,30.9618,,,fee schedule,,,27.5216,,,fee schedule,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,,17.1218754,49.77,percent of total billed charges,,,,30.9618,90,percent of total billed charges,,,,32.6819,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,25.8015,75,percent of total billed charges,,,,,,,,,17.1218754,34.402,
"MEASLES,MUMPS,RUBELLA (MMR)",2502551,CDM,90707,CPT,636,RC,outpatient,1,EA,,114.33,62.8815,,102.897,90,percent of total billed charges,,,,114.33,100,percent of total billed charges,,,82.54,,,fee schedule,,,82.54,,,fee schedule,,,82.54,,,fee schedule,,,,,,,,,,,,,,,,97.1805,85,percent of total billed charges,,,,,,,,,,56.902041,49.77,percent of total billed charges,,,,102.897,90,percent of total billed charges,,,,108.6135,90,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,85.7475,75,percent of total billed charges,,,,,,,,,13.14,114.33,
TENIVAC TETANUS & DIPTHERIA,2502552,CDM,90714,CPT,636,RC,outpatient,1,EA,,123.909,68.14995,,111.5181,90,percent of total billed charges,,,,123.909,100,percent of total billed charges,,,26.96,,,fee schedule,,,26.96,,,fee schedule,,,26.96,,,fee schedule,,,,,,,,,,,,,,,,105.32265,85,percent of total billed charges,,,,,,,,,,61.6695093,49.77,percent of total billed charges,,,,111.5181,90,percent of total billed charges,,,,117.71355,90,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,92.93175,75,percent of total billed charges,,,,,,,,,13.14,123.909,
DEXAMETHASONE SOD/PHOS 10mg,2502558,CDM,J1100,HCPCS,636,RC,outpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,7.4,,,fee schedule,,,9.398,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.14,9.785,
CELESTONE SOLUSPAN PER 3mg INJ,2502570,CDM,J0702,HCPCS,636,RC,outpatient,3,ME,,23.69,13.0295,,21.321,90,percent of total billed charges,,,,23.69,100,percent of total billed charges,,,7.89,,,fee schedule,,,7.89,,,fee schedule,,,7.89,,,fee schedule,,,,,,,,,,,,,,,,20.1365,85,percent of total billed charges,,,,,,,,,,11.790513,49.77,percent of total billed charges,,,,21.321,90,percent of total billed charges,,,,22.5055,90,percent of total billed charges,,,,,,,,,3.46,,,fee schedule,,,4.3942,,,fee schedule,,,,17.7675,75,percent of total billed charges,,,,,,,,,3.46,23.69,
CEFEPIME 2 GRAM INJECTION,2502573,CDM,J0692,HCPCS,636,RC,outpatient,2,GR,,26.471,14.55905,,23.8239,90,percent of total billed charges,,,,26.471,100,percent of total billed charges,,,2.15,,,fee schedule,,,2.15,,,fee schedule,,,2.15,,,fee schedule,,,,,,,,,,,,,,,,22.50035,85,percent of total billed charges,,,,,,,,,,13.1746167,49.77,percent of total billed charges,,,,23.8239,90,percent of total billed charges,,,,25.14745,90,percent of total billed charges,,,,,,,,,7.28,,,fee schedule,,,9.2456,,,fee schedule,,,,19.85325,75,percent of total billed charges,,,,,,,,,2.15,26.471,
REGITINE UP TO 5mg INJ,2502635,CDM,J2760,HCPCS,636,RC,outpatient,5,ME,,175.409,96.47495,,157.8681,90,percent of total billed charges,,,,175.409,100,percent of total billed charges,,,447.65,,,fee schedule,,,447.65,,,fee schedule,,,447.65,,,fee schedule,,,,,,,,,,,,,,,,149.09765,85,percent of total billed charges,,,,,,,,,,87.3010593,49.77,percent of total billed charges,,,,157.8681,90,percent of total billed charges,,,,166.63855,90,percent of total billed charges,,,,,,,,,27.37,,,fee schedule,,,34.7599,,,fee schedule,,,,131.55675,75,percent of total billed charges,,,,,,,,,27.37,447.65,
MEROPENEM 1gr INJ,2502649,CDM,J2185,HCPCS,636,RC,outpatient,1,GR,,19.879,10.93345,,17.8911,90,percent of total billed charges,,,,19.879,100,percent of total billed charges,,,1.12,,,fee schedule,,,1.12,,,fee schedule,,,1.12,,,fee schedule,,,,,,,,,,,,,,,,16.89715,85,percent of total billed charges,,,,,,,,,,9.8937783,49.77,percent of total billed charges,,,,17.8911,90,percent of total billed charges,,,,18.88505,90,percent of total billed charges,,,,,,,,,4.4,,,fee schedule,,,5.588,,,fee schedule,,,,14.90925,75,percent of total billed charges,,,,,,,,,1.12,19.879,
REGLAN 5mg/ml 2ml VIAL,2502655,CDM,J2765,HCPCS,636,RC,outpatient,2,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,1.43,,,fee schedule,,,1.43,,,fee schedule,,,1.43,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,3.95,,,fee schedule,,,5.0165,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,1.43,9.785,
DOBUTAMINE/D5W 500mg/250ml,2502681,CDM,J1250,HCPCS,636,RC,outpatient,250,ME,,19.261,10.59355,,17.3349,90,percent of total billed charges,,,,19.261,100,percent of total billed charges,,,9.74,,,fee schedule,,,9.74,,,fee schedule,,,9.74,,,fee schedule,,,,,,,,,,,,,,,,16.37185,85,percent of total billed charges,,,,,,,,,,9.5861997,49.77,percent of total billed charges,,,,17.3349,90,percent of total billed charges,,,,18.29795,90,percent of total billed charges,,,,,,,,,21.55,,,fee schedule,,,27.3685,,,fee schedule,,,,14.44575,75,percent of total billed charges,,,,,,,,,9.5861997,27.3685,
LEVETIRACETAM 500mg/5ml INJ,2502690,CDM,J1953,HCPCS,636,RC,outpatient,5,ME,,18.54,10.197,,16.686,90,percent of total billed charges,,,,18.54,100,percent of total billed charges,,,0.12,,,fee schedule,,,0.12,,,fee schedule,,,0.12,,,fee schedule,,,,,,,,,,,,,,,,15.759,85,percent of total billed charges,,,,,,,,,,9.227358,49.77,percent of total billed charges,,,,16.686,90,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,,,,,,0.43,,,fee schedule,,,0.5461,,,fee schedule,,,,13.905,75,percent of total billed charges,,,,,,,,,0.12,18.54,
RISPERDAL CONSTA MICRO 25mg,2502692,CDM,J2794,HCPCS,636,RC,outpatient,25,ME,,835.845,459.71475,,752.2605,90,percent of total billed charges,,,,835.845,100,percent of total billed charges,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,,,,,,,,,,,,,,710.46825,85,percent of total billed charges,,,,,,,,,,416.0000565,49.77,percent of total billed charges,,,,752.2605,90,percent of total billed charges,,,,794.05275,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,626.88375,75,percent of total billed charges,,,,,,,,,11.36,835.845,
RISPERIDONE MICRO 50mg,2502693,CDM,J2794,HCPCS,636,RC,outpatient,50,ME,,1324.683,728.57565,,1192.2147,90,percent of total billed charges,,,,1324.683,100,percent of total billed charges,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,11.36,,,fee schedule,,,,,,,,,,,,,,,,1125.98055,85,percent of total billed charges,,,,,,,,,,659.2947291,49.77,percent of total billed charges,,,,1192.2147,90,percent of total billed charges,,,,1258.44885,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,993.51225,75,percent of total billed charges,,,,,,,,,11.36,1324.683,
ADENOCARD 12mg/4ml,2502694,CDM,J0153,HCPCS,636,RC,outpatient,12,ME,,188.078,103.4429,,169.2702,90,percent of total billed charges,,,,188.078,100,percent of total billed charges,,,0.72,,,fee schedule,,,0.72,,,fee schedule,,,0.72,,,fee schedule,,,,,,,,,,,,,,,,159.8663,85,percent of total billed charges,,,,,,,,,,93.6064206,49.77,percent of total billed charges,,,,169.2702,90,percent of total billed charges,,,,178.6741,90,percent of total billed charges,,,,,,,,,0.85,,,fee schedule,,,1.0795,,,fee schedule,,,,141.0585,75,percent of total billed charges,,,,,,,,,0.72,188.078,
DEXTROSE 5%-1/4 NS 1000ml,2502696,CDM,J7042,HCPCS,636,RC,outpatient,1000,ML,,19.982,10.9901,,17.9838,90,percent of total billed charges,,,,19.982,100,percent of total billed charges,,,1.1,,,fee schedule,,,1.1,,,fee schedule,,,1.1,,,fee schedule,,,,,,,,,,,,,,,,16.9847,85,percent of total billed charges,,,,,,,,,,9.9450414,49.77,percent of total billed charges,,,,17.9838,90,percent of total billed charges,,,,18.9829,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.9865,75,percent of total billed charges,,,,,,,,,1.1,19.982,
RH IG FULL DOSE 300mcg IM,2502795,CDM,90384,CPT,636,RC,outpatient,1,EA,,260.281,143.15455,,234.2529,90,percent of total billed charges,,,,260.281,100,percent of total billed charges,,,96.4,,,fee schedule,,,96.4,,,fee schedule,,,96.4,,,fee schedule,,,,,,,,,,,,,,,,221.23885,85,percent of total billed charges,,,,,,,,,,129.5418537,49.77,percent of total billed charges,,,,234.2529,90,percent of total billed charges,,,,247.26695,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,195.21075,75,percent of total billed charges,,,,,,,,,96.4,260.281,
CEFTRIAXONE 1gr VIAL,2502985,CDM,J0696,HCPCS,636,RC,outpatient,1,GR,,127.308,70.0194,,114.5772,90,percent of total billed charges,,,,127.308,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,,,,,,,,,,,,,,108.2118,85,percent of total billed charges,,,,,,,,,,63.3611916,49.77,percent of total billed charges,,,,114.5772,90,percent of total billed charges,,,,120.9426,90,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,15.0368,,,fee schedule,,,,95.481,75,percent of total billed charges,,,,,,,,,0.56,127.308,
CEFTRIAXONE 250mg VIAL,2503005,CDM,J0696,HCPCS,636,RC,outpatient,250,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,15.0368,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.56,15.0368,
CEFTRIAXONE 500mg VIAL,2503015,CDM,J0696,HCPCS,636,RC,outpatient,500,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,,9.739989,49.77,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,18.5915,90,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,15.0368,,,fee schedule,,,,14.6775,75,percent of total billed charges,,,,,,,,,0.56,19.57,
COMPAZINE 5mg/ml 2ml VIAL,2503090,CDM,J0780,HCPCS,636,RC,outpatient,2,ME,,10.815,5.94825,,9.7335,90,percent of total billed charges,,,,10.815,100,percent of total billed charges,,,11.8,,,fee schedule,,,11.8,,,fee schedule,,,11.8,,,fee schedule,,,,,,,,,,,,,,,,9.19275,85,percent of total billed charges,,,,,,,,,,5.3826255,49.77,percent of total billed charges,,,,9.7335,90,percent of total billed charges,,,,10.27425,90,percent of total billed charges,,,,,,,,,3.28,,,fee schedule,,,4.1656,,,fee schedule,,,,8.11125,75,percent of total billed charges,,,,,,,,,3.28,11.8,
OCTREOTIDE 500mcg IV,2503106,CDM,J2354,HCPCS,636,RC,outpatient,1,EA,,33.887,18.63785,,30.4983,90,percent of total billed charges,,,,33.887,100,percent of total billed charges,,,0.94,,,fee schedule,,,0.94,,,fee schedule,,,0.94,,,fee schedule,,,,,,,,,,,,,,,,28.80395,85,percent of total billed charges,,,,,,,,,,16.8655599,49.77,percent of total billed charges,,,,30.4983,90,percent of total billed charges,,,,32.19265,90,percent of total billed charges,,,,,,,,,3.81,,,fee schedule,,,4.8387,,,fee schedule,,,,25.41525,75,percent of total billed charges,,,,,,,,,0.94,33.887,
CORTROSYN 0.25mg - OP,2503230,CDM,J0834,HCPCS,636,RC,outpatient,0.25,ME,,305.498,168.0239,,274.9482,90,percent of total billed charges,,,,305.498,100,percent of total billed charges,,,50.31,,,fee schedule,,,50.31,,,fee schedule,,,50.31,,,fee schedule,,,,,,,,,,,,,,,,259.6733,85,percent of total billed charges,,,,,,,,,,152.0463546,49.77,percent of total billed charges,,,,274.9482,90,percent of total billed charges,,,,290.2231,90,percent of total billed charges,,,,,,,,,91.2,,,fee schedule,,,115.824,,,fee schedule,,,,229.1235,75,percent of total billed charges,,,,,,,,,50.31,305.498,
A HYDROCORT UP TO 100 MG INJ,2503535,CDM,J1720,HCPCS,636,RC,outpatient,100,ME,,84.872,46.6796,,76.3848,90,percent of total billed charges,,,,84.872,100,percent of total billed charges,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,,,,,,,,,,,,,,72.1412,85,percent of total billed charges,,,,,,,,,,42.2407944,49.77,percent of total billed charges,,,,76.3848,90,percent of total billed charges,,,,80.6284,90,percent of total billed charges,,,,,,,,,4.94,,,fee schedule,,,6.2738,,,fee schedule,,,,63.654,75,percent of total billed charges,,,,,,,,,4.94,84.872,
SOLU-CORTEF UP TO 100MG INJ,2503545,CDM,J1720,HCPCS,636,RC,outpatient,100,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,14.88,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,4.94,,,fee schedule,,,6.2738,,,fee schedule,,,,12.12825,75,percent of total billed charges,,,,,,,,,4.94,16.171,
INJ METHYLPRED SOD SUCC 5 MG,2503565,CDM,J2919,HCPCS,636,RC,outpatient,5,ME,,58.401,32.12055,,52.5609,90,percent of total billed charges,,,,58.401,100,percent of total billed charges,,,,,,,,,52.5609,,,fee schedule,,,46.7208,,,fee schedule,,,,,,,,,,,,,,,,49.64085,85,percent of total billed charges,,,,,,,,,,29.0661777,49.77,percent of total billed charges,,,,52.5609,90,percent of total billed charges,,,,55.48095,90,percent of total billed charges,,,,,,,,,0.27,,,fee schedule,,,0.3429,,,fee schedule,,,,43.80075,75,percent of total billed charges,,,,,,,,,0.27,58.401,
INJ.METHYLPRED SOD SUCC 5 MG,2503575,CDM,J2919,HCPCS,636,RC,outpatient,5,ME,,17.51,9.6305,,15.759,90,percent of total billed charges,,,,17.51,100,percent of total billed charges,,,,,,,,,15.759,,,fee schedule,,,14.008,,,fee schedule,,,,,,,,,,,,,,,,14.8835,85,percent of total billed charges,,,,,,,,,,8.714727,49.77,percent of total billed charges,,,,15.759,90,percent of total billed charges,,,,16.6345,90,percent of total billed charges,,,,,,,,,0.27,,,fee schedule,,,0.3429,,,fee schedule,,,,13.1325,75,percent of total billed charges,,,,,,,,,0.27,17.51,
STADOL 1MG/ML INJ,2503655,CDM,J0595,HCPCS,636,RC,outpatient,1,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,2.59,,,fee schedule,,,2.59,,,fee schedule,,,2.59,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,3.94,,,fee schedule,,,5.0038,,,fee schedule,,,,23.25225,75,percent of total billed charges,,,,,,,,,2.59,31.003,
STADOL 2MG/ML INJ,2503665,CDM,J0595,HCPCS,636,RC,outpatient,2,ME,,32.136,17.6748,,28.9224,90,percent of total billed charges,,,,32.136,100,percent of total billed charges,,,2.59,,,fee schedule,,,2.59,,,fee schedule,,,2.59,,,fee schedule,,,,,,,,,,,,,,,,27.3156,85,percent of total billed charges,,,,,,,,,,15.9940872,49.77,percent of total billed charges,,,,28.9224,90,percent of total billed charges,,,,30.5292,90,percent of total billed charges,,,,,,,,,3.94,,,fee schedule,,,5.0038,,,fee schedule,,,,24.102,75,percent of total billed charges,,,,,,,,,2.59,32.136,
SUBLIMAZE 0.1mg INJ (2cc),2503765,CDM,J3010,HCPCS,636,RC,outpatient,0.1,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,0.92,,,fee schedule,,,0.92,,,fee schedule,,,0.92,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,3.66,,,fee schedule,,,4.6482,,,fee schedule,,,,9.50175,75,percent of total billed charges,,,,,,,,,0.92,12.669,
SUBLIMAZE 50mcg/ml,2503775,CDM,J3010,HCPCS,636,RC,outpatient,50,ML,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,0.92,,,fee schedule,,,0.92,,,fee schedule,,,0.92,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,3.66,,,fee schedule,,,4.6482,,,fee schedule,,,,16.377,75,percent of total billed charges,,,,,,,,,0.92,21.836,
DEMEROL PER 100mg INJ,2503950,CDM,J2175,HCPCS,636,RC,outpatient,100,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,6.14,,,fee schedule,,,6.14,,,fee schedule,,,6.14,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,2.19,,,fee schedule,,,2.7813,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,2.19,10.403,
INJ. METHYLPRED ACETATE 1 MG,2504020,CDM,J1010,HCPCS,636,RC,outpatient,1,ME,,72.924,40.1082,,65.6316,90,percent of total billed charges,,,,72.924,100,percent of total billed charges,,,,,,,,,65.6316,,,fee schedule,,,58.3392,,,fee schedule,,,,,,,,,,,,,,,,61.9854,85,percent of total billed charges,,,,,,,,,,36.2942748,49.77,percent of total billed charges,,,,65.6316,90,percent of total billed charges,,,,69.2778,90,percent of total billed charges,,,,,,,,,0.13,,,fee schedule,,,0.1651,,,fee schedule,,,,54.693,75,percent of total billed charges,,,,,,,,,0.13,72.924,
DEPO-PROVERA 150mg/ml,2504080,CDM,J1050,HCPCS,636,RC,outpatient,150,ME,,111.755,61.46525,,100.5795,90,percent of total billed charges,,,,111.755,100,percent of total billed charges,,,0.64,,,fee schedule,,,0.64,,,fee schedule,,,0.64,,,fee schedule,,,,,,,,,,,,,,,,94.99175,85,percent of total billed charges,,,,,,,,,,55.6204635,49.77,percent of total billed charges,,,,100.5795,90,percent of total billed charges,,,,106.16725,90,percent of total billed charges,,,,,,,,,0.47,,,fee schedule,,,0.5969,,,fee schedule,,,,83.81625,75,percent of total billed charges,,,,,,,,,0.47,111.755,
TdaP 0.5ml VIAL,2504275,CDM,90715,CPT,636,RC,outpatient,0.5,ML,,55.105,30.30775,,49.5945,90,percent of total billed charges,,,,55.105,100,percent of total billed charges,,,37.49,,,fee schedule,,,37.49,,,fee schedule,,,37.49,,,fee schedule,,,,,,,,,,,,,,,,46.83925,85,percent of total billed charges,,,,,,,,,,27.4257585,49.77,percent of total billed charges,,,,49.5945,90,percent of total billed charges,,,,52.34975,90,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,41.32875,75,percent of total billed charges,,,,,,,,,13.14,55.105,
DIFLUCAN 200mg,2504300,CDM,J1450,HCPCS,636,RC,outpatient,200,ME,,301.481,165.81455,,271.3329,90,percent of total billed charges,,,,301.481,100,percent of total billed charges,,,5.91,,,fee schedule,,,5.91,,,fee schedule,,,5.91,,,fee schedule,,,,,,,,,,,,,,,,256.25885,85,percent of total billed charges,,,,,,,,,,150.0470937,49.77,percent of total billed charges,,,,271.3329,90,percent of total billed charges,,,,286.40695,90,percent of total billed charges,,,,,,,,,85.83,,,fee schedule,,,109.0041,,,fee schedule,,,,226.11075,75,percent of total billed charges,,,,,,,,,5.91,301.481,
DIGIBIND 40ml VIAL,2504310,CDM,J1162,HCPCS,636,RC,outpatient,40,ML,,4024.519,2213.48545,,3622.0671,90,percent of total billed charges,,,,4024.519,100,percent of total billed charges,,,4315.2,,,fee schedule,,,4315.2,,,fee schedule,,,4315.2,,,fee schedule,,,,,,,,,,,,,,,,3420.84115,85,percent of total billed charges,,,,,,,,,,2003.003106,49.77,percent of total billed charges,,,,3622.0671,90,percent of total billed charges,,,,3823.29305,90,percent of total billed charges,,,,,,,,,540.91,,,fee schedule,,,686.9557,,,fee schedule,,,,3018.38925,75,percent of total billed charges,,,,,,,,,540.91,4315.2,
DILANTIN 100mg/2ml,2504320,CDM,J1165,HCPCS,636,RC,outpatient,100,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,2.44,,,fee schedule,,,3.0988,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.86,9.785,
DILANTIN 250MG INJ.,2504350,CDM,J1165,HCPCS,636,RC,outpatient,250,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,0.86,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,2.44,,,fee schedule,,,3.0988,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.86,10.403,
DILAUDID UP TO 2mg/ml INJ,2504390,CDM,J1170,HCPCS,636,RC,outpatient,2,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,2.67,,,fee schedule,,,3.3909,,,fee schedule,,,,15.52725,75,percent of total billed charges,,,,,,,,,2.67,20.703,
THIAMINE HCL 100MG/ML INJ,2504405,CDM,J3411,HCPCS,636,RC,outpatient,100,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.93,,,fee schedule,,,2.93,,,fee schedule,,,2.93,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.80225,75,percent of total billed charges,,,,,,,,,2.93,10.403,
"TETANUS,DIPTERIA",2504450,CDM,90714,CPT,636,RC,outpatient,1,EA,,123.909,68.14995,,111.5181,90,percent of total billed charges,,,,123.909,100,percent of total billed charges,,,26.96,,,fee schedule,,,26.96,,,fee schedule,,,26.96,,,fee schedule,,,,,,,,,,,,,,,,105.32265,85,percent of total billed charges,,,,,,,,,,61.6695093,49.77,percent of total billed charges,,,,111.5181,90,percent of total billed charges,,,,117.71355,90,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,92.93175,75,percent of total billed charges,,,,,,,,,13.14,123.909,
THORAZINE UP TO 50MG INJ,2504465,CDM,J3230,HCPCS,636,RC,outpatient,50,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,37.9,,,fee schedule,,,37.9,,,fee schedule,,,37.9,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,10.33,,,fee schedule,,,13.1191,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,5.1775731,37.9,
DURAMORPH 10MG/10ML INJ,2504720,CDM,J2274,HCPCS,636,RC,outpatient,10,ME,,23.793,13.08615,,21.4137,90,percent of total billed charges,,,,23.793,100,percent of total billed charges,,,13.37,,,fee schedule,,,13.37,,,fee schedule,,,13.37,,,fee schedule,,,,,,,,,,,,,,,,20.22405,85,percent of total billed charges,,,,,,,,,,11.8417761,49.77,percent of total billed charges,,,,21.4137,90,percent of total billed charges,,,,22.60335,90,percent of total billed charges,,,,,,,,,9.28,,,fee schedule,,,11.7856,,,fee schedule,,,,17.84475,75,percent of total billed charges,,,,,,,,,9.28,23.793,
TORADOL 15mg INJ,2504775,CDM,J1885,HCPCS,636,RC,outpatient,15,ME,,12.978,7.1379,,11.6802,90,percent of total billed charges,,,,12.978,100,percent of total billed charges,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,,,,,,,,,,,,,,11.0313,85,percent of total billed charges,,,,,,,,,,6.4591506,49.77,percent of total billed charges,,,,11.6802,90,percent of total billed charges,,,,12.3291,90,percent of total billed charges,,,,,,,,,9.74,,,fee schedule,,,12.3698,,,fee schedule,,,,9.7335,75,percent of total billed charges,,,,,,,,,0.76,12.978,
TORADOL 30mg INJ,2504785,CDM,J1885,HCPCS,636,RC,outpatient,30,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,,9.739989,49.77,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,18.5915,90,percent of total billed charges,,,,,,,,,9.74,,,fee schedule,,,12.3698,,,fee schedule,,,,14.6775,75,percent of total billed charges,,,,,,,,,0.76,19.57,
TORADOL 60MG INJ,2504795,CDM,J1885,HCPCS,636,RC,outpatient,60,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,0.76,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,9.74,,,fee schedule,,,12.3698,,,fee schedule,,,,23.25225,75,percent of total billed charges,,,,,,,,,0.76,31.003,
EPINEPHRINE 0.1mg,2505140,CDM,J0171,HCPCS,636,RC,outpatient,0.1,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,0.98,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,1.64,,,fee schedule,,,2.0828,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.98,9.785,
"INJ, EPOGEN 1,000u - NON-ESRD",2505180,CDM,J0885,HCPCS,636,RC,outpatient,1,EA,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,13.08,,,fee schedule,,,13.08,,,fee schedule,,,13.08,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,,,,,,,11.7,,,fee schedule,,,14.859,,,fee schedule,,,,25.029,75,percent of total billed charges,,,,,,,,,11.7,33.372,
UUNASYN 3gr VIAL,2505315,CDM,J0295,HCPCS,636,RC,outpatient,3,GR,,56.65,31.1575,,50.985,90,percent of total billed charges,,,,56.65,100,percent of total billed charges,,,3.78,,,fee schedule,,,3.78,,,fee schedule,,,3.78,,,fee schedule,,,,,,,,,,,,,,,,48.1525,85,percent of total billed charges,,,,,,,,,,28.194705,49.77,percent of total billed charges,,,,50.985,90,percent of total billed charges,,,,53.8175,90,percent of total billed charges,,,,,,,,,8.7,,,fee schedule,,,11.049,,,fee schedule,,,,42.4875,75,percent of total billed charges,,,,,,,,,3.78,56.65,
VALIUM UP TO 5mg,2505475,CDM,J3360,HCPCS,636,RC,outpatient,5,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,11.54,,,fee schedule,,,11.54,,,fee schedule,,,11.54,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,6.15,,,fee schedule,,,7.8105,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,4.8699945,11.54,
VANCOMYCIN HCl 1gr VIAL,2505535,CDM,J3370,HCPCS,636,RC,outpatient,1,GR,,44.187,24.30285,,39.7683,90,percent of total billed charges,,,,44.187,100,percent of total billed charges,,,4.16,,,fee schedule,,,4.16,,,fee schedule,,,4.16,,,fee schedule,,,,,,,,,,,,,,,,37.55895,85,percent of total billed charges,,,,,,,,,,21.9918699,49.77,percent of total billed charges,,,,39.7683,90,percent of total billed charges,,,,41.97765,90,percent of total billed charges,,,,,,,,,9.4,,,fee schedule,,,11.938,,,fee schedule,,,,33.14025,75,percent of total billed charges,,,,,,,,,4.16,44.187,
VANCOCIN 500mg - OP,2505575,CDM,J3370,HCPCS,636,RC,outpatient,500,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,4.16,,,fee schedule,,,4.16,,,fee schedule,,,4.16,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,9.4,,,fee schedule,,,11.938,,,fee schedule,,,,12.90075,75,percent of total billed charges,,,,,,,,,4.16,17.201,
VERSED 1mg 1ml,2505735,CDM,J2250,HCPCS,636,RC,outpatient,1,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,3.89,,,fee schedule,,,4.9403,,,fee schedule,,,,8.652,75,percent of total billed charges,,,,,,,,,0.14,11.536,
VISTARIL 50MG/ML INJ,2505865,CDM,J3410,HCPCS,636,RC,outpatient,50,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,8.31,,,fee schedule,,,8.31,,,fee schedule,,,8.31,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,2.19,,,fee schedule,,,2.7813,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,2.19,10.403,
"VITAMIN B-12 UP TO 1,000 mcg",2505905,CDM,J3420,HCPCS,636,RC,outpatient,1,EA,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.09,,,fee schedule,,,2.09,,,fee schedule,,,2.09,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,2.23,,,fee schedule,,,2.8321,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,2.09,10.403,
GARAMYCIN UP TO 80mg ADD-VAN,2505940,CDM,J1580,HCPCS,636,RC,outpatient,80,ME,,40.17,22.0935,,36.153,90,percent of total billed charges,,,,40.17,100,percent of total billed charges,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,,,,,,,,,,,,,,34.1445,85,percent of total billed charges,,,,,,,,,,19.992609,49.77,percent of total billed charges,,,,36.153,90,percent of total billed charges,,,,38.1615,90,percent of total billed charges,,,,,,,,,5.05,,,fee schedule,,,6.4135,,,fee schedule,,,,30.1275,75,percent of total billed charges,,,,,,,,,2.08,40.17,
GARAMYCIN 20MG/2ML INJ,2505960,CDM,J1580,HCPCS,636,RC,outpatient,20,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,5.05,,,fee schedule,,,6.4135,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,2.08,10.403,
GARAMYCIN UP TO 80mg,2505980,CDM,J1580,HCPCS,636,RC,outpatient,80,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,2.08,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,5.05,,,fee schedule,,,6.4135,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,2.08,10.403,
GLUCAGON 1MG/ML INJ,2506050,CDM,J1610,HCPCS,636,RC,outpatient,1,ME,,216.712,119.1916,,195.0408,90,percent of total billed charges,,,,216.712,100,percent of total billed charges,,,228.6,,,fee schedule,,,228.6,,,fee schedule,,,228.6,,,fee schedule,,,,,,,,,,,,,,,,184.2052,85,percent of total billed charges,,,,,,,,,,107.8575624,49.77,percent of total billed charges,,,,195.0408,90,percent of total billed charges,,,,205.8764,90,percent of total billed charges,,,,,,,,,38.55,,,fee schedule,,,48.9585,,,fee schedule,,,,162.534,75,percent of total billed charges,,,,,,,,,38.55,228.6,
HALDOL UP TO 5mg,2506300,CDM,J1630,HCPCS,636,RC,outpatient,5,ME,,23.793,13.08615,,21.4137,90,percent of total billed charges,,,,23.793,100,percent of total billed charges,,,1.29,,,fee schedule,,,1.29,,,fee schedule,,,1.29,,,fee schedule,,,,,,,,,,,,,,,,20.22405,85,percent of total billed charges,,,,,,,,,,11.8417761,49.77,percent of total billed charges,,,,21.4137,90,percent of total billed charges,,,,22.60335,90,percent of total billed charges,,,,,,,,,6.78,,,fee schedule,,,8.6106,,,fee schedule,,,,17.84475,75,percent of total billed charges,,,,,,,,,1.29,23.793,
ZOFRAN PER 4mg/1ml 2ml INJ,2506395,CDM,J2405,HCPCS,636,RC,outpatient,4,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,6.79,,,fee schedule,,,8.6233,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.14,9.785,
IMITREX 6MG INJ,2506750,CDM,J3030,HCPCS,636,RC,outpatient,6,ME,,104.339,57.38645,,93.9051,90,percent of total billed charges,,,,104.339,100,percent of total billed charges,,,59.36,,,fee schedule,,,59.36,,,fee schedule,,,59.36,,,fee schedule,,,,,,,,,,,,,,,,88.68815,85,percent of total billed charges,,,,,,,,,,51.9295203,49.77,percent of total billed charges,,,,93.9051,90,percent of total billed charges,,,,99.12205,90,percent of total billed charges,,,,,,,,,30.02,,,fee schedule,,,38.1254,,,fee schedule,,,,78.25425,75,percent of total billed charges,,,,,,,,,30.02,104.339,
INJ METHYLPRED ACETATE 1 MG,2506775,CDM,J1010,HCPCS,636,RC,outpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,0.13,,,fee schedule,,,0.1651,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.13,10.403,
IRON DEXTRAN 50mg,2506970,CDM,J1750,HCPCS,636,RC,outpatient,50,ME,,48.204,26.5122,,43.3836,90,percent of total billed charges,,,,48.204,100,percent of total billed charges,,,16.45,,,fee schedule,,,16.45,,,fee schedule,,,16.45,,,fee schedule,,,,,,,,,,,,,,,,40.9734,85,percent of total billed charges,,,,,,,,,,23.9911308,49.77,percent of total billed charges,,,,43.3836,90,percent of total billed charges,,,,45.7938,90,percent of total billed charges,,,,,,,,,12.25,,,fee schedule,,,15.5575,,,fee schedule,,,,36.153,75,percent of total billed charges,,,,,,,,,12.25,48.204,
ZITHROMAX 500mg VIAL,2506995,CDM,J0456,HCPCS,636,RC,outpatient,500,ME,,68.701,37.78555,,61.8309,90,percent of total billed charges,,,,68.701,100,percent of total billed charges,,,3.15,,,fee schedule,,,3.15,,,fee schedule,,,3.15,,,fee schedule,,,,,,,,,,,,,,,,58.39585,85,percent of total billed charges,,,,,,,,,,34.1924877,49.77,percent of total billed charges,,,,61.8309,90,percent of total billed charges,,,,65.26595,90,percent of total billed charges,,,,,,,,,24.32,,,fee schedule,,,30.8864,,,fee schedule,,,,51.52575,75,percent of total billed charges,,,,,,,,,3.15,68.701,
HUMULIN N INSULIN 3ml VIAL,2507040,CDM,J1815,HCPCS,636,RC,outpatient,3,ML,,16.48,9.064,,14.832,90,percent of total billed charges,,,,16.48,100,percent of total billed charges,,,1.03,,,fee schedule,,,1.03,,,fee schedule,,,1.03,,,fee schedule,,,,,,,,,,,,,,,,14.008,85,percent of total billed charges,,,,,,,,,,8.202096,49.77,percent of total billed charges,,,,14.832,90,percent of total billed charges,,,,15.656,90,percent of total billed charges,,,,,,,,,3.23,,,fee schedule,,,4.1021,,,fee schedule,,,,12.36,75,percent of total billed charges,,,,,,,,,1.03,16.48,
LOVENOX 100mg INJ,2507085,CDM,J1650,HCPCS,636,RC,outpatient,100,ME,,205.485,113.01675,,184.9365,90,percent of total billed charges,,,,205.485,100,percent of total billed charges,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,,,,,,,,,,,,,,174.66225,85,percent of total billed charges,,,,,,,,,,102.2698845,49.77,percent of total billed charges,,,,184.9365,90,percent of total billed charges,,,,195.21075,90,percent of total billed charges,,,,,,,,,17.66,,,fee schedule,,,22.4282,,,fee schedule,,,,154.11375,75,percent of total billed charges,,,,,,,,,0.96,205.485,
DIGOXIN 500mcg INJ,2507790,CDM,J1160,HCPCS,636,RC,outpatient,1,EA,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,5.95,,,fee schedule,,,5.95,,,fee schedule,,,5.95,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,3.47,,,fee schedule,,,4.4069,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,3.47,9.785,
LASIX 100mg INJ,2507820,CDM,J1940,HCPCS,636,RC,outpatient,100,ME,,48.719,26.79545,,43.8471,90,percent of total billed charges,,,,48.719,100,percent of total billed charges,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,,,,,,,,,41.41115,85,percent of total billed charges,,,,,,,,,,24.2474463,49.77,percent of total billed charges,,,,43.8471,90,percent of total billed charges,,,,46.28305,90,percent of total billed charges,,,,,,,,,3.67,,,fee schedule,,,4.6609,,,fee schedule,,,,36.53925,75,percent of total billed charges,,,,,,,,,0.88,48.719,
LASIX 40MG,2507850,CDM,J1940,HCPCS,636,RC,outpatient,40,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,,9.739989,49.77,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,18.5915,90,percent of total billed charges,,,,,,,,,3.67,,,fee schedule,,,4.6609,,,fee schedule,,,,14.6775,75,percent of total billed charges,,,,,,,,,0.88,19.57,
LASIX 40mg VIAL,2507860,CDM,J1940,HCPCS,636,RC,outpatient,40,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,0.88,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,3.67,,,fee schedule,,,4.6609,,,fee schedule,,,,8.652,75,percent of total billed charges,,,,,,,,,0.88,11.536,
LIDOCAINE HCL 2% 20mg/ml,2508090,CDM,J2001,HCPCS,636,RC,outpatient,20,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,1.1176,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.04,10.403,
LIDOCAINE HCL 1% ABBJ 10mg/ml,2508130,CDM,J2001,HCPCS,636,RC,outpatient,10,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,0.04,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,0.88,,,fee schedule,,,1.1176,,,fee schedule,,,,23.25225,75,percent of total billed charges,,,,,,,,,0.04,31.003,
LOVENOX 30mg INJ,2508500,CDM,J1650,HCPCS,636,RC,outpatient,30,ME,,80.855,44.47025,,72.7695,90,percent of total billed charges,,,,80.855,100,percent of total billed charges,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,0.96,,,fee schedule,,,,,,,,,,,,,,,,68.72675,85,percent of total billed charges,,,,,,,,,,40.2415335,49.77,percent of total billed charges,,,,72.7695,90,percent of total billed charges,,,,76.81225,90,percent of total billed charges,,,,,,,,,17.66,,,fee schedule,,,22.4282,,,fee schedule,,,,60.64125,75,percent of total billed charges,,,,,,,,,0.96,80.855,
MAG SULFATE PER 500MG INJ,2508680,CDM,J3475,HCPCS,636,RC,outpatient,500,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,0.78,,,fee schedule,,,0.78,,,fee schedule,,,0.78,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,1.91,,,fee schedule,,,2.4257,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.78,10.403,
MANNITOL 25% IN 50ML INJ,2508710,CDM,J2150,HCPCS,636,RC,outpatient,50,ML,,12.36,6.798,,11.124,90,percent of total billed charges,,,,12.36,100,percent of total billed charges,,,2.41,,,fee schedule,,,2.41,,,fee schedule,,,2.41,,,fee schedule,,,,,,,,,,,,,,,,10.506,85,percent of total billed charges,,,,,,,,,,6.151572,49.77,percent of total billed charges,,,,11.124,90,percent of total billed charges,,,,11.742,90,percent of total billed charges,,,,,,,,,6.09,,,fee schedule,,,7.7343,,,fee schedule,,,,9.27,75,percent of total billed charges,,,,,,,,,2.41,12.36,
MEFOXIN 1gr VIAL,2508890,CDM,J0694,HCPCS,636,RC,outpatient,1,GR,,25.853,14.21915,,23.2677,90,percent of total billed charges,,,,25.853,100,percent of total billed charges,,,5.67,,,fee schedule,,,5.67,,,fee schedule,,,5.67,,,fee schedule,,,,,,,,,,,,,,,,21.97505,85,percent of total billed charges,,,,,,,,,,12.8670381,49.77,percent of total billed charges,,,,23.2677,90,percent of total billed charges,,,,24.56035,90,percent of total billed charges,,,,,,,,,10.88,,,fee schedule,,,13.8176,,,fee schedule,,,,19.38975,75,percent of total billed charges,,,,,,,,,5.67,25.853,
MEFOXIN 2gr VIAL,2508910,CDM,J0694,HCPCS,636,RC,outpatient,2,GR,,103.206,56.7633,,92.8854,90,percent of total billed charges,,,,103.206,100,percent of total billed charges,,,5.67,,,fee schedule,,,5.67,,,fee schedule,,,5.67,,,fee schedule,,,,,,,,,,,,,,,,87.7251,85,percent of total billed charges,,,,,,,,,,51.3656262,49.77,percent of total billed charges,,,,92.8854,90,percent of total billed charges,,,,98.0457,90,percent of total billed charges,,,,,,,,,10.88,,,fee schedule,,,13.8176,,,fee schedule,,,,77.4045,75,percent of total billed charges,,,,,,,,,5.67,103.206,
METHOTREXATE 50MG INJ,2509060,CDM,J9260,HCPCS,636,RC,outpatient,50,ME,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,2.74,,,fee schedule,,,2.74,,,fee schedule,,,2.74,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,13.63,,,fee schedule,,,17.3101,,,fee schedule,,,,16.377,75,percent of total billed charges,,,,,,,,,2.74,21.836,
MORPHINE 10mg,2509420,CDM,J2270,HCPCS,636,RC,outpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,2.12,,,fee schedule,,,2.6924,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,2.12,9.785,
"INJ, METHYLPRED SOD 5MG",2509802,CDM,J2919,HCPCS,636,RC,outpatient,5,ME,,17.51,9.6305,,15.759,90,percent of total billed charges,,,,17.51,100,percent of total billed charges,,,,,,,,,15.759,,,fee schedule,,,14.008,,,fee schedule,,,,,,,,,,,,,,,,14.8835,85,percent of total billed charges,,,,,,,,,,8.714727,49.77,percent of total billed charges,,,,15.759,90,percent of total billed charges,,,,16.6345,90,percent of total billed charges,,,,,,,,,0.27,,,fee schedule,,,0.3429,,,fee schedule,,,,13.1325,75,percent of total billed charges,,,,,,,,,0.27,17.51,
INJ METHYLPRED ACETATE 1MG,2509803,CDM,J1010,HCPCS,636,RC,outpatient,1,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,0.13,,,fee schedule,,,0.1651,,,fee schedule,,,,7.80225,75,percent of total billed charges,,,,,,,,,0.13,10.403,
NARCAN 1mg INJ,2509910,CDM,J2310,HCPCS,636,RC,outpatient,1,ME,,21.012,11.5566,,18.9108,90,percent of total billed charges,,,,21.012,100,percent of total billed charges,,,19.93,,,fee schedule,,,19.93,,,fee schedule,,,19.93,,,fee schedule,,,,,,,,,,,,,,,,17.8602,85,percent of total billed charges,,,,,,,,,,10.4576724,49.77,percent of total billed charges,,,,18.9108,90,percent of total billed charges,,,,19.9614,90,percent of total billed charges,,,,,,,,,4.84,,,fee schedule,,,6.1468,,,fee schedule,,,,15.759,75,percent of total billed charges,,,,,,,,,4.84,21.012,
ATRIXTA 2.5mg,2510050,CDM,J1652,HCPCS,636,RC,outpatient,2.5,ME,,76.632,42.1476,,68.9688,90,percent of total billed charges,,,,76.632,100,percent of total billed charges,,,1.99,,,fee schedule,,,1.99,,,fee schedule,,,1.99,,,fee schedule,,,,,,,,,,,,,,,,65.1372,85,percent of total billed charges,,,,,,,,,,38.1397464,49.77,percent of total billed charges,,,,68.9688,90,percent of total billed charges,,,,72.8004,90,percent of total billed charges,,,,,,,,,7.4,,,fee schedule,,,9.398,,,fee schedule,,,,57.474,75,percent of total billed charges,,,,,,,,,1.99,76.632,
MORPHINE SULFATE 2mg/ml,2510110,CDM,J2270,HCPCS,636,RC,outpatient,2,ME,,5.15,2.8325,,4.635,90,percent of total billed charges,,,,5.15,100,percent of total billed charges,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,,,,,,,,,,,,,,4.3775,85,percent of total billed charges,,,,,,,,,,2.563155,49.77,percent of total billed charges,,,,4.635,90,percent of total billed charges,,,,4.8925,90,percent of total billed charges,,,,,,,,,2.12,,,fee schedule,,,2.6924,,,fee schedule,,,,3.8625,75,percent of total billed charges,,,,,,,,,2.12,5.4,
HYDROMORPHONE HCL/PF 1mg/ml,2510120,CDM,J1170,HCPCS,636,RC,outpatient,1,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,4.79,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,2.67,,,fee schedule,,,3.3909,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,2.67,9.785,
OFIRMEV 1000mg/100ml VIAL INJ,2510130,CDM,J0131,HCPCS,636,RC,outpatient,100,ME,,98.674,54.2707,,88.8066,90,percent of total billed charges,,,,98.674,100,percent of total billed charges,,,0.39,,,fee schedule,,,0.39,,,fee schedule,,,0.39,,,fee schedule,,,,,,,,,,,,,,,,83.8729,85,percent of total billed charges,,,,,,,,,,49.1100498,49.77,percent of total billed charges,,,,88.8066,90,percent of total billed charges,,,,93.7403,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,74.0055,75,percent of total billed charges,,,,,,,,,0.39,98.674,
ERTAPENEM 1gr INJ,2510161,CDM,J1335,HCPCS,636,RC,outpatient,1,GR,,193.228,106.2754,,173.9052,90,percent of total billed charges,,,,193.228,100,percent of total billed charges,,,50.94,,,fee schedule,,,50.94,,,fee schedule,,,50.94,,,fee schedule,,,,,,,,,,,,,,,,164.2438,85,percent of total billed charges,,,,,,,,,,96.1695756,49.77,percent of total billed charges,,,,173.9052,90,percent of total billed charges,,,,183.5666,90,percent of total billed charges,,,,,,,,,21.24,,,fee schedule,,,26.9748,,,fee schedule,,,,144.921,75,percent of total billed charges,,,,,,,,,21.24,193.228,
ROPIVACAINE Hcl 150mg,2510170,CDM,J2795,HCPCS,636,RC,outpatient,150,ME,,38.934,21.4137,,35.0406,90,percent of total billed charges,,,,38.934,100,percent of total billed charges,,,0.09,,,fee schedule,,,0.09,,,fee schedule,,,0.09,,,fee schedule,,,,,,,,,,,,,,,,33.0939,85,percent of total billed charges,,,,,,,,,,19.3774518,49.77,percent of total billed charges,,,,35.0406,90,percent of total billed charges,,,,36.9873,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,29.2005,75,percent of total billed charges,,,,,,,,,0.09,38.934,
CLONIDINE HCL/PF 10ml 1 VIAL,2510190,CDM,J0735,HCPCS,636,RC,outpatient,10,ML,,34.402,18.9211,,30.9618,90,percent of total billed charges,,,,34.402,100,percent of total billed charges,,,13.21,,,fee schedule,,,13.21,,,fee schedule,,,13.21,,,fee schedule,,,,,,,,,,,,,,,,29.2417,85,percent of total billed charges,,,,,,,,,,17.1218754,49.77,percent of total billed charges,,,,30.9618,90,percent of total billed charges,,,,32.6819,90,percent of total billed charges,,,,,,,,,6.45,,,fee schedule,,,8.1915,,,fee schedule,,,,25.8015,75,percent of total billed charges,,,,,,,,,6.45,34.402,
KCI 20 mEq IN 1/2 NS 1000ml,2510310,CDM,J3480,HCPCS,636,RC,outpatient,1000,ML,,31.518,17.3349,,28.3662,90,percent of total billed charges,,,,31.518,100,percent of total billed charges,,,0.21,,,fee schedule,,,0.21,,,fee schedule,,,0.21,,,fee schedule,,,,,,,,,,,,,,,,26.7903,85,percent of total billed charges,,,,,,,,,,15.6865086,49.77,percent of total billed charges,,,,28.3662,90,percent of total billed charges,,,,29.9421,90,percent of total billed charges,,,,,,,,,1.62,,,fee schedule,,,2.0574,,,fee schedule,,,,23.6385,75,percent of total billed charges,,,,,,,,,0.21,31.518,
KENALOG 40mg/1ml,2510320,CDM,J3301,HCPCS,636,RC,outpatient,1,ME,,26.883,14.78565,,24.1947,90,percent of total billed charges,,,,26.883,100,percent of total billed charges,,,1.82,,,fee schedule,,,1.82,,,fee schedule,,,1.82,,,fee schedule,,,,,,,,,,,,,,,,22.85055,85,percent of total billed charges,,,,,,,,,,13.3796691,49.77,percent of total billed charges,,,,24.1947,90,percent of total billed charges,,,,25.53885,90,percent of total billed charges,,,,,,,,,2.02,,,fee schedule,,,2.5654,,,fee schedule,,,,20.16225,75,percent of total billed charges,,,,,,,,,1.82,26.883,
PREVNAR 13 0.5ml,2510350,CDM,90670,CPT,636,RC,outpatient,0.5,ML,,448.771,246.82405,,403.8939,90,percent of total billed charges,,,,448.771,100,percent of total billed charges,,,245.81,,,fee schedule,,,245.81,,,fee schedule,,,245.81,,,fee schedule,,,,,,,,,,,,,,,,381.45535,85,percent of total billed charges,,,,,,,,,,223.3533267,49.77,percent of total billed charges,,,,403.8939,90,percent of total billed charges,,,,426.33245,90,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,336.57825,75,percent of total billed charges,,,,,,,,,13.14,448.771,
EXPAREL 1.3% 226 mg/20ml,2510360,CDM,C9290,HCPCS,636,RC,outpatient,20,ME,,789.083,433.99565,,710.1747,90,percent of total billed charges,,,,789.083,100,percent of total billed charges,,,,,,,,,710.1747,,,fee schedule,,,631.2664,,,fee schedule,,,,,,,,,,,,,,,,670.72055,85,percent of total billed charges,,,,,,,,,,392.7266091,49.77,percent of total billed charges,,,,710.1747,90,percent of total billed charges,,,,749.62885,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,591.81225,75,percent of total billed charges,,,,,,,,,392.7266091,789.083,
CALDOLOR 800mg/8ml,2510370,CDM,J1741,HCPCS,636,RC,outpatient,8,ME,,18.128,9.9704,,16.3152,90,percent of total billed charges,,,,18.128,100,percent of total billed charges,,,1.82,,,fee schedule,,,1.82,,,fee schedule,,,1.82,,,fee schedule,,,,,,,,,,,,,,,,15.4088,85,percent of total billed charges,,,,,,,,,,9.0223056,49.77,percent of total billed charges,,,,16.3152,90,percent of total billed charges,,,,17.2216,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.596,75,percent of total billed charges,,,,,,,,,1.82,18.128,
MORPHINE 4mg (UP TO 10mg),2510400,CDM,J2270,HCPCS,636,RC,outpatient,10,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,5.4,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,2.12,,,fee schedule,,,2.6924,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,2.12,9.785,
MIDAZOLAM 2mg,2510440,CDM,J2250,HCPCS,636,RC,outpatient,2,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,0.14,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,3.89,,,fee schedule,,,4.9403,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.14,9.785,
OMNIPAQUE 300mg 100ml,2510460,CDM,Q9967,HCPCS,636,RC,outpatient,100,ME,,195.185,107.35175,,175.6665,90,percent of total billed charges,,,,195.185,100,percent of total billed charges,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,,,,,,,,,,,,,,165.90725,85,percent of total billed charges,,,,,,,,,,97.1435745,49.77,percent of total billed charges,,,,175.6665,90,percent of total billed charges,,,,185.42575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,146.38875,75,percent of total billed charges,,,,,,,,,0.13,195.185,
INVEGA SUSTENNA 234 MG,2510628,CDM,J2426,HCPCS,636,RC,outpatient,234,ME,,3969.62,2183.291,,3572.658,90,percent of total billed charges,,,,3969.62,100,percent of total billed charges,,,13.1,,,fee schedule,,,13.1,,,fee schedule,,,13.1,,,fee schedule,,,,,,,,,,,,,,,,3374.177,85,percent of total billed charges,,,,,,,,,,1975.679874,49.77,percent of total billed charges,,,,3572.658,90,percent of total billed charges,,,,3771.139,90,percent of total billed charges,,,,,,,,,7.24,,,fee schedule,,,9.1948,,,fee schedule,,,,2977.215,75,percent of total billed charges,,,,,,,,,7.24,3969.62,
PROTAMINE SULFATE INJ 250MG,2510632,CDM,J2720,HCPCS,636,RC,outpatient,250,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,1.36,,,fee schedule,,,1.36,,,fee schedule,,,1.36,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,5.66,,,fee schedule,,,7.1882,,,fee schedule,,,,2.85825,75,percent of total billed charges,,,,,,,,,1.36,7.1882,
"Injection, daptomycin,500 mg",2510650,CDM,,,636,RC,outpatient,500,ME,,280.984,154.5412,,252.8856,90,percent of total billed charges,,,,280.984,100,percent of total billed charges,,,,,,,,,252.8856,,,fee schedule,,,224.7872,,,fee schedule,,,,,,,,,,,,,,,,238.8364,85,percent of total billed charges,,,,,,,,,,139.8457368,49.77,percent of total billed charges,,,,252.8856,90,percent of total billed charges,,,,266.9348,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,210.738,75,percent of total billed charges,,,,,,,,,139.8457368,280.984,
Acyclovir 50 MG/ML,2510652,CDM,J0133,HCPCS,636,RC,outpatient,50,ME,,18.849,10.36695,,16.9641,90,percent of total billed charges,,,,18.849,100,percent of total billed charges,,,0.06,,,fee schedule,,,0.06,,,fee schedule,,,0.06,,,fee schedule,,,,,,,,,,,,,,,,16.02165,85,percent of total billed charges,,,,,,,,,,9.3811473,49.77,percent of total billed charges,,,,16.9641,90,percent of total billed charges,,,,17.90655,90,percent of total billed charges,,,,,,,,,0.02,,,fee schedule,,,0.0254,,,fee schedule,,,,14.13675,75,percent of total billed charges,,,,,,,,,0.02,18.849,
"BICILLIN CA 600,000 UNIT/ML",2510661,CDM,J0561,HCPCS,636,RC,outpatient,600,ML,,225.879,124.23345,,203.2911,90,percent of total billed charges,,,,225.879,100,percent of total billed charges,,,15.81,,,fee schedule,,,15.81,,,fee schedule,,,15.81,,,fee schedule,,,,,,,,,,,,,,,,191.99715,85,percent of total billed charges,,,,,,,,,,112.4199783,49.77,percent of total billed charges,,,,203.2911,90,percent of total billed charges,,,,214.58505,90,percent of total billed charges,,,,,,,,,5.66,,,fee schedule,,,7.1882,,,fee schedule,,,,169.40925,75,percent of total billed charges,,,,,,,,,5.66,225.879,
 RECOMBIVAX HB HEP B pediatric,2510672,CDM,90744,CPT,636,RC,outpatient,1,EA,,28.222,15.5221,,25.3998,90,percent of total billed charges,,,,28.222,100,percent of total billed charges,,,30.7,,,fee schedule,,,30.7,,,fee schedule,,,30.7,,,fee schedule,,,,,,,,,,,,,,,,23.9887,85,percent of total billed charges,,,,,,,,,,14.0460894,49.77,percent of total billed charges,,,,25.3998,90,percent of total billed charges,,,,26.8109,90,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,21.1665,75,percent of total billed charges,,,,,,,,,13.14,30.7,
NEUPGEN 300 MCG/0.5ML,2510677,CDM,J1442,HCPCS,636,RC,outpatient,300,ML,,756.741,416.20755,,681.0669,90,percent of total billed charges,,,,756.741,100,percent of total billed charges,,,1.12,,,fee schedule,,,1.12,,,fee schedule,,,1.12,,,fee schedule,,,,,,,,,,,,,,,,643.22985,85,percent of total billed charges,,,,,,,,,,376.6299957,49.77,percent of total billed charges,,,,681.0669,90,percent of total billed charges,,,,718.90395,90,percent of total billed charges,,,,,,,,,0.99,,,fee schedule,,,1.2573,,,fee schedule,,,,567.55575,75,percent of total billed charges,,,,,,,,,0.99,756.741,
HEPAGAM-B IM INJ .5 ML,2510684,CDM,J1571,HCPCS,636,RC,outpatient,0.5,ML,,342.063,188.13465,,307.8567,90,percent of total billed charges,,,,342.063,100,percent of total billed charges,,,68.89,,,fee schedule,,,68.89,,,fee schedule,,,68.89,,,fee schedule,,,,,,,,,,,,,,,,290.75355,85,percent of total billed charges,,,,,,,,,,170.2447551,49.77,percent of total billed charges,,,,307.8567,90,percent of total billed charges,,,,324.95985,90,percent of total billed charges,,,,,,,,,59.25,,,fee schedule,,,75.2475,,,fee schedule,,,,256.54725,75,percent of total billed charges,,,,,,,,,59.25,342.063,
DALVANCE 500MG INJECTION,2510696,CDM,,,636,RC,outpatient,500,ME,,4649.214,2557.0677,,4184.2926,90,percent of total billed charges,,,,4649.214,100,percent of total billed charges,,,,,,,,,4184.2926,,,fee schedule,,,3719.3712,,,fee schedule,,,,,,,,,,,,,,,,3951.8319,85,percent of total billed charges,,,,,,,,,,2313.913808,49.77,percent of total billed charges,,,,4184.2926,90,percent of total billed charges,,,,4416.7533,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3486.9105,75,percent of total billed charges,,,,,,,,,2313.913808,4649.214,
REGEN-COV 1200MG,2510722,CDM,Q0244,HCPCS,636,RC,outpatient,1200,ME,,0.103,0.05665,,0.0927,90,percent of total billed charges,,,,0.103,100,percent of total billed charges,,,,,,,,,0.0927,,,fee schedule,,,0.0824,,,fee schedule,,,,,,,,,,,,,,,,0.08755,85,percent of total billed charges,,,,,,,,,,0.0512631,49.77,percent of total billed charges,,,,0.0927,90,percent of total billed charges,,,,0.09785,90,percent of total billed charges,,,,,,,,,0.01,,,fee schedule,,,0.0127,,,fee schedule,,,,0.07725,75,percent of total billed charges,,,,,,,,,0.01,0.103,
FLUZONE QUADRIVALENT 2021-2022,2510726,CDM,90686,CPT,636,RC,outpatient,1,EA,,37.801,20.79055,,34.0209,90,percent of total billed charges,,,,37.801,100,percent of total billed charges,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,,,,,,,,,,,,,,32.13085,85,percent of total billed charges,,,,,,,,,,18.8135577,49.77,percent of total billed charges,,,,34.0209,90,percent of total billed charges,,,,35.91095,90,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,19.6215,,,fee schedule,,,,28.35075,75,percent of total billed charges,,,,,,,,,15.45,37.801,
INJ.METHYLPRED ACETATE 1 MG,2510729,CDM,J1010,HCPCS,636,RC,outpatient,1,ME,,32.754,18.0147,,29.4786,90,percent of total billed charges,,,,32.754,100,percent of total billed charges,,,,,,,,,29.4786,,,fee schedule,,,26.2032,,,fee schedule,,,,,,,,,,,,,,,,27.8409,85,percent of total billed charges,,,,,,,,,,16.3016658,49.77,percent of total billed charges,,,,29.4786,90,percent of total billed charges,,,,31.1163,90,percent of total billed charges,,,,,,,,,0.13,,,fee schedule,,,0.1651,,,fee schedule,,,,24.5655,75,percent of total billed charges,,,,,,,,,0.13,32.754,
CEFTRIAXONE 2000MG VIAL,2510744,CDM,J0696,HCPCS,636,RC,outpatient,2000,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,0.56,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,11.84,,,fee schedule,,,15.0368,,,fee schedule,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.56,15.0368,
FLUZONE QUADRIVALENT 2022-2023,2510748,CDM,90686,CPT,636,RC,outpatient,1,EA,,37.286,20.5073,,33.5574,90,percent of total billed charges,,,,37.286,100,percent of total billed charges,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,,,,,,,,,,,,,,31.6931,85,percent of total billed charges,,,,,,,,,,18.5572422,49.77,percent of total billed charges,,,,33.5574,90,percent of total billed charges,,,,35.4217,90,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,19.6215,,,fee schedule,,,,27.9645,75,percent of total billed charges,,,,,,,,,15.45,37.286,
Methocarbamol 10 ML Injection,2510764,CDM,J2800,HCPCS,636,RC,outpatient,10,ML,,97.438,53.5909,,87.6942,90,percent of total billed charges,,,,97.438,100,percent of total billed charges,,,14.29,,,fee schedule,,,14.29,,,fee schedule,,,14.29,,,fee schedule,,,,,,,,,,,,,,,,82.8223,85,percent of total billed charges,,,,,,,,,,48.4948926,49.77,percent of total billed charges,,,,87.6942,90,percent of total billed charges,,,,92.5661,90,percent of total billed charges,,,,,,,,,6.33,,,fee schedule,,,8.0391,,,fee schedule,,,,73.0785,75,percent of total billed charges,,,,,,,,,6.33,97.438,
Cefuroxime 1.5 g vial,2510766,CDM,J0697,HCPCS,636,RC,outpatient,1,EA,,11.433,6.28815,,10.2897,90,percent of total billed charges,,,,11.433,100,percent of total billed charges,,,2.09,,,fee schedule,,,2.09,,,fee schedule,,,2.09,,,fee schedule,,,,,,,,,,,,,,,,9.71805,85,percent of total billed charges,,,,,,,,,,5.6902041,49.77,percent of total billed charges,,,,10.2897,90,percent of total billed charges,,,,10.86135,90,percent of total billed charges,,,,,,,,,8.84,,,fee schedule,,,11.2268,,,fee schedule,,,,8.57475,75,percent of total billed charges,,,,,,,,,2.09,11.433,
Fluzone Quadrivalent 2023-2024,2510768,CDM,90686,CPT,636,RC,outpatient,1,EA,,36.771,20.22405,,33.0939,90,percent of total billed charges,,,,36.771,100,percent of total billed charges,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,21.73,,,fee schedule,,,,,,,,,,,,,,,,31.25535,85,percent of total billed charges,,,,,,,,,,18.3009267,49.77,percent of total billed charges,,,,33.0939,90,percent of total billed charges,,,,34.93245,90,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,19.6215,,,fee schedule,,,,27.57825,75,percent of total billed charges,,,,,,,,,15.45,36.771,
Prevnar 20 Syringe,2510769,CDM,90677,CPT,636,RC,outpatient,1,EA,,512.322,281.7771,,461.0898,90,percent of total billed charges,,,,512.322,100,percent of total billed charges,,,,,,,,,461.0898,,,fee schedule,,,409.8576,,,fee schedule,,,,,,,,,,,,,,,,435.4737,85,percent of total billed charges,,,,,,,,,,254.9826594,49.77,percent of total billed charges,,,,461.0898,90,percent of total billed charges,,,,486.7059,90,percent of total billed charges,,,,,,,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,384.2415,75,percent of total billed charges,,,,,,,,,13.14,512.322,
HYLENEX 150U/ ML INJECTION,2510775,CDM,J3470,HCPCS,636,RC,outpatient,150,ML,,110.107,60.55885,,99.0963,90,percent of total billed charges,,,,110.107,100,percent of total billed charges,,,24.26,,,fee schedule,,,24.26,,,fee schedule,,,24.26,,,fee schedule,,,,,,,,,,,,,,,,93.59095,85,percent of total billed charges,,,,,,,,,,54.8002539,49.77,percent of total billed charges,,,,99.0963,90,percent of total billed charges,,,,104.60165,90,percent of total billed charges,,,,,,,,,7.05,,,fee schedule,,,8.9535,,,fee schedule,,,,82.58025,75,percent of total billed charges,,,,,,,,,7.05,110.107,
Nitroglycerin 50mg/10 ml Vial,2510778,CDM,J2305,HCPCS,636,RC,outpatient,10,ME,,35.329,19.43095,,31.7961,90,percent of total billed charges,,,,35.329,100,percent of total billed charges,,,,,,,,,31.7961,,,fee schedule,,,28.2632,,,fee schedule,,,,,,,,,,,,,,,,30.02965,85,percent of total billed charges,,,,,,,,,,17.5832433,49.77,percent of total billed charges,,,,31.7961,90,percent of total billed charges,,,,33.56255,90,percent of total billed charges,,,,,,,,,1.3,,,fee schedule,,,1.651,,,fee schedule,,,,26.49675,75,percent of total billed charges,,,,,,,,,1.3,35.329,
"Retacrit 40,000 Units/ML Inj",2510800,CDM,Q5106,HCPCS,636,RC,outpatient,40,ML,,833.682,458.5251,,750.3138,90,percent of total billed charges,,,,833.682,100,percent of total billed charges,,,11.63,,,fee schedule,,,11.63,,,fee schedule,,,11.63,,,fee schedule,,,,,,,,,,,,,,,,708.6297,85,percent of total billed charges,,,,,,,,,,414.9235314,49.77,percent of total billed charges,,,,750.3138,90,percent of total billed charges,,,,791.9979,90,percent of total billed charges,,,,,,,,,11.36,,,fee schedule,,,14.4272,,,fee schedule,,,,625.2615,75,percent of total billed charges,,,,,,,,,11.36,833.682,
"Anastrozole, oral, 1 mg",2510809,CDM,J8999,HCPCS,636,RC,outpatient,1,ME,,2.369,1.30295,,2.1321,90,percent of total billed charges,,,,2.369,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.01365,85,percent of total billed charges,,,,,,,,,,1.1790513,49.77,percent of total billed charges,,,,2.1321,90,percent of total billed charges,,,,2.25055,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1.77675,75,percent of total billed charges,,,,,,,,,1.1790513,2.369,
FLUZONE TRIVALENT 2024-2025,2510817,CDM,90656,CPT,636,RC,outpatient,1,EA,,19.5803,10.769165,,17.62227,90,percent of total billed charges,,,,19.5803,100,percent of total billed charges,,,22.57,,,fee schedule,,,22.57,,,fee schedule,,,22.57,,,fee schedule,,,,,,,,,,,,,,,,16.643255,85,percent of total billed charges,,,,,,,,,,9.74511531,49.77,percent of total billed charges,,,,17.62227,90,percent of total billed charges,,,,18.601285,90,percent of total billed charges,,,,,,,,,15.45,,,fee schedule,,,19.6215,,,fee schedule,,,,14.685225,75,percent of total billed charges,,,,,,,,,9.74511531,22.57,
TECHNETIUM TC 99m MERTIATIDE,3403005,CDM,A9562,HCPCS,636,RC,outpatient,1,EA,,362.457,199.35135,,326.2113,90,percent of total billed charges,,,,362.457,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,308.08845,85,percent of total billed charges,,,,,,,,,,180.3948489,49.77,percent of total billed charges,,,,326.2113,90,percent of total billed charges,,,,344.33415,90,percent of total billed charges,,,,,,,,,31.27,,,fee schedule,,,39.7129,,,fee schedule,,,,271.84275,75,percent of total billed charges,,,,,,,,,31.27,362.457,
LYMPHOSEEK UP TO 0.5 MCI,3439520,CDM,,,636,RC,outpatient,1,EA,,306.219,168.42045,,275.5971,90,percent of total billed charges,,,,306.219,100,percent of total billed charges,,,,,,,,,275.5971,,,fee schedule,,,244.9752,,,fee schedule,,,,,,,,,,,,,,,,260.28615,85,percent of total billed charges,,,,,,,,,,152.4051963,49.77,percent of total billed charges,,,,275.5971,90,percent of total billed charges,,,,290.90805,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,229.66425,75,percent of total billed charges,,,,,,,,,152.4051963,306.219,
OPTIMARK - MRI - PER ML,6360050,CDM,A9579,HCPCS,636,RC,outpatient,1,ML,,7.519,4.13545,,6.7671,90,percent of total billed charges,,,,7.519,100,percent of total billed charges,,,1.78,,,fee schedule,,,1.78,,,fee schedule,,,1.78,,,fee schedule,,,,,,,,,,,,,,,,6.39115,85,percent of total billed charges,,,,,,,,,,3.7422063,49.77,percent of total billed charges,,,,6.7671,90,percent of total billed charges,,,,7.14305,90,percent of total billed charges,,,,,,,,,2.55,,,fee schedule,,,3.2385,,,fee schedule,,,,5.63925,75,percent of total billed charges,,,,,,,,,1.78,7.519,
LEXISCAN 0.1mg,6362785,CDM,J2785,HCPCS,636,RC,outpatient,0.1,ME,,248.745,136.80975,,223.8705,90,percent of total billed charges,,,,248.745,100,percent of total billed charges,,,67.66,,,fee schedule,,,67.66,,,fee schedule,,,67.66,,,fee schedule,,,,,,,,,,,,,,,,211.43325,85,percent of total billed charges,,,,,,,,,,123.8003865,49.77,percent of total billed charges,,,,223.8705,90,percent of total billed charges,,,,236.30775,90,percent of total billed charges,,,,,,,,,56.55,,,fee schedule,,,71.8185,,,fee schedule,,,,186.55875,75,percent of total billed charges,,,,,,,,,56.55,248.745,
"CT LOCM 200-249 mg/ml ""PER ML""",6369947,CDM,Q9966,HCPCS,636,RC,outpatient,200,ME,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,0.36,,,fee schedule,,,0.36,,,fee schedule,,,0.36,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.09,75,percent of total billed charges,,,,,,,,,0.36,4.12,
"LOCM 200-249 mg/ml ""PER ML""",6369947.1,CDM,Q9966,HCPCS,636,RC,outpatient,200,ME,,9.785,5.38175,,8.8065,90,percent of total billed charges,,,,9.785,100,percent of total billed charges,,,0.36,,,fee schedule,,,0.36,,,fee schedule,,,0.36,,,fee schedule,,,,,,,,,,,,,,,,8.31725,85,percent of total billed charges,,,,,,,,,,4.8699945,49.77,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,9.29575,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.33875,75,percent of total billed charges,,,,,,,,,0.36,9.785,
"CT LOCM 300-399 mg/ml ""PER ML""",6369949,CDM,Q9967,HCPCS,636,RC,outpatient,300,ME,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.09,75,percent of total billed charges,,,,,,,,,0.13,4.12,
"LOCM 300-399 mg/ml ""PER ML""",6369949.1,CDM,Q9967,HCPCS,636,RC,outpatient,300,ME,,4.12,2.266,,3.708,90,percent of total billed charges,,,,4.12,100,percent of total billed charges,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,0.13,,,fee schedule,,,,,,,,,,,,,,,,3.502,85,percent of total billed charges,,,,,,,,,,2.050524,49.77,percent of total billed charges,,,,3.708,90,percent of total billed charges,,,,3.914,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.09,75,percent of total billed charges,,,,,,,,,0.13,4.12,
ACTIGALL 300mg CAPSULE,2500060,CDM,,,637,RC,outpatient,300,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
NEO-SYNEPHRINE 2.5% 2ML DROPS,2500095,CDM,,,637,RC,outpatient,2,ML,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
NEOMYCIN 500MG TAB,2500105,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
AEROBID (AEROSOL),2500200,CDM,,,637,RC,outpatient,1,EA,,151.41,83.2755,,136.269,90,percent of total billed charges,,,,151.41,100,percent of total billed charges,,,,,,,,,136.269,,,fee schedule,,,121.128,,,fee schedule,,,,,,,,,,,,,,,,128.6985,85,percent of total billed charges,,,,,,,,,,75.356757,49.77,percent of total billed charges,,,,136.269,90,percent of total billed charges,,,,143.8395,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,128.6985,85,percent of total billed charges,,,,,,,,,75.356757,151.41,
ALDACTONE 25MG TAB.,2500260,CDM,,,637,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
NITRO DUR 0.4MG/HR (10MG) TOP,2500345,CDM,,,637,RC,outpatient,0.4,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
NITROSTAT 1/150 (0.4MG) TAB,2500415,CDM,,,637,RC,outpatient,0.4,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
NORGESIC FORTE 100MG TAB,2500525,CDM,,,637,RC,outpatient,100,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
AMOXIL 500MG CAP,2500570,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
OSCAL 500MG TAB,2500865,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ANTIVERT 25MG TAB.,2500880,CDM,,,637,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PAPAVERINE 150MG TAB,2500945,CDM,,,637,RC,outpatient,150,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
APRESOLINE 10mg TABLET,2500960,CDM,,,637,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
APRESOLINE 25MG TABLET,2500980,CDM,,,637,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ARTANE 2MG TAB,2501040,CDM,,,637,RC,outpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ASPIRIN 81MG TAB,2501110,CDM,,,637,RC,outpatient,81,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
PENICILLIN 500MG TAB,2501125,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ATARAX 25MG TAB,2501140,CDM,,,637,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PERIACTIN 4MG TABLET,2501245,CDM,,,637,RC,outpatient,4,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PERSANTINE 25MG TABLET,2501285,CDM,,,637,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PHENERGAN 25MG TAB,2501335,CDM,,,637,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PHENOBARBITAL 100MG (1 1/2 GR),2501415,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
BACTRIM DS  800MG/160MG  TAB,2501460,CDM,,,637,RC,outpatient,800,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
BENADRYL 25MG  CAPSULE,2501520,CDM,,,637,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
BENEMID 500MG TAB,2501550,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
BENTYL 10MG CAP,2501560,CDM,,,637,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PLAQUENIL 200MG TAB,2501625,CDM,,,637,RC,outpatient,200,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
BETAPACE 80MG TAB,2501660,CDM,,,637,RC,outpatient,80,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
BIAXIN 500MG TAB,2501710,CDM,,,637,RC,outpatient,500,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,14.5539,,,fee schedule,,,12.9368,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,8.0483067,16.171,
PREDNISONE 5MG TABLET,2501795,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PREDNISONE 1MG TABLET,2501805,CDM,,,637,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PREDNISONE 20MG TAB,2501825,CDM,,,637,RC,outpatient,20,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
BUMEX 1 MG TAB,2501900,CDM,,,637,RC,outpatient,1,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
PLAVIX 75MG TABLET,2501906,CDM,,,637,RC,outpatient,75,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
WELLBUTRIN 150 MG SR,2501907,CDM,,,637,RC,outpatient,150,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
REQUIP 0.25MG TABLET,2501908,CDM,,,637,RC,outpatient,0.25,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
DEPAKETE 500 MG TABLET,2501909,CDM,,,637,RC,outpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
NEURONTIN 100MG CAPSULE,2501911,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
HYDROXYUREA 500MG,2501924,CDM,,,637,RC,outpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
COZAAR 25MG TABLET,2501929,CDM,,,637,RC,outpatient,25,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
CALAN SR 120 TABLET,2501931,CDM,,,637,RC,outpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
COREG 6.25MG TABLET,2501932,CDM,,,637,RC,outpatient,6.25,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
MS CONTIN 15MG TABLET,2501936,CDM,,,637,RC,outpatient,15,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
LOXITANE 25MG TABLET,2501938,CDM,,,637,RC,outpatient,25,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
ZYPREXA 5MG TABLET,2501943,CDM,,,637,RC,outpatient,5,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,,,,,,,17.613,,,fee schedule,,,15.656,,,fee schedule,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,,9.739989,49.77,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,18.5915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,9.739989,19.57,
PAXIL 10MG TABLET,2501951,CDM,,,637,RC,outpatient,10,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
ASACOL 400MG TAB,2501968,CDM,,,637,RC,outpatient,400,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
EVISTA 60 MG TAB,2501969,CDM,,,637,RC,outpatient,60,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
AGGRENOX CAPSULE,2501978,CDM,,,637,RC,outpatient,1,EA,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
PROZAC 10MG,2501991,CDM,,,637,RC,outpatient,10,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
GUAIFENESIN LA 600MG TABLET,2502002,CDM,,,637,RC,outpatient,600,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
CHG CALAN 80MG TAG,2502010,CDM,,,637,RC,outpatient,80,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TOPROL XL 50mg TABLET,2502016,CDM,,,637,RC,outpatient,50,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
PROCAN SR 750MG SR SLOW REL,2502035,CDM,,,637,RC,outpatient,750,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
GLUCOPHAGE XR 500MG TABLET,2502037,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
GLUCOTROL XL 2.5MG TABLET,2502038,CDM,,,637,RC,outpatient,2.5,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
GEODON 20MG CAPSULE,2502039,CDM,,,637,RC,outpatient,20,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,14.5539,,,fee schedule,,,12.9368,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,8.0483067,16.171,
PLETAL 100MG TABLET,2502044,CDM,,,637,RC,outpatient,100,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
PROCARDIA 10MG CAP,2502045,CDM,,,637,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
FOSAMAX 70mg TABLET,2502046,CDM,,,637,RC,outpatient,70,ME,,41.303,22.71665,,37.1727,90,percent of total billed charges,,,,41.303,100,percent of total billed charges,,,,,,,,,37.1727,,,fee schedule,,,33.0424,,,fee schedule,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,,20.5565031,49.77,percent of total billed charges,,,,37.1727,90,percent of total billed charges,,,,39.23785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,35.10755,85,percent of total billed charges,,,,,,,,,20.5565031,41.303,
ZANAFLEX 4MG TABLET,2502047,CDM,,,637,RC,outpatient,4,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
CALAN SR 180MG SR SLOW REL,2502050,CDM,,,637,RC,outpatient,180,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
OXYCONTIN 10MG TABLET,2502053,CDM,,,637,RC,outpatient,10,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
OXYCONTIN 20MG TABLET,2502054,CDM,,,637,RC,outpatient,20,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
PROCARDIA XL 30MG SLOW REL,2502055,CDM,,,637,RC,outpatient,30,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
TAMIFLU 75mg CAPSULE,2502059,CDM,,,637,RC,outpatient,75,ME,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
COMTAN 200mg TABLET,2502078,CDM,,,637,RC,outpatient,200,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
ZOCOR 40mg TABLET,2502089,CDM,,,637,RC,outpatient,40,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
TRILEPTAL 300mg TABLET,2502111,CDM,,,637,RC,outpatient,300,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
TOPAMAX 25mg TAB,2502122,CDM,,,637,RC,outpatient,25,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
TOPAMAX 100mg TABLET,2502123,CDM,,,637,RC,outpatient,100,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
DETROL LA 2mg CAPSULE,2502128,CDM,,,637,RC,outpatient,2,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
KEPPRA 500mg TABLET,2502136,CDM,,,637,RC,outpatient,500,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
PROLIXIN 5MG TAB,2502155,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ZEBETA 5mg TABLET,2502156,CDM,,,637,RC,outpatient,5,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
ZETRA 10mg TABLET,2502157,CDM,,,637,RC,outpatient,10,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
PRIMIDONE 50mg TABLET,2502158,CDM,,,637,RC,outpatient,50,ME,,3.502,1.9261,,3.1518,90,percent of total billed charges,,,,3.502,100,percent of total billed charges,,,,,,,,,3.1518,,,fee schedule,,,2.8016,,,fee schedule,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,,1.7429454,49.77,percent of total billed charges,,,,3.1518,90,percent of total billed charges,,,,3.3269,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,2.9767,85,percent of total billed charges,,,,,,,,,1.7429454,3.502,
NORCO 10/325 TABLET,2502161,CDM,,,637,RC,outpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
PROTONIX 20mg TABLET,2502176,CDM,,,637,RC,outpatient,20,ME,,14.935,8.21425,,13.4415,90,percent of total billed charges,,,,14.935,100,percent of total billed charges,,,,,,,,,13.4415,,,fee schedule,,,11.948,,,fee schedule,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,,7.4331495,49.77,percent of total billed charges,,,,13.4415,90,percent of total billed charges,,,,14.18825,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,12.69475,85,percent of total billed charges,,,,,,,,,7.4331495,14.935,
CLOZARIL 100mg TABLET,2502183,CDM,,,637,RC,outpatient,100,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
DEPAKOTE 500mg TABLET - ER,2502184,CDM,,,637,RC,outpatient,500,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
LYRICA 25mg TABLET,2502187,CDM,,,637,RC,outpatient,25,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
DEPAKOTE 250mg TABLET - ER,2502198,CDM,,,637,RC,outpatient,250,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
NORMODYNE 100mg TAB (LABETALOL,2502204,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PERCOCET 5/325 TABLET,2502216,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LAMICTAL 25mg TABLET,2502219,CDM,,,637,RC,outpatient,25,ME,,11.536,6.3448,,10.3824,90,percent of total billed charges,,,,11.536,100,percent of total billed charges,,,,,,,,,10.3824,,,fee schedule,,,9.2288,,,fee schedule,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,,5.7414672,49.77,percent of total billed charges,,,,10.3824,90,percent of total billed charges,,,,10.9592,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,9.8056,85,percent of total billed charges,,,,,,,,,5.7414672,11.536,
SEROQUEL 200mg TABLET,2502229,CDM,,,637,RC,outpatient,200,ME,,21.836,12.0098,,19.6524,90,percent of total billed charges,,,,21.836,100,percent of total billed charges,,,,,,,,,19.6524,,,fee schedule,,,17.4688,,,fee schedule,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,,10.8677772,49.77,percent of total billed charges,,,,19.6524,90,percent of total billed charges,,,,20.7442,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,18.5606,85,percent of total billed charges,,,,,,,,,10.8677772,21.836,
REQUIP 1mg TABLET,2502231,CDM,,,637,RC,outpatient,1,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
JANUVIA 100mg,2502233,CDM,,,637,RC,outpatient,100,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
LAMICTOL 100mg,2502238,CDM,,,637,RC,outpatient,100,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
LAMISIL 250mg,2502239,CDM,,,637,RC,outpatient,250,ME,,31.003,17.05165,,27.9027,90,percent of total billed charges,,,,31.003,100,percent of total billed charges,,,,,,,,,27.9027,,,fee schedule,,,24.8024,,,fee schedule,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,,15.4301931,49.77,percent of total billed charges,,,,27.9027,90,percent of total billed charges,,,,29.45285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,26.35255,85,percent of total billed charges,,,,,,,,,15.4301931,31.003,
FIORICET,2502243,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
AVODART 0.5mg,2502244,CDM,,,637,RC,outpatient,0.5,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
CARDIZEM 30MG TAB,2502250,CDM,,,637,RC,outpatient,30,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
MINOXIDIL 10mg,2502252,CDM,,,637,RC,outpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
NIACINAMIDE 500mg,2502253,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LYRICA 75,2502264,CDM,,,637,RC,outpatient,1,EA,,18.231,10.02705,,16.4079,90,percent of total billed charges,,,,18.231,100,percent of total billed charges,,,,,,,,,16.4079,,,fee schedule,,,14.5848,,,fee schedule,,,,,,,,,,,,,,,,15.49635,85,percent of total billed charges,,,,,,,,,,9.0735687,49.77,percent of total billed charges,,,,16.4079,90,percent of total billed charges,,,,17.31945,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.49635,85,percent of total billed charges,,,,,,,,,9.0735687,18.231,
PROSCAR 5MG TAB,2502265,CDM,,,637,RC,outpatient,5,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
EXELON 3mg CAPSULE,2502277,CDM,,,637,RC,outpatient,3,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
CARDIZEM CD 120MG SLOW REL,2502310,CDM,,,637,RC,outpatient,120,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
CARDIZEM CD 180MG SLOW REL,2502320,CDM,,,637,RC,outpatient,180,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
CLOZAPINE 25mg TABLET,2502322,CDM,,,637,RC,outpatient,25,ME,,6.077,3.34235,,5.4693,90,percent of total billed charges,,,,6.077,100,percent of total billed charges,,,,,,,,,5.4693,,,fee schedule,,,4.8616,,,fee schedule,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,,3.0245229,49.77,percent of total billed charges,,,,5.4693,90,percent of total billed charges,,,,5.77315,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.16545,85,percent of total billed charges,,,,,,,,,3.0245229,6.077,
PHENYLEPHRINE 10mg TAB,2502326,CDM,,,637,RC,outpatient,10,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
PERCOCET 10/325 TABLET,2502328,CDM,,,637,RC,outpatient,1,EA,,8.24,4.532,,7.416,90,percent of total billed charges,,,,8.24,100,percent of total billed charges,,,,,,,,,7.416,,,fee schedule,,,6.592,,,fee schedule,,,,,,,,,,,,,,,,7.004,85,percent of total billed charges,,,,,,,,,,4.101048,49.77,percent of total billed charges,,,,7.416,90,percent of total billed charges,,,,7.828,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.004,85,percent of total billed charges,,,,,,,,,4.101048,8.24,
CHOLECALCIFEROL 1000u TAB,2502333,CDM,,,637,RC,outpatient,1,EA,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
CARDURA 2MG TAB,2502360,CDM,,,637,RC,outpatient,2,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
CATAPRES/CLONIDINE 0.1MG TAB,2502380,CDM,,,637,RC,outpatient,0.1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PROVERA 5MG TAB,2502445,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
PYRIDIUM 100MG TAB,2502485,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ORAGEL 1 TUBE,2502505,CDM,,,637,RC,outpatient,1,EA,,20.703,11.38665,,18.6327,90,percent of total billed charges,,,,20.703,100,percent of total billed charges,,,,,,,,,18.6327,,,fee schedule,,,16.5624,,,fee schedule,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,,10.3038831,49.77,percent of total billed charges,,,,18.6327,90,percent of total billed charges,,,,19.66785,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,17.59755,85,percent of total billed charges,,,,,,,,,10.3038831,20.703,
CEFTIN 250 MG TAB,2502520,CDM,,,637,RC,outpatient,250,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,14.5539,,,fee schedule,,,12.9368,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,8.0483067,16.171,
REGLAN 5MG TAB,2502665,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
RENESE-R 2/0.25MG TAB,2502725,CDM,,,637,RC,outpatient,0.25,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
RESTORIL 15MG CAP,2502745,CDM,,,637,RC,outpatient,15,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
CIPRO 500MG TAB,2502770,CDM,,,637,RC,outpatient,500,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
CLEOCIN 150MG CAP.,2502850,CDM,,,637,RC,outpatient,150,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
RITALIN 5MG TAB,2502865,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ROBAXIN 500MG TAB,2502885,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ROBINUL 1MG TAB,2502925,CDM,,,637,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ROBITUSSIN 100mg/5ml Unit Dose,2502935,CDM,,,637,RC,outpatient,100,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
ROBITUSSIN AC SYRUP,2502955,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ROCALTROL 0.25MCG CAP,2502975,CDM,,,637,RC,outpatient,1,EA,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
COLACE/DIOCTO 20MG/5ML,2502990,CDM,,,637,RC,outpatient,20,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
COLCHICINE 0.6MG TAB.,2503000,CDM,,,637,RC,outpatient,0.6,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
LIDODERM 5% 700mg PATCH,2503001,CDM,,,637,RC,outpatient,700,ME,,19.57,10.7635,,17.613,90,percent of total billed charges,,,,19.57,100,percent of total billed charges,,,,,,,,,17.613,,,fee schedule,,,15.656,,,fee schedule,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,,9.739989,49.77,percent of total billed charges,,,,17.613,90,percent of total billed charges,,,,18.5915,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,16.6345,85,percent of total billed charges,,,,,,,,,9.739989,19.57,
ROXANOL SOLUTION 20MG/ML LIQ,2503065,CDM,,,637,RC,outpatient,20,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
RYTHMOL 150MG TAB,2503075,CDM,,,637,RC,outpatient,150,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
CORDARONE 200MG TABLET,2503130,CDM,,,637,RC,outpatient,200,ME,,16.171,8.89405,,14.5539,90,percent of total billed charges,,,,16.171,100,percent of total billed charges,,,,,,,,,14.5539,,,fee schedule,,,12.9368,,,fee schedule,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,,8.0483067,49.77,percent of total billed charges,,,,14.5539,90,percent of total billed charges,,,,15.36245,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,13.74535,85,percent of total billed charges,,,,,,,,,8.0483067,16.171,
COUMADIN 1MG TAB.,2503240,CDM,,,637,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
COUMADIN 2MG TAB,2503250,CDM,,,637,RC,outpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
COUMADIN 5MG TAB,2503280,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SINEMET 10-100 TAB,2503285,CDM,,,637,RC,outpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
SINEMET 25-100 TAB,2503295,CDM,,,637,RC,outpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
SINEMET 25-250 TAB,2503305,CDM,,,637,RC,outpatient,1,EA,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
SINEQUAN 10MG CAP,2503325,CDM,,,637,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
CYTOTEC 100MCG TAB,2503350,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SINEQUAN 50MG CAP,2503355,CDM,,,637,RC,outpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SODIUM BICARBONATE 10GR TAB,2503405,CDM,,,637,RC,outpatient,10,GR,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SODIUM CHLORIDE 1GM TAB,2503465,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SPEC-T DM 10MG LOZENGE,2503625,CDM,,,637,RC,outpatient,10,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
DANOCRINE 200MG CAP.,2503650,CDM,,,637,RC,outpatient,200,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
STELAZINE 2MG TAB,2503675,CDM,,,637,RC,outpatient,2,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
STUARTNATAL 1+1 TAB,2503755,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DECADRON 4 MG TAB,2503820,CDM,,,637,RC,outpatient,4,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SURMONTIL 25MG CAP,2503865,CDM,,,637,RC,outpatient,25,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
DECLOMYCIN 150MG CAP,2503880,CDM,,,637,RC,outpatient,150,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
SYMMETREL 100MG CAP,2503895,CDM,,,637,RC,outpatient,100,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
SYNTHROID 0.025MG TAB,2503955,CDM,,,637,RC,outpatient,0.025,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
SYNTHROID 0.05MG TAB,2503965,CDM,,,637,RC,outpatient,0.05,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DEMEROL 50MG/5ML SYRUP,2503970,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DEPAKENE 250MG CAP,2503990,CDM,,,637,RC,outpatient,250,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
SYNTHROID 0.112MG TAB,2503995,CDM,,,637,RC,outpatient,0.112,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DEPAKENE 250MG/5ML SYRUP,2504000,CDM,,,637,RC,outpatient,250,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
DEPAKOTE 250MG CAP.,2504010,CDM,,,637,RC,outpatient,250,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
DESYREL 100MG TAB,2504140,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TAMBOCOR 50MG TAB,2504145,CDM,,,637,RC,outpatient,50,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
TEGRETOL 200MG TAB,2504195,CDM,,,637,RC,outpatient,200,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TENEX 1MG TAB,2504205,CDM,,,637,RC,outpatient,1,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
TENORMIN 50MG TAB,2504225,CDM,,,637,RC,outpatient,50,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
DIAMOX 250MG TAB,2504250,CDM,,,637,RC,outpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TESSALON PERLES 100MG CAP,2504255,CDM,,,637,RC,outpatient,100,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
TETRACYCLINE 250MG CAP,2504295,CDM,,,637,RC,outpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DILANTIN 100MG CAP,2504330,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DILANTIN 50MG CHEWABLE,2504370,CDM,,,637,RC,outpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DILAUDID 2MG TAB,2504380,CDM,,,637,RC,outpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
THIAMINE 100MG TAB,2504415,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
THORAZINE 25MG TAB,2504445,CDM,,,637,RC,outpatient,25,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DISALCID 500MG TAB,2504460,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DITROPAN 5MG TAB,2504480,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
Diuril 250mg tab,2504490,CDM,,,637,RC,outpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DONNATAL 5ML ELIXIR,2504560,CDM,,,637,RC,outpatient,5,ML,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
DYAZIDE 50MG/25MG CAP,2504760,CDM,,,637,RC,outpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TORADOL 10MG TAB,2504765,CDM,,,637,RC,outpatient,10,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
ECOTRIN 325MG TAB,2504850,CDM,,,637,RC,outpatient,325,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
EFFEXOR 37.5MG TAB,2504890,CDM,,,637,RC,outpatient,37.5,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
TRENTAL 400MG TAB,2504925,CDM,,,637,RC,outpatient,400,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ELAVIL 10MG TAB,2504930,CDM,,,637,RC,outpatient,10,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ELAVIL 50MG TAB,2504950,CDM,,,637,RC,outpatient,50,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TUCKS MEDICATED PADS - BOX,2505045,CDM,,,637,RC,outpatient,1,EA,,23.896,13.1428,,21.5064,90,percent of total billed charges,,,,23.896,100,percent of total billed charges,,,,,,,,,21.5064,,,fee schedule,,,19.1168,,,fee schedule,,,,,,,,,,,,,,,,20.3116,85,percent of total billed charges,,,,,,,,,,11.8930392,49.77,percent of total billed charges,,,,21.5064,90,percent of total billed charges,,,,22.7012,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,20.3116,85,percent of total billed charges,,,,,,,,,11.8930392,23.896,
ENTEX CAP,2505100,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
TYLENOL 160MG/EML ELIXIR,2505145,CDM,,,637,RC,outpatient,160,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
TYLENOL 325MG TAB,2505175,CDM,,,637,RC,outpatient,325,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
TYLENOL 500MG TAB,2505185,CDM,,,637,RC,outpatient,500,ME,,3.811,2.09605,,3.4299,90,percent of total billed charges,,,,3.811,100,percent of total billed charges,,,,,,,,,3.4299,,,fee schedule,,,3.0488,,,fee schedule,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,,1.8967347,49.77,percent of total billed charges,,,,3.4299,90,percent of total billed charges,,,,3.62045,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.23935,85,percent of total billed charges,,,,,,,,,1.8967347,3.811,
TYLENOL #3 TABLET,2505245,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ERYTHROMYCIN BASE 250MG TAB,2505260,CDM,,,637,RC,outpatient,250,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ERYTHROMYCIN BASE 500MG TAB,2505270,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ULTRAM 50MG TAB,2505285,CDM,,,637,RC,outpatient,50,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
ESTRACE 1MG TAB,2505320,CDM,,,637,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
FEOSOL 220MG/5ML ELIXIR,2505440,CDM,,,637,RC,outpatient,220,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
FERRO-SEQUELS 150MG/100MG CAP,2505480,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
VALIUM 2MG TAB,2505485,CDM,,,637,RC,outpatient,2,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
VALIUM 5MG TAB,2505495,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
FIBERCON TAB,2505510,CDM,,,637,RC,outpatient,1,EA,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
FLAGYL 500MG TAB,2505570,CDM,,,637,RC,outpatient,500,ME,,9.27,5.0985,,8.343,90,percent of total billed charges,,,,9.27,100,percent of total billed charges,,,,,,,,,8.343,,,fee schedule,,,7.416,,,fee schedule,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,,4.613679,49.77,percent of total billed charges,,,,8.343,90,percent of total billed charges,,,,8.8065,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,7.8795,85,percent of total billed charges,,,,,,,,,4.613679,9.27,
FLEXERIL 10MG TAB,2505620,CDM,,,637,RC,outpatient,10,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
FLORINEF 0.1MG TAB,2505640,CDM,,,637,RC,outpatient,0.4,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
FLOXIN 300MG TAB,2505670,CDM,,,637,RC,outpatient,300,ME,,18.437,10.14035,,16.5933,90,percent of total billed charges,,,,18.437,100,percent of total billed charges,,,,,,,,,16.5933,,,fee schedule,,,14.7496,,,fee schedule,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,,9.1760949,49.77,percent of total billed charges,,,,16.5933,90,percent of total billed charges,,,,17.51515,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,15.67145,85,percent of total billed charges,,,,,,,,,9.1760949,18.437,
VIBRAMYCIN 100mg VIAL,2505755,CDM,,,637,RC,outpatient,100,ME,,58.504,32.1772,,52.6536,90,percent of total billed charges,,,,58.504,100,percent of total billed charges,,,,,,,,,52.6536,,,fee schedule,,,46.8032,,,fee schedule,,,,,,,,,,,,,,,,49.7284,85,percent of total billed charges,,,,,,,,,,29.1174408,49.77,percent of total billed charges,,,,52.6536,90,percent of total billed charges,,,,55.5788,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,49.7284,85,percent of total billed charges,,,,,,,,,29.1174408,58.504,
FOLVITE 1MG TAB,2505760,CDM,,,637,RC,outpatient,1,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
VIBRAMYCIN 25MG/5ML SUSP,2505775,CDM,,,637,RC,outpatient,25,ME,,33.372,18.3546,,30.0348,90,percent of total billed charges,,,,33.372,100,percent of total billed charges,,,,,,,,,30.0348,,,fee schedule,,,26.6976,,,fee schedule,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,,16.6092444,49.77,percent of total billed charges,,,,30.0348,90,percent of total billed charges,,,,31.7034,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.3662,85,percent of total billed charges,,,,,,,,,16.6092444,33.372,
FURADANTIN 5MG/ML SUSP,2505850,CDM,,,637,RC,outpatient,5,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
VIT B-12 500MCG TAB,2505915,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
VIT C 500MG TAB,2505935,CDM,,,637,RC,outpatient,500,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
"VIT-D 50,000 UNITS TAB",2505955,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
VIT-E 400 IU CAP,2505965,CDM,,,637,RC,outpatient,1,EA,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
VOLTAREN 50MG TAB,2506005,CDM,,,637,RC,outpatient,50,ME,,8.137,4.47535,,7.3233,90,percent of total billed charges,,,,8.137,100,percent of total billed charges,,,,,,,,,7.3233,,,fee schedule,,,6.5096,,,fee schedule,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,,4.0497849,49.77,percent of total billed charges,,,,7.3233,90,percent of total billed charges,,,,7.73015,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,6.91645,85,percent of total billed charges,,,,,,,,,4.0497849,8.137,
WELLBUTRIN 100MG TAB,2506015,CDM,,,637,RC,outpatient,100,ME,,5.768,3.1724,,5.1912,90,percent of total billed charges,,,,5.768,100,percent of total billed charges,,,,,,,,,5.1912,,,fee schedule,,,4.6144,,,fee schedule,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,,2.8707336,49.77,percent of total billed charges,,,,5.1912,90,percent of total billed charges,,,,5.4796,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,4.9028,85,percent of total billed charges,,,,,,,,,2.8707336,5.768,
GLUCOTROL 5MG TAB,2506080,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
HABITROL 7MG TOPICAL,2506200,CDM,,,637,RC,outpatient,7,ME,,17.201,9.46055,,15.4809,90,percent of total billed charges,,,,17.201,100,percent of total billed charges,,,,,,,,,15.4809,,,fee schedule,,,13.7608,,,fee schedule,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,,8.5609377,49.77,percent of total billed charges,,,,15.4809,90,percent of total billed charges,,,,16.34095,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,14.62085,85,percent of total billed charges,,,,,,,,,8.5609377,17.201,
ZAROXOLYN/DIULO 5MG TAB,2506225,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
HALDOL 5MG TAB,2506280,CDM,,,637,RC,outpatient,5,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
ZOLOFT 50MG TAB,2506425,CDM,,,637,RC,outpatient,50,ME,,12.669,6.96795,,11.4021,90,percent of total billed charges,,,,12.669,100,percent of total billed charges,,,,,,,,,11.4021,,,fee schedule,,,10.1352,,,fee schedule,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,,6.3053613,49.77,percent of total billed charges,,,,11.4021,90,percent of total billed charges,,,,12.03555,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,10.76865,85,percent of total billed charges,,,,,,,,,6.3053613,12.669,
ZOVIRAX 200MG CAP,2506445,CDM,,,637,RC,outpatient,200,ME,,6.901,3.79555,,6.2109,90,percent of total billed charges,,,,6.901,100,percent of total billed charges,,,,,,,,,6.2109,,,fee schedule,,,5.5208,,,fee schedule,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,,3.4346277,49.77,percent of total billed charges,,,,6.2109,90,percent of total billed charges,,,,6.55595,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,5.86585,85,percent of total billed charges,,,,,,,,,3.4346277,6.901,
ZYLOPRIM 100MG TAB,2506495,CDM,,,637,RC,outpatient,100,ME,,4.635,2.54925,,4.1715,90,percent of total billed charges,,,,4.635,100,percent of total billed charges,,,,,,,,,4.1715,,,fee schedule,,,3.708,,,fee schedule,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,,2.3068395,49.77,percent of total billed charges,,,,4.1715,90,percent of total billed charges,,,,4.40325,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,3.93975,85,percent of total billed charges,,,,,,,,,2.3068395,4.635,
CEPHALEXIN SUSP 250MG/5CC,2507480,CDM,,,637,RC,outpatient,250,ME,,10.403,5.72165,,9.3627,90,percent of total billed charges,,,,10.403,100,percent of total billed charges,,,,,,,,,9.3627,,,fee schedule,,,8.3224,,,fee schedule,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,,5.1775731,49.77,percent of total billed charges,,,,9.3627,90,percent of total billed charges,,,,9.88285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,8.84255,85,percent of total billed charges,,,,,,,,,5.1775731,10.403,
TRAUMA RESP W CRITICAL CARE,6840390,CDM,G0390,HCPCS,684,RC,outpatient,,,,1389.779,764.37845,,1250.8011,90,percent of total billed charges,,,,1389.779,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1181.31215,85,percent of total billed charges,,,,,,,,,,691.6930083,49.77,percent of total billed charges,,,,1250.8011,90,percent of total billed charges,,,,1320.29005,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1181.31215,85,percent of total billed charges,,,,,,,,,691.6930083,1389.779,
POST OP RECOVERY  1-30 MIN,7100000,CDM,,,710,RC,outpatient,,,,166.551,91.60305,,149.8959,90,percent of total billed charges,,,,166.551,100,percent of total billed charges,,,,,,,,,149.8959,,,fee schedule,,,133.2408,,,fee schedule,,,,,,,,,,,,,,,,141.56835,85,percent of total billed charges,,,,,,,,,,82.8924327,49.77,percent of total billed charges,,,,149.8959,90,percent of total billed charges,,,,158.22345,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,141.56835,85,percent of total billed charges,,,,,,,,,82.8924327,166.551,
POST OP RECOVERY 31-60 MIN,7100010,CDM,,,710,RC,outpatient,,,,279.233,153.57815,,251.3097,90,percent of total billed charges,,,,279.233,100,percent of total billed charges,,,,,,,,,251.3097,,,fee schedule,,,223.3864,,,fee schedule,,,,,,,,,,,,,,,,237.34805,85,percent of total billed charges,,,,,,,,,,138.9742641,49.77,percent of total billed charges,,,,251.3097,90,percent of total billed charges,,,,265.27135,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,237.34805,85,percent of total billed charges,,,,,,,,,138.9742641,279.233,
POST OP RECOVERY 61-90 MIN,7100020,CDM,,,710,RC,outpatient,,,,340.518,187.2849,,306.4662,90,percent of total billed charges,,,,340.518,100,percent of total billed charges,,,,,,,,,306.4662,,,fee schedule,,,272.4144,,,fee schedule,,,,,,,,,,,,,,,,289.4403,85,percent of total billed charges,,,,,,,,,,169.4758086,49.77,percent of total billed charges,,,,306.4662,90,percent of total billed charges,,,,323.4921,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,289.4403,85,percent of total billed charges,,,,,,,,,169.4758086,340.518,
POST OP RECOVERY 91-120 MI,7100030,CDM,,,710,RC,outpatient,,,,380.688,209.3784,,342.6192,90,percent of total billed charges,,,,380.688,100,percent of total billed charges,,,,,,,,,342.6192,,,fee schedule,,,304.5504,,,fee schedule,,,,,,,,,,,,,,,,323.5848,85,percent of total billed charges,,,,,,,,,,189.4684176,49.77,percent of total billed charges,,,,342.6192,90,percent of total billed charges,,,,361.6536,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,323.5848,85,percent of total billed charges,,,,,,,,,189.4684176,380.688,
POST OP RECOVERY 121-150 MIN,7100040,CDM,,,710,RC,outpatient,,,,420.446,231.2453,,378.4014,90,percent of total billed charges,,,,420.446,100,percent of total billed charges,,,,,,,,,378.4014,,,fee schedule,,,336.3568,,,fee schedule,,,,,,,,,,,,,,,,357.3791,85,percent of total billed charges,,,,,,,,,,209.2559742,49.77,percent of total billed charges,,,,378.4014,90,percent of total billed charges,,,,399.4237,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,357.3791,85,percent of total billed charges,,,,,,,,,209.2559742,420.446,
POST OP RECOVERY 151-180 MIN,7100050,CDM,,,710,RC,outpatient,,,,485.439,266.99145,,436.8951,90,percent of total billed charges,,,,485.439,100,percent of total billed charges,,,,,,,,,436.8951,,,fee schedule,,,388.3512,,,fee schedule,,,,,,,,,,,,,,,,412.62315,85,percent of total billed charges,,,,,,,,,,241.6029903,49.77,percent of total billed charges,,,,436.8951,90,percent of total billed charges,,,,461.16705,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,412.62315,85,percent of total billed charges,,,,,,,,,241.6029903,485.439,
POST OP RECOVERY 241-270 MIN,7100080,CDM,,,710,RC,outpatient,,,,751.179,413.14845,,676.0611,90,percent of total billed charges,,,,751.179,100,percent of total billed charges,,,,,,,,,676.0611,,,fee schedule,,,600.9432,,,fee schedule,,,,,,,,,,,,,,,,638.50215,85,percent of total billed charges,,,,,,,,,,373.8617883,49.77,percent of total billed charges,,,,676.0611,90,percent of total billed charges,,,,713.62005,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,638.50215,85,percent of total billed charges,,,,,,,,,373.8617883,751.179,
AMBULATORY SURG RECOVERY/HRLY,7100130,CDM,,,710,RC,outpatient,,,,618,339.9,,556.2,90,percent of total billed charges,,,,618,100,percent of total billed charges,,,,,,,,,556.2,,,fee schedule,,,494.4,,,fee schedule,,,,,,,,,,,,,,,,525.3,85,percent of total billed charges,,,,,,,,,,307.5786,49.77,percent of total billed charges,,,,556.2,90,percent of total billed charges,,,,587.1,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,525.3,85,percent of total billed charges,,,,,,,,,307.5786,618,
POSTOP RECOVERY TO ONE HOUR PA,7101000,CDM,,,710,RC,outpatient,,,,661.26,363.693,,595.134,90,percent of total billed charges,,,,661.26,100,percent of total billed charges,,,,,,,,,595.134,,,fee schedule,,,529.008,,,fee schedule,,,,,,,,,,,,,,,,562.071,85,percent of total billed charges,,,,,,,,,,329.109102,49.77,percent of total billed charges,,,,595.134,90,percent of total billed charges,,,,628.197,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,562.071,85,percent of total billed charges,,,,,,,,,329.109102,661.26,
POSTOP RECOVERY ADDL 30MINS PA,7102000,CDM,,,710,RC,outpatient,,,,330.63,181.8465,,297.567,90,percent of total billed charges,,,,330.63,100,percent of total billed charges,,,,,,,,,297.567,,,fee schedule,,,264.504,,,fee schedule,,,,,,,,,,,,,,,,281.0355,85,percent of total billed charges,,,,,,,,,,164.554551,49.77,percent of total billed charges,,,,297.567,90,percent of total billed charges,,,,314.0985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,281.0355,85,percent of total billed charges,,,,,,,,,164.554551,330.63,
POSTOP RECOVERY ADDL 30MINS GY,7103000,CDM,,,710,RC,outpatient,,,,330.63,181.8465,,297.567,90,percent of total billed charges,,,,330.63,100,percent of total billed charges,,,,,,,,,297.567,,,fee schedule,,,264.504,,,fee schedule,,,,,,,,,,,,,,,,281.0355,85,percent of total billed charges,,,,,,,,,,164.554551,49.77,percent of total billed charges,,,,297.567,90,percent of total billed charges,,,,314.0985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,281.0355,85,percent of total billed charges,,,,,,,,,164.554551,330.63,
POSTOP RECOVERY ADDL 30MINS MS,7104000,CDM,,,710,RC,outpatient,,,,330.63,181.8465,,297.567,90,percent of total billed charges,,,,330.63,100,percent of total billed charges,,,,,,,,,297.567,,,fee schedule,,,264.504,,,fee schedule,,,,,,,,,,,,,,,,281.0355,85,percent of total billed charges,,,,,,,,,,164.554551,49.77,percent of total billed charges,,,,297.567,90,percent of total billed charges,,,,314.0985,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,281.0355,85,percent of total billed charges,,,,,,,,,164.554551,330.63,
POST OP RECOV ADDL 30 MINS ICU,7105000,CDM,,,710,RC,outpatient,,,,551.05,303.0775,,495.945,90,percent of total billed charges,,,,551.05,100,percent of total billed charges,,,,,,,,,495.945,,,fee schedule,,,440.84,,,fee schedule,,,,,,,,,,,,,,,,468.3925,85,percent of total billed charges,,,,,,,,,,274.257585,49.77,percent of total billed charges,,,,495.945,90,percent of total billed charges,,,,523.4975,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,468.3925,85,percent of total billed charges,,,,,,,,,274.257585,551.05,
FETAL NON-STRESS TEST,7200020,CDM,59025,CPT,720,RC,outpatient,,,,158.002,86.9011,,142.2018,90,percent of total billed charges,,,,158.002,100,percent of total billed charges,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,49.2655,,,fee schedule,,,49.2655,,,fee schedule,,,,134.3017,85,percent of total billed charges,,,49.2655,,,fee schedule,,,,78.6375954,49.77,percent of total billed charges,,,,142.2018,90,percent of total billed charges,,,,150.1019,90,percent of total billed charges,,,50.743465,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,134.3017,85,percent of total billed charges,,,49.2655,,,fee schedule,,,49.2655,317.5,
LABOR,7210000,CDM,,,720,RC,outpatient,,,,506.657,278.66135,,455.9913,90,percent of total billed charges,,,,506.657,100,percent of total billed charges,,,,,,,,,455.9913,,,fee schedule,,,405.3256,,,fee schedule,,,,,,,,,,,,,,,,430.65845,85,percent of total billed charges,,,,,,,,,,252.1631889,49.77,percent of total billed charges,,,,455.9913,90,percent of total billed charges,,,,481.32415,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,430.65845,85,percent of total billed charges,,,,,,,,,252.1631889,506.657,
DELIVERY,7220000,CDM,,,720,RC,outpatient,,,,405.717,223.14435,,365.1453,90,percent of total billed charges,,,,405.717,100,percent of total billed charges,,,,,,,,,365.1453,,,fee schedule,,,324.5736,,,fee schedule,,,,,,,,,,,,,,,,344.85945,85,percent of total billed charges,,,,,,,,,,201.9253509,49.77,percent of total billed charges,,,,365.1453,90,percent of total billed charges,,,,385.43115,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,344.85945,85,percent of total billed charges,,,,,,,,,201.9253509,405.717,
FETAL STRESS TEST,7200030,CDM,59020,CPT,721,RC,outpatient,,,,295.404,162.4722,,265.8636,90,percent of total billed charges,,,,295.404,100,percent of total billed charges,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,181.15875,,,fee schedule,,,71.568125,,,fee schedule,,,71.568125,,,fee schedule,,,,251.0934,85,percent of total billed charges,,,71.568125,,,fee schedule,,,,147.0225708,49.77,percent of total billed charges,,,,265.8636,90,percent of total billed charges,,,,280.6338,90,percent of total billed charges,,,73.71516875,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,251.0934,85,percent of total billed charges,,,71.568125,,,fee schedule,,,71.568125,317.5,
CIRCUMCISION NB IP W/BLOCK,7230000,CDM,54150,CPT,723,RC,outpatient,,,,2083.69,1146.0295,,1875.321,90,percent of total billed charges,,,,2083.69,100,percent of total billed charges,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,94.869375,,,fee schedule,,,94.869375,,,fee schedule,,,,1771.1365,85,percent of total billed charges,,,94.869375,,,fee schedule,,,,1037.052513,49.77,percent of total billed charges,,,,1875.321,90,percent of total billed charges,,,,1979.5055,90,percent of total billed charges,,,97.71545625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1771.1365,85,percent of total billed charges,,,94.869375,,,fee schedule,,,94.869375,2083.69,
CIRCUMCISION NB IP W/O BLOCK,7230001,CDM,54150,CPT,723,RC,outpatient,,,52,447.02,245.861,,402.318,90,percent of total billed charges,,,,447.02,100,percent of total billed charges,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,1886.4675,,,fee schedule,,,94.869375,,,fee schedule,,,94.869375,,,fee schedule,,,,379.967,85,percent of total billed charges,,,94.869375,,,fee schedule,,,,222.481854,49.77,percent of total billed charges,,,,402.318,90,percent of total billed charges,,,,424.669,90,percent of total billed charges,,,97.71545625,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,379.967,85,percent of total billed charges,,,94.869375,,,fee schedule,,,94.869375,1886.4675,
DEFIBRILLATION - MED/SURG,4590040,CDM,93799,CPT,730,RC,outpatient,,,,44.187,24.30285,,39.7683,90,percent of total billed charges,,,,44.187,100,percent of total billed charges,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,138.0435,,,fee schedule,,,,,,,,,,,,,,,,37.55895,85,percent of total billed charges,,,,,,,,,,21.9918699,49.77,percent of total billed charges,,,,39.7683,90,percent of total billed charges,,,,41.97765,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,37.55895,85,percent of total billed charges,,,,,,,,,21.9918699,138.0435,
ELECTROCARDIOGRAM (EKG),7300000,CDM,93005,CPT,730,RC,outpatient,,,,158.62,87.241,,142.758,90,percent of total billed charges,,,,158.62,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,6.324625,,,fee schedule,,,6.324625,,,fee schedule,,,,134.827,85,percent of total billed charges,,,6.324625,,,fee schedule,,,,78.945174,49.77,percent of total billed charges,,,,142.758,90,percent of total billed charges,,,,150.689,90,percent of total billed charges,,,6.51436375,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,134.827,85,percent of total billed charges,,,6.324625,,,fee schedule,,,6.324625,158.62,
12 LEAD EKG - ER,7300001,CDM,93005,CPT,730,RC,outpatient,,,,174.276,95.8518,,156.8484,90,percent of total billed charges,,,,174.276,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,6.324625,,,fee schedule,,,6.324625,,,fee schedule,,,,148.1346,85,percent of total billed charges,,,6.324625,,,fee schedule,,,,86.7371652,49.77,percent of total billed charges,,,,156.8484,90,percent of total billed charges,,,,165.5622,90,percent of total billed charges,,,6.51436375,,,fee schedule,,,17,,,fee schedule,,,21.59,,,fee schedule,,,,148.1346,85,percent of total billed charges,,,6.324625,,,fee schedule,,,6.324625,174.276,
TELEMETRY/MED-SURG,7320110,CDM,93041,CPT,730,RC,outpatient,,,,195.803,107.69165,,176.2227,90,percent of total billed charges,,,,195.803,100,percent of total billed charges,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,54.558,,,fee schedule,,,6.324625,,,fee schedule,,,6.324625,,,fee schedule,,,,166.43255,85,percent of total billed charges,,,6.324625,,,fee schedule,,,,97.4511531,49.77,percent of total billed charges,,,,176.2227,90,percent of total billed charges,,,,186.01285,90,percent of total billed charges,,,6.51436375,,,fee schedule,,,6,,,fee schedule,,,7.62,,,fee schedule,,,,166.43255,85,percent of total billed charges,,,6.324625,,,fee schedule,,,6,195.803,
Holter Monitor Set Up & Record,7313242,CDM,93242,CPT,731,RC,outpatient,,,,151.204,83.1622,,136.0836,90,percent of total billed charges,,,,151.204,100,percent of total billed charges,,,32.235,,,fee schedule,,,32.235,,,fee schedule,,,32.235,,,fee schedule,,,11.9835,,,fee schedule,,,11.9835,,,fee schedule,,,,128.5234,85,percent of total billed charges,,,11.9835,,,fee schedule,,,,75.2542308,49.77,percent of total billed charges,,,,136.0836,90,percent of total billed charges,,,,143.6438,90,percent of total billed charges,,,12.343005,,,fee schedule,,,14.67,,,fee schedule,,,18.6309,,,fee schedule,,,,128.5234,85,percent of total billed charges,,,11.9835,,,fee schedule,,,11.9835,151.204,
DRESS/DEBRID P-THICK BURN MED,4200200,CDM,16025,CPT,761,RC,outpatient,,,GP,335.265,184.39575,,301.7385,90,percent of total billed charges,,,,335.265,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,111.18025,,,fee schedule,,,111.18025,,,fee schedule,,,,284.97525,85,percent of total billed charges,,,111.18025,,,fee schedule,,,,166.8613905,49.77,percent of total billed charges,,,,301.7385,90,percent of total billed charges,,,,318.50175,90,percent of total billed charges,,,114.5156575,,,fee schedule,,,205,,,fee schedule,,,260.35,,,fee schedule,,,,284.97525,85,percent of total billed charges,,,111.18025,,,fee schedule,,,111.18025,335.265,
DRESS/DEBRID P-THICK BURN SM,4200210,CDM,16020,CPT,761,RC,outpatient,,,GP,196.524,108.0882,,176.8716,90,percent of total billed charges,,,,196.524,100,percent of total billed charges,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,183.65625,,,fee schedule,,,55.923,,,fee schedule,,,55.923,,,fee schedule,,,,167.0454,85,percent of total billed charges,,,55.923,,,fee schedule,,,,97.8099948,49.77,percent of total billed charges,,,,176.8716,90,percent of total billed charges,,,,186.6978,90,percent of total billed charges,,,57.60069,,,fee schedule,,,102,,,fee schedule,,,129.54,,,fee schedule,,,,167.0454,85,percent of total billed charges,,,55.923,,,fee schedule,,,55.923,196.524,
OP PROCEDURE -,7610000,CDM,,,761,RC,outpatient,,,,164.285,90.35675,,147.8565,90,percent of total billed charges,,,,164.285,100,percent of total billed charges,,,,,,,,,147.8565,,,fee schedule,,,131.428,,,fee schedule,,,,,,,,,,,,,,,,139.64225,85,percent of total billed charges,,,,,,,,,,81.7646445,49.77,percent of total billed charges,,,,147.8565,90,percent of total billed charges,,,,156.07075,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,139.64225,85,percent of total billed charges,,,,,,,,,81.7646445,164.285,
OP PROCEDURE -,7610001,CDM,,,761,RC,outpatient,,,,262.238,144.2309,,236.0142,90,percent of total billed charges,,,,262.238,100,percent of total billed charges,,,,,,,,,236.0142,,,fee schedule,,,209.7904,,,fee schedule,,,,,,,,,,,,,,,,222.9023,85,percent of total billed charges,,,,,,,,,,130.5158526,49.77,percent of total billed charges,,,,236.0142,90,percent of total billed charges,,,,249.1261,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,222.9023,85,percent of total billed charges,,,,,,,,,130.5158526,262.238,
CENTRAL LINE PLCMNT >5 YRS,7613655,CDM,36558,CPT,761,RC,outpatient,,,,4645.403,2554.97165,,4180.8627,90,percent of total billed charges,,,,4645.403,100,percent of total billed charges,,,3029.715,,,fee schedule,,,3029.715,,,fee schedule,,,3029.715,,,fee schedule,,,253.983625,,,fee schedule,,,253.983625,,,fee schedule,,,,3948.59255,85,percent of total billed charges,,,253.983625,,,fee schedule,,,,2312.017073,49.77,percent of total billed charges,,,,4180.8627,90,percent of total billed charges,,,,4413.13285,90,percent of total billed charges,,,261.6031338,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,3948.59255,85,percent of total billed charges,,,253.983625,,,fee schedule,,,250,4645.403,
DX BONE MARROW NEEDLE BIOPSY,7613822,CDM,38221,CPT,761,RC,outpatient,,,,2026.319,1114.47545,,1823.6871,90,percent of total billed charges,,,,2026.319,100,percent of total billed charges,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,1525.095,,,fee schedule,,,69.238,,,fee schedule,,,69.238,,,fee schedule,,,,1722.37115,85,percent of total billed charges,,,69.238,,,fee schedule,,,,1008.498966,49.77,percent of total billed charges,,,,1823.6871,90,percent of total billed charges,,,,1925.00305,90,percent of total billed charges,,,71.31514,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1722.37115,85,percent of total billed charges,,,69.238,,,fee schedule,,,69.238,2026.319,
ARTERIAL LINE PLACEMENT,7614000,CDM,36620,CPT,761,RC,outpatient,,,,1147.523,631.13765,,1032.7707,90,percent of total billed charges,,,,1147.523,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,43.27375,,,fee schedule,,,43.27375,,,fee schedule,,,,975.39455,85,percent of total billed charges,,,43.27375,,,fee schedule,,,,571.1221971,49.77,percent of total billed charges,,,,1032.7707,90,percent of total billed charges,,,,1090.14685,90,percent of total billed charges,,,44.5719625,,,fee schedule,,,363,,,fee schedule,,,461.01,,,fee schedule,,,,975.39455,85,percent of total billed charges,,,43.27375,,,fee schedule,,,43.27375,1147.523,
INTUBATION BEDSIDE,7614100,CDM,31500,CPT,761,RC,outpatient,,,,1405.744,773.1592,,1265.1696,90,percent of total billed charges,,,,1405.744,100,percent of total billed charges,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,211.365,,,fee schedule,,,138.808875,,,fee schedule,,,138.808875,,,fee schedule,,,,1194.8824,85,percent of total billed charges,,,138.808875,,,fee schedule,,,,699.6387888,49.77,percent of total billed charges,,,,1265.1696,90,percent of total billed charges,,,,1335.4568,90,percent of total billed charges,,,142.9731413,,,fee schedule,,,363,,,fee schedule,,,461.01,,,fee schedule,,,,1194.8824,85,percent of total billed charges,,,138.808875,,,fee schedule,,,138.808875,1405.744,
CHEST TUBE PLACEMENT,7614150,CDM,32551,CPT,761,RC,outpatient,,,,1196.345,657.98975,,1076.7105,90,percent of total billed charges,,,,1196.345,100,percent of total billed charges,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,152.789625,,,fee schedule,,,152.789625,,,fee schedule,,,,1016.89325,85,percent of total billed charges,,,152.789625,,,fee schedule,,,,595.4209065,49.77,percent of total billed charges,,,,1076.7105,90,percent of total billed charges,,,,1136.52775,90,percent of total billed charges,,,157.3733138,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,1016.89325,85,percent of total billed charges,,,152.789625,,,fee schedule,,,152.789625,1513.1925,
CHEST TUBE REMOVAL,7614155,CDM,32552,CPT,761,RC,outpatient,,,,969.848,533.4164,,872.8632,90,percent of total billed charges,,,,969.848,100,percent of total billed charges,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,588.3525,,,fee schedule,,,155.11975,,,fee schedule,,,155.11975,,,fee schedule,,,,824.3708,85,percent of total billed charges,,,155.11975,,,fee schedule,,,,482.6933496,49.77,percent of total billed charges,,,,872.8632,90,percent of total billed charges,,,,921.3556,90,percent of total billed charges,,,159.7733425,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,824.3708,85,percent of total billed charges,,,155.11975,,,fee schedule,,,155.11975,969.848,
PICC LINE PLCMT W/O IMAGING,7614200,CDM,36569,CPT,761,RC,outpatient,,,,1755.738,965.6559,,1580.1642,90,percent of total billed charges,,,,1755.738,100,percent of total billed charges,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,1513.1925,,,fee schedule,,,92.872125,,,fee schedule,,,92.872125,,,fee schedule,,,,1492.3773,85,percent of total billed charges,,,92.872125,,,fee schedule,,,,873.8308026,49.77,percent of total billed charges,,,,1580.1642,90,percent of total billed charges,,,,1667.9511,90,percent of total billed charges,,,95.65828875,,,fee schedule,,,297,,,fee schedule,,,377.19,,,fee schedule,,,,1492.3773,85,percent of total billed charges,,,92.872125,,,fee schedule,,,92.872125,1755.738,
BLADDER SCAN US - NON IMAGE,7615179,CDM,51798,CPT,761,RC,outpatient,,,,484.924,266.7082,,436.4316,90,percent of total billed charges,,,,484.924,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,11.31775,,,fee schedule,,,11.31775,,,fee schedule,,,,412.1854,85,percent of total billed charges,,,11.31775,,,fee schedule,,,,241.3466748,49.77,percent of total billed charges,,,,436.4316,90,percent of total billed charges,,,,460.6778,90,percent of total billed charges,,,11.6572825,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,412.1854,85,percent of total billed charges,,,11.31775,,,fee schedule,,,11.31775,484.924,
BONE MARROW ASPIRATIONS & BX,7618222,CDM,38222,CPT,761,RC,outpatient,,,,2905.115,1597.81325,,2614.6035,90,percent of total billed charges,,,,2905.115,100,percent of total billed charges,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,2627.2575,,,fee schedule,,,73.89825,,,fee schedule,,,73.89825,,,fee schedule,,,,2469.34775,85,percent of total billed charges,,,73.89825,,,fee schedule,,,,1445.875736,49.77,percent of total billed charges,,,,2614.6035,90,percent of total billed charges,,,,2759.85925,90,percent of total billed charges,,,76.1151975,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,2469.34775,85,percent of total billed charges,,,73.89825,,,fee schedule,,,73.89825,2905.115,
BLADDER SCAN,7618500,CDM,51798,CPT,761,RC,outpatient,,,,484.924,266.7082,,436.4316,90,percent of total billed charges,,,,484.924,100,percent of total billed charges,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,58.455,,,fee schedule,,,11.31775,,,fee schedule,,,11.31775,,,fee schedule,,,,412.1854,85,percent of total billed charges,,,11.31775,,,fee schedule,,,,241.3466748,49.77,percent of total billed charges,,,,436.4316,90,percent of total billed charges,,,,460.6778,90,percent of total billed charges,,,11.6572825,,,fee schedule,,,250,,,fee schedule,,,317.5,,,fee schedule,,,,412.1854,85,percent of total billed charges,,,11.31775,,,fee schedule,,,11.31775,484.924,
OBSERVATION - DIRECT ADMISSION,7620379,CDM,G0379,HCPCS,762,RC,outpatient,,,,555.273,305.40015,,499.7457,90,percent of total billed charges,,,,555.273,100,percent of total billed charges,,,520.2855,,,fee schedule,,,520.2855,,,fee schedule,,,520.2855,,,fee schedule,,,,,,,,,,,,,,,,471.98205,85,percent of total billed charges,,,,,,,,,,276.3593721,49.77,percent of total billed charges,,,760,,,case rate,,,,527.50935,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,471.98205,85,percent of total billed charges,,,,,,,,,276.3593721,760,
OBSERVATION PER HOUR (60 MIN),7629999,CDM,G0378,HCPCS,762,RC,outpatient,,,,39.552,21.7536,,35.5968,90,percent of total billed charges,,,,39.552,100,percent of total billed charges,,,,,,,,,35.5968,,,fee schedule,,,31.6416,,,fee schedule,,,,,,,,,,,,,,,,33.6192,85,percent of total billed charges,,,,,,,,,,19.6850304,49.77,percent of total billed charges,,,760,,,case rate,,,,37.5744,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,33.6192,85,percent of total billed charges,,,,,,,,,19.6850304,760,
REGENERON INFUSION & MONITOR,2600240,CDM,M0243,HCPCS,771,RC,outpatient,,,,709.773,390.37515,,638.7957,90,percent of total billed charges,,,,709.773,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,603.30705,85,percent of total billed charges,,,,,,,,,,353.2540221,49.77,percent of total billed charges,,,,638.7957,90,percent of total billed charges,,,,674.28435,90,percent of total billed charges,,,,,,,,,450,,,fee schedule,,,571.5,,,fee schedule,,,,603.30705,85,percent of total billed charges,,,,,,,,,353.2540221,709.773,
IM IMMUNIZATION INITIAL,7710000,CDM,90471,CPT,771,RC,outpatient,,,,77.456,42.6008,,69.7104,90,percent of total billed charges,,,,77.456,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,65.8376,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,38.5498512,49.77,percent of total billed charges,,,,69.7104,90,percent of total billed charges,,,,73.5832,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,65.8376,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,77.456,
ADMIN PNEUMONIA VACCINE - OBS,7710001,CDM,G0009,HCPCS,771,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,40.2255,,,fee schedule,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,,,,,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,43.86255,85,percent of total billed charges,,,,,,,,,25.6828131,51.603,
IM IMMUNIZATION ADD'L,7710002,CDM,90472,CPT,771,RC,outpatient,,,,58.504,32.1772,,52.6536,90,percent of total billed charges,,,,58.504,100,percent of total billed charges,,,,,,,,,52.6536,,,fee schedule,,,46.8032,,,fee schedule,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,49.7284,85,percent of total billed charges,,,14.6465,,,fee schedule,,,,29.1174408,49.77,percent of total billed charges,,,,52.6536,90,percent of total billed charges,,,,55.5788,90,percent of total billed charges,,,15.085895,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,49.7284,85,percent of total billed charges,,,14.6465,,,fee schedule,,,13.14,58.504,
ADMIN FLU VACCINE LDRP,7710008,CDM,90471,CPT,771,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN FLU VACCINE- OBS,7710010,CDM,90471,CPT,771,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN FLU VACCINE - MED/SURG,7710020,CDM,90471,CPT,771,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN PNEUMONIA VACCINE - M/S,7710030,CDM,90471,CPT,771,RC,outpatient,,,,53.354,29.3447,,48.0186,90,percent of total billed charges,,,,53.354,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,45.3509,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,26.5542858,49.77,percent of total billed charges,,,,48.0186,90,percent of total billed charges,,,,50.6863,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,45.3509,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,64.0395,
VACCINE/TOXOID ADMIN - OP,7710040,CDM,90471,CPT,771,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN FLU VACCINE - GERO,7710070,CDM,90471,CPT,771,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN PNEUMONIA VAC - GERO,7710071,CDM,90472,CPT,771,RC,outpatient,,,,53.354,29.3447,,48.0186,90,percent of total billed charges,,,,53.354,100,percent of total billed charges,,,,,,,,,48.0186,,,fee schedule,,,42.6832,,,fee schedule,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,45.3509,85,percent of total billed charges,,,14.6465,,,fee schedule,,,,26.5542858,49.77,percent of total billed charges,,,,48.0186,90,percent of total billed charges,,,,50.6863,90,percent of total billed charges,,,15.085895,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,45.3509,85,percent of total billed charges,,,14.6465,,,fee schedule,,,13.14,53.354,
ADMIN FLU VACCINE - REHAB,7710080,CDM,90471,CPT,771,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN FLU VACCINE - ICU,7710090,CDM,90471,CPT,771,RC,outpatient,,,,51.603,28.38165,,46.4427,90,percent of total billed charges,,,,51.603,100,percent of total billed charges,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,64.0395,,,fee schedule,,,20.63825,,,fee schedule,,,20.63825,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,,25.6828131,49.77,percent of total billed charges,,,,46.4427,90,percent of total billed charges,,,,49.02285,90,percent of total billed charges,,,21.2573975,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,43.86255,85,percent of total billed charges,,,20.63825,,,fee schedule,,,13.14,64.0395,
ADMIN PNEUMONIA VACCINE - ICU,7710091,CDM,90472,CPT,771,RC,outpatient,,,,53.354,29.3447,,48.0186,90,percent of total billed charges,,,,53.354,100,percent of total billed charges,,,,,,,,,48.0186,,,fee schedule,,,42.6832,,,fee schedule,,,14.6465,,,fee schedule,,,14.6465,,,fee schedule,,,,45.3509,85,percent of total billed charges,,,14.6465,,,fee schedule,,,,26.5542858,49.77,percent of total billed charges,,,,48.0186,90,percent of total billed charges,,,,50.6863,90,percent of total billed charges,,,15.085895,,,fee schedule,,,13.14,,,fee schedule,,,16.6878,,,fee schedule,,,,45.3509,85,percent of total billed charges,,,14.6465,,,fee schedule,,,13.14,53.354,
ADMIN HEP B VACCINE/NEWBORN,7713090,CDM,,,771,RC,outpatient,,,,33.681,18.52455,,30.3129,90,percent of total billed charges,,,,33.681,100,percent of total billed charges,,,,,,,,,30.3129,,,fee schedule,,,26.9448,,,fee schedule,,,,,,,,,,,,,,,,28.62885,85,percent of total billed charges,,,,,,,,,,16.7630337,49.77,percent of total billed charges,,,,30.3129,90,percent of total billed charges,,,,31.99695,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,28.62885,85,percent of total billed charges,,,,,,,,,16.7630337,33.681,
INITIAL ASSESSMENT - IOP,9009080,CDM,90791,CPT,900,RC,outpatient,,,,309.721,170.34655,,278.7489,90,percent of total billed charges,,,,309.721,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,147.463625,,,fee schedule,,,147.463625,,,fee schedule,,,,263.26285,85,percent of total billed charges,,,147.463625,,,fee schedule,,,,154.1481417,49.77,percent of total billed charges,,,,278.7489,90,percent of total billed charges,,,,294.23495,90,percent of total billed charges,,,151.8875338,,,fee schedule,,,,,,,,,,,,,,,,263.26285,85,percent of total billed charges,,,147.463625,,,fee schedule,,,138.306,309.721,
PSYCH THERAPY 30 MIN W/WO FAM,9140816,CDM,90832,CPT,914,RC,outpatient,,,,163.358,89.8469,,147.0222,90,percent of total billed charges,,,,163.358,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,68.239375,,,fee schedule,,,68.239375,,,fee schedule,,,,138.8543,85,percent of total billed charges,,,68.239375,,,fee schedule,,,,81.3032766,49.77,percent of total billed charges,,,,147.0222,90,percent of total billed charges,,,,155.1901,90,percent of total billed charges,,,70.28655625,,,fee schedule,,,,,,,,,,,,,,,,138.8543,85,percent of total billed charges,,,68.239375,,,fee schedule,,,68.239375,163.358,
PSYCH THERAPY 45 MIN W/WO FAM,9140818,CDM,90834,CPT,914,RC,outpatient,,,,223.51,122.9305,,201.159,90,percent of total billed charges,,,,223.51,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,90.209125,,,fee schedule,,,90.209125,,,fee schedule,,,,189.9835,85,percent of total billed charges,,,90.209125,,,fee schedule,,,,111.240927,49.77,percent of total billed charges,,,,201.159,90,percent of total billed charges,,,,212.3345,90,percent of total billed charges,,,92.91539875,,,fee schedule,,,,,,,,,,,,,,,,189.9835,85,percent of total billed charges,,,90.209125,,,fee schedule,,,90.209125,223.51,
PSYCH THERAPY 60 MIN W/WO FAM,9140821,CDM,90837,CPT,914,RC,outpatient,,,,223.51,122.9305,,201.159,90,percent of total billed charges,,,,223.51,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,133.15,,,fee schedule,,,133.15,,,fee schedule,,,,189.9835,85,percent of total billed charges,,,133.15,,,fee schedule,,,,111.240927,49.77,percent of total billed charges,,,,201.159,90,percent of total billed charges,,,,212.3345,90,percent of total billed charges,,,137.1445,,,fee schedule,,,,,,,,,,,,,,,,189.9835,85,percent of total billed charges,,,133.15,,,fee schedule,,,111.240927,223.51,
IOP GROUP THERAPY PER SESION,9159085,CDM,90853,CPT,915,RC,outpatient,,,,159.753,87.86415,,143.7777,90,percent of total billed charges,,,,159.753,100,percent of total billed charges,,,71.9985,,,fee schedule,,,71.9985,,,fee schedule,,,71.9985,,,fee schedule,,,23.967,,,fee schedule,,,23.967,,,fee schedule,,,,135.79005,85,percent of total billed charges,,,23.967,,,fee schedule,,,,79.5090681,49.77,percent of total billed charges,,,,143.7777,90,percent of total billed charges,,,,151.76535,90,percent of total billed charges,,,24.68601,,,fee schedule,,,,,,,,,,,,,,,,135.79005,85,percent of total billed charges,,,23.967,,,fee schedule,,,23.967,159.753,
FAMILY PSYTX W/PT PER SESSION,9160847,CDM,90847,CPT,916,RC,outpatient,,,,280.16,154.088,,252.144,90,percent of total billed charges,,,,280.16,100,percent of total billed charges,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,138.306,,,fee schedule,,,101.526875,,,fee schedule,,,101.526875,,,fee schedule,,,,238.136,85,percent of total billed charges,,,101.526875,,,fee schedule,,,,139.435632,49.77,percent of total billed charges,,,,252.144,90,percent of total billed charges,,,,266.152,90,percent of total billed charges,,,104.5726813,,,fee schedule,,,,,,,,,,,,,,,,238.136,85,percent of total billed charges,,,101.526875,,,fee schedule,,,101.526875,280.16,
POLYSOM 6 YRS>,7409580,CDM,95810,CPT,920,RC,outpatient,,,TC,2360.039,1298.02145,,2124.0351,90,percent of total billed charges,,,,2360.039,100,percent of total billed charges,,,886.9455,,,fee schedule,,,886.9455,,,fee schedule,,,886.9455,,,fee schedule,,,623.142,,,fee schedule,,,623.142,,,fee schedule,,,,2006.03315,85,percent of total billed charges,,,623.142,,,fee schedule,,,,1174.59141,49.77,percent of total billed charges,,,,2124.0351,90,percent of total billed charges,,,,2242.03705,90,percent of total billed charges,,,641.83626,,,fee schedule,,,122,,,fee schedule,,,154.94,,,fee schedule,,,875,,,case rate,,,623.142,,,fee schedule,,,122,2360.039,
POLYSOMNOGRAM W/CPAP,7409581,CDM,95811,CPT,920,RC,outpatient,,,TC,2832.294,1557.7617,,2549.0646,90,percent of total billed charges,,,,2832.294,100,percent of total billed charges,,,886.9455,,,fee schedule,,,886.9455,,,fee schedule,,,886.9455,,,fee schedule,,,651.436375,,,fee schedule,,,651.436375,,,fee schedule,,,,2407.4499,85,percent of total billed charges,,,651.436375,,,fee schedule,,,,1409.632724,49.77,percent of total billed charges,,,,2549.0646,90,percent of total billed charges,,,,2690.6793,90,percent of total billed charges,,,670.9794663,,,fee schedule,,,205.37,,,fee schedule,,,260.8199,,,fee schedule,,,875,,,case rate,,,651.436375,,,fee schedule,,,205.37,2832.294,
MULTIPLE SLEEP LATENCY TEST,9290000,CDM,95805,CPT,920,RC,outpatient,,,TC,1318.4,725.12,,1186.56,90,percent of total billed charges,,,,1318.4,100,percent of total billed charges,,,458.8815,,,fee schedule,,,458.8815,,,fee schedule,,,458.8815,,,fee schedule,,,431.406,,,fee schedule,,,431.406,,,fee schedule,,,,1120.64,85,percent of total billed charges,,,431.406,,,fee schedule,,,,656.16768,49.77,percent of total billed charges,,,,1186.56,90,percent of total billed charges,,,,1252.48,90,percent of total billed charges,,,444.34818,,,fee schedule,,,101,,,fee schedule,,,128.27,,,fee schedule,,,875,,,case rate,,,431.406,,,fee schedule,,,101,1318.4,
STD EXT ART 2 LEVEL,9200010,CDM,93922,CPT,921,RC,outpatient,,,,243.183,133.75065,,218.8647,90,percent of total billed charges,,,,243.183,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,82.220125,,,fee schedule,,,82.220125,,,fee schedule,,,,206.70555,85,percent of total billed charges,,,82.220125,,,fee schedule,,,,121.0321791,49.77,percent of total billed charges,,,,218.8647,90,percent of total billed charges,,,,231.02385,90,percent of total billed charges,,,84.68672875,,,fee schedule,,,27.3,,,fee schedule,,,34.671,,,fee schedule,,,,206.70555,85,percent of total billed charges,,,82.220125,,,fee schedule,,,27.3,243.183,
US - LOW EXT ARTERIAL RT,9201501,CDM,93926,CPT,921,RC,outpatient,,,RT,302.202,166.2111,,271.9818,90,percent of total billed charges,,,,302.202,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,143.802,,,fee schedule,,,143.802,,,fee schedule,,,,256.8717,85,percent of total billed charges,,,143.802,,,fee schedule,,,,150.4059354,49.77,percent of total billed charges,,,,271.9818,90,percent of total billed charges,,,,287.0919,90,percent of total billed charges,,,148.11606,,,fee schedule,,,73,,,fee schedule,,,92.71,,,fee schedule,,,,256.8717,85,percent of total billed charges,,,143.802,,,fee schedule,,,73,302.202,
US - LOW EXT ARTERIAL LT,9201502,CDM,93926,CPT,921,RC,outpatient,,,LT,302.202,166.2111,,271.9818,90,percent of total billed charges,,,,302.202,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,143.802,,,fee schedule,,,143.802,,,fee schedule,,,,256.8717,85,percent of total billed charges,,,143.802,,,fee schedule,,,,150.4059354,49.77,percent of total billed charges,,,,271.9818,90,percent of total billed charges,,,,287.0919,90,percent of total billed charges,,,148.11606,,,fee schedule,,,73,,,fee schedule,,,92.71,,,fee schedule,,,,256.8717,85,percent of total billed charges,,,143.802,,,fee schedule,,,73,302.202,
DUP SCAN ART/ARTL BPGS UNI,9201602,CDM,93931,CPT,921,RC,outpatient,,,LT,304.571,167.51405,,274.1139,90,percent of total billed charges,,,,304.571,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,123.496625,,,fee schedule,,,123.496625,,,fee schedule,,,,258.88535,85,percent of total billed charges,,,123.496625,,,fee schedule,,,,151.5849867,49.77,percent of total billed charges,,,,274.1139,90,percent of total billed charges,,,,289.34245,90,percent of total billed charges,,,127.2015238,,,fee schedule,,,73,,,fee schedule,,,92.71,,,fee schedule,,,,258.88535,85,percent of total billed charges,,,123.496625,,,fee schedule,,,73,304.571,
US - VENOUS DOPPLER RT,9201701,CDM,93971,CPT,921,RC,outpatient,,,RT,406.541,223.59755,,365.8869,90,percent of total billed charges,,,,406.541,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,118.836375,,,fee schedule,,,118.836375,,,fee schedule,,,,345.55985,85,percent of total billed charges,,,118.836375,,,fee schedule,,,,202.3354557,49.77,percent of total billed charges,,,,365.8869,90,percent of total billed charges,,,,386.21395,90,percent of total billed charges,,,122.4014663,,,fee schedule,,,73,,,fee schedule,,,92.71,,,fee schedule,,,,345.55985,85,percent of total billed charges,,,118.836375,,,fee schedule,,,73,406.541,
US - VENOUS DOPPLER LT,9201702,CDM,93971,CPT,921,RC,outpatient,,,LT,406.541,223.59755,,365.8869,90,percent of total billed charges,,,,406.541,100,percent of total billed charges,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,101.451,,,fee schedule,,,118.836375,,,fee schedule,,,118.836375,,,fee schedule,,,,345.55985,85,percent of total billed charges,,,118.836375,,,fee schedule,,,,202.3354557,49.77,percent of total billed charges,,,,365.8869,90,percent of total billed charges,,,,386.21395,90,percent of total billed charges,,,122.4014663,,,fee schedule,,,73,,,fee schedule,,,92.71,,,fee schedule,,,,345.55985,85,percent of total billed charges,,,118.836375,,,fee schedule,,,73,406.541,
DUPLEX SCAN LOW-EXTR ART;BILAT,9210000,CDM,93925,CPT,921,RC,outpatient,,,,570.723,313.89765,,513.6507,90,percent of total billed charges,,,,570.723,100,percent of total billed charges,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,240.002875,,,fee schedule,,,240.002875,,,fee schedule,,,,485.11455,85,percent of total billed charges,,,240.002875,,,fee schedule,,,,284.0488371,49.77,percent of total billed charges,,,,513.6507,90,percent of total billed charges,,,,542.18685,90,percent of total billed charges,,,247.2029613,,,fee schedule,,,73,,,fee schedule,,,92.71,,,fee schedule,,,,485.11455,85,percent of total billed charges,,,240.002875,,,fee schedule,,,73,570.723,
DUP SCAN UP-EXTR ART BIL092724,9210010,CDM,93930,CPT,921,RC,outpatient,,,,690.7901,379.934555,,621.71109,90,percent of total billed charges,,,,690.7901,100,percent of total billed charges,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,197.72775,,,fee schedule,,,197.72775,,,fee schedule,,,,587.171585,85,percent of total billed charges,,,197.72775,,,fee schedule,,,,343.8062328,49.77,percent of total billed charges,,,,621.71109,90,percent of total billed charges,,,,656.250595,90,percent of total billed charges,,,203.6595825,,,fee schedule,,,33,,,fee schedule,,,41.91,,,fee schedule,,,,587.171585,85,percent of total billed charges,,,197.72775,,,fee schedule,,,33,690.7901,
DUPLEX EXTRACRANIAL; BILATERAL,9210020,CDM,93880,CPT,921,RC,outpatient,,,,670.53,368.7915,,603.477,90,percent of total billed charges,,,,670.53,100,percent of total billed charges,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,189.73875,,,fee schedule,,,189.73875,,,fee schedule,,,,569.9505,85,percent of total billed charges,,,189.73875,,,fee schedule,,,,333.722781,49.77,percent of total billed charges,,,,603.477,90,percent of total billed charges,,,,637.0035,90,percent of total billed charges,,,195.4309125,,,fee schedule,,,70,,,fee schedule,,,88.9,,,fee schedule,,,,569.9505,85,percent of total billed charges,,,189.73875,,,fee schedule,,,70,670.53,
DUPLEX SCAN EXTR VEINS; BILAT,9210040,CDM,93970,CPT,921,RC,outpatient,,,,563.307,309.81885,,506.9763,90,percent of total billed charges,,,,563.307,100,percent of total billed charges,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,221.6655,,,fee schedule,,,186.742875,,,fee schedule,,,186.742875,,,fee schedule,,,,478.81095,85,percent of total billed charges,,,186.742875,,,fee schedule,,,,280.3578939,49.77,percent of total billed charges,,,,506.9763,90,percent of total billed charges,,,,535.14165,90,percent of total billed charges,,,192.3451613,,,fee schedule,,,42,,,fee schedule,,,53.34,,,fee schedule,,,,478.81095,85,percent of total billed charges,,,186.742875,,,fee schedule,,,42,563.307,
HOME SLEEP TEST TYPE III >6 HR,9290020,CDM,95806,CPT,929,RC,outpatient,,,,298.082,163.9451,,268.2738,90,percent of total billed charges,,,,298.082,100,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,94.203625,,,fee schedule,,,94.203625,,,fee schedule,,,,253.3697,85,percent of total billed charges,,,94.203625,,,fee schedule,,,,148.3554114,49.77,percent of total billed charges,,,,268.2738,90,percent of total billed charges,,,,283.1779,90,percent of total billed charges,,,97.02973375,,,fee schedule,,,,,,,,,,,,,,,875,,,case rate,,,94.203625,,,fee schedule,,,94.203625,875,
"PHLEBOTOMY, THERAPEUTIC",9409919,CDM,99195,CPT,940,RC,outpatient,,,,139.977,76.98735,,125.9793,90,percent of total billed charges,,,,139.977,100,percent of total billed charges,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,110.2185,,,fee schedule,,,95.535125,,,fee schedule,,,95.535125,,,fee schedule,,,,118.98045,85,percent of total billed charges,,,95.535125,,,fee schedule,,,,69.6665529,49.77,percent of total billed charges,,,,125.9793,90,percent of total billed charges,,,,132.97815,90,percent of total billed charges,,,98.40117875,,,fee schedule,,,,,,,,,,,,,,,,118.98045,85,percent of total billed charges,,,95.535125,,,fee schedule,,,69.6665529,139.977,
MEDICAL NUTRITION THERAPY 15M,9429780,CDM,97802,CPT,942,RC,outpatient,,,,71.585,39.37175,,64.4265,90,percent of total billed charges,,,,71.585,100,percent of total billed charges,,,31.7835,,,fee schedule,,,31.7835,,,fee schedule,,,31.7835,,,fee schedule,,,31.623125,,,fee schedule,,,31.623125,,,fee schedule,,,,60.84725,85,percent of total billed charges,,,31.623125,,,fee schedule,,,,35.6278545,49.77,percent of total billed charges,,,,64.4265,90,percent of total billed charges,,,,68.00575,90,percent of total billed charges,,,32.57181875,,,fee schedule,,,,,,,,,,,,,,,,60.84725,85,percent of total billed charges,,,31.623125,,,fee schedule,,,31.623125,71.585,
MED NUTRITION REASSESS 15MIN,9429781,CDM,97803,CPT,942,RC,outpatient,,,,53.766,29.5713,,48.3894,90,percent of total billed charges,,,,53.766,100,percent of total billed charges,,,26.8065,,,fee schedule,,,26.8065,,,fee schedule,,,26.8065,,,fee schedule,,,26.962875,,,fee schedule,,,26.962875,,,fee schedule,,,,45.7011,85,percent of total billed charges,,,26.962875,,,fee schedule,,,,26.7593382,49.77,percent of total billed charges,,,,48.3894,90,percent of total billed charges,,,,51.0777,90,percent of total billed charges,,,27.77176125,,,fee schedule,,,,,,,,,,,,,,,,45.7011,85,percent of total billed charges,,,26.962875,,,fee schedule,,,26.7593382,53.766,
ANESTHESIA 1ST HOUR-FACILITY,3703000,CDM,,,370F,RC,outpatient,,,,1653.15,909.2325,,1487.835,90,percent of total billed charges,,,,1653.15,100,percent of total billed charges,,,,,,,,,1487.835,,,fee schedule,,,1322.52,,,fee schedule,,,,,,,,,,,,,,,,1405.1775,85,percent of total billed charges,,,,,,,,,,822.772755,49.77,percent of total billed charges,,,,1487.835,90,percent of total billed charges,,,,1570.4925,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,1405.1775,85,percent of total billed charges,,,,,,,,,822.772755,1653.15,
ANESTHESIA-EA ADDL 30 MINS FAC,3704000,CDM,,,370F,RC,outpatient,,,,661.26,363.693,,595.134,90,percent of total billed charges,,,,661.26,100,percent of total billed charges,,,,,,,,,595.134,,,fee schedule,,,529.008,,,fee schedule,,,,,,,,,,,,,,,,562.071,85,percent of total billed charges,,,,,,,,,,329.109102,49.77,percent of total billed charges,,,,595.134,90,percent of total billed charges,,,,628.197,90,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,562.071,85,percent of total billed charges,,,,,,,,,329.109102,661.26,
CT HEAD BRAIN W/O DYE READING,7045001,CDM,70450,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,86,,,fee schedule,,,,,,,,,,,,,,,,,,,,,86,86,
CT HEAD BRAIN W/ DYE READING,7046001,CDM,70460,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102,,,fee schedule,,,,,,,,,,,,,,,,,,,,,102,102,
CT HEAD BRAIN W/O&W DYE READIN,7047001,CDM,70470,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,125,,,fee schedule,,,,,,,,,,,,,,,,,,,,,125,125,
CT MAXILLOFAC/SINUSES WO READI,7048601,CDM,70486,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,92,,,fee schedule,,,,,,,,,,,,,,,,,,,,,92,92,
CT MAXILLOFACIAL/SINUSES W REA,7048701,CDM,70487,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.79,,,fee schedule,,,,,,,,,,,,,,,,,,,,,85.79,85.79,
CT NECK SOFT TISSUE WO READING,7049001,CDM,70490,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.86,,,fee schedule,,,,,,,,,,,,,,,,,,,,,84.86,84.86,
CT ANGIOGRAPHY HEAD READING,7049601,CDM,70496,CPT,972,RC,both,,,,179.22,98.571,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.13,,,fee schedule,,,,,,,,,,,,,,,,,,,,,94.13,94.13,
CT ANGIOGRAPHY NECK READING,7049801,CDM,70498,CPT,972,RC,both,,,,179.22,98.571,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.13,,,fee schedule,,,,,,,,,,,,,,,,,,,,,94.13,94.13,
"MRI,BRAIN & STEM W/O&W READING",7055301,CDM,70553,CPT,972,RC,both,,,,196.2974,107.96357,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,182,,,fee schedule,,,,,,,,,,,,,,,,,,,,,182,182,
X-RAY CHEST 1 VIEW READING,7104501,CDM,71045,CPT,972,RC,both,,,,32.96,18.128,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.09,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.09,11.09,
X-RAY CHEST 2 VIEWS READING,7104601,CDM,71046,CPT,972,RC,both,,,,41.2,22.66,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.27,,,fee schedule,,,,,,,,,,,,,,,,,,,,,13.27,13.27,
CT CHEST W/CONTRAST READING,7125001,CDM,71250,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,106,106,
CT CHEST W/O CONT READING,7126001,CDM,71260,CPT,972,RC,both,,,,154.5,84.975,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,112,,,fee schedule,,,,,,,,,,,,,,,,,,,,,112,112,
CT ANGIOGRAPHY CHEST,7127501,CDM,71275,CPT,972,RC,both,,,,191.786,105.4823,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.88,,,fee schedule,,,,,,,,,,,,,,,,,,,,,64.88,64.88,
X-RAY SPINE/LUMBOSAC LAT READ,7210001,CDM,72100,CPT,972,RC,both,,,,36.2045,19.912475,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.92,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.92,14.92,
CT SPINE CERIVAL W/O,7212501,CDM,72125,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,106,106,
CT SPINE THORACIC WO READING,7212801,CDM,72128,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,106,106,
CT SPINE LUMBAR WO READING,7213101,CDM,72131,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,106,,,fee schedule,,,,,,,,,,,,,,,,,,,,,106,106,
"MRI,SPINAL CANAL CERV W/O READ",7214101,CDM,72141,CPT,972,RC,both,,,,190.55,104.8025,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,165,,,fee schedule,,,,,,,,,,,,,,,,,,,,,165,165,
"MRI,LUMBAR SPINE W/O CONT READ",7214801,CDM,72148,CPT,972,RC,both,,,,206,113.3,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,182,,,fee schedule,,,,,,,,,,,,,,,,,,,,,182,182,
XR PELVIS 1 OR 2 VWS READING,7217001,CDM,72170,CPT,972,RC,both,,,,32.96,18.128,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.66,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.66,11.66,
CT ANGIOGRA PELV W/O&W DYE REA,7219101,CDM,72191,CPT,972,RC,both,,,,191.786,105.4823,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.88,,,fee schedule,,,,,,,,,,,,,,,,,,,,,64.88,64.88,
XR HUMERUS READING,7306001,CDM,73060,CPT,972,RC,both,,,,32.96,18.128,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12,12,
XR ELBOW 1 OR 2 VWS READING,7307001,CDM,73070,CPT,972,RC,both,,,,32.96,18.128,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12,12,
XR FOREARM,7309001,CDM,73090,CPT,972,RC,both,,,,32.96,18.128,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12,12,
CT EXTREMITY UPPER WO READING,7320001,CDM,73200,CPT,972,RC,both,,,,119.48,65.714,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89,,,fee schedule,,,,,,,,,,,,,,,,,,,,,89,89,
CT ANGIO UPR EXTRM W/O&W READ,7320601,CDM,73206,CPT,972,RC,both,,,,191.786,105.4823,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.88,,,fee schedule,,,,,,,,,,,,,,,,,,,,,64.88,64.88,
XR TIBIA & FIBULA READING,7359001,CDM,73590,CPT,972,RC,both,,,,32.96,18.128,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12,12,
CT ANGIO LWR EXTR W/O&W READIN,7370601,CDM,73706,CPT,972,RC,both,,,,191.786,105.4823,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.88,,,fee schedule,,,,,,,,,,,,,,,,,,,,,64.88,64.88,
MRI LOW EXT JNT WO/GAD RT READ,7372101,CDM,73721,CPT,972,RC,both,,,,123.6,67.98,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,152,,,fee schedule,,,,,,,,,,,,,,,,,,,,,152,152,
X-RAY ABDOMEN 1 VIEW READING,7401801,CDM,74018,CPT,972,RC,both,,,,27.81,15.2955,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.09,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.09,11.09,
CT ANGIO ABD&PELV W/O&W READ,7417401,CDM,74174,CPT,972,RC,both,,,,231.441,127.29255,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,136.95,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.95,136.95,
CT ANGIO ABD W/O& W DYE READ,7417501,CDM,74175,CPT,972,RC,both,,,,191.786,105.4823,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.88,,,fee schedule,,,,,,,,,,,,,,,,,,,,,64.88,64.88,
CT ABD&PELVIS W/O CONTR READIN,7417601,CDM,74176,CPT,972,RC,both,,,,224.849,123.66695,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,112.11,,,fee schedule,,,,,,,,,,,,,,,,,,,,,112.11,112.11,
CT ABD & PELV W/CONTRAST READ,7417701,CDM,74177,CPT,972,RC,both,,,,224.849,123.66695,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,117.51,,,fee schedule,,,,,,,,,,,,,,,,,,,,,117.51,117.51,
CT ABD&PELV 1>REGNS READING,7417801,CDM,74178,CPT,972,RC,both,,,,224.849,123.66695,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,130.03,,,fee schedule,,,,,,,,,,,,,,,,,,,,,130.03,130.03,
CT ANGIO ABD ARTERIES READING,7563501,CDM,75635,CPT,972,RC,both,,,,308.588,169.7234,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,101.26,,,fee schedule,,,,,,,,,,,,,,,,,,,,,101.26,101.26,
"ULTRASOUND,NECK,HEAD,THYR READ",7653601,CDM,76536,CPT,972,RC,both,,,,56.65,31.1575,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35.2,,,fee schedule,,,,,,,,,,,,,,,,,,,,,35.2,35.2,
US ABDOMEN COMPLETE READING,7670001,CDM,76700,CPT,972,RC,both,,,,69.01,37.9555,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,73,,,fee schedule,,,,,,,,,,,,,,,,,,,,,73,73,
"ULTRASOUND,ABD SINGLE ORG READ",7670501,CDM,76705,CPT,972,RC,both,,,,59.74,32.857,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53,53,
"ULTRASOUND,RENAL OR AORTA READ",7677001,CDM,76770,CPT,972,RC,both,,,,66.95,36.8225,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55,55,
US ABDOMEN LIMITED READING,7677501,CDM,76775,CPT,972,RC,both,,,,94.76,52.118,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.96,,,fee schedule,,,,,,,,,,,,,,,,,,,,,41.96,41.96,
US PREG TRANSAB 1ST TRIM READ,7680101,CDM,76801,CPT,972,RC,both,,,,94.76,52.118,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.34,,,fee schedule,,,,,,,,,,,,,,,,,,,,,57.34,57.34,
US PREGNANCY TRANSVAGINAL READ,7681701,CDM,76817,CPT,972,RC,both,,,,94.76,52.118,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.32,,,fee schedule,,,,,,,,,,,,,,,,,,,,,43.32,43.32,
US PELVIS TRANSVAG NON OB READ,7683001,CDM,76830,CPT,972,RC,both,,,,66.95,36.8225,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,104,,,fee schedule,,,,,,,,,,,,,,,,,,,,,104,104,
US PELV TRANSABD COMP NONOB RE,7685601,CDM,76856,CPT,972,RC,both,,,,94.76,52.118,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,62,,,fee schedule,,,,,,,,,,,,,,,,,,,,,62,62,
US SCROTUM &CONTENTS READING,7687001,CDM,76870,CPT,972,RC,both,,,,94.76,52.118,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58,58,
"DXA AXIAL/HIPS,PELV,SPINE READ",7708001,CDM,77080,CPT,972,RC,both,,,,35.02,19.261,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.44,,,fee schedule,,,,,,,,,,,,,,,,,,,,,19.44,19.44,
TRANSTHORACIC ECHO INTERP,9330601,CDM,93306,CPT,972,RC,both,,,,154.5,84.975,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,94.37,,,fee schedule,,,,,,,,,,,,,,,,,,,,,94.37,94.37,
US DUPLEX EXT VEINS UNIL READI,9397101,CDM,93971,CPT,972,RC,both,,,,94.76,52.118,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54,,,fee schedule,,,,,,,,,,,,,,,,,,,,,54,54,
DRESS/DEBRID P-THICK BURN SM,9811602,CDM,16020,CPT,981,RC,both,,,,102.382,56.3101,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.13,,,fee schedule,,,,,,,,,,,,,,,,,,,,,8.13,8.13,
SHORT ARM SPLINT,9812912,CDM,29125,CPT,981,RC,both,,,,88.889,48.88895,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.7,,,fee schedule,,,,,,,,,,,,,,,,,,,,,10.7,10.7,
APPLICATION SHORT LEG SPLINT,9812951,CDM,29515,CPT,981,RC,both,,,,113.197,62.25835,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.91,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.91,11.91,
TRIGGER POINT 1-2,9820552,CDM,20552,CPT,983,RC,both,,,,88.065,48.43575,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.03,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.03,14.03,
TRIGGER POINT INJECTION  3+,9820553,CDM,20553,CPT,983,RC,both,,,,100.4044,55.22242,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.03,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.03,14.03,
Small Joint/Bursa Injection,9820600,CDM,20600,CPT,983,RC,both,,,,81.061,44.58355,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.8,,,fee schedule,,,,,,,,,,,,,,,,,,,,,8.8,8.8,
Inj Interlaminar L/S,9822323,CDM,62323,CPT,983,RC,both,,,,235.149,129.33195,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.01,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.01,55.01,
EXT ECG>48HR<7DAYS REV&INTERP,9823244,CDM,93244,CPT,985,RC,both,,,,57.268,31.4974,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.48,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,25.48,
Injection Nerve Branch,9824450,CDM,64450,CPT,983,RC,both,,,,99.601,54.78055,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.52,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.52,14.52,
INJ ANESTHETIC EA ADD LEVEL PF,9824484,CDM,64484,CPT,983,RC,both,,,,132.252,72.7386,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.49,,,fee schedule,,,,,,,,,,,,,,,,,,,,,42.49,42.49,
INJECT PARAVERT F JNT L/S 1 LF,9824493,CDM,64493,CPT,983,RC,both,,,,237.209,130.46495,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.27,,,fee schedule,,,,,,,,,,,,,,,,,,,,,31.27,31.27,
INJ PARAVERT F JNT L/S 2 LEVEL,9824494,CDM,64494,CPT,983,RC,both,,,,237.209,130.46495,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.1,,,fee schedule,,,,,,,,,,,,,,,,,,,,,16.1,16.1,
INJ PARAVERT F JNT L/S 3 LEVEL,9824495,CDM,64495,CPT,983,RC,both,,,,237.209,130.46495,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.29,,,fee schedule,,,,,,,,,,,,,,,,,,,,,16.29,16.29,
DESTROY LUMB/SAC FACET JOINT,9824635,CDM,64635,CPT,983,RC,both,,,,455.26,250.393,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208,,,fee schedule,,,,,,,,,,,,,,,,,,,,,208,208,
DESTROY L/S FACET JNT ADDL,9824636,CDM,64636,CPT,983,RC,both,,,,231.75,127.4625,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208,,,fee schedule,,,,,,,,,,,,,,,,,,,,,208,208,
INJ SACROILIAC JOINT ANES/STER,9827096,CDM,27096,CPT,983,RC,both,,,,220.111,121.06105,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,92,,,fee schedule,,,,,,,,,,,,,,,,,,,,,92,92,
OFFICE VISIT EXP PROBLEM 15-29,9829202,CDM,99202,CPT,982,RC,both,,,,112.3627,61.799485,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.78,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.78,48.78,
LOW COMPLEXITY OFF VIS 30-44,9829203,CDM,99203,CPT,983,RC,both,,,,160.474,88.2607,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.19,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.19,70.19,
OFFICE OP MOD COMP 45-59 MINS,9829204,CDM,99204,CPT,983,RC,both,,,,286.546,157.6003,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,95.17,,,fee schedule,,,,,,,,,,,,,,,,,,,,,95.17,95.17,
Inter Joint/ Bursa Pro Fee,9830605,CDM,20605,CPT,983,RC,both,,,,103,56.65,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.66,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.66,11.66,
LUMBAR PUNCTURE W/O IMAGING,9832272,CDM,62272,CPT,983,RC,both,,,,164.8,90.64,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.78,,,fee schedule,,,,,,,,,,,,,,,,,,,,,21.78,21.78,
INJ ANESTH AGENT/STEROID EPI,9834483,CDM,64483,CPT,983,RC,both,,,,241.02,132.561,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.04,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.04,46.04,
OFFICE OP EST LOW 20-29 MINS,9859213,CDM,99213,CPT,983,RC,both,,,,137.608,75.6844,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.26,,,fee schedule,,,,,,,,,,,,,,,,,,,,,39.26,39.26,
MOD COMPLEXITY VISIT 30-39 MIN,9859214,CDM,99214,CPT,983,RC,both,,,,200.644,110.3542,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.76,,,fee schedule,,,,,,,,,,,,,,,,,,,,,75.76,75.76,
1ST HOSP IP/OBS MODERATE 55MIN,9879222,CDM,99222,CPT,987,RC,both,,,,209.193,115.05615,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,92.4,,,fee schedule,,,,,,,,,,,,,,,,,,,,,92.4,92.4,
1ST HOSP IP/OBS HIGH 75 MIN,9879223,CDM,99223,CPT,987,RC,both,,,,294.683,162.07565,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,141.9,,,fee schedule,,,,,,,,,,,,,,,,,,,,,141.9,141.9,
SBSQ HOSP IP OBS SF LOW 25,9879231,CDM,99231,CPT,987,RC,both,,,,61.697,33.93335,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,34.5,,,fee schedule,,,,,,,,,,,,,,,,,,,,,34.5,34.5,
SBSQ HOSP IP/OBS MODERATE 35 M,9879232,CDM,99232,CPT,987,RC,both,,,,111.24,61.182,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.6,,,fee schedule,,,,,,,,,,,,,,,,,,,,,50.6,50.6,
SBSQ HOSP IN OBS HIGH 50MIN,9879233,CDM,99233,CPT,987,RC,both,,,,159.65,87.8075,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,68.2,,,fee schedule,,,,,,,,,,,,,,,,,,,,,68.2,68.2,
HOSP IP OBS DSCH MGT 30MIN <,9879238,CDM,99238,CPT,987,RC,both,,,,117.008,64.3544,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.8,,,fee schedule,,,,,,,,,,,,,,,,,,,,,52.8,52.8,
HOSP IP OBS DSCH MGT 30MINS >,9879239,CDM,99239,CPT,987,RC,both,,,,166.551,91.60305,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.31,,,fee schedule,,,,,,,,,,,,,,,,,,,,,109.31,109.31,
CT NECK SOFT TISSUE W READING,70491001,CDM,70491,CPT,972,RC,both,,,,127.926,70.3593,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96,,,fee schedule,,,,,,,,,,,,,,,,,,,,,96,96,
"MRI,BRAIN & STEM W/O CONT READ",70551001,CDM,70551,CPT,972,RC,both,,,,192.919,106.10545,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,162,,,fee schedule,,,,,,,,,,,,,,,,,,,,,162,162,